Dr. Calkins Chapter IV: The Pharmacology Of Opium

The “War on Drugs” has been a great success in achieving its true intent – to fund the bloated bottomless budgets of untouchable government agencies, to pay outrageous salaries to squads of goons who otherwise couldn’t keep a minimum-wage job, to give half-human morons unrestricted license to kill, destroy and imprison millions of people, and to empower soul-dead halfwits with the freedom to practice their piggish racism.

As an intro to Chapter 4 of Dr. Calkins’ book, I thought that I would offer you a brief excerpt from an excellent article “Ethical and practical issues with opioids in life-limiting illness” By Robert Fine MD (in) Proceedings Of Baylor University Medical Center Journal 2007.

While Dr. Fine’s references are from the 1980s and 1990s, before the current “Opioid Epidemic”  whose advocates love to screech “Just one pill and you’re hooked”, the observations of these research studies are worth thinking about.

Quoting Dr Fine:

“… the reality is that opioids are rarely addictive in the setting of life-limiting illness. Substantial information in the peer-reviewed literature backs up this statement. For example:

• In 1980, Porter and Jick reported on a prospective study of 12,000 hospitalized patients who received at least one opioid preparation for moderate to severe pain. They found only four reasonably well-documented cases of addictive behavior (1)

• In 1981, Kanner and Foley noted that the medical use of opioids rarely leads to drug abuse or to iatrogenic opioid addiction among cancer patients (2)

• In 1982, 181 health care professionals with an average of 6 years of experience who worked at 93 burn units and cared for at least 10,000 hospitalized patients reported no case of addiction in patients treated for burn pain (3)

• In 1992, Schug et al reported only one case of addiction among 550 cancer patients who experienced pain and were treated with morphine for a total of 22,525 treatment days (4)

• In 1992, Zenz et al reported no incidents of serious toxicity or addiction among 100 patients with diverse pain syndromes who received narcotics for prolonged periods (5)

1. Porter J, Jick H. Addiction rare in patients treated with narcotics. N Engl J Med. 1980;302(2):123. [PubMed]

2. Kanner RM, Foley KM. Patterns of narcotic drug use in a cancer pain clinic. Ann N Y Acad Sci. 1981;362:161–172. [PubMed]

3. Perry S, Heidrich G. Management of pain during debridement: a survey of U.S. burn units. Pain. 1982;13(3):267–280. [PubMed]

4. Schug SA, Zech D, Grond S, Jung H, Meuser T, Stobbe B. A long-term survey of morphine in cancer pain patients. J Pain Symptom Manage. 1992;7(5):259–266. [PubMed]

5. Zenz M, Strumpf M, Tryba M. Long-term oral opioid therapy in patients with chronic nonmalignant pain. J Pain Symptom Manage. 1992;7(2):69–77. [PubMed]

(From) “Opium And The Opium Appetite”, by Alonzo Calkins, MD 1870

Chapter IV: The Pharmacology Of Opium

“Incedis per ignes Suppositos cineri doloso.” – Horace.

O true Apothecary, thy drugs are quick!” — Romeo and Juliet.

Opium (from Onos, the Juice) – Ufiyoon in Arabic, Ufeent in Hindu, O-fu-jung in Chinese – is the crystalline liquid that exudes from the capsules of the Poppy, and what Galen has poetically denominated “Lachrymae papaveris” – poppy tears. All species of the family yield opium in some proportion; that known to commerce is in botanical nomenclature the Papaver Somniferum.

Opium by pharmaceutical classification ranks among the gums. It is stimulant and exhilarating, tonic and roborant, or anodyne and soporific, according to the indications for using, the quantity employed, and the period of use.

The purest extract is procured from the borders of the great Mediterranean basin; Europe and the United States (where the poppy has scarcely as yet secured a habitat) have their supplies mainly from India.

Bengal opium, often adulterated by admixture with foreign ingredients, is inferior in strength to that from Turkey. At the Exposition Universelle held in 1867, specimens from Persia and the Levant proved to be of double the strength as compared with others from India (Schroff). The opium of the Peninsula is bitter and nauseous to the taste, that from Western Asia is more acrid and heating. In France the imported gum, having been subjected to a process of depuration, is afterward compacted into masses of definite strength and inclosed in a stamped envelope of metal-foil. This is the “opium titre,” as known in the Paris market.

Prepared Opium, alias Smoking-opium, is properly an extract, procured by subjecting the crude gum to a thorough filtration with water assisted by heat for the menstruum. In China the process is conducted with the most scrupulous care, as anything of an inferior quality would be rejected by the chief purchasers, i.e. the grandees, positively and altogether. This article, known as the Chandoo (Tschandii), which constitutes about 54 percent of the original, is marked by a more pronounced development of the exhilarant and sedative properties, with a corresponding reduction upon the narcotic element. A similar preparation is the Ya-pieu-kao, made up of Indian and native opium in mixture.

The residuum of all (faex) is denominated Tye or Tinco, and there is further a refuse of a refuse, the Samshung.

In the region of the Bosphorus there is used a confection made by combination with aromatics, and fashioned into the lozenge form. Pellets of the sort are put up in packets bearing the label Mash-Allah or Maslach (“The great gift of God”), to be exposed for public sale (Ollivier).

Opium is variously combined, besides, with other narcotics. At Cairo is found a conserve, El Mogen (Magoon), in which hyoscyamus is the adjunct. In India it is cannabis resin, or the datura, or nux vomica. In Borneo opium and tobacco are often smoked together.

