View source for Sherlock Holmes's Cocaine Habit

{{Cargo_Research_Articles
 |date=1993-01-01
 |author=J. Thomas Dalby
 |topic=Cocaine
 |summary=This article analyses Sherlock Holmes's cocaine use within its late nineteenth-century medical context, arguing that Arthur Conan Doyle's portrayal was unusually accurate and prescient regarding addiction and relapse. It contrasts contemporary professional approval of cocaine with Watson's clinical warnings, presenting the stories as an early and remarkably modern commentary on substance abuse.
}}
''Sherlock Holmes's Cocaine Habit'' is an article written by [[J. Thomas Dalby]], PhD., published in the [[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 4, 1993).

This article analyses [[Sherlock Holmes]]'s cocaine use within its late nineteenth-century medical context, arguing that [[Arthur Conan Doyle|Conan Doyle]]'s portrayal was unusually accurate and prescient regarding addiction and relapse. It contrasts contemporary professional approval of cocaine with [[Dr. Watson|Watson]]'s clinical warnings, presenting the stories as an early and remarkably modern commentary on substance abuse.


== Sherlock Holmes's Cocaine Habit ==
[[File:Acd-society-journal-1993-vol4-p12-sh-s-cocaine-habit.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 4, 1993, p. 12)]]
[[File:Acd-society-journal-1993-vol4-p13-sh-s-cocaine-habit.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 4, 1993, p. 13)]]
[[File:Acd-society-journal-1993-vol4-p14-sh-s-cocaine-habit.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 4, 1993, p. 14)]]
[[File:Acd-society-journal-1993-vol4-p15-sh-s-cocaine-habit.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 4, 1993, p. 15)]]

Many of the professional (1,2) and lay (3) articles describing the recent epidemic abuse of cocaine give casual reference to the first popular figure to abuse the drug, London's consulting detective, [[Sherlock Holmes]]. This depiction is rarely understood for its full value as commentary on addictions from both a medical and historical vantage. As recently noted (4) until the early 1980s cocaine was generally considered to be a relatively safe, non-addicting agent and any historical reference to dependence on this substance dismissed as moralistic exaggeration. 

[[Arthur Conan Doyle|Conan Doyle]] was a prolific and rapid writer who contributed more than thirty full-length books, over one hundred and fifty short stories, as well as numerous poems, plays, essays, and pamphlets, but is best known for the four novels and fifty-six short stories that comprise the Holmesian canon. The first story, '[[A Study in Scarlet]]', was published initially in November 1887, and the final study, '[[SHOS|Shoscombe Old Place]]', was published in the Strand in April 1927. 

[[Sherlock Holmes|Holmes]]'s much publicised drug habit is directly observed in only two stories: [[The Sign of the Four]] (1890) and '[[A Scandal in Bohemia]]' (1891), with vague or historical references in seven other tales. Why did [[Arthur Conan Doyle|Conan Doyle]] inflict his character with this behavioural flaw? The view promoted by some Holmesian scholars (5) that this was for no other reason than to add to his idiosyncrasies' is unsatisfactory. [[Arthur Conan Doyle|Conan Doyle]] had watched his own father's addiction to alcohol and his eventual commitment to mental institutions. His medical knowledge of drugs also added to his appreciation of cocaine's potency. (6) Another biographer suggested that because [[Arthur Conan Doyle|Conan Doyle]] began writing A Study in Scarlet on 8 March 1886, the same day that an article on cocaine appeared in one of [[Arthur Conan Doyle|Conan Doyle]]'s favourite periodicals, [[Chambers's Journal]], that this supplied him with the idea for [[Sherlock Holmes|Holmes]]'s addiction. (7) This is a flawed deduction for no reference was made to cocaine in the story, although Watson states that he 'might have suspected him of being addicted to the use of some narcotic had not the temperance and cleanliness of his whole life forbidden such a notion.' [[Arthur Conan Doyle|Conan Doyle]] had no intention of serialising this fiction at that stage and it is thus implausible that he would lay down this suspicion to be proven true in later adventures. 

