RC 371 .06 K4 1890 Copy 1 LIBRARY OF CONGRESS. Glp? SnpnrigWm. UNITED STATES OF AMERICA. 5Y " "m !■ lUSE^BUS LESLIE E. KEELEY, M DlflllGHT. 4LL. OPIUM: ITS USE, ABUSE AND CURE; OR. FROM BONDAGE TO FREEDOM. THE OPIUM, MORPHINE AND KINDRED HABITS ; THEIR ORIGIN, NATURE AND EXTENT ; TOGETHER WITH THE PROPER METHOD OF TREATMENT TO BE ADOPTED. LESLIE E. KEELEY, M D., Svu-geon Chicago & Alton R. R. Co., D wight, Illinois. Late Surgeon U. S. Army, AUTHOR OF ■'The Morphine User," "A Popular Treatise on DninkenneKS," "Neurasthenia, the Modern American Disease," "Opium Smoking," etc., etc. The disease, that shall destroy at length, Grows -^ath his gi'owth, and strengthens with his strength. — Pope. Within the infant rind of this small flower Poison hath residence, and medicine power. — Shakspeare. The image of a wicked, heinous fault Lives in his eye : that close aspect of his Does show the mood of a much troubled breast. — Shakspeare. Timely advised, the coming e\'ll shun ; Better not do the deed, than weep it done. — Pry or. DWIGHT, ILL.: THE LESLIE E. KEELEY COMPANY, PUBLISHERS \ V \ i-i ,0l.^'•. Entered, according to act of Congress, in the year 1890, by THE LESLIE E, KEELEY CO., In the office of the Librarian of Congress, at Washington, D. C. TO THE MEMBERS OF THE MEDICAL PROFESSION A>-D OTHERS WHO HATE SO KINDLY CONTRIBUTED • INFORMATION, AND TO WHOM I AM INDEBTED FOR MUCH VALUABLE ASSISTANCE THROUGH A CORRESPONDENCE WHICH, THOUGH LARGE, HAS BEEN MARKED WITH UNIFORM COURTESY AND KINDNESS TOWARD :ME, THIS BOOK IS RESPECTEULLY DEDICATED BY THE AUTHOR. TO MY READERS. For the past thirty years I have devoted much time to the study of the Opium Habit in all its fonns. During the war, and in an active practice since then, I have been favored with many opportunities for successfully observing Opium cases. I have conversed and corresponded with thousands of victims of the habit, and have thus been able to arrive at practical conclusions concerning the pathology and treatment of this disease. For many years I entertained the popular ideas of the profession upon this subject; but extended research and personal observa- tions have given me a more accurate and certain knowledge of its nature and results. It is because the habit is so little understood, and the exist- ing need for the latest scientific and medical information con- cerning it, that I have written the following pages. They contain no idle theories, but are replete with practical facts. I have written for the people as well as the profession, in the hope that the unwary may be fully warned against a vice which is so delu- sive and dangerous. The members of the profession will, I trust, find in this vol- ume a help in the treatment of Opiumania and Morphism ; while to the myriad victims of the drug it will open a door of hope which will lead them into the perfect sunshine of liberty and health. Leslie E. Keeley, M. D. DwiGHT, III., March 1. J890. PRELUDE. " God's best gift to man,'" is the Arab's favorite name for Opium. The poor, worn nomad of the desert, battling against the elements, as he toils across the dry and trackless waste, comes to his encamp- ment as the evening shadows gather, suffering from an exhaustion overpowering. And, as the stars gleam out from that eastern sky, like bolts of glowing steel fresh-forged from the furnace of Jove, and the sighing winds breathe out their requiem for the dying day, he finds in the all-potent "• drug." •' surcease of sorrow.'" The morning of delight breaks upon his weary soul, the richest melodies lull him into delicious calm : he feeds upon ambrosial joys in which rest and refreshment come to him like a benediction from God. The en- campment is no longer dreary with oppressive desolation : the simoon of the day past is remembered as a laughing zephyr, and the sands about him are glistening pearls. The gossamer clouds, flecking the, sky above him, no longer pass his vision like restless spirits of departed joys, to mock him, but like the white-robed angels of God, with out-spread wings, they come to watch and guard his rest from disturbing influences. And now he" sleeps, and, while those oriental priests of nature — the tamarind and date-palm — bend over him and their own shadows, in rustling song, he dreams, in serene and rapturous delight, of that heaven and the houris promised him when lie has passed to the •• voiceless beyond." What wonder, then, that he of the "Saracen-faithful." pronounces this nepenthe of the soul. •' God's best gift to man." FEOM BOI^DAGE TO FEEEDOM; OR. THE FETTERS BROKEN. CHAPTER I. THE MIKAGE OF THE SOUL : OR THE HABIT FOKMIXG. "The primrose path of dalliance leads to hell.""— Shakespeare. The dream}-, blissful languor ; the ecstacies of pleasure, described by the Tictims of the morphine habit during the earlier stages of their disease, and while j^et they were only on the confines of the opium Inferno, have been given to the world by various writers, in the most graphic and vivid terms. The subject has been treated of by a master, whose genius has enwrapped it in the most gorgeous robing of balanced sentences and resounding periods, malting the story of the famous opium user a classic in English literature. Every writer upon the subject, when he recalls his experiences, seems to linger upon the pleasurable sensations of his initiation with special fondness. His imagination, so worn and jaded with respect to all other things, renews its strength, in the memory of these first sensations— even adding to the glory of the golden haze in which his soul was veiled, when first he entered the fellowship of " The mild-eyed, melancholy lotos eaters " in the island where all things were dim and quiet and far away. There is a mingling of truth and falsehood in the opium users record of his earlier experiences. Those who have published the story of their lives for the general reader, in books or magazines, while they do not and cannot exaggerate the dreariness of the desert into which the habit leads at last, have haloed the entrance to that desert with an unreal glory. To the cured morphine user it seems as though a luring demon had furnished the inspiration of these records in order to wile innocent souls into bondage and doom them to despair 1 And yet it is difiicult to depict with too much color and light the peace, the perfect calm, the blissful quietude which opium and its preparations bring to the physical nature. They are the masters of nearly every form of bodily pain. The pangs of physical anguish, 10 fromTbondage to freedom: which before were unbearable, stinging to madness, are suddenly repulsed and kept at bay, as Russian wolves are driven back into the outer darkness by the sudden upleaping of flames from the fright- ened traveler's camp-flre. The tiger fangs of neuralgia are suddenly wrenched apart by the strong hand of the opium giant, and the shrieking victim has hours of blessed rest ! The agony of diseased nerves is quieted. The morphine spirit touches the tossing victim of sleepless nights and days with its soft white hand, and he be- comes as peaceful as a sleeping child. It is a blessed peace, it is a sudden transition from infernal regions to gardens of Paradise ! The sweeping condemnation, indulged in by so many, of the ex- hibition of the various opium sedatives used by the profession, is not founded upon reason. It results from an uninformed sentimen- tality. Not for nothing does Nature, our mother, nurse the pale poppy flower in her fruitful soil with out-pouring sunshine. Like the Buddhist Satan, the opium spirit is dual, an angel of light as w^ell as of darkness. It has for humanity blessings as w^ell as curses. The wise and careful physician uses the "drug" to allay the torture of disease, for he knows that the torments of agonized nerves may often be as exhaustive to the vital forces as the malady which causes the anguish. Nor is it the prescription of the physician, or a strict compliance with his directions, which, except in a small percentage of cases, leads to the formation of the morphine habit. There are, of course, thoughtless and inexperienced medical men, who estab- lish in patients the opium craving by their heedless continuance of the "drug." But, as a rule, the victims themselves create the tyr- annous appetite by continuing the use of morphia, or other nar- cotics, after the medical attendant has ceased to prescribe. They have found relief in the "drug," and they prescribe it for them- selves. The lesson to be drawn from such instances is, not that physicians should never prescribe opium sedatives to their patients, but that the treatment of disease should be left to those who have devoted their lives to the study of maladies and their remedies. If patients take up the administration of narcotics to them- selves at the point where their physician has ceased to prescribe them, and creating in themselves the morphine habit, they have only themselves to blame; as in this age of public schools, newspa- pers and of scientific knowledge, none should be ignorant of the powers of opium or morphine, and the dangers attendant upon their continued use. The vast majority of the slaves of the "drug" are OR, THE FETTERS BROKEN. 11 neither unlearned nor inexperienced. They stand much above the average in intelligence and general information. How then can they justly plead the excuse of ignorance, and throw the blame upon the physician ? In cases where morphine is administered to ignor- ant patients to tell them the name of the "drug" which has re- lieved their pain, might be like pointing out to Adam and his wife the tree of good and evil, and making it easy for them to pluck and eat its fruit. If the patient only knows that he was relieved from pain, but does not know the agent by which relief was obtained, he cannot dispense the potent and dangerous medicine to himself. To keep him in ignorance is his best safeguard. The m^edical profes- sion have, perhaps, enough to lament, and even to repent of, because of their lack of positive knowledge, but the blame of making mor- phine users need not rest more heavily on their consciences than may be needful to keep them from carelessness in the pursuance of their duty to relieve the physical sufferings of humanity. I do not, then, deny that the vivid portrayals of the power of opium and its preparations to quiet physical, pain by writers of books and magazine articles upon the opium habit are, in the main, truthful. It is also true that certain unnatural appetites and pas- sions which sometimes become despotic, spoiling the life, and bring- ing, like a dark cloud over the soul, a tearful dread of desperate crime and awful judgment, are held in check, shorn of their ram- pant power by the wonderous might of opium. The inebriate some- times finds at least temporary relief in the "drug" from his tiery craving for alcohol: the abnormally unchaste, through the same magic, obtains relief from this terrible disease. But it may be gravely questioned whether the glowing language used by writers upon the subject to depict the "flowery beds of ease" upon which the soothing power of opium lays the tormented body, is not only unwise, but positively injurious. However this may be, I do insist that the highly rhetorical descriptions of the effects of opium sedatives upon the mind and its power of thought and imagination, have been pregnant of much harm to the world. The whole subject has been pictured with highest lights and warm- est coloring. The reader is told, in effect, that through opium or its preparations he may at once become an orator, a poet, a thinker with grand ideas of liberty and progress, or be lifted from discouragement and even despair to high possibilities of joyous and successful action. 12 FROM BONDAGE TO FREEDOM; Some writers speak of inspirations, which, at the waving wand of the opium spirit, sweep through the mind lilce mighty winds, awakening great thoughts and original ideas, revealing and arous- ing into activity mental powers far surpassing those exhibited by the common, unstimulated, and rugged brain. They tell of poetic sensibilities aroused, so that the soul seems to walk in high and equal fellowship with the shades of Shakespeare and Milton, and all the giants of literature. They speak of great schemes for the bet- terment of mankind revealing themselves to the reformer's thought when wrapped in his opium ecstacy, making the world's future splendid with golden hope and glorious achievement. They tell of the power of expression suddenly developed — the gift of speech be- stowed by the spirit of the " drug," making one eloquent to a degree surpassing the highest hopes of his unopiumized dreaming. They speak too — and ah I how deadly sweet to thousands of aching hearts, and spirits cast down and bruised I — of the opium witchcraft as able to lift "the heart bowed down to heights of calm:" to cure the heartache: to minister to a mind diseased, and soothe the trouble of thick-coming fancies; speak of the " Sweet, oblivious antidote, Cleansing the bosom of the perilous stuff which weighs upon the heart," as soothing mutual sufferings, causing thoughts which torment and feelings which distress, to vanish while the liberated sufferer lies as in a fiery circle, ringed with peace. And at least one of these writers, the one genius of them all, strikes a still higher key, and discourses in tones which, to some, are more fascinating than all the rest. He tells of dreams of indescribable splendor which came to him in the opium torpor, lighting up all the heavens of his sleep with gorgeous coloring, revealing the majestic evolutions of mighty armies, the blast of signaling trumpets, the thrilling rise and dying fall of countless bands of martial music near and far, the shoutings of captains, the muffled thunder of marching feet — an infinite grandeur,— a vision of indescribable magnificence. Are not such words full of temptation *? They may be inspired, but the inspiration is not breathed by a heavenly spirit. So far as regards these gorgeous cloudlands of almost hysterical description of the effects of opium using, in its earlier stages, upon the facul- ties of thought, imagination and expression, there is falsehood as well as mischief in them. That they are mischievous, who can doubt? While it is true that by far the greater number of the OR, THE FETTERS BROKEN. 13 slaves of opium in its different forms began the use of the '* drug " on account of physical distress, yet the number is by no means small of those who at first took it in order to reproduce, if possible, the mental phenomena of which they had read such marvelous things. Is it strange that the language of DeQuincy, describing in words of stately rhythm and wondrous melody, like majestic organ music, the magnificent dreams and visions of his opium sleep; or that even the lower-keyed, but still vivid and fascinating word- pictures of the wonderful influence of the first few doses of opium upon intellect and fancy, as portrayed by less famous writers in our magazines and newspapers, should tempt men and women to flan- gerous, deadly experimenting with the ''drug?*' The fact is, that many a student in college, — perhaps the brightest intellect of all — many a young, ambitious literary man or woman, after reading these unwise and most dangerous books, or articles, upon the opium habit, or personal experiences of morphine users, have hastened to procure the "drug" and test upon themselves its magic power ! They, too, desire to dream dreams and see visions. They, too. would become able to weave into stately and splendid language marvelous revelations from some region "East of the sun. West of the moon " unvisited by any mortal but themselves ! They, also, desire to call up the seeming angel and feel the thrill of its kisses on their lips. They are not wholly ignorant of what they are doing — they have knowledge of the fact that beyond the border land of mirage there lies a baleful desert— but they are tempted by the glittering words in which the opium dream is pictured. They have been told — these writers themselves tell them — that the Lotos Island is the abode of Circe. But desire from within and temptation from with- out make them heedless of warning. The palace of the siren and its delights are so wonderfully seductive that the sight of the grunt- ing herd of those who have been the lovers of the temptress, and upon whom, in past days, her kisses have wrought swinish transfor- mation, does not deter the flushed, eager new-comer, fresh landed upon the "island of joyance." He sees, as he hastens through shadowy avenues, only the white pillars and shining walls of the enchanted palace, he hears only the tender cadence of inviting- voices— he feels only the longings of passions and the thrills of hope I Alas for him, if even but once a flame be kindled In his blood by the fatal sweetness of the siren's kiss I 14 FROM BONDAGE TO FREEDOM; In the case of those who maj' be called "natural" opium users — that is, those in whom the "druj?" arouses the opium ecstac}' — the one, first dose will, in the vast majority of cases, be fatally de- cisive I He who, for the first time, calls upon the opium spirit, may see only a beautiful angel with shining face and hovering wings, but if he would only look behind the apparition he would see, cast upon a background of gloom, a grisly shadow rising vast and awful in the twilight — a terrible warning of judgment and of doom. His sor- cery has been successful — his incantation has raised the spirit and compelled it to weave its spells around him, but during the short hour of glamour and of dream, he has bound himself to the service of a Satanic master whose rule is pitiless and whose reward is death ! The seeming increased intellectual activity, the apparent en- largement of mental capacity and power which are felt by the mor- phine inebriate during the first stages of his experience, are real to him, beyond question. To his own consciousness there is no illusion in the visions which he beholds, no deceitfulness in the inspiration which he feels. As he lies steeped in a "tranced calm" the tides of thought seem to roll into his brain from some exhaustless ocean,— the horizon of his daily thinking seems to lift its curtains, revealing infinite reaches of sublime speculation. He believes himself to have passed into a new world. It is a real world to him. It is not a portion of his nature only which is under the mystic charm, but all of it. He himself is under the power of the spell. His faculties of perception and feeling, his will, every part and power of his nature, are wrought upon by the wonderful witchcraft. There is no central quality of will or judgment that is not influenced by the "drug." This is the Mirage of the Soul! Not only does the morphine neophyte, as he enters the desert of his weary pilgrimage, see an unreal earth and sky, but he also becomes a part of that world, unable to separate himself from it. He is no longer in the actual world, he is no longer a real man. It would not even be correct to say that he is a man plus opium — he is, rather, an opiumized man. He is not so much deceived as transformed. Every thought, every feeling, every act of judgment and will is opium-tinged. The luminous mist does not enwrap the outside world alone — its shin- ing folds enshroud his inmost nature and permeate his whole being. He is himself a part of the opium dream, and cannot separate him- OR, THE FETTERS BROKElSf. 