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PJ Online | Christmas 2001 (Gladstone's pick-me-up and other stories)

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The Pharmaceutical Journal Vol 267 No 7179 p911-936
22-29 December 2001

This article

Christmas miscellany summary

Gladstone's pick-me-up and other stories

Described as the plant of joy, it was the first recorded medicine. Regarded by many as the most useful remedy ever discovered, it is the only drug that has given rise to wars. Gladstone took it in his coffee. DeQuincey made his fortune writing a book about the drug. When in the 1860s doctors wanted to confine the substance to medical usage, it was the opposition of pharmacists that kept it on free sale. Opium is and always has been the most controversial medicament. Ray Sturgess unravels some of the facts from the myths

Papaver somniferum, the white poppy, source of opium. Opium was not only the sole drug available for the relief of pain and fevers, but in Europe was the only drug then widely used for its euphoric effects. Probably many users did not distinguish between the two

In the 18th century, the Society of Arts in London instituted awards of 50 guineas or a gold medal to encourage the production of a rare field crop in England and Scotland. The Society met with some success, for over a hundred years the plant was grown in Somerset, Buckinghamshire, Middlesex, Surrey, around Edinburgh and, where it flourished best, in Norfolk. The crop was harvested by cheap labour, children aged eight to 12, casual women labourers, and by Irish immigrants. The youngest children were paid three pence for an 11-hour day, the women and the Irish a shilling.

The crop was the white poppy, Papaver somniferum, the source of opium. The reason for encouraging a home-grown supply of the drug was solely economic. The demand for opium for use as a medicine was growing fast in the 18th century and continued to do so in the next, and the raw opium had to be imported from Turkey and Persia at great expense. The home-grown product was not only less expensive than imports but highly profitable to the grower.

Even with the benefit of hindsight and much research, it is difficult to assess how much of the increases in the consumption of opium was due to medicinal demand and how much to its use as a mood enhancer. Opium was not only the sole drug available for the relief of pain and fevers, but in Europe the only drug then widely used for its euphoric effects, and probably many users did not distinguish between the two. Whether the cause of discomfort was bodily pain or life's burdens, opium provided temporary oblivion.

Laudanum, the alcoholic tincture made from raw opium, was the only medication in many households, and in the respectable homes where its use as a mood enhancer would have been frowned upon, a pain could always be exaggerated or invented. Although there was still a prevalently rural population, with all from the squire to the farm hand knowing each other's business, a little laudanum tippling in the community was an acceptable peccadillo. The rapid growth of towns and cities resulting from the industrial revolution altered things. Laudanum indulgence in a rural setting was one thing, but once the working classes were confined to smoke-laden warrens around the factories and mills which had spawned the new urban slums, places rarely visited by anyone who could avoid it, the middle classes developed uneasy consciences. They became paranoid and went out of their way to repress any sign of unacceptable behaviour..

To alleviate the miseries of slum existence the first waves of urban workers took to cheap gin, and when the gin craze was halted by parliament's imposition of a spirit tax, there was another solace readily available in the form of opium. The thought of hordes of overworked and underpaid denizens resorting to laudanum was enough to change the views of the ruling classes about opium.

Stories, mostly circulated in the new crusading Victorian newspapers, about mothers dosing their babies with laudanum drops to quieten them while they were away working in the factories sent shudders through middle class drawing rooms. Soon there were demands for control of the drug, strongly supported by the expanding and ambitious medical profession. Putting opium into doctors' hands would be another way of publicly demonstrating their power.

In Parliament, other aspects of opium trafficking were causing concern. The British government had long turned a blind eye to the large scale and highly profitable opium trade with China by the East India Company. British involvement in the opium trade with China is hard to defend, but so is the view that it was the result of a sinister plot to convert a nation to drug addiction so that huge profits could be made supplying the drug.

As always the truth is more complicated than the do-gooders would have us believe. The opium poppy had grown in parts of China, and been used medicinally, from time immemorial. Opium had also been used there as elsewhere for its mood-altering properties, but it was not widely cultivated there. From the 15th century onwards China had imported moderate quantities of opium, along with spices like saffron and wormwood, from Malacca on the Southwest coast of the Malay peninsula, which suggests that its abuse was on a small scale, perhaps as a relaxant by overworked mandarins, who took it in cake form if a surviving early recipe is anything to go by.

