Cocaine, surgery and an experiment too far

William Stewart Halsted is known as the ‘father of American surgery’ and was widely-known to have been addicted to both cocaine and morphine for large stretches of his life. I always assumed this was due to recreational sampling of the medicine cabinet but it turns out it was the rather unfortunate result of some initially serious scientific experimentation.

I just found this article on Halsted from The Annals of Surgery that explains the astounding and tragic story.

Halsted’s career changed dramatically on October 11, 1884, when he read in the Medical Record a report of the Ophthalmological Congress in Heidelberg. Dr. Henry D. Noyes, who had attended the conference, reported that the most notable event at the Congress was a demonstration of the extraordinary anesthetic power that a 2% solution of muriate of cocaine had on the cornea and conjunctiva when it was dropped into the eye. Later in his report, he was prophetic in his summary that “it remains, however, to investigate all the characteristics of this substance, and we may yet find that there is a shadow side as well as a brilliant side in the discovery.”

After reading this report, Halsted quickly obtained cocaine and began a series of experiments on himself, colleagues, and medical students that led to the development of local and regional anesthesia. Through a series of brilliant experiments, Halsted showed that virtually every peripheral nerve in the body could be injected with cocaine so that its peripheral distribution was anesthetized entirely and thus rendered insensitive to surgical interventions. This, of course, was of particular interest to dentists, and in 1922, shortly before his death, his priority in being the first to show the anesthetic properties possible with local infiltration of nerves was established by the National Dental Association. Unfortunately, during the process of these experiments, Halsted and several of his colleagues became addicted to cocaine. Only Halsted and Dr. Richard Hall, who moved subsequently to Santa Barbara, California, for his rehabilitation, survived. The rest died of their addiction.

Halsted’s only publication on local and regional anesthesia appeared in the New York Medical Journal in 1885. This article is a rambling, incoherent paper that is a testament to the addicted debilitated state that Halsted had reached. The first sentence of that article reads as follows: “Neither indifferent as to which of how many possibilities may best explain, nor yet at a loss to comprehend, why surgeons have, and that so many, quite without discredit, could have exhibited scarcely any interest in what, as a local anesthetic, had been supposed, if not declared, by most so very sure to prove, especially to them, attractive, still I do not think that this circumstance, or some sense of obligation to rescue fragmentary reputation for surgeons rather than the belief that an opportunity existed for assisting others to an appreciable extent, induced induced me, several months ago, to write on the subject in hand the greater part of a somewhat comprehensible paper, which poor health disinclined me to complete.”

Link to PubMed entry for article.
Link to full text at PubMed central.

One Comment

  1. rita
    Posted March 5, 2010 at 9:02 am | Permalink

    “After reading this report, Halsted quickly obtained cocaine and began a series of experiments on himself, colleagues, and medical students that led to the development of local and regional anesthesia”.
    At least he had the cojones to experiment with this stuff on himself and volunteers…………
    But what a prose style! And only a year after he started on the experiments! If taking drugs makes you write like a bad combination of Henry James and St. Paul, better stay off them altogether, I say. :)


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