The dried milky juice from the green, half-ripe heads of the papaver somniferum, especially the large-headed white poppy, the papaver officinale. A number of chemists have endeavored recently to ana- lyze opium into morphine, narcotine, meconic acid, extrac- tive matter, caoutchouc, opium-balm, fat oil, glutinous matter, resin, gum, volatile matter. Most of them, however, disa- gree both in regard to the mode which they adopt in sepa- rating opium into its constituent ingredients, and in regard to their chemical nature and relative power. Considering this difference of opinion, the probability is that not much can be expected from those alkaloids in the treatment of disease. Homoeopathy uses the drug as nature gives it, and prepares it for medicinal purposes in such a manner as will make every constituent element of the original drug to enter into the pre- pared drug in the original proportions. The object of Homoeo- pathy being to save, not to destroy life, we have no occasion, in our art, for morphine, or indeed for any of those dangerous artificial preparations. We therefore either use the alcoholic solution of opium, or we triturate one grain of opium with ninety grains of sugar of milk, and prepare the potencies in the usual manner, using one or two pellets of the 30th potency at a dose, which is quite sufficient. It is much more difficult to observe the effects of opium than those of any other drug. The primary effect of small doses, which affect the organism passively, appears to be to irritate for a lime the voluntary, and to diminish the irritability of the involuntary muscles, VOL. IV. 2 2 OPIUM. to exalt the fancy and courage, and to blunt and stupify the external senses, the sentient sphere, and the consciousness. The contrary of this takes place when the organism reacts ; want of irritability and activity of the voluntary, and morbidly exalted irritability of the involuntary muscles, absence of ideas and dullness of the fancy, timidity and excessive susceptibility of the sentient sphere. The primary symptoms of large doses are not only danger- ous, but they frequently succeed one another with a sort of tumultuous hurry, are frequently intermingled with secondary effects, or suddenly change to the latter. In some persons single symptoms are more striking than in others. We know of no medicine which is more capable of sup- pressing the lamentations of the patient more easily than opium. It is in this delusive power of opium that originates the great abuse which has been made of it. If the use of opium were generally followed by as good effects as it frequently is, there would be no drug which would do as much good as opium. But the contrary is generally the case. The power and speed with which it acts, make great cau- tion and a careful knowledge of the circumstances where it ought to be administered, an indispensable condition of its being administered with benefit. This is not possible except when it acts homoeopathically to the symptoms. In some rare cases where physicians dared to act contrary to the rule " contraria contrariis curentur," or when they made a mistake or acted numinis affiatu, by the inspiration of a god, wonderful cures have been effected by opium. Generally, how- ever, opium has been used as a palliative, and no palliative is more capable of disguising morbid symptoms or smoothing them over, no palliative produces a more dangerous reaction and does more positive injury after its palliating effect has passed off, than opium. Opium has been used as the principal remedy against all sorts of cough, diarrhoea, vomiting, sleeplessness, melancholy, spasms, nervous complaints, especially against all sorts of pains. But very few of those ailments are primary effects of opium • most of them are the opposite of those primary effects ; this shows how little permanent good must have been accom- plished by opium in the treatment of those affections, as is indeed abundantly confirmed by experience. Opium has sometimes removed slight and recent cases of diarrhoea, vomiting, sleeplessness, trembling, etc., in a perfectly healthy body. A short cough which has been occasioned by a OPIUM. 3 cold, a recent trembling occasioned by fright/ a diarrhoea which has been suddenly occasioned by fear, by a cold or other slight causes ; retching, which has come on in consequence of a moral emotion, loathing, etc., may yield to opium, and some- times does yield suddenly, because all that opium requires to do in these affections, is, to suppress them for a short while, in order to enable the organism to remove in the meanwhile all disposition to those aftections, and to effect its restoration to health by means of its own inherent recuperative power. (See Organon of the Healing Art, § 63. Note.) The power which opium possesses, to palliate the above named trivial affections, should not lead one to suppose that opium really possesses the power to cure such affections per- manently, under all circumstances ; those affections cannot be cured by opium if they are fragmentary symptoms of a more comprehensive affection to which opium is not homoeopathic, or after they have lasted for some time. It is for this reason that opium has been employed in every country to the detriment of patients affected with old cough, chronic diarrhoea, chronic sleeplessness, chronic vomiting, habit- ual spasms, fits of anxiety and trembling. These ailments have never, in a single instance, been cured by opium, if they were either fragmentary symptoms of an affection to which opium was a mere antipathic, or after they had been in the organism for a certain length of time. In using opium in the above mentioned affections, as a pal- liative remedy, a delusive alleviation is at first experienced ; the influence of opium disappearing in a couple of hours, the dose of opium has to be increased in order to secure the continu- ance of its palliating