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Our Love Affair with Drugs
Our Love Affair with Drugs:
The History, the Science,
the Politics
vwv
Jerrold Winter, PhD
Professor of Pharmacology and Toxicology
Jacobs School of Medicine and Biomedical Sciences
University at Buffalo

1
 1
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.

Published in the United States of America by Oxford University Press

198 Madison Avenue, New York, NY 10016, United States of America.

© Jerrold Winter 2020

All rights reserved. No part of this publication may be reproduced, stored in

a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by license, or under terms agreed with the appropriate reproduction
rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.

You must not circulate this work in any other form

and you must impose this same condition on any acquirer.

Library of Congress Cataloging-​in-​Publication Data

Names: Winter, Jerrold, author.
Title: Our love affair with drugs: the history, the science, the politics / Jerrold Winter.
Description: New York, NY : Oxford University Press, [2020] |
Includes bibliographical references and index.
Identifiers: LCCN 2019014952| ISBN 9780190051464 (hardback) |
ISBN 9780190051471 (updf) | ISBN 9780190051488 (epub)
Subjects: | MESH: Psychotropic Drugs | Central Nervous System Agents |
Substance-Related Disorders—prevention & control | Public Policy |
Drug and Narcotic Control
Classification: LCC RM315 | NLM QV 77.2 | DDC 615.7/88—dc23
LC record available at https://lccn.loc.gov/2019014952

1 3 5 7 9 8 6 4 2

Printed by Integrated Books International, United States of America

To Barbara
 CON T E N T S

Preface  ix
Acknowledgments  xi

1. Pharmacology: The Science of Drugs   1

2. Opioids: God’s Own Medicine   9
3. Marijuana: From Reefer Madness to THC Gummy Bears   31
4. Stimulants: From Coca to Caffeine   55
5. Depressants: Sedative-​Hypnotic-​Tranquilizing Drugs—From Errant Yeast
to Halcion and Its Relatives   86
6. Dissociative Anesthetics: Angel Dust to Special K to Ketamine
Clinics  110
7. Hallucinogens: Magic Mushrooms, Ayahuasca, Mescal Buttons, and
Dr. Hofmann’s Problem Child   118
8. Methylenedioxymethamphetamine (MDMA): a.k.a. Ecstasy   148
9. Pharmacological Puritanism and the War on Drugs: All the King’s Horses
and All the King’s Men . . .   162

Index  185
 PR E FAC E

This book is about psychoactive drugs. For me, the adjective psychoactive
has a touch of pretention about it. We might better say that these are
simply drugs that in various ways influence the way our brains function.
Manifestations of their influence on the brain are quite varied. There may
be the comfort provided by opioids to those who are dying or in pain or,
in everyday life, the surge of contentment for the users of caffeine, nico-
tine, heroin, alcohol, or marijuana upon the taking of their drug of choice.
Turning to the more exotic, a drug such as LSD may alter the way the world
looks to us; it may even inspire thoughts of God. All of this and more is
encompassed by psychoactive; the term, I must admit, has the virtue of
brevity and I will use it often, but we should ever keep in mind the enor-
mous complexity of our brains and the actions of drugs upon them. Adding
to the purely scientific questions which confront us are the ways in which
our society chooses to respond to the presence of psychoactive drugs.
Should they be banned and their users sent to prison, tolerated as a reflec-
tion of man’s eternal search for an escape from anxiety, pain, and the mo-
notony of daily life, or celebrated as therapeutically useful agents?
This book is an attempt to bring order and genuine understanding to
the thousands of bits of information which swirl about us concerning psy-
choactive drugs. These come to us from newspapers, magazines, television,
social media, the Internet, and in everyday conversation with family and
friends. To accomplish this end, we must strive to attain total perspective.
The rise of the Internet has made achieving such perspective both easier
and more difficult. Easier because an enormous store of information is
readily at hand; a Google search today will turn up 462 million hits for LSD,
including offers to sell us the drug. But our striving for total perspective is
made more difficult because, as we are inundated with information from all
sides, we may become, not informed, but more confused.
In commenting on those who write for the general reader about psy-
choactive drugs, Daniel Kunitz, a noted editor and author, said that “the
 (x) Preface

grail is a comprehensive tome that would reveal the secrets of all drugs
and would stand as the last, totalizing word on the subject.” Alas, Our
Love Affair with Drugs: The History, the Science, the Politics is not that book.
Indeed, the Kunitz goal has never been reached nor is it ever to be reached,
for there can be no last word on an ever-​changing subject. There is no place
for dogma in writing of these drugs. What we believe today is only the best
approximation of truth based on what has come before. We must ever be
prepared to alter our beliefs as Nature’s secrets are revealed by the methods
of science.
This book is divided into nine chapters, the middle seven of which are
concerned with individual drugs or drug classes. It is my hope that these
chapters are made intelligible by the contents of ­chapter 1, in which I in-
troduce the reader to that branch of medical science called pharmacology.
Central to that introduction is the concept of the drug receptor and the
phenomena of drug tolerance, physical dependence, and addiction. The
middle seven chapters can be read pretty much in any order. A reader with
a particular interest in hallucinogens may wish to start with ­chapter 7.
However, I do recommend that c­ hapter 1 be read first as it will provide a
basis of understanding for all that follows.
The contents of this book are largely factual, for example, the
consequences of an overdose with heroin or a heart attack following the
use of cocaine or methamphetamine or evidence of benefit provided to ep-
ileptic children by derivatives of marijuana or by ecstasy (MDMA) for a
veteran suffering from posttraumatic stress disorder. I will, however, insert
my personal opinions from time to time but, in all instances, will strive to
identify them as such. These personal opinions are most evident in the final
chapter, which deals with our war on drugs and the tools with which we
have chosen to fight it.
I welcome the reader to join me on what I hope is an informative and
even sometimes an enjoyable trip.
 AC K N O W L E D GM E N T S

There are many to whom I owe thanks. Among those who will remain name-
less are the staff of the Health Sciences Library (HSL) of the University at
Buffalo. The superb holdings of the HSL have provided me with many pleas-
urable hours and form the backbone of this book. The conversion of their
journal collection to electronic form has saved me many trips to the HSL
but unfortunately has diminished my personal contact with the staff. The
medical literature is, of course, entirely the work of countless scientists,
physicians, and scholars; some have been named, many more have not. To
each I am indebted.
I thank the students who for a time shared my laboratory and who are
now my mentors. From them I have learned far more than I taught. It was a
privilege to know them all. In the writing of the present book, I am particu-
larly indebted to Katherine R. Bonson, PhD, Scott Helsley, MD, PhD, David
J. McCann, PhD, and Chad J. Reissig, PhD. Special thanks go to Mireille
M. Meyerhoefer, MD, PhD, who read each chapter as it was completed and
offered valuable criticism.
My colleagues in the Department of Pharmacology and Toxicology of
the Jacobs School of Medicine and Biomedical Sciences of the University
at Buffalo have been unstinting in sharing with me their profound know-
ledge of drugs. Thanks go to Margarita Dubocovich, PhD, and David Dietz,
PhD, who chaired the Department during the time that this book was in
progress. David Nichols, PhD, and Rick Strassman, MD, both of whom
have been major contributors to our understanding of psychoactive drugs,
offered helpful comments regarding my chapter on hallucinogens. Rick
Doblin, PhD, kindly corrected my account of his crusade to bring MDMA
into clinical use. Daphne Lloyd-​Alders, MD, PhD, and Howard Chambers,
MD, PhD, provided support whenever it was needed.
This project would not have been completed without the superb profes-
sionalism of Jeremy Lewis and Bronwyn Geyer of the Oxford University
Press. The assistance of Raj Suthan and Leslie Anglin is much appreciated.
 ( xii ) Acknowledgments

Finally, I will be forever grateful to Andy Ross of the Andy Ross Literary
Agency for being the first to have had faith in this undertaking.
My children, Anne, Jerrold, Jr., Kurt, and Jessica, have endured decades
of my talk about drugs, and I thank them for their forbearance. The book
is dedicated to Barbara, my wife of 59 years and a constant source of
encouragement.
Our Love Affair with Drugs
 CHAPTER 1
w
Pharmacology
The Science of Drugs

A ldous Huxley once said that man was a pharmacologist before he was
a farmer.1 Although written records rarely go back more than 5,000 or
6,000 years, there is reason to believe that humans did indeed experience
the effects of a variety of drugs much earlier, perhaps even before the rise of
agriculture some 12,000 years ago in the Nile Valley. Likely drugs available
to the ancients include opiates, cocaine, tetrahydrocannabinol, cathinone,
and numerous hallucinogens. But these were drugs in their crude natural
forms: the opium poppy, coca leaves, hemp, khat, and a variety of other
plant sources. Identification of pure chemicals and a science of drugs was
much slower in coming.
Pharmacology had to wait for the rise early in the 19th century of or-
ganic chemistry, largely in Germany, and physiology, chiefly in France and
England.2 Pharmacology was born of the marriage of these two disciplines.
Signifying its maturation in this country, the first department of pharma-
cology was established at Johns Hopkins University School of Medicine in
1893. Today, pharmacology is taught as a basic medical science, along with
anatomy, pathology, physiology, biochemistry, and microbiology, to every
medical student.
Each of the drugs I mentioned earlier will be discussed in detail in the
chapters that follow, but before we do this we need a basic pharmacological
vocabulary and a little knowledge of how drugs act. Pharmacology deals
with the interaction of chemicals with a living system: the human body.

