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of laudanum daily, for many months. Occasionally he ran up to five hundred, and once nearly to seven hundred. We believe it is not known how much Coleridge was in the habit of taking daily, but, according to all the accounts we have of him, it was “inordinate." De Quincy took it medicinally as well as pleasurably, but Colderidge seemed wholly enamoured of it, though troubled and shocked by the occasional glimpses he got of how he was degrading and destroying his intellect. He was continually sipping laudanum, and he saturated his system with it. Blair took forty grains of opium daily. The anonymous Philadelphia patient does not give, in so many words, the quantity he took, but from certain expressions he lets fall, it may be inferred that he consumed from half an ounce to an ounce daily; in addition to which he habitually smoked tobacco, and drank alcohol, strong tea, and coffee. He must have had a constitution of iron, since he ultimately recovered.
The unfortunate G. W. Brush, a clergyman of Delaware, who committed suicide on the 25th of January, 1868, fell a victim to the worst and most potent form of opium--morphine-of which he at one time took nine grains daily. He originally fell into the habit of taking it about seventeen years previously, when it was prescribed for him as a remedy for occasional disorder in the bowels and for a dormant cancer of the tongue. He made strenuous efforts to overcome the habit, but it proved to be too strong for him, and in despair he put an end to himself. llere, again, iş a case in which the constitution was originally in fault, the cancerous taint probably pervaded his entire system, affecting the brain. The whole of the evil results must, therefore, not be attributed to the morphine. Another case is recorded where the sufferer first took laudanum for ten years, and then resorted to morphia, beginning with two grains and a half every two days for the first year, and increasing the dose ultimately to sixty grains a day, which he continued for six months, until in desperation he made a frantic effort to abandon the use of it, and succeeded. But in this case the patient had a naturally sound and preternaturally vigorous constitution, and he was induced to resort to morphia merely to
cure insomnia, brought on by overwork at a European university, and, not like the Rev. Robert Hall, who took it to relieve racking pain in the back, with which he had been troubled from childhood. The quantity of laudanum taken by this celebrated divine throws that taken by De Quincy into the shade. In 1812 he took from fifty to one hundred drops every night; but before 1826 the quantity had increased to one thousand drops! Yet he was never overcome by the soporific quality of the medicine, but once, on which occasion, during an uncommonly severe attack of pain in the back, which lasted the whole night, he took, while it was troubling him, no less a quantity than 125 grains of solid opium, equal to more than 3,000 drops, or nearly four ounces of laudanum. And even then,” adds his biographer, Mr. Addington, “it was hard to determine whether the effect was owing so much to the quantity administered as to the unusual circumstance of its not having proved, even for a short time, an effectual antagonist to the pain it was expected to relieve.” Mr. Hall was a great smoker, and resorted to other remedies besides laudanum ; he freely used brandy, ether, and ammonia in his paroxysms of suffering.
John Randolph was diseased from his birth. Possessing a temperament of the most excitable kind, he seems to have lived, during the greater part of his life, only just outside of the bounds of confirmed insanity. He was a great sufferer from various maladies, and resorted to opium for relief. He acknowledged that when he took it moderately he was relieved from pain ; but he acquired the taste for it, and took it in such quantities that it produced temporary aberrations of the mind and shortened his life. On the other hand, we have the case of the celebrated Wilberforce to show that the moderate use of opium may be beneficial. He used it for many years without any apparent injury to his health. His son says: "His returning health was in a great measure the effect of a proper use of opium, a remedy to which even Dr. Pitcairn's judgment could scarcely make him have recourse ; yet it was to this medicine that he now owed his life as well as the comparative vigor of his later years. So sparing was he always of its use, that as a stimulant he never knew its
power, and as a remedy for his specific sickness he had not to increase its quantity during the last twenty years he lived. • If I take,' he would often say, “but a single glass of wine I can feel its effect, but I never know when I have taken my dose of opium by my feelings ?' Its intermission was too soon perceived by the recurrence of the disorder."* Now, in this case the sufferer was a man of moral and temperate habits, with exalted views of philanthropy. He exercised his brain naturally and without excitement, and the opium demon acquired no power over him, though it never relinquished its hold.
