Module #7 reading: “Mania Americana": Narcotic Addiction and Modernity in the United States Study Notes

Historical Context and the Emergence of the Narcotic Habit (1870-1920)

• Post-Civil War Transition: Following the American Civil War, several factors converged to move drug use from a private practice into the public sphere as a perceived social problem.

• Technological and Medical Expansion: Medical knowledge and the use of narcotics expanded throughout the $19th$ century. A critical catalyst was the broad adoption of the hypodermic syringe during the $1860s$ and $1870s$.

• Refutation of the "Army Disease" Myth: While popular belief attributed subsequent narcotic use to Civil War battlefield medicine, historians have disproved this as the chief cause. However, a general increase in narcotic prescriptions during that era did foster a "taste" for the substances.

• Addiction Statistics and Trends:     * Reliable estimates suggest the rate of addiction peaked in the mid-$1890s$ at approximately $4.59$ per thousand people.     * Despite a subsequent decline, reformers and entrepreneurs exaggerated figures to convince the public that $1,000,000$ or more addicts—approximately $10.9$ per thousand—existed during the $1910s$.

• Demographic Shift: A primary driver of negative public attention was the changing composition of the drug-using population. The demographic shifted from upper- and middle-class white women (whose habits usually began with physician prescriptions) to lower-class urban men on the fringes of the criminal underworld. Historian David T. Courtwright argues this shift facilitated the depiction of narcotic use as deviant and threatening.

The Cultural Paradox of Modernity

• Modernity as Crisis: The Gilded Age and Progressive Era were characterized by a struggle to redefine human agency amidst rapid technological, economic, and political shifts.

• Theoretical Perspectives:     * Matei Calinescu: In Five Faces of Modernity ($1987$), he traces the term modernus back to the $4th$ century. Modernity is defined by a sense of linear time, positioning the present against a closed past and an unrealized future.     * Jean-François Lyotard: Described postmodernity as the latest instance of modernity.     * Paradox of Specificity: Modernity is both a recurring historical condition (chronic) and a specific experience of time. People in various epochs have faced challenges to the "self," but the late $19th$ century modern crisis was unique in its obsession with renegotiating the notion of a challenged self.

• Threat to the Autonomous Individual: Modernity imperiled the cornerstone of $19th$-century bourgeois identity: the autonomous individual whose moral master was himself (T. J. Jackson Lears).

• Social and Intellectual Factors of "Weightlessness":     * Corporate Capitalism: Managerial systems reduced personal risk but seemed to move independently of human will.     * Intellectual Trends: The works of Charles Darwin, Herbert Spencer, and Sigmund Freud made personal identity seem problematic.     * Interdependence: Technological expansion created a sense of regional and individual interdependence, devaluing the "irreducible atomic constituent of society," the individual (Thomas L. Haskell).

Narcotics and Scientific Progress

• Chemical Innovations:     * Morphine: The active alkaloid of opium; isolation methods were widely known by $1820$.     * Heroin: A semisynthetic opium derivative introduced in $1898$ by Germany's Bayer Chemical Company, originally marketed as a cough medication.     * Cocaine: Isolated from the coca plant in the $1850s$.

• Narcotics as a Symptom of Civilization: George Miller Beard, the physician who coined "neurasthenia" ($1871$), argued that drug use was extended by the "progress of civilization," technological innovation, and commerce. He believed this form of narcotic interconnectedness reduced independent subjects to a state of abject dependence.

• The Syringe as a Boundary of the Modern: The hypodermic syringe helped distinguish the "opium eaters" of the early $19th$ century—such as Thomas De Quincey—from the "morphinists" of the fin de siècle.

Evolution of Medical Discourse: Roberts Bartholow’s Manuals

• The Role of the Manual: Roberts Bartholow published five editions of Manual of Hypodermic Medication between $1869$ and $1891$. He defined the practice as a technology composed of a physical artifact (machine), an activity (treatment), and specific knowledge.

• Changing Perspectives on the "Morphia Habit":     * $1869$ & $1873$ Editions: Devoted less than two pages to the habit. Bartholow viewed the potential for addiction as a minor side effect of a successful technique.     * $1879$ (Third) Edition: Expanded the section to a $17$-page chapter. Bartholow characterized the habit as a "gigantic evil" and a "most serious abuse," warning that "every remote village has its slave… to the hypodermic syringe."     * $1891$ (Fifth) Edition: Bartholow showed ambivalence, admitting that some individuals were benefited by habitual use, citing Thomas De Quincey (who died at age $74$) as an example of a productive user.

