(From vol. I, 3rd edit., 1830.)
(The dried milky juice of the green, half-ripe heads of the Papaver somniferum, especially of the large-headed white poppy, Papaver officinale, Gm.)
In recent times many chemists have given themselves unspeakable trouble to analyze opium, and to dissociate its several sontituent parts; morphium (morphia), narcotin (opian), meconic acid, extractive matter, caoutchuc, opium-balsam, fatty substance, gluten, resin, gum, volatile matter. They generally differ so much among one another, both in respect to the methods used to separate them, consisting of a number of dissimilar and complicated processes, and in respect to the chemical nature of their component parts, as also in their opinions about the relative efficacy of these constituents, that, all things considered, very little of a trustworthy or useful characted seems to have resulted, either for the medical art in general, or for the benefit of the sick in particular.
But as homoeopathy concerns itself only with whole, undivided medicial substances, as they exist in the natural state, and aims at the simplest mode of preparing them, in which all their constituents shall be uniformly dissolved and develop their medicinal powers, and as it looks only to healing and not to injuring human beings consequently it does not, like the new pharmacy, consider it an honour to prepare from opium the most painlessly and quickly killing substance (Mohpium aceticum); hence the homoeopathic art, which is only intended for beneficent ends, willingly dispenses with all these dangerous manoeuvres.
It will therefore – as has hitherto been the custom – macerate one grain of finely pulverised opium in 100 drops of alcohol in the temperature of the room for a week, in order to make a tincture, and mix one drop of this with another 100 drops of alcohol by two succussions, and so proceed to the higher developments of power; or, better:
One grain of selected good opium is treated like other dry medicinal substances, is first brought to the million-fold trituration in three hours, by triturating with three times 100 grains of milk-sugar (in the manner taught at the commencement of the second part of the book on Chronic Diseases); of this one grain is then dissolved in 100 drops of diluted alcohol, and potentized by two succussions. This gives a fluid, one drop of which, diluted in a similar way with 100 drops of alcohol, and through 25 more dilution-phials. One or two globules of the smallest size moistened with this last potency will do all the good that is capable of being effected homoeopathically in the treatment of human ailments for which it suitable.
It is much more difficult to estimate the action of opium than of almost any other drug.
In the primary action of small and moderate doses, in which the organism, passively as it were, lets itself be affected by the medicine; it appears to exalt the irritability and activity of the voluntary muscles for a longer time, but to diminish those of the involuntary muscles for a longer period; and while it exalts the fancy and courage in its primary action, it appears at the same time to dull and stupefy (the external senses) the general sensibility and consciousness. Thereafter the living organism in its active counter-action produces the opposite of this in the secondary action: diminished irritability and inactivity of the voluntary, and morbidly exalted excitability of the involuntary muscles, and loss of ideas and obtuseness of the fancy, with faint-heartedness along with over sensitiveness of the general sensibility.
In large doses the symptoms of the primary action not only rise to a far more dangerous height, but they pass from one to another with impetuous rapidity, often mingled with secondary actions or quickly passing into the latter. In some persons certain symptoms are more conspicious, in others other symptoms.
No medicine in the world suppresses the complaining of patients more rapidly than opium and misled by this, physicians have made immense use (abuse) of it, and have done enormous and wide-spread mischief with it.
Were the results of the employment of opium in diseases as beneficial as its employment is common, there would be no medicine by which patients would be so often cured as by opium. But exactly the opposite of this is universally the case.
Its enormous power and rapid action imply that an uncommon amount of knowledge of its actions and an uncommonly accurate judgement and appreciation of it must be required in order to employ it medicinally, if we would use it in a really benificial manner, which is impossible without making a homoeopathic application of it.
Hitherto opium has been almost exclusively employed antipathically or palliatively, and hardly any but its primary actions have been opposed to the contrary morbid states, contraries curentur – except when the physician prescribed (by mistake? Or numinis afflatu?) in a sense exactly opposite to this antiquity hallowed therapeutic rule of Galen’s, and so effected miraculous cures. No medicine in the world has affected more illusory relief, more deceptive concealment and suppression of the morbid symptoms, with consequence more disastrous than the original disease. No medicine in the world has done more harm (with preliminary apparent relief) than this opium.
