Next in order to alcohol, opium and morphine are habitually abused to a greater extent than any other narcotic. Chloral is used in the same way by a large number of individuals. Paraldehyde, cannabis indica, ether, chloroform, and cocaine are also used to a less extent. The scope of this article does not include the consideration of acute poisoning by these drugs.
The habit of taking narcotics, whether medicinally or as a mere matter of indulgence, is apt speedily to become confirmed. The physiological dose more or less rapidly loses its power to affect the nervous system in the ordinary way. Tolerance increases with increasing doses, and in a comparatively short space of time poisonous doses are taken with impunity as far as immediate danger to life is concerned. The toxic effects of the poison are shown in characteristic perversion of the functions of the nervous system and of the mind. A condition is established in which the ordinary functions of life are properly performed only under the influence of the habitual narcotic, and in which its absence results in languor, depression, and derangement of bodily and mental processes. The habit, once established, thus makes for itself a constantly recurring plea for its continuance. Especially is this true of opium and morphia.
Opium and Morphine.
Opium-eating is chiefly practised in Asia Minor, Persia, and India. It is also prevalent in Turkey. It has been practised in India from very ancient times. The prevalence of this habit in the East is probably largely due to the restrictions placed upon the use of alcoholic beverages among the Mohammedans, and to some extent also to the long religious fasts observed by the Buddhists, Hindoos, and Moslems, during which opium is often used to allay the pangs of hunger. The prevalence of the opium habit in India is shown by the fact that the license fees for a single year amounted to nearly five hundred thousand pounds sterling. It is stated that in Samarang, a town of 1,254,000 inhabitants, the average quantity of opium consumed monthly is 7980 pounds. The town of Japava, with 671,000 inhabitants, consumed in fifteen days 5389 pounds of opium. In 1850, 576,000 pounds of opium were imported into Java, besides an unknown quantity smuggled.1
1 Archiv für Pharmazie, 1873, cited by Von Beck, Ziemssen's Cyclopædia, vol. xvii.
The habit is not confined to Oriental countries, but is also practised in various forms in the West. It is by no means rare on the continent of Europe. In certain districts of England, especially in Lincolnshire and Norfolk, more opium is consumed than in all the rest of the United Kingdom. Shearer2 states that the increase in the practice of opium-eating among the workpeople of Manchester is such that on Saturday afternoons the druggists' counters are strewed with pills of opium of one, two, and three grains, in preparation for the known demand of the evening. The immediate occasion is said to be the lowness of wages, opium being used as a cheap substitute for alcohol or as a food substitute, or with the view of removing the effects of disease and depression. According to the same observer, laudanum is more or less in use as a narcotic stimulant in the cotton-spinning towns, where female labor is in requisition and is well paid. Children are accustomed to it from their earliest infancy. Their parents drug them with daily potions of Godfrey's cordial, Dalby's carminative, soothing syrup, and laudanum itself, during the long hours of their absence from home. While the habit of opium-eating cannot be said to be generally prevalent in any part of the United States, instances of it are frequently encountered in all classes of society, and particularly among people of means and refinement. The preparations employed in this country are crude opium, tincture of opium or laudanum, camphorated tincture of opium or paregoric, McMunn's elixir, Dover's powder, and the salts of morphia. All of these preparations are used by the mouth; opium is very frequently, especially among women of the better classes of society, habitually taken in the form of suppositories; finally, the acetate and sulphate of morphine are used by means of the hypodermic syringe. While it will be necessary to point out some differences in the effects of these drugs due to the preparation used or to the method in which it is employed, the distinction between the opium habit and the morphine habit, in itself an artificial one, will not be regarded in the course of the present article.
2 Opium-smoking and Opium-eating, their Treatment and Cure, by George Shearer, M.D., F. R. S.
Opium-smoking is chiefly practised by the inhabitants of China and of the islands of the Indian Archipelago. It has been imported into those countries where Chinese labor is largely employed. The Chinese have transmitted it, to an extent which is fortunately very limited, to the inhabitants of certain of our cities. Opium-smoking is habitually practised in this country only among the more debased orders of society.
SYNONYMS.—Opiophagia, Morphiopathy, Morphinism, Morphinomania, Morphiomania, Morpheomania, are terms occasionally employed to designate the opium or morphia habit.3 Landowski, Levinstein, Jouet, and others use the term morphinism to denote the condition of the body; morphinomania, the condition of the mind in chronic morphine-poisoning. This distinction may be misleading. In effect, the pathological condition is complex, including derangements both somatic and psychical.