CH 



OPIUM 



When <i|iiiini is used habitually a tolerance for 

 it IK-COMICS established, iiinl enormous doses may 

 lie taken wit limit any special effects. In medicine 

 it in used chiefly to procure Bleep niul relieve 

 jMiin. Fr these pur|>o-e- it has no equal. It 

 18 also emploxed to arrest secretions, to allay irri- 

 tntioii. ninl in diarrho-a. In diabetes, heart disease, 

 h.emoptvsis, and many other conditions it is gi\en 

 with mftl advantage, Proliably no remedy has 

 Mirli wiili' ami uni\ ei-.il application-. 



It must IK- given with great caution to young 

 children, Imt nmny other factors, Hiicli as pain, 

 Imliit. idiosyncrasy, and various diseases influence 

 its action and dosage. 



Poisoning. About half the deaths from poison 

 which occur in the United Kingdom are due to 

 opium or its preparations. When the effects of a 

 large dose become fully developed the person lies in 

 deep ronm and in a state of complete insensibility. 

 Respiration in slow, noisy, and stertorous, the 

 pupil is contracted to a 'pin-point,' and insensible 

 to light, the pulse is rapid and weak, or sometimes 

 full and slow, the face and skin generally are pale 

 and livid, and covered with cold perspiration. 

 Constant stimulation may rouse the patient par- 

 tially, but lie always tends to relapse into stupor. 

 Death is due to paralysis of the respiratory centres 

 in the brain, but may be due to apoplexy or 

 collapse. Such are the usual symptoms, but many 

 cases present |ieculiar features, such as convulsions, 

 vomiting, diarrhoea, delirium, dilated pupils, MM 

 other anomalous symptoms. The pott-murtnn 

 appearance* are not characteristic, but tin- cerebral 

 blood-vessels are usually very full, and there may l>e 

 effusion of serum into the ventricles. The smallest 

 fatal dose recorded for an adult is four grains, but 

 enormous quantities are often taken without serious 

 symptoms. In infants very minute doses (\ to i 

 grain ) may prove fatal. Death may occur in about 

 two hours or even less ; few cases are prolonged 

 bevond twenty four hours. 



The treatment consists in making the patient 

 vomit, and in washing out the stomach with large 

 quantities of water. Owing to the state of insensi- 

 bility emetics sometimes fail to act. Atropine is 

 often given subcutaneously, while coffee or tea or 

 caffeine may IB- also freely given. The patient 

 may be further aroused by keeping him moving 

 altout supported by attendants, by cold cloths 

 applied to the chest, and by electric stimulation. 

 Any violence or measures which tend to exhaust 

 the patient should be carefully avoided. 



ii/iitiin-caliuy. The habitual consumption of 

 opium or any of its preparation* by persons other 

 wise in good health is known as opium-eating, the 

 opium habit, morphine habit, or morphinism. 

 Opium, laudanum, elilorodyne, black drop, nepenthe, 

 morphine, ami other forms are all used. They are 

 iiio-t commonly taken by the mouth, the sub- 

 cutaneous injection of Morphine (q.v.) I wing almost 

 entirely confined to the more cultured and edu- 

 cated classes. Its habitual use is usually 

 IB-gnu to relieve pain or sleeplessness, and one 

 month's constant use is said to be sufficient in 

 many cases to confirm the habit. The amount 

 consumed by different individuals varies great I v. 

 Of morphine most habitues take aliont three grains 

 daily, some five or six grains, while a few go much 

 higher. I)e Quincey says that at one time of his 

 life he consumed 8000 drops of laudanum daily, 

 but his ration was verv excessive. The immediate 

 effect* are a feeling of stimulation and well-lieing, 

 but as soon as these have passed off there ensues a 

 state of de|K>ndencv, to banish which a fresh dose 

 i* taken. It is a craving brought on by indulgence, 

 and is to lie ranked with such habits as drinking. 

