opium and the people

Morphine and Its Hypodermic Use
greatly increased general number of case histories and comments on the subject gag substance to a feeling that an
epidemic was threatening.
Medical susceptibility to morphine addiction was established. Drury, for instance, thought that morphinomania was
particularly prevalent among the medical profession, and a standard medical text like Sir William Osler's The
Principles and Practice of Medicine (1894) saw doctors forming one of the main classes of addicts .35 Conventional
ideas about the weakness of the female sex were-al-so soon linked with the spread of morphine use. As the Lancet put
it, `Given a member of the weaker sex of the upper or middle class, enfeebled by a long illness, but selfishly fond of
pleasure, and determined to purchase it at any cost, there are the syringe, the bottle, and the measure invitingly to
hand, and all so small as to be easily concealed, even from the eye of prying domestics.' Most medical writings on the
subject were united in seeing women pecukarly at risk .36 Female susceptibility was linked with the iatrogenic origin
of most morphine addiction, and also with the idea of selfmedication. The apparent willingness of practitioners to hand
over control of injection either to a nurse or to the patient herself was stressed, and this usurpation of the professional
role of the doctor was a continuing theme in discussions of morphine addiction. Dr Macnaughton Jones told the British
Gynaecological Society in 1895 that no patient should be allowed to inject herself. Levinsein, too, attributed the spread
of the disease to the carelessness bf medical menrin allowing patients to inject .37
These questions of the amount of increased usage of the drug (and its hypodermic usage in particular), the numbers of
addicts at this period, and their social class and gender badly need more extended examination if the reality of the
picture presented in the medical journals is to be assessed. In certain respects, it is clear that the medical profession
was myopically exaggerating the dimensons of a situation it had helped create. How much morphine was actually
being used in England at this time is difficult to estimate. To arrive at any picture of overall home consumption of
morphine is almost impossible. Duty on imported opium ceased in 186o and no actual `home consumption' figures are
available after that date. Estimates of home consumption of all narcotics, including morphine, after 186o can only be
obtained by subtracting the amount exported from that imported. This is an uncertain method of assessing anything but
the most general trends in overall consumption. These moved upward for the first fifteen years after the abolition of
duty in 1 860, but decreased between the mid 1 870s and the 1890s.38 General trends reveal little about the production
and home consumption of domestic morphine. Morphine was not separately incorporated into the trade statistics until
1911 (and then largely because of the demands of the 1911 Hague Convention for the collection and production of
morphine and cocaine statistics). Until this date, it was included in the `drugs, unenumerated' section and measured
only in terms of financial value. The trade statistics are of little direct value in an examination of morphine production.
Yet there was a widening post-186o gap between imports and exports. This strongly suggests that much of the
imported drug was being used to make morphine, since even the best Turkey opium would yield only around 10 per
cent morphine. The general trend of home consumption also bore a strong relation to the business cycle. The
connection with the onset of the `Great Depression' of the 1870s was particularly marked, and consumption appears to
have declined. Fluctuations like this again suggest a connection with the overall fortunes of the morphine industry.
Yet how much morphine Thomas Morson and Son, J. and F. Macfarlan and T. and H. Smith in Edinburgh were
actually producing and exporting at this time remains uncertain. Wholesale business records show that morphine was
popular, but no more so than other opium preparations and derivatives. The Society of Apothecaries for instance, one
of the major wholesaling organizations, was producing large quantities of morphine preparations in the 1860s, but
fewer a decade later. Yet the importance of morphine should perhaps not be overemphasized or singled out. The
Society was still making large quantities of other opium preparations, too - it had twenty-six on its laboratory list in
1871. There were thirteen batches of paregoric, ten of laudanum, nine of powdered opium, and also of gall and opium
ointment. Morphine at this wholesale level was only a part of the whole spectrum of
opiate use. 39
This is also the picture which emerges of 'grass-roots' usage in the second half of the century. In everyday medical and
pharmaceutical practice morphine was in increased use. But there was nothing like the epidemic of rising consumption
which the medical accounts suggested. Nor was everyday medical practice a matter of hypodermic injection alone.
Morphine was used in many varied forms and there is little evidence 0f extensive self-administration of the
hypodermic syringe. The evidence of prescription books shows that morphine was in quite regular use in the second
half of the century, but that dispensing 0f the drug was not rapidly escalating. An Islington pharmacist, for instance,
dispensed fiftyfive morphine prescriptions in 1855 (from a total 0f 378), or 14.5 per cent of the whole number of
opium-based remedies. By 1865, the number had risen t0 sixty-four (out of 316), or 20 per cent. But figures in 1875
and 1885 were lower.40 Re-dispensing must be a matter of conjecture, since chemists noted only new prescriptions
and did not re-enter a copy each time an old prescription was dispensed. Clearly, however, the picture of morphine
prescribing at the level of general practice differed from the conventional stereotype. Doctors were likely to administer
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