Our Love Affair with Drugs: The History, the Science, the Politics. Jerrold Winter, Oxford University
Press (2020). © Jerrold Winter.
DOI: 10.1093/oso/9780190051464.001.0001
 (2) Our Love Affair with Drugs

Although drugs act on every element of the body, we will be most inter-
ested in that most complex of organs, the brain.

DRUG MOLECULES AND OUR BRAINS

We are aware that a drug has acted upon our brains by the effects that it
produces. These effects may be as direct and unequivocal as vomiting after
apomorphine or convulsing after strychnine. These effects may be of such
subtlety as to inspire poetry or to stimulate thoughts of God. Diffuse, re-
laxed pleasure or orgasmic high; tranquility or terror: Drugs can produce
any of these reactions and more. Some drugs may even inspire us to love
our fellow man. And in every instance the effects of a drug are colored and
made still more complex by the structure and past experience and current
state of the brain upon which it acts. No wonder that humans throughout
their history have been fascinated by such chemicals.
Most readers of this book have had ample opportunity to experience the
effects of numerous drugs over their lifetime. For example, I daily ingest
what I like to call a “geriatric cocktail” aimed at staving off cardiovascular
problems. This consists of metoprolol (Lopressor), atorvastatin (Lipitor),
ramipril (Altace), aspirin, and hydrochlorothiazide. When it comes to drugs
acting on my brain, I have caffeine in the form of Coke or Pepsi or choco-
late, alcohol in beer and wine or, on a good day, a margarita or two, and, if
my sciatica is acting up, a modest dose of hydrocodone, an opioid, in combi-
nation with acetaminophen (Vicodin). In listing these drugs, you may have
noticed that I said metoprolol (Lopressor), atorvastatin (Lipitor), ramipril
(Altace), and hydrocodone in combination with acetaminophen (Vicodin).
The capitalized name is a trade or proprietary name; the other is the ge-
neric name. The trade name is the one most often heard by patients, at
least until the patent on the drug runs out and a generic form is available.
Most of the drugs we will be talking about will be addressed by their ge-
neric name, but if a drug such as fluoxetine is well known by its trade name
Prozac, I will use that as well.
The basic unit of every drug is the molecule, the smallest particle of the
drug that retains all of the drug’s properties. There are lots of them. The
modest doses of the five drugs in my daily geriatric cocktail alone contain
about 5 x 1020 molecules; that’s 5 followed by 20 zeros. How in the world
do they know where to go? I know where I want them to go: metoprolol,
atorvastatin, ramipril, and aspirin to one or another element of my cir-
culatory system; hydrochlorothiazide to my kidneys; caffeine, alcohol, and
hydrocodone to my brain. But the fact is that they don’t know where to
 P h a r m a c ol o g y (3)

go—​once in the bloodstream, my drugs, with few exceptions, bathe vir-

tually every cell and organ in my body. This does not mean that they act
everywhere in my body.

DRUG RECEPTORS

In most instances a drug produces its desired effects by attaching itself

to a structure of the cell called the receptor; receptors can be very selec-
tive, responding only to certain drugs and ignoring the rest. For example,
opiates, about which much more will be said in c­ hapter 2, reach receptors
in the brain and spinal cord to dampen our experience of pain. But there
are other opiate receptors. Some are in the gut and, when acted upon, can
cause constipation.
Although the slowing of bowel activity by opiates does not strike fear
as does addiction, constipation can be a major problem, especially in the
elderly. After being treated with an opiate for postsurgical pain, the late
comedian Robin Williams said he felt the need for a turd exorcism. More
ominously, there are opiate receptors in a primitive area of the brain, the
medulla oblongata. When opiates act on these receptors, the activity of the
medulla is suppressed; breathing is slowed and may stop entirely. Death is
the endpoint. Hardly a day goes by that we are not made aware by the media
of this pharmacological fact. The death of Prince in 2016 at the hands of
fentanyl, an especially potent opiate, was a much publicized and lamented
but not unusual example.3
The concept of the receptor is fundamental to an understanding of
drugs, and I will invoke it repeatedly in the chapters to follow. However,
in preparing to talk about a variety of drugs with disparate mechanisms of
action, I want to provide three additional definitions that are particularly
relevant to the drugs acting on my brain and to which I will make frequent
reference. These are for drug tolerance, physical dependence, and addic-
tion. Morphine, the drug that remains the gold standard for the relief of
severe pain, nicely illustrates the phenomena.

DRUG TOLERANCE AND PHYSICAL DEPENDENCE

Let us imagine that I suffer from metastatic cancer. My physician prescribes

morphine, and the pain-​relieving effects are wonderful. But, over time, in
order to maintain analgesia, it is necessary to increase the amount of mor-
phine that I receive. It is now said that I have become tolerant to morphine.
 (4) Our Love Affair with Drugs

Blessedly, that tolerance can be overcome with increasing doses of the drug.
I may, after a few months, receive on a daily basis a quantity of morphine
that would have killed me prior to my development of tolerance.
Tolerance, in and of itself, is benign. On the other hand, if I am a user
of illicit cocaine or heroin, other drugs to which a high degree of tolerance
develops, tolerance presents a problem. To acquire larger doses requires
more money. For those not blessed with wealth, available sources of more
money may involve theft, robbery, or prostitution.
During the period that I am treated with increasing doses of morphine
for my cancer pain, my brain is undergoing adaptive changes in addition to
tolerance. Surprisingly, I am totally unaware that these adaptations have
taken place. Only upon abruptly stopping my morphine are they manifest.
Taken together, the constellation of signs and symptoms that results is
called the withdrawal syndrome or abstinence syndrome. I am now said to
be physically dependent on morphine.
In the physically dependent state, so long as the direct effects of the
drug and the compensatory changes in my brain are in rough balance,
nothing very remarkable happens. If I upset that balance by suddenly
depriving myself of morphine, the fact my brain has been altered by the
drug will quickly be evident. Put another way, after physical dependence
has developed, the continued present of morphine is required for normal
function. But, so long as the drug of dependence is provided, I will not
experience withdrawal. As we will see later, avoidance of the abstinence
syndrome can become a powerful motivator for the continued use of a
drug. A full discussion of the morphine abstinence syndrome will be given
in ­chapter 2.
Tolerance and physical dependence are invariable pharmacological phe-
nomena. They have nothing to do with willpower or your moral character.
They certainly have nothing to do with the law. Every human, indeed every
living animal going far down the evolutionary scale, will develop phys-
ical dependence when exposed to an appropriate drug for an appropriate
period of time. In treating my hypothetical cancer pain in a perfectly ac-
ceptable medical fashion, it is quite likely that I will become physically de-
pendent upon morphine. Addiction is another matter.

ADDICTION

Before I provide you with the definition of addiction which I favor and
which I will use throughout this book, we need to understand that there is
 P h a r m a c ol o g y (5)

no universally accepted definition. The situation is such that 40 years ago

a committee of experts suggested that we get rid of the term as being ill-​
defined and unhelpful. Well, it didn’t go away, and it will not go away, and
we must face the fact that ambiguity and misunderstanding concerning
addiction prevail at all levels of society. For this reason, any time we en-
counter anyone trying to tell us something about “addiction,” whether it be
labeling a person as an “addict,” speaking of a drug said to induce addiction,
or suggesting a means to treat addiction, we need first to establish what
they mean by the word. Humpty Dumpty’s dictum to Alice, “When I use a
word—​it means just what I choose it to mean—​neither more nor less,” will
not satisfy us.
Let us begin with two authoritative definitions of addiction. The first
comes to us from the Federation of State Medical Boards of the United
States: “Addiction is a primary, chronic, neurobiological disease, with ge-
netic, psychosocial, and environmental factors influencing its development
and manifestations. It is characterized by behaviors that include impaired
control over drug use, craving, compulsive use, and continued use despite
harm.”4
The second definition is provided by the American Association for
Addiction Medicine (AAAM): “Addiction is a primary, chronic disease of
brain reward, motivation, memory, and related circuitry. Dysfunction in
these circuits leads to characteristic biological, psychological, social and
spiritual manifestations. This is reflected in an individual pathologically
pursuing reward and/​or relief by substance use and other behaviors.”5 The
Society provides an alphabetic mnemonic: inability to Abstain, impair-
ment in Behavioral control, Craving for drugs or rewarding experiences,
Diminished recognition of significant problems, and a dysfunctional
Emotional response.
This concept of addiction as a chronic disease of the brain,6 and thus pos-
sibly amenable to medical treatment, is antithetical to many who regard ad-
diction as a moral failure, a condition we bring voluntarily upon ourselves.
Given these uncertainties, I prefer a purely operational definition such as
that provided by Alan Leshner, a former director of the National Institute
on Drug Abuse, the primary funding agency for addiction research in the
United States: Addiction is the behavioral state of compulsive, uncontrol-
lable drug craving and seeking.7
I would amend Dr. Leshner’s definition only to add that the drug of ad-
diction must do harm to the individual. For example, caffeine is a drug that
induces physical dependence; the abstinence syndrome is characterized by
anxiety, insomnia, and headache. Most of us have known some who surely
 (6) Our Love Affair with Drugs

do compulsively crave and seek the drug but, because caffeine does no harm
except in massive doses, we do not label the users, habitual coffee drinkers
for example, as drug addicts. Alcoholism, on the other hand, completely
fits our definition of addiction. Not only is there compulsive drug craving
and seeking, but the drug harms the individual in multiple ways, including
physical damage to the liver and other organs as well as inducing recurrent
social or interpersonal problems.

