(From) “Opium And The Opium Appetite” by Alonzo Calkins, MD (1870)
Chapter V: Methodical Forms Of Opium Stimulation
“Que voulez-vous? Il est fait comme cela.” – Fr. Proverb
“Oh, that men should put an enemy into their mouths to steal away their brains!”- Othello.
The term Opodipsesis or Opodipsia is a legitimate coinage, being pathognomonic of the morbid condition; Opophagesis or Opophagia (Opium-eating) is a pseudonym. This latter term, however, being in accommodation to the popular idea – though indeed in no proper sense is opium ever taken by any eating process, unless hypothetically so – may serve for a technical convenience as well as any.
Among opium eaters two prevalent usages obtain: one consisting in swallowing a draught or a bolus, the other in firing a boulette or pea (the chandoo), and then inhaling the smoke through a pipe adapted to the purpose. Such pipe is known in China by the appellative yen-tsiang or opium-pistol. The people of the Flowery Kingdom universally smoke the chandoo; in Persia and the Levant they swallow the lozenge.
In the base of the bowl is a chink for transmitting the smoke into a stem, and above this is laid the pellet. The smoker, having taken the position of recumbency with a sideward inclination, the pipe in one hand and a small lamp for flame in the other, makes one full inspiration. Experienced operators swell the lungs to their full expansion, and after retaining the smoke a considerable time, as long practice enables them to do, finally exhale the fumes through the nostrils. When the spirituous preparation is used in such way, as by the grandees, a single whiff of the vaporized liquid permeates the entire cell area as with a thrill from a galvanic circuit.
For the novice a single pellet may suffice; not so for the practised smoker. Surgeon Hill describes a scene he witnessed on board the ship Sunda. The smoker, a young man of twenty-four years only, used eight pellets of the pea-size one after another, and all in the course of twenty minutes, making one long inspiration after each; he then fell into a profound sleep, which continued unbroken for three hours. The breathing was heavy and the circulation depressed, the pulsations being reduced by about one in twenty.
The progress towards stupefaction is less speedy as experience grows into a habit. Old stagers may require hours and many repetitions ere the coveted excitation is secured. Libermann, an attache of the Imperial army against the Yaous, and the author of surgical memoirs covering several years, speaks of pellets of 10-15 centigrammes in weight, 10, 20, or 30 of which, even up to 200, might be requisite to the complete somnolescence. Suppose the full influence attained in two hours, it will hold for four or five.
In certain regions modes altogether peculiar obtain. The Rajpoots, a military class exclusively, have the following fashion. On the arrival of a friend, the first question put to him is, “Umul Nya – Have you opiumed?” At their festive gatherings a big bowl of water, into which has been dropped a lump of opium, is set in the centre of the table. When the guests around have a dip each in turn, making a cup of the hollow of the hand. (Col. Tod, 1829.)
Another mode is observed in Siam. Here the company, be it opium or bhang that makes for the time the entertainment, sit squat in a circle, just like a Choctaw with his squaw and the rest, when settled in a ring around they are ready to pass from mouth to mouth the whiskey canteen.
The opium shops in the cities (where the hoi polloi, the “filth and scum” are prone to hive) are narrow rooms, secluded from outside observation, dingy and dank, with a solitary lamp suspended midway, apparently for the purpose of making darkness visible rather, and which are packed almost to suffocation. These dens of dissoluteness and debasement are but rarely visited by merchants and others of better class, unless with a view to greater privacy for the time.
“At the mansions of the rich (says Hue) there is usually found fitted up for the accommodation of friends, a private boudoir, richly ceiled, and garnished with superb adornments, such as art only can achieve and wealth procure; and here rich paintings, with choice scraps from Confucius, adorn the walls, and carvings in ivory with other articles of virtu, grace the tables. Here also is provided in chief the gilded opium pipe with all its appurtenances; and here host and guests, unrestrained by curious eyes, deliver themselves up without concern to the inebriating chandoo and its beatific transports.”
In Constantinople the bazaars are adorned in a style more accordant with the Asian pomp of the Ottoman. The visitor, having placed himself reclining upon a dais, the servitor in waiting, with a tactus eruditus such as ever designates the trained expert, deftly lays a single lozenge upon the tongue of the recipient, like as is the manner in a Christian country with the knight of the mortar and pestle, who “(Most mild of men!) Bids you put out your tongue, Then put it in again.”
As between pipe and bolus, in view of their pathologic consequences, says Surgeon Smith, there is little to choose. The chandoo being partially denarcotized, has the advantage in respect of purity, an advantage evenly counterbalanced if not more than that in this, that the area of cellular surface in the expanded lungs directly exposed to the narcotizing action is in excess so many times over of that of the stomach-membrane.
