66 KBB. 



result of its prolonged and continuous use. The hepatic and general 

 metabolism is greatly reduced in activity. Jaundice is often seen. Ee- 

 tention or incontinence of urine,, and nocturnal emissions frequently 

 occur. Persons who use hypodermic injections suffer from chronic 

 abscesses appearing in the places where the needle punctirres are found. 

 Yawning, a prominent symptom of chronic opium poisoning, often leads 

 to dislocation of the jaw. 



Treatment of chronic opium poisoning. — Fully 25 per cent of the 

 Chinese population of this city (6,000 individuals) are confirmed users 

 of one or the other form of opium, and with the present law in effect, 

 and the provision that on and after March 31, 1908, no opium will be 

 imported except for medicinal purposes, our services in attending to 

 the treatment of this chronic poisoning will become more and more 

 necessary. It is true that the treatment of the chronic poisoning offers 

 no very great hope if once a person has contracted the habit. However, 

 in treating these cases it must be remembered that great variations in 

 the intensity of the habit exist among various individuals, and one 

 important point is to discover if the drug is being used as a medicine or 

 for pleasure, for, as a rule, the latter condition is the more amenable to 

 treatment. 



There are three principal methods which we may, according to the 

 condition of the patient, employ with fair success. 



1. The sanitarium or retreat. 2. The gradual treatment. 3. The 

 bromide or the alcohol treatment. 



The first step is to induce the patient to resolve to break up the habit, 

 the determination on the part of the patient liimself being very important 

 and absolutely necessary if successful results are to expected. Many 

 cases are encountered in whom the self-control seems completely to have 

 disappeared. However, if the contraction of the habit was due to pleasure 

 and is only recent, determination on the part of the patient alone, 

 together with a prescription of bitters by the physician, will often be 

 sufficient to effect a cure. In these cases the patient is under the im- 

 pression that the doctor is prescribing for him some medicine to take 

 the place of opium, and he usually is satisfied with whatever he may be 

 given. If restlessness on the part of the habitue is evident, then either 

 the bromide or the alcohol treatment may be administered with fair 

 success, but it must be remembered that bromide and alcohol are cardiac 

 depressants and are to be given with caution, and from my experience, 

 in not too large doses. Many have recommended 120 grains of bromide 

 every two hours, until one ounce or more has been given to produce what 

 is called the "bromide sleep." Others advise the administration of 

 alcohol in such doses as to keep the patient under the influence of alco- 

 holism for several days, when the further treatment is that for ordinary 

 alcoholic excess. Both of these practices are, according to my opinion, 



