Popular Science Monthly/Volume 12/March 1878/Opium and its Antidote
By CHARLES RICHET.
OPIUM is the juice of the poppy, and, as there are many varieties of the poppy, so too are there many kinds of opium; the mode of collecting the juice is, however, always the same. In Egypt, Syria, and India, the three countries which produce opium, a number of semicircular incisions are made in the capsule of the poppy, and the juice which exudes is carefully gathered. This juice, on being dried in the sun, becomes of a dark color, thickens, and forms a brown, firm paste: this is opium. Laudanum is a solution of opium in alcohol and water. Both opium and laudanum are to be regarded as a mixture of several similar but not identical substances. Since the time of Derosne (1804) and Robiquet (1817), who first isolated narcotine and morphine, chemists have very carefully investigated the different chemical compounds occurring in opium. Thus they have discovered codeine, narceine, thebaäine, papaverine, and other substances, all of them bases, i. e., bodies that unite with acids to form crystallizable salts.
These bases do not all affect in the same way the organic functions. Thus, narcotine possesses very little or no soporific power: two grammes of it can be injected without perceptible effect, while a centigramme of morphine is quite sufficient to produce therapeutic and physiological results. Thebäine does not cause sleep, and in animals produces convulsions like those caused by strychnine, while morphine in the same dose produces deep comatose sleep. Another curious thing about these opium alkaloids is, that they do not act alike on man and animals, as has been demonstrated by Claude Bernard. Man is specially sensitive to the action of morphine, while thebäine is almost without effect upon his nervous system: animals, on the other hand, feel the effects of morphine only when it is given in large doses, while thebäine is for them a violent poison. So, too, with belladonna, and atropine, its active principle, they are a deadly poison for man, but almost without effect on rabbits: the dose of atropine that would suffice to kill ten men would hardly be enough to kill one rabbit. The difference is not so great with respect to morphine, yet morphine specially affects man; hence in this article we will consider only this one opium alkaloid.
When, in "Le Malade imaginaire," honest Argan is asked why opium causes sleep, his artless reply is, "Quia habet proprietatem dormitivam." Nowadays we are not content with this kind of explanation, and some authors have sought for the "dormitive property" of opium in the state of the cerebral circulation; and, though the true cause has not yet been certainly established, still it is something that research has been made.
It is not yet positively decided whether opium produces anæmia or whether it produces congestion of the brain; indeed, we know little more than did Argan, namely, that it sets one asleep. This sleep, however, is in some respects different from ordinary sleep. From thirty to sixty minutes after taking opium one feels a slight excitation; there is a general feeling of buoyancy and contentment, soon followed by drowsiness and a state of reverie rather than of dreaming. There is a pleasurable feeling of abandon, and an agreeable sense of torpor creeps over the whole frame; the thoughts are like the ever-shifting scenes of a phantasmagoria, on which we passively gaze, without will or effort to alter the series. Still, so long as the intoxication is not deep, such effort is possible. One feels that he is falling asleep, and that if he would but bestir himself he might overcome his drowsiness. But little by little the legs grow heavy, the arms fall to the sides almost powerless, and the weighted eyelids refuse to remain open. A dreamy, rambling sort of thinking still goes on, and there is as yet no sleep; we are still conscious of the world around. We indistinctly hear the tic-tac of the clock and the rumble of passing vehicles, but it is as though, so to speak, another person were listening and not we. The active, conscious Me exists no more, and another personality seems to have taken its place. Gradually everything becomes more and more indistinct, our thoughts are enveloped in a haze, we feel ourselves detached from matter, detached from our bodies, and transformed into thought, which flits about, so to speak, becoming more and more brilliant, but at the same time more and more confused. Then the outer world disappears, and there remains only an inner world, sometimes full of tumult and delirium, and producing feverish excitement, or, as is more frequently the case, calm and quiet, and full of delightful repose. This intoxication is purely psychical, and far superior to the intoxication produced by alcohol or hasheesh, for, though hasheesh gives one a few hours of insanity, opium gives sleep, and with this boon there is nothing that can compare. One must have suffered from insomnia in order to appreciate the value of opium. It brings sleep, and it banishes pain.
It is one of the most powerful agents we possess for modifying the sensibility, but whether it does this by acting upon the sensor nerves or on the brain we know not with certainty. Even where it does not procure sleep, it has the singular power of calming the excitability of the nerves, and of subduing that morbid state of the sensibility called by physicians hyperæsthesia. It has been observed that when it reduces hyperæsthesia it does not cause sleep, all its force seemingly being spent in combating pain. In cases of stubborn neuralgia opium appeases suffering, and a larger dose is required to produce sleep. But is it not enough that it allays the irritability of a diseased nerve? Some persons cannot live without opium, and they swallow enormous quantities of it without perceptible effect. Herein opium differs widely from alcohol. Alcohol is cumulative in its effects, and the more one is addicted to its use, the more easily is he intoxicated by it. One does not become habituated to alcohol intoxication, but with opium the case is different; one may become so accustomed to it as to be able to drink daily a litre of laudanum, twenty drops of which would be a strong enough medicinal dose for a non-habituated person.