[[Arthur Conan Doyle|Conan Doyle]] has been described as a prototype of his age, holding a belief in the concept of honour and commitment to a chivalric code of behaviour. (8) Would such a man have himself experimented with drugs? To many this would have been inconceivable. But in the late 19th century there was no moral, medical or legal censure on such exploration. Indeed, while a third-year medical student, [[Arthur Conan Doyle|Conan Doyle]] engaged in auto-experimentation with tincture of gelsemium, publishing his findings in the British Medical Journal on 20 September 1879. (9) 

Did he also conduct experiments with cocaine? His knowledge of the drug is reasonable in that it is used by [[Sherlock Holmes|Holmes]] who uses other stimulants to excess (once drinking two large pots of coffee in a day [[[The Hound of the Baskervilles]]]). Individuals with unstable affective response (like [[Sherlock Holmes|Holmes]]) are most prone to cocaine abuse and a 'self-treating' hypothesis, now in vogue, suggests that choice of drugs of abuse often reflect an individual's attempt to correct behavioural or mental disorder. (10) [[Sherlock Holmes|Holmes]] states that his mind 'rebels at stagnation. Give me problems, give me work, give me the most abstruse cryptogram or the most intricate analysis, and I am in my own proper atmosphere. I can dispense then with artificial stimu- lants. (The Sign of the Four). 

In '[[A Scandal in Bohemia]]' [[Arthur Conan Doyle|Conan Doyle]] errs in referring to cocaine in describing 'the drowsiness of the drug'. This error is puzzling. Cocaine was recognised widely as a stimulant and, given [[Arthur Conan Doyle|Conan Doyle]]'s attempt to specialise as a oculist, in which profession cocaine was used as an anaesthetic, it is likely that he was well versed with the drug. His clear depiction of cocaine addiction in The Sign of the Four, published before '[[A Scandal in Bohemia]]', and accurate depiction of other drugs, (6) suggests that this is one of [[Arthur Conan Doyle|Conan Doyle]]'s infamous errors of detail. In The Sign of the Four it is suggested that [[Sherlock Holmes|Holmes]] also abused morphine and [[Arthur Conan Doyle|Conan Doyle]] may have forgotten which drug he was referring to. ACD wrote very quickly, sometimes not even revising his draft, and in his memoirs admits that he has never been nervous about details and that he was reprimanded by his readers for his lapses. (11)

The most singular aspect of cocaine in the [[Sherlock Holmes|Holmes]] stories is not [[Sherlock Holmes|Holmes]]'s habit but [[Dr. Watson|Watson]]'s reaction to it. In spite of celebrated cases of cocaine addiction (e.g., Dr W.S. Halsted), and even reports of death from cocaine use as early as 1891, there was no general medical condemnation of cocaine use in the late 19th century. The retired surgeon-general of the U.S. Army extolled its fatigue reduction and mood elevating properties, and others vigorously promoted cocaine as an anaesthetic, a cure for alcoholism and opium abuse. Freud's endorsement of cocaine at the time was extreme, suggesting that its therapeutic use might even do away with inebriate asylums. (12) Against this professional acclaim we see Watson admonishing [[Sherlock Holmes|Holmes]]: 


: 'But consider!... Count the cost! Your brain may, as you say, be roused and excited, but it is a pathological and morbid process, which involves increased tissue-change, and may at least leave a permanent weakness. You know, too, what a black reaction comes upon you. Surely the game is hardly worth the candle. Why should you, for a mere passing pleasure, risk the loss of those great powers with which you have been endowed? Remember that I speak not only as one comrade to another, but as a medical man to one for whose constitution he is to some extent answerable.'
: The Sign of the Four 


One hundred years after this was published we are beginning to confirm [[Dr. Watson|Dr Watson]]'s knowledge. (13) Previous medical explorations (12) of [[Sherlock Holmes|Holmes]]'s drug use conclude by stating that, following a cure, cocaine ceased to be a problem for him in 1894. 

The then current medical notion was that 'cure' was a viable goal for addictive behaviour. Watson knew better. In '[[MISS|The Adventure of the Missing Three-Quarter]]' (published in 1904 and dated to December 1896 (14) in [[Sherlock Holmes|Holmes]]'s time), Watson tells how he gradually weaned him from the drug mania, but relates that 'I was well aware that the fiend was not dead but sleeping; and I have known that the sleep was a light one and the waking near when in periods of idleness I have seen the drawn look upon [[Sherlock Holmes|Holmes]]'s ascetic face, and the brooding of his deep-set and inscrutable eyes. Again this reflects current models of addiction which document low probability of complete abstinence over the long term. 

