Views & Reviews MEDICAL CLASSICS

Phantastica

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39132.459236.94 (Published 22 February 2007) Cite this as: BMJ 2007;334:429
  1. Jeff Aronson, reader in clinical pharmacology, Oxford jeffrey.aronson@clinpharm.ox.ac.uk

    Louis Lewin (pronounced Leveen), whom some have called the father of toxicology, died in December 1929, aged 79. He spent a lifetime studying morphine and cocaine, mescaline from Anhalonium Lewinii (the peyote plant, named after him by Hennings), the harmala alkaloids, Piper methysticum (kava kava), and Chavica betel. And he left a legacy of almost 300 journal publications and several monographs on toxicological, forensic, ethnographic, pharmacological, and historical topics.

    Lewin eventually became a full professor at the Friedrich-Wilhelm Universität in Berlin, although for various reasons (mostly the usual ones) recognition took a long time coming. His most important works were Gifte und Vergiftungen—Lehrbuch der Toxikologie (Poisons and Poisoning—a Textbook of Toxicology, 1885), and Die Nebenwirkungen der Arzneimittel (1871), a compendium of information about the adverse effects of drugs, which preceded by 70 years the first edition of Leopold Meyler's similar, and now standard, work, Side Effects of Drugs.

    But Lewin's most accessible book is Phantastica, in which he describes a wide range of what we nowadays call recreational drugs. After some introductory remarks, he outlines pharmacological tolerance. His examples range from adaptation by freshwater amoebae to increasing concentrations of salt in their environment, to the adaptability of Everest mountaineers to the adverse effects of altitude. He then mentions interspecies variability, and he regales us with the information that hedgehogs can endure large quantities of cantharides, that opium does not intoxicate ducks, hens, and doves, and that the rhinoceros bird can consume nux vomica seeds, titmice stramonium seeds, and snails belladonna leaves, all with impunity.

    Lewin then deals in detail with the major psychoactive drugs, including morphine, heroin, cocaine, cannabis, peyotl, fly agaric, henbane, datura, alcohol, chloral, kava kava, betel, coffee, tea, cocoa, and tobacco, classifying them as euphorics, phantastics, inebriants, hypnotics, and excitants. His descriptions have not, in my view, been bettered anywhere. As the first investigator, both toxicological and anthropological, of Piper methysticum, he details the nature of the plant, how kava kava is prepared and drunk, its effects, and its active ingredients. He then paints the plight of the kavaist, “incessantly tormented with the craving for his favourite beverage . . . degenerate through prolonged abuse . . . eyes red, inflamed, bloodshot, dull, bleary, and diminished in their functions . . . extremely emaciated.” Not what Western purveyors of kava tell us. Of all the vignettes, that on alcohol is the best, illuminated by a profound historical perspective. Here, among many other things, we learn how alcoholic beverages have been prepared through the ages, around the world, by fermentation and distillation techniques used by Anglo-Saxons and Aymaras, Kalmuks and Quechuas, Tatars and Tungus. And a sober essay on temperance and abstinence gives counterbalance to the intoxicating language and lore of inebriation.

    The word phantastica comes from a Greek word meaning to shine, and that's what Lewin does here. One could get drunk on his literary prose, with its historical allusions, without needing recourse to the substances themselves. But don't rely on my hallucinations: read this classic yourself.

    Footnotes

    • By Louis Lewin

    • Georg Stilke: Berlin, 1924; reprinted by Park Street Press, 1998

    View Abstract

    Log in

    Log in through your institution

    Subscribe

    * For online subscription