The Influence of Thomas De Quincey on Nineteenth-Century Medicine - Book Report/Review Example

and Number (month, day, year) The Influence of Thomas De Quincey on Nineteenth-Century Medicine Thomas De Quincey, nineteenth-century author of Confessions of an English Opium Eater, was what the medical profession today might consider a challenge in terms of his lifelong addiction to the drug. Looking at his early years, De Quincey, a weak and sickly child, spent most his time alone under the awe-inspiring influence of a domineering mother. A rebellious nature lead him to run away from his family, although it appears they never completely gave up on him and tried on many occasions to bring him back into the fold. In De Quincey as an adult we see a gifted yet unstable individual prone to both serious health and psychological problems, including depression, unable, perhaps due to his addiction, to ever find financial security for himself or his family. Personally I found the work Confessions a rambling testament to De Quincey’s excuses and weaknesses, a typical example of the justifications most addicts use to “support their habit,” as it were. Hammack in her journal article makes the point in a tongue-in-cheek description of the work. Significantly, De Quincey explicitly positions himself as "a scholar" in the subtitle to his autobiographical Confessions of an English Opium-Eater... Although De Quinceys advocacy of the pleasures of opium-eating is offset to some extent by his descriptions of the mortifying pains of withdrawal, he still manages to suggest that imaginative users can expect to invigorate their mental powers if they carefully manage their intake. (Hammack, p 83+) One gets the impression from De Quincey himself that in writing the Confessions he was well aware of its impact on a public already enamored with both the drug, its use as medical palliative and a romantic idealized ingredient by the nation’s literati. He writes to the reader, “We come face to face with the moral, the intellectual, the spiritual emotions of men who pass before us with the inmost secrets of their hearts laid bare to curious eyes -- and we are electrified by what we see.” (De Quincey, v) While the public at the time may have found him a fascinating and gifted writer and poet, for all his life De Quincey remained a beggar at life’s door. And although not only did many fellow poets of his day as well as the populace at large follow his example in their liberal use of opium, some, such as Alfred Lord Tennyson, did not find the image particularly positive and actually lived in fear of the stigma. Platizky writes, “...he (Tennyson) suffered from some of the physical ailments and nervous disorders--including gout, chronic indigestion, and hypochondria--that were commonly treated with opiates...” (Platizky, 1) Citing Anne C. Colley in her chapter on Tennysons treatments for such disorders, Platizky says “Tennyson chose doctors who did not believe in treating such symptoms with drugs like opium.” (Platizky, 1) By his own testimony De Quincey admitted using opium as a recreational drug “for pleasure,” but he insists in Confessions that he continued, “...not for the purpose of creating pleasure, but of mitigating pain in the severest degree, that I first began to use opium as an article of daily diet. In the twenty-eighth year of my age, a most painful affection of the stomach, which I had first experienced about ten years before, attacked me in great strength. This affection had originally been caused by extremities of hunger, suffered in my boyish days.” (De Quincey, p 3-4) In the periods of 1813–16 and 1817–19 his daily dose was very high, and resulted in the sufferings recounted in the final sections of his Confessions. “The starry hosts behind us had all contracted into an obscure nebula, and at length that also had vanished. And I thought to myself, "At last the universe has ended;" and I trembled at the thought of the illimitable dungeon of pure, pure darkness which here began to imprison the creation: I shuddered at the dead sea of nothing, in whose unfathomable zone of blackness the jewel of the glittering universe seemed to be set and buried for ever” (De Quincey, p 263) Passages from the essay recounted by Platizky confirm De Quincey’s descent into what could hardly be called a desirable drug induced state. “De Quincey describes nightmares "of Oriental imagery, and mythological torture" that rival those of Tennysons Lucretius. In his nightmares De Quincey finds himself buried in "stone coffins" or laid with "all unutterable slimy things, amongst reeds and Nilotic mud." (Platizky, p 1) For most of his life his opium use fluctuated between extremes… Hayter writes “periods of low usage were literarily unproductive.” (Hayter, pp 229-31) This counters De Quincey’s own perspective that the drug enhanced his artistic abilities, despite his protestations to the contrary that his single goal in writing Confessions was thus: “Those who have read the Confessions will have closed them with the impression that I had wholly renounced the use of Opium. This impression I meant to convey... (De Quincey, p 114) He was gratified that he had successfully reduced his intake “...from so large a quantity as 8000 drops to so small a one (comparatively speaking) as a quantity ranging between 300 and 160 drops, might well suppose that the victory was in effect achieved. (De Quincey, p 114) The truth was, he was still an addict, and admitted it here. While many of his contemporaries shared the view that the drug did enhance their artistic capabilities, some, including