JF Ptak Science Books Post 153
This book review on the use of narcotics in treating the insane appeared in the New York Journal of Medicine for 1846. The book, “An Essay on the Use of Narcotics, and other remedial Agents calculated to produce Sleep in the Treatment of Insanity….”, by Joseph Williams, M.D., and published in London in 1845. The theory behind the sleep treatment was that the basic mechanism of insanity was “cerebral inflammation” or “excessive vascular action” in the brain—inducing deep sleep, evidently, was a good way to combat the over-active brain.
The article itself comes at an odd time in the history of the treatment of the insane. It came almost 40 years after the establishment of McLean Hospital (first known as the “Asylum for the Insane,” a division of the Massachusetts General Hospital), which opened on Oct. 1, 1818, and was the first hospital dedicated to the treatment of the insane in the U.S. It came 70 years after the great advances of Benjamin Rush, who elevated the “Mental Patient” from chains on the floor to the status of medical or nervous illness or disease. The use of narcotics over this period seems to have surged and waned. In 1879, in an article in the New York Times, the reputation of the Asylum for the Insane on Ward’s Island in NYC was considered—and one of the high points was that it had (largely) discontinued the use of narcotics. (There were still problems, of course, what with the asylum being overcrowded, housing 1100 in an institution meant to house 700, and where the chores and even nursing positions were staffed by the inmates, who were feed on 32 cents a day.) As late as 1921, though, Jacob Alter Goldberg notes in his Social Aspects of the Treatment of the Insane, that there was a new, sharp increase in “toxic narcotic” treatments of the insane. Of course, I guess one could replace “narcotic” with some sort of other misplaced treatment, like shock therapy, or Freudian mélanges, or something. Each age must necessarily have their entry in the encyclopedia of embarrassments
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In this article we find sleep assaulted by the use of the following: purgatives (“to subdue vascular action when the propriety of bleeding is doubtful’), emetics, opium (to be used “in cases of high nervous excitability and in puerperal mania”), morphia (“the most valuable remedy for calming excitement”), hyosciamus (“to produce sleep, tranquilizing the irritability of the insane”). It is weird to see that the last sentence in the description of hyosciamus reads “some fatal cases have occurred from exhibiting henbane as an enema”. A narcotic enema? Still to come in the review is conium (“I have used it frequently and in large doses…it is chiefly valuable as a deobstruent and alternative”, followed by camphor, Belladonna, hydrocyanic acid, colchirum, stramonium aconite, and others. “Warm baths’ makes an appearance (“90 degrees may be considered to be the best temperature for a warm bath for the insane”), as do cold baths, and the applications of ice caps.
I’m not so sure about what to make of it all, the sleep treatment of insanity I mean—after all, Joseph Lister only makes his epochal pronouncements on cleanliness in the operating theatre 15 or so years after this paper, which seems today to be the most rudimentary thing that one could do in treatment in the surgical room, so treating extra blood in the brain through drug-induced sleep doesn’t seem all that far away from the realm of possibility back there in early Victorian England.
I don’t think I’ll forget the toxic narcotic enema any time soon, though. Or the word “deobstruent”.
This map comes to us from The Illustrated London News, 3 August 1940, which reproduced it from an article in Fortune Magazine. Though it looks oddly wrong from the outset, it really is pretty lucid–elegant, even–once you understand its purpose. And the purpose of this map was to show the distances that the goods and raw materials from the British Empire (and from the possessions of France) had to travel via the then-closed Suez Canal route versus the new routes “not open to enemy interference” to Great Britain. Countries depicted in outline show the distance via Suez while the same country depicted in shade show the new, longer, non-Suez route. Ever stiff lipped, the Brits announced that even though some of their major natural resources are coming from these vastly removed areas, “even with the fall of France, the British Empire and its allies remain an economically self-contained and immensely powerful war unit, and still control the great part of the world production of some vital commodities…” I’m not sure why, exactly, that it was necessary to display this map to the public eye, what with England under assault in the Battle of Britain (the Nazis extending their aerial assault in preparation for Operation Sealion), the loss of France, and the nearly-there Nazi blockade of English waters. Perhaps it was drawn to show that even though the material was coming from the same places that were now further away, they were still getting there. 
