OPIUM

(From vol. I, 3^rd edit., 1830.)

(The dried milky juice of the green, half-ripe heads of the Papaver somniferum, especially of the large-headed white poppy, Papaver officinale, Gm.)

In recent times many chemists have given themselves unspeakable trouble to analyze opium, and to dissociate its several sontituent parts; morphium (morphia), narcotin (opian), meconic acid, extractive matter, caoutchuc, opium-balsam, fatty substance, gluten, resin, gum, volatile matter. They generally differ so much among one another, both in respect to the methods used to separate them, consisting of a number of dissimilar and complicated processes, and in respect to the chemical nature of their component parts, as also in their opinions about the relative efficacy of these constituents, that, all things considered, very little of a trustworthy or useful characted seems to have resulted, either for the medical art in general, or for the benefit of the sick in particular.

But as homoeopathy concerns itself only with whole, undivided medicial substances, as they exist in the natural state, and aims at the simplest mode of preparing them, in which all their constituents shall be uniformly dissolved and develop their medicinal powers, and as it looks only to healing and not to injuring human beings consequently it does not, like the new pharmacy, consider it an honour to prepare from opium the most painlessly and quickly killing substance (Mohpium aceticum); hence the homoeopathic art, which is only intended for beneficent ends, willingly dispenses with all these dangerous manoeuvres.

It will therefore – as has hitherto been the custom – macerate one grain of finely pulverised opium in 100 drops of alcohol in the temperature of the room for a week, in order to make a tincture, and mix one drop of this with another 100 drops of alcohol by two succussions, and so proceed to the higher developments of power; or, better:

One grain of selected good opium is treated like other dry medicinal substances, is first brought to the million-fold trituration in three hours, by triturating with three times 100 grains of milk-sugar (in the manner taught at the commencement of the second part of the book on Chronic Diseases); of this one grain is then dissolved in 100 drops of diluted alcohol, and potentized by two succussions. This gives a fluid, one drop of which, diluted in a similar way with 100 drops of alcohol, and through 25 more dilution-phials. One or two globules of the smallest size moistened with this last potency will do all the good that is capable of being effected homoeopathically in the treatment of human ailments for which it suitable.

It is much more difficult to estimate the action of opium than of almost any other drug.

In the primary action of small and moderate doses, in which the organism, passively as it were, lets itself be affected by the medicine; it appears to exalt the irritability and activity of the voluntary muscles for a longer time, but to diminish those of the involuntary muscles for a longer period; and while it exalts the fancy and courage in its primary action, it appears at the same time to dull and stupefy (the external senses) the general sensibility and consciousness. Thereafter the living organism in its active counter-action produces the opposite of this in the secondary action: diminished irritability and inactivity of the voluntary, and morbidly exalted excitability of the involuntary muscles, and loss of ideas and obtuseness of the fancy, with faint-heartedness along with over sensitiveness of the general sensibility.

In large doses the symptoms of the primary action not only rise to a far more dangerous height, but they pass from one to another with impetuous rapidity, often mingled with secondary actions or quickly passing into the latter. In some persons certain symptoms are more conspicious, in others other symptoms.

No medicine in the world suppresses the complaining of patients more rapidly than opium and misled by this, physicians have made immense use (abuse) of it, and have done enormous and wide-spread mischief with it.

Were the results of the employment of opium in diseases as beneficial as its employment is common, there would be no medicine by which patients would be so often cured as by opium. But exactly the opposite of this is universally the case.

Its enormous power and rapid action imply that an uncommon amount of knowledge of its actions and an uncommonly accurate judgement and appreciation of it must be required in order to employ it medicinally, if we would use it in a really benificial manner, which is impossible without making a homoeopathic application of it.

Hitherto opium has been almost exclusively employed antipathically or palliatively, and hardly any but its primary actions have been opposed to the contrary morbid states, contraries curentur – except when the physician prescribed (by mistake? Or numinis afflatu?) in a sense exactly opposite to this antiquity hallowed therapeutic rule of Galen’s, and so effected miraculous cures. No medicine in the world has affected more illusory relief, more deceptive concealment and suppression of the morbid symptoms, with consequence more disastrous than the original disease. No medicine in the world has done more harm (with preliminary apparent relief) than this opium.

Opium has been employed as the supposed chief remedy against all kinds of coughs, diarrhoeas, vomiting, sleeplessness, melancholy, spasms and nervous ailments – and more especially against all kinds of pains without distinction.

But all these innumerable affections are not contained in the primary action of opium, but just the opposite. Hence we can easily understand how far from permanent, how far from benificial must be the result of such an employment of this drug in the majority of diseases of body and mind! And daily experience teaches this.

If in some few cases opium removes cough, diarrhoea, vomiting, sleeplessness, trembling and so forth, this only happens when these ailments are of recent date or have arisen suddenly in a previously healthy body, and when they are of a slight character, Thus, for example, a cough brought on by a chill, a trembling caused by recent fright, (Smelling at a globule the size of a mustard-seed, moistened with a potentized dilution of opium, gives almost immediate relief to one how has undergone a violent fright, but only on the condition that he performs the olfaction immediately after trifling cause the fright has been received, If employed later, it not only brings no relief, it rather doe harm.) a diarrhoea suddenly excited by fear, a chill or other trifling case , vomiting and other symptoms produced by mental excitement, loathing, 7c., are sometimes quickly removed by opium, because it is only necessary that it should suppress these ailments in a superficial and temporary manner, in order to restore to the previously healthy body its freedom to ward off spontaneously all further tendency to these affections, and to continue its former condition of health by its own powers (vide Organon of Medicine, 4^th edition, § 63, note).

Though opium succeeds in the palliative suppression of these rapid trivial ailments in the few instances indicated above, it by no means follows that it possesses a true curative power of permanently removing such affections in every case and under all conditions even when they are of a persistent character. It cannot remove them and restore health when they are symptoms of another disease to which opium does not correspond as a homoeopathic remedy in its primary effects, or if they have already lasted a considerable time, because these ailments are not contained in the primary actions of opium. (They are only to be found in its secondary action (and in the preliminary, momentary reaction – their reflexion – described below).

Hence it has hitherto been universally employed in medical practice throughout the whole, almost always with injurious and disasterous results, in old coughs, persistent diarrhoeas, long-continued sleeplessness, chronic vomiting, habitual spasms , anxiety and trembling. But when these affectiexisted for some time in the system and depended on totally different diseases for which opium is not the homoeopathic remedy, they could never, not in one single instance, be cured by opium, so that permanent health was restored by its use.

In employing opium in the above-mentioned chronic maladies we learn that it effects only at first an illusory alleviation, a transient suppression of the affection for a few hours; that it then ceases to alleviate without increasing the size of the dose, that on further increasing the dose it only allays the symptoms for a short time, and even when it does this it creates on the other hand new affections and a much more serious and a worse artificial disease. Verily this is an injurious, though hitherto universally practised misuse of this gift of God which was created for the removal of quite opposite morbid states. (For where shall we find a remedy equal to opium for the most obstinate constipation and for acute fevers, with umcomplaining stupefied sopor, with snoring from a half opened mouth, and twitching of the limbs, with burning heat of the perspiring body, and in several other morbid states corresponding in similarity to the primary effects of opium.)

But most striking was the abuse which all physicians over the whole world down to the present time (Although as long as twenty years ago, I showed incontrovertibly in these very words (in the first edition of the ORAGNON, 1810), the misuse universally made by physicians of opium for pains to be a palpable injury to the well-being of patients, yet we have not seen that their conscience was the least touched, and that they abandoned a practice that is as stupid as it is criminal. To such remonstrances they only exclaim that their routine is interfered with, and they abuse and persecute the man who calls attention to their erronous practice, just as the sinner who feels himself hit the words of a sermon on repentence only abuses the preacher, without reforming his own conduct. But why should I, who feel an inward call to enunciate such important verities, and who have truth and nature on my side, why should I bother myself about these incorrigible sinners?) have made of opium, in prescribing it as a powerful remedy for pains of all sorts, be they ever so old and deeply rooted, it is obviously contrary to common sense, and is almost equal to the folly of a universal remedy, to expect from one single substance the cure of all pains which differ so infinitely among one another. Seeing that the various kinds of pains in diseases differ so much from one another in their seat, in the time and conditions of their occurrence, recurrence, increase and diminution, &c., it might be supposed that the Creator would not fail to create a large number of different medicines for their cure; for every finite thing can only have a finite, limited sphere of action. But opium is precisely not one of those pain-allaying and curing remedies. Opium is almost the only medicine that in its primary action does not produce a single pain. Every other known drug, on the other hand, produces in the healthy human body each its own kinds of pain in its primary action, and hence is able to cure and remove (homoeopathically) similar pains in diseases, especially if the other symptoms of the disease correspond in similarity to those observed from the administration of that medicine. Opium alone is unable to subdue homoeopathically, i.e. permanently, any one single pain, because it does not cause in its primary action one single pain, but the very reverse, namely, insensibility, the inevitable consequence (secondary action) of which is greater sensitiveness than before, and hence a more acute sensation of pain.

