“According to Pflueger’s theory, in cases of amenorrhœa due to morbid craving for morphia, the growth of the ovarian cells would be stopped from one monthly period to another, and consequently there would be a want of stimulus on the ovarian nerves, causing on the one hand the rupture of Graaf’s follicles, and producing, on the other hand, a congested state of the generative organs by reflex action. Hence, the morphia would act in the same manner on the ovaries as on other secreting glands, i. e., would render them devoid of function under its continued influence. It is likely, therefore, that the menstrual discharge does not show on account of no ovulation taking place; this also would account for the sterility.”[5]
Accompanying this condition of non-menstruation there is always sterility. That this is due to the habitual use of morphia is proven by the fact that these women have borne a child or children before the use of the drug was commenced, and have again become pregnant and gone to full term after the habit was abandoned. So long, however, as menstruation does occur, there is a possibility of the woman’s becoming pregnant.
In the majority of instances sensation is finally lost, although it is usually increased during the first few months’ use of the drug. A patient of mine, a lady who had used morphine by the mouth for sixteen years, found her virile power during and at the end of that time in no way impaired. If anything, it was increased. Her dose of morphine was ten grains. She had not menstruated for a long time. This was the only case in which I tried Levenstein’s plan of at once stopping the drug, and I shall certainly never try it again.
With the suppression of the menstruation, there sometimes come the usual symptoms attending the suppression of this function in non-habituès.
Levenstein states that ladies suffering from leucorrhœa are often cured of this complaint by the habitual use of morphia; the discharge returning, however, as soon as the habit is broken, and causing labor-like pains.
Certain it is that most female patients, on breaking the habit, suffer from a severe leucorrhœa, whether or not they had such a discharge previous to commencing the use of the drug. One of my lady patients who used six grains a day, subcutaneously, had a leucorrhœal discharge before she began the use of morphia, and upon which a four years’ habituation had no curative or modifying effect. As soon, however, as the habit was broken, the discharge increased greatly in quantity, and changed in character, becoming more tenacious.
Spasmodic closure of the mouth of the vagina on attempting to introduce the finger or a speculum, I have noticed in two cases. It, also, readily passes away after the use of morphia is abandoned.
A woman becoming pregnant in the early course of her addiction to this habit will, in the majority of cases, abort before reaching full term, especially if the amount used is large. Levenstein has noted the fact that wives of men addicted to the habitual use of this drug in large doses had in the last two years never carried children to full term, although young, healthy, and having borne children before the husband became an habituè.
There is no question in my mind but that the excessive use of this drug by one or both parents, but especially the mother, in case she is able to carry her child to full term, will modify disadvantageously the physical, mental, or moral development of the child thus born. A physician from the South tells me of the case of a lady who commenced the use of opium at the beginning of her pregnancy. She was delivered of a fair-sized child that grew up in fair, though not robust health, and menstruated at the proper age. She is, however, very simple and childish, still plays with dolls, although a young lady, is very eccentric, and shuns the society of young men. The mother, who is still living, ceased to menstruate at the age of 30 and has never menstruated since, some twenty years. For the past two or three years she has been using sixty grains of gum opium daily.
Dr. Alonzo Calkins[6] relates several cases where the children of such parents were either physically or intellectually deficient. I give but one of them: “At an inquest held by Dr. Macnish it appeared that a child five years of age, though to appearance only so many weeks old, had never been able to walk, nor so much as utter an articulate sound. The mother, during her gestation (as was in evidence), had taken to morphine, using a drachm a day in the months just preceding her demise. A child born before the habit had become fixed showed a normal development and the aspect of general health.” Another case is related where both parents were “healthy and robust by original constitution and by habits of life too, with the exception that the woman had, for a very considerable period, been in the practice of using morphine regularly and to great excess. An infant born subject to the liabilities, had only a very imperfect physical organization, with weak intellectual indications.”