Opium has been employed as the supposed chief remedy against all kinds of coughs, diarrhoeas, vomiting, sleeplessness, melancholy, spasms and nervous ailments – and more especially against all kinds of pains without distinction.
But all these innumerable affections are not contained in the primary action of opium, but just the opposite. Hence we can easily understand how far from permanent, how far from benificial must be the result of such an employment of this drug in the majority of diseases of body and mind! And daily experience teaches this.
If in some few cases opium removes cough, diarrhoea, vomiting, sleeplessness, trembling and so forth, this only happens when these ailments are of recent date or have arisen suddenly in a previously healthy body, and when they are of a slight character, Thus, for example, a cough brought on by a chill, a trembling caused by recent fright, (Smelling at a globule the size of a mustard-seed, moistened with a potentized dilution of opium, gives almost immediate relief to one how has undergone a violent fright, but only on the condition that he performs the olfaction immediately after trifling cause the fright has been received, If employed later, it not only brings no relief, it rather doe harm.) a diarrhoea suddenly excited by fear, a chill or other trifling case, vomiting and other symptoms produced by mental excitement, loathing, 7c., are sometimes quickly removed by opium, because it is only necessary that it should suppress these ailments in a superficial and temporary manner, in order to restore to the previously healthy body its freedom to ward off spontaneously all further tendency to these affections, and to continue its former condition of health by its own powers (vide Organon of Medicine, 4th edition, § 63, note).
Though opium succeeds in the palliative suppression of these rapid trivial ailments in the few instances indicated above, it by no means follows that it possesses a true curative power of permanently removing such affections in every case and under all conditions even when they are of a persistent character. It cannot remove them and restore health when they are symptoms of another disease to which opium does not correspond as a homoeopathic remedy in its primary effects, or if they have already lasted a considerable time, because these ailments are not contained in the primary actions of opium. (They are only to be found in its secondary action (and in the preliminary, momentary reaction – their reflexion – described below).
Hence it has hitherto been universally employed in medical practice throughout the whole, almost always with injurious and disasterous results, in old coughs, persistent diarrhoeas, long-continued sleeplessness, chronic vomiting, habitual spasms, anxiety and trembling. But when these affectiexisted for some time in the system and depended on totally different diseases for which opium is not the homoeopathic remedy, they could never, not in one single instance, be cured by opium, so that permanent health was restored by its use.
In employing opium in the above-mentioned chronic maladies we learn that it effects only at first an illusory alleviation, a transient suppression of the affection for a few hours; that it then ceases to alleviate without increasing the size of the dose, that on further increasing the dose it only allays the symptoms for a short time, and even when it does this it creates on the other hand new affections and a much more serious and a worse artificial disease. Verily this is an injurious, though hitherto universally practised misuse of this gift of God which was created for the removal of quite opposite morbid states. (For where shall we find a remedy equal to opium for the most obstinate constipation and for acute fevers, with umcomplaining stupefied sopor, with snoring from a half opened mouth, and twitching of the limbs, with burning heat of the perspiring body, and in several other morbid states corresponding in similarity to the primary effects of opium.)
But most striking was the abuse which all physicians over the whole world down to the present time (Although as long as twenty years ago, I showed incontrovertibly in these very words (in the first edition of the ORAGNON, 1810), the misuse universally made by physicians of opium for pains to be a palpable injury to the well-being of patients, yet we have not seen that their conscience was the least touched, and that they abandoned a practice that is as stupid as it is criminal. To such remonstrances they only exclaim that their routine is interfered with, and they abuse and persecute the man who calls attention to their erronous practice, just as the sinner who feels himself hit the words of a sermon on repentence only abuses the preacher, without reforming his own conduct. But why should I, who feel an inward call to enunciate such important verities, and who have truth and nature on my side, why should I bother myself about these incorrigible sinners?) have made of opium, in prescribing it as a powerful remedy for pains of all sorts, be they ever so old and deeply rooted, it is obviously contrary to common sense, and is almost equal to the folly of a universal remedy, to expect from one single substance the cure of all pains which differ so infinitely among one another. Seeing that the various kinds of pains in diseases differ so much from one another in their seat, in the time and conditions of their occurrence, recurrence, increase and diminution, &c., it might be supposed that the Creator would not fail to create a large number of different medicines for their cure; for every finite thing can only have a finite, limited sphere of action. But opium is precisely not one of those pain-allaying and curing remedies. Opium is almost the only medicine that in its primary action does not produce a single pain. Every other known drug, on the other hand, produces in the healthy human body each its own kinds of pain in its primary action, and hence is able to cure and remove (homoeopathically) similar pains in diseases, especially if the other symptoms of the disease correspond in similarity to those observed from the administration of that medicine. Opium alone is unable to subdue homoeopathically, i.e. permanently, any one single pain, because it does not cause in its primary action one single pain, but the very reverse, namely, insensibility, the inevitable consequence (secondary action) of which is greater sensitiveness than before, and hence a more acute sensation of pain.