15 self from its unrealities. WhateTer thirst it may have been which wrought upon him to begin his desert journey — the longing to do great deeds, the craving to search out all hidden things, the ambi- tion to taste all that is strange and weird in human experience, the desire to gain special strength for burdens heavy to bear, or to en- dure troublps which torment the spirit and mar the life — whatever thirst may have parched him — he is a portion of the visions which he beholds, the shining waters and the shading palms are in his own soul, they are a part of himself. The deception is absolute. In body, soul and spirit there remains not one sensation, not one power by which an actual, true perception of the real world can be obtained. Surely one in this condition cannot correctly judge of the value of his thoughts and the genuineness of his revelations I The reader will bear in mind that it is of the beginning of the morphine habit that we are speaking. What has just been said of the influence of the "drug" upon the entire nature will apply with still greater force to the condition of those in whom the appetite has become confirmed. But, in view of the language used by writers in depicting the delightful sensations and effects produced by the first moderate doses of the "drug,'* it is necessary to insist with great emphasis that, in the exhilarations, the enchantment of the first experiments in opium intoxication there is an element of deceit and falsehood. The narcotic ecstacies do not bring forth genuine fruit. The thinking which one does while lulled by mor- phine witchery is not nearly so original or brilliant as it appeared when it flashed through the dreamer's consciousness. It will not endure the test of true criticism, viewed in the light of the facts and principles of this real work-a-day world. The young preacher who nerves himself with two or three pellets of morphine to face his congregation and overcome the fatigue and shrinking which oppress him, may, at the time, believe that he is reaching the loftiest heights of eloquence. But, however greatly an audience, satisfied with rhetoric and declamation, may admire his morphinized oratory, their lives will not be influenced by his words. He seems himself to have been caught up into paradise and to have heard unspeakable words — but it was not the Paradise of God. The eloquence produced by narcotic poisons — can it be true eloquence? — can it have that touch of nature to which all hearts respond? Let the testimony of the thousands of authors, lawyers, and clergymen, who have become confirmed in the habit of IH FROM BONDAGE TO FREEDOM: opium using, be taken on this point and they will admit that their stimulated brilliancy of thought and expression did not, in its effects, fulfill their anticipations. How can a speaker whose mouth and throat are dry, whose voice is husky and whose eyes are dulled, have the highest and most effective power over his audience? But his first tampering with the "drug"' will have these physical effects. Literature has received little, if any, enrichment from opium using. Granting that the "Confessions," the " Raven," the "Rime of the Ancient Mariner," and "Kubla Khan " were inspired by the poppy juice— what thoughtful critic would claim that these are to be classed with the strong, healthy poems which live on because they are full of "sweetness and light"? It is doubtful if these weird creations, as a whole, are ever highly esteemed by sound and bal- anced intellects except for the music of their rhythm, or as studies of the effects of a diseased imagination. It is the immature or the abnormally developed mind which regards them as masterpieces. And as for the best that is in them like those stanzas in the "Rime of the Ancient Mariner : " " Sometimes, a-dropping from the sky. I heard the sky lark siug; Sometimes all little birds that are,— How they seemed to fill the sea and air With their sweet .iargoningi ***.!=*** A noise like that of a hidden brook. In the leafy month of June That, to the sleeping woods all night Singeth a quiet tune. ******* He prayeth best who loveth best And all things both gi'eat and small : For the dear God who loveth us. He made and loveth all : — " these may well be credited to those periods when the grasp of the black tyrant was slackened, and the soul looked out through clear- ing eyes upon Nature and Heaven. It is not through morphine inspiration that writers can lead us to the sweet spring waters and golden fruits of our mother Nature. As soon as the "drug" begins to drone its lullaby and lap the senses in its waking dreams, the eye-lids droop, the iris contracts, and a veil comes down between the senses and the outward world. How OK. thp: fettees bkokek. 17 can one in such a condition see, as they are, '"this goodly frame, the earth; this most excellent canopy, the air: this majestical roof, fretted with golden fire? " He is separated from these things. He can no longer press his heart against the hosom of isTature and feel its mighty throb. His perceptions and his sympathies are dulled. The veil in which he has enshrouded himself shuts out from his soul the true "light which lighteth every man that cometh into the world." It w^ould contravene an eternal l«w — that law which has been? and ever will be, the only basis for attainment of great success and high reward, if merely swallowing a white powder or a dark gum can make it possible to achieve great things in any field of work. "In the sweat of thy face shalt thou eat bread" — that is the im- mutable, the unescapable ordinance. Who ever has, who ever can, evade it? Real, solid, lasting results are reached only by honest and severe labor — not by morphine stimulation — not by any false or easy way whatsoever. That is the perpetual, unchanging law of Xature and of God. To endeavor to escape from its sway is to enter upon a life tinged at its beginning w'ith falsehood, and surely tending to failure and despair. It would not be just to close this chapter without again refer- ring to the very large class who acquired the habit of using some form of opium, not for the sake of its mental stimulus, or to make labor more easy, or simply as an intoxicant, but to escape physical anguish which they felt too terrible to endure. To blame them harshly for seeking the relief which the "drug" affords in such cases would be to add an undeserved burden to those whose load is, without it, too heavy for them. If some of them were too easily induced to begin the habit, if, shrinking too sensitively from pain, they hasten to alleviate, by the use of morphine, sufferings which they might have endured, who shall speak severely of their weak- ness, now that they have come into the bitter bondage of an anguish which torments not only the body but the soul ! Let no useless blame be cast upon them. If in the past they were weak, they now comprehend that fact better than any one else can know it, and he would be heartless indeed w^ho would add even a little to the burden which crushes them beneath its weight. Of all the causes of self-reproach which fill the hearts of the slaves of opium with in- creasing remorse and self-condemnation, the fact that their en- slavement began in their own weakness is the sorest. Of them 18 FROM BONDAGE TO FREEDOM t it may be truly said, "the heart knoweth its own bitterness." And as for those who sought relief in morphine from the sorrows of life — upon whom calamity came suddenly, beating them down as the tall grain is prostrated by driving storms; those whose light of hope went out in sudden darkness: those who saw that all the future held for them only weariness and heartache and tears — who shall cast the first stone at them ? No doubt it is true that thousands of men and women find their only relief from bitter memories and from daily, hopeless sorrow in the benumbing in- fluence of morphine. It is not because of the climatic influences alone that the Southern States contain so many who are addicted to the use of opium. The ruin wrought by the war extends beyond the loss of lives and the wTeck of fortunes. It has caused^ many a bereaved and despairing woman, many a man, ruined in property and hope- less of regaining the wealth and position he has lost, to endeavor to dull all their sensibilities and make life endurable by the use of the "drug." Thus the devastation has continued long after wrecked plantations have been restored and earth-works ploughed level with the ground. It reaches to those still living, who, having desper- ately sought alleviation from mental suffering in the narcotic are now living a "death in life." But who, knowing what these men and women were, in the 3'ears long past, what they have suffered, and into what state they have at last come, shall reproach them ? If their pride repels our pity, let us sit in silence in the presence of their great calamity, only eager, if but once they lift to us despairing but yet questioning eyes, to point out to them, if possible, some certain way of deliv- erance. In speaking, as I have in this chapter, of the forming of the opium habit, it has been my earnest desire to discourage any as yet unscathed reader from those beginnings which are so seductive and so deadly. Do not cross the confines of the opium desert, nor even once look upon and become a part of its mirage. Many a confirmed opium user, who first took the "drug" to alleviate physical tortures of the most intense kind, will now say that he wishes he had died in agony rather than have become what he is. Let the weary and heavy laden still endeavor to bear and wait and hope. To seek mitigation of mental sufferings in opium or morphine is to woo a deeper sorrow, an intenser despair. t OR, THE FETTERS BROKEN. 19 CHAPTER II. morphia-mania; or, the habit established. How use doth breed a habit in a man.— Shalcespeare. O death in life,— the days that are no more.— Tennyson. It is not given to any human being to know the line at which an indulgence becomes a habit. That line has been crossed by the feet of innumerable millions hastening with laughter and shouting along the first gentle descent of the way to death — but not one of them saw, or could ever tell just where the fatal point was passed. They did not look, they did not think, they did not heed. The laws which avenge evil indulgences by changing them into tyran- nous habits are indeed shod with wool, and do their work with quiet, noiseless hands. Slowly, unceasingly— "without ha^te, without rest" — the wreaths of flowers are replaced by silken bands, and the bands of silk by chains of steel. .The consciousness of liberty remains long after the bondage has become as fixed and certain as the grasp of Fate. This statement applies with peculiar force to the involuntary opium victim. There are, indeed, too many cases in which the sufferer on a sick bed, from long continued and intense pain, has believed himself compelled for the sake of rest— for the sake of life, even,— to alleviatf^ his torments with the v>^eapons which only the poppy provides. Suddenly and without warning he discovers that he has acquired the Opium Habit : —acquired it without having experienced one pleasant hour of dalliance with the "drug" — no exhilirations, no mental up-liftings during the initiation. Physical agony had absorbed his powers of attention and thought. He could not heed the warning voice which began to sound before the fatal line was reached; — without a knowledge of the fact, he found him- self captive to a giant whose grasp was pitiless, whose power was re- lentless. But those who are themselves responsible, to a greater or lesser extent, for beginning and continuing the use of the " drug, " do not become aware of their slavery until long after their captivity is as- sured. They still imagine the opium spirit to be their servant, or their playfellow, when, long before, it has become a tyrant master. But at what time, in the earlier days of thoughtless or willful tam- 20 FROM BOjSTDAGE TO FREEDOM; pering with the "drug, "the transformation occurred, they cannot tell. Once the}^ were free — now bodj^ and soul are given over to a slavery whose dull days are passing wearily, and upon which little light is cast except by the memory of "days that are no more." That is all they know. Probably in the majority of cases, at the time of initiation into the habit, the morphine doses are not taken daily, but at intervals of three or four days — or whenever pain or desire calls for it. After the first exhilarative or sedative effects there may be a period of sev- eral days during which no uneasiness, and no desire to resort to the drug is felt. The thoughtless dupe is ignorant of the more subtle and lasting effects of opium and morphine. He imagines that the influences of each his doses are limited to the period during which he experiences the pleasant and the more positive reactive or second- ary effects of it. He does not suspect that his quietude and freedom from desire for the opiate are caused by what he has taken two or three days before. He thinks himself to be still his own master— if he thinks at all — he honestly believes that he "can quit when he wants to, " because of these intervals between his days of indulgence. If he can go one or two days after apparent effects of his dose have passed away, why cannot he extend the time of abstinence four or Ave days, a week, — or indefinitely just as long as he may please ? Thus he argues to himself — thus he persuades himself — not knowing that the feeling of liberty with which he quiets himself is but the " stuff that dreams are made of. *' Then, too, his delusion is strengthened by the quiet, insinuating nature of his desire for another dose when at length the want of it begins to be felt. If he could not obtain the opiate as soon as he begins to think about it and feel its influ- ence will be pleasant or helpful, he would soon be aroused to the fact that he had lost his freedom. The agony caused by nerves and brain awaking from their enforced torpor would fill body and mind with horror and anguish, and that he has already become an " opium user, " would be testified by a thousand shrieking voices crying out from every particle of his frame. If any reader has begun to ques- tion within himself whether as yet he has become one of the many hundred thousand American opium users, let him test his condition by doubling or trebling the interval between his last dose and the next. But those who assert to themselves that they are free, when, in fact, they are slaves, do not often, either Involuntarily or with pur- i^l^i^^H^^HMII OR, THE FETTERS BROKEN. 21 pose, resist the upspringing of desire to feel again the narcotic in- toxication. They actually do go without the "drug"' as long as they please — but they "please" to take it again so ciuickiy ! The desire is so NATURAL — SO much like that for food, or rest, that it awakens no alarm. The quantity taken at this stage is not large, nor is its cost great. It is easy to gratify what seems to the self-deluded, or the ignorant, a moderate want, which they think they could ree?ist if they wished, hut somehow do not wish to resist. There is al- ways SQch a good satisfactory reason for yielding I One does not feel just right and wants to feel a little better, or has some extra work to do, or is sluggish in mind, or it is a rainy, cheerless day and he would like to have more comfortable sensations, or he feels well and thinks how a dose of morphine would exhilarate -^him — in a hundred ways the grip of the tyrant is disguised and his bond slave "fooled to the top of his bent" with the delusion that he is free. The poor victim does not " crave for " or " demand" the drug, — he merely " wants it " — and he thinks the ' ' want " to be only an ordi- nary desire, which can at any time be mastered by the will. He does not either realize or know that these wants are but the quiet tuggings by which his captor tightens the chain. To abstain would undeceive him, but he does not wish to abstain. He has not come, as 3^et, to that stage of his experience — the matter is not important enough. Or, if he would but consider, he would see that his fertility in excuses for self -gratification shows that his nature, his uncon- scious self has become so opiumized, that his brain has taken sides witn the drug, and submitted to its autocracy. While those who are passing through this stage of the morphine habit are really confirmed opium users, yet their case is not so hope- less as it afterward becomes. To stop in the downward path and retrace their steps may not be impossible even without aid, although the sufferings which they experience cannot be imagined by those who have not felt them. But the diflflculty is that thoy will not think. They are already opiumized or morphinized — they cannot see their condition as it is. As long as there is any relief from pain, any mental stimulus, any trace of pleasant exhilaration in the "drug" they will, almost without exception, continue its use, and close against themselves the door of self-deliverance. But as surely as the pursuit of the Furies and the decrees of Fate, the time comes when they are awakened — not .0 their danger perhaps — but to their condition. The intervals between doses have 22 FROM BONDAGE TO FREEDOM; decreased until every day —perhaps twice or even three times in each twenty-four hours, the narcotic must be indulged in. The desire for it is no longer a mere want — it is an imperious demand. The amount of the " drug, " taken each time has been steadily increased until many deaths are hidden in each dose. The captive of the "drug," can no longer quiet himself with the thought that there are days when he has no longing for the opiate, for there is not an hour nor a minute of his conscious existence when he does not real- ize that he is under the influence of the poison, even with the cun- ning help of the opium spirit he can no longer deceive himself. He has, doubtless, always had a feeling of strong repulsion against the opium habit. All through his life he has heard those who have ac- quired it spoken of with contemptuous disgust, at the best with con- temptuous pity. He has seen the pale, thin victims of the poison as they passed silently along to secure a fresh supply of the opiate, upon which their very lives depend, and has shrunk from the thought of becoming like them. But at last he can no longer hide the fact from himself — he has become an opium user. He has acquired the habit which once seemed to him like a horrible leprosy — he belongs to the class which once he shrank from and despised. It would seem that when once aroused to this terrible fact, one would at once begin to seek for some way of escape. But as a gen- eral rule this is not the case. Usually the process of self-conviction is a long one. At first one says to himself that he is not, and cannot become an opium user. In time he begins to wonder if he is, or ever will be one. And when, at last, he admits to himself that he is involved in the toils from which so few escape, he has become accustomed to the condition which once seemed worse than death. The dulled eyes of the opium user open but sluggishly to a view of his own condition, and his dulled sensibilities do not acutely feel his danger. He simply accepts the fact. Perceiving no open door of escape, he does not try, or but rarely tries, at this ijeriod of his his- tory, to be delivered from his thraldom. The Satanic spirit which dwells in the "drug" has at last revealed its power, and asserted its imperious mastership just when, I might almost say, the time for manly revolt has passed, and the hour of terror-stricken awakening may yet be far distant. The heavy and evil servitude is sadly ac- cepted and the dull, weary life is lived on. This must, of necessity, be a sombre chapter because it treats of a sad subject. The life of the confirmed user of any form of opium OR, THE FETTERS BROKEN. 23 is full of bitter thoughts — he hears within himself a ceaseless undertone of despair. Only in sleep can he find forgetfulness of his great calamit3^ and in some cases even sleep becomes Ireacherous and brings dreams which distress, or visions which affright him. There is a mingling of life and death in the opium user's existence. In alcoholic intoxication there may be lights as well as shadows, — even though the lights be false and treacherous. But that of the confirmed opium user is for the most part a dull, unrelieved torpor, full of shadows and bitterness. It is usually the case that those permanent changes in the phy- sical appearance which give the victim of opium, or its alkaloid, morphia, his diseased and often repulsive appearance, do not occur until he has reached a still later period in his habit. Frequently the first effect of the habitual use of the opiate is to give a plethora of body — so that, at a distance, or to unobservant eyes, there is an ap- pearance of health and streugth. People will congratulate the victim of the habit upon his excellent physical condition — as they often do those who begin to be bloated in the face from the use of alcoholic liquors. It is hardly necessary to add that such congratu- lations cannot call forth a very hearty response from the opium user — for he knows that it is disease, not health, which gives him the appearance on which he is complimented. And all who observe closely recognize the fact that he is no longer a physically sound man, while those who have learned to know the signs of it, see that he is suffering from the opium disease — the secret leprosy of mod- ern days, which permeates the body, mind, and spirit of its victim. The apparently healthy flesh, which, at a hasty glance seemed to betoken good health, is seen to be both soft and pasty. There is little power of physical exertion, except, perhaps an ability to take long walks. Other forms of bodily exercise or labor in many cases soon produce breathlessness. There is a distaste for physical exertion, and the body often becomes fat and gross because there is so little waste of tissue — that is, because of persistent indolence. The eyes furnish the plainest and most easily observed proofs of the habit. The contraction of the pupil, the flaccid eyelids, and the dullness of the eye itself, become chronic. The quick brightness or the steady shining of intellectual power, are no longer seen in it. The soul that looks out of those windows is darkened, and the windows them- selves become clouded. There are tens of thousands *of women in this country from 24 FROM BONDAGE TO FREEDOM'. whose eyes the morphine spirit has long since blotted out beauty and brightness and tenderness and love, leaving only a dull gaze, an unseeing, lifeless look. And yet they were once lovely to behold, and strong men have humbled themselves and passed anxious days and sleepless nights in their desire and endeavor to win from them but a glance of trustfulness and love. To how many of these women, now opium wrecked, have been repeated by voices trembling with honest passion : '■' Thine eyes are springs in whose «ereue And silent waters, heaven is seen, Thy lashes are the herhs that look On their reflections in the brook." But now, not only has the use of opiates ruined all their beauty — it has made them repulsive to look upon, and often those who once loved them avoid their gaze and even forget that their glances were sweet in days gone by. One of the earliest effects of the proper and successful treatment of opium patients is seen in the clearing and brightening of their eyes. The opium cloud passes away, and there is a clear shining after the long and dreary dark- ness. The influence of the habit upon the voice is also very marked. Whatever music there may have once been in its tones, has van- ished. It becomes hoarse. The morphinized public speaker can no longer express various shades of sentiment by varying tones and cadences. The wondrous organ which once uttered every thought and feeling with convincing strength or persuasive sweetness is now "out of tune and harsh." The voice loses its flexibility. It can no longer bear its part in fireside song— even if the opium user cares to join in fireside singing— which he does not. The music has not only gone out of his voice, but out of his heart and life, and he sits in silence where once he would have been foremost in song. ■m OR, THE FETTERS BROKElir. 