The Turks supplement the gum with the Sublimate of mercury to the extent even of 10 percent of the mass, and for the purpose of intensifying the stimulation. There was an opium eater at Broussa who used 40 grains of the sublimate. A more marvellous instance is the case of Suleyman Yeyen, a centenarian well known towards the close of the last century as a familiar pedestrian about the streets of Constantinople, who had attracted the notice of De Pouqueville, Hobhouse, and other Europeans. This veteran among the eaters, having used opium a lifetime until with him it had become effete, betook himself one day to the shop of a Jew, and procured a drachm of the mercurial. This Israelite in name that was (but not “an Israelite indeed”), having anxiously expected for over a day the reappearance of his singular customer, began to apprehend a summons from the Cadi to answer to the charge of complicity in a suicide, and forthwith shut up shop. To his intense relief the desired visitant returned after the lapse of two days, and for a fresh supply.

Morphia (Morphine) is an alkaloid extract, in which the sedative property is amply developed, but where the narcotic force is reduced to the minimum. Good opium yields 8 to 10 percent or more. This is the form preferred by the more intelligent classes, and what is held in superior favor by the sex. The “dear morphine” it is that commands the especial patronage of English ladies. An additional reason for preference is this, that in the protracted use less disturbance of the stomach eventuates.

Laudanum – in the French Codex an Alcoole – is a spirituous solution. This form, which in China is limited to the gentry rather, is in the U. S. the choice of plebeians, and of such as have broken down upon alcoholic potations. In Persia there is made a vinous liquor of similar character, the Coquemar or Cocomar (D’Herbelot). Laudanum has long been the favorite agent for effecting suicide, but of two hundred cases of direct attempts and accidental substitutions through mistake, as appears from a collation of cases made by the writer, laudanum was the form in 138 of them; and of 60 suicides pure, 46, or 4 out of every 5, were accomplished by the same means.

The record for England and Wales, 1863-67, is 682 out of an aggregate of 2,097 instances. In reference to the suicidal propensity generally it may be here observed, that when traceable to moral obliquities it is commonly consummated, if not by laudanum, then by some other poison proper; whereas cases that have their origination in pure despondency are oftener finished by the more summary process of self-strangulation.

Opium in conjunction with alcohol in any form operates with a revivified energy. This reciprocal action did not escape the notice of Galen. Champagne wine or anisette-cordial, for instance, would be an “extra hazardous” adjunct. In a goodly city of ours, among whose conspicuous adornments are the long colonnades of towering elms that enfilade its avenues, there was an Esculapian brother, whose wont was to prepare himself with liberal potations of the like preparatory to the expected soiree, and once mingled with the throng, to grow decidedly impulsive and loquacious in the general not only, but amusingly demonstrative and ingratiative in the particular.

Black-Drop (Quaker Drop) is an acetous tincture. This, as compared with laudanum, exerts a duplicated sedative action, but holds in narcotic influence an inferior place. The merits of this “drop” are certified to by a Philadelphian, a purchaser of the stimulus by the gallon for a good while, who, after ample trial, assures her friends that the preparation is less perturbative of the proper nerve energy, and is furthermore less damaging to the complexion.

McMunn’s Elixir is a denarcotized laudanum, prepared with ether for a menstruum. Extensively used empirically, and held in request by eaters, it has a large patronage in regular practice.

Paregoric is an aromatized laudanum, camphor being the adjunct. This elder elixir, originally intended for the infantile period, has long enjoyed a most intimate family hospitality.

Godfrey’s Cordial. This and the preceding, with “Mistress Winslow’s Syrup,” constitute together a sort of triad of household idolship undisturbed by any rivalling interlopers. The monopoly of patronage so long secured to the first two named is now arrogated by the Soothing Syrup and its arriere-garde, “Mother Bailey’s Quieting Syrup.”

The basis of Winslow – “haud ignota loquor” – is morphine; what had been certified to before upon indubitable testimony is now assured by a recent analysis, which gives nearly one grain of the alkaloid to an ounce of the liquid. The dose for an infant, as per label, is at least five times over what ordinary prudence would authorize. This nostrum, now distributed broadcast over the country, has well-nigh distanced all competitors.

Such are the elixirs and syrups which, as administered whether by deluded mothers or crafty nurses, have soothed many and many a luckless infant into that state of quiet that knows no after-disturbing. Among our publicans there obtains only a very vague apprehension of the pregnant fact that the popular nostrums of the day, the cholera-drops, the pain-killers, the lung-troches and other pectorals, draped as they are in a flaunty incognito, or ensconced as they may be behind the objective screen of a caveat – enough, if mustered into line, to make up a regiment — owe whatever inherent virtue (if any) they possess to the omnipresent leaven, opium.

The stereotyped cautionary phrase, Caveat Emptor, should be the statutory appendix to every one of their trade-marks.

The manipulators in this species of manufacture – marauders upon society they are, for out of the life-blood of the people comes their bread – would appear to be the legitimate representatives, by a sort of apostolic succession, of a class described by Celsus, the Circulatores (“homines circumforanei”), who went about enticing and amusing the popellum or dregs by their high-and-low tumbling, and all, “lucri causa”, for filthy lucre’s sake.

The only difference between now and then appears in this – the originals circulated themselves, their imitators circulate placards.