9. Occasional prostration of strength.

10. Inaptitude for steady exertion.

I mention without hesitancy these consequences of the abandonment of opium, from the belief that any person really in earnest in his desire to relinquish the habit will be more likely to persevere by knowing at the start exactly what obstacles he may meet in his progress toward perfect recovery, than by having it gradually revealed to him, and that at times when his body and mind are both enfeebled by what he has passed through. With a single exception, the dismost serious one I have been obliged to encounter. Whether it is one of the specific effects of the disuse of opium, or only one of the many general results of a disordered constitution, I do not know.

I can only say in my own case, that after the lapse of years, this particular difficulty is not wholly overcome. This electric condition, so to call it, still continues a serious annoyance. But when it occurs, the pain is of less duration, and gradually, but very slowly, is of diminished frequency. Violent exercise will sometimes relieve it; a long walk has often the same effect. The use of stimulants brings alleviation for a time, but there seems to be no permanent remedy except in the perfect restoration of the system by time from this effect of the wear and tear of opium upon the nerves. Irregularity in the action of the liver, while singularly marked in the earlier stages of the experiment, and continuing for years to make its agency manifestly felt, is in a considerable degree checked and controlled by a judicious use of calomel.

The condition of the digestive organs is less impaired than I should have supposed possible, judging from the experience of others. A moderate degree of attention to the quality of what is eaten, with proper care to avoid what is not easily digested, with the exercise of habitual self-control in respect to quantity, suffices to prevent, for the most part, all unendurable feelings of discomfort in this part of the system. Whether the habitually febrile condition of the mouth, and the swollen state of the tongue, is referable to a disturbed action of the stomach or of the liver I can not say. It is certain that none of the effects of opium-eating are more marked or more obstinately tenacious in their hold upon the system than these. I barely advert to the frequent impossibility of retaining some kinds of food upon the stomach, which has been one unpleasant part of my experience, because I doubt whether this return of a difficulty which began in childhood has any necessary connection with the use of opium. For many years before I knew any thing of the drug I had been a daily sufferer from this cause. Indeed the use of opium seemed to control this tendency, and it was only when the remedy was abandoned that the old annoyance returned. For a few months the stomach rejected every kind of food; but in less than a year, and subsequently to the present time, this has been of only occasional ocurrence.

I am also at a loss how far to connect the disuse of opium with the lancinating pains which have troubled me since the time to which I refer. These pains began long before I had recourse to opium, they did not cease their frequent attacks while opium was used, nor have they failed to make their potency felt since opium was abandoned. While it is not improbable that the neuralgic difficulties of my childhood might have remained to the present time, even if I had never made use of opium, I think that the experience of all who have undergone the trial shows that similar pains are invariably attendant upon the disuse of opium. How long their presence might be protracted with persons not antecedently troubled in this way, is a question I can not answer. I infer from what little has been recorded, and from what I have learned in other ways, that the reforming opium-eater must make up his mind to a protracted encounter with this great enemy to his peace. That the struggle of others with this difficulty will be prolonged as mine has been I do not believe, unless they have been subjected for a lifetime to pains connected with disorder in the nervous system.

The unnatural sensitiveness to cold to which I have alluded is rather a discomfort than any thing else. It merely makes a higher temperature necessary for enjoyment, but in no other respect can it be regarded as deserving special mention. With the thermometer standing at 80° to 85° the sensation of agreeable warmth is perfect; with the mercury at 70° or even higher, there is a good deal of the feeling that the bones are inadequately protected by the flesh, that the clothing is too limited in quantity, and in winter that the coal-dealer is hardly doing you justice.

The cold perspiration down the spine, which was so marked a sensation during the worst of the trial, has not yet wholly left the system, but is greatly limited in the extent of surface it affects and in the frequency of its return.

The tendency to impatience and irritability of temper to which I have adverted is by far the most humiliating of the effects resulting from the abandonment of opium. Men differ very widely both in their liability to these excesses of temper as well as in their power to control them; but under the aggravations which necessarily attend an entire change of habit, this natural tendency, whether it be small or great, to hastiness of mind is greatly increased. So long as the disturbing causes remain, whether these be the state of the liver or the stomach, or a want of sufficient sleep, or the excited condition of the nervous system, the patient will find himself called upon for the exercise of all his self-control to keep in check his exaggerated sensibility to the daily annoyances of life.

Intimately connected with the preceding is the frequent recurrence of sleepless nights, which seem invariably to attend upon the abandonment of the habit. Possibly some part of this state of agitated wakefulness may pertain to the natural temperament of the patient, but this tendency is greatly aggravated by the condition of the nerves, so thoroughly shattered by the violent struggle to oblige the system to dispense with the soothing influence of the drug upon which it has so long relied. Whatever method others may have found to counteract this infirmity, I have been able as yet to find no remedy for it. Especially are those nights made long and weary which precede any long continuance of wet weather. A moist condition of the atmosphere still serves the double purpose of setting in play the nervous sensibilities, and, as a concomitant or a consequence, of greatly disturbing, if not destroying sleep.