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THE OPIUM HABIT,
SUGGESTIONS AS TO THE REMEDY.
“After my death, I earnestly entreat that a full and unqualified narrative of my wretchedness, and of its guilty cause, may be made public, that at least some little good may be effected by the direful example.”–COLERIDGE.
A SUCCESSFUL ATTEMPT TO ABANDON OPIUM
DE QUINCEY’S “CONFESSIONS OF AN ENGLISH OPIUM-EATER”
OPIUM REMINISCENCES OF COLERIDGE
OPIUM AND ALCOHOL COMPARED
INSANITY AND SUICIDE FROM AN ATTEMPT TO ABANDON MORPHINE
A MORPHINE HABIT OVERCOME
ROBERT HALL–JOHN RANDOLPH–WILLIAM WILBERFORCE
WHAT SHALL THEY DO TO BE SAVED?
OUTLINES OF THE OPIUM-CURE
This volume has been compiled chiefly for the benefit of opium-eaters. Its subject is one indeed which might be made alike attractive to medical men who have a fancy for books that are professional only in an accidental way; to general readers who would like to see gathered into a single volume the scattered records of the consequences attendant upon the indulgence of a pernicious habit; and to moralists and philanthropists to whom its sad stories of infirmity and suffering might be suggestive of new themes and new objects upon which to bestow their reflections or their sympathies. But for none of these classes of readers has the book been prepared. In strictness of language little medical information is communicated by it. Incidentally, indeed, facts are stated which a thoughtful physician may easily turn to professional account. The literary man will naturally feel how much more attractive the book might have been made had these separate and sometimes disjoined threads of mournful personal histories been woven into a more coherent whole; but the book has not been made for literary men. The philanthropist, whether a theoretical or a practical one, will find in its pages little preaching after his particular vein, either upon the vice or the danger of opium-eating. Possibly, as he peruses these various records, he may do much preaching for himself, but he will not find a great deal furnished to his hand, always excepting the rather inopportune reflections of Mr. Joseph Cottle over the case of his unhappy friend Coleridge. The book has been compiled for opium-eaters, and to their notice it is urgently commended. Sufferers from protracted and apparently hopeless disorders profit little by scientific information as to the nature of their complaints, yet they listen with profound interest to the experience of fellow-sufferers, even when this experience is unprofessionally and unconnectedly told. Medical empirics understand this and profit by it. In place of the general statements of the educated practitioner of medicine, the empiric encourages the drooping hopes of his patient by narrating in detail the minute particulars of analagous cases in which his skill has brought relief.
Before the victim of opium-eating is prepared for the services of an intelligent physician he requires some stimulus to rouse him to the possibility of recovery. It is not the _dicta_ of the medical man, but the experience of the relieved patient, that the opium-eater, desiring–nobody but he knows how ardently–to enter again into the world of hope, needs, to quicken his paralyzed will in the direction of one tremendous effort for escape from the thick night that blackens around him. The confirmed opium-eater is habitually hopeless. His attempts at reformation have been repeated again and again; his failures have been as frequent as his attempts. He sees nothing before him but irremediable ruin. Under such circumstances of helpless depression, the following narratives from fellow-sufferers and fellow-victims will appeal to whatever remains of his hopeful nature, with the assurance that others who have suffered even as he has suffered, and who have struggled as he has struggled, and have failed again and again as he has failed, have at length escaped the destruction which in his own case he has regarded as inevitable.
The number of confirmed opium-eaters in the United States is large, not less, judging from the testimony of druggists in all parts of the country as well as from other sources, than eighty to a hundred thousand. The reader may ask who make up this unfortunate class, and under what circumstances did they become enthralled by such a habit? Neither the business nor the laboring classes of the country contribute very largely to the number. Professional and literary men, persons suffering from protracted nervous disorders, women obliged by their necessities to work beyond their strength, prostitutes, and, in brief, all classes whose business or whose vices make special demands upon the nervous system, are those who for the most part compose the fraternity of opium-eaters. The events of the last few years have unquestionably added greatly to their number. Maimed and shattered survivors from a hundred battle-fields, diseased and disabled soldiers released from hostile prisons, anguished and hopeless wives and mothers, made so by the slaughter of those who were dearest to them, have found, many of them, temporary relief from their sufferings in opium.
There are two temperaments in respect to this drug. With persons whom opium violently constricts, or in whom it excites nausea, there is little danger that its use will degenerate into a habit. Those, however, over whose nerves it spreads only a delightful calm, whose feelings it tranquillizes, and in whom it produces an habitual state of reverie, are those who should be upon their guard lest the drug to which in suffering they owe so much should become in time the direst of curses. Persons of the first description need little caution, for they are rarely injured by opium. Those of the latter class, who have already become enslaved by the habit, will find many things in these pages that are in harmony with their own experience; other things they will doubtless find of which they have had no experience. Many of the particular effects of opium differ according to the different constitutions of those who use it. In De Quincey it exhibited its power in gorgeous dreams in consequence of some special tendency in that direction in De Quincey’s temperament, and not because dreaming is by any means an invariable attendant upon opium-eating. Different races also seem to be differently affected by its use. It seldom, perhaps never, intoxicates the European; it seems habitually to intoxicate the Oriental. It does not generally distort the person of the English or American opium-eater; in the East it is represented as frequently producing this effect.
It is doubtful whether a sufficient number of cases of excess in opium-eating or of recovery from the habit have yet been recorded, or whether such as have been recorded have been so collated as to warrant a positive statement as to all the phenomena attendant upon its use or its abandonment. A competent medical man, uniting a thorough knowledge of his profession with educated habits of generalizing specific facts under such laws–affecting the nervous, digestive, or secretory system–as are recognized by medical science, might render good service to humanity by teaching us properly to discriminate in such cases between what is uniform and what is accidental. In the absence, however, of such instruction, these imperfect, and in some cases fragmentary, records of the experience of opium-eaters are given, chiefly in the language of the sufferers themselves, that the opium-eating reader may compare case with case, and deduce from such comparison the lesson of the entire practicability of his own release from what has been the burden and the curse of his existence. The entire object of the compilation will have been attained, if the narratives given in these pages shall be found to serve the double purpose of indicating to the beginner in opium-eating the hazardous path he is treading, and of awakening in the confirmed victim of the habit the hope that he may be released from the frightful thraldom which has so long held him, infirm in body, imbecile in will, despairing in the present, and full of direful foreboding for the future.
In giving the subjoined narratives of the experience of opium-eaters, the compiler has been sorely tempted to weave them into a more coherent and connected story; but he has been restrained by the conviction that the thousands of opium-eaters, whose relief has been his main object in preparing the volume, will be more benefited by allowing each sufferer to tell his own story than by any attempt on his part to generalize the multifarious and often discordant phenomena attendant upon the disuse of opium. As yet the medical profession are by no means agreed as to the character or proper treatment of the opium disease. While medical science remains in this state, it would be impertinent in any but a professional person to attempt much more than a statement of his own case, with such general advice as would naturally occur to any intelligent sufferer. Very recently indeed, some suggestions for the more successful treatment of the habit have been discussed both by eminent medical men and by distinguished philanthropists. Could an Institution for this purpose be established, the chief difficulty in the way of the redemption of unhappy thousands would be obviated. The general outline of such a plan will be found at the close of the volume. It seems eminently deserving the profound consideration of all who devote themselves to the promotion of public morals or the alleviation of individual suffering.
THE OPIUM HABIT.
A SUCCESSFUL ATTEMPT TO ABANDON OPIUM.
In the personal history of many, perhaps of most, men, some particular event or series of events, some special concurrence of circumstances, or some peculiarity of habit or thought, has been so unmistakably interwoven and identified with their general experience of life as to leave no doubt in the mind of any one of the decisive influence which such causes have exerted. Unexaggerated narrations of marked cases of this kind, while adding something to our knowledge of the marvellous diversities of temptation and trial, of success and disappointment which make up the story of human life, are not without a direct value, as furnishing suggestions or cautions to those who may be placed in like circumstances or assailed by like temptations.
The only apology which seems to be needed for calling the attention of the reader to the details which follow of a violent but successful struggle with the most inveterate of all habits, is to be found in the hope which the writer indulges, that while contributing something to the current amount of knowledge as to the horrors attending the habitual use of opium, the story may not fail to encourage some who now regard themselves as hopeless victims of its power to a strenuous and even desperate effort for recovery. Possibly the narrative may also not be without use to those who are now merely in danger of becoming enslaved by opium, but who may be wise enough to profit in time by the experience of another.
A man who has eaten much more than half a hundredweight of opium, equivalent to more than a hogshead of laudanum, who has taken enough of this poison to destroy many thousand human lives, and whose uninterrupted use of it continued for nearly fifteen years, ought to be able to say something as to the good and the evil there is in the habit. It forms, however, no part of my purpose to do this, nor to enter into any detailed statement of the circumstances under which the habit was formed. I neither wish to diminish my own sense of the evil of such want of firmness as characterizes all who allow themselves to be betrayed into the use of a drug which possesses such power of tyrannizing over the most resolute will, nor to withdraw the attention of the reader from the direct lesson this record is designed to convey, by saying any thing that shall seem to challenge his sympathy or forestall his censures. It may, however, be of service to other opium-eaters for me to State briefly, that while endowed in most respects with uncommon vigor of any tendency to despondency or hypochondria, an unusual nervous sensibilitv, together with a constitutional tendency to a disordered condition of the digestive organs, strongly predisposed me to accept the fascination of the opium habit. The difficulty, early in life, of retaining food of any kind upon the stomach was soon followed by vagrant shooting pains over the body, which at a later day assumed a permanant chronic form.
After other remedies had failed, the eminent physician under whose advice I was acting recommended opium. I have no doubt he acted both wisely and professionally in the prescription he ordered, but where is the patient who has learned the secret of substituting luxurious enjoyment in place of acute pain by day and restless hours by night, that can be trusted to take a correct measure of his own necessities? The result was as might have been anticipated: opium after a few months’ use became indispensable. With the full consciousness that such was the case, came the resolution to break off the habit This was accomplished after an effort no more earnest than is within the power of almost any one to make. A recurrence of suffering more than usually severe led to a recourse to the same remedy, but in largely increased quantities. After a year or two’s use the habit was a second time broken by another effort much more protracted and obstinate than the first. Nights made weary and days uncomfortable by pain once more suggested the same unhappy refuge, and after a struggle against the supposed necessity, which I now regard as half-hearted and cowardly, the habit was resumed, and owing to the peculiarly unfavorable state of the weather at the time, the quantity of opium necessary to alleviate pain and secure sleep was greater than ever. The habit of relying upon large doses is easily established; and, once formed, the daily quantity is not easily reduced. All persons who have long been accustomed to Opium are aware that there is a _maximum_ beyond which no increase in quantity does much in the further alleviation of pain or in promoting increased pleasurable excitement. This maximum in my own case was eighty grains, or two thousand drops of laudanum, which was soon attained, and was continued, with occasional exceptions, sometimes dropping below and sometimes largely rising above this amount, down to the period when the habit was finally abandoned. I will not speak of the repeated efforts that were made during these long years to relinquish the drug. They all failed, either through the want of sufficient firmness of purpose, or from the absence of sufficient bodily health to undergo the suffering incident to the effort, or from unfavorable circumstances of occupation or situation which gave me no adequate leisure to insure their success. At length resolve upon a final effort to emancipate myself from the habit.
