170 



POPULAR SCIEInTOE I^EWS. 



[NOVEMBEB, 1888. 



iReUtttne anU jpjarmatp. 



[Original in The Popular Science Jfewa.] 

 THE OPIUM HABIT. 



BY JOHN CROWKLL, M.D. 



Among all the therapeutical agents used in the 

 treatment of disease, none is more potent and more 

 reliable than opium ; and because of its reliability 

 it is often called the "sheet anchor " of medicines. 

 But, like alcohol, this potent drug has been the 

 means, by its misuse among the weak and thought- 

 less, of bringing moral degradation both to the 

 individual and to an entire nation. So great has 

 become this evil, that the thought of the scientist 

 and the philanthropist has been awakened, and 

 methods have been suggested for arresting the spread 

 of the physical and moral results of the dreadful 

 habit. It is really a disease of modern times ; for, 

 although the drug was used by the ancients, we 

 have no mention of the excesses of the present 

 day. Allusions to opium are made by the classical 

 writers, and Homer, Ovid, Pliny, and Virgil make 

 mention of its use, and Hippocrates and Galen con- 

 sidered it of importance. But nowhere among the 

 ancient writings which have come down to ns, nor 

 among the inscriptions found in Egyptian ruins, 

 do we find any evidence of its use as a stimulant or 

 intoxicant, such as we see in our own times. The 

 first we hear of the drug in India is in l.oll, and 

 in 1644 it was carried into China by some of the 

 Tartar tribes. But the people of both countries 

 were slow in acquiring a fondness for it, especially 

 in India. 



In 1767, however, a Mr. Watson suggested to 

 the East India Company the idea of shipping opium 

 into China; and, following this suggestion, the 

 abundant introduction of the drug into that coun- 

 try proved to be the deadly scourge which has so 

 afflicted and degraded that unfortunate people. 

 All efforts to suppress the growing evil have 

 proved abortive; and in 1860 the English, by the 

 menace of cannon, forced the Chinese to legalize 

 the nefarious traffic, and now the vice of opium- 

 eating and opium-smoking has become national 

 Calkins says that " Hindostan has become the 

 great poppy garden, and India the great opium 

 market, of the world." In our own country the 

 opium habit has been developing for about forty 

 years. In 1843 Dr. Wood of Edinburgh intro- 

 duced the hypodermic method of injecting the nar- 

 cotic; but before this, either the gum was used in 

 its crude state or in the form of some of the alco- 

 holic preparations. Since the use of the hypo- 

 dermic syringe the consumption of opium has 

 enormously increased, both in this country and in 

 Europe. The use of the drug in this form, and 

 its quick diffusion through the system, act like a 

 charm to the victim, and the resort that is made to 

 this process for the petty ills and pains of the sys- 

 tem is alarming by its frequency and by its results 



Among Eastern nations smoking has been the 

 favorite method of using opium as a sensuous habit 

 The effect of opium-smoking upon the people of the 

 Orient is quite different from that produced in the 

 temperate zone. The habit was brought into this 

 country by the Chinese; and, according to Kane, the 

 first American to indulge in the pipe was a low 

 fellow in California, who in 1868 induced his 

 associates to try its stimulant effects: and, as a 

 result, in the space of a few years opium-smoking 

 became so general upon the Pacific coast, that the 

 authorities interfered to prevent its debasing ten- 

 dencies. Opium-smoking, however, is chiefly con- 

 fined to the large cities, and is found among people 

 of Oriental habits. It is generally carried on 

 by Chinese proprietors, who in the most subtle 

 way manage their subterranean establishments. 



Smokers consume about six grains of the drug at 

 first, and increase the amount from day to day, 

 until three hundred grains are used daily. 



Habitual use of the drug causes a more or less 

 imperative demand for a repetition of the dose as 

 the effect begins to wear off. As the time draws 

 nigh, the victim begins to feel somewhat nervous 

 and uneasy; sometimes he is chilly, with a habit of 

 yawning and stretching, and oftentimes he may 

 suffer neuralgic pains in different parts of the body. 

 If the administration is not at once made, the victim 

 experiences nausea and profuse perspiration, with 

 a sense of extreme prostration and fatigue. But 

 all these distressing sensations vanish when the 

 dose is taken. After a while it is found that an 

 increase of the drug is n"ecessary in order to pro- 

 duce the desired results, and before long an amount 

 is tolerated of surprising magnitude. 



Opium-eaters take the drug in every variety of 

 form. In the crude state the gum is eaten or 

 smoked. In the liquid preparations the tincture is 

 the most popular; but paregoric is a favorite form, 

 especially with women, while the elixirs are also 

 largely used. !Morphia holds sway over a large 

 proportion of consumers, either by the stomach or 

 hypodermically. The amount of the sulphate of 

 morphia that can be tolerated by a confirmed sub- 

 ject is enoi-mous, sometimes reaching as high as 

 sixty grains in twenty-four hours. 



The organ most directly affected is the stomach, 

 and nausea and impaired digestion, and consequent 

 lack of nutrition, are among the results that follow. 