Tennyson, did not. His stance regarding its benefits, which he works into the otherwise condemnation of the drug in Confessions, and usage were also criticized by many in the medical profession of the day. Hendricks cites Lyon, “A number of medical practitioners have speculated on the physical ailments that inspired and underlay (Thomas) De Quinceys resort to opium, and searched the corpus of his autobiographical works for evidence.” (Hendricks, p 57) Several theories include disease and physical ailments from infantile paralysis (polio), ongoing intestinal problems and other medical problems, and, according to Sandblom, "attacks of piercing pain (trigeminal neuralgia) in the face, of such severity that they sometimes drive the victim to suicide.” (Sandblom, p 49) While De Quincey’s addiction may well have been encouraged by any number of physical ailments, medical professionals today would certainly examine psychological aspects, especially considering De Quincey’s chaotic childhood, rebellious adolescence and a general addictive temperament. According to Hayter in Opium and the Romantic Imagination, it was not until the British writer, Thomas De Quincey theorized the effects of opium on the imagination that many other British poets and writers began experimenting with it. De Quincey believed that opium, especially the dreams that resulted from its use, was an important part of the creative process that contributed to his art. It was upon this theory, unveiled to the world in Confessions of an English Opium-Eater (1821), that De Quincey advocated the use of opium. However, not everyone accepted it; 19th century American and French physicians (and others) disapproved of the recreational use of opium. (Romanticism, Romantic Writers and Opium, 2001) Defending his use of the drug against medical professional of the day, the author writes in his essay, “Indeed the fascinating powers of opium are admitted, even by medical writers, who are its greatest enemies...” (De Quincey, xxvii). Citing Awsiter, apothecary to Greenwich Hospital, in his "Essay on the Effects of Opium,” De Quincey charges that the apothecary deliberately leaves out certain information. "Perhaps he (Awsiter) thought the subject of too delicate a nature to be made common; and as many people might then indiscriminately use it...” (De Quincey, p xxviii) De Quincey suggests that if all of the extensive properties of the drug were known, medical professionals such as Awsiter feared the public would use the drug even more and that would be “a general misfortune...” (De Quincey citing Awsiter, p xxviii) a perspective the author does not share with Awsiter. Yet nineteenth-century medicine, prompted to a great extent by the rampant popular use of opium not only by doctors for medicinal purposes, but by the population as a readily available “self medication” for a variety of problems, began to give way to the idea of addiction as a public malady. Susan Zeigler, postdoctoral fellow at Stanford writes the following. “The debacles over medicinal alcohol and morphine (opium) suggest that addiction emerged in the nineteenth century in part because professional medicine did, too. (Ziegler, 2002) Berridge et al write, “De Quinceys Confessions...have already indicated that such earlier medical discussions of addiction did not concentrate on the elaboration of its theoretical background or on the condition as an exclusively medical one. Doctors were still very much on the periphery of the condition. (Berridge, Edwards, 13) Ziegler traces the nineteenth-century medical community’s opposition to addiction from earlier attitudes focusing on the use of the drug to ensure patient well-being. Ziegler writes that doctors began “observation of the disease unfolding inside his or her body.” (Ziegler, 2002) While De Quincey discussed feelings of intense intellectual stimulation and euphoria as positive aspects of opium use, Ziegler writes of the medical advances of the period that were slowly placing its use in the category of disease. “As medicine became more empirical...more precise...physicians were transformed from the status of aristocrats servants to knowledgeable authorities on disease.” (Ziegler, 2002) Earlier attitudes of making patients feel better at any cost changed to physician authority to cure disease. Ziegler writes, “Patient self-medication was to be discouraged....popular and folk cures...such as poppy head tea, gradually disappeared as medical knowledge became institutionalized.” (Ziegler, 2002) These attitudes were a far cry from earlier attitudes toward the drug as suggested by doctors Kulkarni and Vithal, who report in Opium, Joy of Medicine. They quote medical pioneer Thomas Sydenham (1624 – 1689), sometimes known as ‘the English Hippocrates’ and ‘the Shakespeare of medicine. “Among the remedies which it has pleased Almighty God to man to relieve his sufferings, none is so universal and so efficacious as Opium.”(Kulkarni et al, Similima.com) Aside from strictly expressed empirical medical considerations, it is of interest to understand the evolution of the gradual acceptance of medical objections from the political and commercial consequences of the anti-opium movement percolating throughout the nineteenth century. Opium, in the early years, was not a prohibited substance in the Britain and was being smuggled by merchants from British India into China in defiance of its laws, driving the Chinese population into indolence and poverty. Open warfare between Britain and China broke out in 1839 opening a floodgate of criticism from clergy, politicians and medical professionals alike against the drug trade. Arguments, mostly politically expedient one way or the other, continued for the rest of the century. Berridge et al trace the results of the wars on the anti-opium movement. “In several ways the reactions and associations evoked by the wars were portents of the more developed anti-opium movement at the end of the century...