In a majority of cases by experienced choice of clinical procedure, combined with judgment and technical skill, the arrest of addiction-mechanism and the restoration of the narcotic addict to health and freedom from both opiate need and thought of opiate drug is a matter of assured accomplishment attended by little if any nervous strain and physical suffering. Ability to accomplish this is not beyond the power or any competent practitioner, whether he reside in a hospital or is in private practice. All that is required is instruction or information as to the mechanism of addiction-disease, clinical demonstration of its manifestations and reactions and the same amount of experience in their handling as is expected of a man who treats any other disease. I have purposely refrained in this book from discussion of technical details of therapeutic procedures, and of various medications, and of their various indications, contraindications, applications, dosage, etc. Such discussion, to be adequate and competent, would require much space and would distract from the general presentation of the problem, which is the purpose of this volume. I have learned from experience in teaching and in treatment of cases that before there has been established appreciation of the whole personal and clinical problem and picture, and conception of its disease mechanism, and ability clinically to recognize and interpret symptomatology, discussion of technical details is premature and misleading. CHAPTER VII RELATION OF NARCOTIC DRUG ADDICTION TO SURGICAL CASES AND INTERCURRENT DISEASES It is a common idea in the minds of both surgeons and physicians that an addict to narcotic drug is a difficult case for surgical handling and is a poor surgical risk. Numerous instances of surgeons refusing to operate upon a narcotic addict until the addict should have “stopped” the use of the drug, voice the almost prevailing attitude. Very many, if not most, internists and practitioners view with gravest concern the presence of addiction in a serious illness coming under their care. That the addict has borne this undeserved reputation as a poor surgical and medical risk, and that this reputation has been seemingly merited by previous medical and surgical experience, is not to be laid at the door of the existence of addiction in the patient. It is to be laid at the door of insufficient medical comprehension of addiction-disease and its mechanism in its material manifestations, and in its functional and organic influences, and at the door of inadequate clinical study into the analysis, estimation and control of these. Like much else that has been for generations generally accepted as true about narcotic drug addiction, the belief is erroneous that the addict is a poor surgical and medical risk because he is an addict.