Therefore all pains of any duration allayed in a palliative and temporary manner by opium by means of its stupefying and pain-subduing power, return immediately when the stupefying primary action is exhausted, and that at least (Thus WILLIS in his Pharmacia rationalis, p. 298, says: “Opiatas generally allay, the most excruciating pains, and produce insensibility – for a certain time; but when this time is past the pains are immediately renewed, and soon attain their ordinary violence;” and p. 295: “When the duration of the action of opium is over, the abdominal pains return, having lost nothing of their excruciating character, until we again employ the magic power of opium.” )as severely as before, as the experience of all observant physicians testifies, These pains, indeed, generally return in a worse degree, and as long as no better plan than this old injurious routine is adopted, they must be again and again allayed, not only by repeated, but by larger doses of opium, whilst it developes other worse ailments, from which the patient did not suffer previously. Suppressing pain of any considerable duration and intensity by opium is therefore nothing but quackery - nothing but an imposition on the patient and his friends with illusory relief, to be followed by injurious results that are often disastrous, and not unfrequently fatal, but which are alleged by such practitioners of the non-healing art to be new diseases that they have had no hand on producing. (The true (homoeopathic) physician never sees in his practice any inflammation of the brain, except at the commencement of the most dangerous forms of typhus fever, which he cures along with its cerebral inflammation; nor does he ever encounter inflammation of the bowels, except in cases of poisoning and strangulated hernia or ileus; but fatal cerebral and intestinal inflammations frequently result from the efforts of the allopaths to suppress severe headache and intolerable colic by increasing doses of opium.)

Chronic diseases only are the test of the genuine healing art, because they do not of themselves pass into health; slight ailments that have come quickly pass away with or without medicine – evidently by the inherent powers of the organism; but with medicines acute diseases must distinctly yield more quickly and permanently than when left to themselves, if what can be called a cure is accomplished.

If opium sometimes seems to remove pains in a acute diseases, this is owing to the very obvious fact that such diseases, if they do not kill, run their course spontaneously in a few days, and disappear together with their pains.

Opium can only seem really to cure pains in those rare cases where it corresponds homoeopathically in its other primary effects to the symptoms of the disease, and so removes the disease itself, for then the pains also must naturally depart; but this is only an indirect cure of the pains. For instance, as every dysentery depends on a retention of faeces in the upper part of the intestines, some varieties of it accompanied by heat and stupefaction can be cured by opium, because these symptoms will be homoeopathically removed by the similar primary action of opium, and as a necessary consequence their attendant pains also, because these generally depend on spasmodic retention of the faeces in the bowels.

In like manner opium cannot stop the pains of lead colic until it has homoeopathically removed the obstinate constipation produced by the lead by virtue of its constipating primary action; in this case also the cure of the pains is indirect and not owing to the stupefying power of the opium, as it is given in small, not stupefying, doses. But opium is never able to remove pains directly without injury; on the other hand, it is a principal remedy in those stupefactive diseases where the pain of a serous malady in those stupefactive diseases where the pain of a serious malady is not felt by the patient, as for example, in dangerous bed sores, where the patient, in the stupefied state of his consciousness, cannot complain of any pain, &c.

The painful diseases of acute and chronic character can (whatever the whole worldful of anthipathic and allopathic physicians may allege to the contrary) only be cured and altered into health of a permanent character by a medicine which, besides corresponding in similarity in its other primary effects to the symptoms of the morbid state, is at the samtime able to excite pains very similar in kind to those observed in the disease. If such a medicine be selected then pain and disease disappear together in a marvellously rapid and permanent manner, when the smallest dose is administered, as is taught in the Organon of Medicine, and as experience will convince every one.

But as this method was not employed, and as all kinds of pains were anthipathically treated by opium alone, many injurious results were observed from its use; stupefaction, constipation, and other troublesome and dangerous symptoms which naturally resulted from this inappropriate anthipathic employment of it, and these are the peculiar effects of opium, without which it would not be opium. But these inevitable disastrous effects of such an employment of opium were not regarded as being what they actually are, to wit, the essential characteristics of opium, but as a kind of bad behavius inherent in it, which must be eliminated from it by all sorts of devices, in order to render it innocuous and well-behaved. Under this delusion attempts have been made from time to time, for now nearly two thousand years, to do away with this pretended improper action by means of so0called correigenta, so that it should henceforth be taught to allay pains and spasms without producing deliruim or constipation, check vomiting and diarrhoea without exciting heat, and without leaving behind it headache, trembling, exhaustion, chilliness and prostration.

Hence pungent spices were combined with it in order to prevent the chilling propensity observed in the secondary action, and purgatives and salines were added in order to counteract its constipating misconduct, &c. More especially was it sought to separate from it its crude, and alleged useless and hurtful resin by repeated solution in water, filtration and inspissation, and also to deprive it of the volatile, and supposed poisonous, narcotic quality attached to it by macerating it for months; and practitioners even went so far as to attempt to refine it and render it mild by roasting it over a fire, and in this way they imagined that they had produced a precious penacea for all ailments and troubles, for pains, sleeplessness, diarrhoea, &c., which was free from all the well-known evil propensities of opium.

But they were completely mistaken; by these processes they only made the opium weaker without altering its nature. Now much large doses were required in order obtain the same result, and when these larger doses were administered they always acted just like the original opium; the new preparation caused the same stupefaction, and the same constipation, and so forth, and hence it became evident that opium possesses no removable bad qualities, just as little as any other medicine, but that its peculiar medicinal powers must ever prove injurious and dangerous when it is employed anthipathically in large doses and when it is not understood ho to make a homoeopathic employment of it;- opium might be employed in its natural powerful state or, weakened by a number of expensive artificial processes, in the large doses required to produce its anthipathic effects.

Opium has this peculiarity more than many other medicines, that in the case of persons unaccustommed to its use and in very excitable subjects, and still more when given in large doses, it sometimes at first displays a transient, often momentary, reaction of a peculiar sort, which, partly on account of its short duration, partly owing to sort, which, partly on account of its short duration, partly owing to its rarity, and partly owing to its very nature, must not be confounded with its characteristic chief and primary action. These rare, momentary, preliminary reactions correspond almost exactly with the secondary action of the organism upon opium (and are, so to speak, a reflexion of this secondary action); deathy paleness, coldness of the limbs or of the whole body, cold perspiration, timorous anxiety, trembling and despair, mucous evacuations from the bowels, transient vomiting or short cough, and very rarely certain kinds of pain.

Hardly any of the peculiar primary effects of opium are observed from large poisonous doses, but this initiatory reaction passes at once, as secondary action, to death, as I myself have seen, and as WILLIS (Pharm. Rat., sect. Vii, cap. I, p, 292) relates.

The oriental indulgers in opium, after sleeping off their opium intoxication, are always in a state of secondary opium action; their mental faculties are much weakened by too frequent indulgence in the drug. Chilly, pale, bloated, trembling, spiritless, weak, stupid, and with a perceptible anxious inward malaise, they stagger in the morning into the tavern to take their allowence of opium pills in order to quicken the circulation of their blood and obtain warmth, to revive their depressed vital spirits, to reanimate their dulled phantasy with some ideas, and to infuse, in a palliative way, some activity into their paralysed muscles.

The symptoms of opium arranged below are mostly secondary action and counter-action of the organism. Physicians who cannot make up their mids to refrain from making a hurtful use of opium in large doses for palliative (anthipathic)purposes, may be encouraged to do so by a pesual of these horrible secondary effects; their feelings of humanity can hardly fail to be shocked by them, and their conscience roused so as to compel them to be better.

The antidotes to dangerous doses of opium are tincture of ipecacuanha, camphor, but especially strong warm infusion of coffee, introduced in large quantities above and below, accompanied by frictions on the body. But when icy coldness of the body, insensibility, and loss of irritability of the muscular fibres have already set in, a (palliative) warm bath must be resorted to.

When opium has been given in large doses in order to allay pains and check diarhoea, and, as not unfrequently occurs, true paralysis of the limbs has been produced, there is no cure for this kind of paralysis, just as paralysis can never be cured by strong electric shocks.

Some of the primary effects of opium last but a few seldom admit of a homoeopathic application in human diseases; but when it is so used a small portion of a drop of the decillion-fold potency suffices for a dose.

[HAHNEMANN”S fellow-observers were CUBITZ, GUTMANN. SCHONIKE, STAPF.]

The following old-school authorities are quoted:

Acta Nat. Cur., iv.

AEPLI, sen in Hufel. Journ., xxiv.

ALIBERT, in Wibmer. Wirkung der Arzneien u, Gifte.

ALPIN, med. Aegypi, iv.

ALSTON, Medical Essays.

BARD, SAM., Diss. de Viribas Opii, Edinb., 1765.

BAUER, in Act. Nat. Cur., ii.

BAUTZMANN, in Misc. Nat. Cur., dec, is, ann. 8.

BAYLIS, Prax. Med., Lib. i.

BELLONIUS, Observat.

BERGER, Diss. de vi Opii raifacient., Viteb., 1708.

BERGIUS, Mat. Med.

BOERHAAVE, Praelect iv. – De Morb. Nerv.

BOHN, de officio Med.

BONET, pulcert, Anatom., lib. i.

BORELLI, PET., Cent. 4.

BUCHNER, Diss. de opio, Halae, 1748.

BUTTNER, CH. G., Unterr. Uber d. Todtlichkeit d. Wunden.

CHARAS, MOSES, Pharm. Reg. Chym.

CHARDIN, Voyage eg perse, AMST., 1771, VOL. IV.

CHARVET CLARK, DE V OPIUM, 1826.

CLAUDER, GABR., in Misc. nat. Cur., dec. ii, ann. 5.

COCQ, in Stalpaart van der wiel’s Observat., Cent. ii.

CROIX, DE LA, Journ, de Med., xxxix.