26 CHAPTER III. MORPHIA-MANIA — CONTINUED. The mental condition of the confirmed morphine user grows more and more unnatural. The flights of fancy which the " drug " may once have stimulated, the abnormal intellectual activity which the beginner believed to be new and genuine power — the enlarged faculty of expression which caused him, even though naturally slow of speech, to be fluent in language — all these effects have long since ceased to be felt. The preacher, the public orator, the author, no longer persuade themselves that they can open the gates to new and infinite fields of thought by a dose of the " drug. " The illusion has passed away. The Mirage has utterly faded. "The cloud-capped towers, the gorgeous palaces, the solemn temples, " the splendid world of their dreaming, all have dissolved. It may be accepted as a rule, almost without exception, that the beginning of the period in life during which one becomes con- firmed in the morphine habit, is also the limit of his highest achievement. The confirmed opium user may indeed seem to others and even to himself to reach new heights of success after that time. He may continue to be a public character, he may be re-elected to office again and again, he may be raised from lower to higher station — but his apparent growth in power is only on the surface and not genuine. The opium-taking preacher, the public writer or lawyer may for years preserve his place in popular esteem, or seem to be falling from it but little, but they acquire no new strength. They do not enlarge to any extent the area of their earlier acquired stores of information, and sooner or later, when those are exhausted, their deterioration is rapid. The lawyer may still hold in his memory the principles and precedents of law and practice which he learned before he began to use the "drug, " but when he has be- come an opiumized lawyer his growth ceases. One of the more pro- nounced effects of opiates upon the mental nature is to weaken and confuse the memory. It becomes less and less strong and accurate, until facts, principles, recollections which once stood out clear and definite to retrospective thought, are like dim, mist-enveloped forms, their outlines indistinct, and their relations confused. The business man achieves no great sucxiess after he becomes a 26 FROM BONDAGE TO FREEDOM : slave to morphine. In most instances he simply plods on in the old way with ever-failing energy making no new ventures, winning no great rewards. He sees his clear-headed active rivals, with their hew and more intelligent methods, gradually pushing before him, successful, prosperous, — while he, weak in courage and energy, is unable to match them in the race for wealth, and he often grows envious and bitter. Or, with flickering, unreal energy he may at- tempt to mend his failing fortunes by hazardous ventures, and feeble in nerve and weak in judgment, add the calamity of financial ruin to the burden of misery which weighs upon his heart. The judgment of the opium user is impaired. Whether a business or a professional man he will more and more frequently make mistakes, and decide incorrectly. His counsel to others becomes unreliable, and his con- clusions as to his own conduct grow more and more noticeably un- wise. The effects of the use of opium in any of its forms upon the will are very marked. So far as regards the taking of his regular opiate by the confirmed opium user, he has no will at all. The questioning of his friends, when they become aware of his condition, as to why he continues so dangerous and fatal a practice, or why he does not cease it at once, are not only as idle as the noise of the wind, but proceed from perfect ignorance of the nature and consequences of the habit. The opium user's will is no longer the will of a free man. It has not only become enslaved, but it consents to the bondage. More than that — it has become the purveyor of the tyrant — his willing helper. While under the influence of his dose the victim may have dreams of revolt and self-control — but they are the merest dreams. At the first awakening of the opium craving the will ceases all show of resistance to the desire. Its subjugation is complete, its obedience abject. When the will has once become o])iumized, to call upon it, unaided to resist the cravings of body and mind for the ac- customed opiate, is asking it to resist itself, and reverse all the laws of its operation. It is true that there may come a time when, owing to certain physical changes produced by the "drug, " the mind will become desperate at the thought of the subjection of body and soul to so hideous a slavery, and the will may rally to its aid. Of this experience I shall speak in a subsequent chapter. But in most instances, and usually for a considerable length of time, the victim has no will as regards his habit. He simply yields ; 5delds not only his body and mind, but his very self to the power of the tyrant. ^^^^^^^^^ OR, THE FETTERS BROKEJ^. 27 And to exhort him to exercise will-power and abandon at once his opiate, seems to him (what it really is ) the language of the foolish and the blind. But the change produced in the will by opiates influences the life, not only with respect to the habit, but in all its activities. The whole being is smitten with torpor. The old energy which once made action necessary and occupation a delight has become a thing of the past. There is a shrinking from exertion in most cases, which steadily increases. Kot that the body is incapable of work, for under the influence of the habitual stimulant the opium user may, while yet the drug has some stimulative effects, show fictitious strength. But. the will power has become so poisoned and so weak that it will not urge to exertion, or sustain for any length of time either physical or intellectual activity. The man is sluggish and listless. For hours he may sit gazing at vacancy. In many instan- ces simply to rise and cross a room seems too great an exertion — something to be postponed as long as possible. Weakness of will results in procrastination. Duties which should be attended to at once are put off — and often, when performed, are done as hastily and with as little exertion as possible. The opium user's promise to do anything cannot be depended upon, partly because the impair- ment of his memory will probably cause him to forget, but also because it becomes a habit of his life to put off whatever requires exertion and the exercise of will-power. The duties remain undone, business is not attended to, or is carried on almost mechanically. The captivity of the opium user's will causes him to fail in at- tention to what he should remember or perform. He does not fix his thought upon what he sees and hears. He promises, and before the echo of his word has died away he forgets. It is because he promised mechanically — he did not give attention to his own words — his will was torpid, and did not add its confirmation to his promise — as in the old days, when in full possession of its royal power, it would have done. The will being in such vassalage, the whole life is filled with weakness and failure. The impairment of memory by the opium habit, already referred to, extends both to the facts and circumstances external to one's self, and to his own inner experiences. He fails to recollect his own ideas and emotions. His days are no longer linked together in his con- sciousness, but he lives, each day, each hour of his opium torpor, by itself, almost without remembrance of his more recent past, and 28 FROM BONDAGE TO FREEDOM: careless of the future. He thus misses that which is the best result of living, the attainment of experience. He does not gain wisdom from the lessons of life. He only forgets what he reaps, so that books cease to add to his stores of information. He may read and re-read, but facts and principles seem to leak through his brain, like rain falling upon a bed of barren sand, fertilizing and refreshing nothing. It is often the case that those who habitually use opium or morphine almost wholly cease to read anything but the lightest kind of literature and even such books they will go over again and again. They retain so little of what they read that a book will be almost new to them if read once a week. The sentimental and social elements of the nature of the typi- cal opium user are touched and deadened by the paralyzing effects of his indulgence. His emotions do not respond, as they once did, and as those of a healthy nature will, to the joys and sorrows of this human life of ours. His laughter lacks the genuine ring of merri ment. As for tears, their very springs seem to be dried up. If his usual dose be delayed or lessened he may become hysterical, and tears may flow at the lightest provocation, but, while in his usual condition, he will look even at the sorrow which touches him. most nearly, with dull, unwet eyes. He does not feel deeply — his emo- tions are deadened. He frequently exhibits, in trying circumstan- stances what people may call "good nature," but it is not that cheerful spirit which, while it sees and comprehends trial and per- plexity and loss, bears them with a bright courage — fronting ad- versity with a brave smile. The opium user's freedom from gloom and repining and ill fortune arises from his apathy. It is easiest to take what comes, without exerting himself to welcome or to resist. His social nature undergoes a similar change. Very often he becomes a silent member of his own household, withdrawing himself from its conversation, and its interests. That little world is, to him like the great world, dim and only partially real to his thought and feeling. He avoids society. He does not care to make new acquaint- ances nor even to keep up old friendships, for this would require exertion and compel him to go out of the life he is living, — a life lived in the narrow circle which the dim opium light reveals. He does not enjoy social company — his mind is too sluggish and his aversion to leave his little opium-world too great. He is happiest when left alone to his own vague thoughts and useless dreaming. How many thousands of the women of this country are living most MHI OR. THE FETTERS BROKEN. 29 unnatural and most useless lives because they have become enslaved by the opium habit ! Their faces lose the beauty of youth and grow sallow, their countenances no longer respond to the play of thoughts and feelings, — there is no longer any activity of mind or emotion — or at the most only an occasional outburst of unnatural vivacity which causes the listeners to look at each other with wonder. As the habit grows more and more confirmed, its shadow deepens in the soul and in the life. The distaste for exertion and for society which it causes, results in neglect of social activities. Even household duties are in time postponed or carelessly performed. All that is finest, most helpful, and most winning is destroyed, affection sadly departs from the fireside and comfort from the home. It is not possible that the opium user's moral nature should be unaffected by his practice. The tendency of the habit to destroy truthfulness has often been referred to by writers on this subject. How can it be otherwise ? The one upon whom the opium habit has become fixed carries with him a secret shame. The endeavor to hide his practice is constantly in his thought. There is hardly an arti- fice, a subterfuge, a deceit which he will not adopt in order to keep it secret. No matter how high his standing, or whether he be preacher or layman, the instinct for concealment is stronger than his respect for the truth, or his impulses toward open and manly acts. Even Coleridge, clergyman as he was in early life, an eloquent discourser upon the mo*ralities to the end of his days, would deceive and cheat in order to procure his tremendous draughts of opium tincture. Not that it would be just to blame him for such conduct, as we would blame those who do not use opiates, for deceit or false- hood. The laudanum was a necessity— the outcry of his whole nature, for it was fiercer than even the clamors of hunger and thirst are in the starving. But whether to be blamed or not for his specific acts of dishonesty, the fact remains that through the opium habit a noble being, endowed by nature with moral attributes of the highest kind, became depraved. And his constant efforts to conceal the habit, and the underhand methods used to obtain the "drug, " without attracting notice or awakening suspicion, must necessarily affect the opium user's truthfulness and honesty in other things. That it does have this influence upon the moral nature, causing it to deteriorate as a whole, is the case almost without exception. But even worse than this, is the effect upon the opium user of his consciousness that the secret which he is hiding in his breast is 30 FROM BONDAGE TO FREEDOMS a shameful one. He conceals his habit because he is ashamed of it. Growing more and more apathetic concerning all other things, he retains his sensitiveness as to this. As long as the habit continues this sensitiveness never leaves him. It is only the really cured opium user who, grateful for his deliverance and rejoicing in his lib- erty and '"newness of life,*' has courage to speak of the bondage from which he has escaped. But before his cure, he felt within him- self a constant sense of shame. All through the day it weighed upon his heart and at evening, when he. lay down upon his pillow, the feeling grew stronger and more bitter. Regrets, self-reproaches, pangs of self-accusation — all the voices of a rebuking conscience which torment and murder sleep — thronged around him crying "guilty I'' ''guilty!" Even if by little or no fault of his own his enslavement began, still the sense of concealed disgrace is almost as strong* and as fatal to self-respect as that of positive guilt. No one who must hide from all eyes such an evil secret, can help being injured in all his better nature. He has a sense of falseness — of not being what he seems to be. He knows well that if his friends and acquaintances knew what he is hiding they would not greet him as cordially nor continue to hold him in esteem, as they now do. And being all the time conscious of the secret, and of its shame, he becomes degraded in his own eyes. He loses his self- respect— and when that is lost the process of deterioration becomes general and rapid. The processes of physical and moral degrada- tion go on side by side, or, if physical debasement be the most rapid, that of the moral nature may be the most repulsive and com])lete. OR, THE FETTERS BR0KE:N^. ' 31 CHAPTER IV. MORPHIA MANIA — CONTINUED. " The pains of hell gat hold upon me." — Bible. There are two classes of conflrmed opium users and morphagists who have realized to the full extent what it is to victims of the opium fiend. They are (1st) those who, after long suhjugation, have rallied all their failing energies, and made a determined effort to forsake the habit, and ( 2d ) those whose digestive organs have temporarily refused to act upon the usual dose of the opiate and therefore fail to supply the system with the poison which has he- come so essential to life itself. These two classes of opium users, and they alone of all people that live on earth, have actual knowl- edge of what opium or morphine habituation involves. Every hab- itual user of the " drug" soon discovers that its tender mercies are cruel, but those above mentioned have passed beyond the Limbo of all lesser pains, and have felt the burning of Tartarean fires. Those who belong to the first class spoken of are all who, of their own determination, make a desperate effort to turn and re-ascend the steep declivity down which they have so easily come. They may be led to this resolve by the pressure of poverty, which in view of the in- creased amount taken, seems to make the necessary quantity of their opiate unattainable in the future. In other cases the victim sud- denly rallies and determines to break the fetters which have held him in a long duress of stupor and lifelessness. He sees all at once. and almost clearly, what he has become, what he has lost, and how barren of all that makes life sweet and bright is his whole future. Hope and ambition paralyzed, wealth failing or dissipated, the dreams of his youth all unfulfilled, his social position lowered, his self-respect gone — he sees himself sinking fast toward a condition in which there will be "none so poor to do him reverence. " This hideous vision of the past, and present, and future, rises before him in some hour when his possession by the opium devil is perhaps less powerful than usual, and he resolves, in desperation, that his life shall not be wholly spoiled. He will deliver himself from this " Death-in-Llf e. " His whole existence shall not be made an utter failure by the benumbing tyranny of the " drug" .' 