A Cure for (Anything) that Ails You: Cocaine in Victorian Medicine

10.2307_community.28537599-1Although the medicinal properties of the coca plant had been well known to the indigenous people of South America for thousands of years, cocaine as we know it was first isolated from the coca plant by German chemists in the 1850s. Having observed its status among indigenous people, scientists wanted to explore its uses in medicine. Among other things, the Incans had used it as a painkiller in early brain surgery. It had to be good, right?

No one was prepared for how good.

Not only did cocaine turn out to be an effective anesthetic, but it reduced bleeding by constricting blood vessels. Doctors loved it, dentists used it for toothaches and routine surgery, and Dr. Karl Koller, a friend of Sigmund Freud, confirmed its ophthalmic use when he applied it to his own eye and repeatedly stabbed it with pins. Freud himself was a champion of the drug, using it to fight his own indigestion and depression for years. He wrote a formal report praising the drug, “Uber Cocaine,” a seventy-page opus we can only assume he completed in one sitting.

While medical professionals were experimenting with it, it hit the market in Vin Mariani, a wine fortified with coca leaves developed by French chemist Angelo Mariani in 1863. “French coca wine,” as it was soon called, proved to particularly potent. The alcohol in the wine accomplished what the chemists were attempting in Germany and pulled the cocaine from the coca, so each bottle contained about a teaspoon of cocaine. It doesn’t sound like much, but it only takes about 20mg to produce a high. Each bottle contained approximately 160mg. Pope Leo XIII was so impressed that he gave Mariani a gold medal and kept a hipflask filled with it for easy access.

10.2307_community.24785561A Miracle Cure

When cocaine was released to the public as a pharmaceutical, the conditions couldn’t have been better. After the Civil War (1861-65) and the Franco-Prussian War (1870-71), morphine addiction was common among veterans with chronic pain on both sides of the Atlantic. Like laudanum, another common opiate, morphine was available for purchase without prescription. Cocaine was likewise available over the counter, and doctors encouraged its use to fight morphine addiction and alcoholism.

And why wouldn’t they? It was thought to be harmless. In 1877, a doctor in the Boston Medical and Surgical Journal (now the New England Journal of Medicine) reported: “Coca…diminishes weariness, strengthens the pulse, calms nervous excitement, and increases mental activity. (…) Careful observations lead me to believe that, so far from being injurious, the moderate consumption of coca is not only wholesome, but frequently beneficial.”

Thomas Edison and Jules Verne championed it. In fiction, Sherlock Holmes used it to stave off “the dull routine of existence.” US Surgeon General Dr. William Hammond said it was harmless and particularly useful for athletes and “brain-workers,” reassuring the public that it was not addictive in the slightest.

10.2307_community.28561236Cocaine was touted as a miracle substance, added to every remedy for every purpose. It was sold as a powder—it was claimed it eliminated dandruff when applied to the scalp or treated allergies when inhaled through the nose. The Hay Fever Association named cocaine an official remedy. Beauty columns reported that it cured cold sores when applied to the skin. It was sold in candies or syrups to fight fatigue, toothaches, or sore throat. It came in bottles, tablets, wine, powder, cigarettes, salve, and even with syringes for easy injection. Cocaine is even thought to be one of the secret ingredients of Dr. Keeley’s legendary “Gold Cure,” a concoction administered at his addiction treatment centers throughout the end of the nineteenth century.

Coca-Cola

In Georgia, Dr. John Pemberton unwittingly turned cocaine into an enduring global phenomenon of another kind in 1886. A biochemist and Confederate Army veteran, he spent the decades following the war experimenting with painkillers and other compounds for commercial consumption. Pemberton had survived a sabre wound to the chest during the Battle of Columbus in April of 1865, but it pained him for the rest of his life, leading to a morphine addiction that would last until his death in 1888.

coca-cola_ideal_brain_tonic_1890sHe had some success with his Pemberton’s French Wine Coca, which was marketed to veterans and “highly strung” Southern women as a recreational beverage with medicinal properties. A wine fortified with coca and kola nut, it was claimed it fought depression, morphine addiction, alcoholism, and anxiety. Pemberton created his non-alcoholic version when Fulton County enacted temperance legislation in 1886; the wine was replaced with soda water, it was sold at drug stores, and Coca-Cola was born.

The active ingredient certainly sped its success. It woke people up, helped them to work longer hours with greater focus, and it made them feel wonderful. Pemberton marketed it as a “valuable brain tonic…delicious, refreshing, pure joy, exhilarating.”