CRUMPE, Natur und Eigensch, des Opiums.

ETTMULLER, Diss. de vi. Opii diaphor., Lips., 1694.

FRIEND, Opera. Tom. I, Emmanol.

GARCIAS AB HORTO, hist, Aromat., i.

GASTER, DE, Med, Dodgm.

GUIAND (no reference).

GEOFFROY, Mat. Med.

GRIMM, F. C., Acta Nat, Cur., iii.

HALLER, DE., de partib. Corp. irritab. Et sensib. – in Praelect. Boerh. Instit., iv.

HAMBERGER, Diss. de Opio, Jen., 1749.

HARGENS, in hufel. Journal, ix.

HECQUET, reflexions sur l’usage de Opium, a paris. 1726.

HELLWICH, CH. DE., Bresl. Samml, 1702.

HOFFMANN, ER., Diss. de operatione Opii, Hal., 1700, - med. rat. Syst., ii. – D. Correct. Opii, hal, 1702.

HUNTER., J., On the Venereal Disease.

JONES, The Mysteries of Opium revealed.

JOERDENS, in Hufel. Journ., xviii.

JUNCKER and BOHMER, Diss. sistens casum matrona largissimo usu opii tractatoe, Halae, 1744.

KA, Amoen, exot., fasc. iii.

KILIAN, in Med, Annal., 1800, Oct.

KNEBEL, in Hufel. Journ., xxvi.

LASSUS, in mem. de l’ Inst, national des sc. Et des Arts, tom. ii.

LEROUX, Journ. de Med.

LEVESQUE-BLASOURCE, in Journ. de medec., 1808, Juillet.

LINDESTOLPE, de Venenis.

LORRY, Journ. Encyclop., I, - recueil Period.

MANCHART, Eph. Nat. Cur., Cent. i.

MATTHAEI, C. C., in Hufel. Journ., xi.

MATTHIOLUS, in Tralles, l. c.

MEAD, de Venenis, in Opera, t. ii. Misc. Nat. Cur., dec. ii. ann. 10.

MONRO, Essays Phys. And Liter., vol. iii.

MULLER, in Hufel. Journ., xviii.

MURRAY, Apparat. Med., ii.

MUZELL, Wahrnehmungen, ii.

OUTREPONT, D, Deutsche Zeitsch. F. Geburtsheilk., i.

PITCAIRNE, Diss. de Circulatione in Animalibus genetis et non genetis, L. B.- Element. Med., lib. ii.

PLATER, Observ., lib. i.

PYL, Aufshtze, Samml. i.

RADEMACHER, in Hufel. Journ., iv.

REINEGGS. in Blumenbach’s med. Bibl., i.

RENOAEUS, Mat. Med., Lib. i.

ROLANDSON, MARTEN, in Vetensk. Acad. Handling., 1773, pt. ii.

RUDGERI, Ouwens Noctes Haganoe, Vorr.

RIEDLIN, Lin. Med., ann. Iv, Dec.

RUEF, DE, App. Ad. Nova Acta nat. Cur., Dec. ii, ann. 5.

SAAR, JON. JAC., Reise nach dem Orient.

SACHS VON LEWENHEIM, in Misc. nat. Cur., ann. 2.

SAUVAGES, Nosol. Method., i.

SCHELHAMMER, in Misc. nat. Cur., Dec. ii, ann. 5.

SCHWEIKERT, in Hufel. Journ., viii.

STALPAART VAN DER WIEL, Cent. ii.

STENZELIUS, de Venenis, i.

STUTZ, in Hufel. Journ., viii.

SWEITEN, VAN, Comment., i.

THOMPSON, AL., Diss. de Opio.

TRALLES, De Usu et abusu Opii, i.

THUESSINK, EV. JO. THOMMASSEN A, Diss. de opii usu in Syphilitide, L. B., 1785.

VERMANDOIS, no reference.

VICAT, Plantes Veneneuse de la Suisse. – Observationum Delectus.

WALDSCHMID, J. J., Monita medica circa opium, marburg, 1679.

WARD, in Neues Journ. d. ausland. Med. Literatur, iv.

WEDEL, Opiologia.

WEPFER, De Apoplexia.

WHYTT, New edinb. Essays.

WILLIS, Pharm. Rat.

YOUNG, treatise on opium, edinb., 1753.

In the Fragmenta de Vir; there are 274 symptoms, in the 1^st edit. 578, in the 2^nd edit. 638, and in this 3^rd edit. 662.]

OPIUM

Vertigo from stooping (aft. 20 h.).

Vertigo. [C. C. MATTHAEI, in Hufel. Journ., xi. 2. (Observations on patients.) – Young, treatise on oium. – Tralles, De Usu et abusu opii. – (Observations and statements.) - CLARK, Essays and Obs. Phys. And Lit., edit. 3, 1771. (Poisoning of a man by twenty grains (wrongly given as “Clarck”).) - Murray, Apparat. Med., ii, p. 282. (General statement.)

Vertigo and stupefaction of the head. [MATTHAEI, l. c.]

Great vertigo compels him to lie down. [MATTHAEI, l. c.]

5. Vertigo, as if all went round in a circle with him. [SCHELHAMMER, (From pills of styrax and opium.) in Misc. nat. Cur., Dec. ii, ann. 2, obs. 12.]

Giddy, anxious, insane. [TRALLES, l. c., p. 283.]

Vertigo and confusion of the head. [YOUNG, l. c.]

Giddy intoxication; he staggered hither and thither. [AL. THOMPSON, Diss de. Opio. P. 121. (Observations and statements). ]

Intoxication. [RADEMACHER, in Hufel. Journ., iv, 3, p. 587. (From tincture Thebaica given in Dysentery.) - BUCHNER, Diss. de Opio, Halae, 1784, § 45. (Not accessible.)

10. A kind of intoxication, that prevented for supporting herself on her legs. [LEROUX, Journ. de Med. (From nearly a drachm. In a woman of 51.)]

In larger doses than those that cause cheerfulness, opium excites intoxication. [TRALLES, l. c.]

Cloudiness of the head (immediately). [DE LA CROIX, Journ. de Med., xxxix. (From two grains taken by a woman in a clyster (p.313). Preceded by a feeling as if something mounted to her head.) ]

Dulness in the head, with a dry hot feeling in the eyes, and inclination of the eyes to shut, without sleepiness, with a sensation as if he had not slept the previous night. [Ctz.]

The head is heavy, and as if intoxicated (for 12 hours). [TRALLES, l. c., p. 101.]

15. Confusion of the head. [MATTHAEI, l. c.]

Confusion of the head, as if smoke had got into the brain. (From a mixture of Hoffmann’s anodyne and opium; momentarily occuring.) . [MATTHAEI, l. c.]

Stupor. [BERGIUS, (From a mixture of Hoffmann’s anodyne and opium; momentarily occuring.) Mat. Med., p. 482.]

Stupefaction of the intellect, as if he had a board in front of the head, and vertigo compelling him to lie down; then trembling of the body for some time. (As S. 16.) . [MATTHAEI, l. c.]

Violent stupefaction and intoxication (from the smell of a large quantity of opium). [LORRY, Journ. Encyclop., I, part ii, p. 72. (Observations and statement.) ]

20. Dull stupefaction, with dull eyes and excessive powerlessness. . [MATTHAEI, l. c.]

Stupefaction and insensibility, and yet he answers rationally. [VICAT, Plantes Veneuses de la Suisse, p. 226. (From overdose of laudanum mixed with amber and nitre. (All the symptoms referred to Vicat belong to this case.) (Comp. with 40.)

Sensation in the head as if he had slept off a severe wine debauch and awake. [TRALLES, l. c., p. 101.]

Obtuseness of the intellect, short anxious respiration, in which the chest is raised high; the eyes look dead and are full of water. . [MATTHAEI, l. c.]

Copious flow of ideas with gaiety.

25. It makes his mind livelier and more disposed to serious, important work. [WEDEL, Opiologia, p. 165. (Not accessible.) ]

More disposed to elevated contemplations all night, without sleep. [Misc. Nat. Cur., Dec. ii, ann. X, obs. 80. (Statement (wrongly given Eph. Nat. Cur.)]

All inclination to sleep disappeared (after taking opium the previous evening), the imaginative faculty and the memory became exalted to a wonderful degree, so that he was compelled, as it were, to pass the night in the most profound meditations; at day dawn he slumbered for some hours, but then could no longer recall all that he had been thinking of at night. (The symptoms of the mind and disposition caused by opium cannot be so easily separated as those caused by other medicines, so that we can place the former at the commencement among the head symptoms, and the latter at the end of all the other symptoms, because in opium both generally occur together. When opium is used for palliatively suppressing pains, spasms, and the opposite mental and moral states (as in Ss. 619, 25, 612, 613, 611, 605, 614 0, or even for dispelling natural night-sleep (in this latter case in some degree homoeopathically), it produces in their stead usually such mental ecstasises and transports often closely resemble the inner lucid waking of the somnambulists (clairvoyance). )[RUDGERI, Ouwens Noctes Haganoe Vorr., p. 14. (From laudonum taken for spasms of legs.) ]

Slow recollection, stupidity, senselessness. [WILLIS, Pharm. Rat., p. 305.]

Keeping silence. [BERGIUS, l. c.]

30. Weakness of mind. [F. C. GRIMM, Acta. Nat. Cur., iii, obs. 19. (Experiments on self with gr. J – iij.) [F. C. GRIMM, Acta. Nat. Cur., iii, obs. 19. (Experiments on self with gr. J. iij.) ]

The mental faculties depart. [BERGUIS, l. c.]