DRUG-​I NDUCED PLEASURE/​AVOIDANCE

OF WITHDRAWAL

As we will see in discussing the drugs we love in the chapters that follow,
there are two major factors in the continued use of a drug of addiction.
The first, often overlooked by those who oppose the use of any psychoac-
tive drugs, is the fact that these drugs can bring us pleasure. This can take
the form of the euphoria induced by a drug such as cocaine, the relaxation
following an alcoholic drink or a deep drag on a nicotine or marijuana cig-
arette, the mystical state induced by a hallucinogen, or the relief of pain in
our lives, whether that pain be psychic or physical.
The second major factor influencing the compulsive use of an addictive
drug is avoidance of a withdrawal syndrome. Just as drug tolerance has
different implications for the patient chronically treated for pain com-
pared with the illicit user, so too does physical dependence. A cancer or
postsurgical patient physically dependent on morphine and no longer in
need of the drug can slowly be weaned off of the drug with minimal dis-
comfort and no risk of addiction. In contrast, the morphine or alcohol
addict must each day face the prospect of desperate illness; for him the
avoidance of the abstinence syndrome provides a powerful incentive
for continued use of the drug. To paraphrase Thomas Hardy, once you
have been tormented by the withdrawal syndrome, mere relief becomes
delight.
Past thinking about physical dependence and its role in addiction
was based almost exclusively on the abstinence syndromes peculiar
to opiates, drugs such as morphine and heroin, as will be discussed in
­chapter 2, and the depressant drugs of c­ hapter 5, especially alcohol and
the barbiturates. The syndromes differ in detail, but both are quite dra-
matic; abrupt withdrawal of alcohol can even be life-​threatening. Then
along came cocaine.
 P h a r m a c ol o g y (7)

PHYSICAL VERSUS PSYCHOLOGICAL DEPENDENCE

Fifty years ago it was said that there was no abstinence syndrome, that
is, no physical dependence, following chronic cocaine use, and as a result,
cocaine would be a negligible factor in drug misuse. Indeed, one writer
opined that there is no such thing as cocaine addiction.8 Yet, in 2014, it
was estimated that there were 1.5 million regular users of cocaine in the
United States, with nearly a million meeting accepted psychiatric criteria
for dependence or abuse. In 2017, there were more than 14,000 deaths
involving cocaine.9 The drug cartels are well aware of cocaine’s appeal for
many Americans; in 2017, Colombia alone produced 1,500 tons of the drug
with most destined for the United States.10
How are we to rationalize this behavioral state of compulsive, uncontrol-
lable cocaine craving and seeking which does harm to the individual, thus
fully meeting our definition of addiction, but in the absence of physical
dependence of the classical type? The explanation offered was the notion
of psychological dependence. For example, smokers of cigarettes and users
of cocaine were said to be merely psychologically dependent and not re-
ally addicted to nicotine and cocaine; these were soft drugs and not to be
compared with hard drugs able to induce physical dependence of the kind
seen in heroin addicts or alcoholics. American tobacco companies were par-
ticularly emphatic in their denial that nicotine is a drug that leads to both
physical dependence and addiction.
What has changed is that we are now willing to accept as a withdrawal
syndrome the irritability of the smoker denied his nicotine and the de-
pression of a cokehead without a line to snort and the craving of both
for a fix.11 And this is as it should be; the notion that compulsion to
use a drug is “just in your mind” forgets the wise remark of Susanna
Kaysen that “a lot of mind is brain.”12 Put more formally, the rebound of
compensatory homeostatic adjustments that manifest as anxiety, irrita-
bility, depression, or craving for a drug such as nicotine or cocaine are as
real and as compelling for the nicotine or cocaine addict as are the aches,
gooseflesh, and nausea of heroin withdrawal for the junkie. With the ac-
ceptance of the hypothesis that all human subjective states have a neu-
rochemical basis, the notion of psychological dependence and artificial
distinctions between hard and soft drugs may be discarded; addiction
and its ability to control human behavior should be our focus. Smokers
of nicotine cigarettes are as addicted as any heroin addict. Indeed, on a
statistical basis, the heroin addict is more likely to escape his addiction.
 (8) Our Love Affair with Drugs

In the chapters that follow, we will repeatedly revisit the concept of the
drug receptor and our definitions of drug tolerance, physical dependence,
and addiction as they apply to the drugs we love.

NOTES

1. Huxley A (1958) Collected Essays. New York: Harper & Brothers.

2. Holmstedt B, Liljestrand G (1963) Readings in Pharmacology. London:
Pergamon Press.
3. Winter JC (2016) What addiction really means. www.slate.com/​articles/​health_​
and_​science/​medical/​examiner/​2016/​05/​prince
4. Federation of State Medical Boards of the United States (2005) Model policy
for the use of controlled substances for the treatment of pain. J Pain Palliat Care
Pharmacother 19(2):73–​78.
5. American Society of Addiction Medicine (2011) Definition of addiction.
www.asam.irg/​resources/​definition-​of-​addiction
6. Volkow ND, Goob GF, McLellan AT (2016) Neurobiological advances from the
brain disease model of addiction. N Eng J Med 374(4):363–​371.
7. Leshner AI (1997) Addiction is a brain disease, and it matters. Science 278:45–​47.
8. Ashley A (1975) Cocaine: Its History, Use, and Effects. New York: St. Martin’s Press.
9. National Institute on Drug Abuse (2018) Overdose death rates. https://​
www.drugabuse.gov/​related-​topics/​trends-​statistics/​overdose-​death-​rates
10. United Nations Office on Drugs and Crime (2018) Coca crops in Colombia at all-​
time high. https://​www.unodc.org/​unodc/​en/​frontpage/​2018/​September/​coca-​
crops-​in-​colombia-​at-​all-​time-​high-​-​unodc-​report-​finds.html
11. Winter JC (1998) The re-​demonizing of marijuana. Pharm News 5(3):22–​27.
12. Kaysen S (1993) Girl Interrupted. New York: Vintage Books.
 CHAPTER 2
w
Opioids
God’s Own Medicine

A lbert Schweitzer called pain “a more terrible lord of mankind than even
death.” Thus, it is not surprising that humans have from the earliest
times attempted to identify plants which might provide pain relief. The
Odyssey by Homer provides a mythic account of the use of one such agent.

Then Helen, daughter of Zeus, took other counsel. Straightaway she cast into
the wine of which they were drinking a drug to quit all pain and strife, and bring
forgetfulness of every ill. Whoso should drink this down, when it is mingled in
the bowl, would not in the course of that day let a tear fall down over his cheeks,
no, not though his mother and father should lie there dead . . . Such cunning
drugs had the daughter of Zeus, drugs of healing, which Polydamna, the wife of
Thor, had given her, a woman of Egypt, for there the earth, the giver of grain,
bears the greatest store of drugs . . .1

More than a century ago, it was suggested by Oswald Schmiedeberg, a

German scientist regarded by many as the father of modern pharmacology,
that the drug to which Homer refers is opium for “no other natural product
on the whole earth calls forth in man such a psychical blunting as the one
described.”2 When today, in the fields of Afghanistan or Turkey or India,
the seed capsule of the opium poppy, Papaver somniferum, is pierced, a
milky fluid oozes from it which, when dried, is opium.