32 FROM BONDAGE TO FREEDOM; The African explorer and missionary, Livingstone, gives a graphic account in one of his volumes, of an attack upon himself by a lion which crippled one of his arms for life. The animal seized him in its tremendous jaws, and shook him as easily and violently as a ter- rier shakes a rat. And the effect of it was to cause all sensation of fright and fear to cease utterly. He felt no pain from the crunch- ing teeth and shattered bone ; he was not afraid Qf the death which seemed so near. There was some strange, anodynic power in the shaking which he had received, that caused all feeling to cease. But, when Livingstone had been rescued from the lion's jaws, there came a reaction, and fever and pain. And to the opium or morphine victim, gripped by a fiercer and more terrible monster than any wild beast of the jungle, there comes, when he rallies from his torpor, and endeavors to loosen the clutch of the fangs which hold him, an experience of indescribable torture, involving the whole nature. in its agonies. A more full reference to this experi- ence will be found in another chapter of this book. For the present it is enraigh to say that the chief result of such unaided attempts to escape from the clutches of the opium monster, is simply to plunge the sufferer into the opium users Hell — the Gehenna of burning torment and hopeless despair ! While Dr. J. V. R., of Southern Illi- nois, was under my treatment, he said, in reference to this subject : *' When I had been taking thirty grains of sulphate of morphia every twenty-four hours for a long time, I got to thinking one day how the "drug" was utterly ruining my life and killing me by inches, and I resolved firmly for the first time after forming the habit, to stop its use. And for four days I did stop. But if I had gone without it one day or even a few hours longer I should have been a raving maniac. No brain could endure such agonies for any longer period. ' Hell tortures ' is no name for them. " The second class of those who know all the terrible significance of the term "habitual opium using" are they who continue to use the "drug" until nature refuses to respond to the call made upon it by its customary dose. In many such cases, the system, after pa- tiently accepting for years the unnatural poisonous "potions" forced upon it, and necessary to it from long use, at last refuses— refuses to be stimulated by its accustomed narcotic, and without warning rejects the "drug." The victim then suddenly finds that the "dev- il's manna." upon which his very life depended, can no longer be taken. What follows? If this condition becomes permanent. OR. THE FETTERS BROKEN. .38 insanity and death are not far distant. Tts ett'ects are terribie. The first feeling which it awakens is tliat of alarm, deepening grad- ually into a horrible and foreboding fear: and if the system does not rally, and again respond to the ••drng." death by eonvulsions and spasms comes speedily. Opium users who take the ••drug" by the stomach often find tliat organ in a state of semi-paralysis, from what is called an •■over-dose."' The first and usual portion of the opiate having failed to produce its accustomed effects, because it lies inert, undi- gested in the stomach, another one is taken. That. too. failing to influence the physical system and quiet the mind, still another, and another dose is swallowed. Then, as an overloaded camel which has fallen down mid- way in the desert path and is beaten with frantic excitement by its affrighted rider, whose very life de- pends upon its own. rises and staggers on its wa>'. so the stomach at length is goaded into action by the mass of poison with which it is burdened, and pours the whole of it. almost at once, into the blood. But the s.ystem of the suft'erer. notwithstanding its habit- uation to the '"drug, '" cannot endure so tremendous a load of poison. and he passes through sleep to death. If the morphine victim fears to arouse his digestive organs by such desperate means, he may preserve his life for a time, but if the torpidity of the stomach continues for three or four days, or if. affrighted at the warning he has received, and which has shown him the fearful end of an opium user's life, he tries to abandon the habit, he passes into tortures beyond the power of words to describe. He pays for every pleasant sensation in the past with agonies inten- sified a hundred fold. Every hour of false opium quiet must have its compensation of sleepless torment. The avenger is upon him. A hundred voices within him will shriek out the awful question "What shall we do to be saved?" But, alas I too often, the only answer is a horrible silence, a gathering darkness deepening into insanitv or death. 34 rR03I BONDAGE TO FREEDOM : CHAPTER V. THE GROWTH AND EXTENT OF THE HABIT. Opium is the Mepiiistopheles of the age ! Insidious and deceit- ful in its character, it has permeated all classes of society with its baleful influence, and in thousands of homes it holds an autocratic sway. The physician daily meets it in some of its Protean forms, for it has defiled the sacred desk, sullied the pure ermine of justice ruthlessly entered every profession, nay, fastened its terrible and pitiless fangs upon every class and condition of our people ! A curse so widespread and so disastrous demands the earnest at- tention of thinking men and women ; and yet but few are aware of its extent and power. Medical text books are silent on the subject ; even the medical profession seems unaware of its magnitude, and in every instance in which it comes under their treatment, they are unable to cope with its influence. So little has morphism been comprehended by physicians, that they have almost universally re- garded it as an incurable disease, and by throwing it out of their list and passing it by, have confessed themselves inadequate to the task of curing it. Usually they have relegated this work to the patient himself, advising a sudden cessation, or, perhaps, a rapid reduction, with nothing to support the system during the trying ordeal except a few alleged physiological antipathies, which tor the most part are useless as sustaining agents and wholly without curative value. The "drug" is used so secretly, the habit is so carefully hidden be- neath the surface of social life, that the uninitiated are utterly ignorant of its rapid growth and present proportions. And yet so general has the practice become, that as one looks at the past and regards the future, he is appalled at the terrible picture which rises before him. This is the nervous age of the world's history. A progressive civilization has left its impress upon tlie mental and physical pow- ers of man, and brought with it a variety of disorders of a nervous character unknown in the heretofore. They are different from the diseases of a century ago: they are consequent upon the changed condition of the people's life. They are a natural result of the in- tense mental strain necessary to the carrying on of new and great enterprises, the attainment of professional or political success, and ^_^^^..,..,.-..-p .-.--. . _^^^^^^^^^^^^ OK, THE FETTERS BROKEX. 3o the maintenance of society. The result is that Americans are largely subject to neurasthenic troubles, growing out of excessive waste of nerve force. We live too fast ; we do as much work in a day as our forefathers did in a week, and, physically, we are not so well qualified for work as they were. We eat too fast: we think and read, and even take our recreation, at a high rate of speed. This phenomenal method of living can have but one result, viz : a rapid destruction of nerve tissue, a wasteful expenditure of nerve force, a breaking down of the nervous system, premature decrepi- tude, and finally death. Americans as a rule die early; they live their lives too quickly, and pass aw^ay at a time when they should be in the prime of a vigorous manhood. In order to repair the waste which is constantly going/on, and recuperate the system for each day's duties as they present them- selves, many resort to stimulants. In some ranks of life, alcoholic liquors are commonly used, but among professional and business men and women, the use of narcotics has steadily increased during the last fifty years. Particularly is this true of opium and its alka- loid, morphia. Fifty years ago, gum opium was used exclusively by those addicted to the "drug, " but morphine has largely superseded the original juice of the poppy. The ancients paid sacred homage to Morpheus, god of sleep and dreams, and now, in the midst of an age of intelligence and advancement, we find a vast army of men and women bowing at the shrine of the arch-fiend Morphia, named after the classic diety of old I The majority of those using the "drug," now employ the sul- phate of morphia, chiefly because of its potency { it being six times stronger than the gum opium ), its small bulk, and the rapidity with which it affects the system. It has been stated that the greater proportion inject the solution subcutaneously by means of the hypo- dermic syringe, and my experience leads me to believe that this class is in the majority. I find that the general method is to take the sulphate of morphia hypodermically. If it were possible to paint all the horrors, the agonies and woes which this deceitful " drug " has wrought upon humanity, it would form a picture of unparalleled misery and despair. The mere recital of figures and the facts which they teach, will, however, be suflicient to stir up a spirit of inquiry and investigation. They are startling enough to cause alarm, and lead us to seek some explanation of so dire a curse and some method for stopping its sweeping ravages. :](i FROM BONDAGE TO KIJEEDOM 1 Thirty years ago, the quantity of opium imported into the United States was 109,536 pounds. The flrst importation of mor- phia occurred tlie same year, and consisted of but twelve ounces. In 187.1, ten years later, the import of opium was 315,121 pounds ; and of morphia 237 ounces. In 1880, the opium import was 533,451 pounds : and 8,822 ounces of morphia were received at the port of Kew York. Add to these figures about ten per cent, for smuggled opium, and we have some idea of the quantity then used, in the United States. A comparison between 1861 and 1871 shows a fearful increase in ten years, yet the difference between 1871 and 1880 shows a still larger increase in nine years. The revenue statistics unmistakably show that the consumption of oi:)ium is rapidly increasing, and that, too. at a rate far in excess of the increase of population. In 1880 this country received 97,000 pounds of opium from China, 326,975 from England, and 92,633 from Turkey in Asia. The crude opium, after reaching this country, undergoes ditferent processes at the hands of manufacturers, a large portion of it being made into the sulphate of morphia. In 1876, it was estimated that there were 225,000 opium users in this country, at least two-thirds of them belonging to the better classes of society. To-day it is estimated that there are not less than one and one-half millions. One and one-half millions men and women in America slaves of a -'drug ! '' The thought of slavery is, in itself, abhorent ; but when we remember that this is a slavery the most damnable on earth : a bondage to a soulless, merciless tyrant: a captivity whose daylight is Despair and whose Hope is Death, the* impressive fact fills our minds with pity and sympathy ! It will thus be seen that on an average three in every hundred are a slave to the drug in some form. The saddest feature of this is, that the majority of the victims are women. Not poor, de- graded, outcast women, although this class helps to swell the list, but those occupying high positions in the world. Brilliant society- ladies, zealous workers in good causes, literary toilers, ambitious women, have fallen beneath the witching power of morphia. The simple fact that women form by far the larger proportion of those using the •' drug " is one that should excite universal pity, the more so as they are not generally responsible for contracting the habit, as will hereafter be shown. Some localities have a greater proportion than others, the South OK. IHE FETTERS BROKEN. HI having more victims tiian the jS'orth, and the city more than the country. Texas is said to have more opium users in proportion to its population than any State in the Union, and I believe the claim to be well founded. The effects of the war upon the South were very marked in this matter, as since that time the habit lias largely increased in the Southern States. In Albany, New York, there is annually consumed 3,500 pounds of opium, 5,500 ounces of morphia, and about 500,000 pills of morphia. In Chicago, 111., there are about 25,000 persons addicted to the habit, and the leading druggists, ac- cording to a recent statement, say that their principal customers are ladies. In St. Louis, Mo., it is estimated there are not less than 20,000, while many Southern cities show, in proportion to population, eveil higher figures than these. I know small towns where the aver- age is five in every hundred, and the habit is constantly increasing. The amount annually paid out for the '"drug" by these victims is about $15,000,000 : an immense sum, which is deflected from the proper channels of industry and commerce, and devoted to a vice which is destructive of body and soul, and detrimental to the best interests of society. Three grains of morphine will, as a general rule, cause death. This fact is not generally known to those unacquainted with the properties of morphine, but it ought to be well understood by every- V)ody. Our high schools ought to teach this fact, and also the greater truth, that when a man can so accustom his system to the use of a poison in doses more than sufficient to cause death in ordi- nary cases, he subjects his system to abnormal effects, which must have a disastrous and in time a deadly influence upon the mind and the body. The records show us that it is comparatively an easy matter to learn the use of morphine in excessive quantities, and when the reader bears in mind that only three grains is necessary to termi- nate life, he can apj^reciate the significance of the following illus- trations : A lady in central Illinois took 60 grains of morphine every 24 hours : another took a gallon of laudanum every 22 days. A physi- cian in Texas took 60 grains of morphine every 24 hours ; a lawyer in the northern part of Illinois took 40 grains ; a farmer in Missouri took 40 grains ; a physician in St. Louis took 25 grains hypodermi- cally ( equal to 50 grains by the mouth ) ; a physician in New York took 72 grains every day, enough to kill 24 ordinary men. These 38 FROM BONDAGE TO FREEDOM: cases can be multiplied ad infinitum, suffice it to say that the un- fortunate beginner rapidly increases his dose from I or i of a grain until he reaches a quantity which seems almost incredible. A list of 150 cases shows an average of 15 grains per day, the quantities ranging from 1 grain to 40 grains, and in my opinion this average will be found generally correct. It is difficult to ascertain exact figures in relation to this part of the subject, as the opium user in- variably understates the extent of his habituation. It is only after he has been restored to a normal condition that he will admit the truth. The figures I have given are taken from my own records, and are as accurate as they can possibly be made. They should be sufficient to arouse the careless and indifferent to examine this im- portant matter for themselves, and carefully weigh the statements made in the succeeding chapters. The different phases of the opium and morphine habit, as therein presented, form a chain of facts, an array of truths which, though startling, may prove of countless value to the friends of our common humanitv. CHAPTER VI. PATHOLOGICAL CONDITIONS ~ JSTERVOUS DISEASES AND THEIR ORIGIN. The human body is marvelously and wondrously made ; so deli- cate and accurate in its varied mechanism that a slight injury to one part will often affect the workings of the whole machinery, and cause a difficulty which may suspend the action of important func- tions. In some cases, through a complication of causes, it may stop the wheels of life, and death ensues. In a system, every part of which is so harmoniously organized, any injury to a part of the structural formation must have its effect upon the whole organism to a greater or less extent, the different parts being so intimately connected with each other. The introduction of anything delete- rious or poisonous into the system is at once repelled by nature. The blood, the liver, the kidneys, the stomach, the secretories. all unite in protesting against the intrusion, seeking to expel the OR. THE FETTEHS BROKEN . 39 intruder. A general revulsion ensues, nor does it cease until the poison has been thrown out and entirely eliminated. True as this is, it is also certain that poisonous substances can be taken into the system in small quantities, and assimilated, and by degrees increased, so that eventually systemic changes are made, and the body becomes accustomed to the abnormal condition, and finally accepts it as its i^'ormal condition. This has been re- peatedly evidenced in the formation of diseases arising out of the excessive use of narcotics and stimulants. There is now a class of diseases which, having a neurotic origin, are developed by stimu- lants and narcotics until a new complication arises which gives them a much more important and dangerous character. It is not my purpose to speak of the different branches of this class in detail, including as it does, dipsomania, inebriety, opiumania, morphism, etc., but only to state the general facts and leave them for the con- sideration of the thoughtful reader. There is a striking contrast, mental as well as physical, between the people of this century and the preceding one. It Is traceable to direct causes, and is not so much a growth of civilization as it is a change of the conditions of life. It is expected that a people, a na- tion, will undergo changes in a century ; these will occur in the out- ward appearance, in the expressions of language, in the processes of thought and in ,the manifestations of feelings. But they are the natural result of a people's growth in civilization; they are conse- quent upon Increased knowledge, upon the diffusion of education, the progress of scientific research, the development of art, the culti- vation of literature, and other ennobling pursuits. This has been illustrated throughout all history. Look at one period ; examine its laws, its poetry, its literature, its political economy, its industries, its portraits of the people then living, its architecture, etc. Com- pare that period with one a hundred years later and how different ! The laws are more humane, the poetry is purer, the literature is more classical, the statesman has a broader view and more compre- hensive grasp of political economy, the industries are reaching out into new fields and filling new marts with their products, the peo- ple have keener, brighter faces and a more clearly defined contour, while the houses are larger, more comfortably built and better arranged for health. It is so all through the long catalogue : j^ou find change stamped upon everything, but it is simply the change of growth : it is the process of gro'wing older and profiting by the 40 FROM BONDAGE TO FREEDOM: information brought with the years : it is the development of the butterfly from the chrysalis, the growth of the boy into the man- hood of strength and power. But during the last century a change has come over our people which is different from that of growth. There has been a remark- able, almost phenomenal, spirit of enterprise abroad in the earth, and it has swept the nations forward as though on the crest of a mighty wave. Wonderful strides have been made in every depart- ment. Invention has sought out strange and unsuspected combi- nations : valuable discoveries of scientific and general worth have been made; the arts and sciences have trodden unknown fields: commerce has thrown her mighty forces across continents and oceans, floating her flag in silent seas, and across the pathless des- ert, heralding the advent of civilization and progress. The move- ment of the world is onward, and to-day it is carrying forward its gigantic enterprises at a speed undreamed of by those who lived even fifty years ago. A growth so marvelous, and 3^et so rapid, has im- posed mental burdens upon the people which the physical system could not carry without foreign aid. The modern method of cook- ing and eating is enough to impair the digestive powers and injure the body : while the modern method of living is, and must be, pro- ductive of serious injury to the physical sj^stem. It is noticeable that the ages do not bring us any higher development of the physi- cal man: but each succeeding age shows no positive degeneracy, however. The body not being perfectly fitted for its work, it fol- lows that an increase in the mental burdens must be fraught with disastrous consequences. And the spirit of the age— that restless, feverish, speculative, exciting spirit of enterprise — forces men to accept and shoulder responsibilities and mental tasks far in excess of either their physical or mental powers. Then there comes the over-exertion, the mental strain, the overtaxing of the system, until it breaks down under the accumulated and overpowering weight. This increased mental activity has had the effect of enlarging the brain, much the same as the arm of the blacksmith becomes enlarged and developed on account of his constant use of thai member. But with the enlargement of the brain we have a finer and more delicate structure, and hence it is not so well adapted to a constant mental strain. In other words, it is more easily dis- turbed in its functions, and consequently leads to complications in those organic forces cjonDect.ed with it. (JR. THE KETTEKS UKOKEIS'. 