Opium Idiosyncrasies

(Editor’s Note) In this chapter, Calkins relates tales of both great tolerance for Opium and great sensitivity to its influence, and doesn’t go to any lengths to explain the difference except for remarking that Opium gets them all in the end. Of course, dying at the age of 100 after smoking Opium all your life doesn’t really do much for what Calkins wants us to think of as a death sentence. Unlike many of his other chapters, however, he doesn’t rant and condemn the moral weakness of those who over-indulge, nor does he go to great lengths regarding the life circumstances of those he describes. Some of these “collected tales” are quite interesting; the rest merely ho-hum. I am posting this chapter mainly to maintain the flow of the narrative.  I couldn’t find a graphic that illustrates what Calkins calls “Opium Idiosyncrasies” but perhaps this one is idiosyncratic enough to make the point. I didn’t know that Buddy Holly played the banjo.

(From) “Opium And The Opium Appetite”

By Alonzo Calkins, MD (1870)

Chapter XII: Idiosyncrasies

 

“Quo teneam, vultus mutantem,Protea, vinclo?” – Horace

 

“’Tis green, ’tis green, sir, I assure ye –

Green (cries the other in a fury),

Why, sir, d’ye think I’ve lost my eyes?” – Merrick

 

Individual constitutions here and there turn up to notice, upon which the action of opium appears to be nearly if not quite innocuous; others again, if not altogether intolerant of the malign influence, are extremely impressible to such influence. All such are cases of idiosyncrasy.

Organizations there are which seem fortified by the very constitution of their nature against exterior influences altogether. Thus speaks Cabanis: “N’oubliez pas jamais, qu’il est des organisations qui triomphent de tous les exces, parcequ’ils ont recu de Dieu le privilege de se retremper ou tant d’autres succombent.

Memorable instances may be cited in illustration.

Darius (says Athenaeus), an extravagant wine-bibber, was never overcome by intoxication. This monarch took the pains to have engraved over his tomb the following epitaph (Henderson): “Here lies the man who could drink more wine and bear it more bravely than any other.”

The great commoner, Pitt, on retiring from the House of Commons after an exciting debate, would drink off two bottles of port as if it had been so much lemonade. Carre d’ Avignon instances an invalid, yet short of his fiftieth year, who daily consumed two-thirds of a litre of brandy, and with this two pounds of tobacco in the course of a week. Marcet knew of a case not unlike, a man who besides his pint of spirit used up in the course of the day a gallon to a gallon and a half of country-ale. Drinkwater of Worcestershire had a field laborer who could drink his sixteen quarts of cider in the working hours of the day; but even this man is put into the shade by a Welsh squire told of, who weighed forty stone, and whose score was eight gallons of “home-brewed.”

Brissiac, one hundred and sixteen years old as reported, died as he had lived, with a cigar in his mouth. Von Tschudi while in Peru met a coquero, a man reputedly one hundred and thirty years of age (a centenarian undoubtedly), who had been a coca eater the larger part of his life, but who had never been sick, not for a day.

There was a gentleman of New Jersey, Dr. G. known to the writer, who died something more than ten years since at the ripe age of eighty-two. This man, hale and agile, an early riser, a temperate eater, and of marked mental activity, was a noted consumer of whiskey, though never to the extent of inebriation. The quantity for a single drink was about half a wine glass, but this was repeated three times or sometimes oftener before breakfast, and so in proportion for the other parts of the day, to the amount altogether of one to one and a half pints. Such cases, however, belong rather to the catalogue of rare cases.

Tolerance of opium is as conspicuous as is that of other narcotic stimuli. There was Mahomet Rhiza Khan of Schiraz, who took opium enough at a time to poison thirty ordinary persons, and yet when seen ten years after when he had got to be ninety-six years old, he was to appearance as vigorous as ever.

In the Pharmaceutical Transactions (London) of 1860 is the report of an inquest held in the case of a young rogue, who, now tired of life and prepared to shuffle off the mortal coil, proceeded (as appeared from a memorandum left on his table) after the following manner: Laudanum, a half-ounce draught, was followed up by eight grains of the gum; but these proving inefficient, four grains of morphine and a swallow of Battley’s liquor (what he had kept as a reserve) were superadded, all having been used in about a week’s time. The pistol completed the business: “Il lui falloit, au lieu d’opium, Un pistolet, et du courage.”

