TO THE
President and Fellows
OF THE
Royal College of Physicians
Gentlemen,
I Was induced to write this Essay, from a Desire of throwing a Light upon a Subject, hitherto but triflingly, and, at best, obscurely treated. As I had no beaten Path to direct me, many perhaps are the Errors that may be traced through every Page.
I do not boast an Ability to enforce my Sentiments with that energic and expressive Beauty of Style some are so happy to possess. I am no Author, and can therefore only rely on your Candour, in Behalf of a simple Recital of such Facts as I have experienced.
When I consider the Novelty of the Subject, and the Rareness of Patients poisoned with Opium, I am inclined to flatter myself, you will not discourage, but be rather inclined to cherish under your Wings, every Effort (however weak) that tends to elucidate so extensive a Branch of Science, as Physic. I beg the Honour of subscribing myself,
Gentlemen,
Your most obedient,
Humble Servant,
J. AWSITER.
St. Margaret's Church-Yard, Westminster, January 5, 1762.
PREFATORY DISCOURSE
Among People who are unacquainted with the Nature of Opium, it is a received Opinion, – That as it will, when taken in proper Doses, lull Pain, and procure Rest; so, in large Quantities, that it will terminate a Life of Cares, by an easy and quiet Death; but it is not so: this argument is directly contrary to the Nature of our Existence, the animal Oeconomy being so formed, as not to bear a total Solution, without some Agonies. Thus, when this Drug is received into the Stomach, in Quality of a Poison, easy Rest is denied, the Senses, roused by their threatened Solution, force the animal Powers into immediate Conflict with the noxious Body, which produces Convulsions, and other dreadful Symptoms, the Forerunners of Death. – The Drug is besides of so strong a Nature, that, though taken only into the Stomach, it can change the Colour of the Skin, and even of the Linen wore next it; a Body also, many Hours after Death, will smell so strongly of it, as to determine whether it was the Instrument of Destruction used.
I might have encreased the Bulk of this Essay, by expatiating on the Effects of Opium upon the arterial Fluid; I could inform you, that the Power of it is diffused by the Stimulus of the recurrent Nerves, to their Origin in the Cerebellum, whence, by Consent of Parts, the whole System partakes of the Affect, and the contaminated Fluid is propelled by them, through the Heart into the Arteries, and communicated to the most distant Parts of the Body; also that the Skin is formed by very minute Fibres of the Nerves, interwoven with arterial Fibres and Veins, forming numerous Compages of secerning Vessels, &c. &c. but these are Subjects best suiting the medicinal Powers of Opium, which being derogatory from my Design, are purposely avoided, and, but that these Pages are for the Perusal of more than the Circle of Physical Gentlemen, the Cases alone would have been inserted, without even giving the natural History of the Drug; for this same Reason, the Prescriptions are set down in English, and the whole Essay disrobed of technical Expressions, as far as the Subject will allow.
It will be thought, perhaps, that I have made too free with Dr. Jones, who is the only English Author that has wrote professedly on this Subject; but many of his Sentiments being directly opposite to mine, I was under a Necessity of bringing them into an immediate Point of View. It is therefore hoped, no Person will be so unfriendly, as to impute to me a Malevolence of Disposition, which is a Character I would always diligently avoid.
THE
EFFECTS
OF
OPIUM,
Considered as a POISON, &c
Opium is a Drug brought to us from the Eastern Countries (the Use of it was first known to the Greeks who gave it the Name of Ὀπὸς, Succus, which was collected from the Papaver Hortense, Semine Albo of Caspar Bauhine) where the Plant, from which it is produced, grows in great Plenty, both wild and cultivated, and is the same with that of the white Poppy in England, the Heads of which are very large, and possess a sleeping Power, many Degrees beyond any other Part of it; the Seeds contained in these Heads are very numerous, and partake of this Quality in so small a Proportion, as to be scarce discernible, and rather help, from the soft Oil they contain, to correct the bad Effects of the acrid Juice of the Mother-Plant; they are therefore separated from the Heads, and used in Emulsions, being esteemed both cooling and emollient.
Distinctions were formerly made of the Goodness of this Drug, according to the Places where it was gathered; that of Thebes being the most famous; but, as it is now, and has been for some Time past, an Article of general Traffic, not only in the Places where it grows, but throughout all Europe, those Distinctions of Country, are necessarily laid aside, and the only Difference now consists in its Purity, or Adulteration by the original Manufacturers or Venders.
It is a natural Supposition, and indeed the Turkish Histories sufficiently demonstrate, that the original Use of Opium, or Extract from the Poppy, was first introduced to dissipate Anxieties, Pains, and Perturbations of the Mind, which appears not unlike the Use of intoxicating Drinks, so much requested in Europe. Labours of Mind and Body in every Person's Life, being somewhat considerable, a temporary Relief becomes indispensably necessary; and though Opium is not in common Use in England, such similar Advantages we instance of Tobacco, with which alone the Soldier can perform his March, and the Sailor his Service, through the rudest Storm, in a Night-watch upon Deck.
In Europe, we are not only fond of intoxicating Liquors, but add to their sleeping Qualities by the Use of Tobacco; Smoaking and Snuff-taking are fashionable, and Chewing not uncommon; all which Methods have, until familiarized to the Party, very disagreeable Effects, the Plant containing a corrosive Oil or Sulphur, with a volatile Salt, which makes it partake the Quality of Opium, though in a distant Degree; the Chinese, indeed, exceed us, they having a Narcotic Weed, which they smoak, a Species of the Poppy.