41 Hence we have what are now known as Nervous Diseases, — a class that was unknown a hundred j^ears ago, and which is, pecu- liarly, a product of our progressive civilization. As a people, Amer- icans are more subject to nervous disorders than anj^ other nation, because the waste of nerve tissue and depletion of nerve force is greater on account of their methods of life and business. It would almost seem from these statements as though men alone were the sufferers. I have referred chiefly to the exhaust ive- ness of professional and mercantile life at the present time. But while these classes furnish a large army of victims, it must be re- membered that women are liberally represented. They are specially subject to troubles having their origin in the nerve centres, and which assume many different forms. It is not difficult to find the cause of all this; a mere glance at the ordinary life of a woman will show us the secret. The present system of education must be held responsible in a great measure, as its tendency is to increase the activity and susceptibility of the nervous system by diminish- ing the nutrition of the brain and thus promote organic disease. Among young girls we find headaches, somnambulism, sleeplessness, hydrocephalus, night terrors, epilepsy and kindred troubles, which undoubtedly arise from an over-stimulation of the nerve centres, brought on by the pressure of the present educational system. It has been frequently said that our schools are responsible for the larger proportion of nervous diseases, and there is no doubt that the foundation of a life of misery is often laid during the educa- tional period of life. The domestic cares and demands of society are another fruitful cause of nervous diseases among women, especially when they do not take sufficient care of themselves, as is generally the case. The clothing is often wholly inadequate to protect them from the weather, and is seldom in consonance with the rational laws of health. There is a tendency to daintiness rather than wholesome- ness of food ; the emotional and sentimental passions are constantly stimulated, the nerves are sometimes put to a severe tension, while at others extreme lassitude prevails. Such flagrant violations of natural laws are necessarily productive of disease. Quite recently the term Neurasthenia, or Nerve Exhaustion, has been applied to a large class of diseases, and it is now well known that neurasthenicf tendencies prevail among us to an alarming extent. It has several clinical varieties, but the same general 42 FR031 BONDAGE TO FREEIKJjM : symptoms prevail in all cases. It is manifested in many functional forms. These may be divided into two classes, the mental and phy- sical. The mental faculties become confused, and it is difiQcult to think consecutively and clearly, while the memory loses its grasp of previous events and fails to perform its duties satisfactorily. In this condition sleep is generally out of the question, and insomnia aggravates the nervous condition of the mental forces. The mind is quite active, but is unable to bear any burden, and incapable of any labor except that of the most ordinary kind. It not unfre- quently happens that the patient is tormented with fears lest he should lose his reasoning powers entirely. The physical symptoms are varied. The appetite appears to be capricious : the patient sometimes eating to excess, but oftener hav- ing no appetite at all. Foods of all kinds will become obnoxious, and there is sometimes nausea, vomiting, and consequently, emacia- tion. Depression of the spirits is a very common and general symp- tom, accompanied with great lassitude and nervous prostration. All these symptoms, especially the mental one, are not usually present in an equal degree, but may increase, diminish, or at times disappear, proportionately to the leading symptoms of the disease. In its early stages the sufferer is very apt to regard it as only a temporary debility arising from a disordered stomach, the state of the weather, or some similar cause. He seeks a remedy and, unfor- tunately, he often takes something which aggravates the disease. The sale of neurotic remedies is rapidly increasing, and this in itself is an important fact. The sufferer seeks stimulation, he wants to be "braced up," as he expresses it, and he finds in alcoholic liquors a powerful stimulant : or he desires exhilaration of the mental and restfulness of the nerve forces, and he resorts to opium or mor- phine. In order to build up his system he takes a stimulant or a narcotic. The result is that after the first effects wear off he is left in a worse state of depression and languor than at first, and the remedy has to be taken again. Time only increases the quantity used, until at length he becomes a drunkard or a confirmed opium user. If the skeletons could be dragged out of millions of closets to-day they would be found labelled " Alcohol " or "Morphine. " The addition of a new factor complicates the disease, or rather creates a new and more dangerous one, and thus we have dipsoma- nia, opiumania and morphiamania. As stated in a previous chapter, the victims of morphine have steadily increased in number until OR, THE FETTERS BROKEJf. 43 now they aggregate, in the United States alone, millions of souls !' It is of this class that I wish particularly to speak, and show the special effects of morphine upon the human system. I speak speciflcally of ^N^eurasthenia. or Nerve Exhaustion, in another chapter. CHAPTER YII. PATHOLOGICAL CONDITIONS — PHYSIOLOGICAL EFFECTS. Opium, in its various forms, is the most seductive agent known to the materia medica, and as such it holds a distinctive position of its own. It occupies a place which cannot he so well filled by any other drug, and produces effects unlike those produced by any other agent. It is this seductive and insidious feature which has enabled it to assume a position of masterful authority where it was first introduced as an obedient servant. Its first mission is to allay pain, and this it does so readily that the patient, like the Arab of the desert, regards it as ''God's best gift to man." The "drug," however, quietly, yet surely, works its sinuous way until it com- pletely captures the citadels of both body and mind. Opium produces different effects according to the temperament, the condi,tion and the education of the user. Its first action is to stimulate the physical powers and intensify the mental forces. It lifts the patient out of himself ; he rises superior to all petty annoy- ances and difficulties, and feels capable of great labor and endurance. Some are lulled to sleep by its soothing influence, and easily fall into a dreamy semi-consciousness of unalloyed pleasure. Others again find their mental faculties heightened and quickened to such an ex- tent that they are able to perform literary work with marvelous facility; and when they sleep, the active mind weaves around them magnificent visions of unheard of splendor beyond the ordinary con- ception of the human intellect. These peculiar characteristics of opium and morphine have been the means of ensnaring tens of thousands into their use. They are not only subtle, but also potent. Each day the victim is brought into a closer relationship with the "'drug:*' each day it makes new 44 FROM BOIfDAGE TO FKEED03I : conquests, and although :yature resists it at ever}' step, yet it makes sure and certain headway. It has wonderful cumulative power: every inch of ground gained is occupied, fortified and garrisoned, and the work of conquest pushed on still further. The system may hold out for a long time, but the final result is uniformly the same : the tired orgaiA succumb to the ceaseless attacks of the ''drug,*' at last, and with a peculiar facility they adapt themselves to the new condition of things. The drug now assumes a different character : it is not taken for the purpose of exhilaration and mental activity, nor yet to relieve the pains of disease. The system simply demands so MUCH opium or morphine each day, because it will assuage the terrible pain and destroying agony pkoditced by itself, and in which the victim cannot live. The ''drug** has now lost its former office as an angel of mercy, and has become the black avenger of n wasted life. CHAPTER VIII. PATHOLOGICAL CONDITIONS — PHYSICAL AND MENTAL PATHOLOGY. Although opium or morphine using is usually termed a •" habit." it is, properly speaking, a disease, and, as such, is susceptible of path- ological demonstration. As this book is intended for the general reader, as well as the educated physician and scientist, I shall not here attempt a learned disquisition on this important branch of the subject, but shall speak briefly and plainly, so that it will be readily understood. Were I to do otherwise I should defeat one of the prin- cipal objects of this work, viz : to bring before the people a clear, comprehensive and accurate account of one of the greatest evils of the present day. The nervous system is very complex in its character, extending to every part of the human body. It is divided and sub-divided into many distinct classes, yet each having a relationship to the other. The central nervous system consists of (1) the brain and spinal cord: and f2) of nerves that begin in various parts of the Mm OK. rnE FETTKTtJ* BROKEN. 4« body and end in the brain or spinal cord, called afferent or centrip- etal nerves, and of nerves which begin in the brain or spinal cord and end in different parts of the body, called efferent or centrifugal nerves. The afferent nerves, as the name implies, carry sensation TO the brain, while the efferent nerves carry motor force fko3i the brain to the muscles. They are sometimes so closely interwoven as to form a complete network, and are termed ^hxed nerves, yet each separate nerve fibre has a direct line of communication of its own. and is encased in a sheath or membrane which acts in the same manner as the covering of a telegraph wire which prevents the electric current from being transmitted to any other medium. If erve fibres are simply conpuctors of sensation, as the afferent nerves : or, 3IOTOR I3IPULSES, as the efferent nerves. The mind decides that the right hand shall strike a blow. The brain transmits the impulse or motor force to the muscles of the arm. which contract, and the blow is struck. Here we have a simple illustration of the action of the efferent nerves. Sensation may be classed as a force. Those feelings or impres- sions which are conducted by the afferent nerves are in the nature of a force. Commencing at a given part of the body it travels with an unknown and inconceivable rapidity to the brain, and is then PERCEIVED by the mind. The nerve fibre and the brain are both unconscious of their conductivity : it is the mind alone which takes actual cognizance of the impression or sensation which is conducted by the afferent nerves. The sensation of pain is an illustration of this. Pain is a force. A force, in this sense, is a motion of the molecules composing the nerve tissue. It is this rapid molecular motion which is the vehicle or carrier of sensation to any given point. So, if the finger is touched with the point of a needle, the nerve fibre receives a slight sensation, which is instantaneously con- vej'ed to the brain, and the mind is conscious that the finger has touched a sharp point. But if the point of the needle is pressed into the finger, the nerve force is materially increased : it rolls in on the brain with tremendous energy, and the mind becomes conscious of the distinct sensation of pain. The mind conveys the impres- sion to the motor region of the cerebro-spinal centre, the force wave rolls along the efferent or motor nerves to the hand, and it is in- stantly jerked away from the cause of pain. All this happens so quickly that it is impossible to measure the time. It is an instance of the complete action of the nervous forces. There is sensation. 46 FROM BONDAGE TO FREEDOM: mental consciousness, pain and mobility, exercising the functions of both the afferent and efferent nerves which comprise the central nervous system. EFFECT OF OPIU3I OR 3IORPHINE ON THE SYSTEJI. We will now consider the effect produced by opium or morphine on the nerves and their functions. As pain is an increased motion of the molecules forming the nerve tissue, it is evident that the only way in which morphine can allay pain is to diminish or stop the motion of the molecules in cells. It can ease pain in no other way. As the nerves of sensation convey their impressions by molecular motion, and as the .tendency of morphine is to arrest this functional activity of the molecules, it is a logical conclusion that the physio- logical action of opium is to diminish the natural forces of the ner- vous system. This is its primary action. It arrests the legitimate processes of nature and prevents the nerve fibres from fulfilling their accustomed duties. Morphine does even more than this. When the "drug" has been constantly used for a long time it produces an iso- meric change in the nerve fibre. This may result from the continued and excessive use of various drugs, as bromine, chloral, tobacco, alcohol, ether, opium and morphine. It is a distinct chemical change in the structure and action of the nerves, and is as positive and well defined as that produced in albumen in coagulation by heat. After this change has been produced, the nervous system requires the new food in order to perform its work. In its natural condition, its structure and functions were an equivalent of the food required by it. In its new state of isomerism, the structure and functions must be the equivalent of the natural food plus the "drug" which caused the change. Studied objectively, then, morphism is a condition of isomeric change produced in the nervous system by opium or mor- phine, and which necessitates the continued use of the "drug" in order to enable its functions to continue. Every nerve fibre of the opium user's body cries for the "drug," and cannot rest without it. It is an absolute necessity ; without it life becomes a hell of torment, and death a vision of hope. It will be seen that I interpret the physiology of the nervous system and the pathology of the opium habit in terms of matter and motion. They are both purely physical processes. The orbit of a moving molecule is unknown, whether it be that of the light ether OR. THE FETTERS BROKEN. 47 or the medullary protoplasmic matter of a nerve. It is not unrea- sonable to suppose that the molecules of opium may hold a relation as close to those of the nerve in this pathology as are the molecules of hydrogen and oxygen in water. Be this as it ma}', there is a physical union between them, and a modification of movement of the molecules of the nerve that is the basis of the opium habit. The victim's nervous system has an added factor in its structure as well as function, and the victim is a man or woman plus opium or morphine. This being the foundation of the opium habit, it mil readily be seen that the will has very little influence over it. The will is as much under the influence as is any other function of the nervous system, and. far from having any power over the habit, it is largely dominated by it. It is the general testimony of confirmed opium users that the will power is lost : they are mere machines, carrying out the behests of an imperious master, and their own voli- tion is no longer a factor in the case. CHAPTER IX. PATHOLOGICAL CO>rDITIOXS — THE SEQUENT PATHOLOG-Y. The condition above referred to is undoubtedly one of disease. There is life in the body, both physical and mental, but it is that state which is expressed by the term mokphism. and not the healthy, natural life which is exhibited without opium. Morphism is that condition which results from the process of isomeric change, in which the functions of the nerves, the liver, spleen, kidneys, stom- ach, and other organs, are robbed of their natural powers, their energies are curtailed, and the entire system is subject to the palsy- ing influences of a destroying ''drug." Sometimes morphine distributes itself evenly throughout the system, and the result is a somnolent consciousness, a dreamy inac- tivity, in which the mind takes no active part, but is entirely con- trolled by the "'drug.'" In others it seems to awaken certain portions of the brain to excessive action, and then we have strange and 48 KROIM BONDAGE TO FREEDOM : marvelous flights of rhetorical fancy, weird dreams, grandiloquent expressions, and unheard-of visions. The action of opium is the same in all cases as far as it relates to the nervous system; its spe- cial effects differ with individuals. In every case the long-continued use of the drug is followed by mental disease. This follows as a natural sequence. The nerves of sensation being diseased, the brain, which is their terminal point, must also be diseased, and hence the mind is unsound. One of the well-known causes of insanity is the isomeric change which is often produced in the brain by the exces- sive use of narcotics. This condition is known as opiumania, and when the victim reaches that stage he may be said to be completely given over to the power of a barbarous flend. To go without the •'drug," is to set every nerve- tibre, every muscle, nay, every particle of his body, frantically shouting for morphine; in his convulsions, he is thrown to the floor as though by a superhuman agency; he foams at the mouth, his body and face are horribly contorted, and he writhes in dreadful agony. Of such a wretched l)eing it may fitl\ be said, '' He hath a devil." One of the earlier symptoms of this horrible consummation is the perversion of the mind. Thought becomes a flctitious relation between realities, the power of creating or originating grand or use- ful ideas is largely diminished, and the mind runs in narrow grooves. The emotions are besotted and the natural affections dulled; he becomes fanciful, discontented, morose and irritable ; he is troubled with vertigo, headache, sleeplessness, loss of memory, energy, and will power. Jle loses his regard for truth, especially in reference to his habit, and his moral perceptions undergo a demoralizing change. These are the earlier results of the chemical action of the "drug" on the nervous system, and are a strong indication of the awful future which awaits him who continues its use. Although I have dwelt principally upon the action of morphine' upon the nervous system, it should be borne in mind that its power is extended to all the organs of the human body. This is not accomplished in a day or a month : it is a gradual growth, as certain as it is gradual. Opium never loses ground, never gives up a point gained, never stops in its w^ork, never calls a truce : but is ever and always, day and night, enforcing its grim commands, and pushing its victories from stronghold to stronghold. Unless stopped by some superior power, it never halts short of a subjugation of every func- tion of the body and mind. This has been amply demonstrated by OR. THE FETTERS BROKEN. 49 post mortem examinations, which have shown congestion of the brain; an accumulation of fluid in the ventricles and arachnoid space : catarrhal inflammation of the stomach and intestines ; con- gestion of the liver: oedma of the lungs and cellular tissues; dis- tension of the bladder, owing to the long paral^'sis of that organ, and the presence of opium in the urine. A disease so subtle, yet so pervasive, might well baffle .the skill of the medical profession in the years gone by : but we may rejoice that, at last, by the persistent efforts of science, its pathology stands revealed in all its ghastli- ness ; and the means of its complete eradication and cure have been made known to the world. CHAPTER X. 3IETHODS OF TREATMENT — THE PLAN OF '• SELF-CrRE." It^ there no balm in Gilead ': ~ Bible. It is only within the last fifteen years that the subject of -the opium and morphine habit and its treatment, has been brought prominently before the world. I think I can truthfully say that it Is only within the same period that the medical profession have bestowed upon it any large degree of thought and attention. Dur- ing the term mentioned, the habit, and various methods of treating it, have been brought into more and more prominence. Members of the profession have advocated alleged physiological antipathies in the medical journals. ••Antidotes."' '"Remedies," and "Cures" have been ''invented."' advertised and pushed by non-professionals until they are as numerous as the harvest which sprang from the tilth of Cadmus and his broadcasting of dragon's teeth. The busi- ness of "curing" the opium and morphine habit has become a new liydra. As one ••discovery" fails and ceases, another, like a new head, takes its place, with lips as thirsty and jaws as strong, to drain the very life-blood of its victims. Many thousands of opium users have found that this monstrous, many-headed leech is only less exhausting and fatal than the opium disease itself. It is my purpose to describe and discuss, with all possible accuracy and 50 FROM BONDAGE TO FREEDOM*, fairness, the various methods of treating the opium disease. And at the outset I will speak of that one which is still believed by the great majority of physicians to be the only means of recovery for their patients of this class, viz : that of overcoming the habit by "gradual reduction" of the daily doses of the "drug." As this method is so frequently tried by sufferers without reference to med- ical advice, it has been called that of "self-cure." The first thought of the opium or morphine user, whose opiate- life has reached a crisis, is to cure himself, without seeking the assistance of medicine. He usually does not ask the aid or counsel of a physician, for the instinct of concealment continues even to the latest stages of his habit, and he shrinks from revealing, even to the doctor whom he trusts, the secret which he has so long en- deavored to guard. But even if he should tell his doctor the story of his misfortune, he would, in the vast majority of cases, simply be told that he must gradually reduce his daily "quantum" of the "drug," and thus in time learn to do without it. If he turns to the one enduring work which the opium habit has produced, the "Con- fessions of an English Opium Eater," he will find that its author based all his hopes of recovery from the abyss into which he had fallen, and whose dark depths were stirred by the sound of his '' Suspiria de Profundis,^- upon the method of self-cure by "gradual reduction." And, unless he read the words of the famous essayist more carefully than many have done, he may fail to notice the fact, which is half hidden and half revealed, that DeQuincey never found the deliverance for which he strove. The last words of his last utterance on the subject end in an awful plagal cadence, of hopeless despair. After stating that twice he had, for a time, entirely abandoned the use of opium and again resumed its use, he thus concludes : "During this third prostration before the dark idol, and after some years, new phenomena began slowly to arise. For a time, these were neglected as accidents, or palliated by such remedies as I knew of. But when I could no longer conceal from myself that these dreadful symptoms were moving forward forever, by a pace steadily, solemnly, and equably increasing, I endeavored, with some feeling of panic, for a third time to retrace my steps. But I had not reversed my motions for many weeks before I became profoundly aware that this was impossible. Or, in the imagery of my dreams, which translated everything into their own language. I saw. through OR, THE FETTERS BROKEN. 