Papaver somniferum, the white poppy.
Introduction
ONE of the ancient saws of medicine has it : “Sine papaveribus et sine medicamentis ex eis confectis manca et clauda esset medicina,” which may be vernacularized,”Without poppy and its derivatives, medicine would be a wash-out.”
Nothing better than Opium exemplifies the difference between the two ways of medical practice. Opium and its most important alkaloid, Morphia,* We are told that”the action of Opium is due almost entirely to its Morphine.” are a tremendous standby for the orthodox physician : and to the young and inexperienced doctor it may sometimes seem absolute cruelty to withhold them. True that, given in material doses they cure nothing. True that, the more they are given, the greater the need and the craving for the lying peace they bring. True, that one of the toughest problems of medicine is the cure of the Opium eater, and the rescue of the victim of morphia habit. At one period it was the fashion among the medicos of Paris to supply young girls with a morphia hypodermic, so that they might render themselves insensible to menstrual pain; with shocking results. We used to be taught in our Insanity Course, that it might be worth while to attempt to break the morphia habit once, but that, if the patient relapsed it was more merciful to leave him to his fate : the sufferings were too terrible to be inflicted a second time.
The ultimate effect of these, at once seductive and tyrannical drugs, is to utterly destroy all sense of right and wrong. Lying and thieving are the characteristics of Opium. Nothing that the Opium victim says can be trusted : more especially so when the drug-need is imperative and the drug difficult to obtain. One remembers well the tragedy of a young naval officer; this was many years ago. For a bad bout of sciatica he was doped with morphia till he acquired the craving and unfortunately, with the ship’s drugs in his care, he had only to help himself. He was at one time treated with a view to cure, and one heard of him, forcibly held down in bed at night, when he was raving for his dope. He was ” cured “, only to relapse, and the last news that came through was his arrest for stealing a pair of boots.
Therefore Opium is a drug (in homoeopathic preparation) to be thought of for those abnormal children whose moral sense has never been developed, who lie and steal, and are heading for a Mental Institution. But some children are merely late in growing a conscience, which seems to develop at different ages: and the “no conscience” child may turn out to have a very tender conscience later on.
But what to do about Opium or Morphia in the face of great pain? We will let Nash answer that question for us. He says, “Opium in narcotic doses does not produce sleep, but stupor, and it only relieves pain by rendering the patient unconscious to it. How many cases have been so masked by such treatment, that the disease progressed until there was no chance of cure. Pain, fever, and all other symptoms are the voice of the disease, telling where is the trouble, and guiding to the remedy. The true curative often relieves pain even more quickly than Opium, and does so by curing the condition upon which it depends.”
And here one remembers the warnings of one of our surgical lecturers in regard to the danger of these drugs in acute abdominal conditions that should call for emergency operation.
Even in the most hopeless cases of extensive, inoperable malignant, disease, where Morphia would seem, in common humanity, to be not only indicated, but imperative, one sees again and again, that small doses of Arsenicum, or some other remedy to which the symptoms point, will abolish pain, improve health and spirits and add length to life, without the nausea and misery that dog such treatments by Morphia.
Hahnemann says, “Opium is almost the only medicine that in its primary action does not produce a single pain.” He tells us that every other known drug produces in the healthy human body pain, each after his kind, and is therefore able to remove such pains when they occurs in disease; but “Opium is alone unable to subdue permanently any one single pain, because it does not cause in its primary action one single pain, but the very reverse, namely, insensibility, whose inevitable consequence (secondary action) is greater sensitiveness than before, and hence a more acute sensation of pain.”
And he quotes from Willis’s Pharmacies rationalis: “Opiates generally allay the most excruciating pains and produce insensibility-for a certain time; but when this time is passed the pains are immediately renewed, and soon attain their ordinary violence wren the duration of the action of Opium is over, the abdominal pains return, having lost nothing of their excruciating character until we again employ the magic of Opium”
So, in the topsy-turvydom of curative medicine, Opium comes in for cases of painlessness where there should be distress and pain: for desperate sickness where the patient says, “I feel so well!-so well!” or complaints of nothing: for cases of insensibility-coma-as in apoplexy: for cases of painless, symptomless, complete constipation; and so on. But more this anon.
Hahnemann tells us that it is far more difficult to estimate the action of Opium than that of almost any other drug. The primary action of small and moderate doses exalts the irritability and activity of the voluntary muscles for a short time, but diminishes those of the involuntary muscles for a longer period. And while it exalts fancy and courage in its primary action, it appears at the same time to dull and stupefy the general sensibility and consciousness. But thereafter the living organism, in active counter-action, produces the opposite of all this (in the secondary action), i.e. diminished irritability and inactivity of the voluntary, with morbid exalted excitability of the involuntary muscles, and loss of ideas and obtuseness of fancy, with faint-heartedness, along with oversensitiveness of general sensibility. And he says, “No medicine in the world suppresses the complainings of patients more rapidly than Opium.”
HALE WHITE tells us that in Opium the higher faculties are first excited: intellectual power and mental vigour increased, especially imagination: while reason and judgment are dulled. Then follows sleep, wherein he responds to nothing, and feels no pain. “This makes the drug invaluable,” says Hale White.
And again, “Opium diminishes all secretions, except sweat. It paralyses the peristaltic movements of stomach and intestines.”
Opium’s drugged unconsciousness, with stertorous breathing, jaw dropped, pupils generally contracted, face mottled, purple, hot, with hot sweat, and cheeks blown out with every expiration, gives a beautiful picture of apoplexy, and it is in just cases of cerebral haemorrhage that Opium is so invaluable. As NASH says “there is no response to light, touch, noise, or anything else, except the indicated remedy, which is Opium.”
And KENT says: “Opium causes a flow of blood to the brain, and when given homoeopathically it checks this, and in six and a half hours he will become rational, his skin cool, face normal colour, pulse normal. We thus see the usefulness of the crude effects of Opium in giving us a picture of apoplexy.”
Kent says,”among the striking features of Opium is a class of complaints marked by painlessness, inactivity, and torpor deceptions in vision, taste, touch: deception of the state he exists in: in his own realization: a perversion of all the senses with much deception.”
He adds, following Hahnemann,” the general characteristic is painlessness, but now and then the alternate state is produced, in which a small dose of Opium will cause pain, sleeplessness, inquietude, nervous excitability. The majority are constipated, but in some there is dysentery and tenesmus. The patient is sleepy, yet at times the drugs is characterized by sleepless nights, anxiety, increased sensitiveness to noise, so that he says he can almost here the flies walking on the wall, and hears the clock striking in the distant steeple.”
We are told that few drugs have such different effects on different people.
And talking of Opium, as everywhere a producer of insensibility and partial or complete paralysis, Nash add:
“Now we find an exactly opposite state of things under Opium. Delirious: eyes wide open, glistening; face red, puffed up.” “Vivid imagination, exaltation of the mind.” “Nervous, irritable, easily frightened.” “Twitching, trembling of head, arms and hands; jerkings of the flexors, even convulsions.”Sleeplessness with acuteness of hearing, cocks crowing at a great distance keep her awake.”
And CLARKE, commenting on Hahnemann’s saying that, “It is more difficult to estimate the action of Opium than of almost any other drug.” says, “That is true if we conceive it necessary to divide the effects of the drug into primary and secondary. “He finds that “whether the action is `primary’ or `secondary’ depends on the prover or the patient. I know some people who are made absolutely sleepless by Opium in all sorts of doses; and Opium 30 had helped me in cases of sleeplessness as often as Coffea. My experience goes to show that whether the drug-effect is primary or secondary, it is a drug-effect and is good for prescribing on.”
