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

4.7 out of 5 stars 51 customer reviews

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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 (51 customer reviews)
  • Amazon Best Sellers Rank: #316,738 in Books (See Top 100 in Books)

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Top Customer Reviews

By E. Bukowsky HALL OF FAMETOP 500 REVIEWERVINE VOICE on August 8, 2011
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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Sigmund Freud's first major published paper, in July 1884, reported his praise of the "magical substance" of "Über Coca", which he had been studying and experimenting with personally. It also marked the beginning of a transition for Freud, in moving from controlled scientific observations within the laboratory environment, to including his own personal thoughts and experiences into his work. Was experimentation with cocaine an important factor in Freud's revolutionary work in psychology? The reader can reach his or her own conclusions, with this book providing a fascinating accounting of the journey that Freud made (he is said to have discontinued his use of cocaine by 1896, prior to the publishing of his most influential works).

William Halsted, a contemporary of Freud, was a Yale trained chief of surgery at John Hopkins Hospital who developed important surgical techniques while also dealing with his own addiction to cocaine. His efforts to control the addition also resulted in a profound self-control which contributed to his development of surgical techniques with significant theraputical benefits, including the introduction of germ-free operating rooms at Johns Hopkins Hospital. He is also created with first using the now mandatory rubber glove in surgery.

The story of these two scientific pioneers, and the role that cocaine played in their personal and professional lives, is fascinating. Also included are stories of famous advocates of the cocaine-enhanced wine "Vin Mariani", developed in the 1860's, who included Ulysses S. Grant, Jules Verne, and Thomas Edison, among many others.
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