influence, until, finally, it is increased to such an extent that opium-symptoms are produced in the sys- tem, which are frequently much more troublesome and dan- gerous than the original disease. What a pernicious although universal abuse of a drug which God has destined for the cure of totally different affections \^ The greatest abuse which has been made of opium is as ' Smelling of a pellet of the 30th potency of opium, removes the effects of recent frights, were they ever so violent, almost instantaneous- 'ly, but only when the smelling is resorted to immediately after tlie fright; if used too late, the opium does mischief, 2 Opium is a specific for certain kinds of the most obstinate consti- pations, and for acute fevers characterized by a sopor bordering upon stupor and by absence of without any complaint, snoring with the mouth open, half jerking of the limbs, burning heat of the perspiring body, and for some other morbid conditions to which opium is homoeopathic. 4 OPIUM. an anodyne against pains of any kind, no matter how old and inveterate they might have been.' The fact that opium should be used as an anodyne against all sorts of pain, appears of itself foolish to common sense. Physicians ought to consider that pains vary according to the nature of the disease, locality, time, the circumstances in which they originate, are excited again, increased or diminished, etc., and that this variety of pains requires a corresponding variety of remedies, inasmuch as every drug, being itself a finite substance, can only have a finite sphere of action. Opium is no true anodyne, does not cure pain. Among the primary symptoms of opium there is not one symptom of pain. Every other drug excites a particu- lar kind of pain in the organism and is therefore capable of curing a similar pain, especially when all the other symptoms correspond. Opium is the only drug which is incapable of curing a single pain, for this reason, that it does not produce any kind of pain as a primary symptom, but on the contrary insensibility, which is necessarily followed by an increase of sensibility as a secondary eifect and a corresponding increase of pain. All the pains which have been palliated by opium, return as soon as the stupefying effect of opium has passed off, and return at least with all their former violence.*^ Generally the pains return with gi eater violence, and their farther suppres- ' Although I have condemned the practice of administering opium as an anodyne as late as twenty years ago fsee the first edition of the Organon, 1810); although I have shown tnat practice to be a sinful transgression of the just rights of the patient, nevertheless the practice ha^ continued as before without any intermission. The perpetrators of that practice have indignantly rejected my exhortations ; my exhortations, intruding upon their thoughtless routine, have roused their anger just as the impenitent sinner, whose conscience is struck by the sermon of the minister, growls at the latter instead of being dissatisfied with him- self. But what does a man like me, who feels bound in his soul to teach important truths, and who has truth and nature on his side, care what those incorrigible spouters may say ? He who feels strong enough to discover errors and to enlarge the boundaries of science, is obliged to do so, and the public ought to listen to him, although ti whole school, who thinks its authority so well found- ed that it does not think it worth while to appeal to nature, or who feels bound, at any rate to suppress the memory of the discoverer, should be offended by the new doctrine. — Fr. Casimir Mediais. ^ Willis, in his Pharmacia Rationalis, says, p. 298 : " Opiates gen- erally alleviate the most horrid pains and produce insensibility for a certain time ; but as soon as that time is passed, the pains return imme- diately and soon become as violent as before ;" and page 295 : " When the opium ceases to act, the colic returns, and does not abate till the opium is resorted to again." OPIUM. 5 sion requires increasingly large doses of opium, which, finally, establishes its own peculiar effects in the organism. This sup- pression of pain by means of opium is mere quackery, decep- tion of both the patient and his friends, and is frequently at- tended with dangerous and even fatal consequences, which are represented as a new disease by those who administer the poisonous drug.' Chronic maladies are the touch-stone of true treatment, be- cause they do not disappear of themselves ; slight aiUiients which come on of a sudden, pass off with or without medi- cines, by the recuperative power of the organism ; but if rem- edies do act as curatives in acute affections, these ought to disappear much more speedily than when no medicine is given. If opium seems to appease pain in acute diseases, it is be- cause these diseases either became speedily fatal, or else dis- appear of themselves in a few days, together with the pain. Opium cures pain indirectly when it is homoeopathic to the general affection, in which case the pain disappears together with the disease. Every case of dysentery, for instance, de- pends upon a retention of faeces in the upper part of the intes- tinal canal ; it is evident that some cases of dysentery which are accompanied with heat and stupor, may be cured by opium, for the simple reason that certain primary effects of opium cor- respond to those symptoms homoeopathically, and of course cover the accompanying pains which were occasioned by the spasmodic retention of the faeces. The pain in lead-colic cannot be removed by opium until the constipation which had been occasioned by the lead, has been conquered by small doses of opium ; the pain disappears indirectly, but does not yield to the stupefying power of opium. Opium can never cure pain directly, without doing injury ; on the contrary, it is a principal remedy in those affections where a condition of stupor has made the patient insensible to pain, for instance, in decubitus, etc. Painful diseases, both acute and chronic, can only be cured by a remedy which is capable of producing in its primary ac- tion upon the organism a pain similar to the one which it is intended to cure ; when that remedy is administered, both the disease and the pain disappear at the same time. Opium being given as an antipathic remedy to pains, it was ' Alloeopathic physicians frequently occasion inflammations of the brain and bowels by attempting to suppress violent headache and colic by large doses of opium. 