 This imperfect action of the stomach shows its 

 effects in the impaired condition of the intestinal 

 canal, and the depressing condition of a faulty 

 assimilation of the food. The red corpu.scles di- 

 minish in number, the skin becomes sallow, the 

 muscular system flabby, and the power of endur- 

 ance is greatly diminished. Obstinate constipation 

 follows, caused by paralysis of the intestinal glands; 

 and this condition is often so severe as to render 

 the action of the bowels almost impossible. The 

 action upon other organs is more or less potent ; 

 especially are the kidneys affected, and albumi- 

 naria has been traced to the use of the drug in the 

 subcutaneous injection. 



But it is upon the nervous system that the use of 

 opium produces the most profound results. It is 

 here that the pathological effect is clearly seen, the 

 influence upon the secretory glands being nierelv 

 secondary. This action extends to the highest 

 nerve-centres in the brain, and often the mental 

 and moral faculties are disturbed by a prolonged 

 use of the drug. Every physician has seen in 

 opium habitues cases illustrating, to a greater or 

 less extent, the stimulant action upon the intel- 

 lectual centres. Wliile under the influence of the 

 drug, there is seen the vivacity, the loquacity, the 

 brilliant flash of the eye, the ardor and glow of 

 the countenance, and the general super-excitation 

 so peculiar to the morbid condition, and in such 

 contrast to the depression and wretched melancholy 

 attending a deprivation of the drug. 



There are cases of society women who, having 

 spent most of the day in bed, will flash most bril- 

 liantly in the evening under the influence of the 

 drug. And the fascination of litei-ary and aesthetic 

 conversation, so captivating to the habitue's of 

 salon.t, is not unfrequently the inspiration of the 

 potent stimulant. 



When the habit is given up, the mind usually is 

 restored to its normal activity; but when indulged 

 in for years, opium may produce a permanent ener- 

 vation of the mental and moral faculties, and this 

 deterioration is no doubt due to an organic degen- 

 eration of the cerebral centres. 



The question of the moral and legal responsi- 

 bility of the opium-eater is an interesting one. 



The same rules would apply here as in the case of 

 the victim of alcoholism. A case is recorded by 

 Obersteiner, in 1880, of a young man who attempted 

 to evade punishment for theft by reason of his 

 being an opium-eater, or morphinist. His plea 

 was, that, on account of his habit, "his cerebral 

 blood-vessels were so congested that his ideas of 

 things were perverted." The plea did not prevail, 

 and he was unable to prove that he was addicted to 

 the habit. The case illustrates the danger of ex- 

 tenuating crime committed by persons while under 

 the influence of a degrading habit. 



In tlie treatment of this morbid condition two 

 methods are tried, — a sudden withdrawal of the 

 use of the drug, or a gradual diminution iu its 

 administration. Both method!* have strong advo- 

 cates; among the former, Levinstein is a strong 

 adherent of the sudden and total cessation of its 

 use, and he sustains his position by ingenious and 

 able argument and illustration. 



But this theory and practice are sharply con- 

 troverted by the wisdom and experience of the 

 managers of retreats for the victims of this dread- 

 ful habit. According to Dr. Bancroft of the 

 Concord, N.H., Asylum, gradual reduction is gen- 

 erally approved by physicians in this country. 

 The change can often be made with a good deal of 

 success up to a certain point. Thus, Dr. Bancroft 

 reports a case where twenty-seven grains of mor- 

 phine /)er rf/em were brought down to nine grains 

 in three days. After this point the reduction was 

 slower, and sometimes the use is held to the frac- 

 tion of a grain for a long time. Of course, the 

 will of the patient must be enlisted in the process, 

 as far as is possible; and hence hospital treatment 

 is the b*>t, where the oversight can be constant 

 and severe. Bartholow, in his work on hypoder- 

 matic medication, recommends the use of atropine 

 with the morphine; increasing the former, while 

 the latter is diminished. By this process he con- 

 tends that the terrible sufferings caused by the 

 abolition of the final doses are materially lessened. 



[Specially corapiled for The Popular Science Ntws.'\ 



MONTHLY SUMMARY OF MEDICAL 

 PROGRESS. 



BY W. S. WELLS, M.D. 



SuccKSSFUL transplantation of skin from a corpse 

 to a living patient is reported by Dr. Bartens in 

 the Berliner Klinische Woch. The patient was a 

 boy aged fourteen, who was suffering from a loss 

 of the integuments of both feet, consequent upon 

 a burn. Some skin was taken from the legs of a 

 man aged seventy-five, who had died twenty min- 

 utes before, and was transplanted to the boy's feet. 

 Cicatrization of the ulcers promptly followed. 



Dr Stephen Smith of New York is reminded 

 by the above {Meilical Record ) that several years 

 ago he transplanted seventy-five particles of skin 

 from a leg that had been amputated over two hours, 

 and of this number seventy-three lived, and grew 

 vigorously. 



M. BARife {London Lancef) has observed four 

 cases of variolous periostitis. The bones most 

 frequently attacked were the left tibia, the radius, 

 and the humerus. The periostitis generally ap- 

 peared five or six weeks after the onset of the 

 smallpox, and manifested itself first by severe pain, 

 limited to one part of the skeleton. There was no 

 redness or heat of s^iu ; a sort of swelling or hard 

 oedema beiug found over the seat of pain, but no 

 fluctuation. It was supposed to be identical, 

 pathologically, with the periostitis supervening ii» 

 typhoid-fever. 



