Drugs that enslave

by H. H. Kane

“Although persons who suffer from morbid craving for morphia show different symptoms, some of them beginning to feel the effects of the poison after using it for several months, while others enjoy comparatively good health for years together, there is no difference between them as regards the consequences upon the partial or entire withdrawal of the narcotic drug.

“In this respect they are all equal. None of them have the power of satisfying their passions unpunished.

“Only a few hours have passed since using the last injection of morphia, and already the feeling of comfort brought on by the action of the drug is passing off. They are overcome by a feeling of uneasiness and restlessness; the feeling of self-consciousness and self-possession is gone, and is replaced by extreme despondency; a slight cough gradually brings on dyspnœa, which is increased by want of sleep and by hallucinations.

“The vaso-motoric system shows its weakness by abundant perspiration, by the dark color of the face, which replaces the pale condition apparent during the first few days.

“Flow of blood to the head and palpitation of the heart, with a hard pulse, soon show themselves. The latter symptom often disappears suddenly, and is replaced by a slow, irregular, thread-like pulse, which is the sign of the beginning of a severe collapse.

“The reflex irritability increases, the patients begin to sneeze and to have paroxysms of yawning; they start if any one approaches them; touching their skin causes crampy movements or convulsions; the trembling of the hands, if not already evident, now becomes distinctly perceptible. The power of speech is disordered; lisping and stammering take place. Diplopia, and disorders of the power of accommodation, frequently accompanied by increased secretion of the lachrymal glands, show themselves. The patients are overcome by a feeling of weakness and total want of energy, and are thus compelled to lay in bed.

“Neuralgic affections of various parts of the body, pain in the front and back of the head, cardialgia, abnormal sensations in the legs, associated with salivation, coryza, nausea, vomiting and diarrhœa, tend to bring them into a desperate condition.

“Some persons will bear up with fortitude under all these trials; they will quietly remain in bed, and will endure the unavoidable suffering, hardly uttering a complaint. Of the others, although the great minority of them sleep and doze during this trying time, some can find rest nowhere; they jump out of bed, run about the room in a state of fear, crying and shrieking. Gradually they become calmer, although occasionally their excitement increases. A state of frenzy, brought on by hallucinations and illusions of all the sensitive organs, at last causes a morbid condition, to which I have given the name of delirium tremens, resulting from morbid craving for morphia, it being similar to that caused by alcohol. Some of the patients, however, will be found walking about in deep despair, hoping to find an opportunity of freeing themselves forever from their wretched condition.”

The patient whom I treated by the sudden deprivation of the drug was a married lady, aged forty-five, stout and flabby. She had been using morphia by the mouth for nearly sixteen years, in the last year taking from seven to ten grains daily. I saw her one afternoon and commenced treatment the next morning. The drug was taken away at once. That day she began to complain of salivation, dyspnœa, intense grinding pains in the calves of the legs, headache, pain about the heart and a strong desire for morphia. The first night she did not sleep at all. Was feverish and restless, tossing from side to side of the bed, moaning, occasionally crying out. Toward morning she became delirious, ran about the room, screamed, attacked the nurse, attempted to jump out of the window and battered at the door. By 8 A.M. she had sunk into a stupor, from which she was occasionally roused by fits of sneezing. A hard, dry, hacking cough supplemented the dyspnœa. Nausea was intense and vomiting frequent. She, on the third day, knew none of those about her, saw imaginary men and animals, wept, laughed, moaned and muttered incoherently. Sordes formed upon teeth and lips; the fæces and urine were passed in the bed. In this state she remained for six weeks, in spite of every effort to arouse her. All day in a typhoid condition; at night staggering about the room, screaming, crying and attacking the nurse. In the seventh week she began to recognize faces, although her hallucinations and delusions continued. She very slowly regained strength. Pains persisted in the limbs. There was trembling of the hands and tongue, inability to read, and she would cry at the most trivial thing. Her nights were filled with terrible sights and dreams, the memory of which lasted her the whole of the following day. Several times there was severe collapse, necessitating the free use of stimulants and an occasional small dose of opium. During all this time tonics, concentrated food, baths and electricity were given. It was fully four months before her mind regained its balance. She was seen once, in consultation, by Dr. G. H. Wynkoop, of this city.