51 vast avenues of g-loom, those towering gates of ingress, which hith- erto had always seemed to stand open, now at last harred against my retreat and hung with funeral crape. "The sentiment which attends the sudden revelation that all is LOST ! silently is gathered up into the heart ; it is too deep for gest- tures or for words ; and no part of it passes to the outside. Were the ruin conditional, or were it in any point doubtful, it would be natural to utter ejaculations, and to seek sympathy. But where the ruin is understood to be absolute, where sympathy can not be consolation, and council can not be hope, this is otherwise. The voice perishes : the gestures are frozen ; and the spirit of man flies back upon its own center. I, at least, upon seeing those awful gates closed and hung with draperies of woe, as for a death already past, spoke not, nor started, nor groaned. One profound sigh ascended from my heart, and I was silent for days." Ignorant of this tremendous failure, or not appreciating its sig- nificance, the sufferer of to-day resolves to pursue the same process of self -deli vera nee. He remembers that it was by means of doses gradually increased that he came to be a confirmed opium user, and he argues with himself that, as he entered the regions of horror step by step, down a descending path, so he may retrace the long and steep incline, and, finding, at its top, the "gates of ingress" still open, pass ouS into a free and happy life I Easy is it to glide downward into the awful opium gulf, but to return and escape, — how hard I The recorded experiences of opium. and morphine users, who have attempted to cure themselves by gradual reductions of the daily dose of their opiate, is like a horrible, infernal chorus of shrieks and screams. The language has been ransacked by these sufferers for terms intense enough to set forth even a little of their misery. Let me endeavor to place before the reader the experiences of a typical case of attempted self-cure. Every incident and detail of suffering, and of lamentable and disastrous failure, can be substan- tiated by scores of published experiences, and by hundreds of in- stances described in my own correspondence. Let the individual be of middle age, and, originally, of more than ordinary strength of constitution, and of a hopeful temperament. His powers have not been greatly wasted, as yet, and he has, by nature, a strong mind and a determined will. He has, for some years, been taking, let us suppose, an average quantity of H grains of morphine in each 24 .'.l! FT50:M BOXDAGE to FREEDO^kl : hours. He has, hitherto, made onl}^ feeble and abortive attempts to cease using the "drug," but now, alarmed bj' a failing stomach, or shocked by a vision of a life ruined, he summons all his strength and condenses, all his energies of mind and body into a resolution to break the withes which are binding all his powers. He with- draws himself from his accustomed duties and cares, so that he may be burdened by no unnecessary weight in the contest, and begins to carry out his determination to reduce, gradually, his daily " ration '" of the poison until the amount taken shall become so insignificant that he can entirely abandon it. He may. possibly, make a rapid reduction during the first thre«" or four days, — perhaps come down to one-half his habitual quantity in that time. Many a victim of the habit, beginning such a strug- gle, has felt a short and utterly deceptive joy at the idea of a speedy deliverance from his bondage, because he has. in so short a time, reduced his daily doses of the ''drug" one-half, without experienc- ing any feelings worse than general uneasiness and discomfort. He does not know that the perverted machinery of his body has been storing up morphine in all the tissues, and that it is this hoarded poison which makes the first stage of his trial so easy, by supplying the stimulus which the system has come to require. But the third or fourth day of such continued reduction, this store of isomerized morphine begins to fail, and, although it might require weeks to entirely exhaust it, the help which it giA'es becomes less and less. From this time, be his daily reductions ever so minute, the sufferer rapidly passes into the seething crater of the opium agony. He experiences an intense irritability, both mental and physical : cold chills pierce to his very marrow, to be suddenly succeeded l)y hot flashes and out-bursts of perspiration, which make him drip at every pore. Pains which pierce and sting like poisoned spears are felt here and there all over the body. In the stomach there is a constant, terrible sensation, as if a pack of sharp-toothed, hungry wolves were gnawing and tearing its coats. The mind becomes affected. The power of attention and continu- ous thought is lost; reading becomes impossiV>le, not merely on account of ceaseless restlessness and tormenting pains, but because the mental faculties are incapable of concentration, and it is im- possible to fix the attention upon consecutive sentences. All mental activity is paralyzed. Consciousness remains, but it is a conscious- ness of unceasing pain. There is no longer any restful sleep, but OR. THE FETTERS BROKEN. O-^ only half slumber, and this is fall of conscious uneasiness, or is tormented with delirious dreams. And yet, this is but the threshold of the torture chamber. As the days pass, and, with stubborn endurance, the reductions are still made until the daily dose is but a grain, or even less, the patient experiences horrors which no words can portray I For a brief period after taking his comparatively minute dpse of the •'drug" he may experience some mitigation of his sufferings, but the relief is only partial and exceedingly brief. ]N'ot for an instant does his torment cease, and day and night not a concious moment is free from i)ains. like those which, in darker ages than these, wrenched shrieks and awful secrets from victims tortured on the rack. If the ej^elids close, it is not in slumber, — the "drug " which once gave such sweet and irresistible invitation to repose, has per- fected its treachery — it has "murdered sleep.'* Instances are not wanting where the victims of the morphine disease, endeavoring to cure themselves, have gone absolutely without sleep for one or two weeks. The sleepless days and nights appear to lengthen, until t'ach day. each hour seems endless. One who has described his own I'xperience of self-cure, writes : "It may aid the reader to form some adequate notion of the dreary length to which these nights drew themselves along, to men- tion that on one occasion I resolved neither to look at the clock nor open my eyes for the next two hours. It then wanted ten minutes to one. * * * * yot what seemed thousands upon thousands of times. I listened to the clock's steady ticking. I heard it repeat, with murderous iteration. ' Ret-ri-bu-tion.* varied occa- sionally, under some new access of pain, with other utterances. * "" * * With these allotted tasks accomplished, and with the suspicion that the allotted hours must have long expired, I would yet remind myself that I was in a condition to exaggerate the lapse of time ; and then, to give myself every assurance of fldelity to my purpose, I would start off on a new term of endurance. I seemed to myself to have borne the penance for hours, to have made myself a shining example of what a resolute will can do imder circumstances 1 lie most inauspicious. At length, when certain that the time must have much more than expired, and with no little elation over the happy result of the experiment, I looked up at the clock and found it to have been just three minutes past one." And everv second of those interminable minutes is full of 54 FROM BONDA.GZ TO FREEDOM: indescribable pain. The feet and lower limbs seem filled — not with blood, but with fire. The nerves, so long held in unnatural quiet, awake and begin, at once to pay, with interest, for every moment of enforced, abnormal torpor with intensest torture in every atom of their fibre. A fierce, insatiable restlessness pervades every particle of the body — constant motion through each day and night is a necessity, but in no wise a relief. One who was endeavoring to cure himself by reducing his quan- tum of crude opium at the rate of one grain each twenty-four hours, writes : " From seventeen grains downward my torture (for by that word alone can I characterize the pangs I endured) commenced. I could not rest, either lying, sitting, or standing. I was compelled to change my position every moment, and the only thing that re- lieved me was walking about the country. My sight became weak and dim ; the gnawing at my stomach was perpetual. * * * * A dull, constant pain took possession of the calves of my legs, and there was a continual jerking motion of the nerves, from head to foot. My head ached ; my intellect was terribly weakened and con- fused, and I could not think, talk, read, nor write. * * * * i became unable to walk, and used to lie on the floor and roll about in agony for hours together.'' But it is unnecessary to dwell upon the physical agonies of those who try to retrace their steps along the path of the opium habit. The way is paved with red-hot coals and encompassed with burning flames. In addition to the pangs of body there is a distress of mind which broods over all like a dense cloud of despair. Whether the victim was sinful, weak, or only deceived, makes no difference— his punishment is superlative, surpassing all other pains. In the em- phatic language of Fitz Hugh Ludlow: "The grasp with which liquor holds a man when it turns on him, even after he has abused it for a life-time, compared with the ascendency possessed by opium over the unfortunate habituated to it but for a single year, is as the clutch of an angry woman to the embrace of Victor Hugo's Pieuvre. A patient whom, after habitual use of opium for ten years, I met when he had spent eight years more in reducing his daily dose to half a grain of morphia, with a view to its eventual complete aban- donment, once spoke to me in tliese words: 'God seems to help a man in getting out of every ditticulty but opium. There you have to claw your way out, over red-hot coals, on your hands and knees, and drag yourself, by main strength, through the burning dungeon OK, THE FETTERS BROKEN. on bars." '' It is well known that inebriates taken hold of by religious excitement, sometimes, for a while, and perhaps permanently, cease wholly the use of alcohol, and lose, at once, all desire for it. But who ever heard of a confirmed opium user who had experienced such a cure ? The saddest fact in connection with this method of cure by •'gradual reduction " is that after enduring such torment of fire, the few who succeed in finally abandoning the opiate, are, by no means, CURED. The great majority of those who try this terrible backward path, soon turn, affrighted, from its horrors and go forward toward the ruin that awaits them. But the very few who, by reason of extraordinary strength of constitution and will, go through the ordeal and emerge with life and reason, are but the wrecks of what they once were. As they lay like souls in the burning flames of an- cient superstition, waiting for the period of their torment to end, they hoped that when, at last, the brazen gate opened and they went out free, they would come into the old, bright world which existed for them before they passed into the eclipse of the drug. They hoped to be strong and full of energy once more. But these hopes are not fulfilled. In some cases, in which a very moderate amount of the "drug" has been used each day, and that only for a short time { as three or four grains daily for a few months), and in which the physical nature possesses exceptional strength and endurance, the opium user, cured by "gradual reduc- tion " alone may become reasonably healthy in body and mind. But cases of this kind are so rare that they do not modify the general fact, that the exceedingly small percentage of those who succeed in this method of self-cure are so weakened in body and mind by the "drug," and their struggle to cease its use, that life is almost useless to them. Their condition is vividly described in the narrative of his experience by a gentleman who, in about forty days, reduced his quantum from eighty grains of gum opium to nothing. He says : "During the time I was leaving off opium I had labore'd under the impression that the habit once mastered, a speedy restoration to health would follow. I was by no means prepared, therefore, for the almost inappreciable gain in the weeks which succeeded. * * * So exceedingly slow has been the process toward the restoration of a natural condition of the system, that writing now, at the expiration of more than a year since opium was finally abandoned, it seems to me very uncertain when, if ever, this result will be reached. .")H FH()3i hondactE to kkekdom : Between four and live months elapsed before I was at all capable of commanding my attention or controlling the nervous impatience of mind and body. * * * The business I had undertaken required a clear head, and average health, and I had neither. The sleep was short and imperfect, rarely exceeding two or three hours. The chest was in constant heat and very sore, while the previous bilious diffi- culties seemed in no way overcome. The mouth was parched, the tongue swollen, and a low fever seemed to have taken entire posses- sion of the system, with special and peculiar exasperations in the muscles of the arms and legs. * * * i would sit for hours looking listlessly upon a sheet of paper, helpless of originating an idea upon the commonest of subjects, and with a prevailing sensa- tion of owning a large emptiness in the V^rain, which seemed chiefly tilled with a stupid wonder when all this would end. •'More than an entire year has now passed, in which I have (lone little else than to put the preceding details into shape from brief memoranda made at the time of the experiment. While the physical agony ceased almost immediately after the opium was abandoned, the irritation of the system still coutinues. * * * Had some virus been transfused into the blood, which carried with it to every nerve of sensation a sense of painful, exasperating un- iiaturalness, the feeling would not. T imagine, be unlike what I am endeavoring to indicate." And this was his reward for a battle and a victory compared with which the torments of martyrs were as pleasant dreams I But this is not the end of it. In a postscript to the statement from which the above is quoted, he says: '' At the time of writing the preceding narrative 1 had supposed that the entire story was told, and that the intelligent reader, should this record ever see the light, would naturally infer, as I my- self imagined would be the case, that the unnatural condition of body would soon become changed into a state of average health. En this I wa's mistaken. So tenacious and obstinate in its hold upon its victim is the opium disease, that even after the lapse of te]s YEARS its poisonous agency is still felt. * * " "In my case, the most marked among the later consequences of the disease of opium, some of which remain to the present time and seem to be permanently engrafted upon the constitution, have been these: 1. Pressure upon the muscles of the limbs and in the extremi- OR. THE FETTEES BROKEN. ST ties, sometimes as of electricity apparently accumulated there under a strong mechanical force. 2. A disordered condition of the liver, exhibiting itself in the variety of uncomfortable modes in which that organ, when acting irregularly, is accustomed to assert its grievances. 3. A sensitive condition of the stomach, rejecting many kinds of food which are regarded by medical men as simple and easy of digestion. 4. Acute shooting pains, confined to no one part of the body. 5. An unnatural sensitiveness to cold. 6. Frequent cold perspiration in parts of the body. 7. A tendency to impatience and irritability of temper, with paroxysms of excitement wholly foreign to the natural disposition. 8. Deficiency and irregularity of sleep. 9. Occasional prostration of strength. 10. Inaptitude for steady exertion.-' What a dismal outlook this presents to those who are searching ror encouragement in curing themselves of the opium or morphine habit by the methods now under consideration 1 This is not recov- ery from a disease— it is a permanent diseased condition. Unless the victim of opium can find some stronger and more efficient aid his case is pitiable indeed. CHAPTEE XI. 3IETH0DS OF THE ATIMENT — CONTINUED. THE LEYENSTEIN METHOD, AND THAT OF '-RAPID REDUCTION." The first mode of treatment mentioned in the heading of this chapter consists, at least in theory, in placing the patient under the care of a physician, who at once prohibits the further use of the ■'drug," even in the smallest doses. In the method of ''rapid re- duction," constantly diminishing doses are administered during the first eight or ten days, at the end of which time the supply ceases. These methods are so nearly alike in their immediate and secondary lesults. that they may be treated as one. 08 FROM BONDAGE TO FREEDOM: The patient is to be removed from his usual surroundings and placed under the supervision of a physician specially skilled in the treatment of opiate diseases. He must have attendants, educated to their duties, and in whom the medical director can place the most implicit confidence that they will rigidly follow his instructions, and will not yield in the least to the entreaties of patients, nor be moved by the sight of their sufferings to modify the rules of treatment. The patient is placed in a room, the windows of which are carefully- fastened so that he cannot escape, and the walls padded, so that when, in his agony, he dashes himself against them he will receive no injury. The room must contain no furniture with which suicide can be accomplished, no sharp instruments, and no projecting cor- ners from which the patient can suspend himself by the neck. His clothing is to be removed and carefully searched for concealed opiates before it is restored to him. After all these necessary pre- liminaries, the method of treatment by entire cessation, or by "rapid reduction" of the dose, begins. I will not attempt the impossible task of picturing the suffer- ings which patients exi^erience under these methods of treatment. The author, whose name has been given to one of them, Levenstein, in referring to it, says: "Although persons who suffer from morbid craving for morjjhia show different symptoms, some of them be- ginning to feel the effects of the poison after using it for several months, while others enjoy comparatively good health for years together, there is no difference between them as regards the con- sequences upon the partial or entire withdrawal of the narcotic "drug." In this respect they are all equal. None of them have the power of satisfying their passions unpunished. "Only a few hours haA^e passed since using the last injection of morphia, and already the feeling of comfort brought on by the action of the "drug" is passing off. They are overcome by a feel- ing of uneasiness and restlessness : the feeling of self-consciousness and self-possession is gone, and is replaced by extreme despondency ; a slight cough gradually brings on dyspnoea, which is increased by want of sleep and by hallucinations. "The vaso-motoric system shows its weakness by abundant per- spiration and by the dark color of the face, which replaces the pale condition apparent during the first few days. "Flow of blood to the head and palpitation of the heart, with a hard pulse, soon show themselves. The latter symptom often OK, THE FETTERS BROKEN. 