What influence might this public account of drug use have had on the reading public? It has been suggested (15) that some literary descriptions of drug induced states have enticed readers into use of drugs. In the case of [[Sherlock Holmes]] there is no evidence that this occurred, and it may be argued that the destructive portrayal of the drug may have limited its abuse. Even the cocaine 'epidemic' of 1916 seems more press hysteria than fact. (16) The English media vehicle for most of [[Sherlock Holmes|Holmes]]'s adventures was The Strand Magazine. Its popularity (selling 300,000 copies in the first month) was an unprecedented event in English publishing history. A newly-literate public looked to [[Sherlock Holmes|Holmes]] as an era hero, as seen in the outcry which arose when [[Arthur Conan Doyle|Conan Doyle]] hurled him over the falls of Reichenbach in 1893. [[Arthur Conan Doyle|Conan Doyle]]'s constant theme in his writings, that of moral courage overcoming or striving against human weakness, was not lost on this audience in its perception of [[Sherlock Holmes|Holmes]]'s cocaine habit. 

[[Sherlock Holmes]], in addition to providing a literature of entertainment with perennial attraction, is an example of an accurate illustration of recreational drug abuse and its consequences. [[Arthur Conan Doyle|Conan Doyle]]'s portrayal of the seriousness of this addiction likely grew to be shared by his colleagues, but this attitude lapsed in time (17) only to be restated in the last decade. [[Arthur Conan Doyle|Conan Doyle]]'s window on medical history reminds us that in addition to fascination for the past we can scrutinise it for applicable lessons. 


'''References'''

1. Grinspoon, L., Bakalar, J.B.: Drug dependence: nonnarcotic agents in Kaplan, H.I., Sadock, B.J., eds., Comprehensive textbook of Psychiatry, 4th ed.; Baltimore; Williams & Wilkins, 1985. 

2. Kleber, H. D.: 'Cocaine abuse: historical, epidemiological and psychological perspectives'; Journal of Clinical Psychiatry, 1988; 40:3-6. 

3. White, P. T.: 'Coca - an ancient herb turns deadly'; National Geographic, 1989; 175:3-47. 

4. Gawin, F. H., Ellinwood, E. H.: 'Cocaine and other stimulants: actions, abuse and treatment'; New England Journal of Medicine 1988; 318:1173-1182. 

5. Hardwick, M.: The Complete Guide to Sherlock Holmes, London; Weidenfield & Nicholson, 1986. 

6. Maltby, J. R.: 'Sherlock Holmes and Anaesthesia'; Canadian Journal of Anaesthesia, 1988; 35:58-62; [[A.C.D. - The Journal of The Arthur Conan Doyle Society|ACD - The Journal of The Arthur Conan Doyle Society]], 1:3 (September 1990):185-192. 

7. Higham, C.: The Adventures of Conan Doyle, New York; W.W. Norton, 1976. 

8. Jaffe, J. A.: Arthur Conan Doyle, Boston; Twayne, 1987. 

9. Rodin, A. E.: 'Autoexperimentation with a drug by Arthur Conan Doyle'; Journal of the History of Medicine, 1980; 426-30. 

10. Weiss, R. D., Mirin, S. M.: Subtypes of cocaine abusers; Psychiatric Clinics of North America, 1986; 9:491-501. 

11. [[Arthur Conan Doyle|Doyle, A. C.]]: [[Memories and Adventures]], London; Hodder and Stoughton, 1924. 

12. Musto, D. F.: 'A study in cocaine: Sherlock Holmes and Sigmund Freud'; JAMA, 1968; 204:125-30. 

13. Baxter, L. R., Schwartz, J.M., Phelps, M.E., et al: 'Localization of neurochemical effects of cocaine and other stimulants in the human brain'; Journal of Clinical Psychiatry, 1988; 49:23-6. 

14. Baring-Gould, W. S.: The Annotated Sherlock Holmes, New York; Clarkson, N Potter, Inc., 1967. 

15. Montagne, M.: 'The influence of literary and philosophical accounts on drug taking'; Journal of Drug Issues 1988; 18:229-244. 

16. Berridge, V.: 'The origins of the English drug "scene" 1890-1930'; Medical History, 1988; 32:51-64. 

17. Gay, G. R., Sheppart, C. W., Inaba, D. S., Newmeyer, J. A.: 'An old girl: flyin' low, dyin' slow, blinded by snow: cocaine in perspective'; International Journal of Addictions, 1973; 8:1027-1042. 


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''Dr Maltby's article first appeared in the Irish Journal of Psychological Medicine, 1991: 8:73-74. We are grateful to that Journal's editor, Dr Mark Hartman, for permission to reproduce the article here.''
 







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