To treat upon the Effects of Opium, and the various Shapes wherein it may be advantageously used for many Diseases, would frustrate my present Design; therefore I shall confine myself to that Property, which makes it considered as a Poison; and by the Analysis of the various Powers it contains, destroy, or in a great Measure prevent, the fatal Consequences which often attend the immoderate and imprudent Use of this Drug.
The great Doctor Mead, in his Tract upon Poisons, gives an Example of such a Power being in Opium, by pouring it, dissolved in warm Water, into a Dog. Had that able Genius, adequate to the Task, pursued his Experiments with that Spirit wherewith he abounded, it would have yet added to the Obligation the World owes him; but over the Means necessary to be used to counteract this Poison, and the Effects of it upon human Bodies, he has drawn a Veil, and informs us, that the Cure is to be compleated by acid Medicines, and lixivial Salts: Far be it from me to comment upon the Principles of this Doctrine; he was too just not to be sensible of what he wrote; perhaps he thought the Subject of too delicate a Nature to be made common, and as many People might then indiscriminately use it, it would take from that necessary Fear and Caution, which should prevent their experiencing the extensive Power of this Drug; for there are many Properties in it, if universally known, that would habituate the Use, and make it more in Request with us than the Turks themselves, the Result of which Knowledge must prove a general Misfortune.
From the Ease it affords to the Pains of Mind and Body, Opium obtained the Name of Laudanum, derived from the Latin Laudabilis, or Laudatum; yet, though it has this Property of easing Anxieties and Torments of the most excruciating Diseases, the constant Use of it should be rejected, as it will impair the Memory, destroy the Appetite, bring on a Stupor, and by Relaxation, weaken the whole Frame. That it impairs the Nerves, is manifest, for applied to the Ear, to ease Pain, it may cause Deafness; to the Nostrils, to stop an Hæmorrhage, Loss of Smelling; and however applied, whether internally or externally, (unless very sparingly) it will benumb the Part most immediately in Contact with it. When we consider the nervous Coats of the Stomach, and the Action of Opium upon them by constant Use, the Effects may easily be judged; and if a Person so habituated, is prudent enough to throw aside the Use of it, before he is betrayed into some fatal Disease, the Appetite is to be restored by nervous Stimulants, Bracers, and Cold-bathing. Doctor Jones advises gradual Decrease of the Opiate, and to use, instead of it, generous Wine in Moderation.
The Production of Opium is from the Fruits or Seed-vessels of the Poppy-Plants, commonly called the Heads; they are gathered while green, which (the Seeds being taken out) are bruised and pressed. The Juice thus collected from them is dried to a Substance, which being wrapped in Leaves, is formed into Balls or Lumps, generally under a Pound Weight, and in that Form transported to all the Markets of Europe.
Though it is a received Opinion, that Opium, with us, and other Countries where not manufactured, has not near the Strength of that used by the People where it grows; yet in Turkey they can venture to take it in larger Quantities; and hence it is manifest, that the Effects would be more pernicious amongst them, if they did not use it in a most pure State; and though Habit might conduce to the Constitution bearing it in much larger Doses, than we in England dare give it, yet certainly the constant Use of it, unless when of a most fine Texture of Parts, must sooner prove hurtful, than the immoderate and constant Drinking of Wines, and Spirits; and by this Means, the Lives of the major Part of the Eastern Countries, where it is so much requested, would drop in the Flower of their Youth, and whole Nations, in the Space of a Century, be depopulated.
The ancient Accounts of the Manner of gathering Opium, was, according to Diascorides, by the milky Juice being collected from Time to Time, that distilled from the wounded Head of the Poppy; thus gathered, it is entirely pure, and being taken, gives no disagreeable Sensation to the Stomach. This Extract being almost wholly volatile, immediately enters into Action, and discharges itself by Perspiration, opening the Pores, and refreshing the Spirits, without any attendant Injury; and daily Experience will convince every one who will put it to the Tryal, that the purer the Opium, in the greater Quantity it may be taken, unattended with the Nausea, Vertigo, and Tremor, which are so often the Consequences of it with us, though used in small Doses. Tournefort, Page 292, Materiæ Medicæ, informs us, that Opium, or Laudanum, does not only pass off freely by Perspiration, but cures those Distempers arising from Obstructions of the Organs of Respiration in hot Countries, without any Inconvenience whatever, which cannot be said of it, in such Cases, in England, though assisted with volatile and cordial Medicines. This seems a palpable Contradiction to the Opinion of Doctor Jones, who says, that Opium may be taken in much larger Doses, in Cold, than in hot Climates.
It is a natural Supposition, that when a Country produces a Commodity, in a Manner peculiar to herself, the Manufacturers will embrace the most ready Means of collecting it. The first Consideration generally is, how to make the greatest Emolument with the least Labour; if the Opium, which is brought into Europe, were to be taken from the Head of each Poppy, by Incision, as is supposed by some Authors, the Produce would not be sufficient to supply the Markets; for as the daily Collection of Opium, from one Head, could not exceed one Grain in Weight, and many might fail even of that the Labour, Time, and Hands requisite to gather one Pound only, must necessarily make that Article, five, if not ten Times the Price it now bears. Though it is not improbable, that Opium, being a pure body, and wholly volatile, may be gathered by Incision, Yet it is not natural to suppose, that the Quantity of Opium, so nicely produced can answer, in any moderate Proportion, what may be made by gathering the Heads, while green, grinding them, and expressing the Juice, which may be easily inspissated. Vide Plin. Secund. Lib. 20. Cap. 18.