The public agreed. Coca-Cola survived Pemberton’s death, using his original recipe until the cocaine was removed in 1906.

Coming down

It took several years for the long-term effects of cocaine to become apparent. Freud himself fell out of love with it in the 1890s, when he began to observe increasingly negative reactions among his own patients. He eventually gave it up himself when it began to affect his own performance, causing him to nearly kill of his own patients during a surgery.

Although cocaine was effective for short-term use for toothaches and dental surgery, its effects on the teeth overtime proved to be more than detrimental; it increased tooth decay and erosion, periodontal disease, oral lesions and infections, and loss of taste and smell.10.2307_community.28556929-1

By 1891, there were thirteen deaths attributed to cocaine, as well as countless reported addictions. Though it worked as a stimulant and painkiller, its other side effects were less appealing. Finally, it was discovered to cause delirium, breathing issues, convulsions, high blood pressure, coma, and cardiac arrest.

Cocaine was outlawed in the US with the Harrison Narcotics Act of 1914. It experienced a further surge in Germany following WWI and was used in Nazi experiments throughout WWII. It is still legal for medical use or decriminalized in many countries around the world as well as the state of Oregon.

Jessica Cale

 

Further reading

Gardiner, Richard. “The Civil War Origin of Coca-Cola in Columbus, Georgia”, Muscogiana: Journal of the Muscogee Genealogical Society(Spring 2012), Vol. 23: 21–24

Lestrange, Aymon de (2018). Coca wine : Angelo Mariani’s miraculous elixir and the birth of modern advertising ([English translation, revised and expanded edition] ed.). Rochester, Vermont.

Musto, David F. “Why Did Sherlock Holmes Use Cocaine?” Pharmacy in History, vol. 31, no. 2, 1989, pp. 78–80. JSTOR, http://www.jstor.org/stable/41112485.

Ohler, Norman. Blitzed: Drugs in the Third Reich. Houghton Mifflin Harcourt, 2017.

“Cocaine.” The British Medical Journal, vol. 1, no. 6169, 1979, pp. 971–972. JSTOR, http://www.jstor.org/stable/25431933.

Images: 

  1. An Invitation to Cocaine. William Golden Mortimer, 1904.
  2. An advertisement for Hall’s Coca Wine, 1915.
  3. Advertisement for Iron Bitters. Iron Bitters was an over-the-counter cure-all with cocaine as an active ingredient.
  4. Advertisement for Coca-Cola, 1890s.
  5. Advertisement for Cocaine Toothache Drops, 1885. Like Iron Bitters, these were marketed for children.

Nellie Bly Takes the Gold Cure

Journalist and Traveler Nellie Bly

Nellie Bly in 1900

When Nellie Bly died in 1922, at least one obituary described her as “the best reporter in America.” She was certainly an impressive investigative journalist. As an advocacy journalist, she wasn’t shy about putting her opinions in her stories, and she could even be seen as a precursor for the later New Journalism, where the writer is part of the story.

She also was a feminist pioneer, and ran her husband’s iron works company after his death, patenting or co-patenting a better metal oil drum. She was a celebrity in her own right. Her name appeared in the headlines of many of her stories, and board games and playing cards were designed with her image. She was a phenomenon.

Bly is best remembered for her 1887 career-making series Ten Days in a Mad-house and for besting Verne’s hero Phileas Fogg’s time—and that of a rival journalist—by traveling around the world in seventy-two days in 1889. Both are still readily available online and in book form.

The Keeley Institute and the Gold Cure

Bly’s articles about the treatment of madness were written in New York near the start of her career. Near the end, Bly investigated a so-called “alcoholism cure” for the well-to-do in White Plains. In a way, this lesser-known chapter is a thematic bookend to her life as a reporter.

keeley institute

The Keeley Institute in White Plains, NY

While Mad-house dealt with life-and-death issues—the need for mental illness treatment reform among the mostly poor, foreign-born women on Blackwell’s Island—her 1894 story Nellie Bly Takes the Keeley Cure was less serious and ran in a single installment. It was as concerned with Bly’s preparations to pass herself off as a high-functioning absinthe drinker as the cure itself. It exposed The Keeley Institute, a fraudulent alcoholism cure clinic. While the mental asylum was making people worse, Keeley’s clinic may have been helping alcoholics, even though its “cure” was hokum.

Founded by Leslie Keeley in 1879 in Illinois and expanding to branches throughout the United States and Europe, the Keeley Institute’s slogan was “Drunkenness is a disease and I can cure it.” It also claimed to work for “opium inebriates” and “morphine fiends.” They treated people with Keeley’s proprietary “gold cure” for alcoholism, not available anywhere else.

