118 
OPIUM  AS  A  THERAPEUTIC  AGENT. 
Two  circumstances  in  explanation  of  this  great  variation  in 
the  strength  of  opium,  deduced  from  the  writer's  limited  know- 
ledge of  the  history  of  the  drug,  and  not  noticed  in  the  works 
on  Materia  Medica  within  his  reach,  are,  first,  that  the  poppy, 
in  common  with  other  plants,  must  so  exhaust  the  soil  upon 
which  it  is  cultivated  year  after  year  that  its  chemical  products 
may  vary  and  deteriorate  in  the  ratio  of  this  exhaustion.  And 
secondly,  that  the  opium  reaches  Smyrra  in  small  lots  from 
various  sources,  is  there  thrown  together  in  heaps  in  the  store- 
houses as  it  accumulates  day  after  day  during  the  season  of 
transportation,  and  after  inspection  is  boxed  up  indiscriminate- 
ly from  these  heaps,  so  that  any  single  case  may  in  its  various 
lumps  represent  a  great  variety  of  original  locality,  individual 
management,  soil,  and  even  climate. 
Under  such  circumstances  it  must  be  true  that  no  therapeutic 
applications  of  opium  can  be  uniform  in  effects  or  results,  and 
that  it  cannot  therefore  properly  meet  many  of  the  indications 
to  its  use. 
The  remedy  for  this  that  naturally  first  presents  itself,  is  a 
reliance  upon  the  salts  of  morphia.  But  apart  from  the  varia- 
bility of  effects  noticed  in  the  use  of  these  salts  as  found  in  the 
market,  most  observers  have  found  that  there  are  certain  good 
effects  obtained,  or  certain  unpleasant  consequences  avoided, 
more  frequently  by  the  use  of  the  natural  combination,  while  all 
agree  that  the  whole  therapeutic  power  and  influence  of  opium 
cannot  be  obtained  from  any  salt  of  morphia.  Taking  the  whole 
profession  of  medicine  of  all  countries  in  connection  with  this 
well  known  want  of  uniformity  in  the  medicinal  power  of  the 
drug,  it  is  a  remarkable  and  significant  fact  that  so  large  a  pro- 
portion of  the  profession  adhere  to  it  and  to  these  preparations 
which  most  nearly  represent  it,  for  certain  and  very  numerous 
purposes,  in  preference  to  salts  of  morphia,  so  that  repeated 
and  continued  efforts  are  made  to  improve  the  class  of  prepara- 
tions in  which  its  natural  condition  is  preserved,  and  one  or  two 
such  preparations  are  found  in  habitual  use  in  almost  every  na- 
tion or  country.  Some  of  the  best  of  these  have  always  been 
made  by  secret  and  proprietary  formulae,  and  are  largely  used 
even  by  the  profession  notwithstanding.  It  is  not  known,  and 
perhaps  not  probable,  that  in  any  of  these;  preparations  any 