There is yet another case to be referred to, besides that of the great British philanthropist. It is that of an Englishman 103 years old, an officer in the British army,* who has served in all parts of the world. Many years ago he took up his residence in New York, and ever since the year 1816, when he first began to use opium as a relief from a severe attack of rheumatism, he had been in the habit of taking large quantities of the drug, varying from forty grains daily to many times that amount. When last seen by the writer of the brief notice of him from which we quote, he was in full possession of a physical and mental vigor which would have been surprising in a man of eighty. The enormous quantity of opium which he had taken had been beneficial to him! The writer of the notice in question well remarks that “the case remains as a striking illustration of the weakness of that physiological reasoning which would deduce certain phenomena as the invariable consequences of a violation of the fundamental laws of health. Until the chemistry of the living body is better understood, medical science seems obliged to accept many anomalies which it cannot explain.”
What, then, is the best mode of curing this habit? Must opium, laudanum, and morphine, be struck out of the pharmacopeia ? If they are to be discarded on account of the pernicious use which may be made of them, then brandy, ether, alcohol, wine, and stimulants of all kinds ought to be
Life of William Wilberforce, p. 255.
discarded, also. This would be not only a very difficult thing to do, but it might be very injurious. Emergencies frequently arise wherein the prompt application of a strong stimulant is the means of saving life. The subject, however, is one which may be left to physicians and physiologists; it is not our intention to enter upon it here. Confining our attention to opium, it may be observed that the habit of relying upon large doses is easily established; and, once formed, the daily quantity is not easily reduced. All who have long been accustomed to opium, are aware that there is a maximum beyond which no increase in quantity does much in the further alleviation of pain, or in promoting pleasurable excitement. Here, then, is a stopping point, if the patient can be made to understand it thoroughly. He need not increase his dose, for that will be useless. Can he decrease it steadily? We have always doubted this, just as we have done in the case of an inebriate. Many thousands have tried to reform themselves of the habit of drinking, by diminishing gradually the quantity they take daily. When successful, this process is generally slow and painful; but we believe it seldom is successful. The most striking instances of reform have been those wherein the patient has abruptly and totally discontinued the use of intoxicating liquors, and resorted at once to abstinence. Why, then, should not the same success attend the experiment of abruptly and totally discontinuing the use of opium? We are not speaking, now, of extreme cases, any more than of extreme cases of inebriates, whose brain has become so alcoholized as to be insensible to any remedy but death.
The truth is, that the opium habit is a disease sui generis, and cannot be treated on general rules or in analogy with other diseases. It must be dealt with on its own symptoms, and in reference to the peculiar temperament and constitution of the patient. Moreover, the hearty coöperation of the latter with his physician is absolutely necessary to successful treatment.
The grasp with which liquor holds a man when it turns on him, even after he has abused it for a lifetime, is feeble compared with that which the use of opium but for a single
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year acquires over the unfortunate one who resorts to it. And even when, after unimagined sufferings, the patient overcomes the habit, he is liable to suffer from the disuse of opium and to have some very painful consequences permanently engrafted upon his constitution. Among them are: 1. Pressure upon the muscles of the limbs and in the extremities, sometimes as of electricity, apparently accumulated there under a strong mechanical force. 2. A disordered condition of the liver, exhibiting itself in the variety of uncomfortable modes in which that organ, when acting irregularly, is accustomed to assert its grievances. 3. A sensitive condition of the stomach, rejecting many kinds of food which are regarded by medical men as simple and easy of digestion. Of this De Quincy's is a remarkable case. He found roast pork, mince pies, and cheese, comparatively easy of digestion, while poultry, milk, oysters, fish, vegetables, and dry toast, caused him serious inconvenience. 4. Acute shooting pains, confined to no one part of the body. 5. An unnatural sensitiveness to cold. 6. Frequent cold perspiration in parts of the body. 7. A tendency to impatience and irritability of temper, paroxysms of excitement wholly foreign to the natural disposition. 8. Deficiency and irregularity of sleep. 9. Occasional prostration of strength. 10. Inaptitude for steady exertion.
Such are the calamities which are likely to attend the disuse of opium, according to the experience of one who has gone through the fiery ordeal of giving up the habit of using it. And if this be the case with others, it becomes a serious question whether it is desirable to do more with a voracious opium-eater than bring him back to temperance and not total abstinence. These intense sufferings are occasioned by decomposition of the tissues and disorganization of the nerves, followed sometimes by paralysis of the nervous fibres of the stomach. In some cases this fearful demoralization had gone on to such an extent that the patient must either go on taking opium or die. The only way left to preserve his intellectual faculties intact is to keep his future daily dose at a tolerable minimum.