Our Love Affair with Drugs: The History, the Science, the Politics. Jerrold Winter, Oxford University
Press (2020). © Jerrold Winter.
DOI: 10.1093/oso/9780190051464.001.0001
 ( 10 ) Our Love Affair with Drugs

Virginia Berridge, in her elegant history of opium in England, tells us

that the effects of opium on the human mind have probably been known for
about 6,000 years and that opium had an honored place in Greek, Roman,
and Arabic medicine.3 I will not dwell on that ancient history but will in-
stead jump ahead to the 17th century by which time opium had gained
wide use in European medicine.
Writing in 1680, Thomas Sydenham, a British physician, said
this: “Among the remedies it has pleased Almighty God to give to man to
relieve his sufferings, none is so universal and so efficacious.”4 Sydenham’s
favored form of opium was a solution in alcohol, a combination which came
to be called laudanum. In addition to the relief of pain, opium was em-
ployed against dysentery, asthma, uncontrollable cough, fever, and a va-
riety of other ailments; even diabetes was an indication for its use. Today
opium remains in American medicine only in the form of paregoric, cam-
phorated tincture of opium. Many a parent has witnessed relief of their
child’s diarrhea by paregoric without knowing the origins of this remedy.
In the past, babies born of heroin or methadone-​dependent mothers, and
thus themselves physically dependent, have had their withdrawal syn-
drome eased by paregoric.5

CONFESSIONS OF AN OPIUM EATER

AND OTHER PLEASURES

But, as was suggested by Homer, there is more to opium than its ability to
relieve pain, fever, cough, and diarrhea. John Jones, a British physician,
published a book in 1700 called The Mysteries of Opium Reveal’d.6 In it he
said that opium also causes “a most delicious and extraordinary refresh-
ment of the spirits” as upon receiving “very good news or any other great
cause of joy.” In language bold for his day, Jones went on to say that “It has
been compared not without good cause to a permanent gentle degree of
that pleasure which modesty forbids the name of . . .” Modern film-​makers
show no such modesty. Speaking of heroin, an opioid we soon will consider,
Rent-​Boy, an opioid addict in the film adaptation of Irvine Welsh’s novel
Trainspotting, says this: “People think it’s about misery and deprivation and
death and all that shit, which is not to be ignored, but what they forget is
the pleasure of it all. Otherwise we wouldn’t do it. . . . Take your best or-
gasm, multiply by a thousand, and you’re still nowhere near . . . ”7
The smoking and eating of opium in the Orient has a long history.
Indeed, so lucrative was the Chinese opium trade for the English in the
19th century that the British East India Company conducted the so-​called
 Op i o i d s ( 11 )

opium wars to keep open the import of Indian opium into China.8 In the
West, the opium habit in China was generally viewed as no more than a
vice among the lower levels of society, and it was little recognized that
opium had become an increasingly popular drug among the working class
of England as well. In any event, opium was of little interest to European
intellectuals. This changed with the publication in 1821 of The Confessions
of an English Opium Eater.9
The Confessor was Thomas De Quincey, who would go on to be one of
England’s most prolific and admired authors. De Quincey was introduced
to opium at the age of 19 to relieve the pain of a toothache but soon be-
came a regular user for reasons which he described in The Confessions: “For
it seemed to me as if then I stood at a distance, aloof from the uproar of
life; as if the tumult, the fever and the strife were suspended; a respite were
granted from the secret burdens of the heart. . . . Here was the panacea for
all human woes; here was the secret of happiness. . . . Thou hast the keys of
paradise, O just, subtle and mighty opium.”
De Quincey was not alone in his admiration for opium. Its use was a
regular feature of romantic writers of the time: George Crabbe, Wilkie
Collins, Francis Thompson, and John Keats in England, Charles Baudelaire
in France, and Edgar Allan Poe in America were all devotees. (Some
scholars have suggested that Poe was more regular in the use of opium
in his writings than in person.) Samuel Taylor Coleridge wrote that his
epic poem Kubla Khan was inspired by an opium dream. For many of these
men, laudanum was the vehicle of choice, thus raising the issue of concur-
rent alcoholism.10
Despite lavishly praising the virtues of opium, De Quincey as well as
medical writers of the time were aware of its more sinister aspects. In the
mid-​19th century, an American textbook of pharmacology noted that the
use of opium was a vice, “very often pernicious in its effects,” and the source
of much abuse.11 However, the author went on to say that “it does little ap-
parent injury even through a long course of years . . . is less injurious to
the individual and society than alcohol and that this evil may be corrected
without great difficulty if the patient is in earnest . . .” De Quincey’s view of
the ease of “correction” of the opium habit, or as we would term it, opium-​
induced physical dependence, was less sanguine.
In The Confessions, De Quincey wrote that “I have struggled against this
fascinating enthrallment with a religious zeal and have accomplished what
I never heard attributed to any other man—​have untwisted almost to its
final links, the accursed chain which fettered me.” We should note the in-
clusion of “almost” in that sentence. In fact, De Quincey soon relapsed
and used opium on and off for the remaining 55 years of his life.12 I am
 ( 12 ) Our Love Affair with Drugs

reminded of Mark Twain’s comment that “giving up smoking is easy. I’ve

done it many times.”

MORPHINE: THE ESSENCE OF OPIUM

Pharmacologists are never pleased to deal with crude materials of unknown

composition; the isolation of pure chemicals is the goal. Only in this way
can precise studies be conducted and modifications of the original material
be made in the search for better drugs and a clearer understanding of how
they might work. It was toward that goal that a young German chemist
named Friedrich Serturner began early in the 19th century to identify the
chemicals in opium which might account for its remarkable properties.
Summarizing his results in a classic paper published in 1817, Serturner
revealed what he called “the specific narcotic element of opium.”13 Noting
that it produced sleep in dogs, he named the chemical morphine after the
god of sleep, Morpheus.
We of the 21st century, accustomed to reading about long prison
sentences for the mere possession of morphine, might find Serturner’s
methods interesting: “To obtain a reliable assessment of morphine’s action,
I myself acted as a subject and asked others to do the same . . . I persuaded
three people under the age of seventeen to join me in taking morphine . . .”
There were no legal consequences for Serturner, as it was common for
physicians and scientists of the time to experiment on themselves and on
volunteers. With the isolation of morphine, one might think that opium
quickly fell into obscurity, but this was hardly the case.
By the mid-​1800s, the stage was set in the United States for a dramatic
rise in the use of opium and its active principle, morphine. These drugs were
equally attractive to physicians for whom few other effective remedies were
available, to adventuresome youth as well as intellectuals influenced by De
Quincey, and to the huddled masses seeking respite from their bleak lives.
Often less expensive than alcohol, that other great and addictive soother
of human misery, opium and morphine were freely available in every drug
and grocery store without legal constraints.

OPIUM IN THE 19TH-​C ENTURY MARKETPLACE

Readers familiar with the Dietary Supplement Health and Education Act
of 1994 are aware that sellers of vitamins, minerals, amino acids, and bo-
tanical products in the United States are free to this day to make unproven
 Op i o i d s ( 13 )

claims for the value of these materials. Our television screens are replete
with these advertisements each night. The environment in the 19th cen-
tury was even wilder. For one thing, as I have noted, the medical profession
had few effective drugs; then as now, where no effective therapy exists,
irrational therapies will thrive. Furthermore, there was little or no govern-
mental regulation; no Food and Drug Administration existed to attempt to
rein in the hucksters. Patent medicines filled the vacuum.
The active principle of Mrs. Winslow’s Soothing Syrup, which first
appeared in 1849, was morphine. For Dr. Buckland’s Scotch Oates Essence,
it was opium. The Essence was said to be “Nature’s Nerve and Brain Food,”
useful for the treatment of a wide variety of ailments, including insomnia,
anxiety, sciatica, paralysis, and epilepsy. Claims for Soothing Syrup were
more modest but included was a suggestion for use in quieting irritable
infants and children. Given what we know of the remarkable pharmaco-
logical properties of morphine and opium, I have no doubt that adults and
children alike were often comforted by these nostrums.
A second effect, physical dependence, was certainly common, but little
attention was paid. So long as patent medicines containing morphine
or opium remained freely available, the withdrawal syndrome would be
avoided. Years earlier the editors of the Journal of the American Medical
Association noted the irony that of 20 “opium cures,” 19 contained opium.14
It was also said that the relative popularity of these nostrums “depends on
the amount of alcohol or opium they contain.” As far as the medical profes-
sion was concerned, it was stated in an authoritative textbook of pharma-
cology published in 1913 that “Opium . . . occupies a position of its own in
therapeutics and is one of the most important and most extensively used
drugs in the pharmacopeia at the present day as in the past.”15

THE CIVIL WAR AND OUR FIRST OPIOID EPIDEMIC

Patent medicines and the unfettered marketing of these products together

with widespread medical applications were certainly major factors in the
prevalence of opioid use in mid-​19th century America. However, it was the
combination of a simple invention and the American Civil War that led to
national concern about opioid physical dependence and addiction.
The shelling of Fort Sumter on April 12, 1861, marked the beginning of
a war which, by its end in 1865, would claim the lives of more than 700,000
soldiers and leave countless wounded veterans. To appreciate the role that
opioids would play, we must remind ourselves of the state of medical care
at that time. The germ theory of disease was just that, a theory, and not
 ( 14 ) Our Love Affair with Drugs

accepted by most physicians. After all, some argued, if we can’t see germs,
how can they hurt us?
Surgeons and obstetricians would go directly from the autopsy room to
the operating suite with bare hands and filthy clothing. To enter the body
surgically was to invite death. To avoid infection, a battlefield wound to
an arm or leg of any but the most trivial nature called for amputation. It
has been estimated that there were 30,000 amputations among the Union
forces alone. Opioids were freely used both at the time of operation and
to deal with postoperative pain. As a result, opioid physical dependence
among Civil War survivors was so prevalent that the condition came to be
called “soldier’s disease.” This opioid epidemic, unlike that of the present
day, was not accompanied by condemnation of the user or concern about
the consequences. No one spoke of addiction as we define it today.
The simple invention to which I alluded was the hypodermic syringe,
a hollow barrel fitted with a plunger and a beveled, hollow steel needle.
With it, drugs could be delivered not only beneath the skin—​hence the
term hypodermic—​but also into a muscle or other tissue or even directly
into the blood via a vein. The Civil War saw the first large-​scale use of
the hypodermic syringe with opioids among the first drugs administered
by this method. Many veterans and their relatives even learned to inject
themselves.

