Two other drugs have long been thought of, along with opium, as `dangerous narcotics'. The same problem framework was applied to cannabis and cocaine. Neither in fact can properly be called a narcotic drug. Cannabis is closer to the hallucinogens than to any other drug classification; cocaine is a stimulant. In the nineteenth century the drugs, both late arrivals on the scene, played a quite minor medical and social role in comparison to that of opium. They were nevertheless associated with that drug, not least in the discussions of the concept of addiction. They too had a part in the establishment of altered perceptions of `narcotic' use.

Cannabis

Cannabis itself has a quite bewildering variety of derivations, variously named. The resinous exudation of the flowering tops and leaves is generally known as hashish; material derived by chopping the leaves and stalks is termed marijuana. But the variety of alternative terms in use was and is testimony to the drug's established place in the culture of many Eastern countries. Hashish was called esrat in Turkey (meaning simply a secret production or preparation), kif in Morocco, or madjun when it was made into a sweetmeat with butter, honey, nutmeg and cloves. It had been known to the Chinese several thousand years before Christ and the ancient Greeks and Romans had used it for both medical and social purposes.1 In India, Persia, Turkey and Egypt it was in common use from quite remote times. The word `assassin' supposedly derived from its use in Syria in the twelfth century to designate the followers of the `Old Man of the Mountains' or Hasan-IbnSabbah; they were called so because hashish was in frequent use among them. The term possibly owed its origin, too, to those Saracens who, \intoxicated with the drug, were willing at the time of the crusades to go on suicidal expeditions into the enemy camp.
Cannabis vas known in Europe well before the nineteenth century. In 1563, Garcia de Orta noted its use in India. Engelbert Kaempfer, the seventeenth-century German physician and botanist, had described the plant and its medical uses in an account of his travels in the Far East, Amoenitatum Exoticarum Politico-Physico-Medicarum (1712), known in England through the efforts of Sir Hans Sloane, president of the Royal College of Physicians.2 Dr Robert Hooke brought it to the attention of Fellows of the Royal Society in 1689. Indian hemp, which 'seemeth to put a man into a dream', might, he thought, `be of considerable use for lunatics'. Berlu in his Treasury of Drugs (169o) described its import from Bantam in the East Indies.3 Such early accounts were, on present evidence, not followed up and the drug was not used in medical practice. Its popular usage was known. Pollen evidence indicates that hemp was cultivated in Western Europe before the birth of Christ; there is evidence of it in north-west England and southern Norway in Romano-British times. From around A.D. 500, hemp cultivation was more abundant, and persisted until quite recently. As contemporary court cases demonstrate, domestic cultivation of the plant is not impossible. Streets and districts in rural areas known as Hempfield are testimony to the former cultivation of the drug.4
Cannabis, like opium, had its popular uses which have been forgotten in the later medical emphasis. It was in the nineteenth century, however, that medical usage of the drug began in England. European, and particularly French, awareness of the intoxicating properties of the drug had been stimulated by the Napoleonic conquest of Egypt; the French administration of the country imposed heavy penalties for selling, using or trafficking in it. `Travellers' tales' of the East, as in the case of opium, also served to publicize the drug.5 Dr William O'Shaughnessy, an Edinburgh-educated Irishman, had a notable medical career. His studies of the blood in the English cholera epidemic of 1831, although controversial at the time, laid the foundations of intravenous fluid therapy, and his experiments with the electric telegraph while in India led to the establishment of an early telegraph network and a knighthood from Queen Victoria.6 It was while he was out in India that O'Shaughnessy encountered the use of cannabis. His paper `On the preparations of the Indian hemp, or gunjah (cannabis indica); their effects on the animal system in health, and their utility in the treatment of tetanus and other convulsive diseases' was published in 1842 in the Transactions of the Medical and Physical Society of Calcutta .7
O'Shaughnessy's careful survey of the uses of the drug led him to an advocacy of it as an 'anti-convulsive remedy of the greatest value'. While noting `the singular form of delirium which the incautious use of the Hemp preparations often occasions ... the strange balancing gait ... a constant rubbing of the hands; perpetual giggling; and a propensity to caress and chafe the feet of all bystanders of whatever rank', he nevertheless recommended that both the extract and the tincture should be used by medical men.8 Peter Squire of Oxford Street was responsible for converting cannabis resin into the extract and distributed it to a large number of the profession under O'Shaughnessy's directions. The extract and tincture both later appeared in the British Pharmacopoeia, and the Society of Apothecaries and other wholesalers included both in their wholesale production.9 The drug was even cultivated commercially for a time near Mitcham.10
Cannabis appears to have been quite infrequently used in medical practice. Interruption of supply and uncertainty of action were the reasons given. Dr Russell Reynolds, in his textbook, recommended its use for sleeplessness (in particular in the treatment of delirium tremens), for neuralgia and dysmenorrhoea.11 Seasickness and asthma also opened up possibilities for the use of the drug. 12 Cannabis indica was also in limited use as part of a possible treatment regime for opium eating, as that condition became considered as one suitable for treatment. Dr Mattison recommended the use of the fluid extract for the restlessness and insomnia consequent upon the withdrawal of opium.13 But cannabis was never anything of a rival to opium; its medical acceptability was always far more limited.