Therefore all pains of any duration allayed in a palliative and temporary manner by opium by means of its stupefying and pain-subduing power, return immediately when the stupefying primary action is exhausted, and that at least (Thus WILLIS in his Pharmacia rationalis, p. 298, says: “Opiatas generally allay, the most excruciating pains, and produce insensibility – for a certain time; but when this time is past the pains are immediately renewed, and soon attain their ordinary violence;” and p. 295: “When 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 power of opium.” )as severely as before, as the experience of all observant physicians testifies, These pains, indeed, generally return in a worse degree, and as long as no better plan than this old injurious routine is adopted, they must be again and again allayed, not only by repeated, but by larger doses of opium, whilst it developes other worse ailments, from which the patient did not suffer previously. Suppressing pain of any considerable duration and intensity by opium is therefore nothing but quackery – nothing but an imposition on the patient and his friends with illusory relief, to be followed by injurious results that are often disastrous, and not unfrequently fatal, but which are alleged by such practitioners of the non-healing art to be new diseases that they have had no hand on producing. (The true (homoeopathic) physician never sees in his practice any inflammation of the brain, except at the commencement of the most dangerous forms of typhus fever, which he cures along with its cerebral inflammation; nor does he ever encounter inflammation of the bowels, except in cases of poisoning and strangulated hernia or ileus; but fatal cerebral and intestinal inflammations frequently result from the efforts of the allopaths to suppress severe headache and intolerable colic by increasing doses of opium.)
Chronic diseases only are the test of the genuine healing art, because they do not of themselves pass into health; slight ailments that have come quickly pass away with or without medicine – evidently by the inherent powers of the organism; but with medicines acute diseases must distinctly yield more quickly and permanently than when left to themselves, if what can be called a cure is accomplished.
If opium sometimes seems to remove pains in a acute diseases, this is owing to the very obvious fact that such diseases, if they do not kill, run their course spontaneously in a few days, and disappear together with their pains.
Opium can only seem really to cure pains in those rare cases where it corresponds homoeopathically in its other primary effects to the symptoms of the disease, and so removes the disease itself, for then the pains also must naturally depart; but this is only an indirect cure of the pains. For instance, as every dysentery depends on a retention of faeces in the upper part of the intestines, some varieties of it accompanied by heat and stupefaction can be cured by opium, because these symptoms will be homoeopathically removed by the similar primary action of opium, and as a necessary consequence their attendant pains also, because these generally depend on spasmodic retention of the faeces in the bowels.
In like manner opium cannot stop the pains of lead colic until it has homoeopathically removed the obstinate constipation produced by the lead by virtue of its constipating primary action; in this case also the cure of the pains is indirect and not owing to the stupefying power of the opium, as it is given in small, not stupefying, doses. But opium is never able to remove pains directly without injury; on the other hand, it is a principal remedy in those stupefactive diseases where the pain of a serous malady in those stupefactive diseases where the pain of a serious malady is not felt by the patient, as for example, in dangerous bed sores, where the patient, in the stupefied state of his consciousness, cannot complain of any pain, &c.
The painful diseases of acute and chronic character can (whatever the whole worldful of anthipathic and allopathic physicians may allege to the contrary) only be cured and altered into health of a permanent character by a medicine which, besides corresponding in similarity in its other primary effects to the symptoms of the morbid state, is at the samtime able to excite pains very similar in kind to those observed in the disease. If such a medicine be selected then pain and disease disappear together in a marvellously rapid and permanent manner, when the smallest dose is administered, as is taught in the Organon of Medicine, and as experience will convince every one.