A third mode of bringing the system under the desired influence, is the Hypodermic method – subcutaneous injection by means of a syringe. In this way one-third the quantity that would ordinarily be taken by the mouth suffices, i.e. the same amount exerts a triple force. The practice, as favoring the habit, appears to be less hazardous in instances, but not certainly. Eulenberg in a case of disease made 1200 injections in all, and without manifest injury appertaining. For withdrawal he advises graduated reductions, with atropia incorporated in proportionately increased quantities. Any reliance placed upon this form of use, however, for its supposed comparative security, is likely to prove delusive.
Dr. Sewall of N. Y. has just reported two cases. In the first, the practice, after a two months’ continuance, was arrested, but not without much embarrassment; the second patient still continues on, writhing as helplessly as if, Laocoon-like, he were wound around in the coils of some monster-serpent. This gentleman, now of middle life, having suffered much from a diseased ankle, was advised (professionally) to use morphine hypodermically. The immediate effect being found most soothing and satisfactory, an indefinite continuance was suggested; and now, after a habituation for two years, the invalid is hopelessly delivered over, an abject slave to the habit, enervated in body and enfeebled in mind. The thigh of the affected limb is literally studded with punctures, to be counted by the score.
There is a case reported by Dr. Parrish, marvellous indeed in every view. The patient, a country physician, having now become an inmate of the Sanitarium, thus introduces himself before the public.
The Probe: by Joseph Parrish, M.D., Media, Penna., No. 1, 1869.
“Two years ago, I was suffering under a violent attack of neuralgia; meanwhile I could procure no sleep, not even any respite from suffering through the agency of any one of the recognized narcotics as employed in the usual modes. A medical friend suggested morphine, eighth-grain doses in solution by the subcutaneous mode. The relief experienced so sudden, so complete, I can never forget. Delivered of all pain, I was furthermore enjoying a repose indescribably entrancing. From the day on which these sensations occurred, I date my present bondage to a habit that has well-nigh ruined my health, prostrated my business, and blasted my hopes for coming time.”
This gentleman, of good position at home, with a moral constitution peculiarly sensitive under the pangs of self-reproach, and the mortification arising from having yielded to a fascination whose history he was sufficiently familiar with, now lay prostrate under the inertia of despair. The quantity he had fixed upon for the day was 5 grains regularly, and for 730 consecutive days he had used his instrument at home when time allowed, or again when abroad in his carriage; by the roadside; at the house of a patient; or during a halt at the tavern. The punctures, averaging several a day, were made irrespective of locality, though commonly near the seat of the central pain, and not unfrequently to the depth of an inch. They numbered altogether 2190. The morphine consumed amounted to 3650 grains, the equivalent of thrice such quantity taken in the ordinary way, that is to say, 23 ounces. For the sequel vide c. xxi.
Methodical Forms of Opium-Stimulation (Chapter 5, continued)
This being eminently an age of novelties and experimentations, there falls in here, not malapropos, a case quite unique in character certainly, and illustrative of what may be more delicately described perhaps by a euphemism, the Methodus per Inversionem. The case is contributed by Dr. L. of New York. Mrs. B., demi-veuve, age 25, of delicate habit and fair complexion, had been habituated to morphine three to four years, introducing solutions of the same intra-rectum, by means of a small acuminated glass syringe.
Repeated efforts to break off, with veratria for a substitute, had been of no permanent avail, for the appetite would not thus be put down. One day, in the height of the gold-excitement (Sept. 1869), the lady (a frequenter of the bourse) went down to Wall Street about ten o’clock in the morning, but without her usual supply which she in her hurry had left behind. Suddenly seized with overpowering tremors, she rushed into the first saloon she could find and swallowed a full tumbler of raw whiskey, and again a second after a little interval only, besides purchasing a bottle for use on the return home.
The doctor found her about 7 p.m., tremulous all over in body, and in great mental perturbation, for she had drunk, as appeared, a good deal besides the extra bottle, though without any inebriating feeling. Ale was advised for the night, and several pints were taken, but no sleep came. The case proving intractable (for “she must have her morphine or die” – so she said), was, after a few days’ treatment, abandoned. Her mode of using was (the account is her own), to pour into the palm of the hand a quantity – about 10 grains, as she illustrated by drawing a vial from beneath her pillow – then to transfer the same with water to another vial for solution, and from this to charge the instrument. The operation was repeated several times in the day, and abroad as well as at home; any by-place serving as a convenience, a side-room in a broker’s office, or a nook in a secluded street. Verily “knowledge by witty inventions” is not yet, it would appear, “past finding out.”
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)
Porter J, Jick H. Addiction rare in patients treated with narcotics. N Engl J Med. 1980;302(2):123. [PubMed]
Kanner RM, Foley KM. Patterns of narcotic drug use in a cancer pain clinic. Ann N Y Acad Sci. 1981;362:161–172. [PubMed]
Perry S, Heidrich G. Management of pain during debridement: a survey of U.S. burn units. Pain. 1982;13(3):267–280. [PubMed]
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]
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]