Photo from: Revue des Monats 1926–27, H.4, Februar (Zuschnitt)

Hannes Walter: The medical and social construction of cocainism in the 19th and early 20th century Addiction and deviance in the focus of medicine

“With the therapeutic use of cocaine, modern medicine had evoked, as the psychiatrist Albrecht Erlenmeyer phrased it in 1886, a “worthy third scourge of mankind” besides alcoholism and morphinism – cocainsm. By placing cocaine use alongside alcohol and morphine addiction, medical experts characterized the unauthorized consumption of cocaine over the final decades of the nineteenth century and the first of the twentieth as an uncontrollable and terminal pathological disorder and associated it with various forms of social and sexual deviance.

This concept was refined after the First World War, when cocaine consumption became perceived to be a widespread practice in hedonistic urban leisure culture. It was first then when the practice became tantamount to a social disease that fears of a “cocaine wave” sweeping through society prompted more intense medical research activities. After physicians threw themselves into field studies, clinical observations, and controlled experiences of the problem, by the 1920s a common clinical conception of “cocainism” emerged. Indeed, this medicalization of cocaine use culminated in the terms’ inclusion in the first manual for psychiatric diagnoses, the so-called “Würzeburger Schlüssel,” which standardized diagnoses across the German-speaking lands. And this definition, in turn, shaped the medical and public image of this addition and of cocaine users thereafter.

My dissertation will trace the social and medical construction of cocaine-use in the German lands through the multi-dimensional forces shaping its development. The aim is to analyze the interaction of natural and human sciences, on the one hand, and normative as well as cultural beliefs, on the other, to reconstruct the emergence of “cocainism” in the medical and social imaginary. In so doing, my dissertation will demonstrate how the clinical understanding of concainism was a hybrid construct linking ideas of health and normality with those of illness and deviance. Against the backdrop of the emergence of the “cocainist” as an ideal type of pathological and deficient being, in a second step I will explore how this stereotype affected not only the treatment patients received but also consumer behavior and cocaine users’ self-perception. To this end, I ask how the picture of the ideal-typical addict, portrayed in medical and medial discourses, corresponded with the experiences of clinical practice and the social structure of the patients. Since historical drug research has centered on the more influential actors in medicine, the media, politics, and the justice system, this study will contribute to this field more broadly by accounting for the subaltern voices and agency of the consumers themselves.

To examine the mutual interaction between psychiatric and psychopharmacological research, the creation and transfer of knowledge in medical specialist discourses, clinical practice as well as the self-perceptions, and the practices and motives of the consumers, my dissertation will weave together a wide range of source materials. Besides medical and pharmacological journal articles, surveys, monographs and conference reports, I will also draw on medical records from the psychiatric clinic of the Charité Berlin and the psychiatric clinic Leipzig-Dösen. By linking the sporadic ego-documents, which can be found in some medical records, with corresponding reports of police, judicial and welfare authorities, I will reconstruct the subjectivities and fates of a small number of patients in detail.

By examining the hybrid medico-social construction of “cocainism”, my project will ultimately reveal the cultural forces undergirding public attitudes toward cocaine users and the types of medical treatment they receive, which in turn also shaped consumers’ own self-image and influenced their actions in decisive ways.”

Hannes Walter is a PHD candidate in History of Science at TU Berlin. His thesis is supervised by Friedrich Steinle and Rainer Herrn.