Obtuse senses. [SAUVAGES, Nosol. Method. I, p. 847. (From Diss of laudanum drunk by a boy of 15.) ]

Obtuseness of the mind. [BOHN, De officio med., p. 362. (Symptoms not found.) ]

All the faculties of the mind, all the senses, are blunted. [CHARDIN, Voyage en Perse, Amst., 1771, tom. iv, pp. 203, 204. (Statements as to opium-eaters.) ]

35. Indifference to pain and to pleasure. [REINEGGS, (Account of the effects of opium-eating) in Blumenbach’s Med. Bibl. I, l]

Stupefaction, indifference. [EV. JO. THOMPASSEN A THEUSSINK, Diss. de Opii usu in Syphilitide, L. B. 1785, 8. (Not accessible).]

Confusion of the head; he has no true conception of anything, and cannot understand the sense of what he reads. [SCHELHAMMER, l. c.]

Obtuseness of the senses (aft. 8, 12 h.).

He does not know his nearest relatives, nor the most familiar objects.

40. Obtuseness of senses, insensible, almost unconsciousness of his existence, and yet his answers are tolerably appropriate. [SCHELHAMMER, l. c.](comp. with 21).

Is not in his right consciousness. [REINEGGS, l. c.]

Stupefaction of the senses and loss of reason. [FR. HOFFMANN, Diss. de operatione Opii, Hal., 1700, p. 5. (General statement.)

35. Indifference to pain and to pleasure. [REINE, in Blumen. [TRALLES, l. c.]

She knew not what was going on around her and gave no sign of feeling; the limbs were flexible and all muscles were relaxed. [LASSUS, in Mem. de l’Inst National des sc. Et arts tom. ii. (From twenty-six grains taken by a woman of 60.) ]

45. Obscuration and weakness of the understanding; self-deception, as if his eyes were four times larger and his body (Observer says nothing about his body.) of gigantic size. [SCHELHAMMER, l. c.]

He feels as if he flew or floated in the air, and as if all turned round to him. [SCHELHAMMER, l. c.]

He is no destitute of sight and hearing, but of the senses of taste, smell, and touch in regard to external objects; and yet he feels the coldness of his own body (The last clause in the original is – “He felt his cheeks cold when he touched them.”) (aft. 1.1/2 h.). [SCHELHAMMER, l. c.]

Stupidity. [REINEGGS, l. c.]

Stupidity, indifference to external objects. [CRUMPE, Natur und Eigensch. des Op. (General statement(p. 38.) ]

50. Stupidity and imbecility. [HALLER, in Proelect. In Boerh. Instit., iv, p. 519. (General statement.) ]

Opium eaters are drowsy and almost stupid. [ALPIN, (General statements as to Egypten opium – eaters.) Med. Aegypt. Iv, cap. i.]

Opium eaters are always lazy and intoxicated. [ALPIN, l. c.]

Want of memory. [REINEGGS, l. c.]

Loss of memory. [BERGIUS, l. c.]

55. Often weakness of memory (from the frequent use of opium). [WILLIS, (Observations and statements.) l. c.]

Loss of memory for several weeks. [WILLIS, l. c.]

Long continued loss of memory. [COCQ, (Symptoms not found.) in STALPAART VAN DER WIEL, Observ., cent. ii, obs. 41.]

Lost memory. [BONET, Sepilcret. Anatom., lib. I, sect. L, p. 214. (General statement.)(Note to 48, 49. 50, 51, 52, 53, 45, 55, 56, 57, 58. – If all these states are long continued they become permanent after a prolonged repetition of indulgence in opium; they then amount to the chronic disease, to a kind of paralysis of the mental organs, which may well be incurable (53 to 58 secondary action). ]

Fluctating conceptions. [SCHELHAMMER, l. c.]

60. Insensibility to modesty and the finer feelings. [REINEGGS, l. c.]

The power of the will was lost at the merest trifle. [DE RUEF, (General statement.) App. Ad Nova Acta Nat. Cur., v., p. 63.]

Opium eaters have a reputation for fickleness; they often promise what they hesitate to perform (every one guards himself from them, no one will have anything to do with them). [ALPIN, l. c., cap. 2.]

Rush of blood to the brain. [HALLER, l. c., iv, p. 509.]

(The cerebral vessels were distented with blood.) [MEAD, (General statement. This is merely an hypothesis thrown out by the author.) De Venenis, in Opera, t. ii, p. 190, edit. Gotting.]

65. Pulsation of the arteries of the head. [CHARVET, (Experiments with various doses (act. de l’ Opium, Paris, 1826). L. c.]

He hears the arteries bringing the blood to the brain. [CHSRVET, l. c.]

Very painful headache, involving the occiput. [D’ OUTERPONT. (From a large dose taken by a woman eight months gone in pregnancy (Deutsche Zeitschrift f. Geburtskunde, i, I, 99). ]

One sided headache in the forehead as if it pressed out, diminished by external pressure.

Headache like outward pressure in the forehead.

70. Tearing and pecking in the forehead, sour vomiting, she must lie down and then she perspired.

Single twitches in the temporal muscles.

A kind of pressure in the forehead that seemed to extend to the eyes and nose. [CHARVET, l. c.]

A sensation of tension in the head. [CHARVET, l. c.]

Headache. [MATTHAEI, l. c., viii, 4.]

75. Violent headache. [MUZELL, (From a mixture of opium and spiritus cornu cervi.) Wahrnehmungen, ii, p. 131.]

Aching pain in the head. [MATTEHAEI, l. c., viii, 4; and xi, 2.]

Pain as if all were lacerated in the head and sensation as if all turned round in the body, with cross discomfort. [Ctz.]

Heaviness of the head. [MURRAY, l. c. – BERGIUS, l. c., p. 482. – Gn.]

For several days very heavy head, the occiput like lead, so that the head always fell back and he could not hold it up. [TRALLES, l. c., p. 87.]

80. He cannot hold the head up; it sways to and fro. [TRALLES, l. c., I, p. 283.]

Sunken, pale face. [PYL, Aufsatze, samml. I, p. 95. (From a large dose of the extract in a man of 50-60) ]

Pale face. [Sche.]

Frequent alternation of redness and paleness of the face.

Paleness of the face and nausea, with sensation of drowsiness and diminution of all secretion and excretions, often even of the perspiration. [A. THEUSSINK, l. c.]

85. Pale face and forehead, glassy eyes. (Observer adds : fixed” before “glassy” )[SAUVAGES, l. c.]

Earthy complexion. [REINEGGS, l. c.]

Earthy pale complexion, dull eyes full of water; he slumbers with half open eyes, observes nothing, gives irrelevant answers, passes his faeces involuntarily, sinks down in a heap, and has short anxious respiration. [MATTHAEI, l. c.]

Bluish and earthy complexion. [GRIMM, l. c.]

Appearance of the face as if he had not slept enough, or had been dissipating during the night, with sunken, blinking eyes. [Ctz.]

90. All the facial muscles appear to be relaxed, whereby the countenance has a stupid expression; the lower lip has a tendency to hang down loosely, the nostrils are wide open, and the upper eyelid can with difficulty be raised. [Sche.]

Red spots on the pale cheeks. [MATHAEI, l. c.]

Bloated face. (“Somewhat swollen” would better represent the original.) [THOMPSON, l. c., p. 120. – Young, l. c.]

Bloated face, hot, dry skin, white tongue. Hoarseness, very oppressed breathing, haemoptysis. (From opium taken for an incipent cold when in a plethoric state (S. 144, 305, 316, 332, 578, all belong to this observation). [YOUNG, l. c.]

Dark red face. (Not found.) [VICAT, l. c.]

95. Quite red face. [MATTHAEI, l. c.]

Red, bloated, swollen face. [MURRAY, l. c. – MULLER, in Hufel. Journ., xviii, iv. (From a mixture of tinct. Thebaieca and Hoffmann’s anodyne given for a nervous affection(p. 55).]

Cherry-brown face. [SCHWEIKERT, in Hufel. Journ., viii, 3. (Not found.) ]

Distented blood-vessels in the face. [REINEGGS, l. c.]

Red, bloated face and distented blood-vessels on the head. [HOFFMANN, l. c.]

100. Red face and red eyes. [BERGER, l. c.]

Red face and red inflamed eyes. [J. HUNTER, Ueber de vener. Krankh., p. 640. (Observations on patients.) ]

Uncommon redness of face with swollen lips. [HAMBERGER, Diss. de Opio, jen., 1749, § 16.(A general statement cited from Geoffroy.) ]

Face not merely red, but as if inflamed. [HECOUET, (Not accessible.) Reflexious sur l’usage de l’Opium, Paris, 1726, p. 184.]

Face quite red, with wild, projecting, red eyes. [STENTZEL, De Venenis, I, § 46. (Not accessible). ]

105. Distorted features, silence, open eyes. [AEPLI, sen., in Hufel. Journ., xxv, 3, (From mixture of opium and rhuburb given to a baby for colic.) ]

Spasms of the facial muscles. [KNEBEL, in Hufel. Journ., xxvi, 2. (Observation on a child with whooping-cough (p. 148.))]

Spasmodic movements of the facial muscles (aft. 7 d.). [LEVESQUE-BLASOURCE, in Journ. de Medec., 1808, July. From large doses in a man (vol. xvi, part I, pp. 21-24). ]

Convulsive trembling of the facial muscles, lips, tongue.[AEPLI, l. c.]

