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
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