In China there is the same popular demand for opium that exists in Europe for alcohol and tobacco. The use of opium does not date very far back, and it is probably the only innovation that China has adopted from the West. The importation of opium from India into China amounted in 1798 to 300 tons, in 1863 to 3,000 tons, in 1866 to 3,903, and since then the increase has been still more rapid.
Opium is chewed, or smoked in a pipe, the latter mode of using it being the more common. The bowl of a long-stemmed pipe is filled with the drug, and, as the opium swells and adheres to the pipe, a needle is in constant use to keep open an air-passage. As the drug burns with difficulty, the smoker must have a light ready at hand for use whenever his pipe goes out.
The number of opium-smokers is considerable, but the great majority of them use the drug only in moderation. The wealthiest mandarins, the most intelligent merchants, smoke opium, as do the humblest coolies. The use of opium is like the use of tobacco among ourselves; nor does it produce any greater mischief, at least among the well-to-do classes; but with the common people it is different. There are establishments specially devoted to opium—smoking-places where, for a trifling sum of money, one may gratify this appetite. Rarely does a smoker leave before he is fully under the influence of the drug, just as the drunkard does not quit the gin-shop until he is fuddled. So used, opium is certainly a dangerous poison, and, according to the testimony of all travelers, the wretches who daily commit such excesses speedily fall to a fearful state of degradation, both moral and physical. Pale, wan, gaunt, shambling along with difficulty, they must have recourse to artificial stimulation in order to regain a part of their wasted energy. Still the injurious effects of opium have in all probability been very much exaggerated: the number of deaths caused by the abuse of the drug is not very great; and many of those who smoke it, even in considerable quantity, retain unimpaired their mental faculties. True, the digestive functions rarely escape impairment. Dyspepsia and general emaciation are the result of this sad habit; but, however that may be, China is not yet by any means on the brink of ruin, and, if she is in a state of decadence, the blame does not attach to opium.
Opium has its antidote: just as we can produce sleep, so too can we produce sleeplessness, by the employment of a mind-poison whose effects are diametrically opposite to those of the other. The antidote of opium is coffee. One hundred years ago coffee was almost unknown, but now there is hardly another beverage that is so widely distributed. Every one has it in his power to judge of the effects of coffee. For some persons it is a stimulus necessary for the performance of intellectual work. In others it produces a painful state of insomnia: taken even in weak doses it causes restlessness and anxiety, a sort of feverish activity altogether different from the indolent activity of opium. Under the action of opium the will seems to be lulled to sleep and the imagination runs riot. But under the influence of coffee the imagination is hardly stimulated at all, while there does appear to be excitation of the will. Did I not fear being suspected of having a theory to defend, I should say that the faculties of will and consciousness seem to be superexcited: there is, as it were, a constant strain on attention and memory, whereas in the case of alcohol, hasheesh, and opium, there is a relaxing of attention. Hence coffee produces a true intoxication that fatigues one far more than does the somnolent intoxication of opium, but it leads to the same result. In striving to do too much, the mind does less: under stimulation the will is impaired; and the perfect equilibrium of the mental faculties is disturbed as well by excess as by defect of will.
Coffee is said to produce cerebral anæmia, while opium and alcohol cause congestion; but this theory still needs confirmation. Nevertheless, the part played by coffee in general nutrition is very well understood. It retards organic combustion, and hence it is an aliment d'epargne—a food-stuff that effects a saving of other food-stuffs. In the normal state there is always going on within our tissues a multitude of chemical actions, the final result of which is heat-production and liberation of carbonic acid. This carbonic acid passes into the venous blood, and the venous blood, on reaching the lungs, parts with its carbonic acid. Thus the quantity of the carbonic acid is, to some extent, the expression of the nutritive activity. Now, on taking coffee, though no greater quantity of oxygen be inhaled, and without increasing the ration of food, the quantity of the carbonic acid is reduced, and yet the amount of force is not lessened. As illustrating this doctrine, it is usual to cite a fact observed among Belgian miners, who can perform a considerable amount of work almost without food, their strength being maintained solely by the absorption of a large quantity of coffee. Hence coffee is a food-stuff which moderates nutrition by lessening the activity of the chemical transformations incessantly going on within the tissues.