3 Opium: Explorations of an Ambiguous Drug Introduction Since at least the 1960s, when increasing drug abuse became an issue of political and public concern in the West, the history of opium has been of considerable interest. As in other areas of historical investigation inspired by today’s problems, the focus tended to be on precursor stages or roots of present phenomena, i.e., attention was devoted mainly to earlier perceptions of the drug’s psychotropic and addictive properties, and to medical and social responses to this. The by now classical study in this field was published in 1962/63 by Glenn Sonnedecker, who gave an overview of the development of the concept of opiate addiction from the sixteenth to the twentieth century. Sonnedecker documented Western knowledge about the dangers of habitual consumption of the drug since the Renaissance, mainly from reports of travellers to countries of the Near, Middle and Far East about indigenous opium-eaters. Yet he also pointed out that an awareness of opium addiction as a serious medical or even social problem could not be found in the West before the nineteenth century. 1 This was confirmed by John C. Kramer in a brief survey of the medical uses and misuses of opium in Western countries during the seventeenth and eighteenth centuries, and more recently in a comprehensive study of the history of opium addiction by Margit Kreutel. 2 Accordingly most of the scholarly work on historical aspects of opium has been devoted to developments from the late eighteenth or early nineteenth century onwards, when the non-medical, recreational use of the drug became popular in the Western world. Alethea Hayter’s book on opium-eating writers of the Romantic period, such as Samuel Taylor Coleridge and Thomas De Quincey, 3 was followed in the 1980s by detailed studies into the social history of opium consumption in nineteenth- and twentieth-century Britain and North America by Virginia Berridge, Terry M. Parssinen, and David Courtwright. They elucidated changes in the public perception of addiction and the beginnings of modern drug control. 4 127 Andreas-Holger Maehle - 9789004333291 Downloaded from Brill.com10/02/2021 11:08:22PM via free access Opium: Explorations of an Ambiguous Drug The Chinese opium wars (1840-42 and 1856-58) have of course found their historians as well. 5 Compared to this body of historical knowledge on issues related to opium addiction and recreational consumption, only a little disparate work has been done on the history of the therapeutic uses of the drug and on the develpoment of pharmacological knowledge about it. The existing studies into opium therapy have usually concentrated on some specific aspect or period. Most recently, John Scarborough has examined the knowledge about opium in Hellenistic and Roman medicine, especially as documented in the materia medica of Dioscorides. J. Worth Estes investigated the potency and contents of seventeenth-century opium preparations on the basis of data published by the English physician John Jones in 1701. And Andreas Niklaus Bindler traced attitudes towards the use of opium as a painkiller as reflected in a number of German and Swiss medical inaugural dissertations of the seventeenth and eighteenth centuries. Luzius von Rechenberg and Huldrych M. Koelbing looked into the opium therapy of Christoph Wilhelm Hufeland, who introduced the term “Opiumsucht” (opium addiction) in 1829. The psychopharmacological use of opium in nineteenth-century German psychiatry has been reviewed by Matthias M. Weber. Finally, some insights into its more general medical usage in the nineteenth century have been provided by John S. Haller Jr. on the basis of articles in Anglo-American medical journals.6 Studies of Brunonian therapeutics, such as those by Verena Jantz and Guenter B. Risse, have discussed opium, since John Brown and his followers regarded it as the strongest stimulant and applied it therefore frequently in so-called asthenic diseases. Recently Claudia Wiesemann has argued that the genesis of the modern concept of drug addiction around 1800 was closely linked with Brownianism. 7 Finally, some historical accounts of concepts of pain have touched upon opium as an analgesic. 8 As for the history of the pharmacology of opium, some pertinent eighteenth-century experiments have been described and analysed in the early 1960s by Melvin P. Earles, particularly those which dealt with the question whether the drug acted directly on the nervous system or indirectly via absorption into the blood. 9 After Earles’ work this area attracted only scant interest of historians, however. In the 1970s Rolf Winau reviewed some trials with opium in his account of experimental pharmacology and toxicology in the eighteenth century, and Claire Salomon-Bayet drew attention to auto- experiments with the drug by the seventeenth-century pharmacist 128 Andreas-Holger Maehle - 9789004333291 Downloaded from Brill.com10/02/2021 11:08:22PM via free access Opium: Explorations of an Ambiguous Drug Moyse Charas. 