6 OPIUM. a matter of course that it should produce dangerous drug- symptoms, such as stupefaction, constipation, and the hke. Instead of looking upon these symptoms as necessary effects of improper doses of opium, they were looked upon as acci- dental inconveniences which might be corrected by certain ar- tificial contrivances, so called corrigentia, the effect of which was supposed to be that opium would alleviate pain without producing delirinm and costiveiiess ; that it would arrest vo- miting and diarrhoea without stupefying, and that it would convert sleeplessness into sound sleep without exciting heat, and without leaving any headache, trembling, weakness, chil- liness or low-spiritedness. To counteract the coldness which was experienced as a sec- ondary effect of opium, heating spices were added, and its con- stipating virtue was supposed to be counteracted by cathartics and salts. By dissolving it several times in water, by filtering and inspissating it, its crude, pretendedly useless and hurtful resin was supposed to be separated from it, and the pretendedly poisonous narcotic essence was supposed to be expelled by sub- mitting the opium to digestive processes for months ; it was even thought that it might be refined and moderated by roast- ing, and that it might in this manner be converted into a pre- cious and faultless panacea against all sorts of complaints, pains, sleeplessness, diarrhoea, etc. This was, however, an illusion ; all that could be accom- plished by such expedients was, to diminish the power of opium without changing its nature. Larger doses were now required to attain the same object, and whenever those larger doses were administered, they acted as the original opium ; the new preparation had the same stupefying effect, produced the same kind of costiveness, etc.and it became evident that opium has no useless or bad quality, but that its peculiar effects must become troublesome, prejudicial, and even dangerous, if the drug is employed antipathically, no matter whether in its original form or after having been weakened 1 y a multitude of exi)ensive contrivances. Opium, especially when administered in large doses, has a peculiar effect upon those who are not accustomed to it, or who are very excitable ; it produces a momentary reaction of a pe- culiar kind, which is short, occurs but seldom, and ought not to be confounded with the real primary and principal effect of opium. These rare, momentary, incipient reactions correspond almost entirely to the secondary effects of the organism when primarily acted upon by opium ; they are a sort of reflex of these secondary effects ; deadly paleness, cold sweat, timid an- OPIUM. ^ guish, trembling, mucous diarrhoea, momentary vomiting or short cough, and occasionally one or the other kinds of pain. In cases of poisoning by opium, the genuine primary effects of opium are not seen; but the incipient reactions just men- tioned at once terminate in death. I have seen such cases, and Willis relates some in his Pharm. Rat., sect. VIL, can. I p. 292. ' F » The oriental opium-eaters are constantly in a state of the secondary effects of opium, after the effects of opium have sub- sided ; Iheir mental powers are very much weakened by the frequent use of that drug ; chilly, pale, bloated, trembhng, low- spirited, Aveak, stupid, and with an evident feeling of internal discomfort and anxiety does the opium-eater stagger to the opium shop in the morning to swallow his number of opium- pills, in order to accelerate the course and restore the warmth of the blood, to raise his sunken spirits, to animate his cold and barren imagination with a few ideas, and to rouse for a time the activity of his paralytic muscles. The symptoms which will be found enumerated hereafter are, most of them, secondary effects of the organism. AVould that those physicians who continue to administer large doses of opium as an antipathic remedy, reflected on those horrid secondary effects. I should say that they ought to suffice to arouse the humane feelings of those men, to enlighten their con- sciences about the wrong they commit, and to prompt them to use opium for the benefit, not for the ruin of their patients. Dangerous doses of the tincture of opium are antidoted by the tincture of ipecacuanha, camphor, and especially by strong coffee, which is to be given by the mouth and rectum, and is to be accompanied by friction of the body. But when icy-cold- ness of the body, insensibility and want of irritability of the muscular fibre have already set in, a warm bath is to be added to the above means. When large doses of opium, which had been administered for the purpose of alleviating pain and arresting diarrhoea, had produced paralysis of the limbs, it can scarcely ever be expected that such paralysis should be cured, no more than paralysis caused by violent electric shocks can ever be relieved. Some of the primary effects of opium last only a couple of hours, others, especially when produced by larger doses, last longer, unless they should cause immediate death. Opium is one of those drugs the primary effects of which seldom correspond homoeopatliically to the symptoms of dis- ease ; but, when they do, a few pellets of the 30th potency are sufficient at a dose. My co-observers are, Cubitz, Gutmann, Schoenike, Stapf S OPIUM.