"Mania Americana": Addiction as a Disease of Overcivilization

• Neurasthenia and Drug Sensitivity: George Miller Beard categorized a susceptibility to narcotics as a symptom of "neurasthenia" ($1878$), a functional nervous disease of modern American origin. He equated the novelty of addiction to the telegraph, railway, or telephone.

• Societal Pressure: W. F. Waugh ($1894$) argued that drug habits were the "price we pay for our modern civilization," essentially causative factors of suicide and insanity.

• The "Mania Americana" Definition: Dr. L. L. Stanley ($1915$) explicitly used the term "Mania Americana" to describe the nervous strain of modern life temporarily relieved by opium.

• Hamilton Wright and Federal Legislation: Dr. Hamilton Wright, a primary influence on government policy and the Foster bill, used the Civil War as a temporal marker. He argued that the war created a "physical and mental overstrain" leading to a breakdown in a large portion of the population, marking the shift to an "addicted present."

The American Association for the Study and Cure of Inebriety (AASCI)

• Formation and Evolution: Organized in $1870$ as the American Association for the Cure of Inebriates; later changed to the AASCI to sound more scientific.

• Definition as Disease: The group aimed to define chronic drunkenness and drug use as "inebriety," a curable disease, rather than a moral failing.

• Shift to "Addiction" Terminology: In $1885$, Dr. J. B. Mattison argued that "opium addiction is a disease" and that the term "habit" was a misnomer because it implied the user retained individual control.

• War on Drugs Inception: Alonzo Calkins, author of Opium and the Opium Appetite ($1871$), used combative rhetoric, calling for a "wall of circumvallation" against a "subtle," "insidious," and "dangerous" antagonist.

The Corruption of Agency: T. D. Crothers and Medicolegal Relations

• Thomas Davison Crothers: A leading figure in the AASCI and proprietor of a Hartford asylum. He wrote hundreds of essays on the hazards of narcotic use.

• The Loss of Volition: Crothers defined addiction as a "paralysis of the centers of volition." He argued that the inebriate was a "mental waif, without helm or sail," incapable of acting as a subjective agent.

• Sensory Disordering and Reason: Crothers developed a neurophysiology where continuous narcotism blunted sensory centers, thereby impairing the power of reasoning. Because senses were obscured, the "objective world [was] not correctly seen."

• Disintegration of Time: Asa P. Meylert argued that opiates caused the drug user to lose track of the flow of time. The addict became suspended in an "eternal, unchanging present," separated from the past and future by a "bottomless pit of eternal despair."

• Moral Perversion: Dr. Henry Freeman Walker claimed that the perversion of the moral sense obliterated the distinction between truth and falsehood, meaning an addict's testimony in legal matters should be discredited.

Leslie E. Keeley and the "Gold Cure"

• Financial and Popular Success: Dr. Leslie E. Keeley opened the first Keeley Institute in Dwight, Illinois, in $1879$. Between $1880$ and $1920$, over $500,000$ people took the "Bi-Chloride of Gold Cure." The company earned over $2,700,000$ between $1892$ and $1900$.

• Controversy with "Regular" Medicine: AASCI members such as Crothers branded Keeley a "quack" and a "degenerate," criticizing his secrecy regarding his formula (a violation of the AMA code of ethics).

• The Rhetoric of Gold and the Currency Debate:     * Keeley’s branding relied on the cultural logic of the Gold Standard. For "goldbugs" like David Wells (author of Robinson Crusoe's Money, $1876$), gold signified authenticity and "substance" against the "shadow" of mass-produced paper money (greenbacks).     * The "Barber Pole": The gold cure was delivered via a red, white, and blue syringe.     * Restoration: Keeley claimed that gold could "cleanse, renew and re-create" the poisoned system, restoring a patient to a "Golden Age" before they tasted the intoxicant. This effectively returned the user's life to the control of their own "will and judgment," supposedly curing the cultural crisis of modernity itself.

Political and Societal Consequences

• Legislative Control: The Harrison Narcotic Act of $1914$ placed drug access under professional medical and federal control.

• The Two-Tier System: Historian Caroline Jean Acker notes that this created a divided system: treatment for the middle and upper classes, and incarceration for the poor, ethnic minorities, and immigrants.

• Medicolegal Formulation: Hickman concludes that the concept of addiction served to inscribe the cultural crisis of modernity onto the bodies of those it identified as addicts, with lasting implications for contemporary drug policy.