In one sphere it did gain a foothold. The utility of cannabis in the treatment of insanity was seriously mooted in the last quarter of the century. Experimentation with the use of the drug for this purpose was initially a French interest. It was the work of Dr Jean Moreau at the Bicetre Hospital in Paris and his publications of Du haschish et de l'alienation mentale in 1845, which drew attention in France to the possibilities of its use for the insane. 14 In England, trials of cannabis appear to have owed little directly to the French example. They were part of the elaboration of more extensive treatment and drug regimes at this time - and part, too, of the reaction away from opium as a standby. Dr Thomas Clouston, superintendent of the Cumberland and Westmorland Asylum at Carlisle, won the Fothergillian Gold Medal of the Medical Society of London in 1870 for his `Observations and experiments on the use of opium, bromide of potassium, and cannabis indica in insanity, especially in regard to the effects of the two latter given together'15 Clouston's researches inclined him to favour the two latter and his conclusions attracted a fair amount of medical attention. Henry Maudsley himself, while enthusiastic about Clouston's denigration of opium, was less sure about the remedies he proposed to substitute. The question in his mind was `whether the forcible quieting of a patient by narcotic medicines does not diminish the excitement at the expense of his mental power'. Maudsley had nevertheless used Clouston's method in a recent case, where he had seen a rapid recovery. 16
But cannabis was also seen as a cause of insanity. The connection between cannabis use and mental illness, debated to this day, had its origin in English medical discussions and in Indian and Egyptian evidence at the end of the nineteenth century. The connection initially arose in observation of the form of intoxication which the drug's use could give rise to. What was seen as a form of poisoning was elaborated into a distinct variety of insanity. As early as 1848 frequent use of the drug was said to brutalize the intellect; it was in the 1870s that the argument was developed.W. W. Ireland, writing in the Journal of Mental Science, likened
the condition following the use of the drug to the delirium of insanity. The alteration of notions of time and space and the illusions of sight also, where short distances appeared immense, were akin to the delusions of insanity. 11 The 'professionalization' of varieties of insanity had its effect in the area of cannabis use.
Since cannabis was so little used in England, it was evidence from the East which most effectively gave support to the view.
It was through British doctors' 'reports on the Cairo Asylum in the 1890s that the connection between cannabis use and insanity was made in England. The colonial implications of the drug had significant domestic repercussions. But there was quite telling testimony which pointed to the absence of a connection. Parliamentary and governmental investigations on the East and India in the 1890s tended to cast doubt on any link.18
This was very much the conclusion reached, on the basis of a more scientific evaluation of the evidence, by the Indian Hemp Drugs Commission of 1893-4. The Commission, set up to examine the trade in hemp drugs, their effect on the social and moral condition of the people, and the desirability of prohibiting cultivation, has, in recent years, been rescued from obscurity. Its conclusions - that the physical, mental and moral effects of hemp drugs used in moderation were not adverse, that there was no evidence of cannabis use leading to addiction and that prohibition would be unworkable - appeared particularly relevant to the campaign to legalize cannabis in the 1960s, even though the blanket applicability of the Commission's findings has been disputed. There was little domestic discussion of the Commission's findings in the 1 890s, partly because they appeared to have little relevance to English experience. There was no perceived problem of domestic cannabis use. What the Commission did succeed in doing, however, was to demolish the more facile medical belief in the connection of cannabis with insanity. Its detailed analysis of how those statistics connecting the two had been compiled decisively demonstrated the haphazard way in which conclusions had been drawn. Nine out of fourteen cases in the Dacca asylum attributed to hashish insanity, for instance, were shown not to have been so caused. The idea that hemp drugs were responsible for one third of all the cases of insanity in India had to be seriously revised. In many cases over-indulgence in hashish was not a cause, but merely a symptom of some underlying predisposition to insanity. 19 Nevertheless the insanity argument proved obstinately persistent. Dr Warnock, superintendent of the Cairo Asylum, published a report of his work there in 1895 which took no account at all of the findings of the Indian Commission .20 Warnock's findings were taken up and incorporated within popular and medical belief; the analyses of the Hemp Drugs Commission were forgotten.
