For the relief of pain in the dying wherever it may be situated, we have our one trustworthy remedy in opium. Heberden writes, “In impetu autem doloris, ubi ubi is fuerit, opium est unicum remedium.” If judiciously and freely administered it is equal to _most_ of the emergencies in the way of pain, that we are likely to meet with in the dying,[54] whereas if timidly and inadequately used, the sufferer is deprived of the relief which it alone is capable of affording. The value of opium in allaying pain, great as that is, is however second to its value in relieving the feeling of exhaustion and sinking--of indescribable distress and anxiety--referred to the stomach and heart, which so often attends some part of the act of dying. To the practised eye, this condition is evidenced, as much by the pinched features, pallid complexion, and _anxious expression of face_, as by any verbal complaint of the sufferer. Here the action of opium is that of a cordial in the fullest sense of the word. “Of all cordials,” says Sydenham, “opium is the best that has hitherto been discovered. I had nearly said,” adds he, “that it is the only one.”[55] “Under the protection of an opiate,” writes Dr. Heberden,[56] “the patient’s strength has been kept up, and even in hopeless cases in which the dying person is harassed by unspeakable inquietude, he may be lulled into some composure, and without dying at all sooner may be enabled to die more easily.” I know of nothing in our attendance on the dying more gratifying, than to witness the improvement in face, feature, and expression, that marks the kindly action of opium under these circumstances. In an hour or thereabouts, after it has been taken, some colour returns to the face, the features lose somewhat of their sharpness, a placid expression replaces the look of anxiety, and the sufferer passes into an easy, gentle sleep, from which he awakes refreshed and comforted, and helped as it would seem, to die more easily, when his time arrives. Hufeland, writing at the end of a long professional life, did not hesitate to declare that opium “is not only capable of taking away the pangs of death, but it imparts even courage and energy for dying.”[57] Opium must be administered in such doses as will appease suffering and disorder, and in this respect we are to be governed solely by the effect and relief afforded. The dose for an adult should be rarely less than a grain, but oftener more. “There exists,” writes Sir Henry Holland, “distrust, both as to the frequency and extent of its use not warranted by facts, and injurious in many ways to our success;”[58] “its use is not to be measured timidly by tables of doses, but by fulfilment of the purpose for which it is given. A repetition of small quantities will often fail, which concentrated into a single dose would safely effect all we require.”[59]