The Opium Habit

by Horace B. Day

My patient was a gentleman of forty, who for several years of his youth occasionally used opium, and for the last eight has habitually taken it. During these eight years he has made at least three efforts to leave it off, in each instance diminishing his dose gradually for a month before its entire abandonment, and in the most successful one holding the enemy at bay for but a single summer. In two cases he had no respite of agony from the moment he dropped till he resumed it. In the third case, a short period of comparative repose succeeded the first fiery battle, but in the midst of felicitations on his victory he was attacked by the most agonizing hemicranial headaches (resulting from what I now fear to have been already permanent disorganization of the stomach), and went back to his nepenthe in a state of almost suicidal despair, only after the torture had continued for weeks without a moment's mitigation.

He had first learned its seductions, as happens with the vast majority of Anglo-Saxon opium-eaters, through a medical prescription. An attack of inflamed cornea was treated with caustic applications, and the pain assuaged by internal doses of M'Munn's Elixir. When my friend came out of his dark room and bandages at the end of a month he had consumed twenty ounces of this preparation, whose probable distinction from the tincture known as laudanum I point out below in the note. [Footnote: Mr. Frank A. Schlitz has kindly made for me a special analysis of M'Munn's Elixir, which seems to prove that the process of its preparation amounts to more than the denarcotization of opium, which is spoken of on the wrapper of each vial. As nearly as can be ascertained, M'Munn's Elixir is simply an aqueous infusion of opium—procured by the ordinary maceration—and preserved from decomposing by the subsequent addition of a small portion of alcohol. Narcotin being absolutely insoluble in water is eliminated as the circular says. This fact alone would not account for the difference between its action and that of laudanum. This is explained by the fact that all the other alkaloids possess diverse rates of solubility in water, and exist in M'Munn's Elixir in very different relative proportions from those which they bear to each other in the alcoholic tincture called laudanum.] Here it may not be superfluous to say that the former preparation has all the essential properties of the latter, save certain of the constipatory and stupefying tendencies which, by a private process known to the assigns of the inventor, have been so masked or removed that it possesses in many cases an availableness which the practitioner can not despise, though compelled by the secrecy of its formula to rank it among quack medicines. The amount of it which my friend had taken during his month's eclipse represents an ounce of dry gum opium—in rough measurement a piece as large as a French billiard ball. I thus particularize because he had never previously been addicted to the drug; had inherited a sound constitution, and differed from any other fresh subject only in the intensity of his nervous temperament. I wish to emphasize the fact that the system of a mere neophyte, with nothing to neutralize the effects of the drug save the absorbency, so to speak, of the pain for which it was given, could so rapidly adapt itself to them as to demand an increase of the dose in such an alarming ratio. There are certain men to whom opium is as fire to tow, and my friend was one of these. On the first of October he sensibly perceived the trifling dose of fifty drops; on the first of November he was taking, without increased sensation, an ounce vial of "M'Munn" daily.

From that time—totally ignorant of the terrible trap which lay grinning under the bait he dabbled with—he continued to take opium at short intervals for several years. When by the physician's orders he abandoned "M'Munn," on the subsidence of the eye-difficulty, his symptoms were uneasy rather than distressing, and disappeared after a few days' oppression at the pit of the stomach and a few nights' troubled dreaming. But he had not forgotten the sweet dissolving views at midnight, the great executive achievements at noonday, the heavenly sense of a self-reliance which dare go anywhere, say any thing, attempt any thing in the world. He had not forgotten the nonchalance under slight, the serenity in pain, the apathy to sorrow, which for one month set him calm as Boodh in the temple-splendors of his darkened room. He had not forgotten that the only perfect peace he had ever experienced was there, and he remembered that peace as something which seemed to blend all the assuaged passion and confirmed dignity of old age with that energy of high emprise which thrills the nerves of manhood. He had tasted as many sources of earthly pleasure as any man I ever knew; but the ecstasies of form and color, wine, Eros, music, perfume, all the luxuries of surrounding which wealth could purchase or high-breeding appreciate, were as nothing to him in comparison with the memory of that time on which his family threw away their sympathy when they called it his "month of suffering."

Accordingly, without much more instinct of concealment than if it were an occasional tendency to some slight convivial excess, he had resort to M'Munn, in ounce doses, whenever the world went wrong with him. If he had a headache or a toothache; if the weather depressed him; if he had a certain "stint" of work to do without the sense of native vigor to accomplish it; if he was perplexed and wished to clear his head of passion; if anxieties kept him awake; if irregularities disturbed his digestion—he had always one refuge certain. No fateful contingency could pursue him inside M'Munn's enchanted circle. He was a young and wealthy bachelor, living the life of a refined bon vivant; an insatiable traveller, surrounded by flatterers, and without a single friend who loved him enough to warn him of his danger excepting those who, like himself, were too ignorant to know it. After three years of dalliance he became an habitual user of opium, and had been one for eight years when I was first called to him.

By the time that the daily habit fastened itself he had learned of other opiate preparations than M'Munn's, and finding a certain insufficiency characterize that tincture as he increased the size of the dose, had recourse to laudanum, which contains the full native vigor of the drug unmodified. This nauseated him. He had the same experience with gum opium, opium pills, and opium powder; so that he was driven to that form of exhibition which sooner or later naturally strikes almost every opium-eater as the most portable, energetic, and instantaneous—morphia or one of its salts. My friend usually kept the simple alkaloid in a paper, and dissolved it as he needed it in clear water, sometimes substituting an equivalent of "Magendie's Solution," which contains sixteen grains of the salt diffused through an ounce of water by the addition of a few drops of sulphuric acid. When I first saw him he had reached a daily dose of twelve grains of sulphate of morphia, and on occasions of high excitement had increased his dose without exaggerating the sensible effect to nearly twenty. The twelve which formed his habitual per diem were divided into two equal doses, one taken immediately after rising, the other just about sundown.

