In publishing his case I am not violating that Hippocratic vow which protects the relations of patient and adviser; for, as I dropped my friend's wasted hand and stepped to the threshold, he repeated a request he had often made to me, saying:
"It is almost like Dives asking for a messenger to his brethren; but tell them, tell all young men, what it is, 'that they come not into this torment.'"
Already perhaps—by the mere statement of the case—I might be considered to have fulfilled my promise. But since monition often consists as much in enlightenment as intimidation, let me be pardoned for briefly presenting a few considerations regarding the action of opium upon the human system while living, and the peculiar methods by which the drug encompasses its death.
WHAT IS OPIUM?
It is the most complicated drug in the Pharmacopoeia. Though apparently a simple gummy paste, it possesses a constitution which analysis reveals to contain no less than 25 elements, each one of them a compound by itself, and many of them among the most complex compounds known to modern chemistry. Let me concisely mention these by classes.
First, at least three earthy salts-the sulphates of lime, alumina, and potassa. Second, two organic and one simpler acid—acetic (absolute vinegar), meconic (one of the most powerful irritants which can be applied to the intestines through the bile), and sulphuric. All these exist uncombined in the gum, and free to work their will on the mucous tissues.
A green extractive matter, which comes in all vegetal bodies developed under sunlight, next deserves a place by itself, because it is one of the few organic bodies of which no rational analysis has ever been pretended. Though we can not state the constitution of this chlorophyl, we know that, except by turning acid in the stomach, it remains inert on the human system, as one might imagine would happen if he swallowed a bunch of green grass. Lignin, with which it is always associated, is mere woody fibre, and has no direct physical action. In no instance has any stomach been found to digest it save an insect's—some naturalists thinking that certain beetles make their horny wing-cases of that. I believe one man did think he had discovered a solvent for it in the gastric juice of the beaver, but that view is not widely entertained. So far as it exists in opium it can only act as a foreign substance and a mechanical irritant to the human bowels. Next come two inert, indigestible, and very similar gummy bodies, mucilagin and bassorine. Sugar, a powerfully active volatile principle, and a fixed oil (probably allied to turpentine) are the only other invariable constituents of opium belonging to the great organic group of the hydro-carbons.
I now come to a group by far the most important of all. Almost without exception the vegetable poisons belong to what are called the "nitrogenous alkaloids." Strychnia, brucia, ignatia, calabarin, woovarin, atropin, digitalin, and many others, including all whose effect is most tremendous upon the human system, are in this group. Not without insight did the early discoverers call nitrogen azote, "the foe to life." It so habitually exists in the things our body finds most deadly that the tests for it are always the first which occur to a chemist in the presence of any new organic poison. The nitrogenous alkaloids owe the first part of their name to the fact of containing this element; the second part to that of their usually making neutral salts with acids, like an alkaline base. The general reader may sometimes have asked himself why these alkaloids are diversely written—as, e.g., sometimes "morphia," and sometimes "morphine," The chemists who regard them as alkalies write them in the one way, those who consider them neutrals, in the other. Of these nitrogenous alkaloids, even the nuts of the tree, which furnishes the most powerful, swift poison of the world, contains but three—the above-named strychnia, brucia, and ignatia—principles shared in common with its pathological congener, the St. Ignatius bean. Opium may be found to contain twelve of them; but as one of these (cotarnin) may be a product of distillation, and the other (pseudo-morphia) seems only an occasional constituent, I treat them as ten in number—rationally to be arranged under three heads.
First, those whose action is merely acrid—so far as known expending themselves upon the mucous coats. (Pseudo-morphia when it occurs belongs to these.) So do porphyroxin; narcein; probably papaverin also; while meconin, whose acrid properties in contact with animal tissue are similar to that of meconic acid, forms the last of the group.
The second head comprises but a single alkaloid, variously called paramorphta or thebain. (It may interest amateur chemists to know that its difference from strycchnia consists only in having two less equivalents of hydrogen and six of carbon—especially when they know how closely its physical effects follow its atomic constitution.) A dose of one grain has produced tetanic spasms. Its chief action appears to be upon the spinal nerves, and there is reason to suppose it a poison of the same kind as nux vomica without the concentration of that agent. How singular it seems to find a poison of this totally distinct class—bad enough to set up the reputation of any one drug by itself—in company with the remaining principles whose effect we usually associate with opium and see clearest in the ruin of its victim!