Freud and Cocaine -- The Deal
Freud leads the late nineteenth Century charge for the cause of cocaine.
On April 24, 1884, Sigmund Freud ordered his first gram of cocaine from the local apothecary.
It was not to be his last. He'd read about coke, it was supposed to be great for fatigue. So great, the German army used it to stave off exhaustion, and he thought it might help out a few of his patients suffering nervous disorders. Like most people who purchase their first gram of coke, he was rather shocked - it cost him a small fortune. One tenth of his monthly salary to be precise. And again, like new kids in the cocaine game, the first thing he did was take a dose himself.
Then another. And another.
He sent some to his friends; he sent some to his fiancee, Martha Bernays, who lived some miles away, saying:
I will kiss you quite red and feed you till you are plump. And if you are forward you shall see who is the stronger, a little girl who doesn't eat enough or a big strong man with cocaine in his body. In my last serious depression I took cocaine again and a small dose lifted me to the heights in a wonderful fashion. I am just now collecting the literature for a song of praise to this magical substance.
Clearly, he was off his nut.
A junkie in the making
Freud was going through a bad patch. He desperately wanted to marry the fetching Martha, but her parents were rich and sceptical of this young upstart who presumed to ask for their daughter's hand. He'd started studying a variety of sea creatures in the hope of making great leaps forward in the new science of neurology and had the honour of being the first person to find the genitals of an eel (how he found the genitals while looking for the brain is a bit of a mystery). But it wasn't enough. Poking around in the nether regions of fish wasn't going to impress anybody, not least Martha's snooty parents.
So when the cocaine came along, he had high hopes. How could a highly addictive simulant not impress one's presumptive in-laws? Not only did this new drug cure hunger, thirst and melancholy, it made him feel fantastic. Like totally groovy, man. He couldn't wait to announce this new wonder drug to the scientific community, publishing "On Coca" in June 1884. Considering Freud was the father of psychoanalysis and spurred an entire new realm of intellectual discourse, the article was a complete mess. Rife with misspellings and inaccuracies, he managed to even get the comparatively simple chemical formula of cocaine incorrect. Why? Let's just say he was extremely thorough in his research.
The rip off
During this time, Freud had made the acquaintance of an ophthalmology intern named Carl Koller. Koller was keen to find a local anaesthetic for eye surgery, which, as one can imagine, was a terrible business, particularly given that the patient was generally required to stay awake throughout the procedure, rendering other available anaesthetics useless. Try convincing someone to hold still while you push a scalpel into their eyeball and you'll get the picture. It involved much fussing about with burly lads holding down the patient and the use of gags and other apparatus to restrain the struggling victim; and a bullet or wooden spoon to bite, perhaps. Stitches were often torn out, and the results were, in a word, an eyesore.
Freud and Koller started dosing up on cocaine together, doing a variety of medical experiments on themselves. Noticing that cocaine numbed his lips when he drank it, Koller had the bright idea to try putting a coke solution into his patients' eyes before surgery. It worked a treat
Sadly, for Freud, he was on leave at the time. He was off being a "big strong man" for Martha, whom he hadn't seen in a year When he returned, he was mortified to know that his new discovery had been hijacked and that Koller was currently enjoying the accolades of his colleagues as the discoverer of the first local anaesthetic for eye surgery.
While Freud was lamenting the loss of his breakthrough, the rest of the medical fraternity on both sides of the Atlantic were chattering like monkeys about the possible applications of this new drug. They started testing it in droves - mostly on themselves.
They painted it on their skin, in their ears and up their noses. They injected it, ingested it and snorted it by the bucketload. They stuffed it into a variety of orifices. One particularly fervent researcher injected it into his penis, following up with the insertion of a range of objects to test its efficacy in anaesthetising mucus membranes.
Research at the time suggested that cocaine could be used for urethral operations, removing ingrown toenails, catarrh, asthma, nymphomania, impotency, masturbation, lip waxing, seasickness, weight problems, head colds, gastritis, and toothache. And best of all, it had no side effects. They could all agree on one thing -- coke felt good.
I'd like to buy the world some coke
Cocaine products started flooding the market: there were lozenges and pastilles, elixirs and pills. The most notable, however was cocaine wine, which was first sold in Europe under the name of Vin Mariani, named after its creator Angelo Mariani in 1860. It was a roaring success, and spawned an army of impostors. In the US, an enterprising chap by the name of John Styth Pemberton brought out his own version of the drink in 1881. He was moderately successful, but in 1885, Atlanta banned the sale of alcohol. Clearly, something had to be done. So Pemberton changed the recipe, took out the alcohol, and sold his new drink under the name Coca-Cola. It was good, but not great. Disillusioned that his fortune hadn't been made overnight, he sold the entire operation to Asa Griggs Candler for a paltry $2,300.
What goes up must come down
We all know cocaine is an addictive drug: just about the most addictive drug on the planet. In one experiment, a chimp was trained to hit a bar in his cage to be administered with a dose of cocaine. At regular intervals, the number of times the chimp had to hit the bar to get the coke was increased. The experiment was finally abandoned when the chimp hit the bar over 12,000 times to get a single dose of coke.
But in 1885, the medicos were blissfully ignorant. So, not surprisingly, by the late 1800s more than half the scientific and medical community had developed healthy coke habits. One notable example was William Halstead, a founding father of the Johns Hopkins Hospital in Baltimore. Halstead was a talented surgeon, now famous for introducing the rubber glove to surgical hygiene. Halstead became hopelessly addicted to the drug while perfecting nerve block anaesthesia in the mid 1880s. He developed a hefty two-gram a day habit injecting nerves, and never recovered. In a move that must make the legions of JHU medical graduates beam with pride, he eventually switched to morphine in an effort to cure his cocaine addiction and died an opiate junkie.
