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An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine Hardcover – Deckle Edge, July 19, 2011

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Editorial Reviews


"An incredible book...an absolutely fascinating read".
--Ira Flatow, National Public Radio's Science Friday

"Markel brilliantly describes the paradox of [Halsted's and Freud's] lives".
--George Rousseau, NATURE

"A witty, wide-ranging book".
--Boston Globe

"Inspired, entertaining, and informative...[Howard Markel] tells this fascinating tale in an insightful contemporary book that is both intellectually engaging and exceptionally well written."
--Journal of the American Medical Association

“Markel creates rich portraits of men who shared, as he writes of Freud, a ‘particular constellation of bold risk taking, emotional scar tissue, and psychic turmoil.’” 
 —The New Yorker
“Terrific . . . This rich, engrossing book reminds us of the strangeness of even heroic destinies.”
 —Richard Rayner, Los Angeles Times

“[A] rich, revelatory new book . . . . [Markel is] a careful writer and a tireless researcher, and as a trained physician himself, Markel is able to pronounce on medical matters with firmness and authority.”
—Lev Grossman, TIME
“[An] incisive—and often damning—story of the “miracle drug cocaine.”. . . Elegantly subversive . . . . The author’s insights and analytical skills make An Anatomy of Addiction an irresistible cautionary tale”
—Deborah Blum, The Wall Street Journal
“A splendid history. . . [Markel is a] fluent, incisive and often subtly funny writer.”
—Michael Sragow, The Baltimore Sun

“Absorbing and thoroughly documented. . . a vivid narrative of two of the most remarkable of the many contributors to our understanding of human biology and function . . . A tour de force of scientific and social history, one that helps illuminate a unique period in the long story of medical discovery.”
 —Sherwin Nuland, on the cover of The New York Times Book Review 
“Provocative . . .  persuasive and engrossing.”
 —Laura Miller, Salon.com 

"Compelling and compassionate. . . a book that profoundly demonstrates the complexity and breadth of their genius. . . a richly woven analysis complete with anecdotes, historical research, photos and present-day knowledge about the character of the addictive personality."

“Howard Markel eloquently tells the parallel stories of these two pathbreaking physicians and how their stories intersect in remarkable and sometimes tragic ways . . . Markel's extraordinary achievement combines first-rate history of medicine and outstanding cultural history.”
Publishers Weekly (starred)

“From the dramatic opening scene on the first page to the epilogue, An Anatomy of Addiction is a hugely satisfying read. Howard Markel is physician, historian and wonderful storyteller, and since his tale involves two of the most  compelling characters in medicine, I could not put it down—addictive is the word for this terrific book.”
—Abraham Verghese, author of Cutting for Stone

About the Author

Howard Markel, M.D., Ph.D., is the George E. Wantz Distinguished Professor of the History of Medicine and director of the Center for the History of Medicine at the University of Michigan. His books include Quarantine! and When Germs Travel. His articles have appeared in The New York Times, The Journal of the American Medical Association, and The New England Journal of Medicine, and he is a frequent contributor to National Public Radio. Markel is a member of the Institute of Medicine of the National Academy of Sciences and lives in Ann Arbor, Michigan.


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Product Details

  • Hardcover: 352 pages
  • Publisher: Pantheon; 1 edition (July 19, 2011)
  • Language: English
  • ISBN-10: 0375423303
  • ISBN-13: 978-0375423307
  • Product Dimensions: 6.6 x 1.2 x 9.6 inches
  • Shipping Weight: 1.4 pounds
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (50 customer reviews)
  • Amazon Best Sellers Rank: #515,030 in Books (See Top 100 in Books)

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More About the Author

Howard Markel, M.D., Ph.D., an award-winning and New York Times bestselling author, is the George E. Wantz Distinguished Professor of the History of Medicine and Director of the Center for the History of Medicine at the University of Michigan. He also holds professorial appointments in Psychiatry, Public Health, History, English Literature and Language, and Pediatrics and Communicable Diseases. He was born in Detroit, Michigan on April 23, 1960 and grew up in Oak Park and Southfield, Michigan. Educated at the University of Michigan (A.B., 1982, summa cum laude; M.D., 1986, cum laude) and the Johns Hopkins University School of Medicine and Hospital (Intern, Resident and Fellow in General Pediatrics, 1986-1993 and Ph.D, in the History of Medicine, Science and Technology, 1994), he joined the University of Michigan faculty in 1993.

