May 27, 2005|By Tonya Maxwell | Tonya Maxwell,CHICAGO TRIBUNE
In a tiny laboratory in Germany, an obscure young pharmacist's apprentice managed to concentrate the power of poppies into crystals that could control coughs, ease pain and tease users into a pleasant slumber.
Friedrich Sertuerner, 22, published a paper announcing his discovery in 1805. He was ignored.
So he went back to his experiments, injecting dogs with the drug he had extracted from opium and doping himself and his buddies. A dozen years later he published again, this time naming his discovery after Morpheus, the Greek god of dreams. And this time, the medical world took note.
Two hundred years later, physicians and academics from around the globe gathered recently in Germany to toast the native son who discovered one of medicine's most important advances: morphine.
Over two centuries, the painkiller and sedative has comforted soldiers, eased the pain of the dying, calmed babies and been feared as an addictive seducer.
Sertuerner's finding ranks on the short list of groundbreaking medical advances, along with the discovery of ether, X-rays and blood types, said Dr. Jonathan Moss of University of Chicago's Department of Anesthesia and Critical Care.
Morphine, he said, remains the drug for post-operative pain against which all other painkillers are measured.
Opiates like morphine work so well because they mesh with the brain's existing hard wiring and chemical processes. Morphine triggers the release of dopamine, responsible for pleasurable sensations like the high an experienced runner feels during a workout.
It also works no matter how it enters the body, making it versatile for a host of ailing patients. They can swallow a tablet, allow it to dissolve under the tongue or have it injected into the bloodstream, muscle tissue or near the spine.
The drug's biggest drawback is constipation, along with nausea and vomiting, Moss said. So University of Chicago researchers have developed a drug, now in advanced clinical trials, designed to block those side effects.
Morphine was a staple drug for Civil War doctors in part because of that lessthan- glamorous effect on the morning constitution.
Dysentery and other camp diseases killed more soldiers than battlefield wounds, so the drug was more likely to be used to stave off diarrhea than to ease pain, according to Michael Flannery, a University of Alabama at Birmingham historian of 19th-century pharmaceuticals.
When those soldiers returned home, they carried tales of morphine addiction. About 400,000 veterans were addicts, according to lore. But Flannery, author of Civil War Pharmacy, calls those claims exaggerated.
"I'm not saying it didn't exist. But to pinpoint any drug problems to the Civil War goes a little too far," he said. "You didn't have to enlist in the Army to become a drug addict. You could walk down to the general store."
Morphine's long history and famed relief mean that almost anyone who heads to the movies has brushed up against a morphine- related story.
The pain reliever, fatal in high doses, often accompanies controversial topics like physician- assisted suicide, and Hollywood regularly churns out films with a climactic morphine moment.
Take 1983's Terms of Endearment: "It's past 10! My daughter is in pain; can't you understand that! Give my daughter the shot!" widow Aurora Greenway cried.
In Clint Eastwood's Million Dollar Baby last year, his character helped a quadriplegic commit suicide with a shot, angering many advocates for the physically disabled.
And 1998's Saving Private Ryan, like so many war movies and books, relied on a grim scene of a dying soldier ushered peacefully into slumber with a compassionate overdose.
That movie, set in World War II, depicted morphine rations as always short and precious.
Leo Litwak, a medic of the 76th Division, entered the European Theater later and doesn't recall morphine's being in short supply. But the drug was a lifesaver, he said, that often staved off shock.
Litwak, who lives in San Francisco and chronicled his accounts in The Medic, remembers crossing into Germany in early 1945.
"Rockets!" someone yelled, and Litwak dived into a trench. His sergeant, with his stomach torn open and his ankle nearly ripped off, fell on top of him.
Outside the trench, the platoon messenger's leg had been severed.
"Morphine, Leo, morphine," the messenger moaned.
Litwak nursed both men with shots, but both died as they were taken from the battlefield.
"Morphine was the only thing we could do," said Litwak. "It was probably the most important medication in our kits."
As for Sertuerner, he enjoyed recognition for his accomplishments but may have died addicted to the drug that brought him acclaim. History has not settled that question.
Biographer Rudolf Schmitz, in a 1985 paper published in the journal Pharmacy in History, wrote that no other narcotic has such a central and predictable effect as morphine, making it indispensable to doctors.
He also quoted Italian Enrico Samarelli, who bemoaned in 1934 that history already had forgotten Sertuerner.
"The glorious work of the pioneer Sertuerner brought more well-being to mankind," Samarelli said, "than either a Napoleon or a Caesar could possibly accomplish."