For two or three years previous to this time my general health had been gradually improving. Neuralgic disturbance was of less frequent occurrence and was less intense, the stomach retained its food, and, what was of more consequence, the difficulty of securing a reasonable amount of sleep had for the most part passed away. Instead of a succession of wakeful nights any serioious interruption of habitual rest occurred at infrequent intervals, and was usually limited to a single night.
In addition to these hopeful indications in encouragement of a vigorous effort to abandon the habit, there were on the other hand certain warnings which could not safely be neglected. The stomach began to complain,–as well it might after so many years unnatural service,–that the daily task of disposing of a large mass of noxious matter constantly cumulating its deadly assaults upon the natural processes of life was getting to be beyond its powers. The pulse had become increasingly languid, while the aversion to labor of any kind seemed to be settling down into a chronic and hopeless infirmity. Some circumstances connected with my own situation pointed also to the appropriateness of the present time for an effort which I knew by the experience of others would make a heavy demand upon all one’s fortitude, even when these circumstances were most propitious. At this period my time was wholly at my own disposal. My family was a small one, and I was sure of every accessory support I might need from them to tide me over what I hoped would prove only a temporary, though it might be a severe, struggle. The house I occupied was fortunately so situated that no outcry of pain, nor any extorted eccentricity of conduct, consequent upon the effort I proposed to make, could be observed by neighbors or by-passers.
A few days before the task was commenced, and while on a visit to the capital of a neighboring State in company with a party of gentlemen from Baltimore, I had ventured upon reducing by one-quarter the customary daily allowance of eighty grains. Under the excitement of such an occasion I continued the experiment for a second day with no other perceptible effect than a restless indisposition to remain long in the same position. This, however, was a mere experiment, a prelude to the determined struggle I was resolved upon making, and to which I had been incited chiefly through the encouragement suggested by the success of De Quincey. There is a page in the “Confessions” of this author which I have no doubt has, been perused with intense interest by hundreds of opium-eaters. It is the page which gives in a tabular form the gradual progress he made in diminishing the daily quantity of laudanum to which he had long been accustomed. I had read and re-read with great care all that he had seen fit to record respecting his own triumph over the habit. I knew that he had made use of opium irregularly and at considerable intervals from the year 1804 to 1812, and that during this time opium had not become a daily necessity; that in the year 1813 he had become a confirmed opium-eater, “of whom to ask whether on any particular day he had or had not taken opium, would be to ask whether his lungs had performed respiration, or the heart fulfilled its functions;” that in the year 1821 he had published his “Confessions,” in which, while leading the unobservant reader to think that he had mastered the habit, he had in truth only so far succeeded as to reduce his daily allowance from a quantity varying from fifty or sixty to one hundred and fifty grains, down to one varying from seven to twelve grains; that in the year 1822 an appendix was added to the “Confessions” which contained a tabular statement of his further progress toward an absolute abandonment of the drug, and indicating his gradual descent, day by day, for thirty-five days, when the reader is naturally led to suppose that the experiment was triumphantly closed by his entire disuse of opium.
I had failed, however, to observe that a few pages preceding this detailed statement the writer had given a faint intimation that the experiment had been a more protracted one than was indicated by the table. I had also failed to notice the fact that no real progress had been made during the first four weeks of the attempt: the average quantity of laudanum daily consumed for the first week being one hundred and three drops; of the second, eighty-four drops; of the third, one hundred and forty-two drops; and of the fourth, one hundred and thirty-eight drops; and that in the fifth week the self-denial of more than three days had been rewarded with the indulgence of three hundred drops on the fourth. A careful comparison of this kind, showing that in an entire month the average of the first week had been but one hundred and three drops, while the average of the last had been one hundred and thirty-eight drops, and that in the fifth week a frantic effort to abstain wholly for three days had obliged him to use on the fourth more than double the quantity to which of late he had been accustomed, would have prevented the incautious conclusion, suggested by his table, that De Quincey made use of laudanum but on two occasions after the expiration of the fourth week.
Whatever may have been the length of time taken by De Quincey “in unwinding to its last link the chain which bound” him, it is certain we have no means of knowing it from any thing he has recorded. Be it shorter or longer, his failure to state definitely the entire time employed in his experiment occasioned me much and needless suffering. I thought that if another could descend, without the experience of greater misery than De Quincey records, from one hundred and thirty drops of laudanum, equivalent to about five grains of opium, to nothing, in thirty-four or five days, and in this brief period abandon a habit of more than nine years’ growth, a more resolved will might achieve the same result in the same number of days, though the starting-point in respect to aggregate quantity and to length of use was much greater. The object, therefore, to be accomplished in my own case was to part company forever with opium in thirty-five days, cost what suffering it might. On the 26th of November, in a half-desperate, half-despondent temper of mind, I commenced the long-descending _gradus_ which I had rapidly ascended so many years before. During this entire period the quantity consumed had been pretty uniformly eighty grains of best Turkey opium daily. Occasional attempts to diminish the quantity, but of no long continuance, and occasional overindulgence during protracted bad weather, furnished the only exceptions to the general uniformity of the habit.
The experiment was commenced by a reduction the first day from eighty grains to sixty, with no very marked change of sensations; the second day the allowance was fifty grains, with an observable tendency toward restlessness, and a general uneasiness; the third day a further reduction of ten grains had diminished the usual allowance by one-half, but with a perceptible increase in the sense of physical discomfort. The mental emotions, however, were entirely jubilant The prevailing feeling was one of hopeful exultation. The necessity for eighty grains daily had been reduced to a necessity for only forty, and, therefore, one-half of the dreaded task seemed accomplished. It was a great triumph, and the remaining forty grains were a mere _bagatelle_, to be disposed of with the same serene self-control that the first had been. A weight of brooding melancholy was lifted from the spirits: the world wore a happier look. The only drawback to this beatific state of mind was a marked indisposition to remain quiet, and a restless aversion to giving attention to the most necessary duties.
Two days more and I had come down to twenty-five grains. Matters now began to look a good deal more serious. Only fifteen of the last forty grains had been dispensed with; but this gain had cost a furious conflict. A strange compression and constriction of the stomach, sharp pains like the stab of a knife beneath the shoulder-blades, perpetual restlessness, an apparent prolongation of time, so much so that it seemed the day would never come to a close, an incapacity of fixing the attention upon any subject whatever, wandering pains over the whole body, the jaw, whenever moved, making a loud noise, constant iritability of mind and increased sensibility to cold, with alternations of hot flushes, were some of the phenomena which manifested themselves at this stage of the process. The mental elations of the first three days had become changed by the fifth into a state of high nervous excitement; so that while on the whole there was a prevailing hopefulness of temper, and even some remaining buoyancy of spirits, arising chiefly from the certainty that already the quantity consumed had been reduced by more than two-thirds, the conviction had, nevertheless, greatly deepened, that the task was like to prove a much more serious one than I had anticipated. Whether it was possible at present to carry the descent much further had become a grave question. The next day, however, a reduction of five grains was somehow attained; but it was a hard fight to hold my own within this limit of twenty grains. From this stage commenced the really intolerable part of the experience of an opium-eater retiring from service. During a single week, three-quarters of the daily allowance had been relinquished, and in this fact, at least, there was some ground for exultation. If what had been gained could only be secured beyond any peradventure of relapse, so far a positive success would be achieved.
Had the experiment stopped here for a time until the system had become in some measure accustomed to its new habits, possibly the misery I subsequently underwent might some of it have been spared me. However this may be, I had not the patience of mind necessary for a protracted experiment. What I did must be done at once; if I would win I must fight for it, and must find the incentive to courage in the conscious desperation of the contest.
From the point I had now reached until opium was wholly abandoned, that is, for a month or more, my condition may be described by the single phrase, intolerable and almost unalleviated wretchedness. Not for a waking moment during this time was the body free from acute pain; even in sleep, if that may be called sleep which much of it was little else than a state of diminished consciousness, the sense of suffering underwent little remission. What added to the aggravation of the case, was the profound conviction that no further effort of resolution was possible, and that every counteracting influence of this kind had been already wound up to its highest tension. I might hold my own; to do anything more I thought impossible. Before the month had come to an end, however, I had a good deal enlarged my conceptions of the possible resources of the will when driven into a tight corner.
The only person outside of my family to whom I had confided the purpose in which I was engaged was a gentleman with whom I had some slight business relations, and who I knew would honor any demands I might make in the way of money. I had assured him that by New Year’s Day I should have taken opium for the last time, and that any extravagance of expenditure would not probably last beyond that date. Upon this assurance, but confessedly having little or no faith in it, he asked me to dine with him on the auspicious occasion.
So uncomfortable had my condition and feelings become in the rapid descent from eighty grains to twenty in less than a week, that I determined for the future to diminish the quantity by only a single grain daily, until the habit was finally mastered. In the twenty-nine days which now remained to the first of January, the nine days more than were needed, at the proposed rate of diminution, would, I thought, be sufficient to meet any emergency which might arise from occasional lapses of firmness in adhering to my self-imposed task, and more especially for the difficulties of the final struggle–difficulties I believe to be almost invariably incident to any strife which human nature is called upon to make in overcoming not merely an obstinate habit but the fascination of a long-entranced imagination. Up to this time I had taken the opium as I had always been accustomed to do, in a single dose on awaking in the morning. I now, however, divided the daily allowance into two portions, and after a day or two into four, and then into single grains. The chief advantage which followed this subdivision of the dose was a certain relief to the mind, which for a few days had become fully aware of the power which misery possesses of lengthening out the time intervening between one alleviation and another, and which shrank from the weary continuance of an entire day’s painful and unrelieved abstinence from the accustomed indulgence. The first three days from the commencement of this grain by grain descent was marked by obviously increased impatience with any thing like contradiction or opposition, by an absolute aversion to reading, and by a very humiliating sense of the fact that the _vis vitae_ had somehow become pretty thoroughly eliminated from both mind and body. Still, when night came, as with long-drawn steps it did come, there was the consciousness that something had been gained, and that this daily gain, small as it was, was worth all it had cost. The tenth day of the experiment had reduced my allowance to sixteen grains. The effect of this rapid diminution of quantity was now made apparent by additional symptoms. The first tears extorted by pain since childhood were forced out as by some glandular weakness. Restlessness, both of body and mind, had become extreme, and was accompanied with a hideous and almost maniacal irritability, often so plainly without cause as sometimes to provoke a smile from those who were about me.