ROUTES OF ADMINISTRATION

To appreciate the role played by the hypodermic syringe in the rise of opioid
physical dependence and addiction, we need to talk a bit about routes of ad-
ministration, how drugs get into our bodies. We have already been intro-
duced to the oral route by De Quincey’s “opium eating.” After a drug is
taken by mouth, swallowed, and absorbed into the bloodstream, it passes
through the liver, where it may be altered or even inactivated. Exiting the
liver, the drug reaches the general circulation for body-​wide distribution.
In any event, this process is relatively slow. In contrast, administration of
morphine by injection into a vein allows the drug to reach its receptors in
the brain very quickly and in high concentration.
Why should it matter whether a drug reaches its receptors quickly or
slowly? The reason is that the rate of occupation of its receptors by a drug
of dependence is a major factor in the pleasurable effects of a drug; let us
call it the high. For an experienced opioid addict seeking the highest of
highs, the intravenous route is nearly ideal. Unfortunately, adverse effects
are also maximized. These range from sudden death to the more leisurely
Another random document with
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other rafts were constructed on a similar plan, and fitted carefully,
and fastened with ropes to those tied to the shore. These were
placed further out in the stream, being held in position by ropes
attached to wherries anchored up the stream. The joins between the
two sets of rafts were not visible to the elephants, who, thinking they
were still on land, allowed themselves to be driven on to the outer
rafts, where they were tethered until the time for the crossing should
come. And thus the day passed, and by the following dawn all was
ready.
The first division of the army embarked in the wherries and
canoes, the heavy-armed cavalry men being in the former, two men
in the stern of each boat holding five horses apiece by the bridles,
these horses swimming. The wherries were placed up the stream, so
as to break the current for the canoes below. The infantry soldiers
embarked in their canoes. Thus, all was in readiness, while Hannibal
and his officers remained watching for the signal. Suddenly first a
thin and then a dense column of smoke was seen rising through the
trees in rear of the camp of the Gauls.
“Advance!” cried Hannibal, himself springing into a boat.
“Advance!” cried Mago, Chœras, Maharbal, and all the other
officers.
Then, with a deafening cheer from the army in the boats, and
deafening cheers also of encouragement from their comrades left
upon the bank, the flotilla was set in motion. The Gauls, meanwhile,
had assembled in their thousands upon the opposite shore, and,
waving their spears, and shouting their hoarse war-cries, were
gallantly awaiting their advancing foe.
Suddenly cries of alarm were heard from the Gallic ranks, as
flames of fire were seen arising from the tents of their encampment,
which they had left without a guard. Disconcerted, they turned their
backs to the enemy on the river, to find themselves confronted by
another and unexpected foe in the rear. General Hanno and all his
men were upon them.
Rapidly the boats, amid renewed cheering, pushed to the shore;
rapidly, too, were the first division landed and drawn up on the
beach. Then ensued such a scene of carnage in the Gallic ranks as
had never yet been heard of. In less than an hour Hannibal’s boast
was fulfilled, and scarcely a man was left to tell the tale. Thus was
accomplished the passage of the Rhone.
 CHAPTER V.
AT THE FOOT OF THE ALPS.

When the carnage was completed and the last blow struck, Hannibal
sent for his general of engineers. Monomachus shortly appeared
before him, sword in hand, panting for breath, and covered with
blood from head to foot. A large and long gash upon his swarthy
cheek by no means lessened the ferocity of his appearance, at
which Chœras, who was standing by, tittered audibly.
“Wherefore hast thou this most sanguinary aspect, oh my chief of
pioneers?” quoth the general, in a tone of assumed severity, for he
was really in high good humour. “Thou hast surely not quitted thy
post on the opposite bank, where thy duties were to complete and
guard the means of transport across the river, and joined in the fight
wherewith thy duties had neither part nor parcel?”
Before replying, Monomachus calmly piled three corpses of the
Gauls together, two below and then one on the top, upon which
gruesome group he seated himself as comfortably as possible. Then
wiping the blood streaming from his face, he replied:
“Nay, thanks be to the gods! I had no cause to leave my post on
the elephant rafts to be able to slay a few of the cursed barbarians.
But a party of about a dozen of them had in flight seized a boat, and,
by the mercy of Moloch, just as I was fretting at mine inaction, they
chanced to come my way. So I just killed the lot. One fellow,
however, proved a bit nasty, and gave me this little remembrance.”
Again he wiped his face. “He was the last of them all,” he continued,
“so I had, fortunately, time to make an example of him, although he
fought hard, and scarcely seemed to appreciate my kind attentions.”
“What didst thou do?” questioned Hannibal.
The butcher grinned ferociously, but made no reply at first.
“How didst thou make an example of him?” again questioned his
commander.
“I took him by the waist,” answered Monomachus, “and, for all his
struggles and cries, thrust his head into the mouth of that savage bull
elephant, that king of beasts whom the men call Moloch. It was the
champing up of his skull that has caused my armour and clothing to
thus become somewhat discoloured.” And he looked down with a
grim glance of satisfaction at his bloody attire.
“Methinks ’tis thou who should be named the king of beasts more
rightly than the elephant after such an exploit as that; but, for all that,
I thank thee, Monomachus, for thy skilful arrangements for the
crossing of the river, and likewise for thy gallant defence of the raft,
for Sosilus here, who was by me, taking notes as usual, pointed thee
out to me while engaged in first killing the runaway Gauls, and then
feeding the elephant on such unaccustomed food; and, by my troth, I
think I saw thee slay nearer twenty than twelve of the barbarians.
What was the exact number of them, by the by, Sosilus?”
“Ay,” responded the sage, “the carnage being almost completed
on this bank, I, with a view to some amplifications of a work I am
commencing, called, ‘Duties and Developments of Modern Warfare,’
turned my attention to thee, oh Monomachus! after having first noted
that foolish young man, Chœras, finishing off, in most artistic style, a
naked Gaul of twice his size, with whom he had been indulging in a
somewhat prolonged combat. I requested him then to assist me in
checking the numbers of the Gauls, whom thou mightest thyself
despatch single-handed, which amounted in grand total to just—so
Chœras reckoned—eighteen and a half.”
“Eighteen and a half?” grumped out the man of blood. “How could
I kill eighteen men and a half? It must have been either eighteen or
nineteen. I could not kill half a man.”
“Easily enough,” here interrupted Chœras, who was answerable
for the numbers. “First thou didst slay eighteen barbarians, then thou
didst half-kill a nineteenth. The remainder of him thou gavest, oh
most bloody Monomachus, unto the elephant. Hence thou hast for
thine own grand total of slain got evidently only eighteen and a half.
And thus thou thyself hast killed half a man. It is simple enough
when thou understandeth arithmetic.”
The jest was a good enough one for the occasion. Monomachus,
who was not pleased at it, however, growled out a curse at Chœras
and his flippant tongue, while Hannibal laughed outright.
 “Well, repose thyself awhile on thy ghastly but apparently
comfortable couch, oh thou slayer of half men, or half slayer of whole
men, to quote Chœras, and then bring across the elephants. This
evening will do, for the army will rest here until mid-day, and the
cavalry and elephants, with which both I and thou will remain, will
form the rear guard. After mid-day, the remainder of the army will
march northward up the river, but we will ourselves first destroy the
boats and rafts, and then follow. Should Scipio wish to cross in turn,
he will be somewhat puzzled, I fancy. We will take our lightly-
wounded with us on the elephants and spare horses; the rest, I
regret to say, we shall have to destroy to avoid the risk they will
otherwise run of torture or crucifixion if left behind. But now,
methinks, we all want some food and wine, of which, fortunately,
plenty hath been captured here.”
While Hannibal and Monomachus were talking, Mago and
Maharbal rode up. The latter looked none the worse for his fall on
the previous day, and both were flushed with the delights of victory.
Mago threw himself from his horse and embraced his brother, after
first throwing at his feet a mass of golden collars and necklaces he
had brought in as spoils. Maharbal modestly remained by his horse
after saluting the Chief. He also unloaded many spoils of golden
ornaments, and laid them on the ground. He was unwounded and
triumphant, his sword red with gore from point to hilt; but he was too
exhausted to utter a word. He had that day, indeed, dealt death to
many a Gaul, and richly revenged his reverse at the hands of
Scipio’s cavalry. Hannibal knew how to reward valour, and knew also
full well the meaning of the old Roman proverb that he gives twice
who gives quickly. Taking his own necklace, he threw it round
Maharbal’s neck. Taking his own sword, he presented it to his
general, Hanno, son of Bomilcar. To his brother Mago he gave
nothing, save a return of the salute that his brother had given to him
and a compliment.
“Mago, I knew already that thou wert my brother; this day thou
hast proved also that thou art the son of Hamilcar.” And he fell upon
his brother’s neck.
The troops, crowding round, shouted till they were hoarse in
acclamation of this pithy sentence, and then the whole camp
became for an hour or two a camp of rest.
A few days later, the whole Carthaginian army, having marched to
the northward, found itself in the country of the Allobroges. These
people were not particularly the allies of Rome, yet were subsidised
by them, and therefore hostile to Hannibal. They were a race
inhabiting the slopes of the Alps, and very warlike. Their numbers
were great, and the mixed troops of the Carthaginian army were
excessively alarmed at the opposition that they were likely to receive
from this very hostile people. But a strange and lucky chance
intervened. At the foot of the passes of the Alps, the advancing
Carthaginian army suddenly came upon two armies, drawn up in
warlike array, about to attack each other. These armies were those of
a certain king of the Gauls and his brother, who were at war for the
succession. Each sent to him, before the battle commenced, envoys
asking his help. Hannibal instantly threw in his lot with the elder
brother, and together they fell upon the other, and, after a short but
bloody fight, routed him completely. After this the Carthaginian troops
were so welcomed with wine and food, and every other species of
enjoyment, that for a day or two all discipline was relaxed in the
camp, and all hardships forgotten. And then the Gallic king, having
furnished the invaders with all kind of provisions, with new weapons,
with pack horses and mules, ay, even boots for all the army, set forth
with them, giving guides for an advance guard across the first Alpine
ranges, and himself, with all his own forces, forming a rear guard for
the army for protection against the Allobroges. But at the foot of the
Alps, with many regrets, he left Hannibal, for this king of the Gauls
was not strong enough to leave his own kingdom further.
Abandoned by their ally, the Carthaginian forces were appalled as
they reached the foot of the first range, for from the plain below
every vantage point could be seen gleaming with the spears of the
Allobroges, who were determined to resist to the death the further
advance of the Phœnician forces.
The enemy crowded every mountain-top; they thronged in the
pass itself; it looked, indeed, as if the way were barred as by bars of
iron. At least, so it seemed to all the army, except to the brave and
astute Commander himself. For a few days he encamped at the foot
of the pass, remaining inactive, and resting his men. During this
period, the worthy Sosilus frequently pointed out that, according to
parallel cases, the only thing to be done was to go round and
advance by some other way. Chœras, likewise, when appealed to in
council round the camp fire, merely broke forth into verse. He did not
like mountain warfare; the plains suited him far better as a cavalry
soldier; further, he was one of those who wanted first to go back to
the coast, fight and defeat the Romans there, and proceed the rest
of the way to Italy by sea.
Therefore, when Hannibal, although well knowing his own mind as
usual, merely to keep his officers in good humour, asked the opinion
of each, including Chœras, the latter answered while tossing off a
cup of wine:—