Discussion of hemp drugs and insanity was part of an increased medical interest in the drug and its effects in general in the 1 890s. Part of the expanding medical examination of new and more effective remedies (which had led to the downgrading of opium) was an attempt to examine cannabis more scientifically and in particular to isolate an active principle. There had been attempts at this ever since the drug's introduction in the late 1 830s, and there were a bewildering variety of products, which included cannabis, cannabene, cannabin tannin, cannabinine and others. But the active principle of the drug had still to be isolated. The unreliability of cannabis preparations remained a serious drawback to their general use in medicine. Cannabinol was isolated by Wood, Spirey and Easterfield in 1895. Research into the drug's effects was continued in the medical school at Cambridge. 21 The interest displayed in these years also helped make the reputation of a medical man to be an important force in the shaping of narcotic policy. Walter Ernest Dixon, a leading member of the Rolleston Committee on Morphine and Heroin Addiction in the 1920s and a public opponent of penal narcotics policy on the American model, worked on the pharmacology of cannabis indica while Salters Research Fellow in the 1 890s. His conclusions were that activity would vary greatly according to the type of preparation used. The mode of ingestion had its different effect, too, and Dixon recommended smoking the drug if an immediate effect was desired. `Hemp taken as an inhalation,' he decided, `may be placed in the same category as coffee, tea, and kola. It is not dangerous and its effects are never alarming, and I have come to regard it in this form as a useful and refreshing stimulant and food accessory, and one whose use does not lead to a habit which grows upon its votary.' 22
Research of this type under a medical imprint into the mental as well as the physical effects of cannabis use had a striking parallel in the establishment of a recreational hashish-using sub-culture at the same period. Use of the drug in literary circles in many ways simply transferred to a non-scientific setting the aims and methods of medical research into the drug. Cannabis became part of the same sub-culture which experimented with opium smoking. The doctrine of `art for art's sake' which found expression in the drawings of Beardsley and the aestheticism of Oscar Wilde involved an emphasis on sensation and inner experience redolent of the Romantics. The 1880s and 1890s were a time of interest in the paranormal and in psychic phenomena. Spiritualism underwent a recrudescence; the Theosophical Society and the Society for Psychical Research were both founded in the 1880s. Interest in the occult and mystic phenomena were all part of the same tendency. It was among the members of a mystic order, the Hermetic Order of the Golden Dawn, and its literary associates, organized in 1891 into the Rhymers' Club which met in The Cheshire Cheese in the Strand, that recreational drug use was most common. It recalled the emphasis on experience and the inner life of the Romantic poets and writers; and indeed, Coleridge and Tom Wedgwood had tried a sample of `bang' from India in 1803.43
William Butler Yeats, a member of both the 1890s groups, had smoked hashish while in Paris. He and Maud Gonne had experimented in extra-sensory communication, and she, while using cannabis for insomnia, had awoken one night to find herself apparently translated to the bedside of her sister Kathleen. Smoking hashish and drinking black coffee were reported to be among the more defiant and unconventional activities at the Rhymers' Club meetings; and several of the poets who congregated there toyed with the drug. Ernest Dowson had experimented while at Oxford, and did so again in the company of the writers Arthur Symons and John Addington Symonds and some of Symons' friends from the ballet one afternoon in Symons' rooms in Fountain Court, Temple. By the early 1900s, experimentation with theeffects of drugs on consciousness seems to have been an accepted part of life in certain literary cum artistic milieux. Smoking opium and hashish were perhaps most commonly favoured, although Havelock Ellis (using Dowson and Yeats as guinea pigs) had been experimenting with mescal.24 Drug-taking in this way was a quite minor part of the artists' experience; the sub-culture as a `way of life' was at this period very. much in the future.

Cocaine

Cocaine, perhaps surprisingly, was not an important part of the teach for experience in literary circles at the turn of the century. As a separate alkaloid it had in fact only recently come into medical practice. The coca leaf itself, from which the alkaloid was derived, _was, like cannabis, a nineteenth-century novelty in European medicine. The coca chewing of the Peruvian Indians had been known since the discovery of the Americas, but, unlike tobacco, the coca leaf was never introduced into European society. The attitude of the Spanish conquistadores of Peru was perhaps important; coca chewing, like other native customs, was regarded as a vice. The drug had been originally regarded by the Incas as a symbol of divinity, and it hence became known in Europe initially, as had cannabis and opium-eating, through the medium of `travellers' tales' and later through more scientific description and investigation. Many of these descriptions were enthusiastic about the sustaining properties of the leaf. None was perhaps more so than Abraham Cowley, an English physician and poet who celebrated the virtues of coca in his Book of Plants (166x). Coca was

Endowed with leaves of wondrous nourishment, whose juice sucked in, and lo the stomach taken long hunger and long labour can sustain: From which our faint and weary bodies find more succour, more they cheer the dropping mind, than can your Bacchus and your Ceres joined.25

It was at about this time - in the late eighteenth and early nineteenth centuries - that a more scientific evaluation of coca began to prepare the way for its introduction into European medicine. Joseph de Jussieu, a botanist who had accompanied the French mathematician La Condamine to Quito in 1735, sent specimens to Europe for examination; through him the plant received the classification Erythroxylon coca. Poeppig, the German naturalist, Martius, Dr Weddell, a French botanist who went to South America in 1845, Clements Markham, von Tschudi, the Swiss naturalist, and the English botanist Richard Spriuce - all commented on the Indian use of coca. This examination of the drug was, like the experiments with British opium and interest in the alkaloids of that drug, another illustration of the growth of scientific inquiry and specialization in the early decades of the century.26 The work of Dr Paolo Mantegazza was important in establishing the potentialities of coca for European medical use. Mantegazza, who had practised medicine for some time in Peru, on his return to Italy, published in 1859 Sulle virtii igieniche e medicinali della coca, in which, while describing the hallucinatory effects which the drug had had on him, he recommended it for a range of illnesses including toothache, digestive disorders and neurasthenia. It was about this time that the drug's active principle was isolated. The discovery of cocaine, the main alkaloid contained within the coca leaf, is generally attributed to Albert Niemann of Gottingen, although in 1855 Friedrich Gaedcke had produced from a distillate of the dry residue of an extract of coca a crystalline sublimate he called 'Erythroxylon'. It was Niemann who in 1860 isolated pure cocaine from leaves brought to Europe by Dr Scherzer. Wilhelm Lossen described its chemical formula in 1862; the isolation and description of other coca alkaloids followed later in the century.27
