Considerations of this nature, however, are of too general a character to be of much service to one enduring the misery of the reforming opium-eater. He has now arrived at a point where he is obliged to ask himself when and how the contest is to end. He has succeeded in abandoning three-quarters of the opium to which he has so long been accustomed. A few weeks have enabled him to accomplish this much. He endures, indeed, great discomfort by day and by night; but hope has been re-awakened; his mind has recovered greater activity than it has known for years; and, on the whole, he feels that he has been greatly the gainer from the contest.
Let me repeat, that the main thing for the patient at this point of his trial is not to forego the advantage he has already attained—"not to go back." If he can only hold his own he has so far triumphed, and it is only a question of time when the triumph shall be made complete. When this shall be effected he must decide. The rapidity of his further progress must be determined by what he himself is conscious he has the strength, physical and moral, to endure. With some natures any very sudden descent is impossible; with others, whatever is done must be done continuously and rapidly or is not done at all. The one temperament can not stand up against the assaults of a fierce attack, the other loses courage except when the fight is at the hottest. For the former ample time must be given or he surrenders; the latter will succumb if any interval is allowed for repose. It is, therefore, difficult to suggest from this point downward any rule which shall apply equally to temperaments essentially unlike. I think, however, that the suggestion to divide the daily allowance, whether the descent be a slow or a rapid one, into numerous small parts to be taken at equal intervals of time, will be found to facilitate the success of the attempt in the case of both. The chief value of such subdivision probably consists in its throwing the aggregate influence of the day's opium nearer the hour of bed-time, when it is most needed, than to an earlier hour, when its soporific power is less felt. In addition to this, the importance to the excited and irritated patient of being able to look forward during the long-protracted hours to frequent, even if slight, alleviations of his pain, should not be left out of the account. In general it may be said that whenever the patient feels that he can safely, that is, without danger of failing in his resolution, adventure upon a further diminution of the quantity, an additional amount, smaller or greater according to circumstances, should be deducted till the point is reached where the suffering becomes unendurable; then after a delay of few or many days, as may be needed to make him somewhat habituated to the diminished allowance, a still further reduction should be made, and so on for such time as the peculiarities of different constitutions and circumstances may make necessary, till the quantity daily required has become so small, say a grain or two, that by still more minute subdivisions, and by dropping one of them daily, the final victory is achieved.
I have not ventured to say in how short a time confirmed habits of opium-eating may be abandoned. In my own case it was thirty-nine days, but with my present experience I should greatly prefer to extend the time to at least sixty days; and this chiefly with reference to the violent effects upon the constitution produced by the suddenness of the change of habit. Some constitutions may possibly require less time and some probably, more. While I regard the abandonment of the first three-quarters of the accustomed allowance as being a much easier task than the last quarter, and one which can be accomplished with comparative impunity in a brief period, I would allow at least twice the time for the experiment of dispensing with the last quarter; unless, indeed, I should be apprehensive that my resolution might break down through the absence of the excitement which is unquestionably afforded by the feeling that you are engaged in a deadly but doubtful conflict. So far, also, as can be inferred from cases subsequently narrated in this volume, the probability of success would seem to be enhanced by devoting a longer time to the trial. It can not, however, be too often repeated, that however slow or however rapid the pace may be, the rule to be rigidly observed is this: Never to increase the minimum dose that has once been attained. This is the only rule of safety, and by adhering to it, persons in infirm health, or with weakened powers of resolution, will ultimately succeed in their efforts.
I subjoin my own record of the quantity of opium daily consumed, for the possible encouragement of such opium-eaters as may be disposed to make trial of their own resources in the endurance of bodily and mental distress.
Saturday, Nov. 25….80 grains, = 2000 drops of laudanum.
Sunday, " 26….60 " 1500 " "
Monday, " 27….50 " 1250 " "
Tuesday, " 28….40 " 1000 " "
Wednesday, " 29….30 " 750 " "
Thursday, " 30….25 " 625 " "
Friday, Dec. 1….20 " 500 " "
—- ——-
Average of 1st week….44 " 1089 " "
Saturday, Dec. 2…..19 grains, = 475 drops of laudanum.
Sunday, " 3…..18 " 450 " "
Monday, " 4…..17 " 425 " "
Tuesday, " 5…..16 " 400 " "
Wednesday, " 6…..15 " 375 " "
Thursday, " 7…..15 " 375 " "
Friday, " 8…..15 " 375 " "
—— ——
Average of 2d week…..16.43" 411 " "
Saturday, Dec. 9…..14 grains, = 350 drops of laudanum.
Sunday, " 10…..13 " 325 " "
Monday, " 11…..13 " 325 " "
Tuesday, " 12…..12 " 300 " "
Wednesday, " 13…..12 " 300 " "
Thursday, " 14…..11 " 275 " "
Friday, " 15…..10 " 250 " "
—— ——
Average of 3d week…..12.14" 304 " "
Saturday, Dec.16….. 9 grains, = 225 drops of laudanum.
Sunday, " 17….. 8 " 200 " "
Monday, " 18….. 8 " 200 " "
Tuesday, " 19….. 7 " 175 " "
Wednesday, " 20….. 6 " 150 " "
Thursday, " 21….. 5 " 125 " "
Friday, " 22….. 4 " 100 " "
—— ——
Average of 4th week…..6.71" 168 " "
Saturday, Dec.23….. 3 grains, = 75 drops of laudanum.
Sunday, " 24….. 3 " 75 " "
Monday, " 25….. 2 " 50 " "
Tuesday, " 26….. 2 " 50 " "
Wednesday, " 27….. 2 " 50 " "
Thursday, " 28….. 2 " 50 " "
Friday, " 29….. 1 " 25 " "
—— ——
Average of 5th week…..2.14" 54 " "
Saturday, Dec.30….. 1 grain, = 25 drops of laudanum.
Sunday, " 31….. 1 " 25 " "
Monday, Jan. 1….. 1 " 25 " "
Tuesday, " 2…..1/2 " 12 " "
Wednesday, " 3…..1/4 " 6 " "
—— ——
Average of 6th week….0.75 " 18 " "