For a few days a partial alleviation from too minute attention to the pains of the experiment were found in vigorous horseback exercise. The friend to whose serviceableness in pecuniary matters I have already alluded, offered me the use of a saddle-horse. The larger of the two animals which I found in his Stable was much too heroic in appearance for me in my state of exhaustion to venture upon. Besides this, his Roman nose and severe gravity of aspect somehow reminded me, whenever I entered his stall, of the late Judge —-, to whose Lectures on the Constitution I had listened in my youth, and in my then condition of moral humiliation I felt the impropriety of putting the saddle on an animal connected with such respectable associations. No such scruples interfered with the use of the other animal, which was kept chiefly, I believe, for servile purposes. He was small and mean-looking–his foretop and mane in a hopeless tangle, with hay-seed on his eyelids, and damp straws scattered promiscuously around his body.
Inconsiderable as this animal was, both in size and action, he was almost too much for me, in the weak state to which I was now reduced. This much, however, I owe him; disreputable-looking as he was, he was still a something upon whidi my mind could rest as a point of diversion from myself–a something outside of my own miseries. At this time the sense of physical exhaustion had become so great that it required an effort to perform the most common act. The business of dressing was a serious tax upon the energies. To put on a coat, or draw on a boot, was no light labor, and was succeeded by such a feeling of prostration as required the morning before I could master sufficient energy to venture upon the needed exercise. The distance to my friend’s stable was trifling. Sometimes I would find there the negro man to whose care the horses were entrusted, but more frequently he was absent. A feeling of humiliation at being seen by any one at a loss how to mount a horse of so diminutive proportions, would triumph over the sense of bodily weakness whenever he was present to bridle and saddle him. Whenever he was not at hand the task of getting the saddle on the pony’s back was a long and arduous one. As for lifting it from its hook and throwing it to its place, I could as easily have thrown the horse itself over the stable. The only way in which it could be effected was by first pushing the saddle from its hook, checking its fall to the floor by the hand, and then resting till the violent action of the heart had somewhat abated; next, with occasional failures, to throw it over the edge of the low manger; then an interval of panting rest. Shortening the halter so far as to bring the pony’s head close to the manger, next enabled me easily to push him into a line nearly parallel with it, leaving me barely space enough to pass between. By lengthening the stirrup strap I was enabled to get it across his neck, and by much pulling, finally haul the saddle to its proper place. By a kind of desperation of will I commonly succeeded, though by no means always. Sometimes the mortification and rage at a failure so contemptible assured success on a second trial, with apparently less expenditure of exertion than at first. Occasionally, however, I was forced to call for assistance from sheer exhaustion. The bridling was comparatively an easy matter; with his head so closely tied to the manger little scope was left for dodging. In the irritable condition I was now in, the most trifling opposition made me angry, and anger gave me strength; and in this sudden vigor of mind the issue of our daily struggle was, I believe, with a single exception, on my side.
When I led him into the yard, the insignificance of his appearance, in contrast with the labor it had cost me to get him there, was enough to make any one laugh, excepting perhaps a person suffering the punishment I was then undergoing. Mounting the animal called for a final struggle of determination with weakness. A stone next the fence was the chief reliance in this emergency. It placed me nearly on a level with the stirrup, while the fence enabled me to steady myself with my hand and counteract the tremulousness of the knees, which made mounting so difficult. On one occasion, however, my dread of being observed induced me to make too great an effort. Hearing some one approach, I attempted to raise myself in the stirrup without the aid of stone or fence, but it was more than I could manage. Hardly had I succeeded in raising myself from the ground when my extreme feebleness was manifest, and I fell prostrate upon my back. With the help of the colored woman, the astonished witness of my fall, I finally succeeded in getting upon the horse. Once seated, however, I felt like another person. The vigorous application of a whip, heartily repeated for a few strokes, would arouse the pony into a sullen canter, out of which he would drop with a demonstrative suddenness that made it difficult to keep my seat. In this way considerable relief was obtained for several days from the exasperations produced by the long continuance of pain. After about a fortnight’s use of the animal, and when I had learned to be content with half a dozen grains of opium daily, I found myself too weak and helpless to venture on his back, and thus our acquaintance terminated. As this is the first, and probably the last appearance of my equine friend in print, I may as well say that he was sold a short time afterward in the Fifth Street Horse Market, for the sum of forty-three dollars. This is but a meagre price, but the horse had not then become historical.
For the week I was dropping from sixteen grains to nine the addition of new symptoms was slight, but the aggravation of the pain previously endured was marked. The feeling of bodily and mental wretchedness was perpetual, while the tedium of life and occasional vague wishes that it might somehow come to an end were not infrequent. The chief difficulty was to while away the hours of day-light. My rest at night had indeed become imperfect and broken, but still it was a kind of sleep for several hours, though neither very refreshing nor very sound. Those who were about me say that I was in constant motion, but of this I was unconscious. I only recollect that wakening was a welcome relief from the troubled activity of my thoughts. After my morning’s ride I usually walked slowly and hesitatingly to the city, but as this occupied only an hour the remaining time hung wearily upon my hands. I could not read–I could hardly sit for five consecutive minutes. Many suffering hours I passed daily either in a large public library or in the book-stores of the city, listlessly turning over the leaves of a book and occasionally reading a few lines, but too impatient to finish, a page, and rarely apprehending what I was reading. The entire mental energies seemed to be exhausted in the one consideration–how not to give in to the tumult of pain from which I was suffering. Up to this time I had from boyhood made a free use of tobacco. The struggle with opium in which I was now so seriously engaged had repeatedly suggested the propriety of including the former also in the contest. While the severity of the struggle would, I supposed, be enhanced, the self-respect and self-reliance, the opposition and even obduracy of the will would, I hoped, be enough increased as not seriously to hazard the one great object of leaving off opium forevcr. Still I dreaded the experiment of adding a feather’s weight to the sufferings I was then enduring. An accidental circumstance, however, determined me upon making the trial; but to my surprise, no inconvenience certainly, and scarce a consciousness of the deprivation accompanied it. The opium suffering was so overwhelming that any minor want was aimost inappreciable. The next day brought me down to nine grains of Opium. It was now the sixteenth day of December, and I had still fifteen days remaining before the New Year would, as I had resolved, bring me to the complete relinquishment of the drug. The three days which succeeded the disuse of tobacco caused no apparent intensification of the suffering I had been experiencing. On the fourth day, however, and for the fortnight which succeeded, the agony of pain was inexpressibly dreadful, except for the transient intervals when the effects of the opium were felt.
For a few days I had been driven to the alternative of using brandy or increasing the dose of opium. I resorted to the former as the least of the two evils. In the condition I was now in it caused no perceptible exhilaration. It did however deaden pain, and made endurance possible. Especially it helped the weary nights to pass away. At this time an entirely new series of phenomena presented themselves. The alleviation caused by brandy was of short continuance. After a few days’ use, sleep for any duration, with or without stimulants, was an impossibility. The sense of exhausting pain was unremitted day and night. The irritability both of mind and body was frightful. A perpetual stretching of the joints followed, as though the body had been upon the rack, while acute pains shot through the limbs, only sufficiently intermitting to give place to a sensation of nerveless helplessness. Impatience of a state of rest seemed now to have become chronic, and the only relief I found was in constant though a very uncertain kind of walking which daily threatened to come to an end from general debility. Each morning I would lounge around the house as long as I could make any pretext for doing so, and then ride to the city, for at this time the mud was too deep to think of walking. Once on the pavements, I would wander around the streets in a weary way for two or three hours, frequently resting in some shop or store wherever I could find a seat, and only anxious to get through another long, never-ending day.
The disuse of tobacco, together with the consequences of the diminished use of opium, had now induced a furious appetite. Dining early at a restaurant of rather a superior character, where bread, crackers, pickles, etc., were kept on the table in much larger quantities than it was supposed possible for one individual to need, my hunger had become so extreme that I consumed not only all for which I had specially called, but usually every thing else upon the table, leaving little for the waiter to remove except empty dishes and his own very apparent astonishment. This, it should be understood, was a surreptitious meal, as my own dinner-hour was four o’clock, at which time I was as ready to do it justice as though innocent of all food since a heavy breakfast. The hours intervening between this first and second dinner it was difficult to pass away. The ability to read even a newspaper paragraph had ceased for a number of days. From habit, indeed, I continued daily to wander into several of the city book-stores and into the public library, but the only use I was able to make of their facilities consisted in sitting, but with frequent change of chairs, and looking listlessly around me. The one prevailing feeling now was to get through, somehow or anyhow, the experiment I was suffering under.
Early in the trial my misgivings as to the result had been frequent; but after the struggle had become thoroughly an earnest one, a kind of cast-iron determination made me sure of a final triumph. The more the agony of pain seemed intolerable, the more seemed to deepen the certainty of my conviction that I should conquer. I thought at times that I could not survive such wretchedness, but no other alternative for many days presented itself to my mind but that of leaving off opium or dying. I recall, indeed, a momentary exception, but the relaxed resolution lasted only as the lightning-flash lasts, though like the lightning it irradiated for a brilliant instant the tumult that was raging within me. For several days previous to this transient weakness the weather had been heavy and lowering, rain falling irregularly, alternating with a heavy Scottish mist. During one of the last days of this protracted storm my old nervous difficulty returned in redoubled strength. Commencing in the shoulder, with its hot needles it crept over the neck and speedily spread its myriad fingers of fire over the nerves that gird the ear, now drawing their burning threads and now vibrating the tense agony of these filaments of sensation. By a leap it next mastered the nerves that surround the eye, driving its forked lightning through each delicate avenue into the brain itself, and confusing and confounding every power of thought and of will. This is neuralgia–such neuralgia as sometimes drives sober men in the agony of their distress into drunkenness, and good men into blasphemy.
While suffering under a paroxysm of this kind, rendered all the more difficult to endure from the exhausted state of the body–in doubt even, at intervals, whether my mind was still under my own control–an impulse of almost suicidal despair suggested the thought, “Go back to opium; you can not stand this.” The temptation endured but for a moment, “No, I have suffered too much, and I can not go back. I had rather die;” and from that moment the possibility of resuming the habit passed from my mind forever.
It was at night, however, that the suffering from this change of habit became most unendurable. While the day-light lasted it was possible to go out-of-doors, to sit in the sunlight, to walk, to do something to divert attention from the exhausted and shattered body; but when darkness fell, and these resources failed, nothing remained except a patient endurance with which to combat the strange torment. The only disposition toward sleep was now limited to the early evening. Double dinners, together with the disuse of tobacco, began at this time to induce a fullness of habit in spite of bodily pain. In addition to this, the liver was seriously affected–which seems to be a concomitant of the rapid disuse of opium–and a tendency to heavy drowsiness resulted, as usually happens when this organ is disordered. As early as six or seven o’clock an unnatural heaviness would oppress the senses, shutting out the material world, but not serving wholly to extinguish the consciousness of pain, and which commonly lasted for an hour or two. For no longer period could sleep be induced upon any terms. During these wretched weeks the moments seemed to prolong themselves into hours, and the hours into almost endless durations of time. The monotonous sound of the ticking clock often became unendurable. The calmness of its endlessly-repeated beats was in jarring discord with my own tumultuous sensations. At times it seemed to utter articulate sounds. “Ret-ri-bu-tion” I recollect as being a not uncommon burden of its song. As the racked body, and the mind, possibly beginning to be diseased, became intolerant of the odious sound, the motion of the clock was sometimes stopped, but the silence which succeeded was even worse to the disordered imagination than the voices which had preceded it. With the eyes closed in harmony with the deadly stillness, all created nature seemed annihilated, except my single, suffering self, lying in the midst of a boundless void. If the eyes were opened, the visible world would return, but peopled with sights and sounds that made the misty vastness less intolerable. There appeared to be nothing in these sensations at all approaching the phenomena exhibited in delirium tremens. On the contrary, the mind was always and perfectly aware, except for the instant, of the unreal nature of these deceptions and illusions.
