Here I will be asked (as I am constantly out of the book), why not
begin the abandonment of the drug as soon as this acute attack is
over? When the terrible and immediate peril has been staved off by
such a mere hair's-breadth, why listen again to "the chronic appetite"
which "calls for its habitual dose?" Surely, now that the patient has
gone for forty-eight hours or more without that dose, would it not be
better never to return to it? Must he begin his former career again
and afterward have all the same ground to go over?
I answer that he will not have the same ground. That which he has just
traversed was the ground separating between an excess and his normal
life--and he is in reality in a worse condition to try the experiment
of instant abandonment than he was before the struggle. It is a very
different thing to cure a man of acute from curing him of chronic
opium-poisoning; and my own large experience, together with that of
all the most experienced, the soundest and most skillful men that I
have ever known as successful practitioners among these cases, points
to the unanimous conclusion that it is not safe, either to mind or
body, to make the abrupt transition required of an old opium-eater who
must give up his drug _in toto_ and at once, especially after
such an acute attack as that just described. He would be very likely
to die of exhaustion, to endure an amount of agony which would
permanently enfeeble his mind, or to commit suicide as his only way of
escape from it, if we cut him short from the equivalent of 15 or 20
grains of sulphate of morphia after having used the drug for five
years. The most terrible case of opium-eating which I ever saw
instantly cu short was one where the patient used 33 grains of morphia
per diem, but he had used it for less than a year, and possessed a
constitution whose physical grit and mental pluck anybody would
pronounce exceptional, though even that did not save him from the
tortures which endangered his reason. I am always in favor of a man's
"breaking off short" if he can. I believe that the majority of people
who have used the drug less than a year can, but the number who are
able to do it after that diminish in geometric ratio with every month
of habituation.
I therefore permit Mr. Edgerton, as soon as his stomach will bear it,
to return to the use of opium.
But before giving him his dose I make the stipulation that from this
moment he shall deal as frankly with me as he does with his own
consciousness--that we shall have no opium secrets apart.
Public-domain text, read in full here on John Shaqi.
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