As yet he had not begun to feel the worst physical effects which sooner or later visit the opium-eater. His digestion seemed unimpaired so long as he took his morphia regularly; he was sallow and somewhat haggard, but thus far no distressing biliary symptoms had manifested themselves; his sleep was always dreamy, and he woke at short intervals during the night, but invariably slept again at once, and had so adjusted himself to the habit as to show no signs of suffering from wakefulness; his hand was steady; his muscular system easily exhausted, but by no means what one would call feeble. As he himself told me, he had come to the conclusion to emancipate himself because opium eating was a horrible mental bondage. The physical power of the drug over him he not only realized when attempting its abondonment. Its spiritual thraldom was his hourly misery. He was connected by blood and marriage with several of the best families in the land. Money had not been stinted in his education, and his capabilities were as great as his advantages. He was one of the bravest, fairest, most generous natures I ever came in contact with; was versatile as a Yankee Crichton; had ridden his own horse in a trotting match and beaten Bill Woodruff; had carried his own little 30-ton schooner from the Chesapeake to the Golden Gate through the Straits of Magellan; had swum with the Navigators' Islanders, shot buffalo, hunted chamois, and lunched on mangosteens at Penang. Through all his wanderings the loftiest sense of what was heroic in human nature and divine in its purified form, the monitions of a most tender conscience, and the echoes of that Puritan education which above all other schemes of training makes human responsibility terrible, had gone with him like his tissue. He saw the good and great things within reach of a fulfilled manhood, and of a sudden waked up to feel that they could on earth never be his. He was naturally very truthful, and, although the invariable tendency of opium-eaters is to extirpate this quality, could not flatter himself. Other minds around him responded to a sudden call as his own did not. Every day the need of energy took him more by surprise.

The image-graving and project-building characteristic of opium, which comes on with a sense of genial radiation from the epigastrium about a quarter of an hour after the dose, had not yet so entirely disappeared from its effect on him, as it always does at a later stage of the indulgence. But instead of being an instigation to the delightful reveries which ensued on his earlier doses, this peculiarity was now an executioner's knout in the hands of Remorse. He was daily and nightly haunted by plans and pictures whose feverish unreal beauty he remembered having seen through a hundred times. Those Fata Morgana plans, should he again waste on them the effort of construction? The result had been a chaos of aimless, ineffectual days. Those pictures, why were they brought again to mock him? Were they not horrible impossibilities? Were they not, through the paralysis of his executive faculties, mere startling likenesses of Disappointment? In his opium dreams he had seen his own ships on the sea; commerce bustling in his warehouse; money overflowing in his bank; babies crowing on his knee; a wife nestling at his breast; a basso voice of tremendous natural power and depth scientifically cultivated to its utmost power of pleasing artists or friends; a country estate on the Hudson, or at Newport, with emerald lawns sloping down to the amber river or the leek-green sea; the political and social influence of a great landholder. How pleasurably he had once perceived all these possible joys and powers! How undeludedly he now saw their impossible execution!

So, coming to me, he told me that his object in trying to leave off opium was to escape from these horrible ghosts of a life's unfulfilled promise. Only when he tried to abandon opium did he realize the physical hold the drug had on him. Its spiritual thraldom was his hourly misery.

For three months I tried to treat him in his own house, here in the city. A practitioner of any experience need not be told with what success. I could reduce him to a dose of half a grain of sulphate of morphia a day, keep him there one week, and making a morning call at the expiration of that time discover that some nocturnal nervous paroxysm had necessitated either a return to five grains or a use of brandy (which, though no drinker, he tried to substitute) sufficient to demand a much larger dose of opium in its reaction. He had lost most of his near connections, and not for one hour could any hired attendant have withstood his appeal, or that marvellous ingenuity by which, without appeal, the opium-eater obtains the drug which, to him, is like oxygen to the normal man.

This ingenuity manifests itself in subterfuges of a complicated construction and artistic plausibility which might have puzzled Richelieu; but it is really nothing to wonder at when we recollect the law of nature by which any extreme agony, so long as it continues remediable, sharpens and concentrates all a man's faculties upon the one single object of procuring the remedy. If my house is on fire, I run to the hydrant by a mere automatic operation of my nerves. If my leg is caught in the bight of a paying-out hawser, my whole brain focuses at once on that single thought, "an axe." If I am enduring the agony which opium alone can cause and cure, every faculty of my mind is called to the aid of the tortured body which wants it. When a man has used opium for a long time the condition of brain supervening on his deprivation of the drug for a period of twenty-four hours is such as very frequently to render him suicidal. Cottle tells us how Coleridge one day took a walk along Bristol wharves, and sent his attendent down the pier to inquire the name of a vessel, while he slipped into a druggist's on the quay and bought a quart of laudanum; but in no fibre of his nature could Cottle conceive the awful sense of a force despotizing it over his will, a degradation descending on his manhood, which Coleridge felt as he concentrated on that one single cry of his animal nature and the laudanum which it spoke for, all the faculties of construction and insight which had created the "Ancient Mariner" and the "Aids to Reflection."