A single case will sufficiently illustrate the nature of some of these apparitions. In the absence of sleep, and while engaged as was not unusual at this period in the perpetration of doggerel verse, the irritation of the stomach became intolerable. The sensation seemed similar to what. I had read of the final gnawings of hunger in persons dying of starvation; a new vitality appeared to be imparted to the organ, revealing to the consciousness a capacity for suffering previously unsuspected. In the earlier stages, this feeling, which did not exhibit itself till somewhat late in the process of leaving off opium, was marked by an insatiable craving for stimulus of some sort, and a craving which would hardly take denial. While suffering in this way intolerably on one occasion, and after having attempted in vain to find some possible alleviation suggested in the pages of De Quincey, which lay near me, I threw myself back on the bed with the old resolution to fight it out. Almost immediately an animal like a weasel in shape, but with the neck of a crane and covered with brilliant plumage, appeared to spring from my breast to the floor. A venerable Dutch market-woman, of whom I had been in the habit of purchasing celery, seemed to intervene between me and the animal, begging me not to look at it, and covering it with her apron. Just as I was about to remonstrate against her interference, something seemed to give way in the chest and the violence of the pain suddenly abated.
It may aid the reader to form some adequate notion of the dreary length to which these nights drew themselves along, to mention that on one occasion, wearied out and disgusted with such illusions, I resolved neither to look at the clock nor open my eyes for the next two hours. It then wanted ten minutes to one; at ten minutes to three my compact with myself would close. For 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 occasionally, under some new access of pain, with other utterances. Though ordinarily so little endowed with the poetic gift as never to have attempted to write a line of verse, yet at this time, and for a few days previous, I had experienced a strange development of the rhythmical faculty, and on this particular occasion I made verses, such as they were, with incredible ease and rapidity. I remember being greatly troubled by the necessity for a popular national hymn, and manufactured several with extempore rapidity. Had their merit at all corresponded with the frightful facility with which they were composed, they would have won universal popularity. Unfortunately, the effusions were never written down, and can not, therefore, be added to that immense mass of trash which demonstrates the still possible advent of a true American _Marseillaise_.
With these tasks accomplished, and with a 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 fidelity 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 under circumstances the 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 to the clock and found it to be just three minutes past one! Little as the mind had really accomplished, the sense of its activity in these few minutes had been tremendous. Measuring time by the conscious succession of ideas may, if I may say it parenthetically, be no more than the same infirmity of our limited human faculties which just now is leading so many men of science, consciously or unconsciously, to recognize in Nature co-ordinate gods, self-subsisting and independent of the ever-living and all-present God.
During the five days in which I was descending from the use of six grains of opium to two, the indications of the changes going on in the system were these: The gnawing sensation in the stomach continued and increased; the plethoric feeling was unabated, the pulse slow and heavy, usually beating about forty-seven or forty-eight pulsations to the minute; the blood of the whole system seemed to be driven to the extremities of the body; my face had become greatly flushed; the fingers were grown to the size of thumbs, while they, together with the palms of the hands and the breast, parted with their cuticle in long strips. The lower extremities had become hard, as through the agency of some compressed fluid. A prickling sensation over the body, as if surcharged with electricity, and accompanied with an apparent flow of some hot liquid down the muscles of the arms and legs, exhibited itself at this time. A constant perspiration of icy coldness along the spine had also become a conspicuous element in this strange aggregation of suffering. The nails of the fingers were yellow and dead-looking, like those of a corpse; a kind of glistening leprous scales formed over the hands; a constant tremulousncss pervaded the whole system, while separate small vibrations of the fibres on the back of the hand were plainly visible to the eye. To these symptoms should be added a dimness of sight often so considerable as to prevent the recognition of objects even at a short distance.
With an experience of which this is only a brief outline, Christmas Day found me using but two grains of opium. Seven days still remained to me before I was to be brought by my pledge to myself to the last use of the drug. For several days previous to this I had abandoned my bed, through apprehension of falling whenever partial sleep left the tumbling and tossing body exempt from the control of the will, and had betaken myself to a low couch made up before the fire, with a second bed on the floor by its side. The necessity for such precaution was repeatedly indicated, but through the kindest care of those whose solicitude never ceased, and who added inexpressibly to this kindness by controlling as far as possible every appearance of solicitude, no injury resulted.
Under the accumulated agony of this part of the trial I began to fear that my mind might give way. I was conscious of occasional fury of temper under very slight provocation. An expressman had charged me what was really an extortionate sum for bringing out a carriage from the city. I can laugh now over the absurd way in which I attacked him, not so much I am sure to save the overcharge as to get rid on so legitimate an object of my accumulated irritability. After nearly an hour’s angry dispute, in which I watched successfully and with a malicious ingenuity for any opening through which I could enrage him, and for doing which I am certain he would forgive me if he had known how much I was suffering, he at last gave up the contest by exclaiming, “For heaven’s sake give me any thing you please–only let me go!” I had not only saved my money, but felt myself greatly refreshed at finding there was so much life left in me.
It should have been stated before, that when the daily allowance had been reduced to six grains that quantity was divided into twelve pills, and that as this was diminished the size of the pills became gradually smaller till each of them only represented an eighth of a grain. As the daily amount of opium became smaller, although its general effect on the system was necessarily diminished, the conscious relief obtained from each of its fractional parts was for a few minutes more apparent than when these sub-divisions were first made. In this way it was possible so to time the effect as to throw their brief anodyne relief upon the dinner-hour or any other time when it might be convenient to have the agony of the struggle a little alleviated.
While I am not desirous of going into needless detail respecting all the particular phenomena of the process through which I was now passing, it may yet give the reader a more definite idea of the extremely nervous state to which I was reduced, if I mention that so nearly incapable had my hand become of holding a pen, that whenever it was absolutely necessary for me to write a few lines I could only manage it by taking the pen in one quivering hand, then grasp it with the other to give it a little steadiness, watching for an interval in the nervous twitching of the arm and hand, and then, making an uncertain dash at the paper, scrawl a word or two at long intervals. In this way I continued for several weeks to prepare the few brief notes I was obliged to write. My signature at this period I regard with some curiosity and more pride. It is certainly better than that of Guido Faux, affixed to his examination after torture, though it is hardly equal to the signature of Stephen Hopkins to the Declaration of Independence.
Christmas Day found me in a deplorable condition. No symptom of dissolving nature seemed alleviated; indeed the aggravation of the previous ones, especially of the already unendurable irritation of the stomach, was very obvious. In addition to this, the protracted wakefulness at night began to tell upon the brain, and I resolved to make my case known to a physician. I should have done this long before, but I had been deterred by two things–a long-settled conviction that all recovery from such habits must be essentially the patient’s own resolute act, and my misfortune in never having found among my medical friends any one who had made the opium disease a special study, or who knew very much about it. The weather was excessively disagreeable, the heavens, about forty feet off, distilling the finest and most penetrating kind of moisture, while the limestone soil under the influence of the long rain had made walking almost impossible. With frantic impatience I waited until an omnibus made its appearance long after it was due, but crowded outside and in. The only unoccupied spot was the step of the carriage. How in my enfeebled condition I could hold on to this jolting standing-place for half an hour was a mystery I could not divine. With many misgivings I mounted the step, and by rousing all my energies contrived for a few minutes to retain my foot-hold. My knees seemed repeatedly ready to give way beneath me, my sight became dim, and my brain was in a whirl; but I still held on. I would gladly have left the omnibus, but I was certain that I should fall if I removed my hands from the frame-work of the door by which I was holding on. At length, a middle-aged Irish woman who had been observing me said, “You look very pale, Sir; I am afraid you are sick. You must take my seat.” I thanked her, but told her I feared I had not strength enough to step inside. Two men helped me in, and a few minutes afterward an humble woman was kneeling in her wet clothing in the Church of St. —-, not the less penetrated, I trust, with the divine spirit of that commemorative day by her self-denying kindness to a stranger in his extremity. When the paved sidewalk was at last reached I started, after a few minutes’ rest, in search of a physician. Purposely selecting the least-frequented streets, in dread of falling if obliged to turn from a direct course, as might be necessary in a crowded thoroughfare, I walked down to the office of the medical man whom I wished to consult; but when I arrived it seemed to me that my case was beyond human aid, and I walked on. I can, perhaps, find no better place than this in which to call the distinct attention of opium-eaters who may be induced to start out on their own reformation, to the all-important fact that no part of the body will be found so little affected by the rapid disuse of opium as the muscles used in walking. I am no physiologist, and do not pretend to explain it, but it is a most fortunate circumstance that in the general chaos and disorder of the rest of the system, the ability to walk, on which so much of the possibility of recovery rests, is by far the least affected of all the physical powers.
During the morning, however, my wretchedness drove me again to the office of the same physician. He listened courteously to my statement; said it was a very serious case, but outside of any reliable observation of his own, and recommended me to consult a physician of eminence residing in quite a different part of the city. He also expressed the hope, though I thought in no very confident tone, that I might be successful, and pretending to shut the door, watched my receding footsteps till I turned a distant corner. I now pass the house of the other physician to whom I was recommended to apply, several times every week, and I often moralize over the apprehension and anxieties with which I then viewed the two or three steps which led to his dwelling. When I arrived opposite his house I stopped and calculated the chances of mounting these steps without falling. I first rested my hand upon the wall and then endeavored to lift my feet upon the second step, but I had not the strength for such an exertion. I thought of crawling to the door, but this was hardly a decorous exhibition for the most fashionable street of the city, filled just then with gayly-dressed ladies. Why I did not ask some gentleman to aid me I can not now recall. I only recollect waiting for several minutes in blank dismay over the seeming impossibility of ever entering the door before me. Finally I went to the curbstone and walked as rapidly and steadily as possible to the lower step, and summoning all my energies made a plunge upward and fortunately caught the door-knob. The physician was at dinner, which gave me some time to recover myself from the agitation into which I had been thrown. After I had narrated my case with special reference to the suspicion of internal inflammation and its possible effect upon the brain, he assured me that no danger of the kind needs to be anticipated. He hoped I might succeed in my purpose, but thought it doubtful. An uncle of his own, a clergyman of some reputation, had died in making the effort. However, if I would take care of my own resolution, he would answer for my continued sanity. He prescribed some preparation of valerian and red pepper, I think, which I used for a week with little appreciable benefit. Finding no great relief from this prescription, or from those of other medical men whom for a few days about this time I consulted, and feeling a constant craving for something bitter, I at last prescribed for myself. Passing a store where liquor was sold, my eye accidentally rested upon a placard in the window which read “Stoughton’s Bitters.” This preparation gave me momentary relief, and the only appreciable relief I found in medicine during the experiment.