59 disappears suddenly, and is replaced by a slow, irregular, thread- like pulse, which is the sign of the beginning of a severe collapse. "The reflex irritability increases, the patients begin to sneeze and to have paroxysms of yawning ; they start if any one approaches them : touching their skin causes crampy movements or convul- sions; the trembling of the hands, if not already evident, now becomes distinctly perceptible. The power of speech is disordered : lisping and stammering take place. Diplopia, and disorders of the power of accommodation, frequently accompanied by increased se- cretion of the lachrymal glands, show themselves. The patients are overcome by a feeling of weakness and total want of energy, and are thus compelled to lie in bed. "I^euralgic affections of various parts of the body, pain in the front and back of the head, cardialgia, abnormal sensations of the legs, associated with salivation, coryza, nausea, vomiting and diar- rhoea, tend to bring them into a desperate condition. "Some persons will bear up with fortitude under all these trials ; they will quietly remain in bed, and will endure the unavoidable suffering, hardly uttering a complaint. Of the others, although a great majority of them sleep and doze ( ? ) during this trying time, some can find rest nowhere: they jump out of bed, run about the room in a state of fear, crying and shrieking. Gradually they be- come calmer, although occasionally their excitement increases. A state of frenzy brought on by hallucinations and illusions of all the sensitive organs, at last causes a morbid condition, to which I have given the name of delirium tremens, resulting from morbid craving for morphia, it being similar to that caused by alcohol. Some of the patients, however, will be found walking about in deep despair, hoping to find an opportunity of freeing themselves forever from their wretched condition." What words are these to be read by an opium sufferer who is crying out for help ! What a terrible indictment do they constitute against the method of treatment to which the author of them has contributed his name ! What victim of the habit will not shrink from entering upon such a period of torment, and seek relief from any and every nostrum, rather than face such inevitable agonies? We may be sure, too, that these sufferings are not overstated. In fact, they are under-estimated. I will assert, and can maintain the assertion by the testimony of hundreds treated by me, or who. have recorded their experiences in my correspondence, that if any fin KKOM HONDAGE TO FREEDOM : conflrmed opium users who for one year or longer have taken doses equivalent to four or five grains of the sulphate of morphia each twenty-four hours, sleep and doze during treatment by instant disuse or rapid reduction, they are so few in number, and of so peculiar a physical constitution that their cases are wholly and marvelously exceptional. It they exist at all, they are not possessed of the nervous system, and its capacity for both pleasure and pain, of the average American citizen I The language above cited from Levenstein speaks of some pa- tients as earnestly and persistently seeking for means of self-murder to end their torments. Is it necessary to inform, — not the experi- enced medical practitioner— but the average general reader,— that the agonies which make men not only long for death, but persist- ently seek it. will soon produce lesion of the brain, insanity and death? Only a short time since an account was published of the expe- riences of a German village physician and preacher, who advertised to receive and cure persons afflicted with the opium or morphine disease. He used the Levenstein method, and so large a proportion of his patients either died or became insane that the civil author- ities interfered and compelled him to abandon his specialty, and he was forced to leave the district. In the case which foi'med the text of the magazine article by Fitz Hugh Ludlow, before referred to. in which the patient had been taken to a water-cure establishment and at once deprived of the "drug," the sufferer had been without proper sleep for ninety (lays before the dreadful experiment was abandoned. The writer says : ••I have said that during the first month of trial he had not a moment of even partial unconsciousness. Since that time there has been, perhaps, ten occasions a day when, for a period of one minute in length to five, his poor, pain-wrinkled forehead sank on his crutch, his eyes fell shut, and, to outsiders, he seemed asleep. But that which appeared sleep was internally, to him, only one stupendous succession of horrors, which confusedly succeeded each other for apparent eternities of being, and ended with some nameless catas- trophe of woe or wickedness, in a waking more fearful than the state volcanically ruptured by it. During the nights I sat by him, these occasional relaxations, as I learned, reached their maximum length — my familiar presence acting as a sedative — but from each of them OR. THE FETTERS BROKEN. fil he woke bathed in perspiration from sole to crown ; shivering under alternate flushes of cold and fever ; mentally confused to a degree which, for half an hour, rendered every object in the room unnatural and terrible to him ; with a nervous jerk which threw him quite out of bed, although in his waking state two men were requisit to move him : and with a cry of agony as loud as any under amputation." In the case of this patient the treatment was abandoned and the use of opium resumed; but the sufferer died in a short time, unable to recover from the shock caused by discontinuing the use of the ''drug." Every i;)hysician knows that lesion of the brain may be caused by intense and continued pain, and the tortures which the methods of treatment now under consideration involve, cannot fail to pro- duce insanity in many cases. The details of cases treated by Leven- stein himself show that the mode of treatment produces at least temporary aberration of mind. His patients, many of them, saw terrible visions and dreamed dreadful waking dreams, so real that they shrieked for help in agonies of fear. And it is, in spite of the aid of the various sedatives and nerv- ines, known to the profession that these sufferings occur. As a matter of course, the physician who endeavors to cure by either the method of immediate disuse, or by "rapid reduction," uses all indi- cated therapeutical and hygienic aids. But all these, as a rule, have no more effect toward abating the tortures of the patient than do scattering drops from a summer cloud in extinguishing a roaring conflagration which is licking up great warehouses beneath. The Levenstein method is carried out completely in few, if any. cases. Besides endeavoring to sustain the patient w^ith sedatives, nervines and the free use of distilled and fermented liquors, it is frequently found necessary to administer morphia, at least in small doses, to prevent fatal collapse. The same is true of treatment by -'rapid reduction." And some who treat the disease by the latter method have published to the world that they are accustomed to practice deceit upon their pa- tients. They give hypodermic injections of clear water, or a solution of quinine in water, pretending to the sufferer that it is morphine. Thus the patient is " fooled to the top of his bent " by the very one in whom he should be able to have the most perfect , confidence. Such methods seem like child's, play rather than practicing mecUcine, and do no real good. Those w^ho gravely publish to the world that iVZ FROM BONDAGE TO FREEDOM: such fooling is a proper and prominent means to be used in treating opium patients, can liave liad very little experience, or else yery little true success in the specialty. Nor do the cruel modes of treatment above referred to succeed in really curing those in whom they cause such sufferings. It is true that the patient who survives the ordeal may leave the house of his torment, apparently, or for a time, free from the old morbid craving for the "drug.'" I will not say that he. may not live the remainder of his life without resorting again to opiates. Yet in all the pub- lished and private records which relate to the opium or morphine habit, 1 have not yet been able to find one authentic case in which the patient treated by such methods did not resume the habit sooner or later, or else did not remain an invalid and die an untimely death. The simple fact that those who, not only once, but twice, and, in some cases, even three times, '"clawed" their way backward over the burning coals and between the red-hot bars, and with the memory of their agonies still distinct, as it must be in their minds, go back again and again to the use of the drug after the lapse of months, and even years, proves that there is no radical and certain cure in any of the methods of treatment so far considered. The cases are exceptional in which they do not leave the victims shat- tered in health and so melancholy and hopeless that they, in time, weary of the struggle and fall an easy prey to opiates or stimulants. If there is no more certain way of escape : if the opium victim must go through fires of hell to reach, at last, only a dim, infernal border land of weakness and glooni, instead of green earth, blue sky, and strong and joyous life, who can blame him greatly if he prefers to face the final agonies and the death which the "drug" itself will cause. He will suffer torments then, it is true — to die in that way is to die hideously. But the end of it all is an end. •'After life's fitful fever, he sleeps well." To speak of a patient, after such an ordeal, as "cured," simply because there is no longer any craving for morphia, and the patient is able to live without it, is to misuse language and to deceive those who confide in .such assertions. It is To keep the word of promise to the eaj But to break It to the hope." OR, THE FETTERS BROKE??. (53 The victims of the opium disease plead for a remed}^ or a mode of treatment whicli shall give them hack their strength, their motions, their will, their life again. •"T is life whereof their nerves are scant. 'Tis life, not death, for which they pant: More life and fuller, that they want." CHAPTER XII. METHODS OF TREATMENT — CONTINUED. DRUGS USED IN ATTE3IPTS TO CURE. The search for drugs antipathic to opium, and its products has been pursued, with much energy, for the last ten or fifteen years. The need of some preparation which will sustain the patient during his effort to abandon his opiate has been generally recognized by the medical profession, as well as the almost total inefficiency of the tonics, sedatives, anodynes and stimulants ordinarily used in prac- tice. It appears to have been generally taken for granted that if the patient can be tided over the period of struggle and agony, by some mitigation of his torment which will permit hiin to catch, at intervals, a little restful sleep, and preserve his mind from becoming unbalanced by the fierceness of his pain, he will at length emerge into liberty and health. The sequela? of the opium habit, in cases in which the habitue has been dismissed from treatment as cured, and who may for a little while feel no morbid craving for the "drug," have been studied comparatively little. The end sought by nearly all who have given attention to the opium or morphine habit seems to have been merely to eradicate the unnatural "craving*' for the "drug," while the condition in which the system may be left at the end of the course of treatment has been given much less thought. It seems to satisfy the ambition of many of those in the medical profession who have had an opportunity of treating the " morphine crave "—and who have access to medical periodicals — when they can publish the history of a cure, giving their course of treatment from ^^4 FROM BONDAGE TO FREED03I I day today, with a record of the therapeutical action of the medicines administered, and of the pathological conditions and immediate phys- iological effects. The temporary cessation of morbid desire for the '•drugv' when the patient is able to be dismissed, is published as a •'cure," in forgetfulness of the fact that in all probability the nerves have been so benumbed by the agonies of the final struggle that they are actually for a time incapable of the appetite. To dismiss a patient in such an exhausted condition that he is unable for a while to feel morphine-hunger and denominating it a '■ cure." is like preventing a fever by inducing a collapse I But the use of various nervines, tonics, sedatives and stimu- lants, by the profession, and especially outside of it, to aid the opium patient in passing through the ordeal of fire which it is taken for granted that he must endure if he would be saved, is so exten- sive that the actual value of these agencies in opium disease should be thoroughly understood. Prominent among the drugs used at present in endeavors to cure the opium disease, in comlMnation either with morphia alon(^ or with morphia and other drugs, are N-T'X VOMICA and its alkaloid, strychnine. The class of vegetable growths to which this belongs— the bitter stryclinos—hR\e long been known as containing active poisons. They furnish to the natives of various tropical countries the active agent with which they make their light arrows so venomous that the slightest pricking of a vein by the point surely produces death. The alkaloid, strychnia, is prepared from the seeds of strycfinos nux vomica. An alcoholic extract of these seeds, which are popularly known as "dog-buttons," is also pre- pared. Half a grain of sulphate of strychnia, three grains of the alcoholic extract of nux vomica, or thirty grains of the pulverized seed are fatal to human life. Both the extract of nux vomica and its alkaloid, strychnia, are well known to the medical profession as powerful poisons which must be administered, when indicated, in minute doses and with much caution. They are used as spinal and nerve excitants, in pa- ralysis and hemiplegia, and also as tonics and anti-periodics. I am not aware that any member of the profession has seriously claimed that thevse agents are antipathic to opium, and probably all of them OR, THE FETTERS BROKEN. 65 will admit that if so potent a nerve-excitant as is supplied by nux vomica is practically powerless to fortify the nerves of the sufferer from the opium disease w^hen deprived of the "drug." then there is nothing which can be depended on to accomplish the desired result in the whole list of remedies in general use by the profession. And I venture to assert that no reputable physician will claim that he has conducted a single case of confirmed opium disease to convalescence and health, by means of nux vomica, either alone or in combination with other remedial agents. The largest use, and the most injurious one, of the "drug" now under consideration, is made by individuals outside the medical profession. Certain nostrums are largely advertised and sold as "antidotes" and "painless cures" of the opium habit, wliose chief active principle, so far as they have any besides the morphine which they contain, is prepared from nux vomica. It is only a physician who makes the treatment of the opium disease a specialty, that can know to what extent the victims of the habit are deceived and robbed by these ignorant and heartless charlatans. There scarcely has been one of my patients who does not tell a pitiful story of hope frustrated and purse depleted through following these false lights. Their representations are so specious, their promises so strong, their "testimonials" so apparently convincing, that confirmed opium users of every grade of intelligence and experience, even to the highest, become tributary to their treasuries. I can recall but few patients, of all who have come under my treatment, who have not taken these so-called "remedies." The most widely advertised and sold of these nostrums consists of a preparation of nux vomica, which, together with the morphine which the mixture always contains, are dissolved and disguised in glycerine, the preparation being colored with aniline red. The "theory of treatment" — if the term can be used in this connection — is to very gradually reduce the daily amount of the opiate, the nux vomica being supposed to "sustain" the victim or supply sufficient strength so that hi« system will not feel inconvenience on account of the reduction of his usual quantum of morphia. One of the points upon which the individual under "treatment" is anxiously requested to inform the vendor, is whether the mixture "sustains" him. The meaning of this is simply that if the proportion of morphine in the bottle is not large enough, another bottle will be prepared, in which the requisite quantity of the "drug" will be ^ FROM BONDAGE TO FREEDOM; dissolved. The process of "reduction" is intended to extend over many months, even to a year or longer. One of my patients, a phy- sician of good standing, tells me that he paid to a single concern about three hundred dollars, at the rate of fourteen dollars per month, for a "painless antidote," and did not receive one particle of benefit, but much injury. The questions which those who order these preparations are required to answer, show that morphia or some other form of opium is a necessary ingredient in the compound. They are particularly requested to state what form of the opiate they are accustomed to use, if hypodermically or by the mouth, and the full amount required to "sustain" them for a specified length of time. The price per bottle of the remedy is in proportion to the amount of the opiate taken ; that is, it is graded by the quantity of morphine required to prepare the remedy for each case. With all possible emphasis of exclamation points and capitals, the purchaser is instructed not to take a larger dose of the mixture than that indicated by the vendor, and all other persons are told that for them even to taste the prepa- ration will be highly dangerous I If these self-styled "doctors," who collect such heavy tribute from the victims of the opium disease, would frankly admit that a quantity of morphine, proportionate to the amount used by the purchaser, is an ingredient of their compounds, they would not, perhaps, be deserving of such entire disapprobation. But they not only fail to do this — they also endeavor, by every form of statement short of direct assertion, to convey the idea that their mixtures contain no form of opium. They assure the world that their "pain- less cures" contain no opium, intending to be understood that there is, in their compound, no form or product of opium. They explain their positive prohibition of the use, or even tasting of their nos. trum by any other person than the one for whom it is specially prepared, by telling what strong medicine it contains, and that it "must be made powerful" to do its work. The simple truth is, that the mixtures contain large quantities of morphine, and if a person not habituated to the "drug" should take even a single moderate dose of the poisonous compound he would die. I do not assert that these so-called "Antidotes" are without temporary effect, nor even that the "certificates of cure," by means of which the vendors push their wares, are not "genuine certifi- cates." I will not assert it to be impossible that the nux vomica, isam^^mm^ammmmm^m^^^^mm OR, THE FETTERS BROKEN. 