Bright, sparkling eyes. [MATTHAEI, l. c.]

110. Staring eyes of excessive brightness. [MULLER, l. c.]

Glassy, projecting, immovable eyes that see nothing, like those of a dying person. [VICAT, Observationum Delectus, p. 242.]

Immobility of the pupils to light. [MURRAY, l. c.]

Dilated pupils (the first h.).

Pupils easily dilated.

115. Contracted pupils dilated, their contractility gone. [KILLIAN, in Med. Annal., 1800, Oct. (Not accessible.)]

Open eyes with pupils turned upwards. [PYL, l. c.]

Sensation in the eyes as if they were too large for the orbits. [CHARVET, l. c.]

He stares at those about him, with watery eyes, but he knows not what is going on, and cannot recognise people. [REINEGGS, l. c.]

120. Sparks before the eyes. (The original is – “he thought flashes of fire came from his eyes.”) [CLARCK, l. c.]

Dimness of vision, it is as if he saw through a veil. [MULLER, l. c.]

Blackness before his eyes and he is gidd. [MATTHAEI, l. c.]

He is perfectly sensible, but complains that his eyes become dark and he is blind (Just before death.) (aft. 4 h.). [WILLIS, l. c.]

Swelling of the lower eyelids. [GRIMM, l. c.]

125. The eyelids hang down as if paralysed. [D’OUTREPONT, l. c.]

Trembling eyelids, which only half cover the globes. [GUIAND. (Not accessible.) ]

Dull roaring in the ears, after eating (aft. 4 h.). [CHARVET, l. c.]

Humming in the ears (very soon). [CHARVET, l. c.]

Ringing in the ears. [YOUNG, l. c. – MURRAY, l. c.]

130. The lower lip is painful when he touches it with the upper teeth or with the fingers. [Sche.]

Distortion of the mouth. (With delirium.) [LORRY, l. c.]

Trismus. [DE LA CROIX,-PYL, l. c.]

Violent pains of the lower jaw (These are described as “rapid and momentary.”) (aft. 7 d.). [LEVESQUE – BALSOURCE, l. c.]

Her mouth could only be opened by force, and she could with difficulty swallow some spoonfuls of fluid. [DE LA CROIX, l. c.]

135. Pain of the upper jaw (aft. 8 h.).

Toothache.

Looseness of the teeth.

Fine eroding pain in the nerves of the tooth (aft. 8 h.).

The lower jaw hangs down. [KILIAN, l. c.]

140. Paralysis of the tongue. [REINEGGS, l. c.]

The voice is weak when he speaks; he can only speak loud with an effort. [Ctz.]

He cannot speak with open mouth. [REINEGGS, l. c.]

He stammers. [REINEGGS, l. c.]

White tongue. [YOUNG, GRIMM, l. c.]

145. Black tongue. [LEVES UE- BLASOURCE, l. c.]

Flow of saliva. [HARGENS, in Hufel. Journ., ix, 2. (Observation on a patient , phthisical old woman, who had this symptom whenever she took opium to check a colliquative diarrhoea. Not found under Reineggs.) - REINEGGS, l. c.]

Profuse flow of saliva. [ALSTON, Edinb. Vers., v, l. (Just before death.)]

Flow of saliva as from mercury. [A THUESSINK, l. c.]

Saliva flowed constantly from the mouth. [KLIAN, l. c.]

150. Suppresses the secretion of the salivary glands, the nasal mucus, and that of the glands of the larynx. [MURRAY, l. c.]

Inspissates the salvia, the nasal mucus, the mucus of the windpipe, and makes the tongue dry. [YOUNG, l. c.]

Dryness of the tongue, palate and fauces, without desire to drink. [Ctz.]

Feeling of dryness of the anterior part of the tongue, without thirst, in the morning.

With dryness of the mouth, without desire for drink, chill over the abdomen.

155. Dryness of the whole mouth, with little thirst. [Sche.]

Dryness at the back of the throat. [BERGIUS, l. c.]

Dryness in the throat and on the tongue. [ETMULLER. Diss. de vi Opii diaphor., Lips., 1694, cap. I, § 5. (General statement.) - MURRAY, l. c.]

Dryness of the mouth, so that he can hardly utter a word. [SCHELHAMMER, l. c.]

Great thirst, especially for small beer. [MATHAEI, l. c.]

160. Urgent thirst. [ETTMULLER,-MURRAY, l. c.]

Produces small ulcers in the mouth and on the tongue. [MATTHUILUS, in Tralles, i. c., § iv, p. 190. (From lasting opium. [Rather, from retaining it some time in the mouth. The same holds good of S. 162.]) ]

Causes ulcers on the palate and tongue. [WEDEL, l. c., p. 26.]

When chewed it burns the mouth and tongue, and inflames the fauces. [LINDESTOLPE, De Venenis, p. 591. (General statement.) ]

Causes intolerable biting burning like pepper on the tongue. [BOERHAAVE, Praelect., iv, p. 529. (Taken into the mouth in some quantity.) ]

165. On the neck distented veins, and violently beating arteries. (No distention is made in the original between veins and arteries.) [MATTHAEI, l. c.]

Difficulty of swallowing. [LASSUS, l. c.]

Impossibility of swallowing. [AEPLI, l. c.]

Bitterness of the mouth. [GRIMM, l. c.]

Insipid, flat, almost no taste.

170. Sout taste.

Bitter taste in the mouth, the next morning. [CHARVET, l. c.]

Anorexia.

(In large doses) it takes away the appetite immediately. [WILLIS, l. c.]

Loss of appetite. [JOERDENS, in Hufel. Journ., xvii, 1. (Observation on self, when taking laudanum to secure sleep.) – REINEGGS,- BERGIUS, l. c.]

175. Want of appetite for food and drink. [MURRAY, l. c.]

He loathes everything. [REINEGGS, l. c.]

For a long time distate for all food. [TRALLES, § I, p. 142.]

Extreme loathing of food with great weakness. [MATTHAEI, l. c.]

Extreme loathing of animal food, with dirty tongue. [MATTHAEI, l. c.]

180. He wishes to eat, but has scarcely taken a morsel when he desires no more. [REINEGGS, l. c.]

Increased appetite.

Ravenous hunger in frequent fits, sometimes with insipid taste in the mouth (aft.3 and more h.).

Ravenous hunger. [KAMFER, (Observation on self in health.) Amoen, exot., fasc. iii, obs. 15.]

Ravenous hunger, with distension and oppression of the stomach after eating. [MANCHART, (From a grain of crude opium taken by self. Said by reporter to be a common occurrence with him. (Wrongly printed “Mouchard.”)Eph Nat. Cur., cent. I, obs. 15.]

185. Excessive hunger with great exhaustion. [WARD, in Neues Journ. d. Ausland. Med. Literatur, iv, 1. (From external application.) ]

Ravenous hunger with loathing of food. [GRIMM, l. c.]

Nausea. [GRIMM. MATTHAEI, l. c., viii, 4.]

Inclination to vomit. [MATTHAEI, l. c., xi, 2.]

Frequent loathing and vomiting. [J. J. WALDSCHMID, Monita Medica Circa opium, Marburg. 1679. (Not accessible).]

190. Violent, ineffectual efforts to vomit. [CHARVET, l. c.]

Ineffectual efforts to vomit. [CHARVET, l. c.]

Vomiting (after a few minutes).

Inclination to vomit on moving. [CHARVET, l. c.]

Vomiting after eating. [CHARVET, l. c.]

195. Efforts to vomit, haematemesis. [HECQUET, l. c., p. 314.]

Excites vomiting. [WEDEL, l. c.]

Along with stomachache and convulsive movements she vomits. [JUNCKER and BOEHMER, Diss. sistens casum Matronoe largissimo usu Opii tractoe, Halae, 1744, p. 7. (Not accessible).]

Constant vomiting. [PYL, l. c., p. 94.]

Vomiting of green matter. [DE LA CROIX, l. c.]

200. Insensibility of the stomach to emetics. [MURRAY, l. c.]

Eructation (aft. 5 h.). [GRIMM, l. c.]

Full in the stomach. [JOERDENS, l. c.]

Stomachache. [BOHN, l. c.]

Hiccough continued, with short interruptions. [SCHWEIKERT, in Hufel. Journ., viii, 3.]

205. Great aching in the stomach (immediately). [WILLIS, l. c.]

Pressure in the stomach, as if a stone lay there (aft. 2 h.).

Immediately after a meal violent pressure in the gastric region relieved by walking. [Ctz.]

Painful (i.e. to touch.) distension of the stomach. [D’ OUTREPONT, l. c.]

210. After dinner, extremely annoying pressure over the stomach, as if he had eaten too much or too hard food, which was relieved by movement in the open air. [Sche.]

Violent pains in the stomach. [LEVESQUE – BLASOURCE, l. c.]

Quickly, stomachache and compression of the diaphragm. [FR. HOFFMANN, Diss. de corrections Opii., hal., 1702, § 16. (Not accessible .) ]

Constrictive pain in the stomach, which is intolerable and causes deathly anxiety. [YOUNG, l. c. (From opium taken immediately after dinner. [Young’s statement is that the man took his dose ‘after a plentiful supper and load of liquor.”) ]

Weakens the stomach. [HALLER, l. c., p. 519.]

215. Makes the digestion slower and diminishes the appetite. [GEOFFROY, Mat. Med., ii. (General statement.) ]

Slow digestion. [WILLIS, l. c. cap. 2.]