The nights now began to bring new apprehensions. A constant dread haunted my mind, in spite of the physician’s assurances, that my brain might give way from the excitement under which I labored. I was especially afraid of some sudden paroxysm of mania, under the influence of which I might do myself unpremeditated injury. I never feared any settled purpose of self-injury, but I had become nervously apprehensive of possible wayward and maniacal impulses which might result in acts of violence.
My previous business had frequently detained me in the city till a late hour, sometimes as late as midnight. A part of the road that led to my house was quite solitary, with here and there a dwelling or store of the lowest kind. A railroad in process of construction had drawn to particular points on the road small collections of hovels, many of which were whisky-shops, and past these noisy drinking-places it was considered hazardous to walk alone at a late hour. In consequence of the bad reputation of this neighborhood I had purchased a large pistol which I kept ready for an emergency. Now, however, this pistol began to rest heavily upon my mind. The situation of my house was peculiarly favorable for the designs of any marauder. Directly back of it a solitary ravine extended for half a mile or more until it opened upon a populous suburb of the city. This suburb was largely occupied by persons engaged in navigation, or connected with boat-building, or by day-laborers, representing among them many nationalities. The winter of which I am writing was one of unusual stagnation in business and a hard one for the poor to get over. In the nervously susceptible state of my mind at this time, this ravine became a serious discomfort. When the stillness of night settled within and around the house, the rustling of leaves and the distant foot-falls in the ravine became distinctly audible. By some fancy of Judge —-, who built it, the house had no less than seven outside entrances. At intervals I would hear burglars at one of the doors, then at another, nearer or more remote: the prying of levers, the sound of boring, the stealthy footsteps, the carefully-raised window, the heavy breathing of an intruder. Then came the appalling sense of some strange presence, where no outward indication of such presence could be perceived, followed by gliding shaddos revealed by the occasional flicker of the waning fire.
Illusions of this nature served to keep the blood at feverheat during the hours of darkness. Night after night the pistol was placed beneath the pillow in readiness for these ghostly intruders. A few days, however, brought other apprehensions worse than those of thieves and burglars. The uncontrollable exasperation of the temper obliged me at length to draw the charge from the pistol, through fear of yielding to some sudden impulse of despair. I had also put out of reach my razors, a hammer, and whatever else might serve as an impromptu means of violence. I remember the grim satisfaction with which I looked upon the brass ornaments of the bedroom fire-place, and reflected that, if worse came to worst, I was not wholly without a resource with which to end my sufferings. For nearly a fortnight previously I had refrained from shaving, dreading I scarce knew what.
The day succeeding Christmas I rode to the city and walked the length of innumerable by-streets as my weakness would allow. When too exhausted to walk further, and looking for some place of rest, I observed a barber’s sign suspended over a basement room. Fortunately the barber stood in the door-way and helped me to descend the half-dozen stone steps which led to his shop. I told the man to cut my hair, shave me, and shampoo my head. As he began his manipulations it seemed as though every separate hair was endowed with an intense vitality. It was impossible to refrain from mingled screams and groans as I repeatedly caught his arm and obliged him to desist. Luckily the barher was a man of sense, and by his extreme gentleness contrived in the course of an hour to calm down my excitement.
When he had finished his work the sense of relief and refreshment was astonishing. In this barber-shop I learned for the first time in what the perfection of earthly happiness consists. The sudden cessation of protracted and severe pain brings with it so exquisite a sense of enjoyment that I do not believe that successful ambition, or requited love, or the gratification of the wildest wishes for wealth, has a happiness to bestow at all comparable to the calm, contented, all-satisfying happiness that comes from a remission of intolerable pain. For the first time in a month I felt an emotion that could be called positively pleasant. As I left the shop I needed no assistance in reaching the sidewalk, and waiked the streets for an hour or two with something of an assured step.
Among other indications of the change taking place at this time in the system was the increased freezing perspiration perpetually going on, especially down the spine. This sense of dampness and icy coldness has now continued for many months, and for nearly a year was accompanied with a heavy cold. During the opium-eating years I do not remember to have been affected at all in this latter way; but a severe cold at this time settled upon the lungs, one indication of which was frequent sternutation, consequent apparently upon the inflammation of the mucous membrane.
In the entire week from Christmas to New Year’s the progress in abandonment of opium was but a single grain. I am sure there was no want of resolution at this trying time. Day by day I exhausted all my resources in the vain endeavor to get on with half, three-quarters, even seven-eighths of a grain; but moans and groans, and biting the tongue till the blood came, as it repeatedly did, would not carry me over the twenty-four hours without the full grain. It seemed as if tortured nature would collapse under any further effort to bring the matter to a final issue.
Brandy and bitters after a few day’s use had been abandoned, under the apprehension that they were connected with the tendency to internal inflammation which I have noticed as possibly affecting the brain. For a day or two I resorted to ale, but a disagreeable sweetness about it induced the substitution of Schenck beer, a weak kind of _lager_. This I found satisfied the craving for a bitter liquid, and it became for two or three weeks my chief drink. I should have mentioned that the day subsequent to the disuse of tobacco I had also given up tea and coffee, partly from a disposition to test the strength of my resolution, and partly from the belief that they might have some connection with a constant sensation in the mouth as if salivated with mercury. I soon learned that the real difficulty lay in the liver, and that this organ is powerfully affected in persons abandoning the long-continued use of opium. Had I known this fact at an earlier day it would have been of service in teaching me to control the diseased longing for rich and highly-seasoned food which had now become a passion. Eat as much as I would, however, the sense of hunger never left me; and this diseased craving, in ignorance of its injurious effects, was gratified in a way that might have taxed unimpaired powers of digestion.
At length the long-anticipated New Year’s Day, on which I was to be emancipated forever from the tyranny of opium, arrived. For five weeks of such steady suffering as the wealth of all the world would not induce me to encounter a second time, I had kept my eye steadily fixed upon this day as the beginning of a new life. This was also the day on which I was to dine with my friend. As the dinner-hour approached it became evident that no opium meant no dinner, and a little later, that dinner or no dinner the opium was still a necessity. A half grain I thought might carry me through the day, but in this I was mistaken. As I lay upon my friend’s sofa, suffering from a strange medley of hunger, pain, and weakness, it seemed that years must elapse before the system could regain its tone or the bodily sensations become at all endurable. Soon after dinner I felt obliged to take another half-grain. My humiliation in failing to triumph when and how I had resolved to do, was excessive. In spite of the strongest resolutions, I was still an opium-eater. I somehow felt that after all I had gone through I ought, to have succeeded. I was in no mood to speculate about the causes of the failure; it was enough to know that I had failed, and what was worse, that apparently nothing whatever had been gained in the last four days. While I certainly felt no temptation to give in, I thought it possible that some of the functions of the body, from the long use of opium, might have completely lost their powers of normal action, and that I should be obliged to continue a very moderate use of the drug during the remainder of my life. I saw, in dismal perspective, that small fractional part of the opium of years which was now represented by a single grain, looming up in endless distance, not unlike that puzzling metaphysical necessity in the perpetual subdivision of a unit, which, carried as far as it may be, always leaves a final half undisposed of. But in this I did myself injustice. I had really gained much in these few days, and the proof of it lay in the use of but half a grain on the day which succeeded New Year’s. The third day of January, greatly to my surprise, a quarter-grain I found carried me through the twenty-four hours with apparently some slight remission of suffering.
As I now look back upon it, the worst of the experiment lay in the three weeks intervening between the 10th and the 31st of December. So far as mere pain of body was concerned, there was little to choose between the agony of one day and another; but the apprehension that insanity might set in, certainly aggravated the distress of the later stages of the trial. When a man knows that he is practicing self-control to the very utmost, and holding himself up steadily to his work in spite of the gravest discouragements, the consciousness that a large vacuum is being gradually formed in his brain is not exhilarating.
The next day–to me a very memorable one–the fourth of January, I sat for most of the day rocking backward and forward on a sofa or a chair, speaking occasionally a few words in a low sepulchral voice, but with the one bitter feeling, penetrating my whole nature, that come what would, on that day _I would not_.
When the clock struck twelve at midnight, and I knew that for the first time in many years I had lived for an entire day without opium, it excited no surprise or exultation. The capacity for an emotion of any kind was exhausted. I seemed as little capable of a sentiment as a man well could be, this side of his winding-sheet. I knew, of course, that in these forty days save one, I had worked out the problem, How to leave off opium, and that I had apparently attained a final deliverance: but it was several weeks before I appreciated with any confidence the completion of the task I had undertaken.
Although the opium habit was broken, it was only to leave me in a condition of much feebleness and suffering. I could not sleep, I could not sit quietly, I could not lie in any one posture for many minutes together. The nervous system was thoroughly deranged. Weak as I had become, I felt a continual desire to walk. The weather was unfavorable, but I managed to get several miles of exercise almost daily. But this relief was limited to four or five hours at most, and left the remainder of the day a weary weight upon my hands. The aversion to reading had become such that some months elapsed before I took up a book with any pleasure. Even the daily papers were more than I could well fix my attention upon, except in the briefest and most cursory way. Within a week, however, the sense of acute pain rapidly diminished, but the irritability, impatience, and incapacity to do any thing long remained unrelieved. The disordered liver became apparently more disordered with the progress of time, producing such effects upon the bowels as may with more fitness be told a physician than recorded here. The tonsils of the throat were swollen, the throat itself inflamed, while the chest was penetrated with what seemed like pulsations of prickly heat. There was also a sense of fullness in the muscles of the arms and legs which seemed to be permeated, if I may so express it, with heated electricity. The general condition of the nervous system will be sufficiently indicated by the statement that it was between three or four months before I could hold a pen with any degree of steadiness. Meantime, singular as it may seem, the appearance of health and vigor had astonishingly increased. I had gained more than twenty pounds in weight, partly, I suppose, the result of leaving off opium and tobacco, and partly the consequence of the insatiable appetite with which I was constantly followed. Within a month after the close of the opium strife, I was repeatedly congratulated upon my healthy, vigorous condition. Few men in the entire city bore about them more of the appearance of perfect health, and fewer still were probably in such a state of exhausted vitality.
During the time I was leaving off opium I had labored 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, and in some anxiety consulted a number of physicians, who each suggested in a timid way the trial, some of strychnine, some of valerian, some of lupuline, hyoscyamus, ignatia, belladonna, and what not. I do not know that I derived the slightest benefit from any of these prescriptions, or from any other therapeutic agency, unless I except the good effects for a few days of bitters, and of cold shower-baths from a tank in which ice was floating.
The most judicious of the medical gentlemen whose aid I invoked, was, I think, the one who replied to my inquiry for his bill, “What for? I have done you no good, and have learned more from you than you have from me.”