A more extraordinary case than the preceding has been published by Dr. MacGillivray of Canada. A man of good estate, thirty-seven years of age, who used alcoholic liquors withal and to excess, had besides been addicted to the use of opium now three years. One day and in the doctor’s presence he swallowed a drachm of morphine in half a tumbler of whiskey, and in twenty minutes from this four ounces of laudanum, and finally in the evening, after their return from the opera, he finished off with fifteen grains additional of morphine, with whiskey as at first no prejudicial effects had followed to appearance, though the man admitted his constitution was being gradually undermined. Death from delirium tremens occurred some months after.

Instances less conspicuous, but scarcely less significant, are of no infrequent occurrence. Dr. Russell at Aleppo was one day with a Turk, who in his presence swallowed a drachm lozenge in the morning, repeating his dose at noon and again at evening, and without evident prejudice. Dr. Tait of Edinburgh knew a lady of mature age, ruddy-faced and sound, who had enjoyed her daily half-ounce of laudanum for twenty-four years. Wilberforce, who, as advised by Dr. Pitcairn, had used opium for its roborant power a term of years (though in moderate amounts only), observes, that for any peculiar sensations experienced he was scarcely aware on any one day whether he had taken his dose or had forgotten it. There is a New York lady of patrician connections, Mrs. M., who began the use of opium not far from twenty-five years back, and for causes incidental to the married state. She has reared a family of children nevertheless. Her measure for a good number of years (and what has not since been materially deviated from) was two drachms of morphia every day. The only obvious indication of the habit a certain sparkle in the eyes and a very moderate exaltation of the spirits, and the only morbid effect of consequence, a transient diarrhoea after any casual intermission.

In all such cases, however, signs of deterioration will ultimately show themselves (Dr.L.). In a lower sphere of life was an elderly lady of New Jersey, who used to come over to Moreton’s every three or four days for her opium, seldom varying inside of half a drachm or exceeding a drachm. Thus she did for ten years (though she had been an opium eater for twice that period) down to her death, which occurred about 1850, she being then in her sixty-ninth year. Health in the general was fair, constipation was never complained of, the countenance showed nothing usual other than a degree of sallowness, and the death appears to have had no obvious connection with her habit.

In the London Lancet of 1837 is a narrative by Morewood of an Indian prince, a sensualist of the Oriental type proper, pampered in his imbecility of enjoyment by whatever power could command or gold could purchase. The account is his own, as given on a visit of the English ambassador. Eighteen hours of the twenty-four he spent in sleep (if a dreamy stupor be such), being aroused at intervals, and then only for the renewal of his boluses; the remaining time he passed in a state of half-waking, engrossed ith his hallucinations and reveries. This potentate that was by a Dei-gratia right purely, but victim really to a bondage more abject than pertained to the humblest of his menial attendants, used ounces of opium every day, taking no food proper, a little pilau only excepted. A servile imitator without the merit of originality, he practised upon a text that had been proclaimed centuries before: “Eat, drink, and sleep – what can the rest avail us? – So spake that sceptred fool, Sardanapalus.”

At the opposite extreme are cases as remarkable, evincing the idiosyncrasy of intolerance. An instance is given by Reaumur. Several young men having come together one evening for a carousal, it was agreed to make an experiment upon one of the number, by dropping into his wine a four-grain powder of opium. The individual upon whom the deception was practised having retired to bed, was not thought of again until the next morning, when he was found rigid in death. Tournon gives the case of a lad with earache, whose ear having been plugged with a bolus of four grains, he fell into a sleep soon after, but to wake no more. Morphine too in the proportionately small dose of one grain, and half an ounce of laudanum also (if not less than this), have acted fatally (Sieveking).