Gold_CureThe gold cure was a potion that included something Keeley called “double chloride of gold.” Independent analyses found that the gold cure was a witches’ brew of varying ingredients—gold salts, alcohol, morphine, cannabis, and other substances—in colored water.

Despite the toxic and/or addictive nature of many of these ingredients—and remember, morphine was then legal and even heroin was sold over the counter in the United States until 1924—there were few if any claims of negative side effects or new addictions associated with the cure other than vomiting or dizziness.*

It was snake oil, but enough people reported that it worked—Keeley claimed a 95% success rate—that Bly’s antennae were out. Her stepfather had been an alcoholic, and she didn’t believe in easy cures. The cost was a hundred dollars paid in advance. Bly managed to negotiate a one-week stay for twenty-five, though she was told that was normally not allowed.

The cure was administered by syringe four times a day for four weeks, with tonics given at two-hour intervals. Bly rightly noted with horror that the male patients were all injected with the same needle, which was not cleaned between injections. Female patients, of which there were few at the time of Bly’s visit, were administered privately in their rooms.

1891-1892-CD-Keeley-Institute-300x184Each patient was also given a bottle of whiskey by the institute so they could taper off their drinking on their own. Bly said she “gave it to an expert, who pronounced it the worst rot-gut he had ever tasted.” As a purported absinthe drinker, Bly had to buy her own bottle from a local shop.

Some of the staff had taken the cure themselves. Bly noted approvingly that the attending medic Dr. Millspaugh had a red nose, assuming it revealed a past love of drink.

“It is as it should be, thought I, to have for a doctor one who has tasted the bitter and sweet of loving cups . . . For who could better doctor a man with snakes than one who killed many a one of his own? And who could better tell the condition of a head the next morning than one who had drank all the others under the table?”

Later, when he told her he was not and never had been a drinker, Bly wrote, “How can a doctor who doesn’t know the symptoms of drink doctor one for the complaint?”

Nelly Bly (Absinthe Fiend) Investigates

Bly was less impressed when she discovered that rather than one-and-done, some patients had taken the cure multiple times. The wife of one patient said she had no faith in the cure lasting, though her husband had stopped drinking after a week:

“They give the same tonic, the same injection to each and every man. What will cure the boy of twenty cannot surely cure my husband, who has drank so many more years. And they treat them the same number of times and the same number of weeks.”

Still, she told Bly, “So long as my husband believes it is all I ask. If he can be cured for even a few months, it is well worth the expense and time.” Their doctors had warned that he would be dead in a month if nothing was done.

Mr. J.J. Brown, the manager, explained to Bly why patients sometimes came back. “It puts people back where they were before they began to drink, (but) there must be a desire on the part of the patient not to drink. We can’t make it impossible to drink if they feel so inclined.”

Bly was unconvinced. She wrote: “I would not for the world cast discredit upon anything that would turn people from drink for even four weeks. But it is my honest opinion that the cure is no cure in itself.”

She declared that being “away from temptation, (with) plain, wholesome food, pure, bracing air (and) plenty of rest” make the patient “feel better. He credits it to the cure, and his faith grows stronger . . . He believes he is cured. That is the great thing. So long as he believes that and does not taste, he is all right, but woe to the Keeley patient who tries a drink!”

keeley_ad_2

Advertisement for the Keeley Institute in Greensboro, NC (Blandwood Mansion)

Bly was mostly correct in her analysis, but she was missing one thing. The reason the Keeley Institute worked as well as it apparently did was that it wasn’t just a vehicle to sell snake oil—though it undoubtedly was that—but it offered something else: dignity. The alcoholic was treated not as a lowlife, weak, or evil, but as someone with a disease.

In Slaying the Dragon: The History of Addiction Treatment and Recovery in America, William L. White explains: “The atmosphere was informal and friendly at the clinics, with a marked absence of the bars and restraints that were typical in most inebriate asylums of the period.” Also dissimilar to later programs such as Alcoholics Anonymous, Keeley didn’t include religion as a component. The institute didn’t include addiction counselors, though most of the doctors were former alcoholics themselves. According to White, “There were enough doctors on staff to go around.”

Apart from the dubious gold cure, modern addiction treatment does follow many of Keeley’s tenets, including the way alcoholism is viewed. The US Surgeon General’s 2016 Report on Alcohol, Drugs, and Health clearly states that “Addiction to alcohol or drugs is a chronic but treatable brain disease that requires medical intervention, not moral judgment.”

