BOOK REVIEW: An Anatomy of Addiction. Sigmund Freud, William Halsted, and the Miracle Drug Cocaine by Howard Markel

Sometimes history books are informative and well worth reading, but somewhat of a slog to get through. Other times, nonfiction history can be as enjoyable to read as a historical novel. An Anatomy of Addiction. Sigmund Freud, William Halsted, and the Miracle Drug Cocaine by Howard Markel belongs to the latter category. I read this in two sittings and didn’t want to put it down, despite being in the grip of a horrendous cold that made sleep a temptation and necessity.

This dual biography shows the course of the professional careers of Sigmund Freud and William Halsted, both of whom became addicted to cocaine while experimenting with the new drug. Each used himself as a research subject. Freud (everyone knows Freud, the father of psychoanalysis) hoped to make a name for himself by exploring the medicinal uses of cocaine, particularly as an antidote to the addictive properties of morphine, a huge problem in his day as in our own. Although rather insistent on his success, it’s clear he missed the boat.

William Halsted is one of the pioneers of modern surgery. He was the first chief of surgery at the newly opened hospital/medical school/research institution Johns Hopkins. Aware of initial research that showed cocaine to be a very effective local anaesthetic, Halsted realized how useful local injection could be during surgery. To perfect the injection technique, he practiced on himself.

Both men spent a lot of time in denial about cocaine addiction. Both also experimented with morphine as a way to ease symptoms of withdrawal from cocaine. And both had rather tormented or, at least, difficult interpersonal relationships, with marriages that were very likely harmed by cocaine abuse. And yet, both men were considered brilliant in their fields and made significant contributions to medical science.

The book is written in an engaging style. It is extensively footnoted. The author is an M.D./PhD and a professor of the History of Medicine so his explanations of the mechanisms of action of cocaine and of morphine are thorough yet easily understandable. His knowledge of addiction science also informs his conclusions about how Freud and Halsted managed, somewhat, to hide their addictions from friends and co-workers who didn’t really want to see what was going on, and some of whom were users themselves. He also refuses to buy into any myth that the success of these men was because of their drug use, theorizing instead how much more productive these men could have been if not caught in the throes of addiction.