 smoking, gambling, Vc. Many per-ons indulge this 

 craving during their whole life, and do their daily 



woi k well. Such persons do not, however, go to any 

 great excess, although they may have the craving 

 as markedly as others who suiter intensely from 

 well-developed symptoms of chronic opium poison 

 ing. The typical opium eater is lean and pale, with 

 dull, glazy eyes; he suffers from chronic dv-p, ; 

 from nervous irritability, and disturbance.- ot tin- 

 circulation. Alliiiminuria. glvcosuria, and various 

 other disorders are sometimes present. Sudden 

 deprivation causes never** nervous disturbances and 

 not seldom alarming collapse, h'oi successful In 

 mem of the opium craving tin* patient had liett-r 

 be removed from his own home ami friend- to some 

 institution where he can be under strict and 

 constant medical supervision. There is a differ- 

 ence of opinion as to whether the opium should be 

 abruptly or gradually withdrawn. Recovery is 

 generally complete in a few weeks, but relapse* 

 into the habit are exceedingly apt to occur. 



Opium-mnolriiiff. The smoking of opium as a 

 stimulant-narcotic is practised chiefly in China, 

 India, liorneo, and the far East. In China prob- 

 ably about 1 per cent, of the entire population 

 smoke opium, but the habit is growing rapidly. 

 In 1707 only aliout 200 chests of opium were im- 

 ported yearly, while in 1854, 78,000 diesis were 

 needed. Fines, penalties, and even death have 

 Iwen found ineffective to stop the practice. Opium 

 prepared for .smoking is called cliuiuln, which is 

 simply a watery extract, almut twice the strength 

 of the original drug. A special form of pijic is 

 used, a piece of prepared opium al-oiit the si/e of 

 a pea is placed, by mean- ot a small flattened iron 

 pen, into a small cup at one end ; this is ignited 

 and the smoke inhaled, and then slowly exhaled 

 through the nostrils. As a result, Easterns experi- 

 ence mental and physical excitement, followed by 

 a pleasant sense of well-lieing and content, ana 

 then narcosis. Europeans, as a rule, are not 

 affected by it to any appreciable extent. In the 

 pipe the Opium is destructively distilled, and chielly 

 the products of destructive distillation come over in 

 the smoke pyridine, collidinc, and similar bases. 

 There is probably scarcely a trace of morphine. 

 The flavour of tlie smoke is mild and aromatic. 

 In China and Singa]>ore there are public smoking- 

 hiiu-cs. but it is also largely practised in private. 

 It is reported that there are a million opium- 

 smokers in the United States, especially in San 

 Francisco and New York. 



There is great difference of opinion regarding the 

 hint Milne of the habit. Some authorities hold 

 that in moderation it is not more hurtful than 

 tobacco, while missionaries and others maintain 

 that the habit is fraught with moral, social, and 

 individual degradation. This seems to depend 

 largely on the extent to which it is carried, and 

 the question is probably OD all fours with that of 

 alcohol in this country. Many Chinese smoke 

 opium all their lives in strict moderation without 

 apparent harm, while others have excessive de- 

 bauches lasting a week or more, and often become 

 confirmed in its excessive use. The latter without 

 doubt wreck their constitutions and sutler in much 

 the same way as conlirmed alcoholics do. 



See the articles LAPDANFM, MOIIPHINE, POISON ; th 

 medical works on utimulaiiti and narcotic*. Ag to the 

 hannfulnets of the tuc of opium, nee Calkin, Opium and 

 Ikt Opium Appetite (Phila. 1870) ; H. H. Kane, Opium- 

 tinokinti in America, and China : a Stmlit tif iVj* I'rei'al- 

 enccaml Kfftrti I New York, 1SS2); tlic publication!* "f 

 the Society for th Suppression of the Opium Trade 

 (founded 1874); W. J. Moore, The Other Niile of the 

 Opium Quetlinn. and W. H. Brcreton, The Truth about 

 Opium ( 1882, for the defence ). The Report of the Indian 

 Opium Commission (18U5) indicated great dm-miti,.* 

 of opinion many affirming it to he lew harmful than 

 alcohol ; hut by a majority advised against interference 

 by government. For the Opium Wan, ice CUINA. 