A critically acclaimed social and cultural historian of medicine, Dr. Markel is the author, co-author, or co-editor of ten books including the award winning Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892 (Johns Hopkins University Press, 1997; paperback, Johns Hopkins University Press, 1999) and When Germs Travel: Six Major Epidemics That Have Invaded America Since 1900 and the Fears They Have Unleashed (Pantheon Books/Alfred A. Knopf, 2004; paperback Vintage/Random House, 2005). His most recent book, An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine (Pantheon Books/Alfred A. Knopf) was published in July, 2011 and was a New York Times Best Seller, a San Francisco Chronicle Best Seller, an ABA IndieBound Best Seller, and a New York Times Book Review "Editor's Choice".

From 2005 to 2006, Professor Markel served as a historical consultant on pandemic influenza preparedness planning for the United States Department of Defense. From 2006 to the present, he serves as the principal historical consultant on pandemic preparedness for the U.S. Centers for Disease Control and Prevention. From late April 2009 to February 2011, served as a member of the CDC Director's "Novel A/H1N1 Influenza Team B", a real-time think tank of experts charged with evaluating the federal government's influenza policies on a daily basis during the outbreak.

In collaboration with the U.S. Centers for Disease Control and Prevention, he is Editor-in Chief of The 1918-1919 American Influenza Pandemic: A Digital Encyclopedia and Archive. Funded by grants and contracts from the National Endowment for the Humanities, the Robert Wood Johnson Foundation, and the CDC, the digital encyclopedia is at www.influenzaarchive.org. Working with the CDC and a team of historians at the Center for the History of Medicine, Professor Markel currently directs a research team of medical historians at work on documenting the social history of the 2009 H1N1 Influenza pandemic. He is also at work preparing a second edition of the 1918-1919 Influenza Pandemic Digital Encyclopedia.

Dr. Markel was a contributing writer and columnist for The Journal of the American Medical Association from 2007-2014. Since 2010, he has been a frequent contributor to National Public Radio's Science Friday; his monthly segment, "Science Diction," discussed the history, evolution and meaning of scientific words. Since 2012, he has written a monthly column for PBS NewsHour.org. In 2013, he became editor-in-chief of The Milbank Quarterly, which is one of the leading public health policy and population health peer-reviewed journals in the world.

In addition, Dr. Markel has contributed over 350 articles to scholarly publications and popular periodicals, from The New England Journal of Medicine, Journal of the American Medical Association, American Journal of Public Health, and The Lancet to The New York Times, Harper's Magazine, The Atlantic, The Baltimore Evening Sun, The New Republic, International Herald Tribune, and The Wall Street Journal. He has appeared on numerous national radio and television news broadcasts and film documentaries about the history of medicine and public health for NPR (All Things Considered, Morning Edition, Talk of the Nation, Science Friday, Here and Now, Tell Me More, and Market Place), ABC's Good Morning America and World News Tonight, PBS (Nova, Frontline, NewsHour), BBC The World, CNN, MSNBC, and the History Channel. Most recently, he appeared in the Ken Burns-Siddhartha Mukherjee PBS documentary, "Cancer: The Emperor of All Maladies."

Professor Markel's work has been recognized with numerous grants, honors and awards. In 1996, he received the James A. Shannon Director's Award of the National Institutes of Health and the Burroughs-Wellcome Trust 40th Anniversary History of Medicine Award. In 1998, he was named a Centennial Historian of the City of New York and was an inaugural fellow at the Center for Scholars and Writers of the New York Public Library from 1999-2000; in 2003 he received the Arthur Viseltear Award from the American Public Health Association. In 2007, he received the Theodore Woodward Award from the American Clinical and Climatological Association and the Robert Wood Johnson Health Investigator's Health Policy Award. In 2008, in recognition of his scholarly accomplishments, Dr. Markel was elected as a Member of the Institute of Medicine of the National Academy of Sciences, which in July of 2015 was renamed the National Academy of Medicine (of the National Academies of Sciences, Engineering and Medicine. In 2015, he was named a Guggenheim Fellow by the John Simon Guggenheim Memorial Foundation for "demonstrating exceptional capacity for productive scholarship."

Customer Reviews

Top Customer Reviews

Format: Hardcover
In Howard Markel's "An Anatomy of Addiction," two renowned figures are attracted to "a miracle drug" that reduced appetite and the need for sleep, sharpened one's focus, relieved depression, and induced a feeling of euphoria. It also had anesthetic properties that could be useful for surgeons performing dental or ophthalmological procedures. Both Sigmund Freud, the pioneering psychoanalyst, and William Halsted, one of the greatest surgeons of his time, were fascinated by this drug and decided to try it out on themselves. As a result, both became addicted to cocaine.

