Cocaine: From Medical Marvel to Modern Menace in the United States, 1884-1920 (review)

Joseph F. Spillane. Cocaine: From Medical Marvel to Modern Menace in the United States, 1884–1920. Baltimore, Johns Hopkins University Press, 2000. x, 214 pp., illus. $39.95.

Carl Koller’s 1884 discovery of cocaine’s local anesthetic properties, at a time when patients likened cataract removal to a red-hot needle in the eye, created an international sensation. His success encouraged investigations into cocaine’s therapeutic potential; soon physicians were recommending it as a tonic, stimulant, treatment for opiate addiction, and palliative for colds and hay fever. Though they also quickly discerned cocaine’s toxic and addictive properties (indeed, the majority of early cocaine addicts were medical men), clinicians persisted in regarding it as a valuable medication, when used cautiously and in appropriate circumstances. Challenging the conventional wisdom, Joseph Spillane denies that late-nineteenth-century American physicians were faddish or irresponsible in their use of cocaine.

Spillane is more critical of drug manufacturers. About the time of (and to some degree because of) cocaine’s therapeutic breakthrough, the manufacturers began to change their marketing behavior. No longer content to react to shifts in medical fashion, they shaped physicians’ demand for new products through aggressive sales tactics, such as the mass reprinting of favorable articles. One Parke, Davis production, The Pharmacology of the Newer Materia Medica (1892), included no fewer than 240 pages on coca and cocaine, then among the firm’s leading products. Only 3 of the 240 pages dealt with cocaine’s well-documented dangers, a “clear editorial bias against negative results” (p. 70).

The growing supply of South American coca and cocaine (Spillane’s detailed reconstruction of import, production, and price figures from fragmentary sources is nothing less than heroic) made possible popular drinks like Coca-Cola and lowered the price of patent medicines, notably nasal sprays and catarrh snuffs, which had a high cocaine content. Though these products were “an extension of, rather than a challenge to, mainstream medical wisdom” (p. 86), they also provided a means for recreational use. The trend was particularly noticeable in the urban underworld, where cocaine sniffing and injecting were well established by the end of the century. “Blowing the Birney’s” (the reference is to Birney’s Catarrh Cure, a leading brand) joined opium, morphine, and cigarettes as fashionable indulgences among prostitutes, pimps, delinquents, and petty criminals.

Cocaine abuse prompted a press and police reaction that, as Spillane is quick to point out, ran ahead of formal prohibitive legislation. Rejecting the Lindesmithian interpretation of American drug history (i.e., ill-conceived laws turned innocent victims into unwilling criminals), he shows that growing underworld involvement antedated, and directly contributed to, the consensus to restrict access to cocaine. Even before local and state ordinances limited sales to those bearing a prescription, reputable druggists refused to sell the drug to customers they suspected of abuse. Less scrupulous colleagues did a brisk business with addicts and peddlers, who resold the drug in tenderloins and red-light districts. Suppression of this thriving “shadow market,” operating just beyond the edge of legitimate supply, was a primary object of the legislation that supposedly generated the illicit traffic in the first place.

Spillane’s account of these developments is nuanced, deeply researched, and highly original. The publication of this book, just a year after the appearance of an excellent anthology (Cocaine: Global Histories, ed. Paul Gootenberg, London, Routledge, 1999), marks a new level of sophistication in cocaine history. Though the field remains divided between those who favor social-constructivist and quantitative-objectivist approaches (a conflict Spillane tries to finesse, though his heart is in the latter camp), the history of this controversial drug has progressed far beyond the present-minded accounts that dominated the literature well into the 1980s.

Reviewed by David T. Courtwright, Ph.D.,
Department of History, University of North Florida,
Jacksonville...