It was not cocaine, however, but the properties of the coca leaf which initially attracted most attention. The 1870s in England in particular were the time when most medical discussion took place; .the coca leaf was part of the general increase of medical interest in new and apparently more scientific and exact remedies. Dr Anstie had mentioned the drug in his Stimulants and Narcotics in 1864; its moderate use seemed, he thought, `to have an influence upon nutrition almost indistinguishable from that of ordinary food as to its ultimate results 1.211 The work of Dr Alexander Hughes Bennett of Edinburgh began more detailed investigations. The coca leaf was already in general use as a stimulant and tonic in a variety of diseases; Bennett's work with it, and with cocaine, a small quantity of which he obtained from Macfarlan's in Edinburgh `after great difficulty', demonstrated the similarity of the physiological actions of coca, tea, coffee, guaranine and cocoa and of their active principles .29 There followed a period of increased experimentation .30
In 1876, the American pedestrian, Weston, used the coca leaf in walking trials in London. He found the results disappointing; the leaves did not have the expected effect, but instead acted as an opiate. He came to the conclusion that the drug would in fact be detrimental in any trial of physical endurance .31 Many medical men were, however, also trying the drug in the same way. Foremost among them was the veteran Sir Robert Christison, investigator of opium in the early decades of the century, and now, in his old age, an advocate of the advantages of coca chewing. Christison wrote in the British Medical journal in 1876 how he had made two `walking trials' with coca (or cuca) leaves, one in 1870, the other in 1875. His students at Edinburgh had experienced `the removal of fatigue, and the ability for active exertion' through its use. Christison himself had been enabled to walk fifteen miles without fatigue; and his two ascents of Ben Vorlich in the Highlands were exceptional for a man of his age. He wrote:

My companions ... were provided with an excellent luncheon ... but I contented myself with chewing two-thirds of one drachm of cuca-leaves ... I went down the long descent with an ease like that which I used to enjoy in my mountainous rambles in my youth. At the bottom, I was neither weary, nor hungry, nor thirsty, and felt as if I could easily walk home four miles... '32

For a time chewing coca became quite the rage among medical men. Even Sir Clifford Allbutt took it with him on a walking tour in the Alps in the hope of amazing his fellow climbers.
But there was still much disagreement about the general therapeutic possibilities of the coca leaf. Mr Graham Dowdeswell, for instance, writing of his researches into its action in the Lancet in 1876, concluded that its effect was so slight as to preclude any therapeutic or popular value.$$ Yet other medical men were not averse to recommending it for what would now be more exactly defined as non-medical usage. 'Dr William Tanner was reported as praising it as a cure for bashfulness - `it causes timid people, who are usually ill at ease in society ... to appear to good advantage . . .'. A doctor-sportsman was full of admiration for its effect in steadying his aim: `Filling my flask with the coca tincture, instead of with brandy ... down went the birds right and left ...' 34
It was not until the powers of the alkaloid as a local anaesthetic were fully understood that the drug won complete medical acceptability. It was the early work of Sigmund Freud, and of his friend and research colleague, Carl Koller, in Stricker's laboratory in Vienna, which brought this about. Freud's use of cocaine- is, because of his own enormous fame, well-known. He first became interested in the drug and its properties after reading a report of how Dr Theodore Aschenbrandt, a German army physician, had issued cocaine experimentally to some Bavarian soldiers during autumn manoeuvres. The results were promising. Freud obtained some cocaine for himself from Merck's of Darmstadt and began to experiment. Fifty milligrams in a glass of water left him cheerful and energetic. In May, influenced by American reports of the drug's use as a cure for morphine addiction, he began to administer cocaine to his friend Ernst von Fleischl-Marxow, who had become addicted to morphine to dull the pain of an amputated thumb. In his paper `On Coca' (`Uber Coca') published in July 1884, he produced the first major positive survey of the drug's therapeutic uses. Contending that it should be regarded as a stimulant rather than a narcotic, he blamed past failures on bad-quality preparations. From his own experience, he recommended the drug for a variety of illnesses and specially for symptoms such as fatigue, nervousness, neurasthenia and, most significantly, as a cure for morphine addiction." Freud himself continued to experiment with the drug for several years; he published five papers in all on it, the last, `Craving for and fear of cocaine', in 1887.
What can almost be termed Freud's love-affair with cocaine was an interesting episode in his career, albeit one which he preferred to disguise in later life. His enthusiastic advocacy owed something to his own personal circumstances, in particular the desire as a young medical researcher to establish a serious reputation and hence to be able to marry his fiancee Martha Bemays (to whom he wrote enthusiastically of the properties of cocaine) much earlier than he would otherwise have been able. It is possible, too, that his use of cocaine (which certainly continued to some degree after the last paper was published in 1887) may have mediated his change from physiological to mainly psychiatric interests. Certainly, as this change of emphasis began when he was working with Charcot in Paris in 1885 and 1886, Freud was still using cocaine regularly. Some interpretations relate his usage of the drug more specifically to the release of his creativity.