This constitutes the entire history of my medical experience, and is mentioned as being the only, and a very small adjunct to the great remedy–patient, persistent, obstinate endurance. So exceeding 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. Between four and five months elapsed before I was at all capable of commanding my attention or controlling the nervous impatience of mind and body. I then assented to a proposal which involved the necessity of a good deal of steady work, in the hope that constant occupation would divert the attention from the nervousness under which I suffered and would restore the self-reliance which had so long failed me. It was a foolish experiment, and might have proved a fatal one. 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 a constant heat and very sore, while the previous bilious difficulties seemed in no way overcome. The mouth was parched, the tongue swollen, and a low fever seemed to have taken entire possession of the system, with special and peculiar exasperations in the muscles of the arms and legs.
The difficulty of thinking to any purpose was only equalled by the reluctance with which I could bring myself to the task of holding a pen. For a few weeks, however, the necessity of not wholly disgracing myself forced me on after a poor fashion; but at the end of two months I was a used-up man. 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 sensation of owning a large emptiness in the brain, which seemed chiefly filled with a stupid wonder when all this would end.
More than an entire year has now passed, in which I have done 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 continues. I do not know how better to describe my present state than by the use of language which professional men may regard as neither scientific nor accurate, but which will express, I hope, to unprofessional readers the idea I wish to convey, when I say that the entire system seems to me not merely to have been poisoned, but saturated with poison. Had some virus been transfused into the blood, which carried with it to every nerve of sensation a sense of painful, exasperating unnaturalness, the feeling would not, I imagine, be unlike what I am endeavoring to indicate.
ADDENDA.–At the time of writing the preceding narrative I 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 myself imagined would be the case, that the unnatural condition of the body would soon become changed into a state of average health. In this I was mistaken. So tenacious and obstinate in its hold upon its victim is the opium disease, that even after the lapse of ten years its poisonous agency is still felt. Without some reference to these remoter consequences of the hasty abandonment of confirmed habits of opium-eating, the chief object of this narrative as a guide to others (who will certainly need all the information on the subject that can be given them) would fail of being secured. While unquestionably the heaviest part of the suffering resulting from such a change of habit belongs to the few weeks in which the patient is abandoning opium, it ought not to be concealed that this brief period by no means comprises the limit within which he will find himself obliged to maintain the most rigid watch over himself, lest the feeling of desperation which at times assaults him from the hope of immediate physical restoration disappointed and indefinitely postponed, should drive him back to his old habits. Indeed, with some temperaments, the greatest danger of a relapse comes in, not during the process of abandonment, but after the habit has been broken. Great bodily pain serves only to rouse up some natures to a more earnest strife, and, as their sufferings become more intense, the determination not to yield gains an unnatural strength. The mind is vindicating itself as the master of the body. While in this state, tortures and the fagot are powerless to extort groans or confessions from the racked or half-consumed martyr. Many a sufferer has borne the agony of the boots or the thumb-screw without flinching, whose courage has given way under the less painful but more unendurable punishment of prolonged imprisonment. In the one case all a man’s powers of resistance are roused; he feels that his manhood is at stake, and he endures as men will endure when they see that the question how far they are their own masters, is at issue. There are, I think, a great number of men and women who would go unflinchingly to the stake in vindication of a principle, whose resolution, somewhere in the course of a long, solitary, and indefinite imprisonment, would break down into a discreditable compromise of opinions for which they were unquestionably willing to die.
In the same way a man will for a time endure even frightful suffering in relinquishing a pernicious habit, while he may fail to hold up his determination against the assaults of the apparently never-ending irritation, discomfort, pain, and sleeplessness which may be counted on as being, sometimes at least, among the remoter consequences of the struggle in which he has engaged. I wish it, however, distinctly understood that I do not suppose that the experience of others whose use of opium had been similar to my own, would necessarily correspond to mine in all or even in many respects. Opium is the Proteus of medicine, and science has not yet succeeded in tearing away the many masks it wears, nor in tracing the marvellously diversified aspects it is capable of assuming. Among many cases of the relinquishment of opium with which I have been made acquainted, nothing is more perplexing than the difference of the specific consequences, as they are exhibited in persons of different temperaments and habits. For such differences I do not pretend to account. That is the business of the thoroughly educated physician, and no unprofessional man, however wide his personal experience, has the right to dogmatize or even to express with much confidence settled opinions upon the subject. My object will be fully attained if I succeed in giving a just and truthful impression of the more marked final consequences of the hasty disuse of opium in this single case, leaving it to medical men to explain the complicated relations of an opium-saturated constitution to the free and healthy functions of life.
In my own 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 extremities, 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.
I mention without hesitancy these consequences of the abandonment of opium, from the belief that any person really in earnest in his desire to relinquish the habit will be more likely to persevere by knowing at the start exactly what obstacles he may meet in his progress toward perfect recovery, than by having it gradually revealed to him, and that at times when his body and mind are both enfeebled by what he has passed through. With a single exception, the dismost serious one I have been obliged to encounter. Whether it is one of the specific effects of the disuse of opium, or only one of the many general results of a disordered constitution, I do not know.
I can only say in my own case, that after the lapse of years, this particular difficulty is not wholly overcome. This electric condition, so to call it, still continues a serious annoyance. But when it occurs, the pain is of less duration, and gradually, but very slowly, is of diminished frequency. Violent exercise will sometimes relieve it; a long walk has often the same effect. The use of stimulants brings alleviation for a time, but there seems to be no permanent remedy except in the perfect restoration of the system by time from this effect of the wear and tear of opium upon the nerves. Irregularity in the action of the liver, while singularly marked in the earlier stages of the experiment, and continuing for years to make its agency manifestly felt, is in a considerable degree checked and controlled by a judicious use of calomel.
The condition of the digestive organs is less impaired than I should have supposed possible, judging from the experience of others. A moderate degree of attention to the quality of what is eaten, with proper care to avoid what is not easily digested, with the exercise of habitual self-control in respect to quantity, suffices to prevent, for the most part, all unendurable feelings of discomfort in this part of the system. Whether the habitually febrile condition of the mouth, and the swollen state of the tongue, is referable to a disturbed action of the stomach or of the liver I can not say. It is certain that none of the effects of opium-eating are more marked or more obstinately tenacious in their hold upon the system than these. I barely advert to the frequent impossibility of retaining some kinds of food upon the stomach, which has been one unpleasant part of my experience, because I doubt whether this return of a difficulty which began in childhood has any necessary connection with the use of opium. For many years before I knew any thing of the drug I had been a daily sufferer from this cause. Indeed the use of opium seemed to control this tendency, and it was only when the remedy was abandoned that the old annoyance returned. For a few months the stomach rejected every kind of food; but in less than a year, and subsequently to the present time, this has been of only occasional ocurrence.
I am also at a loss how far to connect the disuse of opium with the lancinating pains which have troubled me since the time to which I refer. These pains began long before I had recourse to opium, they did not cease their frequent attacks while opium was used, nor have they failed to make their potency felt since opium was abandoned. While it is not improbable that the neuralgic difficulties of my childhood might have remained to the present time, even if I had never made use of opium, I think that the experience of all who have undergone the trial shows that similar pains are invariably attendant upon the disuse of opium. How long their presence might be protracted with persons not antecedently troubled in this way, is a question I can not answer. I infer from what little has been recorded, and from what I have learned in other ways, that the reforming opium-eater must make up his mind to a protracted encounter with this great enemy to his peace. That the struggle of others with this difficulty will be prolonged as mine has been I do not believe, unless they have been subjected for a lifetime to pains connected with disorder in the nervous system.
The unnatural sensitiveness to cold to which I have alluded is rather a discomfort than any thing else. It merely makes a higher temperature necessary for enjoyment, but in no other respect can it be regarded as deserving special mention. With the thermometer standing at 80 to 85 the sensation of agreeable warmth is perfect; with the mercury at 70 or even higher, there is a good deal of the feeling that the bones are inadequately protected by the flesh, that the clothing is too limited in quantity, and in winter that the coal-dealer is hardly doing you justice.
The cold perspiration down the spine, which was so marked a sensation during the worst of the trial, has not yet wholly left the system, but is greatly limited in the extent of surface it affects and in the frequency of its return.
The tendency to impatience and irritability of temper to which I have adverted is by far the most humiliating of the effects resulting from the abandonment of opium. Men differ very widely both in their liability to these excesses of temper as well as in their power to control them; but under the aggravations which necessarily attend an entire change of habit, this natural tendency, whether it be small or great, to hastiness of mind is greatly increased. So long as the disturbing causes remain, whether these be the state of the liver or the stomach, or a want of sufficient sleep, or the excited condition of the nervous system, the patient will find himself called upon for the exercise of all his self-control to keep in check his exaggerated sensibility to the daily annoyances of life.
Intimately connected with the preceding is the frequent recurrence of sleepless nights, which seem invariably to attend upon the abandonment of the habit. Possibly some part of this state of agitated wakefulness may pertain to the natural temperament of the patient, but this tendency is greatly aggravated by the condition of the nerves, so thoroughly shattered by the violent struggle to oblige the system to dispense with the soothing influence of the drug upon which it has so long relied. Whatever method others may have found to counteract this infirmity, I have been able as yet to find no remedy for it. Especially are those nights made long and weary which _precede_ any long continuance of wet weather. A moist condition of the atmosphere still serves the double purpose of setting in play the nervous sensibilities, and, as a concomitant or a consequence, of greatly disturbing, if not destroying sleep.
In connection with this matter something should be said on the subject of dreaming, to which De Quincey has given so marked a prominence in his “Confessions” and “Suspiris de Profundis.” In my own case, neither when beginning the use of opium, nor while making use of it in the largest quantities and after the habit had long been established, nor while engaged in the painful process of relinquishing it, nor at any time subsequently, have I had any experience worth narrating of the influence of the drug over the dreaming faculty. On the contrary, I doubt whether many men of mature age know so little of this peculiar state of mind as myself. The conditions in this respect, imposed by my own peculiarities of constitution, have been either no sleep sufficiently sound as to interfere with the consciousness of what was passing, or mere restlessness, or sleep so profound as to leave behind it no trace of the mind’s activity. While it is therefore certain that this exaggeration of the dreaming faculty is not necessarily connected with the use of opium, but is rather to be referred to some peculiarity of temperament or organization in De Quincey himself, I find myself in turn at a loss to know how far to regard other phenomena to which I have previously alluded as the natural and necessary consequences of opium, or how far they may be owing to peculiarities of constitution in myself. Opium-eaters have said but little on the subject. The medical profession, so far as I have conversed with them, and I have consulted with some of the most eminent, are not generally well informed on any thing beyond the specific effects of the drug as witnessed in ordinary medication. In the absence of sufficient authority, it may be safer to say that the remoter consequences of the disuse of opium consist in a general disorder and derangement of the nervous system, exhibiting itself in such particular symptoms as are most accordant with the temperament, constitutional weaknesses, and personal idiosyncrasies of the patient. That some considerable suffering must be regarded as unavoidable seems to be placed beyond question from the nature of the trial to which the body has been subjected, as well as from what little has been said on the subject by those who have relinquished the habit.