Deranges the digestion, excites a feeling of weight and compression in the stomach, and an indescribable uneasiness in the scrobiculus cordis. [ETTMULLER, l. c.]

Painful distension of the scrobiculus cordis. [TRALLES, l. c., p. 142.]

The abdomen is distented especially in the umbilical region. [De LA CROIX, l. c.]

220. Feeling of distension of the abdomen and particularly of the stomach.

In the stomach and bowels accumulation of flatulence. [MURRAY, l. c.]

Distented abdomen. [DE LA CROIX,- TRALLES, l. c.]

Abdomen tense and painful. [J. HUNTER, l. c.]

Bellyache, as from a purgative (aft. ½ h.).

225. Bellyache, as from a chill.

Bellyache of simple pain, as if bruised (aft. 2 h.).

Aching and pressing distension of the abdomen as if it would burst; it was relieved by bodily exertion, on sitting down the aching returned (aft. 2 h.). [Gn.]

Constant development of flatulence. [TRALLES, l. c., pp. 142, 148,- REINEGGS, l. c.]

Frequent discharge of flatus (aft. 24 h.). [Gn.]

230. Sensation ofa weight in the abdomen, in the umbilical region, with anxiety, sensation of transient, internal heat, and stupefaction of the head (aft. 1 h.).

Throbbing in the abdomen.

Aching and tensive pain in the abdomen (aft. 24 h.).

Stitches in the left side of the abdomen, also when not breathing (aft. 3 h.).

Bellyache before and after evacuation of the bowels.

235. Pressure and heaviness in the abdomen as from a stone. [CH G. BUTTNER, Unterr, uber d. Todtlichk. D. Wunden, p. 224. (Observation (p. 204). ]

Drawing pain in the abdomen. [MATTHAEI, l. c.]

Pain in the abdomen, as if the bowels were cut to pieces. [JUNCKER and BOHMER, l. c., p. 8.]

Inactivity of the bowels and retained stool. (In the original – “dulness or difficulty of evacuation.”) [WILLIS, l. c.]

Paralysis of the bowels. (Rather – “the intestines seemed paralysed.”) [PYL, l. c., p. 94.]

240. Almost always binds the bowels. [TRALLES, l. c., p. 145.]

Rare evacuations. [MURRAY, l. c.]

Constant retention of the stool and costiveness. [TRALLES, l. c., p. 144.]

Retention of the intestinal evacuations.

Faeces and urine interrupted. [KILIAN, l. c.]

245. Constipation for ten days (ending in death). [PYL, l. c.]

Hard stool only passed with an effort, for six days. [Ctz.]

Costiveness for six or eight weeks, with anorexia; the excrements only come away with clysters, and in the form of small hard balls. [JUNCKER and BOHMER, l. c., p. 8.]

250. Costiveness for several months. [TRALLES, l. c., p. 145.]

Stool in small hard lumps, with labour-like pains, as in parturition. [TRALLES, l. c., p. 146.]

Almost incurable, chronic costiveness. [WALDSCHMID, l. c., p. 17.]

Opium sometimes causes diarrhoea (in its secondary action). [HAMBERGER, l. c., § 15.]

Evacuation of the bowels, pappy stool (Immediately or within ½ h.).

255. Very foetid stool (aft. 20 h.).

Increased faecal evacuation. [BAURR, (Observation). In (Acta Nat. Cur., ii, obs. 93.)

Watery diarrhoea. [BAUTZMANN, (Observation (Obs.44.) in Misc. Nat. Cur.,Dec. ii, ann. 8. (When ever she uses opium for her toothache.)

Evacuation of a black matter by stool (aft. 24 h.). [LEVESQUE – BLASOURCE, l. c.]

Fluid frothy stools, with itching burning in the anus and violent tenesmus. [GRIMM, l. c.]

260. Very foetid diarrhoea. [GRIMM, l. c.]

Violent painful movements of the foetid, often remitting for hours, but recurring in still greater intensity. [D’OUTERPONT, l. c.]

The uterus as soft. (In the original – “The utherus was so soft that the movements of the child”- see previous symptom – “could be felt externally.” This was coincident with a general paralysed state.)

Horrible labour-like pains in the uterus, which compelled her to bend the abdomen double, with anxious, almost ineffectual urging to stool (aft. ¼ h.).

Horrible pressing-asunder pain in the rectum (between 4 and 6 h.).

265. Lemon-coloured urine, with much sediment. [GRIMM, l. c.]

Dark coloured urine. [RIEDLIN, Lin. Med., ann. Iv, þDecemb., obs. 16. (Observation.)]

Dark urine and dry tongue (in himself). [YOUNG, l. c.]

Very dark red urine, which deposits a sediment. [MATTHAEI, l. c.]

Haematuria. [HECQUET, l. c.]

270. Very scanty, very red urine, without cloudiness. [MATTHAEI, l. c.]

The urine has a brick-coloured sediment. [CHARVET, l. c.]

Sensation when straining to pass urine as if the passage to the urethra were closed.

Involuntary interruption of the stream when urinating. [CHARVET, l. c.]

He can only pass the urine after long straining. [CHARVET, l. c.]

275. He passes little urine of very dark red colour, with cutting pains while urinating. [MATTHAEI, l. c.]

Suppresses the evacuation of urine.[MURRAY, l. c.]

Urine suppressed. [KILIAN, l. c.]

Retention of urine. [MATTHAEI, l. c. – HUNTER, l. c., p. 641.]

Opium suppresses the secretion of urine. [PITCRAINE, Diss. de Circulatione in Animalibus genitis et non genitis, L. B., § 13. (Observations.) ]

280. Retention of urine, with quite dry mouth and increased thirst. [MATTHAEI, l. c.]

Keeps back the evacuation of urine. [ETTMULLER, l. c., §§ 3. 4.]

Weakens the contractile power of the bladder. [DE HALLER, De Partib. Corp. irritab. Et sensib., sect. 2. (Not found.) ]

Opium sometimes suppresses sometimes promotes the urine. [GEOFFROY, l. c.]

Excites the urinary secretion. [WILLIS, l. c. – BERGER, l. c., § 2.]

285. Stiffness of the penis during sleep, and after waking complete impotence. [SRALPAART VAN DER WIEL, cent. ii, obs. 41. (From 3ss of solid opium.) ]

Excessive stiffness of the penis. [MOSES CHARAS, Pharm., Reg., cap. 51. (Symptoms not found.) ]

Exalted sexual desire, with erections, pollutions, and lascivious dreams. [MURRAY, l. c.]

Exaltation of the sexual desire, with erections, pollutions, and lascivious dreams. [MURRAY, l. c.]

Exaltation of the sexual desire, erections of the penis, nocturnal emissions of semen. [GEOFFROY, l. c.]

Lascivious dreams and nocturnal emissions of semen. [WEDEL, l. c., ii, 3.]

200. It excites the sexual desire. [WEDEL, l. c.]

Amorous ecstasy, erection of the penis for twenty-four hours, lascivious dreams, nocturnal seminal emmisions. [TRALLES, l. c., I, p. 131.]

Nocturnal seminal emission (the 1^st n.).

At night amorous pictures of fancy, pollutions. [CH. DE HELLWICH, bresl. Sammlungen, 1702. (Not accessible).

Uncontrollable lechery. [JOH. JAC. SAAR, Reise nach dem Orient. (Statement as to use of opium by Chinese.) ]

295. In some excitation, in others diminution of the sexual desire. [SACHS VON LEWENHEIM, in Misc. Nat. Cur., ann. 2, obs. 69. (General statement.) ]

Sluggishness of the sexual desire. [RENODAEUS, Mat. Med., lib. 1, sect. 13, cap. 2.(Statement.) ]

Is considered as emasculating and weakening the sexual desire. [WEDEL, l. c.]

Excitation of the sexual passion.

Impotence. [CHARVET, l. c.]

300. Impotence of the lame. [REINEGGS, l. c. – GARCIAS AB HORTO, hist. Aromat., cap. 4. (Observation.) ]

Cooling of the sexual desire. [REINEGGS, l. c.]

Increased menstrual flux (aft. 2 h.).

Opium left the menses regular, even in a case where the patient had swallowed for thirty years a drachm and more daily, on account of very painful and spasmodic attacks. [JUNCKER and BOHMER, l. c.]

In the warm room, after walking in the open air, stoppage of the nose like a stuffed cold. [Gn.]

305. Hoarseness. [YOUNG, l. c.]

Hoarseness, with very dry mouth and white tongue. [GRIMM, l. c.]

Extreme hoarseness. [YOUNG, l. c.]

Hoarseness, as from mucus in the windpipe.

She coughed while swallowing fluid. [DE lA CROIN, l. c.]

310. The cough becomes worse after eating.

Hollow, very dry cough (immediately after taking it); it goes off again quickly.

Attack of violent, dry cough; thereafter yawning and sudden loud cry (aft. 36 h.).

He becomes suddenly blue in the face and wants to cough, but the breathing stops (suffocative spasm); thereafter deep sleep with cold sweat of the body (aft. 30 h.).

Cough when swallowing. [DE LA CROIX, l. c.]

315. He coughs up frothy mucus. [MATTHAEI, l. c.]

Haemoptysis. [YOUNG, l. c.]

Expectoration of thick. Bloody mucus. [MATTHAEI, l. c.]

Keeps back bloody expectoration and stool. [THOMPSON, l. c.]