(and) the consequent dangers of increased use of the drug, in particular among the working class.” (Berridge and Edwards, 14) By 1840, the authors write that “...the division between legitimate medical and other non-medical use of the drug were already in the process of establishment... Medical men involved in the English debate were also committed to the agitation against the Far Eastern trade.” (Berridge et al, 14) Medical men involved in the English debate were also committed to the agitation against the Far Eastern trade. By 1943 medical professionals were espousing the notion that the habitual recreational use of opium destroyed not only the body but also the value of an individual as a productive member of society. Berridge et al write, “The anti-opium trade movement was at this stage (early nineteenth century) in its infancy, but moral opposition and medical justification for such views were already closely allied.” (Berridge et al, 14) In 1892 it is reported by Berridge et al that “...a declaration supposedly signed by 5,000 medical men...made the same point...”--that the Indian trade was tantamount to ‘pharmaceutical imperialism’. (Berridge et al, 14). The anti-opium movement included such notables as Risdon Bennett, President of the Royal College of Physicians and a Vice-President of the Society for the Suppression of Opium Trade (S.S.O.T.), along with BenjaminWard Richardson and Robert Pringle, both of whom wrote extensively on addiction, by now the primary focus of the medical community’s perspective on the evils of opium use. Berridge et al write, “The involvement of such men in the moral campaign strengthened the moral bias within the medical concept of addiction...The views of the anti-opium movement supported the medical exclusiveness of disease theories.” (Berridge et al, 14) According to doctors, there was no such thing as moderate or recreational use, a theory hotly contested today in our own discussion of marijuana use as a social drug. Then as today the issue was seriously debated along with guidelines for legitimate medical use of the drug as a palliative for those suffering painful conditions or terminal disease. Berridge writes, “...the moral emphasis of the (anti opium) movements own argument was translated into scientific respectability through the medium of doctors active in both spheres.” (Berridge et al, 14) The authors continue, “Although anti-opiumist arguments were by 1895 apparently defunct, they lived on in Britain at least through the views of a significant section of the medical profession. It was by means of the elite of medical specialists in addiction that the anti-opiumist standpoint was still effectively expressed.” (Berridge et al, 14) Medical influence remained powerful and influential in both the movement and in terms of future impact on the permitted use of the drug. Theories put forth by B.A. Morel reinforced another aspect of the medical debate from a more scientifically disturbing and controversial point of view. In an 1857 Morel named a disease syndrome called degeneration. One of the precepts of the theory essentially asserts that a parent who abuses addictive substances including alcohol, opium, or tobacco runs the danger of doing permanent damage to his heredity, leaving his children susceptible to tuberculosis, mental retardation, and a host of other diseases.  This degeneration, Morel proposed, possessed a cumulative effect for families which could expect extinction over several generations. Andrew Wikholm writes in Morel “Discovers” Degeneration, “...he (Morel) argued that disparate illnesses, physical, intellectual, and moral, are all caused by a single process:  degeneration.  Morels diagnosis quickly became popular in Continental Europe, though his new theories were less successful in England and the United States.” (Wikholm, 1998) Noted psychologist Colin Martindale writes regarding the acceptance of the Morel theory. “The concept...formulated by Morel...gained wide acceptance across the course of the nineteenth century... ((Martindale, p 209) Martindale clarifies the environmental aspect in terms of later more complex theories applied in the field of psychology. Martindale clarifies this association. “Of course, the notion that an environmentally acquired disorder can be transmitted genetically collapsed with the demise of Lamarckian (Darwinian) theories of evolution. It would seem that the entirety of degeneration theory was rejected because Morel (1857) and his followers were wrong about the genetic transmission of what they called degeneration...” (Martindale, pp 209-210) Assessing today’s theories regarding psychological degeneration and providing certain credibility to Morel’s basic theory, Martindale writes, “It remains a reasonable and interesting question whether the psychological trait of degeneration --or psychoticism--is correlated with the physical stigmata of degeneration. My bet would be that such a positive correlation does in fact exist.” (Martindale, p 210). Wikholm, however, points out a negative correlation between the theory and its later use in studies on homosexuality. He writes, “...less than thirty years after he (Morel) invented this imaginary disease, Richard von Krafft-Ebing, wrote that it is an apt description of the cause of  homosexuality.  