Drugs that enslave

by H. H. Kane

In many instances as the appetite for food decreases the appetite for alcoholic stimulants replaces it. A young lady, of twenty, formerly a patient of mine, after using the drug subcutaneously for three years, lost her appetite and subsisted for nearly eight months upon lager beer, a few crackers and a little toast. She would consume about one gallon of beer a day. During this time she somewhat diminished the amount of morphine used (eight grains, dropped to six grains, in twenty-four hours) and gained in weight and health. At the end of this time, however, severe gastric disturbance supervened, and she lay for months in a precarious condition. She is now cured of the habit.

Alcoholic stimulants are used by some habituès to increase the effect of the morphia, which it does to a certain extent. They delude themselves into the belief that they will be enabled to thus reduce the amount of morphia used, but in the majority of cases this is a fallacy. Those who prefer laudanum and paregoric to opium or morphine often do so on account of the amount of alcohol contained in these preparations. I knew a gentleman, some years ago, now dead, an Episcopalian minister, who became addicted to the use of alcoholic stimulants. His excesses were so frequent and so degrading that it was found necessary to expel him from the church. Sobered by the blow, yet unwilling to entirely abandon his habit, he seized upon the expedient of using large quantities of laudanum, thus getting the effect of both opium and alcohol. He died some two years after, from taking an overdose, at the end of a spree, the first and last one in the two years. His tombstone is a monument to blasted hopes, unsatisfied ambition, a life ill-spent, and points a very pregnant moral to those who knew him. Let a man count well the cost before he takes service with a master who is only satisfied with a blasted life, here and hereafter.

THE CUTANEOUS SURFACE.

The effects of these drugs upon the skin may be divided into those relating to color, sensation and nutrition. The sallow, cadaveric hue so often seen in advanced cases is partly due to discoloration by the biliary matters, which are not properly excreted by the liver, and partly to a condition of malnutrition, so often seen in persons suffering from cancerous disease. In case there is serious interference with the working of the kidneys, the sallow color becomes less distinct, diluted expresses it well, and it has an appearance more like that of old white marble. In this case the tissue feels doughy and “soggy,” and at points a pit made in the skin by the pressure of the finger remains. There is also puffiness under the eyelids and the eyes are bleared and watery. When there is no dropsy the skin is usually dry and harsh, although at times bathed with a cold, exhausting perspiration, the odor of which is oftentimes very offensive. A morphia or opium taker, previously ill-nourished, sometimes seems to improve, taking on flesh rapidly. The appearance, often best seen in the face, is very deceptive, and is, in the majority of instances, due to slight dropsy. It is sometimes seen a few weeks after these patients commence to use alcoholic stimulants, especially beer. It soon passes away, leaving them looking thinner and more miserable than before.

In those cases where the habit has not progressed very far, the skin is usually made redder and coarser than natural, and is dotted here and there with pustules.

In one case that I have recently had under my care, that of a young lady who had never used stimulants and who had only used morphia, and that subcutaneously, for seventeen months, a swollen and reddened condition of the nose, exactly like that seen in old drunkards, was present. Two weeks after the morphine was stopped the nose began to lessen in size and the color to disappear, and the condition was entirely cured at the end of three weeks. No local applications were used.

Loss of elasticity of the skin is a common change. That nutrition is seriously interfered with is seen by this alteration, the loss of adipose tissue, the ill-balanced circulation, giving at one time coldness and paleness, at another flushing and undue warmth, and the variable secretion. A plump and well nourished person who commences the use of morphia loses those outlines of health caused by the proper development of the muscular system and normal distribution of fat beneath the skin. Face and form are both changed, and certainly for the worse.

These changes are undoubtedly due to a double action of morphine; that on the alimentary canal preventing the proper digestion and assimilation of food, and that upon the nerves regulating the supply of blood that passes to the skin.

Eruptions after a time appear upon various parts of the body, more especially the face, chest and back. They are usually pustular, with hard, indurated bases; sometimes papular. Herpes zoster or “shingles” is occasionally produced, and is attended by most intolerable itching; less often purpura hemorrhagica. In the case of the literary gentleman already spoken of this was present, as was also bleeding from the kidneys. When it does occur the system must be in a greatly exhausted and the blood in a very poor condition, a condition which it usually takes a long time or large doses of the drug to produce.