Back in Vienna, Freud was having a similar problem with a good friend of his. Dr. Ernst Fleishl von Markow had developed a morphine addiction treating his painful thumb, and the young Freud figured there was one cure - cocaine and plenty of it.
He started dosing Fleishl regularly, and miraculously, his morphine dependence seemed to be on the wane. Things were looking good. But the tide turned, and before long Fleishl had developed an enormous addiction - equivalent to one full gram of pure cocaine a day. He became paranoid, experienced convulsions and tactile hallucinations better know to cocaine aficionados as "coke bugs". This is a sensation caused by chronic cocaine toxicity where the sufferer feels that there are insects or snakes crawling under their skin. Fleishl spent hours at a time trying to pick them out. Eventually, he settled on a morphine-cocaine combo more affectionately known today as a speedball - the very same cocaine cocktail that sent John Belushi to oblivion. Fleishl suffered the same fate, dying in agony six years later in 1891.
Now one would think that watching the slow, tortuous death of a friend and colleague would be enough to suggest that perhaps it was time to get out of the coke game. It wasn't.
The Coke-a-Rama Mutual Nasal Admiration Society
Some four years before Fleishl's death, Freud had had the pleasure of the acquaintance of a young ear, nose and throat specialist called Wilhelm Fleiss. They became firm friends and remained so for years.
His admiration for the young doctor bordered on the extremely creepy. In 1896 he wrote in a letter to Fleiss:
Your kind should not die out, my dear friend; the rest of us need people like you too much. How much I owe you: solace, understanding, stimulation in my loneliness, meaning to my life that I gained through you, and finally even health that no one else could have given back to me. It is primarily through your example that intellectually I gained the strength to trust my judgment, even when I am left alone - though not by you - and like you, to face with lofty humility all the difficulties that the future may bring. For all that, accept my humble thanks! I know that you do not need me as much as I need you, but I also know that I have a secure place in your affection.
To all outsiders, Freud exhibited all the symptoms of a man in love. He shared intimacies about his disappointing sex life with Martha, and told him all the dark secrets of his emotional health. There was only one problem -- Fleiss was a nutter.
He was a master of quackery, a snake-oil merchant of the very first order. He and Freud spent long nights together concocting hare-brained theories.
And Fleiss had a corker. He believed that the nose was the centre of all human illness - both physical and psychological. Rather in the way that phrenologists believed that the bumps on your head dictate the kind of person you are Freud wholeheartedly agreed. And why not? High on cocaine, he was soaring at dizzy heights somewhere outside the galaxy. The two congratulated each other on their genius, named their new science "nasal reflex neurosis" and got down to working out the details.
They experimented extensively with cocaine paint, diagnosed each other, and occasioned the odd operation, where they used cocaine beforehand as an anaesthetic, and afterwards to dull the pain of surgery.
After the first operation, Sigmund started to feel better. A lot better actually. In April 1897 he wrote:
I put a noticeable end to the last horrible attack with cocaine; since then things have been fine and a great amount of pus is coming out... Since the last cocainisation three circumstances have continued to coincide: 1. I feel well; 2. I am discharging ample amounts of pus; 3. I am feeling very well..."
The fact that the drug may have been the primary factor in this feel good saga didn't occur to either of them.
Freud's inevitable disillusionment started around the same time, with the treatment of a young woman by the name of Emma Eckstein. Emma suffered from hysteria, and Freud figured that there was no-one better to cure her disease than his good friend and "magical healer" Fleiss. So he summoned him to Vienna to take a look at the hapless young woman.
Fleiss immediately diagnosed the source of the problem - a bump on the inside of her nose. So he operated and split the city. A month later, Emma came to see Freud again - she was in considerable pain and had clearly developed a serious infection. Other surgeons were consulted, and discovered, stuffed into her nasal cavity, a length of gauze, which Fleiss had negligently, if unwittingly, left behind. In Freud's words:
There was still moderate bleeding from the nose and mouth; the fetid odour was very bad. [The doctor] suddenly pulled at something like a thread, kept on pulling. Before either of us had time to think, at least half a meter of gauze had been removed from the cavity. The next moment came a flood of blood. The patient turned white, her eyes bulged, and she had no pulse...At the moment the foreign body came out and everything became clear to me...I felt sick. After she had been packed, I fled to the next room, drank a bottle of water, and felt miserable...
It was the beginning of the end of the great affair.
The final cut
It's difficult to ascertain exactly when Freud gave up his coke habit. We know he was using in the late 1890s and by 1904 had stopped completely. So what happened in between?
By 1900 the friendship was becoming strained -- Freud was on the brink of success with psychoanalysis, while Fleiss was becoming increasingly grandiose in his theories, which largely centred around the idea of a male and female sexual cycle, and finally that many illnesses could be attributed to left and right handedness. But this is only part of the story.
Freud behaved like a petulant lover, overly sensitive, and prone to fits of depression if Fleiss didn't respond to his communications immediately. In one letter he wrote:
There has never been a six-month period in which I so constantly and ardently longed to be living in the same place as you.
A few months later Freud's jealousy had all but destroyed the friendship. They met for the last time. Freud was cold and cross. He slandered ideas and theories that he had once rapturously congratulated Fleiss for. Typically, Fleiss put it down to envy. We think it was more likely to be the absence of the happy juice.
Needless to say, Fleiss became a footnote in the life of Freud, whose own ideas went on to be celebrated across the globe. Although they're now largely dismissed, there's no doubt that they were ground breaking, and deservedly earned him the moniker of "the father of psychoanalysis". We wonder if he would have had them at all if he half of Columbia hadn't disappeared up his nose in his formative years.
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