Chapter Two - The Morphia Habit

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“It may well be questioned whether the world has been a gainer or the loser by the discovery of subcutaneous medication.” - A physician, 1883.

This chapter looks at addiction, one consequence of the early enthusiasm for injections of morphia (as morphine was generally called in the nineteenth century). Follow our dear Luer as he notices the efforts to ‘cure’ opium addiction ─ an early instance of an opioid drug to treat addiction to another opioid, the encouragement of self-administering morphia, and the blame game played afterwards. 

Something to keep in mind throughout your tour:

– Could we have seen potential addiction to morphia earlier than we did?

– How does gender bias, noticed by Luer in his concern over patients, affect things? 

– How much is miscommunication between patients and practitioners to blame?

Early warnings?

My father started life with a physician in London’s Harley Street, which was renowned for the consulting rooms of many celebrated physicians. I was amused to hear from him that the street also had its dubious inhabitants, even quacks! I wonder, could patients always tell the difference?

Certainly ‘yes’ in the case of John St. John Long. We found this etching from 1830, which lampoons him dressed as a funeral mourner surrounded by ducks and placards that speak of his malpractice cases.

Father also remembers hearing that physician Clifford Allbutt had challenged physicians in 1870 over indiscriminate injections of morphia. Prompted by descriptions of addiction in Victorian ‘sensation’ novels, Allbutt worried over consequences of the early enthusiasm for injections. He did feel that, from the beginning, more care should have been taken with such a potent remedy.

But, in 1870, was he late in saying this? Possibly, but even then many physicians seemingly took no notice.

J. St John Long. Coloured etching attributed to A. Sharpshooter, 1830.
Wellcome Collection. Public Domain Mark

Hearing my father talk about this, it seemed that, for a long time, this addiction was not a significant social issue… In fact, I remember him telling me how it changed. During the last decades of the 1800s,  publicised horrors of opium dens captured public imagination – Dickens’ Life of Edwin Drood (1870) and from the London Illustrated News (August 1874). Father said his physician read the whole article out to a colleague, though my father only remembers the description of “repulsive scenes of deliberate intoxication with the drug.” 

Treating opium habit with morphia

Truax, C. The Mechanics of Surgery. Chicago, 1899: 193.

Such a scene pushed more people to treat this addiction with morphine. Father told me he was often used for such morphia injections. His physician owner believed, though I wonder why, that morphine would not have opium’s addictive properties. 

Could anyone truly be ‘cured’ by this? Certainly, celebrated author Wilkie Collins (1824-1889) was not – he wrote about the treatment in 1869, to break his habit of drinking laudanum. I believe I heard an old uncle of mine talk about this: it was an alcoholic preparation of opium, readily available over-the-counter.

“My doctor is trying to break me of the habit of drinking laudanum. I am stabbed every night at ten with a sharp-pointed syringe which injects morphia under my skin ─ and gets me a night’s rest without the drawbacks of taking opium internally. If I only persevere with this, I am told, I shall be able, before long, gradually to diminish the quantity of morphia and the number of nightly stabbings ─ and so emancipate myself from opium altogether.”

Female Patients

The first owner of a syringe friend of mine was a young lady suffering from excruciating spasms of neuralgia pain. Her physician advised her to purchase a Luer syringe from a local chemist so that she could inject herself whenever needed.

She promised her doctor that she would not abuse the morphia. Sadly, that did not happen.  

Intriguingly, I heard her life mirrored that of Isabel Gordon, shown here, the main character – and sufferer of the morphia habit – in Richard Pryce’s 1888 novel An Evil Spirit

 My great, great grandchildren have told me that doctors do not always ‘listen’ to patients; often, it seems they don’t have the time. I remember witnessing my physician listening (and hearing!) a patient’s complaint. He often told patients this was the central aspect of his job! I think that many may now feel – as we do often see, sitting in the back of our rooms – that this has been diluted due to reliance on the growing numbers of diagnostic tests.
Isabel Gordon from Pryce's 'An Evil Spirit'. 1892. British Library.

Playing the Blame Game!

Eugène Grasset. La Morphiniste/La Morphinomane. 1897. Colour Lithograph. Philadelphia Museum of Art. Public Domain.

I remember physicians who gossiped about colleagues over morphia injections. This has been happening for far longer than I have been around!

Mostly, what I could put together, opinions ranged from physicians blaming other physicians,  physicians denying any fault of their own, and physicians blaming their own patients, especially women (because of their alleged weak willpower).

But, even after some regulatory control of morphine emerged in 1868, it was still not difficult to obtain.

Apparrently, a great number of late 19th-century artists, European artists in particular, depicted scenes of women and morphine. In 1887, it was said ‘morphiomania’ had made formidable headway all over France, enough to prompt the interest of artists.

At the time, medicine and art seemed to echo and reinforce negative views about women, some even supporting opinions that morphia enhanced women’s libido and that the femme fatale was a danger zone! Look here, this image from 1897: a young anxious woman is either satisfying or falling into the morphine habit.

And more below…

Santiago Rusinõl. La morfina. 1894. Wikimedia Commons. Public Domain.
George Moreau. Les Morphinées. 1886. Wikimedia Commons. Public Domain.
Paul Alber Besnard. Morphinomanes ou Le Plumet [Morphine Addicts or The Plume], 1887. Engraving. Gift of Mr. and Mrs. Daniel Bell, in Honor of the 50th Anniversary of the National Gallery of Art. CC0 1.0 Universal Public Domain Dedication.

I have often been struck, that when Victorian physicians blamed patients for disregarding advice, they generally had less sympathy for women. I heard it said that women, often from the upper classes, were inherently ‘weak.’ In fact, they also said that weak willpower also made them lie about their morphia habits!

And nurses… I wonder, too, about male physicians’ attitudes toward nurses – at least up to World War I! Some challenged nurses’ authority to administer morphine injections. 

Was this gender bias? Or a strong belief in the physician’s responsibility to minimise morphia addiction? For instance, influential physician William Osler remarked in 1895: “it is even safer not to entrust this dangerous instrument in the hands of the nurse.”

I cannot consider their justifications for their views, but gender biases persisted after the ‘morphia habit’ came to be classed as a disease of ‘addiction.’

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