Of more long-term significance for medical usage of the drug, however, was the re-discovery of cocaine's anaesthetic properties made by Carl Koller. That the drug had this local anaesthetic effect had been known for some time. In 1862, for instance, a researcher called Schroff had noticed a numbing effect when he put some on his tongue; six years later, a Peruvian doctor, Thomas Moreno y Maiz, suggested that it might be a useful local anaesthetic. In the 1870s both Charles Faurel and von Anrep had noticed the anaesthetizing effect it had on the mucous membranes. Bennett, too, in his 1873 report had observed this property without fully realizing its significance .36 Koller's application of it to surgery was made while working at Vienna with Freud. Koller had been concerned with finding a suitable anaesthetic for eye surgery; the Richardson ether spray then in use was unsuitable for such delicate operations. The general narcosis which resulted prevented the patient's active co-operation, and the subsequent nausea and vomiting often damaged the work which had been carried out. As with many important discoveries much controversy surrounded this one - Freud later declared, for instance, that had he not left Vienna one weekend in September 1884, to see his fiancee, he too would have shared in the discovery; Koller denied that his discovery of the effect of cocaine on the eye was due to the fact that a drop fell into his own eye accidentally. In September 1884, he experimented with the drug on the eye of a frog and of a guineapig. `I found the cornea and conjunctiva anaesthetic,' he reported, '... insensitive to mechanical, chemical, thermic and faradic stimulation. Afterwards, I repeated these experiments on myself, some colleagues and many patients.' Koller's paper on the subject and a practical demonstration of the experiment were given at the Heidelberg Ophthalmological Society in September 1884.37
The anaesthetic properties which Koller thereby disclosed were eagerly seized upon by a profession which had long sought an adequate and safe means of performing such delicate surgery. The use of the drug was extended into other areas. In New York in October 1885, Leonard Corning, a neurologist interested in local medication of the spinal cord, successfully anaesthetized the lower extremities by injecting cocaine between the eleventh and twelfth dorsal vertebrae. In 1889, August Bier of Kiel reported on six operations he had performed using spinal anaesthesia, and the method soon became quite common. Early experiments on nerve blocking or conduction anaesthesia, by injecting cocaine into the path of a sensory nerve trunk to anaesthetize the fibres of its peripheral distribution, were made by William Stewart Halsted in New York in the winter of 1884-5. Halsted's experiments were given little publicity; the method of nerve-block anaesthesia which he pioneered was only generally adopted around the turn of the century.
Even more extraordinary was the wave of popularity which cocaine enjoyed among the medical profession at large once Koller's discovery became known. In England in the mid-1880s, the pages of the medical journals were crammed with enthusiastic demonstrations of the uses of the drug; doctors flooded into print in its praise and each contribution purported to establish a different usage to which this wonder drug could be put. There were sixty-seven separate pieces about it in the first 1885 volume of the British Medical Journal. Its utility as a local anaesthetic in operations on the vagina and urethra, in dentistry, ophthalmic surgery, in vaccination, in operations on the nose and larynx, vomiting, mammary abscess, in cancer, scalds, circumcision, neuralgia, hay fever, senile gangrene and even in the removal of a needle from a foot were all canvassed. Nymphomania, sea-sickness - there seemed no limit to the possibilities. The usual medical controversies over the exact mode of action of the drug began.
The drug made its mark in a popular non-medical way, too; cocaine and coca were used as patent medicines. The name of Mariani was most commonly associated with coca products. W. Golden Mortimer even dedicated his History of Coca `The Divine Plant' of the Incas (1901) to Angelo Mariani, the Parisian chemist and entrepreneur who was successfully selling coca extract not only as Vin Mariani, but also Elixir Mariani, Pate Mariani, Pastilles Mariani and The Mariani (a non-alcoholic variety). Mariani's were not the only commercial coca products on the market. In 1888, Messrs Ambrecht, Nelson and Co. of Duke Street, London, had several varieties of coca wine, including sweet malaga (used by ladies and children) and a Burgundy coca wine for gouty and dyspeptic cases; there was also coca sherry and coca port. In 1894 there were at least seven firms producing coca wines for the domestic market.38
The medical disapproval of opiate-based patent medicines which had found expression even in the seventies and eighties did not initially extend to coca products. The Lancet was recommending them `with confidence' in cases where a restorative was needed; their appearance and listing in medical journals betokened their general acceptability. The line of division between `medical' and 'non-medical' products as well as usage was not closely defined. William Martindale, for instance, whose supplement on cocaine in the third edition of his Extra Pharmacopoea in 1884 had done much to advertise the' uses of the drug as a local anaesthetic and much else besides, was producing his own brand of pastilles `intended for the temporary relief of hunger, thirst, fatigue, exhaustion, distaste for food, or nervous depression and weak digestion'. 39 In the 1890s Burroughs Wellcome likewise had cocaine tabloids for what would now be regarded non-medical use. These `voice tabloids', composed of cocaine, chlorate of potash and borax, were said to `impart a clear and silvery tone to the voice. They were easily retained in the mouth while singing and speaking ... used by the leading singers and public speakers throughout the world. 140
But medical approval began to wane in the 1890s. Commercial coca products were separated from their previous semi-medical status and were incorporated in the general medical and pharmaceutical campaign against the availability of all patent medicines." This was part of a remarkable medical volte face on the use of cocaine in general. The euphoria of 1884-5 was soon replaced by an appreciation of the dangers which such unrestrained use could give rise to. The use of cocaine to treat morphine addiction was strongly called in question. Freud had praised the drug for its utility in this way. Fleischl, to whom he had administered the drug, himself became dependent on it in place of morphine 42 The whole pattern of events was very similar to the earlier medical enthusiasm for, and subsequent partial rejection of, hypodermic morphine. With cocaine, the process was completed in a very much shorter time. By 1887, the British Medical journal could comment that the `undeniable reaction against the extravagant pretensions advanced on behalf of this drug had already set in' .43 The work of Dr J. B. Mattison in New York was noted in the British medical press; he had warned that there was a genuine danger of replacing an opium or morphine with a cocaine habit if the drug was used in this way. Dr Albrecht Erlenmeyer, too, who at the height of the cocaine craze had himself reported on his use of cocaine to treat eight persons addicted to morphia, was by 1888 warning against the method and melodramatically categorizing cocaine as the `third scourge of mankind', after alcohol and opium.44 Soon such warnings came thick and fast. The dependence on the drug of Halsted, pioneer of its anaesthetic use, was not known in England .45 Nevertheless a close connection was established between morphine and cocaine by warnings against the treatment of morphine addiction with cocaine. Cocaine's subsequent classification as a narcotic owed much to this early connection as well as to the later international implications of cocaine abuse.
