Considerations of this nature, however, are of too general a character
to be of much service to one enduring the misery of the reforming
opium-eater. He has now arrived at a point where he is obliged to ask
himself when and how the contest is to end. He has succeeded in
abandoning three-quarters of the opium to which he has so long been
accustomed. A few weeks have enabled him to accomplish this much. He
endures, indeed, great discomfort by day and by night; but hope has
been re-awakened; his mind has recovered greater activity than it has
known for years; and, on the whole, he feels that he has been greatly
the gainer from the contest.
Let me repeat, that the main thing for the patient at this point of
his trial is not to forego the advantage he has already attained--"not
to go back." If he can only hold his own he has so far triumphed, and
it is only a question of time when the triumph shall be made
complete. _When_ this shall be effected _he_ must decide.
The rapidity of his further progress must be determined by what
he himself is conscious he has the strength, physical and moral,
to endure. With some natures any very sudden descent is impossible;
with others, whatever is done must be done continuously and rapidly or
is not done at all. The one temperament can not stand up against the
assaults of a fierce attack, the other loses courage except when the
fight is at the hottest. For the former ample time must be given or he
surrenders; the latter will succumb if any interval is allowed for
repose. It is, therefore, difficult to suggest from this point
downward any rule which shall apply equally to temperaments
essentially unlike. I think, however, that the suggestion to divide
the daily allowance, whether the descent be a slow or a rapid one,
into numerous small parts to be taken at equal intervals of time, will
be found to facilitate the success of the attempt in the case of
both. The chief value of such subdivision probably consists in its
throwing the aggregate influence of the day's opium nearer the hour of
bed-time, when it is most needed, than to an earlier hour, when its
soporific power is less felt. In addition to this, the importance to
the excited and irritated patient of being able to look forward during
the long-protracted hours to frequent, even if slight, alleviations of
his pain, should not be left out of the account. In general it may be
said that whenever the patient feels that he can safely, that is,
without danger of failing in his resolution, adventure upon a further
diminution of the quantity, an additional amount, smaller or greater
according to circumstances, should be deducted till the point is
reached where the suffering becomes unendurable; then after a delay of
few or many days, as may be needed to make him somewhat habituated to
the diminished allowance, a still further reduction should be made,
and so on for such time as the peculiarities of different
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