Quick breathing. [BUCHNER, l. c., § 45.]

320. Quick, oppressed, anxious breathing. [GRIMM, l. c.]

More rapid, difficult breathing. [MURRAY, l. c.]

Breathing always shorter and shorter. [SAUVAGES, l. c.]

Slow breathing.

Difficult, tight breath, especially at night.

325. Sometimes single deep respirations, sometimes cessation of breathing for a minute at a time.

The respirations are long and sighing. [CHARVET, l. c.]

Short, stertorous (Instead of :schnarchendes,” snoring, Pyl says “rochelndes,” rattling.) respiration, which from time to time ceases for half a minute. [PYL, l. c., p. 95.]

Difficult respiration. [TRALLES, l. c.]

Attacks of anxiety of short and duration, with short, tight respiration, and trembling of arms and hands. [Ctz.]

330. Difficult breathing and anxiety. (“Anxiety” not found in original.) [HAMBERGER, l. c., §§ 10 and 49.]

Anxiety with contraction and tightness of the chest. [MATTHAEI, l. c.]

Constriction of the chest, as if it were stiff; difficult respiration. [YOUNG, l. c.]

Tigof the chest as if pleurisy were about to occur, and tension in the shoulder-blade. [GABR. CLAUDER, in Eph. Nat. Cur., dec. ii, ann. 5, obs. 178. (Experiment with an extract prepared with sulphuric acid.)]

Spasmodic tightness of the chest. (In the original,”asthma.”) [YOUNG, l. c.]

335. Tightened and difficult respiration and praecordial anxiety. [FR. HOFFMANN, Med. Rat. Syst., ii, p. 270. (General statement (p.273). “Praecordial anxiety” not found.) ]

Obstructed respiration, tightness of the chest. [STUTZ, in Hufel. Journ., viii, 3. (From opium given in a convulsive attack (X. 4, 35-7).) ]

Difficult obstructed respiration. [VICAT, Pl. Venen., l. c.]

Deep stertorous breathing. [SAUVAGES, l. c.]

Difficult deep breathing. [DE LA CROIX, l. c.]

340. Panting, loud breathing. (Not found.) [WILLIS, Pharm, rat., p. 305.]

Loud, difficult breathing. [LASSUS, l. c.]

He fetches his breath with the greatest effort and anxiety, with open mouth. [GRIMM. l. c.]

The respiration was sometimes stertorous and loud, sometimes difficult and very weak. [LEROUX, l. c.]

Loud, laboured, rattling respiration. [DE LA CROIX, l. c.]

345. Slow, difficult, stertorous breathing. [CRUMPE, l. c.]

Groaning, slow breathing (aft. 4 h.). [MUZELL, l. c.]

Groaning, (Rather, “sobbing.” ) interrupted respiration. [AEPLI, l. c.]

The inspiration is interrupted. [ALIBERT, l. c. (Not accessible.)]

Respiration imperceptible, sometimes with a noise. [VERMENDOIS. (Not accessible.) ]

350. Irregular breathing threatening suffocation. [GRIMM, l. c.]

Oppressed and not merely difficult, but also irregular breathing. [WILLIS, l. c.]

Breathing ceasing for some minutes, (Rather, “for a minute at a time.”) then returning with a deep sigh. [SAUVAGES, l. c.]

Cessation of respiration; he was for five minutes as if dead, then short, sudden snatches of breath, as if hiccup would come on . [SCHWEIKERT, l. c.]

The respiration ceases for a longer and longer time until death. [SAUVAGES, l. c.]

355. Excessive aching pain in the right side of the chest, also when not breathing, with stitches in the same side while inspiring (aft. 1 h.).

Drawing tearing pain in the side of the chest.

Contractive (squeezing) pain in the sternum and back, felt when moving.

He feels heat in the chest (on himself). [BELLONIUS, libr. 3, Observ., cap. 15. (from opium eating(p. 431).]

In the heart, burning as from live coals, so that he thinks he must die. [JUNCKER and BOHMER, l. c., p. 7.]

360. Pain in the hypochondria, especially the right. [GRIMM, l. c.]

Tension of the region below the ribs, which is very painful when touched (aft. 4 h.). [GRIMM, l. c.]

Tensive pain under the short ribs along where the diaphragm is attached, whilst breathing.

Single twitches in the arms. [RADMACHER, l. c.]

Single twitches in the arms.

In one or other arm a convulsive moving to and fro.

Trembling of the left arm in fits (aft. 3 h.).

Formication as if asleep in the fingers, increased by grasping anything.

Itching in the arms and on the shoulder. [MATHHAEI, l. c.]

Trembling of the hands. [A. THEUSSINK, l. c.]

270. The (left) arm is paralyzed (aft. 48 h.). [LEVESQUE-BLASOURCE, l. c.]

Disagreeable formication in the hands and feet, which changed into a frightful, intolerable rolling. [MULLER, l. c.]

Almost no feeling in the legs. [YOUNG, l. c.]

Severe itching in the legs, in the evening. [MATTHAEI, l. c.]

Weakness if the legs. [GRIMM, l. c.]

375. Sensation sometimes as if flashes of fire, sometimes as if ice-cold water flowed through the blood-vessels. [JUNCKER and BOHMER, l. c.]

Drawing tearing pain in the back.

He kicks his feet up and down as in convulsion, with sudden loud cry.

Numbness in the foot.

The foot is so stiff and sensitive that he cannot tread on it nor walk.

380. Swelling of the foot.

Heaviness of the feet after eating )aft. 2 h.).

Frightful pains, that penetrate through the marrow of his bones. (In confirmed opium-eaters.) [CHARDIN, l. c.]

Emaciation of the body. [BERGIUS, l. c.]

Dropsical state of the body. [REINEGGS, l. c.]

385. Intolerance of the open air and feeling as I he would catch cold.

Pale, bluish colour of the skin. [GRIMM, l. c.]

Blueness of the skin of the body, especially of the genitals. [AEPLI, l. c.]

Blue spots here and there on the body (aft. 15 h.). [Histoire de l’ Academie des Sc., 1735. (Not accessible.)

Redness of the whole body. [J. HUNTER, l. c.]

390. Burning pain, (In the original simply “burning.”) sometimes itching of the skin. [MATTHAEI, l. c.]

Burning, itching and elevation of he epidermis into pustules. [HECQUET, l. c. (From taking opium frequently.) ]

Here and there in the skin pricking itching.

Itching, especially on the upper part of the body, from the chest up over the face, especially the nose. [MATTHAEI, l. c.]

Very tiresome itching. [WILLIS, l. c.]

395. Tiresome itching all over the body. [BERGERm, l. c., § 3.]

Redness and itching of the skin. [GEOFFROY, l. c.]

Itching all over the body; after scratching there come thick red lumps (wheals) which itch much, but soon go off. [MATTHAEI, l. c.]

Cutaneous eruption and occasional itching. [FRIEND, (General statement.) opera, tom. I, Emmenol., cap. 14, p. 139.]

After perspirations, frequent cutaneous eruptions and smarting itching on the skin. [TRALLES, l. c.]

400. Small red, (Matthaei adds :thick” to “red”) itching spots here and there on the skin. [MATTHAEI, l. c.]

Itching and formication in all the limbs (Schelhammer simply speaks of “pruritus.”) (aft. 5 h.). [SCHELHAMMER, l. c.]

First diminution of sensibility, afterwards diminution of the irritability.

Obtuseness and insensibility of the limbs. [STUTZ, l. c., x, 4.]

Numbness and insensibility of the limbs with coldness of the whole body (aft. 2 h.). [SCHERLHAMMER, l. c.]

405. Cold, stiff body. (“The whole body paralysed and stiff” is Pyl’s statement.) [PYL, l. c.]

Tetanus. [MUZELL, l. c.]

Beginning of opisthotonos. [AEPLI, l. c.]

Head bent backwards (a kind of tetanus of the nape)(aft. 1 h.).

The back is stiff and straight (a kind of tetanus)(between 1 and 2 h.).

410. Bending of the trunk like a bow from the violent trembling movement in the limbs, which strains all the nerves. [JUNCKER and BOHMER, l. c.]

Stiffness of the whole body (aft. 1 h.). [LEVESQUE-BLASOURCE, l. c.]

Tetanus and epileptic convulsions. [STENTZELIUS, de Venen. I, § 46. (Shortly before death.) ]

Convulsions. [VAN SWIETEN, (General statement.) l. c., p. 372.- Acta Nat. Cur., cent. I, obs. 54. (General statement.) – SCHWEIKERT, l. c. (From large doses.) ]

Spasmodic movements accompanied by crying. [LEVESQUE-BLASOURCE, l. c.]

415. Convulsive movements. [MUZELL, l. c.]

Epilepsy. [MUZELL, l. c.]

Epileptic fits, with violent delirium. [MUZELL, l. c.]

Foam before the mouth. [REINEGGS, l. c.]

Restlessness in the sound limbs, which cannot remain a moment in one place. [MATTHAEI, l. c.]

420. Trembling in the whole body, as if he had been frigthened, with single jerks of the body and twitchings in the limbs, in which only the flexor muscles are involved, with external coldness of the body.

Convulsive trembling of the limbs. [AEPLI, l. c.]

Spasmodic trembling of the limbs. [STUTZ, l. c.]

Trembling movement in all the limbs, which distorts all the nerves. [JUNCKER and BOHMER, l. c.]

Staggering. [REINEGGS,- GRIMM, l. c.]