The `cocaine habit' was; through the connection with morphine, incorporated within the general disease view of addiction.
But the lack of physical symptoms associated with use and withdrawal from the drug engendered a harsher medical response. Disease theories were always notable by the reformulation of moral views in scientific form; and the `vice' categorization was strongly applied to cocaine. To Allbutt, it was `slavery worse than that of morphine'; bondage was a hopeless matter. This appears to have been the almost universal reaction of the addiction specialists.46 Cocaine, it is now recognized, engenders no physical addiction or abstinence sickness. What was particularly worrying to the medical writers on the cocaine habit in the nineteenth century was the greater element of free will, of pleasure rather than pain, in the use and withdrawal from the drug. Crothers noted that no other narcotic made such a pleasing impression on the brain - it was `a foretaste of an ideal life 1.41 The cocaine user seemed more of an autonomous, non-medical personality than the morphinist or opium addict; and the medical response was harsh. Treatment methods retained a punitory aspect after cocaine had been abandoned for morphine addiction. Abrupt and immediate withdrawal was more generally acceptable for cocaine. Numbers of users were in any case small, and few underwent treatment, since the cocaine addict was, like the morphine injector, not covered by the terms of the Inebriates Acts.
But the non-medical cocaine user was quite a rarity at the turn of the century. Recreational cocaine use was spreading in the United States and Europe in the 1890s. In England, it was cannabis and opium smoking which were favoured. Cocaine was apparently confined to even more limited circles. Conan Doyle's famous (and often-quoted) portrayal of Sherlock Holmes's use of the injected drug - the `7 per cent solution' - was indicative more of the medical use of it which Conan Doyle (and through him, Watson), as a doctor himself, had encountered. It was noticeable, too, that references to the great detective's use of cocaine (and possibly morphine, too) became steadily more disapproving as time went on. In A Scandal in Bohemia (1886), at a time when cocaine was still in favour as a 'wonder-drug', and in The Man with the Twisted Lip, in the following year, Holmes's use of the drug was treated with a certain amount of levity. Holmes, according to Watson, was `alternating from week to week between cocaine and ambition.. .'. But through The Five Orange Pips, The Yellow Face and The Sign of Four, Watson's attitude grew steadily more disapproving, until in The Missing Three-quarter (1896) Holmes himself could refer to the hypodermic syringe as `an instrument of evil', while Watson spoke of a `drug mania' which had threatened his friend's career. Conan Doyle's portrayal of his character's cocaine use was a good indication of changed medical attitudes to the drug; but it was no index of recreational cocaine use. 48
In America at this period, such use was spreading down through the social scale; cocaine was becoming a drug with a dubious social reputation. There was less of this in England. Lower-class usage was not at all noticeable until the First World War .49 There was less of a domestic `scene' at this time. The drug use of Aleister Crowley and of his friend and mentor, Allan Bennett, are perhaps the only examples of self-conscious recreational cocaine use in the 1890s. Crowley, at this time living in Chancery Lane, with Bennett, who had been trained as an analytical chemist, was initiated to the Order of the Golden Dawn in 1898. Both men experimented with many drugs, cocaine among them, at this time. Crowley later wrote of Bennett, who suffered acutely from asthma, that `his cycle of life was to take opium for about a month, when the effect wore off, so that he had to inject morphine. After a month of this he switched to cocaine, which he took until he began to "see things", and was then reduced to chloroform.' It was Bennett's wholehearted devotion to the consciousness-expanding potential of drugs (he later became a Buddhist monk in Ceylon) which led Crowley to a life-long advocacy of their use, especially cocaine and heroin, in the pursuit of ritual and sexual magic.50 Crowley apart, the cocaine `scene' was almost non-existent.

References

1. Details of the several varieties and products of the plant are in A. B. Garrod and E. B. Baxter, The Essentials of Materia Medica and Therapeutics (London, Longman, 9th edn 1882), pp. 360-62; and 'Preparations of Indian Hemp', Pharmaceutical Journal, 3rd ser. 4 (1873-4), pp. 696-7. For its early history, see I. Hindmarch, `A social history of the use of cannabis sativa', Contemporary Review (1972), PP. 252-7; and T. Brunner, `Marijuana in ancient Greece and Rome? The literary evidence', Bulletin of the History of Medicine, 47 (1973), PP. 344-55.
2. J. P. Dolan, `A note on the use of cannabis sativa in the seventeenth century'. Journal of the South Carolina Medical Association, 67 (1971), PP. 424-7
3. Quoted in R. Hunter and I. MacAlpine, Three Hundred Years of Psychiatry 1S35-1860 (O.U.P., 1963), pp. 216-17; F. A. Fluckiger and D. Hanbury, Pharmacographia. A History of the Principal Drugs of Vegetable Origin, Met With in Great Britain and British India (London, Macmillan, 1879), PP. 547-8.
