In April 1884 Freud read of a German army doctorwho had successfully employed cocaine as a means ofincreasing the energy and endurance of soldiers. Hedetermined to obtain some for himself and try it asa treatment for other conditions—heart disease,nervous exhaustion and morphine addiction. It waslittle known at that time and the extensive ethicaland methodological rules governing modern drugtrials did not exist.
Freud took some himself and was immediatelyimpressed with the sense of well-being itengendered, without diminishing his capacity for work. Having read a report in the DetroitMedical Gazette concerning its value in the treatment of addictions his next step was torecommend the substance as a harmless substitute to his friend and colleague, Ernst vonFleischl-Marxow. Fleischl. Who had become a morphine addict following repeated therapeuticadministrations for intractable neurological pain and was in desperate straits, took to cocainewith enthusiasm and was soon consuming it in large quantities.
Meanwhile Freud continued to extol the virtues of the drug, writing a review essay on thesubject, taking it himself and pressing it upon his fiancee, friends as a panacea for all ills, Hehad gone overboard with enthusiasm, writing to Martha when he heard she had lost herappetite,“Woe to you, my Princess. When I come. I will kiss you quite red and fees you ‘till youare plump. And if you are forward you shall see who is the stronger, a gentle little girl whodoesn’t eat enough or a big wild man who has cocaine in his body.’’
Among the people to whom Freud introduced cocaine was his colleague Carl Koller, a youngdoctor working in the department of ophthalmology. Freud published his essay in the July issueof the Centralblatt für Therapie, concluding it by drawing attention to the possible future uses ofthe drug as a local anaesthetic. Koller was impressed, thought it likely to be useful in eyeoperations and two months later tried it out , first on animals and then on his own eyes withcomplete success. He was quick to publish his findings, thus securing a place in world history asthe discoverer of what turned out to be virtually the only medical use for the substance.
Freud had missed his chance, but worse was to follow. Fleischl’s temporary improvement ontaking cocaine was short lived. Within a week his condition deteriorated, his pain becameunbearable and he relapsed into morphine consumption. He now had not one addiction buttwo, taking cocaine in doses a hundred times larger than Freud used to do. He suffered toxicconfusional states in which he became agitated, experiencing severe anxiety and visualhallucinations. Yet Freud continued to advocate the use of cocaine in morphinism, presumablyon the basis that (as had been reported by others) it was beneficial in selected cases.
His paper On the General Effect of Cocaine. Written in the spring of 1885, was published inAugust and subsequently abstracted in the Lancer, By the following year, however, cases ofcocaine addiction and intoxication were being reported from all over the world. Freud cameunder severe criticism for his advocacy of the drug and defended himself byclaiming(inaccurately)that he had never advised its use in subcutaneous injections. Heexpressed the following view, “Theory is fine but it doesn’t stop facts from existing.” Thisbecame a favorite warning against the uncritical acceptance of received .