425. Unsteadiness; he cannot walk without staggering. [SCHELHAMMER, l. c.]

Agreeable lassitude, as from intoxication. [MATTHAEI, l. c.]

Slow, unsteady gait.

Unconquerable lassitude. [MATTHAEI, l. c.]

Laziness. [STUTZ, l. c. – FR. HOFFMANN, de Correct. Opii, § 16.]

430. Great desire to lean against everything, to stretch out the lower limbs lazily and to support the head on a hand. [Sche.]

Feeling of strength.

Exhaustion (aft. 8, 12 h.).

Relaxation, laziness. [REINEGGS l. c.]

Lazy movement. [MURRAY, l. c., p. 285.]

435. Exhaustion; everything external is distasteful to him, he is sleepy, dazed, stupefied, sad, and his memory fails him. [MURRAY, l. c. (When the primary action of the opium is passed.) ]

Exhaustion. [BERGIUS,- (immediately) WILLIS, l. c.]

Checks the activity of the voluntary muscles, diminsensibility and hence induces sleep. [TRALLES, l. c., p. 110.]

Diminishes (in robust persons) the power of the muscles subject to the will, causes weight of the head and great exhaustion. [TRALLES, l. c., p. 107. (Opium diminishes only in the secondary action the power of the muscles subject to the will, and then also paralyses them completely; but in its primary action it excites them, but if this primary action is interrupted by stupefaction and stupefied slumber, then in this opium sleep one or another limb twitches.) ]

Premature senility. [BERGIUS, l. c.]

440. It causes remarkable loss of the powers and deprives the firm parts of tone and mobility. [FR. HOFFMANN, Med. Rat., ii, p. 270.]

Relaxation of the limbs and weakness. [HAMBERGER, l. c., § 16.]

The power of movement of the muscles is depressed. [ETTMULLER, l. c.]

Heaviness of the limbs (aft. 1.1/4 h.). [Gn.]

Weakness of the powers. [KAMFER, l. c., p. 645. (From large doses.)]

445. Apoplexy not rare. [WEPFER, de Apoplexia, p. 24. (Not accessible.) - Mead l. c., p. 133. – VAN SWIETEN, l. c., p. 325. – LORRY, l. c.] (From large doses.)

Sinking of the powers. [CLARK,- WILLIS, l. c. §]

Debility, sinking of the powers. [REINEGGS, l. c.]

Unfit for all work, exhausted and weak. [CHARDIN, l. c.]

He can scarcely move the feet, can hardly walk forwards even when forcibly compelled to do so. [SCHELHAMMER, l. c.]

450. Exhaustion of the powers and inability to move. {FR. HOFFMANN, Dissert, de Operatione Opii, p. 8.]

He lay in the greatest weakness. [TRALLES, l. c., p. 238.]

The muscles move with greater difficulty. [BERGER, l. c., § 10.]

Increased immobility of the limbs. [SCHELHAMMER, l. c.]

The muscular tone is relaxed, so that a kind of paralysis ensues. [FRIEND, l. c., cap. 14.]

455. All the muscles relaxed. [LASSUS, l. c.]

Paralysis. [BAGLIO, (Statement.) Prax. Med., lib. 1, p. 65. (From too many and too strong doses of opium.) ]

The limbs lay immovable, and remained lying in the place where they were laid. [KILIAN, l. c.]

Great prostration, sinking of all the vital spirits. [WILLIS, l. c.]

Discomfort, ill feeling of body and mind (aft. 8, 12 h.).

460. Syncope. [MULLER, l. c.- FR HOFFMANN, Diss de Correct. Opii, § 16.]

Syncope recurring every quarter of an hour; he closes the eyes, lets the head hang down, with weak respiration; without consciousness, with unaltered pulse; then some spasmodic shocks of the body, whereupon after a few minutes the paroxysm ends with a sigh; followed by anxiety. (The symptoms of Mullers’s patient before and after taking the opium were so similar, that the effects ascribed to the drug on his authority are very dubious.) [MULLER, l. c.]

Flow of blood from a recently opened vein (until death). [PET. BORELLI, cent. 4, obs. 57. (Observation.) ]

With increased powers she tries to get up out of bed, but immediately becomes faint and giddy; on lying down again she immediately revives. [MATTHAEI, l. c.]

Inclination to lie down. [GRIMM, l. c.]

465. yawning for several hours, with pain in the jaw-joints as if they would break. [Stf.]

Drowsiness. [BERGIUS,- MATTHAEI, l. c.]

Great inclination to sleep. [CHARVET, l. c.]

Sudden falling asleep (aft. a few m.). [CHARVET, l. c.]

Waking sopor.

470. Incomprehensible chattering in the sopor.

A kind of stupefied sleep, with half-opened eyes, eyeballs turned upwards under the upper lid, mouth more or less open and stertorous inspiration.

Drowsiness, slumber, stupefaction. [FRIEND, l. c., xiv, p. 140.]

Slumber. [SAUVAGES,- BUCHNER, l. c.]

In place of sound sleep it easily induces a morbid slumber. [TRALLES, l. c., p. 112.]

475. He lay as if sunk in slumber. [SCHELHAMMER, l. c.]

Nocturnal, continued sopor, with increased thirst, tongue almost clean, with dark red border and dry cracked lips. [JUNCKER and BOHMER,- MATTHAEI. ;/ c/]

Soporous stupefaction. [DE LA CROIX, l. c.]

The sleep caused by opium passed into an unusual stupefaction. [RIEDLIN, l. c., ann. V, Oct., obs. 30.]

Such a stupefied slumber that an answer cannot be got from him. [STALPAART VAN DER WIEL, Cent. ii, obs. 42.]

480. Very sound sleep with rattling respiration, as after apoplexy (aft. 6 h.). [LASSUS, l. c.]

During almost constant slumber, with half-shut eyelids, he has floccilation and feels all about him. [RADEMACHER, l. c.]

Stupid sleep without any consciousness, with rattling on the chest. [KILIAN, l. c.]

Sleep with consciousness, with rattling on the chest. [KILIAN, l. c.]

Sleep with consciousness; he hears everything about him, but cannot rouse himself; waking after two hours. [CHARVET, l. c.]

On shaking the patient and speaking to her she can be roused from her sleep; she then complained and wished to die. [LEROUX.]

485. Sopor and insensibility, with sufficient warmth and normal pulse and respiration. [WILLIS, l. c.]

Unconquerable sleep, in which, however, he feels pain, and when pinched opens his eyes. [SAUVAGES, l. c.]

Irresistable sleep (immediately after taking two grains and upwards), but which is disturbed by dreams, and on waking he is not refreshed, but feels nausea. [A THUESSINK, l. c.]

Unrefreshing sleep with general perspiration. [GRIMM, l. c.]

After long opium sleep weariness. [YOUNG, l. c.]

490. On awaking faint-heartedness. (In original,”sense of faintness and failing about the heat, seizing him as often as he was dropping asleep.”) [YOUNG, l. c.]

After waking inclination to vomit. [YOUNG, l. c.]

After the opium sleep exhaustion, (Better “Lassitude.”) heaviness of the head, and dryness of the throat. [BERGIUS, l. c.]

During sleep erection of the penis, and after waking impotence – in the male. [STALPAART VAN DER WIEL., l. c., obs. 41.]

After the opium sleep stammering. [PLATER, Observ., lib. I, p. 127. (Not found.) ]

495. After waking difficulty of moving the tongue. (With the dryness of mouth of S. 158.) [SCHEHAMMER, l. c.]

After the sleep dulness of the head. [JORDENS, l. c., xvii, 1.]

Starting in sleep, and after waking he is as of intoxicated and half mad. [TRALLES, l. c., I, p. 282.]

After sleep intoxication and vertigo. [TRALLES , l. c., I, p. 282.]

More exhausted after waking, by uneasy dreams during the night. [TRALLES, l. c., I, p. 122.]

500. A man who had long been unused to dreams, dreams after taking opium. [RIEDLIN, l. c., ann. ii, Nov., obs. 16.]

The sleep from large doses of opium is not without dreams. [TRALLES, l. c., p. 120.]

The whole night occupied with a number of visions and fancies in sleep. [TRALLES, l. c., p. 121.]

The sleep of opium is always associated with dreams and grimaces. [LINDERSTOLPE, l. c., cap. 10, thes. 75.]

Merry dreams. [DE RUEF, l. c.]

505. Sometimes agreeable, sometimes sad, sometimes anxious and frightful dreams. [TRALLES, l. c., p. 120.]

Sleep disturbed sometimes by pleasant, sometimes anxious and frightful dreams. [TRALLES, l. c., p. 120.]

Sleep disturbed sometimes by pleasant, sometimes by horrible dreams, degenerating either into sopor or an apoplectic death with convulsions. [MURRAY, l. c.]

Opium affects the brain and produces uneasy dreams. [BELLONIUS, l. c.]

Deep sound sleep with rattling respiration, like an apoplectic. [LASSUS, l. c.]

Snoring. [DE LA CROIX, l. c.]

510. Snoring in sleep whilst expiring.

Whining in sleep (aft. 2 h.).

Piteous cry in sleep.

Restless sleep, full of sighs and moanings. [YOUNG, l. c.]

Anxious sleep, full of dreams (aft. 7 h.). [GRIMM, l. c.]

515. Anxious sleep disturbed by the saddest dreams, so that in slumberous intoxication he seems to be constantly delirious. [GRIMM, l. c.]

Sleep full of dreams.

Attack of suffocation in sleep (