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Sigmund Freud, William Halsted, and the Miracle Drug Cocaine

A-AnatomyAddictionA physician and a professor of medical history at the University of Michigan, Dr. Howard Markel, also an expert in epidemiology, is the author of Quarantine!: East European Jewish Immigrants and the New York City Epidemics of 1892 (1997) and When Germs Travel: Six Major Epidemics That Have Invaded America and the Fears They Have Unleashed (2005).

The Topic: In the 19th century, narcotics such as opium and morphine, available in every hospital and drugstore, were widely used to treat every condition--from a persistent cough to heart disease and hemorrhoids. By the 1880s, South American coca leaves began to arrive in European and American ports, and a new drug--cocaine--was added to the list. Before long, two brilliant young physicians--William Halsted in New York and Sigmund Freud in Vienna--began to self-experiment with cocaine as, respectively, a local anesthetic and a cure for anxiety and depression. Although both men went on to dazzling careers that redefined their particular fields, they first wrestled with the consequences of an addiction that damaged their health and devastated their lives.
Pantheon. 352 pages. $28.95. ISBN: 9780375423307

Baltimore Sun 4 of 5 Stars
"Markel makes their battles with the drug revelatory and suspenseful. He never commits the errors of using their addictions to explain their genius--or wondering why men with mighty intellectual firepower could imperil their careers to feed their risky appetites." Michael Sragow

Boston Globe 4 of 5 Stars
"In this witty, wide-ranging book, Markel, a physician and medical historian ... vouch[es] for cocaine's centrality to both doctors' stories. At the start of their careers, each ‘fully expected cocaine to be the wonder drug' of their day, yet in the end the one transformation it could claim was ‘the invention of the modern addict,' of which both were examples." Kate Tuttle

NY Times Book Review 4 of 5 Stars
"Freud and Halsted never met. But Markel's alternating chapters bring them together in a vivid narrative of two of the most remarkable of the many contributors to our understanding of human biology and function. He has written a tour de force of scientific and social history, one that helps illuminate a unique period in the long story of medical discovery--and the not insignificant cohort of experimenters who have fallen victim to their own research." Sherwin Nuland 4 of 5 Stars
"An Anatomy of Addiction is persuasive and engrossing. Markel is especially good at capturing the hierarchical, ultra-competitive, pressurized world of 19th-century medicine, with its revered masters and mentors presiding over students and young doctors desperately striving to make an impression and a reputation." Laura Miller

Wall Street Journal 4 of 5 Stars
"The author ... raises [fascinating questions] in an elegantly subversive way, intertwining the two men's horrific struggles with modern scientific findings that illuminate the nature of addiction and cocaine's almost uniquely destructive chemistry. ... The author's insights and analytical skills make An Anatomy of Addiction an irresistible cautionary tale." Deborah Blum

New York Times 3.5 of 5 Stars
"In An Anatomy of Addiction Dr. Markel braids these men's stories intricately, intelligently and often elegantly. His book, worthy on many levels, suffers from a pervasive mildness, a certain PBS-ness of the soul. There are few memorable sentences or ecstatic insights." Dwight Garner

San Francisco Chronicle 3.5 of 5 Stars
"An Anatomy of Addiction has an odd hybrid style that doesn't always succeed. Markel offers a thoughtful picture of late 19th century medicine, but then moves away from a historian's tone to explain the physiology and consequences of cocaine use as understood by a 21st century doctor. ... While Markel claims that cocaine disrupted and endangered their lives at times, he is unable to convince us that their work suffered, and therefore the drama of these dual stories is dampened." Michael Stein

Critical Summary

Markel skillfully interweaves the stories of these young men to paint a vivid, eye-opening portrait of late 19th-century medicine. Having worked with addicts in his medical practice, he also composes a heartfelt, if sometimes heavy-handed, condemnation of drug use that a couple of critics found obtrusive. Although Markel does his best to treat both physicians equally, Freud, who was much more forthcoming about his cocaine use than the secretive Halsted, tends to take center stage as the more genuine character. The critics cited a few clichés and a persistent tameness: "This book seems to have been composed not on Bolivian marching powder but on chamomile tea," noted the New York Times. Nevertheless, An Anatomy of Addiction is an absorbing and well-researched slice of medical history.