Dr. Markel's command of his subject is impressive; his excellent source materials include letters, journal articles, and monographs. The author provides enlightening background information about medical practice in the nineteenth century, especially in the United States and Vienna. He vividly describes Bellevue Hospital in New York City, Johns Hopkins in Baltimore, and the Allgemeines Krankenhaus in Vienna, large complexes that were bursting at the seams with both affluent and indigent patients. Young physicians-in-training flocked to these institutions to learn from more experienced and skilled medical practitioners.

It is fascinating to learn how naïve people were concerning cocaine's short and long-term effects. The same could be said of opium, morphine, and laudanum, all of which were dispensed liberally to treat a host of complaints. No one understood the underlying nature of addiction. There were no "rehabs." If someone were unfortunate enough to become dependent on a drug, he or she would have a very difficult time breaking the habit. Freud and Halsted were particularly susceptible to this disease because of who they were.
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In finishing this book, which was hard to put down, sent me searching for other books by this author. It is one of the best presentations that I have read, complete with excellent notes, and close to 100 pertinent illustraions, The scholarship of this Medical Historian is extraordinary.

While the focus is on two contemporay physcians, both trapped by the addictive powers of cocaine, Markel details enlightens us as to the ways of the era of modern medicine. Freud and Halsted (the premier surgeon-in-chief of the John Hopkins Hospital) belief that the super drug potentially capable of curing anything. It would bring them fame and fortune as a pharmaceutical. Sadly there personal trials brought them a debilitating curse. The study details the pathological dispersion of addiction in a manner that is very easily understood by a layman. Through-out the book is written to be understood, and the story line will captivate you. To readers,as myself, the author Markel may be addictive!
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"An Anatomy of Addiction" by Howard Markel examines two famous doctors, Sigmund Freud and William Halsted and their addiction to cocaine. Freud, who invented psychoanalysis, the search for self-truth, became convinced that cocaine was a miracle drug with no side effects. Halsted, considered to be the father of modern surgery was probably the first cocaine addict to come to the attention of medical professionals in the United States.

Peruvian Indians on the eastern slopes of the Andes have been chewing coca leaves for centuries. Their Inca ancestors used it in many religious rituals and initiation rites. Chewing coca leaves was found to have the remarkable ability to suppress hunger, increase tolerance, and stretch the bounds of human endurance, but is no more harmful than several cups of coffee. It wasn't until around 1860 that the devil was unleashed by a German scientist who converted the leaves into the highly purified coca alkaloid.

If there is such a thing as an addictive personality, Freud certainly had it. He became so enamored with cocaine and fascinated with its effects on the mind that he considered it a treatment for morphine addiction and depression among many other ailments. Halsted was interested in the drug's anesthetic qualities and how it could aid him in surgery, so began experimenting on himself by injecting the drug into his arm.

Both men consumed great quantities of the drug and eventually encountered serious problems because they had done so. At the time, the late 1800's, addiction as a bona fide medical diagnosis was not in the medical vocabulary. Freud struggled with this demon for twelve years and Halsted, it is speculated, struggled with cocaine as well as morphine addiction until his death in 1922.
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Both Sigmund Freud, father of psychoanalysis, and William Halsted, originator of modern surgery, practiced medicine in the 1880s and experimented on themselves and others with cocaine's possible therapeutic uses. Freud was interested in it as an antidote for morphine addiction and as treatment for addiction, Halsted saw it as a possible anesthetic. Freud found the drug cured his indigestion, dulled his aches, and relieved his depression. After taking the drug for a few months Freud shifted from his initial focus on neurology to psychology/psychiatry. Halsted became professor of surgery at Johns Hopkins Hospital and devised new and safer surgical techniques - while struggling with his addiction acquired experimenting.

'An Anatomy of Addiction' opens with a laborer being admitted to Bellevue Hospital with a serious compound fracture of the leg. Staff called upon Halsted, their best surgeon, but he had just taken a dose of cocaine. He took one look at the patient and went home to a seven-month cocaine oblivion. Meanwhile, in Europe Freud was using the drug to self-medicate his own anxieties. At the time almost 15% of prescriptions contained cocaine, there were no controlled substances, and addiction was not yet a medical diagnosis. Other users of the day included Ulysses Grant, Queen Victoria, the Shah of Peria, Thomas Edison, and Arthur Conan Doyle (also a physician).

Freud's career goals was to be appointed to a faculty position at the Vienna Medical School, and saw lab experimentation as his preferred means of getting it. His focus on cocaine was initially motivated by a desire to help a friend, Dr. Fleischl-Marxow, addicted to morphine because of the intense, chronic pain created by a non-healing amputation.
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