67 alone, or mixed with nerve sedatives and anodynes, might in excep- tional cases enable moderate opium users to pass through a process of VERY gradual reduction, without unendurable suffering, down to abandonment of the "drug." But I do know that the number of those who have used these mixtures without benefit is legion, and that they are to be found in almost every town and hamlet through- out the continent. The extract of nux vomica, embraced in these compounds, may so disguise the usual effects of the slightly reduced daily doses of the opiate mingled with them, that one who imagines himself thoroughly acquainted with the action of opium products upon his own system may believe that it is not morphine, but some new and wonderful agent which "sustains" him. Even physicians, addicted to the opium habit and lured by the promise of speedy cure, have swallowed these compounds for months without recognizing the fact that they were still taking morphine in a disguised form. The purchaser of these nostrums is thus deceived, and he continues to send for the vaunted "cure" until he becomes wholly discouraged, and as soon as he stops, the habit, which has been lurking all the while near his side, springs once more upon him and bears him down, and he finds that its hunger has grown fiercer and its strength more terrible. I hardly need to add that to place in the opium patient's own hands, and subject only to his own administration, a compound containing large quantities of two such poisons as morphine and nux vomica, is very dangerous indeed. He will not take less than the prescribed dose, for it will not "sustain" him, and if he exceed it, he is plunged more deeply into his misery, and adds strength and heaviness to his chains. A very common result of taking these nostrums is to create a demand in the system for an increased quantity of the " drug." l^o matter what reduction of the opiate may have been accomplished while the mixture was being taken — and no one but the maker can know whether any reduction at all is made — if the patient ceases to take the potion for a time, he almost immediately goes back to a larger dose of the "drug" than he had ever taken before. This seems to have been the experience of a great majority of those who have tried these mixtures. The extract of nux vomica excites, but does not heal the nerves, and as soon as it is no longer taken, and the little supporting power which it exerts is withdrawn, a great 68 FROM BONDAGE TO FREEDOM: reaction takes place, and an increased supplj^ of opium or morphine is demanded hy the nerves in order that tliey ma}^ remain in the opiumized state, wliich has become tlieir normal condition. The cheap glycerine of commerce, which is the menstruum in which the morphia, nux vomica, and the other minor ingredients of these injurious compounds are dissolved, and by the sweetness of which they are considerably disguised, is positively hurtful to the physical system. Many of those who have taken the nostrums of which it forms so large a constituent, speak of its injurious effects upon the mucous lining of the stomach and bowels. It often causes persistent itching of the anus, indicating a disordered condition of the lower bowels. One of my patients, a gentleman who had all means of know^ledge on the subject which could be possessed by one not a phvsician, had repeatedly assured me that a late Chief Justice of the Supreme Court of a Western state died from the effects of the glycerine contained in a so-called "painless antidote" w^hich he took for the opium habit. If ever a "cure" has been made by these nux vomica and morphine nostrums we have no knowledge of it ; but we have a knowledge that wherever they have been tried they have served to fasten the chains of an opium servitude more firmly upon all the victims who have used them. CHAPTER XIII. METHODS OF TKEAT3IENT — CONTINUED. DRUGS USED IN ATTEMPTS TO CURE. Xext in prominence to nux vomica as an alleged antagonist of opium, and the sine qua non of those who advertise the "hypodermic method" in "twenty day cures," and also lately brought to the notice of the profession as of use in treating opium disease, is ATROPIA, A toxic drug, more potent for direct mischief, if not more permanent evil, if possible, than morphine itself. Atropia is the active principle of Atropa Belladonna, and is well OR, THE FETTERS BROKEX. 69 known to the medical profession as a most active and virulent poison, two-thirds of a grain producing death in an adult. It has been brought forward as an alleged physiological antipathic to opium, and in my investigations in search of an effective remedy for the opium habit I have given it much attention. My experi- ments with it, which have been numerous and persistent, have proved it to be not only of no real value for the purpose indicated, but also highly dangerous. In view of the knowledge of it which I have acquired, I cannot express in too strong language my sense of the atrocity of this mode of treating the opium disease, because of its immediate and lasting baneful effects. The patient is reduced to temporary idiotcy during treatment, and is left broken down and with no recuperative energy at its close. In the winter of 1880 an old lady sixty-seven years of age, and somewhat emaciated, applied to me for relief from internal pain. She was suffering from ovarian neuralgia — so named by Prof. De Laskie Miller, of Chicago, who had operated on her some years before. This well-known physician had recommended, after the operation, half grain injections, per anmn, of morphine, and the patient, finding relief in the small doses, gradually increased them, till five grains had no more effect than the original one-half grain dose. She then began to take the morphine by the mouth, and continued to increase her daily quantum, until doses of ten, fifteen, twenty, forty, and fifty grains were successively reached, and finally she swallowed one drachm of the "drug" each twentj^'-four hours. It was at this time and under these conditions that she applied to me for help. She had reached the limit of the aid which morphine could give her, and it no longer exerted an anodynic influence upon her neuralgic pain. On visiting the patient on the morning of January 26th, I found her suffering intense agony, and praying for death to relieve her. She proved wholly insensible to hydrate of chloral in large doses, and I deemed this to be a legitimate case for the exhibition of atropia. I therefore threw into her arm one-thirty-second of a grain. In half an hour the neuralgic pain had left her. but she complained of thickening of the muscles of the throat and difficulty of breath- ing. The vessels of the neck and throat became turgid, and the skin of the face congested and purplish. This, however, passed away in the course of half an hour, and the patient complained of dryness of the mouth and fauces. Upon examination I found the salivary 70 FROM BONDAGE TO FREEDOM; secretions viscid and ropy. I ordered beef tea and quinine, in three grain doses, to be given alternately every three hours, and left her. In the evening I was sent for. Found the patient suffering as much as before treatment in the morning. The salivary secretion, however, had returned, the skin was quite moist, and she had eaten a plentiful dinner and supper. I again injected one-thirty-second of a grain of atropia into the arm, and continued treatment as before. I was unable to remain long enough to observe the action of the atropia, as I had done in the morning. January 27th. Upon visiting the patient this morning, I was told that she had been delirious through the night, and had slept but little, had refused nourishment, but had not complained of pain. Found the pupils of the eyes much dilated, and the tongue dry and chippy, so much so that what she said was unintelligible. Pulse wiry and intermittent. Ordered sponge bath and enema, and in- structed to continue beef essence when possible. Was sent for at two, p. m. Found the patient evidently in intense pain. She was groaning and tossing wildly, as though suffering great agony, with low muttering delirium and subsultas. The pulse was bounding, jerky, and incompressible. The mouth was as dry as an ash-pit : the teeth covered with an abundance of dry sordes : the pupils of the eyes were expanded to their utmost limit. She was a horrible spectacle, and to the attendants appeared to be dying. I at once threw a solution of five grains of morphine and one- sixty-fourth of a grain of atropia into the arm, and washed out the mouth with a diluted wine, of which she swallowed a little. In ten minutes she was perfectly easy, and in five more, asleep and breath- ing naturally. Called again at nine o'clock, p. m. Found her awake, comfort- able, and hungry. The pulse was soft and regular; secretions, plentiful. The bowels had moved off and the urine was abundant and clear. Ordered light food, and that everything be kept as quiet as possible. During thirty-eight hours she had taken but five grains of morphine. January 28th. Visited the patient at eleven o'clock, a. m. She had passed a fairly comfortable night, but was beginning again to suffer. I again injected one-thirty-second of a grain of atropia into the arm. The phenomena which succeeded the former injections reappeared, but intensified — so much so that I was somewhat OR, THE FETTERS BROKEN. 71 concerned lest I had exceeded the intended dose (Tiz : one-thirty- second grain). In a little while, however, some of the alarming symptoms disappeared, and she rested in a state of torpor, with only an occasional suspiration to show that she breathed at all. From this condition she passed into a heavy, dead sleep. At nine p. m., visited her again. Found her awake, violently delirious, chattering wildly about things that had occurred in her younger days — so far as she could be understood — talking to imaginary characters, and believing the room to be filled with devils and hideous monsters. The previous physical phenomena attendant upon the administration of the atropia, as regards the pulse, eyes, mouth, tongue, throat and secretions, were apparent in a greater degree. Ordered meat juice in small quantities, largely diluted, and given frequently. January 29th. Was sent for at eight o'clock a. m. Found the patient in a state of collapse, and to all appearance moribund, the pulse being rapid and hardly perceptible. Injected into the arm five grains of morphine and awaited results. These were soon evident in her re-awakening to consciousness and apparent comfort. Gave her weakened wine, and she soon fell asleep. Left instructions to administer Valentine's meat juice in teaspoonful doses every hour during the day. Patient forty- two hours on five grains of morphine. Visited her at nine o'clock in the evening, and found her fairly comfortable, but much exhausted. The tongue was moist, eyes dilated and star- ing, pulse full, but easily compressible. She had complained of pal- pitation and difficult breathing at intervals throughout the day. Discharges from the bowels and bladder had been frequent, the urine being highly colored. She begged for a little morphine by the mouth, and I gave her two grains. January 30th. Called again in the morning. Found that the patient had passed a comfortable night, and, her condition being so good, I determined to try the atropia once more, and, against the patient's inclination, I threw into her arm one sixty-fourth of a grain. All the physical phenomena of the larger doses soon ap- peared, but in a less degree. Visited the patient again at nine p. m., and found her de- lirious, talking wildly, as before ; very abusive to the attendants, accusing each one of the most criminal intentions toward her. She was constantly contriving means to guard herself against them, and i'2 FROM BONDAGE TO FREEDOM: insisted on leaving the house. It was impossible to quiet or appease her. She had refused all nourishment during the day, and would take no medicine, though she recognized and understood me when I offered to give her morphine by the mouth. I found the mouth dry, as before ; the pulse was hard, wiry and intermittent. I left no morphine, as she would take nothing— feeling satisfied that the effects of the atropia would wear off by morning. January 31st. Called at nine a. m. Found the patient quiet, but very much exhausted, with the mouth and tongue so dry that she could not articulate one intelligible word. The pulse was too rapid and feeble to count: the skin was dry and parched The patient had refused fluid nourishment since the last dose of atropia. I had informed the friends that I was giving atropia, and they now insisted that no more should be administered. I was, for my own part, willing to yield to the request, for the case had verified a con- clusion toward which my mind had been guided by numerous pre- vious experiences, that atropia was either cumulative in the system, or else that the system grows more and more susceptible to its effects through even very small doses continuously given. Whatever the cause may be, the drug has acted very badly, not only in my hands, but in those of other physicians who have related to me their experience of its sub-cutaneous use. But, determined to give it a fair trial in the case, I, next morn- ing, took the patient an eight ounce bottle of tonic mixture, con- taining, in addition, one-half a grain of sulphate of atropia, with orders to administer the same every three hours in teaspoonful doses. With this mixture (containing ri^ of a grain in each dose), and with five grains of morphine per day taken by the mouth, the pa- tient managed to get along with tolerable comfort for the next three weeks, but any effort at reducing the dose of morphine was met by the original intense agony. At the end of that period she went to Chicago to remain for some time, and passed from under my care. I learned, however, one year later, that she was taking nearly her maximum dose of morphia. This, together with my previous and subsequent experiences with atropia, proves to me, conclusively, that while this agent has some virtues in antagonizing the effects of morphia in the system, yet its influence is not only temporary, but very dangerous. The temporary effects of even minute doses upon the mind are very marked and very repulsive. It seems to strike directly at memory, OR, THE FETTERS BROKEN. 73 will, and judgment — and all those principle functions which sep- arate human heings from the lower races. It drags the bright, intelligent patient toward the level of the chattering ape. Only a short time ago, and at his own suggestion. I threw into the arm of an adult patient of strong and vigorous constitution and full habit, the one-thirtj'-second part of a grain of atropia. Its effects lasted three or four hours, and at the end of them, and while his sensations were fresh in his memory, he declared that no possible" consideration would induce him to repeat the experiment. All the physiological effects above noted were apparent, — absolute dryness of the mouth, tongue, and fauces; thick and indistinct utterance like that produced by extreme alcoholic intoxication. Excessive dilation of the pupils of the eye made the vision confused and dim, and caused a wild, staring, insane look. But the feature which, to the experimenter himself, seemed most repulsive, was the effect of the drug upon his intellect. The amount taken was not enough to destroy consciousness, but judgment, will, and "good sense" were dethroned. With thick, indistinct utterances he babbled all man- ner of childish and foolish things. He knew what he was saying, and knew that his remarks were half idiotic ; but he could not, and did not care to restrain them. His condition was that of extreme intoxication without any pleasurable sensation whatever. At the close of the experiment he felt disgusted and degraded. Atropia is simply a poison, and one of the most deadly poisons known to man. It has no power to heal. It is a minister of death, — not of life. It cannot "cure"' the opium habit in any proper sense of the word. The opium user to whom it is administered can be "sustained" by much less than his usual daily "ration" of opium or morphine, I admit, but it is simply a case of one poison being overmastered by another more powerful. The strong man is driven from his citadel by one stronger than he. The whole system is so utterly benumbed by atropia that it cannot, for the time being, realize the "morphine crave." But there is no tonic or sedative virtue in this deadly drug. If it be possible for a victim of the opium habit to finally abandon the " drug " under atropia treatment, his last stage will be worse than the first. His nervous system, bruised and beaten down by the trampling feet of the two gigantic demons in their conflict, will feel no thrills of returning health. If any of the organs of his body were disordered, their debilitated condition will be aggravated. 74 FROM BONDAGE TO FREKDOM: If any lesion of the heart is present, the patient will probably die during the atropia treatment. And if, after undergoing treatment by this poison, and being turned off as cured, simply because his desire for morphine is temporarily paralyzed by the grip of a stronger poison, — if after this his nerves should begin to recover a little from the influence of the atropia, his craving for opium will spring up with more than its original strength. Such '• treatment" and such "cures" are worse than the disease itself. While I do not claim to have verified the incident, yet I am prepared, by my own experiments and observation, to accept as true a telegram sent from Atlanta, Georgia, and widely published, to the effect that the wife of a Baptist clergyman, well known in the vicinity, was found dead on the train near Atlanta, her death being caused by an overdose of morphine taken by her as she was return- ing from treatment in an establishment which advertises to cure the opium habit, and in which the "hypodermic method" and atropia are depended upon. Such "cures" are all that can be expected from such a poison. CHAPTER XIV. METHODS OF TREAT3IENT — CONTINUED, DRUGS USED IN ATTEjMPTS TO CURE. The first agent, for its therapeutical value, put forward as an alleviative for the sufferings consequent upon opium using, is the HYDRATE OF CHLORAL. This drug was hailed at first by the medical profession as a hyp- notic and sedative, producing only good effects, and as the long- sought specific in cases of nervous disturbance, has, after a brief period of popularity, deservedly fallen into disgrace. Experience has shown it to be a dangerous "drug"— one whose reactive, cumu- latiye, and secondary effects are very disastrous. Insomnia or sleep- OR, THE FETTERS BROKEN. .5 lessness from any cause is placeboed by the habitual self-adminis^ tration of chloral in thousands of cases. This has resulted in a habit more rapidly destructive to nerve tissue than any other in the cata- logue. Invalids, who by reason of care, sorrow, or disease-shattered nerves, have accustomed themselves to its use through weary watch- ing for slow coming dawns, and in coaxing sleep to their pillows, have invited a midnight assassin that does its deadly work in the dark. Many a poor creature who has wooed its favor over night, has awakened in the morning in another world from its pernicious etfects. As this habit is easily cured by a few days use of the "Double Chloride of Gold,*- it is needless to discuss it further in this place. The Eemedy becomes a substitute for the "drug" at once, gives the patient sound, healthy and normal sleep, and a Cure in less than a week, without the least pain or inconvenience whatever to the patient. However we will have more to say upon the subject of Hj^drate of Chloral later on. CANNABIS i:j^dica. This is another drug which has been thoroughly tested as a temporary substitute for opium. It is well known as the hashisch of the Oriental world — a drug widely used for purposes of intoxication among the people of the Eastern Continent. This substance has been found very irregular and uncertain in its action, but this has been ascribed to the varying and unreliable qualities of the drug as it is found in the market. Fitz Hugh Ludlow, in an article entitled "Outlines of an Opium Cure," expresses his hope that its active principles may be extracted and an alkaloid produced which shall be to Cannabis Indica what morphia is to crude opium, and in his decidedly fanciful scheme of hospital treatment of opium patients he would evidently make considerable use of the drug. If such a product should be obtained, it would be of no real benefit in the treatment of the opium habit. Its potency is not such as will allay to any extent the tortures caused by depriving the confirmed opium user of his customary dose. It is simply an intox- icant. It makes wrecks of those who use it habitually — how can it repair a wreck already made '? If it be said that the only use of it which is recommended is to give the patient occasional and tempo- rary respite from his sufferings until the vis medicatrix naturae can