“Most brave Commander, since thou wilt

The way seek out, ’tis plain,
For mountains suit not cavalry,
And elephants are vain.
Thus to the low ground keep thy force,
And march south to the coast,
There scourge the Roman with the horse
That is thine army’s boast.
Then from Iberia fetch the fleet,
’Twill danger save and toil,
While we, refresh’d, shall Romans meet
Upon Italian soil.”

Hannibal merely smiled, and then turned to Monomachus.

“And what wouldst thou do, my blood-thirsty general of engineers?
Canst thou not build us a bridge overhead of these barbarians, or
else dig us a tunnel below them. For to the other side of the Alps we
go or die.”
Monomachus rose, and lifting his sword, shook it savagely in the
direction of the foe on the heights ere he replied.
“Build thee a bridge, Hannibal? Ay, that can I, if thou but let me
head the van. I will build thee a solid bridge over the living with the
bodies of the dead. Dig thee a tunnel? Ay, that will I also with this
good sword, right through their livers and intestines. ’Tis a kind of
engineering that suits me right well, and I long to be at it now. My
right arm is grown quite stiff for want of practice; ’tis nigh fifteen days
since I have slain a Gaul, for I was engaged in road-mending during
thy fight the other day. But now, methinks, the time hath come for my
subordinate Hasdrubal to do a little more of the road-making work,
and for me to get back to mine old trade of fighting. I must appeal to
my good friend Sosilus to find me some parallel cases. Say, oh
learned one, hast thou not at thy command some quotation ready
from the ninety-ninth chapter of the hundred and eleventh book of
someone or another wherewith to convince our gallant Commander
that I am far more adapted to wield a sword than a pick-axe?”
“Ay, indeed,” answered Sosilus readily; “there is just such a case
on record, and I have it here in a pamphlet which I have among
many others in the pockets of my tunic.”
He commenced fumbling in his bosom, but before he had time to
demonstrate with chapter and verse the similarity of the cases,
several Gauls arrived on the scene, to whom Hannibal instantly gave
private audience in his tent.
They were spies from among the guides supplied by the friendly
Gallic king, and they had important news to communicate.
When presently Hannibal re-issued from his tent he once more
addressed Monomachus.
“Thy wish shall be granted; thou shalt come with me, and that this
very night, and thy weapon in sooth shall be a sword, not a pick-axe.
For I find that yonder hostile barbarians stay not on the heights by
night, but retire to a town within the hills, of which the name is called,
I think, Brundisium, daily re-occupying their posts at dawn. I myself
shall therefore creep up the passes this night with a chosen band
and occupy the points of vantage whereon we see their armour now
shining. At daybreak the rest of the army, under command of
General Hanno, will commence the ascent, all the cavalry and the
pack animals being placed in the van; then the infantry. Lastly, the
elephants will follow with a rear-guard under thy lieutenant
Hasdrubal, the pioneer, who will destroy the road after them for a
double purpose—to prevent the Gauls from pursuing us, and to
prevent our own men from retreating. For, once embarked upon
these Alpine passes, there is to be no going backward. We conquer
or we die; we do not return.”
Then spoke up Mago. “Brother, thou art the Commander-in-chief.
It is not meet that thou shouldst go upon this hazardous expedition
by night upon these unknown mountain passes. What will the army
do if thou shouldst fall either by the hand of the enemy, or over some
precipice? General Hanno is, indeed, most worthy of all trust, but it is
not to him that the whole force looks for confidence. Therefore, I pray
thee, send me forward in thy stead this night, and stay thou here. My
life is of little worth—thine all important.”
“Not so, Mago,” answered Hannibal; “if confidence be needed it
will be gained by seeing that the first man to mount the Alpine
passes is the Commander-in-chief himself. But give thou unto me
thine own sword, ’tis one of our father Hamilcar’s, and will bring me
luck this night, for it was blessed in the temple of Moloch in
Carthage; mine own I gave unto Hanno. I will wield it in thine honour
and mine own, and return it unto thee to-morrow if I yet live.
Meanwhile, take thou another from those I have in my tent; I have
several there of great value and good metal.”
With great ceremony, and invoking the blessing of the gods, Mago
arose and invested Hannibal with his sword, a magnificent weapon
of truest steel which had, indeed, been borne by Hamilcar in many a
fight.
That night all the watch-fires were lighted as usual in front of the
Carthaginian lines. Nothing in the camp indicated that an advance
was intended, and the Gauls on the heights, deceived completely by
the apparent inaction on the part of the foe, retired as usual from the
mountain crests crowning the passes, to the shelter of the walled
town in the valley on the farther side of this first range of the Alps.
A little before midnight, when the camp fires had burned low,
Hannibal himself started from the camp and commenced the
dangerous ascent of the mountain. No lights had he and his men to
guide their footsteps, but painfully and in silence, they stumbled on,
ever upwards, over rock and boulder, until they found and occupied
the breastworks which the Gauls had evacuated at nightfall. With
Hannibal were Monomachus and Chœras in command of a party of
dismounted cavalry. There were, in addition, about one thousand
men, who toiled wearily upwards after their bold Commander. It
being now near the end of the month of October, cold indeed were
the hours of waiting through the night, which this gallant band were
compelled to endure in the chilly pass. No moving about was
possible after once they had gained their positions, and many a man
who had become overheated in the ascent that night contracted a
chill that ere long laid him low. It was, indeed, a toilsome and terrible
night march which these soldiers of a warmer climate had to endure,
and many a man stumbled in the dark and fell over the precipices
into the roaring torrent below, his armour resounding with many a
clang as it beat against the rocks in the wretched man’s downward
course.
But for those who fell there was no succour. If they were dead,
they were dead, and their troubles were over; if they still survived,
they were left to die miserably in the dark and gloomy ravines
wherein they had fallen. For who could help them? This was merely
the commencement of the crossing of the Alps, and they merely the
advance party! How many thousand more would fall ere the fair
plains of Italy should be won?
At daybreak, the army, under Hanno, commenced in turn the
ascent of the pass. The Gauls instantly set forth to intercept them,
and crowning the heights, hurled down huge stones and pieces of
rock from every side, creating the most terrible distress and
confusion among the defenceless infantry men in the pass, and
speedily likewise driving the pack horses, mules, and cavalry
animals into a state of perfect frenzy. These creatures, many of them
being wounded, rushed madly up and down the narrow road, driving
hundreds of men over the precipices in their headlong flight, and
many of them falling themselves also.
Meanwhile the Allobroges, climbing down the mountain side like
goats, pillaged the fallen warriors, after first brutally cutting their
throats, pillaged also the fallen pack animals, and in many cases
escaped safely again up the further mountain’s side with their booty.
Hannibal, however, seeing the terrible confusion into which the
whole of his army was thrown by this dreadful onslaught, resolved
upon instant action.
 “Chœras,” quoth he, “take thou three hundred men. Crown these
heights on the left of the pass, creep over them, but keep thy force
together. Then charge and destroy all the pillagers who have
crossed the ravine. I myself, with Monomachus, will charge with our
remaining men on the other side of the ravine where the enemy are
thickest.”
Like an avalanche rushing down the Alps, did Hannibal, sword in
hand, charge at the head of his men down slopes upon which they
could scarcely keep their feet, so steep they were, but the steepness
added to the impetus of their terrible onrush. The Allobroges turned
and fled towards the city of the hills. They were, however, cut down
and slaughtered almost to a man; and Hannibal and his men, still
cutting down and slaughtering as they advanced, rushed in after the
fugitives through the gates of the city. The inhabitants were instantly
put to the sword as a warning to other tribes living on the slopes of
the mountains, and an enormous booty of cattle, corn, and pack
horses was captured.
The city was in a fertile valley, and the army encamped in and
round about it for one day to rest.
Thus did Hannibal, by his own personal prowess, although with
serious loss to his army, successfully storm the first of the terrible
Alpine ranges.
 CHAPTER VI.
OVER THE ALPS.

