New-York tribune., 1880-02-22
THE USE OF MORPHINE.
From &" Brain " for JcnuLry.
EFFECTS OF The HABIT.

While the progress of science Is ever dlscOVerlni
new methods of combating disease, the advance o
civil il,zatIon brings with 1t new enemies. Railway
bring in their train spinal cOncusslon, telegtapn'
develop telcgTaphic cramp ava many VaIuapit
remedies become by their abuse the sources OF new
ailments. Such are the various forms OF chroniC
poisoning, the prototype of which rs chrome al
cOhOlism, faithfully portrayed ny seneca Spe
cally worthy of notice in this relation ls the con
tinued abuse of chlOrofOrm, and opium AID ITS
alkaOids more particularly mOrpha. It IS diIcr'
ent with ncOtn. which l. taken without t'e sl'ght-
est evil effect by Il large percentage OF Daikihl OF
even with arsenic. ChlorOiOnn and morpnla d,nei
from alcohol. inasmuch as the latter may We taken
in considerable quantity without appreciable m
jury, SO far as the nervous system is cOncellieu
whereas tine former two very frequently produce
evil effects. and lead to earnest desire on the palt
of the individual to shake off the habit which Is at
all Tunes difficult and often impossible
HOW IT BEGINS.
The first commencement of the use of mOrphia IS
almost always some painful ailmeht: and then, as
the pain continues or even though 1t may have
disappeared, the babit is formed. and more and
more of the drug is demanded. SO began one OF my
patients after traumatic IN jury of the sciatlc an
other i'm consequence of peTiustltis; third IA phy-
slcianl for toOthache; lady took to subcutaneous
injections to allay violent pains III the sacrllm
caused by pelvic disease In other cases. however,
pHlciV nervous symptoms lead 10 the formation OF
the habit. As is we'll known, we have in the sub
cutanrOus injection of mOTphia Il powerful weapon
agaust feelings OF fearful anxiety; that states Of
mrlanchola. even OF high degree, not unfrequehilN
give way before 1t. such intense anxiety ana IN
morphia. But other nervous conditions lead TO q
similar result Thus lady exhausted by long-c0n-
tinHrd vomiting OF nervous origin. found opium the
only remedy Of any avail. Though the existence OF
some painful affection is the chiel cause OF mOrphin-
ISM yet tuege are others. A y0ung medical Gan
rnyc the faliuWn" account OF hIs own case. Nhilc
hc was attending Ice hospital, n patient was dls-
missed suffering lr"m carcinoma of tue stomach
ard who had been Tor a long time treated WIN sun
cutamcou5 objections OF morpha NeNt day the pa,
tieat returned IN state Of great excitement, an"
mteou.ly begged for an injection. as otherwise ne
must DIE. Tins occurred in 1859, ut time when
cLrouIc nCrDhlnlSm and its phenomena were css
known than now. As the physician was nGuhed To-
believe that the patient was r0mahcn$' ne 'Itu
the experiment on himself 10 ascertain What tle
cGecis were. The result was that he formed The
habit of norphin7m, and never couId overcome IT,
QUANTITY OF TIE DOSE.
With reference 10 the quantity taken. it is to be
ted that ia varies within certain limits, ana mas
not exceed the M Xlmrm The smallest quantities
which can ho taken continuously without any very
marked effects or reaction, are NiraDic Win INC
iudNiIual | have under treatment lady VINO ias
taken daliy for moro than year ab0dt O'OU3
rmiur and who has never felt inclined TO increase
The dose. thoIgh size strongly objects 10 gvlhg IL
mn rcly ON account Of Iestlessncss sieepieSsness
efc Wmlr M most cases OF continued moIphlhlslh
a habituaton occurs. SO that more ana more may ne
taken there l. limit, variable IN different lnul-
yldual,. b,yOud which, ~ rule, II IS lHpossIole
to CO. II the molpilinst has reached the maximum
dose hc is aware of ;. and instlnctiyely keeps on
tui, side of II that very seldom near OI acute
uol .onug with mOrphIa in such cases. There are
individuals whu never exceed O.OO1 gIamme dalIy'
aad have similar symptoms TO those VINO cons
% , grammes. More than 30 gIammeS may NOT
he taken daily continuously. THIS appears To be
be the limit even III the most pronounced cases.
SYMPTOMS.
with respect to the symptoms OF morphlnism,
they ARE 80 well known that they 90 not require 10
hp detaile at length. IL mOTphlnlsJ WHO COMES
for advice and hep Is asked what symptoms he
chiefly complains of, the answer Is much the same
in all cases. Discrimination to cxertlon III general
apathy; loss OF memory; reStleSoness; generally
also loss of appetite various pains, hypeIesthes,a;
and in pronounced cases, suicidal tendencies. Inc
patients tc,bc cmaclatcd, nave an ashy-gray or
liVld complexion; }aWn ard SnctZe gTch Oedl' dHu
arc imp9lrcd as to Xual power or completely I'M
potent. Less attcn ION has been pald 70 the PsF-
rhcal condition. In this there Is certain analogy
between alcoholism and mOrDhnlsm. As the 1of-
mer Is characterized by moral deterofatlon or
moral s,arvatiou-whence the name formerly gwen
"iyhuuapitds ebliOsd $50 IN the mOrphinlst there
/, a moral dccadeUCc in many cases. As ne elde2
his respect toI truth and tells lies to conceal MS
condition and afterward from more habit. lie
even lies 10 his ply sCIan one day lie say he mas
been accustomed to take 90 gramme daiIy, ana
noxt day he makes it l gramme. From tins ten
dency To living, which. however, ls not all 10 Oe put
TO the account OF mOrphla, ho soon loses al SELL
rcsp,ct. he feels how deep he has sunk, and, seeing
40 means of escape be sinks deeper ana deeper
This is of course not true of a cases but know
ledge of this fact Is necessary in order rghtly TO
estimate the utterances OF morphlnists. Inc phe-
uoincua of the mOIphla-hungeT vary Win the lnul-
yidunl and with the duration OF the fast. very
often. where the quantity Is slowly diminished,
there are with the exception of increasing d'scom
fort. no violent symptoms When, however, IT Is
entirely withdrawn or nearly 80, NlOlent synp
tnrIs ocrur These are acute darrhGa; insomnia;
Great rNcltemeut or even mania dangerous to those
around and particularly the physician; pains Itch
lng of tnc skin preparations, feeling OF coldness
Examinations collapse etc. In general, the grad
uai withIrawal has little advantage over the sud
Gen. When great care has to be exercised on ac-
count of complications great weakness, great eA-
citnb,ilty e:c.) IL may be- had recourse 10 rather
the Other; Yet. has already been remarked the
explosive symptoms may occur nevertheless
PROCESS OF CURE.
To relieve the sutierings Of the worst period IN
the weauiug process. various methods have been
recommended; but unfortunately, though often
usc fuI tuev are not so i'm all cases e. <. wine IN
toIcrnbly large amount bromide OF potassium. warm
baths Ia some cases, packing III lukewafm Nei
sheets WAS of great service. III may Oe remarked