But as this method was not employed, and as all kinds of pains were anthipathically treated by opium alone, many injurious results were observed from its use; stupefaction, constipation, and other troublesome and dangerous symptoms which naturally resulted from this inappropriate anthipathic employment of it, and these are the peculiar effects of opium, without which it would not be opium. But these inevitable disastrous effects of such an employment of opium were not regarded as being what they actually are, to wit, the essential characteristics of opium, but as a kind of bad behavius inherent in it, which must be eliminated from it by all sorts of devices, in order to render it innocuous and well-behaved. Under this delusion attempts have been made from time to time, for now nearly two thousand years, to do away with this pretended improper action by means of so0called correigenta, so that it should henceforth be taught to allay pains and spasms without producing deliruim or constipation, check vomiting and diarrhoea without exciting heat, and without leaving behind it headache, trembling, exhaustion, chilliness and prostration.
Hence pungent spices were combined with it in order to prevent the chilling propensity observed in the secondary action, and purgatives and salines were added in order to counteract its constipating misconduct, &c. More especially was it sought to separate from it its crude, and alleged useless and hurtful resin by repeated solution in water, filtration and inspissation, and also to deprive it of the volatile, and supposed poisonous, narcotic quality attached to it by macerating it for months; and practitioners even went so far as to attempt to refine it and render it mild by roasting it over a fire, and in this way they imagined that they had produced a precious penacea for all ailments and troubles, for pains, sleeplessness, diarrhoea, &c., which was free from all the well-known evil propensities of opium.
But they were completely mistaken; by these processes they only made the opium weaker without altering its nature. Now much large doses were required in order obtain the same result, and when these larger doses were administered they always acted just like the original opium; the new preparation caused the same stupefaction, and the same constipation, and so forth, and hence it became evident that opium possesses no removable bad qualities, just as little as any other medicine, but that its peculiar medicinal powers must ever prove injurious and dangerous when it is employed anthipathically in large doses and when it is not understood ho to make a homoeopathic employment of it;- opium might be employed in its natural powerful state or, weakened by a number of expensive artificial processes, in the large doses required to produce its anthipathic effects.
Opium has this peculiarity more than many other medicines, that in the case of persons unaccustommed to its use and in very excitable subjects, and still more when given in large doses, it sometimes at first displays a transient, often momentary, reaction of a peculiar sort, which, partly on account of its short duration, partly owing to sort, which, partly on account of its short duration, partly owing to its rarity, and partly owing to its very nature, must not be confounded with its characteristic chief and primary action. These rare, momentary, preliminary reactions correspond almost exactly with the secondary action of the organism upon opium (and are, so to speak, a reflexion of this secondary action); deathy paleness, coldness of the limbs or of the whole body, cold perspiration, timorous anxiety, trembling and despair, mucous evacuations from the bowels, transient vomiting or short cough, and very rarely certain kinds of pain.
Hardly any of the peculiar primary effects of opium are observed from large poisonous doses, but this initiatory reaction passes at once, as secondary action, to death, as I myself have seen, and as WILLIS (Pharm. Rat., sect. Vii, cap. I, p, 292) relates.
The oriental indulgers in opium, after sleeping off their opium intoxication, are always in a state of secondary opium action; their mental faculties are much weakened by too frequent indulgence in the drug. Chilly, pale, bloated, trembling, spiritless, weak, stupid, and with a perceptible anxious inward malaise, they stagger in the morning into the tavern to take their allowence of opium pills in order to quicken the circulation of their blood and obtain warmth, to revive their depressed vital spirits, to reanimate their dulled phantasy with some ideas, and to infuse, in a palliative way, some activity into their paralysed muscles.
The symptoms of opium arranged below are mostly secondary action and counter-action of the organism. Physicians who cannot make up their mids to refrain from making a hurtful use of opium in large doses for palliative (anthipathic)purposes, may be encouraged to do so by a pesual of these horrible secondary effects; their feelings of humanity can hardly fail to be shocked by them, and their conscience roused so as to compel them to be better.
The antidotes to dangerous doses of opium are tincture of ipecacuanha, camphor, but especially strong warm infusion of coffee, introduced in large quantities above and below, accompanied by frictions on the body. But when icy coldness of the body, insensibility, and loss of irritability of the muscular fibres have already set in, a (palliative) warm bath must be resorted to.