In some circles, "degenerate" is still used as an anti-gay epithet.” (Wikholm, 1998) Of von Krafft-Ebing, Wikholm refers to Krafft-Ebing publication, Psychopathia Sexualis, in which the nineteenth psychologist combines a theory that gay individuals have inborn effeminate traits with Morel’s theory of disease, concluding “that most homosexuals have a mental illness caused by degenerate heredity.” (Wikholm, 1998) This theory, Wikholm holds, remained popular until the end of the nineteenth century when it was superseded by more modern theories proposed by Sigmund Freud. Some aspects of degeneration theory further developed by late ninetheenth-century theorists including Nordau and Lombroso have left their mark on twentieth-century thinking. Seen as involving a weakening of higher, inhibitory brain functions, the theory in an evolutionary form has been applied to inherited criminal tendencies where weakening of brains centers can cause primitive functions to emerge uncontrolled. If we accept the notion that such inherited traits can be prompted by poor diet, climate and toxins (such as opium), then Morel’s original theories may have certain validity. If we also accept current medical evidence that “crack babies,” products of parents who are substance abusers, have severe health issues, then Morel’s theory does not seem altogether misplaced. Not knowing what physiological changes were caused by opium, it is possible those effects might be passed to future generations through genetic mutation. While degeneration theory lost steam in the twentieth century and was for the most dismissed, as Martindale has pointed out, the general concept may not have been “wrong” when it came to opium use. That later research indicates that creative people may possess psychopathalogical tendencies could speak to De Quincey himself. Were his parents opium users, perhaps for medicinal purposes? Certainly most people of that era were “users,” to some extent. Perhaps his affinity for the drug was generational. We will never know. Despite De Quincey’s enumerations of the many trials of his life, which one might take as an apology for his later abuse of the drug, it is perhaps the following excerpt that most propelled those in the medical field to take exception to the liberal distribution of a substance so dangerous to man’s ability to face problems squarely in a healthy, well-adjusted state of mind. In the words of De Quincey in his description of his first encounter with the drug we see the beginnings of a dangerous addiction that would remain with him all his life. Arrived at my lodgings, it may be supposed that I lost not a moment in taking the quantity (opium) prescribed. I was necessarily ignorant of the whole art and mystery to opiumtaking: and, what I took, I took under every disadvantage. But I took it: -- and in an hour, oh! Heavens! what a revulsion! What an upheaving, from its lowest depths, of inner spirit! What an apocalypse of the world within me! That my pains had vanished, was now a trifle in my eyes: -- this negative effect was swallowed up in the immensity of those positive effects which had opened before me -- in the abyss of divine enjoyment thus suddenly revealed. Here was a panacea -- a øαρμακον νήπενθες for all human woes: here was the secret of happiness, about which philosophers had disputed for so many ages, at once discovered: happiness might now be bought for a penny, and carried in the waistcoat pocket: portable ecstasies might be had corked up in a pint bottle: and peace of mind could be sent down in gallons by the mail coach...” (De Quincey, p 48) References Berridge, Virginia and Edwards, Griffith. Opium and the People: Opiate Use in Nineteenth- Century England. 13 The Ideology of Opium: Opium Eating as a Disease; 14 ‘Britains Opium Harvest’: The Anti-Opium Movement. http://www.drugtext.org/library/books/opiumpeople/index.html De Quincey, Thomas. Confessions of an English Opium-eater. William Sharp, ed. London: The Walter Scott Publishing Co. Ltd, 1896. www.questia.com. Hammack, Brenda Mann. “Phantastica: The Chemically Inspired Intellectual in Occult Fiction.” Contributor: Mosaic, Vol. 37: 1: (2004). Gale Group. University of Manitoba. Hayter, Alethea. Opium and the Romantic Imagination, revised edition. Wellingborough, Northamptonshire: Crucible, 1988. Hendricks,C.H.. Cited in Lyon, Judson S. Thomas De Quincey. New York: Twayne Publishers, 1969. Kulkarni, Dr. Ajit and Vithal, Dr. S.S. Opium—Joy of Medicine: 2 The History of Opium. http://www.similima.com/mm54.html Martindale, Colin. “Psychoticism: Degeneration and Creativity.” Psychological Inquiry, Vol 4, 1993. Platizky, Roger S. "Like Dull Narcotics, Numbing Pain": Speculations on Tennyson and Opium. Victorian Poetry, Vol. 40: 1, (2002). www.questia.com Romanticism: Quills and Inkwells, Romantic Writers and Opium, 2001. Cited from Hayter, Alethea. Opium and the Romantic Generation. Berkeley and Los Angeles: University of California Press, 1968. http://library.thinkquest.org/C0126184/english/litquillsopium.htm. Sandblom, Philip. Creativity and Disease, Seventh Edition. New York: Marion Boyars, 1992. Wikholm, Andrew. “Morel ‘Discovers’ Degeneration;” “Krafft-Ebing Diagnoses Degenerates.” Timeline: Science and Medicine, 1998. http://www.gayhistory.com/rev2/factfiles/ff1886.htm Ziegler, Susan, Postdoctoral fellow, Stanford University. “The Medical “Discovery” of Addiction in the Nineteenth Century.” The Victorian Web, September 7, 2002. http://www.victorianweb.org/science/addiction/discovery.htm Read More