10 Another survey by John C. Kramer, published in 1980, dealt with the isolation of the opium alkaloids (especially morphine) in the early nineteenth century and the subsequent medical use and abuse of opiates. This was followed by a short paper by Ronald K. Siegel and Ada E. Hirschman, in which they cited excerpts from the extensive pharmacological self- and animal experiments with opium, morphine, and narcotine carried out in 1826 by the French physician Pierre-Alexandre Charvet. 11 Only recently has the topic been taken up again by the present author with an overview of experimental research on opium in the eighteenth century and a brief study into self-experiments in this field during the same period. 12 This chapter aims at providing a more comprehensive picture and better understanding of early pharmacological experimentation with opium and its implications. In particular, it looks into the contemporary leading questions in this area, the methods employed in answering them, the relevance of experimental results for pharmacological theories as well as for therapeutic practice, and also into some ethical considerations. The period under study begins in the second half of the seventeenth century, when concerns among doctors about the safety of opium therapy were coupled with a strong interest in the drug’s pharmacological properties, leading to first experiments. It ends in the early nineteenth century, when the isolation of morphine and other opium alkaloids gave new directions both to therapeutics and pharmacology. The Medical Importance of Opium Though well known as a powerful substance since antiquity, opium became a very widely used remedy in the West only in the seventeenth century. 13 Thomas Sydenham’s dictum that without opium medicine would be a “cripple” has often been referred to in this context. 14 This qualitative statement had its counterpart in the number of pertinent publications. In the part on plants (1787) in his Systematisch-Literaerisches Handbuch der Naturgeschichte , Georg Rudolph Boehmer, “senior” of the University of Wittenberg, listed internationally 76 monographs and 73 articles dealing specifically with opium or poppy plants (papaver) since the early seventeenth century.15 In view of these numbers one may well agree with recent authors, who have referred to an opium or opiology literature as a genre of medical writing. 16 On the other hand, my systematic analysis of the Philosophical Transactions of the Royal Society of London, from 1700 to 1800, and of the leading Edinburgh medical journals of this 129 Andreas-Holger Maehle - 9789004333291 Downloaded from Brill.com10/02/2021 11:08:22PM via free access Opium: Explorations of an Ambiguous Drug time, at first glance seems to arrive at a different result. The Philosophical Transactions had just one article (published in 1701) specifically on opium in the whole eighteenth century. Of the Edinburgh journals, Medical Essays and Observations (1733-44) and Essays and Observations, Physical and Literary (1754-71) each published three, Medical (and Philosophical) Commentaries (1773-95) two, and Annals of Medicine (1796-1800) one such article during the periods stated. 17 These rather small numbers (compared to other pharmacological and therapeutical topics, such as lithontriptics, mineral waters, and Peruvian bark) should not be taken, however, as representing a relatively minor importance of opium in the eighteenth century. Some of the articles, such as those by the Edinburgh professors Charles Alston, Robert Whytt, and Alexander Monro secundus, were major studies into the pharmacology of the drug, that were quoted, translated, and discussed internationally. 18 Other articles reported cases of poisoning or some unusual phenomenon or remarkable success in therapy with opium. 19 This may in fact be seen as reflecting a widespread medical use of the drug, so that – apart from the scientific, experimental studies – only some “extraordinary” practical observations were published in those journals. Reports on contemporary efforts to produce opium in Britain (chiefly in order to solve the problem of varying strength and quality, which existed in the customary opium imported from Oriental countries) point in the same direction. 20 While there is agreement in the secondary literature about the medical importance of opium during the seventeenth and eighteenth centuries, different explanations have been given why it may have gained this prominence. In an essay published in 1971 Richard Toellner argued that with Cartesian dualism pain was re-evaluated in the seventeenth century. It was no longer seen as a God-given evil, following from the original sin, but as a corporeal symptom, which could be accepted as a useful warning sign in diseases, yet also be fought and eliminated with bodily means. 21 On this basis Andreas N. Bindler and Ulrich Tröhler have looked into the use of opium as a painkiller in the late seventeenth and early eighteenth centuries. They suggest a link between a liberal use of opium and an empirical attitude in therapeutics (inclined to purely symptomatic treatment), which was combined with an anatomical understanding of disease.