What transformed opium usage in China, was the introduction of the tobacco pipe in the 17th century. The habit had taken a long time to reach the East. In America, early colonists had disapproved of their native-born neighbours' custom of smoking, but eventually their objections were overcome by the need for the white colonists to participate in peace pipe ceremonies, combined with the addictive potency of nicotine. Sailors and merchants brought tobacco to Europe, and smoking began in France in 1556. The tobacco habit continued its advance despite monarchical disapproval — the Stuart kings James I and Charles I roundly condemned tobacco, as did Louis XIV — and spread throughout Europe to Russia.

Alexis, the second Romanov Czar, tried to ban tobacco and had nicotine deviants tortured and exiled, but the Russians became the keenest of smokers. It was Portuguese and Dutch sailors who spread the habit to India, Siam, China and Japan and by 1644 tobacco smoking in China was so widespread that the emperor Tsung Cheng issued a decree banning the practice. The ban succeeded better than elsewhere, but only because the population was switching to smoking a substance that was not then prohibited: opium. The nausea and stomach cramps caused by oral opium had held consumption of the drug in check, but since inhaling it from a pipe largely avoided these symptoms the Chinese took to opium smoking as the rest of the world had to tobacco.

To satisfy the demand, the trickle of imported opium into China became a flood and the Portuguese were the first to supply the new market. But the East India Company, not used to having profitable business snatched from under its nose, soon stepped in, buying up the Indian opium crop and shipping it to the Pearl River, Canton becoming the distribution centre for the drug. The Chinese opium trade was clandestine and yielded no revenues to the government and it was this fact, as much as its abuse by its citizens, that led in 1729 to an imperial decree banning the sale and smoking of opium. The emperor and his officials did not expect the ban to succeed, but the severity of the penalties — opium retailers were to be strangled and their assistants imprisoned and then deported — ought at least to ensure that the smuggling went through recognised channels and that the government got its rake-off.

Which in fact was what happened, a cosy arrangement developed that allowed the foreign opium shippers to supply the drug through a committee in Canton, called the Co?Hong, who were able to line their purses and pass on enough revenue to the government to keep the emperor happy. That is until the appointment of a commissioner, Lin Tse-Hsu, to oversee the opium trade in 1838. To the astonishment and horror of the shippers and the Co-Hong alike, Lin proved to be that rarity among Chinese bureaucrats, an official who was incorruptible. He seriously intended to ban the opium trade. And very nearly did, causing a couple of wars in the process, the so-called Opium Wars, although there were many other issues at stake.

It was the cost of the Opium Wars that resulted in opium becoming an issue in the British parliament in the 19th century. It seemed reasonable to many members to ask why the nation should be spending money on wars in far-flung parts to enable commercial firms to continue making inordinate profits from smuggling opium to hordes of Chinese addicts. There were other disturbing revelations about opium nearer home. Two authors were to transform the image of opium from that of useful drug and occasional narcotic to altogether more rarefied heights. In the summer of 1869 Dickens and his American publisher spent an evening in the run-down Shadwell district of the East End, looking for low life that might be incorporated into a novel. The result was 'The mystery of Edwin Drood' (1870), Dicken's last and unfinished novel which opens with a character, a choirmaster — even near the end Dickens was as inventive as ever — hallucinating in an opium den. As the choirmaster comes round, noticing two doped "Oriental" customers nearby, the haggard woman owner of the establishment offers him another pipe of opium.

With a few sentences, the East End opium den had been born and was to go on spawning a host of imaginative and purely fictitious literary versions for another half century, culminating in 1913 with Sax Rohmer's 'The mystery of Fu-Manchu'.

The reality was less exotic. By 1868, when the Prince of Wales (later Edward VII) visited London's main Chinese district comprising a couple of streets in Bluegate Fields, he called in at an opium den run by a Chinese immigrant and his English wife. The premises, even for a royal visit, were poor and mean, providing a refuge for Chinese sailors wanting a pipe or two for relaxation after months of hard work at sea. But Edwin Drood and the lurid accounts of journalists that followed put Chinatown on the social circuit and led to a steady stream of West End toffs and artist bohemians wanting to try opium for kicks.

Thomas DeQuincey took his first opium in 1804, in the form of laudanum bought from a druggist in Oxford Street, for stomach pain — doctors have since speculated that he may have been suffering from a gastric ulcer — and by 1813 was taking 320 grains (over 20 grams) of raw opium. The enormity of this amount can be judged from the fact that when raw opium got into the pharmacopoeias, the maximum recommended dose, as older pharmacists will recall, was 2 grains.