4. H. Godwin, `The ancient cultivation of hemp', Antiquity, 41 (1967), pp. 42 and 137-8, examines evidence for the cultivation of the drug. See also E. Porter, op. cit., pp. 44-5 and 375, and Notes and Queries, 181 (1941), P. 119.
5. See, for instance, S. Morewood, A philosophical and statistical history of the inventions and customs of ancient and modern nations in the manufacture and use of inebriating liquors; with the present practice of distillation in all its varieties: together with an extensive illustration of the consumption and effects of opium, and other stimulants used in the East, as substitutes for wine and spirits (Dublin, W. Curry and W. Carson, 1838), p. 115.
6. His career is described in J. B. Moon, `Sir William Brooke O'Shaughnessy - the foundations of fluid therapy and the Indian telegraph service', New England Journal of Medicine, 276 (1967), pp. 283-4.
7. W. B. O'Shaughnessy, `On the preparations of the Indian hemp, or gunjah; their effects on the animal system in health and their utility in the treatment of tetanus and other convulsive diseases', Transactions of the Medical and Physical Society of Calcutta, 8 part 2 (1842), pp. 42161. O'Shaughnessy's work was also noted in the British medical press in 1839, e.g. W. B. O'Shaughnessy, `New remedy for tetanus and other convulsive disorders', Lancet, 2 (1839-40), P. 539.
8. W. B. O'Shaughnessy (1839-40), op. Cit.
9. P. Squire, A Companion to the Latest Edition of the British Pharmacopoeia (London, J. and S. Churchill, 11864), P. 45. Society of Apothecaries Laboratory mixture and process book, 11868-72, op. cit., Ms. 8277. The Society was making extract of cannabis in 1868 and both extract and tincture in 1871.
10. Pharmaceutical journal, 6 (1846-7), pp. 70-72.
11. J. Russell Reynolds, `On some of the therapeutical uses of Indian hemp', Archives of Medicine, 11 (i861), pp. 154-60; and J. Russell Reynolds, ed., A System of Medicine, op. cit., vol. 2, pp. 88, 91, 749, vo1. 5, P. 74o.
12. See, for instance, its recommendation in R. Greene, `Cannabis indica in the treatment of migraine', Practitioner, 9 (1872), pp. 267-7o; F. F. Bond and B. E. Edwards, `Cannabis indica in diarrhoea', ibid., 39 (1887), pp. 8-10; and R. Greene, `The treatment of migraine with Indian hemp', ibid., 41 (1888), pp. 35-8.
13. J. B. Mattison, `Cannabis indica in the opium habit', Practitioner, 35 (1885), P. 58.
14. This also led through the collaboration of Moreau and Theophile Gautier to the foundation of the Club des Haschischins for the nonmedical experimental use of the drug. See P. Haining, ed., The Hashish Club (London, Peter Owen, 1975), vol. I.
15. T. S. Clouston, `Observations and experiments on the use of opium, bromide of potassium, and cannabis indica in insanity, especially in regard to the effects of the two latter given together', British and Foreign Medico- Chirurgical Review, 46 (1870), PP. 493-511, and 47 (1871), pp. 203-20.
16. H. Maudslcy, `Insanity and its treatment', Journal of Mental Science,
17 (I87I-2), pp. 3111-34. See also T. W. McDowall, `Cases in which mental derangement appeared in patients suffering from progressive muscular atrophy', ibid., r8 (1872-3), p. 39o.
17. W. W. Ireland, `On thought without words, and the relation of words to thought', Journal of Mental Science, 24 (1878-9), p. 429.
18. Reported in P.P. 1893-4, LX V I: East India (Consumption of Ganja), pp. 88, 158-62; see also J. H. Tull Walsh, `Hemp drugs and insanity', Journal of Mental Science, 40 (1894), pp. 21-36; also pp. 107-8. See also British Medical Journal, 2 (1893) pp. 630, 710, 813-14, 868-9, 920, 969, 1027, 1452.
19. Indian Hemp Commission. For an analysis of its conclusions, see O. J. Kalant, `Report of the Indian Hemp Drugs Commission, 1893-94 a critical review', International Journal of the Addictions, 7 (I) (1972), PP. 77-96.
20. Quoted in T. S. Clouston, `The Cairo Asylum : Dr Warnock on hashish insanity', Journal of Mental Science, 42 (1896), pp. 79o-95.
21. C. R. Marshall, `The active principle of Indian hemp', Lancet, r (1897), pp. 235-9. There were further attempts at this in the early 1900s, surveyed in Pharmaceutical Journal, n.s. 15 (19o2), pp. 1129-32 and 171.
22. W. E. Dixon, `The pharmacology of cannabis indica', British Medical Journal, 2 (1899), pp. 1354-7.
23. R. B. Litchfield, Tom Wedgwood, The First Photographer (London, Duckworth, 19o3), p. 1135; and J. Cottle, Reminiscences of Samuel Taylor Coleridge and Robert Southey (London, Houlston and Stoneman, 1847), P. 463.