I close this brief reference to the remoter consequences of the habits of the opium-eater by calling the attention of the reader to the physical weakness with consequent inaptitude for continuous exertion which forms a part of my own experience. Unable as I am to refer it to any _immediate_ cause, frequent and sudden prostration of strength occurs, accompanied by slight dizziness, impaired sight, and a sense of overwhelming weakness, though never going to the extent of absolute faintness. Its recurrence seems to be governed by no rule. It sometimes comes with great frequency, and sometimes weeks will elapse without a return. Neither the state of the weather, nor any particular condition of the body, appears to call it out. It sometimes is relieved by a glass of water, by the entrance of a stranger, by the very slightest excitement, and it sometimes resists the strongest stimulants and every other attempt to combat it. I can record nothing else respecting this visitant except that its presence is always accompanied with a singular sensation in the stomach, and that the entire nervous system is affected by its attack.
The inaptitude for steady exertion is not merely the consequence of this occasional feeling of exhaustion, but is for a time the inevitable result of the accumulated pain and weakness to which his system, not yet restored to health, is still subject. This impatience of continued application to work, which is common to all opium-eaters, and which does not cease with the abandonment of the habit, seems to result in the first case from some specific relation between the drug and the meditative faculties, promoting a state of habitual reverie and day-dreaming, utterly indisposing the opium-user for any occupation which will disturb the calm current of his thoughts, and in the other, proceeding from the direct disorder of the nervous organization itself. Strange as it may seem, the very thought of exertion will often waken in the reforming opium-eater acute nervous pains, which cease only as the purpose is abandoned. In other cases, where there is no special nervous suffering at the time, work is easy and pleasant even beyond what is natural.
One effect of opium upon the _mind_ deserves to be mentioned; its influence upon the faculty of memory. The logical memory, De Quincey says, seems in no way to be weakened by its use, but rather the contrary. His own devotion to the abstract principles of political economy; the character of Coleridge’s literary labors between the years 1804-16, when his use of opium was most inordinate; together with the cast of mind of many other well-known opium-eaters, confirms this suggestion of De Quincey. His further statement that the memory of dates, isolated events, and particular facts, is greatly weakened by opium, is confirmed by my own experience. However physiologists may explain this fact, a knowledge of it may not be without its use to those who desire to be made thoroughly acquainted with all the consequences of the opium habit.
If to these discomforts be added a prevailing tendency to a febrile condition of body, together with permanent disorder in portions of the secretory system, the catalogue of annoyances with which the long-reformed opium-eater may have to contend is completed. This statement is not made to exaggerate the suffering consequent upon the disuse of opium, but is made on the ground that a full apprehension of what the patient may be called upon to go through will best enable him to make up his mind to one resolute, unflinching effort for the redemption of himself from his bad habits.
So far as the body is concerned, there is much in my experience which induces me to give a general assent to the opinion expressed by a medical man of great reputation whom I repeatedly consulted in reference to the discouraging slowness of my own restoration to perfect health. “I can not see,” he said, “that your constitution has been permanently injured; but you were a great many years getting into this state, and I think it will take nearly as many to get you out of it.”
It may not be amiss to add that those opium-eaters whose circumstances exempt them from harassing cares, who meet only with kindness and sympathy from friends, and who have resources for enjoyment within themselves, have in respect to these subsequent inconveniences greatly the advantage of those whose position and circumstances are less fortunate.
These free and almost confidential personal statements have been made, not without doing some violence to that instinctive sense of propriety which prompts men to shrink from giving publicity to their weaknesses and from the vanity of seeming to imply that their individual experience of life is of special value to others. Leaving undecided the question whether under any circumstances a departure from the general rule of good sense and good taste in such matters is justifiable, I have, nevertheless, done what I could to give to opium-eaters a truthful statement of the consequences that may ensue from their abandonment of the habit. The path toward perfect recovery is certainly a weary one to travel; but in all these long years, with nervous sensibilities unnaturally active, in much pain of body, through innumerable sleepless nights, with hope deferred and the expectation of complete restoration indefinitely prolonged, I have never lost faith in the final triumph of a patient and persistent resolution. Many men seem to know little of the wonderful power which simple endurance has, in determining every conflict between good and evil. The triumph which is achieved in a single day is a triumph hardly worth the having; but when all impatience, unreasonableness, weaknesses and vanities have been burned out of our natures by the heat of suffering; when the resolution never falters to endure patiently whatever may come in the endeavor to measure one’s own case justly, and exactly as it is; and when time has been allowed to exert its legitimate influence in calming whatever has been disturbed and correcting whatever has been prejudiced, a conscious strength is developed far beyond what is natural to men possessed only of ordinary powers of endurance. It is chiefly through patient waiting that the confirmed victim of opium can look for relief. All who have made heroic efforts to this end, and yet have failed in their attempt, have done so through the absence of adequate confidence in the efficacy of time to bring them relief. The _one_ lesson, however, which the reforming opium-eater must learn is, never to relinquish any gain, however slight, which he may make upon his bad habit. Patience will bring him relief at last, and though he may and will find his progress continually thwarted and himself often tempted to give over the contest in despair, he may be sure that year by year he is steadily advancing to the perfect recovery of all that he has lost.
The opium-eater will not regard as amiss some few suggestions as to the mode in which his habit may most easily be abandoned. The best advice that can be given–the _only_ advice that will ever be given by an opium-eater–is, never to begin the habit. The objection at once occurs, both to the medical man and to the patient suffering from extreme nervous disorder, What remedy then shall be given in those numerous cases in which the protracted use of opium, laudanum, or morphine is found necessary? The obvious answer is, that no medical man ever intends to give this drug in such quantities or for so long a time as to establish in the patient a confirmed habit. The frequent, if not the usual history of confirmed opium-eaters is this: A physician prescribes opium as an anodyne, and the patient finds from its use the relief which was anticipated. Very frequently he finds not merely that his pain has been relieved, but that with this relief has been associated a feeling of positive, perhaps of extreme enjoyment. A recurrence of the same pain infallibly suggests a recurrence to the same remedy. The advice of the medical man is not invoked, because the patient knows that morphine or laudanum was the simple remedy that proved so efficacious before, and this he can procure as well without as with the direction of his physician. He becomes his own doctor, prescribes the same remedy the medical man has prescribed, and charges nothing for his advice. The resort to this pleasant medication after no long time becomes habitual, and the patient finds that the remedy, whose use he had supposed was sanctioned by his physician, has become his tyrant. If patients exhibited the same reluctance to the administration of opium that they do to drugs that are nauseous, if the collateral effects of the former were no more pleasurable than lobelia or castor oil, nothing more could be said against self-medication in one case than the other. Opium-eaters are made such, not by the physician’s prescription of opium to patients in whose cases its use is indispensable, but by their not giving together with such prescriptions emphatic and earnest caution that the remedy is not to be taken except when specially ordered, in consequence of the hazard that a habit may be formed which it will be difficult to break. Patients to whom it is regularly administered are not at first generally aware how easily this habit is acquired, nor with what difficulty it is relinquished, especially by persons of nervous temperament and enfeebled health. The number of cases, I suspect, is small in which the use of opium has become a necessity, where the direction of a physician may not be pleaded as justifying its original employment.
The object I have in view is not, however, so much to make suggestions to medical men as it is to awaken in the victims of opium the feeling that they can master the tyrant by such acts of resolution, patience, and self-control as most men are fully capable of exhibiting. Certain conditions, however, seem to be the almost indispensable preliminaries to success in relinquishing opium by those who have been _long_ habituated to its use. The first and most important of these is a firm conviction on the part of the patient that the task can be accomplished. Without this he can do nothing. The narratives given in this volume show its entire practicability. In addition to this, it should be remembered that these experiments were most of them made in the absence of any sufficient guidance, from the experience of others, as to the method and alleviations with which the task can be accomplished. A second condition necessary to success, is sufficient physical health, with sufficient firmness of character to undergo, as a matter of course, the inevitable suffering of the body, and to resist the equally inevitable temptation to the mind to give up the strife under some paroxysm of impatience, or in some moment of dark despondency. With a very moderate share of vigor of constitution, and with a will, capable under other circumstances of strenuous and sustained exertion, there is no occasion to anticipate a failure here. Even in cases of impaired health, and with a diminished capacity for resolute endeavor, success is, I believe, attainable, provided sufficient time be taken for the trial.
A further condition lies in the attempt being made under the most favorable circumstances in respect to absolute leisure from business of every kind. That nothing can be accomplished by persons whose time is not at their own command, by a graduated effort protracted through many months, I do not say, for I do not believe it; but any speedy relinquishment of opium–that is, within a month or two–seems to me to be wholly impossible, except to those who are so situated that they can give up their whole time and attention to the effort.
This effort should be made with the advice and under the eye of an intelligent physician. So far as I have had opportunity to know, the profession generally is not well informed on the subject. In my own case I certainly found no one who seemed familiar with the phenomena pertaining to the relinquishment of opium, or whose suggestions indicated even in cases where the physician has had no experience whatever in this class of disorders, he can, if a well-educated man, bring his medical knowledge and medical reasoning to bear upon the various states, both of body and mind, which the varying sufferings of the patient may make known to him. Were there, indeed, no professional helps to be secured by such consultation, it is still of infinite service to the patient to know some one to whom he can frequently impart the history of his struggle and the progress he is making. Such confidence may do much to encourage the patient, and no one is so proper a person in whom to repose this confidence as an intelligent physician.
The amount of time which should be devoted to the experiment must depend very greatly upon these considerations–the constitution of the patient, the length of time which has elapsed since the habit was formed, and the quantity habitually taken. When the habit is of recent date, and the daily dose has not been large–say not more than ten or twelve grains–if the patient has average health, his emancipation from the evil may be attained in a comparatively short period, though not without many sharp pangs and many wakeful nights which will call for the exercise of all his resolution.