Opium — the ultimate mystery

As all pharmacists know, opium comes from the latex produced by scratching the surface of the plant's seed pod after flowering. Morphine and the other active alkaloids are present in the seed pod for about 10 days and if the latex is not harvested they break down into inactive compounds. It is not so surprising that the medicinal properties of the plant were discovered: the white juice of the seed pod oozing unexpectedly from the scratched surface does after all invite investigation. But these ephemeral alkaloids do not appear to be of any use to the plant, so why are they produced?

The scientific explanation must be that the alkaloids were random mutations produced by the plant's chemical processes which, once they were found to be useful to humans, ensured the white poppy's survival by virtue of the fact that man thereafter planted and nurtured it.

Romantics and religious fundamentalists would opt for a more colourful explanation, that God created the opium poppy and its medicinal constituents for the benefit of man, just as sunsets were arranged for his edification. But the analogy is not quite apt. Sunsets have never caused wars.

There had been a history of opium taking by creative individuals, especially writers, Byron consuming it in the form of Black Drop — possibly the famous Kendal Black Drop that was four times as strong as laudanum and taken by Coleridge. Coleridge became a life-long opium addict but kept his addiction quiet, whereas DeQuincey flaunted his, and in 1821 published his 'Confessions of an English opium eater', in which he waxed eloquently about the pleasurable and heightened sensations derived from opium. The outcry that resulted among the Victorian establishment led to revision of the book, subsequent editions laying more stress on the miseries of opium addiction. Even so, the Confessions led to much copycat addiction among Victorian romantics. Bramwell Bronte read the book during the long hours of boredom in his Luddenden signal box in West Yorkshire, and when he returned home to Haworth he was soon buying opium from Bessy Hardacre, who kept the druggist's shop opposite his local, the Black Bull Inn.

Regular opium taking was not confined to inadequate romantics. The list of Victorian opium takers is impressive, including such eminent names as Elizabeth Barrett Browning, Wilkie Collins (who persuaded Dickens to become an opium user), John Keats, William Wilberforce and Florence Nightingale, who was one of the first patients to be given opium by her doctor in the form of hypodermic morphine. But opium addiction was not confined to eminent invalids or those seeking oblivion in the slums. Paradoxically the highest consumption of opium was by agricultural workers in the Fens, where opium taking had long been common and excessive.

For most of the 19th century, the opium users in the Fens, as elsewhere, could buy the drug from any corner shop that liked to stock it, but during that century there was increasing pressure from the medical and pharmaceutical professions for the supply of opium to be limited to chemists or on prescription from doctors (many doctors, then as now, supplied prescription drugs). The doctors would have liked to go further and to restrict supply to prescriptions only, and proposed this move in the 1868 Pharmacy Act, but pharmacists in the Fenland areas panicked and persuaded the Pharmaceutical Society that opium sales accounted for such a high proportion of their incomes that curtailment would put them out of business. "So what!" was understandably the doctors' response, but the Pharmaceutical Society carried the day and chemists were able to go on obliging their opium customers well into the 20th century.

There are several matchless aspects to the opium story. There is the scene in parliament in 1891 when a motion deploring Britain's involvement in the Indian opium trade was being debated in parliament, with Gladstone, the great upholder of morality in politics, slipping his customary tot of laudanum into his coffee to steady his nerves before rising to address the House.

Then there is the question that appears never to have been asked as to how the white opium poppy, Papaver somniferum, a Middle Eastern plant, came to be indigenous in Norfolk, where there was a longstanding tradition of reserving a patch of the garden for the plant, for making poppy head tea as a medicine. The answer may lie with the Romans. They had a strong presence in the area, radiating north from Colchester (Camulodunum), one of their leading strongholds, and there was a Roman road running through the area from near present day Felixstowe to join Ermine Street near Stamford. The Romans brought with them their essentials such as olive oil, garlic and wine wherever they settled, and if a valued item would grow, they planted it. They had adopted opium as a medicine, as so much else, from the Greeks. It seems more than possible, in fact likely, that they found the seeds of the white poppy took naturally to the soils and climate of northern East Anglia.

Ray Sturgess is a pharmacist from Knaresborough, North Yorkshire, with experience in the pharmaceutical industry and in community pharmacy. He has now retired and writes on health-related matters

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