The institute promoted “mutual sharing and alternative diversions” as part of the therapy, much like the peer support groups recommended today. Bly credited much of the institute’s success to the healthy food, exercise, and fresh air, and these are often components of modern addiction rehab treatment too. It is now recognized that relapse is not uncommon among addicts, and that rehabilitation rarely works unless the patients want to get better.

nellie bly keeley institute white plains

Nellie Bly tries the “gold cure” at White Plains Keeley Institute

What makes the Keeley story an almost perfect bookend to Bly’s career is that alcohol and drug addiction often co-occur with mental health issues. They are related problems, also known as dual diagnoses—alcohol or drugs may be used to self-medicate for a mental health problem, or drug and alcohol use may exacerbate mental health problems.

Keeley was a conman, but he seems to have helped others in spite of himself, inadvertently using his bogus “cure” as a spoonful of sugar to help the real medicine go down. Call addicts irredeemable, and they’ll stay away. Pretend you have a cure, then distract them with healthy food and exercise, and maybe they will get better.

Nellie Bly knew that Keeley promised more than he could deliver and acted accordingly. A claim of a 95% success rate is crazy, and maybe that put her on her mettle. A better story would have been to find out how many people the Keeley Institute actually helped and why, or to compare its success rate to more traditional inebriate asylums.

Nellie Bly threw herself into her stories, tilted at windmills, slew dragons, suffered defeats, and left behind a record of achievement of which anyone would be proud.

Stephen Bitsoli writes about history, science, addiction, and related topics for several blogs. A former journalist and lifelong reader, he enjoys learning and sharing what he’s learned.

Sources

  1. Arlen, Michael. “Notes on the New Journalism.” The Atlantic, May 1972. Web. Accessed July 26, 2018.theatlantic.com/magazine/archive/1972/05/notes-on-the-new-journalism/376276/
  2. “Remarkable Nellie Bly’s Oil Drum.” American Oil & Gas Historical Society. Web. Accessed July 26, 2018.aoghs.org/transportation/nellie-bly-oil-drum/
  3. Conliffe, Ciaran. “Terrible People from History: Elizabeth “Nellie Bly” Cochrane Seaman, Intrepid Journalist.” Web. Accessed July 26, 2018.headstuff.org/culture/history/terrible-people-from-history/elizabeth-nellie-bly-cochrane-seaman-journalist/
  4. “5 May – Nellie Bly.” Widow’s Weeds. Web. Accessed July 26, 2018.thewidowsweeds.blogspot.com/2012/05/5-may-nellie-bly.html
  5. Bly, Nellie. Ten Days in a Mad-House. Ian L. Munro, Publisher, 1887. Nellie Bly: The Pioneer Woman Journalist, A Resource Website. Web. Accessed July 26, 2018.nellieblyonline.com/herwriting
  6. Himmelfarb, Ben. “Local History: Addicts & Addiction Pt. 1: The Keeley Institute.” October 30, 2017. White Plains Public Library. Web. Accessed July 26, 2018.whiteplainslibrary.org/wp-content/uploads/2017/10/1984-6-10-NYWorld-Bly-1.jpg
  7. Hanson, Dirk. “The Strange and Secret Keeley Cure for Addiction.” September 11, 2011. Addiction Inbox. Web. Accessed July 26, 2018.addiction-dirkh.blogspot.com/2011/09/strange-and-secret-keeley-cure-for.html
  8. “The Keeley Cure.” Digger Odell Publications, 2009. Bottlebooks.com. Web. Accessed July 26, 2018.bottlebooks.com/Keeley/keeley_cure.htm
  9. Detwiler, Jacqueline. “History’s Scariest Addiction Treatments.” The Fix, August 23, 2012.Web. Accessed July 26, 2018.thefix.com/content/grisly-addiction-treatments-history90510
  10. “Alcoholism is a Disease and I Can Cure It”: Dr. Leslie Keeley and the Keeley Institutes. Alcohol Problems & Solutions. Web. Accessed December 4, 2018. https://www.alcoholproblemsandsolutions.org/alcoholism-is-a-disease-and-i-can-cure-it-dr-leslie-keeley-and-the-keeley-institutes/
  11. Nickell, Joe. “Historic ‘Gold Cure’ For Addiction.” Center for Inquiry, March 18, 2016.Web. Accessed December 4, 2018. https://centerforinquiry.org/blog/historic_gold_cure_for_addiction/

*There have been some vague and undocumented claims of deaths, but if there were actual deaths, it’s hard to imagine Bly or other journalists ignoring them or making light of the Keeley cure thereafter.