A very unusual exemplification of extreme sensitiveness under morphine, in the person of Dr. Vandervoort of New York, is here given as communicated by himself. For some unwonted and extreme nervousness, the doctor has now and then found a wonderful quietive in morphine, but what is especially noticeable is the amount of effect so out of proportion to the extremely small quantity used. Three minims of Magendie’s solution (only 1/4 of a grain of morphine) would within a moderate space throw him into a state of serene sedation and most voluptuous repose, to be followed in three or four hours by a profuse sudorific action of the most comfortable kind, and finally by a sleep for the night calm and refreshing. No nausea or other unpleasant symptom was felt in the morning, unless the amount had been exceeded by a single drop or two, or in case the original dose had been repeated.

There is an idiosyncrasy of a secondary order, and of artificial creation rather, the creature of habit carried to excess, but none the less distinguishable and peculiar when once established. This is a morbid lesion of some kind, which, however perplexing to the scrutiny of the anatomist, is none the less discernible in its developments. Here or there may be observed a case of extreme sensitiveness and impressibility of the stomach under the action of opium, whatever be the preparation used or however reduced the dose. Perseverance in the use, or a revived use only after a period of intermission, becomes doubly hazardous. Analogies may be observed in the action of the bromides, of lead, of mercurial salts, upon such as have once undergone the characteristic organic changes. A lady, Miss Louisa X., then under the care of the present writer, suffered once a severe salivation of more than three weeks’ continuance, and, all from a ten-grain dose of calomel, notwithstanding that the medicine had been followed within four hours by oil as a counter-agent This pathologic excitability of the organism had been established through the intemperate employment of mercurials, more than ten years before, against a malarious fever.

The popular belief that opium, used habitually, if in moderation, is proprio vigore pernicious, is a proposition to be accepted only with qualifications. The differences observed are ascribable almost as much to race perhaps as to individual temperament. The peoples of the Orient generally, being of the phlegmatic cast more, are able to bear with more certain impunity than Europeans, not stimuli only but narcotics as well, be these alcoholic liquors or opium or tobacco. The Chinese, as Dr. Parker observes, have indeed “a susceptibility to opium like wax to the seal.”

European families, if perhaps less responsive under the primal influence, appear altogether less tolerant under the permanent impression. If not “wax to receive,” yet “marble to retain” they certainly are. Dr. Macpherson says, that though the Chinese, rich and poor as well, are smokers in so large proportion, nevertheless as a people they are athletic and vigorous and capable of great endurance, and that the lower orders both as to intelligence and physical stamina are quite equal if not superior to the uncultivated classes of the West.

Sir H. Pottinger, and also Mas, Spanish envoy at Peking, have drawn similar inferences from their observations. Even Dr. Little, while insisting that body and mind with it do not seldom wear out from excess, holds that the majority suffer no more from smoking opium than do Englishmen from smoking tobacco. The coolies certainly, inveterate smokers as they are, scarcely yield in persevering endurance to any class we could pit against them.

The indolent Turk too, as appears, is fully as tolerant of the narcotic as his neighbor of the Farther East. A great consumer of tobacco, coffee, and opium, one and all, he breaks down only exceptionally. Turn him out for the big doses. Edward Smith met with a gentleman in Smyrna, who took his three drachms in the morning and at night again, and without experiencing either exhilaration or narcotism in an unwonted degree. This person himself expressed the conviction, however, that his extravagance was wearing him out.

On the borders of the Mediterranean and the Euxine with their balmy skies, like instances, not uncommon, could scarcely be matched here in Cisatlantic land. The prima-facie objection to opium lies no more in the possible extravagance of use and the incidental liabilities than in the presumption, that the habit once fastened upon the man is fixed irreversibly, impressible to no impulse of the will-power from within, unyielding before any moral persuasives brought to bear against it from without. Facilis descensus – smooth is the slide over the slippery verge, but, revocare gradum – to face the whirl and surmount an overwhelming tide, here is a conflict too mighty for mortal endeavor. The desperate opium eater is like some reckless mariner pushing his fragile bark along an unexplored sea, careless of the hidden rock on which he may split or of the foamy eddy into which he is being furiously borne, until in a moment he has passed from sight, “Imo barathri ter gurgite sorptus.”