For the next three days the advance up the passes was continued
in peace. The Gauls came in, offering garlands and branches of
trees in token of goodwill, and gave also hostages and cattle.
Hannibal wisely pretended to trust them, thus securing a period of
cessation from hostilities; but, in reality, he remained ever on the
alert, and made all his dispositions accordingly, keeping his cavalry
and pack animals in front to prevent their being cut off, and following
in rear himself with all the heavy-armed infantry.
He was not in the least surprised when on the fourth day a
determined attack was made upon him by large forces of the enemy,
as the army was passing through a long, narrow, and precipitous
gorge, where the Gauls once more created terrible confusion among
his troops, by rolling down stones and boulders from above, and, by
their superior position on the slopes above him, actually for a time
cutting him off with the infantry from all the cavalry and baggage
animals ahead, among whom terrible losses occurred. The
maddened animals dashed hither and thither, and fell over the
precipices, many an unfortunate warrior going with them in their
headlong flight. But Mago and Maharbal, with indomitable courage,
pushed ever onward and upwards despite all obstacles, while for a
whole night long Hannibal and the infantry had to take shelter
beneath a rock, which was so precipitous that the Gallic tribes
themselves were unable to climb it or use it as a point of vantage
from which to throw down missiles.
Meanwhile Hasdrubal, the pioneer, following in the extreme rear
with the elephants, destroyed the road as he went, thus making it
impossible for any of the army to fly by the road whence they had
come. This rear guard was fortunately not attacked, for the Gauls
were so terrified by the awful appearance of the elephants, whom
they imagined to be evil spirits or malignant gods, that they dared not
even to approach the part of the line where they were. When
daybreak came, the army emerged from the pass, and the enemy,
too terrified to attack in force on more open ground, retired.
At length, after nine more terrible nights and days, during the
whole of which the army was being continually harassed by parties
of the foe cutting off stragglers or attacking the baggage, the gallant
Chief arrived with his army at the head of the pass. Here, despite the
bitter cold, he encamped on the snow for a couple of days, to rest his
men and wait for stragglers to come up.
The men were now in a deplorable condition, and their spirits at
the lowest possible ebb. Therefore, assembling as many of them as
possible around him, and pointing to the panorama of the fair plains
of Italy below, Hannibal addressed them as follows:
“My gallant troops, difficulty, danger, and death now lie behind us,
but before us lie Italy and Rome. Gaze, therefore, before and below
ye as conquerors, for all that fair country shall be ours. The tribes
below are our friends, and will welcome us heartily. Therefore keep
ye up your courage, for soon the spoils of Rome shall reward ye for
all your hardships.”
The courage of the troops was roused by these words; but alas! if
the ascent had been difficult, harder by far was the descent of the
mountain slopes. For owing to new snow having fallen upon the old,
there was no foothold. Thus men and horses in numbers slipped and
fell headlong down the slopes and precipices, rolling over and over,
and bounding from rock to rock, to finally land, battered into pulp,
thousands of feet below. And then they came to a place where, for a
great distance, two land slides and avalanches had carried away the
whole mountain-side, and the road with it. Never daunted, however,
Hannibal, Monomachus, and Hasdrubal, his pioneer captain, built in
two days, with the Numidian troops, an entirely new road over the
mountain-side, over which first the infantry, then the cavalry and
baggage animals, and lastly, even the elephants themselves were
passed in safety. But all the survivors, both men and animals alike,
were nearly dead from starvation, when at length, after fifteen days
in the terrible mountains, the snow was left behind, and the land of
the Taurini, bordering that of the friendly Insubrian Gauls, was
entered on the plains.
 But, whereas Hannibal had started to cross the Alps with nearly
double that number, when the muster was taken round the camp
fires on the first night after the awful journey over the mountains,
only twelve thousand Libyans, eight thousand Iberians, and six
thousand cavalry of all kinds, were present to answer the roll-call.
And with this small force of starving and disheartened troops
Hannibal now prepared to meet all the might of Rome.
So wretched, indeed, were the troops, that not even the fact of
their having at length reached the Italian side of the mountains in
Cis-Alpine Gaul could at first put any heart into them. It was now the
commencement of the month of November, the oak trees were
shedding their leaves, and the grass and herbage losing rapidly the
succulent qualities necessary to sustain the animals. All traces of
cultivation had long since been removed from the fields, while the
wind sighed and moaned sadly through those vast forests of pine,
the home of the wolf and the wild boar, the shelter of whose gloomy
recesses the half-starved army was glad enough to seek.
Biting showers of rain and sleet added to the discomfort of the
troops, and at first the Insubrian Gauls showed but little alacrity in
bringing in the much-needed provisions. Altogether, now that this
remnant of the Carthaginian army had at length reached, after five
and a half months’ marching, this land of promise, it fell far below
their expectations. The whole outlook was indeed so gloomy that
there was not an officer nor man in the whole army who did not
heartily wish himself back again in his own home in the sunny lands
and olive groves of Spain or Libya.
To make things even yet worse, one or two Gallic towns in the
neighbourhood, among them notably the city of the Taurini, which
might have accorded shelter to the half-famished troops, being
fearful of Roman retribution, flatly refused to open their gates to the
wayworn wanderers. This was scarcely to be wondered at, seeing
that the Consul Flaminius had but a short time before defeated the
Boii, the Insubres, and other Gallic tribes repeatedly, and treated the
survivors with the greatest severity, taking many hostages, who were
now entirely at the mercy of the Romans; and founding two Roman
colonies, named respectively Placentia and Cremona, one on either
bank of the river Padus or Po, right in the midst of Cis-Alpine Gaul.
 As Hannibal, accompanied by Silenus and by all his principal
officers, marched round and made a thorough inspection of the
camp a day or two after arriving in the Italian plains, it must be
owned that even he himself felt utterly discouraged. For wherever he
looked, whether at man or beast, he saw nothing but misery and
starvation. The thirty-seven elephants with which he had started
were already considerably diminished in number, many having fallen
down the Alpine precipices, and the remainder were now but gaunt
mountains of skin and bone. The horses tethered in rows showed
distinctly every rib in their carcases, and hung down their heads with
fatigue while patient misery was expressed in their lack-lustre eyes.
Among the men, not the slightest element of discipline had been
relaxed; but, as they stood in their ranks before their tents for the
inspection of their Commander-in-chief, looking like phantoms of
their former selves, utter dejection could clearly be read in every
countenance. Except for the want of a little food they were in hard
enough condition, but there was not sufficient food to be obtained by
fair means, and the men did not look either strong enough or in good
enough spirits to obtain it by force of arms. That, however, was what
Hannibal intended that they should do, and he took, therefore, very
good care neither to show by his face the disappointment which he
felt at their miserable plight, nor the fact that he had received
alarming news, which, had it been known publicly, would have made
the men more disheartened still.
Instead of doing anything likely to keep the troops in a despondent
state, he spoke, as he went along the ranks, words of commendation
and encouragement to all. He praised their valour, told them that
their names would live in history, informed them that he had received
ambassadors with promises of assistance from the Boii, and
generally tried to cheer their waning hopes. After this, he held before
the army some gladiatorial contests among the young Gallic
captives, whose condition was so miserable from the ill-treatment
and blows they had received in crossing the Alps, that the army
would have pitied the survivors even more than the slain had not
their Commander rewarded the conquerors liberally with horses,
cloaks, and suits of armour.
 After these contests he addressed the army. He pointed out to
them that their own condition was similar to that of the captive Gauls
whom they had just seen fighting, and that, if they maintained a stout
heart, either victory and great rewards would be theirs, or a death
nobly won on the field of battle; but that if flight were attempted it
must be useless. For how, Hannibal urged, would any attempt at
flight be successful back over those terrible mountains and all
through the country of Gallia to Spain? Therefore, since any attempt
at flight would be useless, a stout heart, a stout arm, and a
determination to conquer were all that were needful, and victory and
numerous spoils would most assuredly be theirs.
Having cheered all the men with these words, and being ably
seconded by the superior officers, who were themselves once more
fired with his enthusiasm, the Commander, on the following few
days, attacked with fury Turin and the other Gallic towns that had