The question will naturally suggest itself to others, as it has often done to myself, whether a less sudden relinquishment of opium would not be preferable as being attended with less present and less subsequent suffering. Numerous cases have come under my notice where a very gradual reduction was attempted, but which resulted in failure. Only two exceptions are known to me: in one of these the patient, himself a physician, effected his release by a graduated reduction extending through five months. The other is the case of Dr. S., a physician of eminence in Connecticut many years ago. This gentleman had made so free use of opium to counteract a tendency to consumption that the habit became established. After several years, and at the suggestion of his wife, he made a resolution to abandon it, engaging to take no opium except as it passed through her hands, but with the understanding that the process of relinquishment was to be slow and gradual. His allowance at this time was understood to be from twenty to thirty grains of crude opium daily. At the end of two years the habit was abandoned, with no very serious suffering during the time, and so far as his daughter was informed, with no subsequent inconvenience to himself. He lived many years after his disuse of opium, in the active discharge of the duties of his profession, and died at last in the ninetieth year of his age. The hazard of this course, however, consists in the possibility, not to say with some temperaments the probability, that somewhere in the course of so very gradual a descent the same influences which led originally to the use of opium may recur, with no counteracting influence derived from the excitement of the mind produced by the earnestness of the struggle. With some constitutions I have no doubt that a process even so slow as that of Dr. S.’s might be successful, but I suspect, with most men, that some mood of excited feeling, and some conscious sense of conflict, will be found necessary, in order to bring them up resolutely to the work of self-emancipation. On the other hand, I am satisfied that my own descent was too rapid. Had the experiment of between five and six weeks been protracted to twice that time, much of the immediate suffering, and probably more of that which soon followed, might have been prevented. As in the constitution of every person there is a limit beyond which further indulgence in any pernicious habit results in chronic derangement, so also there seems to be a limit in the discontinuance of accustomed indulgence, going beyond which is sure to result in some increased physical disorder. In the cure of _delirium tremens_, the first step of the physician is to stimulate. With more moderate drinkers abrupt cessation from the use of stimulants is the only sure remedy. In the first instance the nervous system is too violently agitated to dispense entirely with the accustomed habit; in the second, the nerves are presumed to be able to bear the temporary strain imposed upon them by the condition of the stomach and other organs. But with opium the case is otherwise. Insanity, I think, would be the general result of an attempt immediately to relinquish the habit by those who have long indulged it. The most the opium-eater can do is to diminish his allowance as rapidly as is safe. For the same reason that no sensible physician would direct the confinement of a patient and the absolute disuse of opium with the certainty that mania would result, so it would be equally ill advised to recommend a diminution so rapid as necessarily to call out the most serious disorder and derangement of all the bodily functions, especially if these could be made more endurable by being spread over a longer period. In one respect the opium-eater has greatly the advantage over those addicted to other bad habits. Those who have used distilled or fermented drinks, tobacco, and sometimes coffee and tea in excess, experience for a time a strong and definite craving for the wonted indulgence. This is never the case with the opium-eater; he has no specific desire whatever for the drug. The only difficulty he has to encounter is the agony of pain–for no other word adequately expresses the suffering he endures–conjoined with a general desire for relief. Yet in the very _acme_ of his punishment he will be sensible of no craving for opium at all like the craving of the drunkard for spirits. As De Quincey justly represents it, the feeling is more that of a person under actual torture, aching for relief, though with no care from what source that relief comes. So far from there being any particular desire for opium, there ensues very speedily, I suspect, after the attempt to abandon it is begun, and long before the necessity for its use has ceased, and even while the suffering from its partial disuse is most unendurable, a feeling in reference to the drug itself not far removed from disgust. The only occasion that I have had of late years to make use of opium or any of its preparations, was within a twelvemonth after it had been laid aside. A morbid feeling had long troubled me with the suggestion that should a necessity ever arise for the medical use of opium, I might be precipitated back into the habit. I was not sorry, therefore, when the necessity for its use occurred, that I might test the correctness of my apprehension. To my surprise, not only was no desire for a second trial of its virtues awakened, but the very effort to swallow the pill was accompanied with a feeling akin to loathing.
The final decision of the question, How long a time should be allowed for the final relinquishment of the drug? must, I imagine, be left to a wider experience than has yet been recorded. The general strength of the constitution, the force of the will, the degree of nervous sensibility, together with the external circumstances of one’s life, have all much to do with its proper explication.
The general directions I should be disposed to suggest for the observance of the confirmed opium-eater would be something as follows:
1. To diminish the daily allowance as rapidly as possible to one-half. A fortnight’s time should effect this without serious suffering, or any thing more than the slight irritation and some other inconveniences that will be found quite endurable to one who is in earnest in his purpose.
2. For the first week, if the previous habit has been to take the daily dose in a single portion, or even in two portions, morning and night, it will be found advisable to divide the diminished quantity into four parts. Thus, if eighty grains has been the customary quantity taken, four pills of fifteen grains each, taken at regular intervals, say one at eight and one at twelve o’clock in the morning, and one at four and one at eight in the evening, will be found nearly equal in their effect to the eighty grains taken at once in the morning. A further diminution of two grains a day, or of half a grain in each of these four daily portions, will within the week reduce the quantity taken to fifty grains, and this without much difficulty, and with positive gain in respect to elasticity of spirits, arising, in part, from the newly-awakened hope of ultimate success. A second week should suffice for a reduction to forty grains. It will probably be better to divide the slightly diminished daily allowance into five portions, to be taken at intervals of two hours from rising in the morning till the daily quantity is consumed. With such a graduated scale of descent, it will be found at the end of two weeks that one-half of the original quantity of opium has been abandoned, and that, with so little pain of body, and so much gain to the general health and spirits, that the completion of the task will seem to the patient ridiculously easy. He will soon learn, however, that he has not found out all the truth.
In the third week a further gain of ten grains can the more easily be made by still further dividing the daily portion into an increased number of parts, say ten. The feeling of restlessness and irritability by this time will have become somewhat annoying, and the actual struggle will be seen to have commenced. It will doubtless require at this point some persistence of character to bear up against the increased impatience, both of body and spirit, which marks this stage of the descent. The feelings will endeavor to palm off upon the judgment a variety of reasons why, for a time, a larger quantity should be taken; but this is merely the effect of the diminished amount of the stimulant. Sleep will probably be found to be of short continuance as well as a good deal broken. Reading has ceased to interest, and a fidgety, fault-finding temper not unlikely has begun to exhibit itself. At this point, I am satisfied, most opium-eaters who have endeavored in vain to renounce the habit, have broken down. Their resolution has failed them not because they were unable to stand much greater punishment than had yet been inflicted, but because they yielded to the impression that some other time would prove more opportune for the final experiment. Under this delusion they have foolishly thrown away the benefit of their past self-control, with the certainty that should the trial be again made, they would once more be assailed by a similar temptation. But if this stage of the process has been safely passed, the next–that of reducing the daily quantity from thirty grains to twenty-five, still dividing the day’s allowance into ten portions–would probably have added little aggravation to the uncomfortable feeling which already existed, but not without some conscious addition, on the other hand, to their enjoyment from the partially successful result of the experiment. Thus in four weeks a very substantial gain, by the reduction of the needed quantity from eighty grains to twenty-five, would have been attained.
If the patient should find it necessary to stop at this point for a week, a fortnight, or even longer, no great harm would necessarily result; it would only postpone by so much his ultimate triumph. He should never forget, however, that the one indispensable condition of success is this: _Never under any circumstances to give up what has been once gained_. If in any manner the patient has been able to get through the day with the use of only twenty-five grains, it is certain that he can get through the next, and the next, and the subsequent day with the same amount, with the further certainty that the habit of being content with this minimum quantity will soon begin to be established, and that speedily a further advance may be made in the direction of an entire disuse. Whenever the patient finds his condition to be somewhat more endurable, whether the time be longer or shorter, he should make a still further reduction, say to one-quarter of his original dose. If this abatement of quantity be spread over the entire week the aggravation of his discomfort will not be great, while the elation of his spirits over what he has already accomplished will go far in enabling him to bear the degree of pain which necessarily pertains to the stage of the experiment which he has now reached. The caution, however, must be borne continually in mind that under no circumstances and on no pretext must the patient entertain the idea that any part of that which he has gained can he surrendered. Better for him to be years in the accomplishment of his deliverance than to recede a step from any advantage he may have secured. If he persists, he will in a few days, or at the longest in a few weeks, find his condition as to bodily pain endurable if nothing more. There may not, probably will not be any very appreciable gain from day to day. The excited sufferer, judging from his feelings alone, may think that he has made no progress whatever; but if after the lapse of a week he will contrast his command of temper, or his ability to fix his attention upon a subject, as evinced at the beginning and end of this period, he can hardly fail to see that there has been a real if not a very marked advance in his status. Such a person has no right to expect, after years of uninterrupted indulgence, that the most obstinate of all habits can be relinquished with ease, or that he can escape the penalty which is wisely and kindly attached to all departures from the natural or supernatural laws which govern the world. It should be enough for him to know that there is no habit of mind or of body which may not be overcome, and that the process of overcoming, in its infinite variety of forms, is that out of which almost all that is good in character or conduct grows, and that the amount of this good is usually measured by the struggle which has been found necessary to ensure success.
Considerations of this nature, however, are of too general a character to be of much service to one enduring the misery of the reforming opium-eater. He has now arrived at a point where he is obliged to ask himself when and how the contest is to end. He has succeeded in abandoning three-quarters of the opium to which he has so long been accustomed. A few weeks have enabled him to accomplish this much. He endures, indeed, great discomfort by day and by night; but hope has been re-awakened; his mind has recovered greater activity than it has known for years; and, on the whole, he feels that he has been greatly the gainer from the contest.
Let me repeat, that the main thing for the patient at this point of his trial is not to forego the advantage he has already attained–“not to go back.” If he can only hold his own he has so far triumphed, and it is only a question of time when the triumph shall be made complete. _When_ this shall be effected _he_ must decide. The rapidity of his further progress must be determined by what he himself is conscious he has the strength, physical and moral, to endure. With some natures any very sudden descent is impossible; with others, whatever is done must be done continuously and rapidly or is not done at all. The one temperament can not stand up against the assaults of a fierce attack, the other loses courage except when the fight is at the hottest. For the former ample time must be given or he surrenders; the latter will succumb if any interval is allowed for repose. It is, therefore, difficult to suggest from this point downward any rule which shall apply equally to temperaments essentially unlike. I think, however, that the suggestion to divide the daily allowance, whether the descent be a slow or a rapid one, into numerous small parts to be taken at equal intervals of time, will be found to facilitate the success of the attempt in the case of both. The chief value of such subdivision probably consists in its throwing the aggregate influence of the day’s opium nearer the hour of bed-time, when it is most needed, than to an earlier hour, when its soporific power is less felt. In addition to this, the importance to the excited and irritated patient of being able to look forward during the long-protracted hours to frequent, even if slight, alleviations of his pain, should not be left out of the account. In general it may be said that whenever the patient feels that he can safely, that is, without danger of failing in his resolution, adventure upon a further diminution of the quantity, an additional amount, smaller or greater according to circumstances, should be deducted till the point is reached where the suffering becomes unendurable; then after a delay of few or many days, as may be needed to make him somewhat habituated to the diminished allowance, a still further reduction should be made, and so on for such time as the peculiarities of different constitutions and circumstances may make necessary, till the quantity daily required has become so small, say a grain or two, that by still more minute subdivisions, and by dropping one of them daily, the final victory is achieved.
I have not ventured to say in how short a time confirmed habits of opium-eating may be abandoned. In my own case it was thirty-nine days, but with my present experience I should greatly prefer to extend the time to at least sixty days; and this chiefly with reference to the violent effects upon the constitution produced by the suddenness of the change of habit. Some constitutions may possibly require less time and some probably, more. While I regard the abandonment of the first three-quarters of the accustomed allowance as being a much easier task than the last quarter, and one which can be accomplished with comparative impunity in a brief period, I would allow at least twice the time for the experiment of dispensing with the last quarter; unless, indeed, I should be apprehensive that my resolution might break down through the absence of the excitement which is unquestionably afforded by the feeling that you are engaged in a deadly but doubtful conflict. So far, also, as can be inferred from cases subsequently narrated in this volume, the probability of success would seem to be enhanced by devoting a longer time to the trial. It can not, however, be too often repeated, that however slow or however rapid the pace may be, the rule to be rigidly observed is this: Never to increase the minimum dose that has once been attained. This is the only rule of safety, and by adhering to it, persons in infirm health, or with weakened powers of resolution, will ultimately succeed in their efforts.