24. Cannabis use among this circle is more fully described in V. Berridge, op. cit.; see also S. Levenson, Maud Gonne (London, Cassell, 1976), pp. 80-81 and 85; V. Moore, The Unicorn. William Butler Yeats' Search for Reality (New York, Macmillan, 1954) P. 25; A. Symons, Studies in Prose and Verse (London, J. M. Dent, 1964), p. 265; H. H. Ellis, `Mescal: a new artificial paradise', Contemporary Review, 73 (1898), pp. 130-47. The painter Augustus John describes some of his drug-taking experiences in this artistic milieu in A. John, Chiaroscuro (London, Jonathan Cape, 1952), pp. 177-9.
25. Quoted in W. Golden Mortimer, History of Coca, `The Divine Plant' of the Incas (1st edn 1901; San Francisco, Fitz Hugh Ludlow Memorial Library edn, 1974), pp. 26-7.
26. For details of the early scientific evaluation of the coca leaf, see R. Ashley, Cocaine: Its History, Uses and Effects (New York, St Martin's Press, 1975), PP. 4-6; W. R. Bett, `Cocaine, divine plant of the Incas. Some pioneers - and some addicts', Alchemist, 21 (1957), pp. 685-9; `Cocaine', Chambers' Journal, 63 (1886), p. 145.
27. L. Grinspoon and J. B. Bakalar, Cocaine. A Drug and its Social Evolution (New York, Basic Books, 1976), pp. 19-2o.
28. F. E. Anstie (1864), op. cit., p. 144.
29. A. H. Bennett, `An experimental inquiry into the physiological actions of theine, guaranine, cocaine and theobromine', Edinburgh Medical Journal, r9 (1873), PP. 323-41; see also `The physiological action of coca', British Medical journal, 1 (1874), p. 510.
30. For example, E. H. Sieveking, `Coca, its therapeutic use', British Medical Journal, r (1874), p. 234; A. Leared, `The use of coca', ibid., p. 272; J. A. Bell, `The use of coca', ibid., p. 305.
31. Weston's use of the drug was reported in British Medical Journal, 1 (1876), pp. 271, 297-8, 334-5, and Lancet, r (1876), pp. 447, 475
32. R. Christison, `Observations of the effects of the leaves of erythroxylon coca', British Medical Journal, 1 (1876), pp. 527-31.
33. G. Dowdeswell, `The coca leaf, Lancet, r (1876), pp. 631-3, 664-7.
34. 'Cuca for bashfulness', Doctor, 7 (1877), p. 113; `A new use for Coca', Lancet, 2 (1876), p. 449.
35. For Freud and cocaine, see W. R. Bett, op. cit., pp. 685-9; W. Golden Mortimer, op. cit., pp. 413, 428; L. Grinspoon and J. B. Bakalar, op. cit., pp. 32-3; R. Ashley, op. Cit., pp. 21-8; and C. Koller, `Historical notes on the beginning of local anaesthesia', Journal of the American Medical Association, go (1928), pp. 1742-3; S. Freud, The Cocaine Papers, R. Byck, ed. (New York, Stonehill, 1974), reprints Freud's writings on cocaine.
36. W. F. van Oettingen, `The earliest suggestion of the use of cocaine for local anaesthesia', Annals of Medical History, n.s. S (1933), PP. 2758o.
37. This sequence of events is reported in many sources, e.g. B. P. Block, `Cocaine and Koller', Pharmaceutical Journal, 18o (1958), p. 69; C. Koller (1928), op. cit., pp. 1742-3; H. K. Becker, `Carl Koller and cocaine', Psychoanalytic Quarterly, 32 (1963), PP. 3o9-73; and G. Sharp, `Coca and cocaine studied historically', Pharmaceutical journal, r (19o9), pp. 28-30.
38. Reported in British Medical journal, 2 (1888), p. 1344, and 2 (1894), p. 1052.
39. `Coca pastils', Lancet, 2 (1884), p. 1078.
40. Advertisement in Everybody's Pocket Cyclopaedia (London, Saxon, 1893).
41. See, for example, R. Hutchison, `Patent medicines', British Medical Journal, 2 (19o3) P• 1654.
42. British Medical journal, r (1885), p. 1183.
43. 'Cucaine habit and cucaine addiction', British Medical journal, I (1887), p.1229; A. Erlenmeyer, `Cocaine in the treatment of morphinomania', Journal of Mental Science, 3r (1885-6), P.. 427.
44. A. Erlenmeyer, `The morphia habit and its treatment', ibid., 34 (1888-9), p. 116.
45. Halsted's dependence on cocaine was in fact translated to a physical addiction to morphine.
46. N. Kerr (1889), op. cit., p. 122; T. S. Clouston (189o), op. cit., pp. 18o6-9; W. Lawton, `Stimulants and narcotics and their users and abusers', Pharmaceutical Journal, I (19o8), pp. 268-9, 544-6 and 56970.
47. T. D. Crothers, op. Cit., p. 282.
48. Cited in A. Conan Doyle, The Complete Sherlock Holmes Short Stories (London, John Murray, 1928, 1976 reprint).
49. V. Berridge, `War conditions and narcotics control: the passing of DO RA Regulation 40B', journal of Social Policy, 7 (1978), pp. 285-304
50. A. Crowley, The Confessions of Aleister Crowley, ed. J. Symonds and F. Grant (London, Jonathan Cape, 1969), p. 18o, and J. Symonds, The Great Beast. The Life and Magick of Aleister Crowley (London, Macdonald, 1971), pp. 17, 23-4.