withstood him, and speedily carried them by assault. And after this
provisions were plentiful, everything was more cheerful in camp, and
thousands of Gauls, both Insubrians and Boii, commenced to come
in daily, and attach themselves to the Carthaginian standard.
Before, therefore, Hannibal thought it necessary to inform his
officers and the army of the news that he had received, he found
himself in an entirely different position in which to meet the Romans
from that in which he had been a week previously.
And he was indeed about to meet the Romans, and that very
shortly, for his news was that Scipio had rapidly returned by sea from
Marseilles to Italy, and was already nigh at hand.
“Hast thou heard the news, Maharbal?” quoth Chœras, early one
morning, bursting into the tent that they occupied in common, and
flinging down his sword and shield, “hast thou heard the news? It
seemeth that Publius Scipio hath returned from Massilia, and landed
with a small force at some place in Etruria. Moreover, he hath, while
travelling northward, crossed the mountain range called the
Apennines, traversed the country of the Boii, and is at this moment
at the new Roman city or colony called Placentia, on the other side
of the Padus. Scipio is not, in fact, very many stadia from the place
where we now are ourselves, since this river Ticinus whereon we are
encamped floweth into the Padus, as thou knowest, not very far
above Placentia.”
Maharbal was resting where he had been sleeping on a couch of
wolf skins on the floor of the tent. As he rose to a sitting posture, he
looked a very different man to what he had been at the time of the
cavalry fight on the banks of the Rhone—so gaunt was he and
drawn, that the muscles of his neck and biceps stood out now like
wires of steel, for there was no flesh to conceal them. He had been
dreaming a dream of love, with Elissa as its heroine, and was angry
at being disturbed. He laughed aloud scornfully.
“Wilt thou never have done with thy foolish jesting, Chœras? But
this is indeed a sorry jest of thine. Publius Cornelius Scipio already
at Placentia! Why, ’tis not yet a month since I bore off his young cub
of a son almost into our lines at the camp upon the Rhodanus. Nay,
nay, my merry-hearted lieutenant, I may know more of horses than
geography, more of dealing death than determining distances, but
this is just a little too much. If this were all the cause thou hadst to
disturb me, I would that thou had left me to sleep, for I am in sooth
sorely fatigued after pursuing and cutting down the last force of
those dogs of Taurini the whole of yesterday.”
The young Colossus sank back upon his couch, and would have
slept again if his comrade had but allowed him.
“A sorry jest! I would it were but a sorry jest,” returned Chœras;
“but, by the head of Hannibal, it is unfortunately no jest, but true. I
had it from Hannibal himself. It seems that the Chief, and Silenus
also, hath known the matter for these several days past, but it was
purposely kept secret until after we had conquered the Taurini, which
conquest hath now raised the hearts of our men, and induced also
many of the Gauls to rally around us. It appeareth that Scipio at first
followed us, but finding we had crossed the Rhone, after returning to
Massilia himself, he sent his brother, Cnœus Scipio, with most of the
Roman army on into Spain to fight with Hasdrubal; then he came to
Pisa by ship, with very few men, but at Placentia there are,
unfortunately for us, a Roman legion or two which were assembled
to hold the Gauls in check during the late Gallic rising; there are also
a large number of Gallic cavalry in the Roman pay. In addition to all
this about Scipio, the General hath imparted to us other weighty
news. It appears that the other Roman consul, Tiberius Sempronius,
hath been recalled from Sicily, where he was about to make a
descent upon Carthage itself, after having defeated a Punic fleet off
Lilybæum, and alas! captured Malta. He is now, so Hannibal informs
us, at a place on the Adriatic coast called Ariminum, and is
encamped there with a very large force. Hannibal is anxious, if
possible, to prevent a junction of the two forces.”
“Then this is no place for me!” cried Maharbal, springing to his
feet, and hastily buckling on his armour; “there can be no rest for the
weary with such tidings as these.” And he picked up his sword and
buckler and strode off to the General’s tent, after first directing
Chœras to go round to the cavalry lines, and to see that all the
horses were instantly properly groomed and fed, and that all the men
remained in camp. For he expected more work shortly, though he did
not know how soon it might be.
Hannibal was sitting at the door of his tent studying a map which
the worthy Sosilus was explaining. He rose as Maharbal
approached, and welcomed him warmly. He knew that Maharbal with
a portion of his force had only returned very late in the night from the
prolonged and bloody pursuit of the Taurini. Chœras, who had been
left in camp, had borne him a verbal report sent by Maharbal to that
effect and delivered upon Hannibal’s awakening. But he had not
seen his well-beloved Numidian leader since his return, and
therefore questioned him anxiously.
“And so, Maharbal, my lad, thou hast, it seems, entirely disposed
of the last of the Taurini. Hast made many prisoners?”
“Nay, my lord, I made no prisoners. I deemed it wiser, since they
were our enemies and evidently the friends of Rome, to kill all whom
we should overtake! ’Twill also make the other and friendly Gauls all
the more friendly, than had we spared those of a disaffected tribe.
But some of them fought hard and ’twould, methinks, have been no
easy job to make prisoners of them.”
“Fought, did they? the dogs! And hadst thou any losses,
Maharbal?”
“Ay, alas! I had, and far too many for a mere pursuit; they amount,
unfortunately, to no less than thirty killed and wounded men, my lord
Hannibal, of whom fifteen are dead. Among them was a most gallant
young fellow, the ensign Proxenus. He was a Greek by birth, but
came over from Libya with the last reinforcement. He will be indeed
a serious loss, for he had both brains and bravery in equal
proportions.”
“Proxenus! is Proxenus, that likely youth, dead? Alas, I grieve to
hear it, and especially that ’twere his lot to fall against such an
unworthy foe as the Taurini. ’Tis sad, indeed. But so it wert not thou
thyself, Maharbal, my grief is fleeting, for daily do we lose useful
men, and young men, too; but they can be replaced. Had it been
thou now, ah, that would indeed have been another matter.
Therefore see to it, Maharbal,” the Chief continued, with a smile,
“that thou let not thyself be killed for many a long day to come. For
Carthage could ill dispense with thy services either at present or in
the future.”
Maharbal flushed and bowed at the compliment, and then
Hannibal called to a slave to bring a stool, and bade him be seated.
After this two Gallic chieftains, who had brought in intelligence, were
called, and together Hannibal and Maharbal, aided by the learned
Sosilus, worked out on the map from their information the respective
positions of the various forces now in the field. When this had been
accomplished, Hannibal rose, folded up the map, and dismissed
Sosilus. Then turning to Maharbal he inquired the state of his men
and horses, and if they would be in a fit condition to march again that
same afternoon or evening if required absolutely to do so.
“March, ay, they could march, my lord, a short march, and could
even fight a little at a pinch; but to fight, and fight well, against fresh
troops, especially after themselves making first a long march, they
would be quite unfit. It would be but throwing away uselessly the
lives of both men and horses.”
“And we can spare neither. Well, we must let it be until to-morrow,
when both men and horses have been rested. There are some other
advantages about the delay. We shall not have so far to march as
will the enemy before we meet them, and therefore our horses will
be the fresher. The Gauls said that Scipio is building and hath almost
completed a bridge across the Ticinus, by which to cross and attack
us. If we with our horse can only catch his cavalry apart from his
infantry and drive the attack home well in front and flanks, we will
force him right back to the crossing place, and perhaps inflict
considerable slaughter ere he can again pass the bridge. Meanwhile,
listen to my plan for the strong cavalry reconnaissance which I intend
to make to-morrow, in hopes of meeting Scipio while similarly
employed. I shall personally, attended by General Monomachus,
whom for the future I shall definitely appoint to the cavalry, lead the
Iberian horse, which will be in the centre. Thou wilt divide thy
Numidian horse into two parties, one to remain on each flank. After
that thou thyself knowest what to do, as usual being guided by
circumstances, which I must leave to thine own judgment to be met
as required. And now, Maharbal, ’twere wise that thou shouldst retire
and take the rest that thou must greatly require.”
“Nay, Hannibal, I require no rest. I am quite sufficiently restored
from all fatigue by the hopes of so soon meeting the Romans once
more, for my heart burns with shame within my breast when I think of
how I was compelled to fly before them when last we met.”
“Tush, man! thou didst not fly; thy troops yielded to superior
numbers, that was all, and I sent thee out not to fight that day, but to
see what the enemy were about. Moreover, thou thyself didst nearly
end the war, and at the very first encounter, by carrying off young
Scipio. But ’twas not to be—and now, for a space, I would speak of
other matters. Come within the tent; ’tis chilly without. We will take a
cup of wine.”
Maharbal entered with his Chief, who carefully closed the entrance
of his tent, after having first summoned a slave to bring him a flagon
and some wine-cups, which were filled.