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                                   AN

                                 ESSAY

                                 ON THE

                           EFFECTS of OPIUM,

                        Considered as a POISON.

                   [Price One Shilling and Sixpence.]




                   AN ESSAY ON THE EFFECTS of OPIUM.

                             Considered as

                               A POISON.

                 With the most Rational Method of Cure,
                        deduced from Experience.

          Directing likewise the proper Means to be used when
            Physical Assistance cannot be readily obtained;

    Necessary to be universally known, for the Preservation of Life.

                           By JOHN  AWSITER,

             Apothecary to the Royal Hospital at Greenwich.

                  —— —— Si quid novisti rectius istis,
               Candidus imperti—Si non, his utere mecum.

                       HORAT. Epist. VI. Lib. I.

                                LONDON:

               Printed for G. KEARSLY, in Ludgate-street,
                               MDCCLXIII.




                                 TO THE

                         President and Fellows

                                 OF THE

                      Royal College of Physicians.


    Gentlemen,

I Was induced to write this Essay, from a Desire of throwing a Light
upon a Subject, hitherto but triflingly, and, at best, obscurely
treated. As I had no beaten Path to direct me, many perhaps are the
Errors that may be traced through every Page.

I do not boast an Ability to enforce my Sentiments with that energic and
expressive Beauty of Style some are so happy to possess. I am no Author,
and can therefore only rely on your _Candour_, in Behalf of a simple
Recital of such Facts as I have experienced.

When I consider the Novelty of the Subject, and the Rareness of Patients
poisoned with Opium, I am inclined to flatter myself, you will not
discourage, but be rather inclined to cherish under your Wings, every
Effort (however weak) that tends to elucidate so extensive a Branch of
Science, as Physic. I beg the Honour of subscribing myself,

    Gentlemen,

      Your most obedient,

          Humble Servant,

                                                             J. AWSITER.

St. _Margaret's Church-Yard, Westminster, January 5, 1762._




                          PREFATORY DISCOURSE.


Among People who are unacquainted with the Nature of Opium, it is a
received Opinion,——That as it will, when taken in proper Doses, lull
Pain, and procure Rest; so, in large Quantities, that it will terminate
a Life of Cares, by an _easy_ and _quiet_ Death; but it is not so: this
argument is directly contrary to the Nature of our Existence, the animal
Oeconomy being so formed, as not to bear a total Solution, without some
Agonies. Thus, when this Drug is received into the Stomach, in Quality
of a Poison, easy Rest is denied, the Senses, roused by their threatened
Solution, force the animal Powers into immediate Conflict with the
noxious Body, which produces Convulsions, and other dreadful Symptoms,
the Forerunners of Death.——The Drug is besides of so strong a Nature,
that, though taken only into the Stomach, it can change the Colour of
the Skin, and even of the Linen wore next it; a Body also, many Hours
after Death, will smell so strongly of it, as to determine whether it
was the Instrument of Destruction used.

I might have encreased the Bulk of this Essay, by expatiating on the
Effects of Opium upon the arterial Fluid; I could inform you, that the
Power of it is diffused by the Stimulus of the recurrent Nerves, to
their Origin in the Cerebellum, whence, by Consent of Parts, the whole
System partakes of the Affect, and the contaminated Fluid is propelled
by them, through the Heart into the Arteries, and communicated to the
most distant Parts of the Body; also that the Skin is formed by very
minute Fibres of the Nerves, interwoven with arterial Fibres and Veins,
forming numerous Compages of secerning Vessels, &c. &c. but these are
Subjects best suiting the medicinal Powers of Opium, which being
derogatory from my Design, are purposely avoided, and, but that these
Pages are for the Perusal of more than the Circle of Physical Gentlemen,
the Cases alone would have been inserted, without even giving the
natural History of the Drug; for this same Reason, the Prescriptions are
set down in _English_, and the whole Essay disrobed of technical
Expressions, as far as the Subject will allow.

It will be thought, perhaps, that I have made too free with Dr. _Jones_,
who is the only _English_ Author that has wrote professedly on this
Subject; but many of his Sentiments being directly opposite to mine, I
was under a Necessity of bringing them into an immediate Point of View.
It is therefore hoped, no Person will be so unfriendly, as to impute to
me a Malevolence of Disposition, which is a Character I would always
diligently avoid.




                                  THE

                                EFFECTS

                                   OF

                                 OPIUM,

                      Considered as a POISON, &c.


Opium is a Drug brought to us from the Eastern Countries (the Use of it
was first known to the _Greeks_ who gave it the Name of Ὀπὸς, _Succus_,
which was collected from the _Papaver Hortense_, _Semine Albo_ of
_Caspar Bauhine_) where the Plant, from which it is produced, grows in
great Plenty, both wild and cultivated, and is the same with that of the
white Poppy in _England_, the Heads of which are very large, and possess
a sleeping Power, many Degrees beyond any other Part of it; the Seeds
contained in these Heads are very numerous, and partake of this Quality
in so small a Proportion, as to be scarce discernible, and rather help,
from the soft Oil they contain, to correct the bad Effects of the acrid
Juice of the Mother-Plant; they are therefore separated from the Heads,
and used in Emulsions, being esteemed both cooling and emollient.

Distinctions were formerly made of the Goodness of this Drug, according
to the Places where it was gathered; that of _Thebes_ being the most
famous; but, as it is now, and has been for some Time past, an Article
of general Traffic, not only in the Places where it grows, but
throughout all _Europe_, those Distinctions of Country, are necessarily
laid aside, and the only Difference now consists in its Purity, or
Adulteration by the original Manufacturers or Venders.

It is a natural Supposition, and indeed the _Turkish_ Histories
sufficiently demonstrate, that the original Use of Opium, or Extract
from the Poppy, was first introduced to dissipate Anxieties, Pains, and
Perturbations of the Mind, which appears not unlike the Use of
intoxicating Drinks, so much requested in _Europe_. Labours of Mind and
Body in every Person's Life, being somewhat considerable, a temporary
Relief becomes indispensably necessary; and though Opium is not in
common Use in _England_, such similar Advantages we instance of Tobacco,
with which alone the Soldier can perform his March, and the Sailor his
Service, through the rudest Storm, in a Night-watch upon Deck.

In _Europe_, we are not only fond of intoxicating Liquors, but add to
their sleeping Qualities by the Use of Tobacco; Smoaking and
Snuff-taking are fashionable, and Chewing not uncommon; all which
Methods have, until familiarized to the Party, very disagreeable
Effects, the Plant containing a corrosive Oil or Sulphur, with a
volatile Salt, which makes it partake the Quality of Opium, though in a
distant Degree; the _Chinese_, indeed, exceed us, they having a Narcotic
Weed, which they smoak, a Species of the Poppy.

To treat upon the Effects of Opium, and the various Shapes wherein it
may be advantageously used for many Diseases, would frustrate my present
Design; therefore I shall confine myself to that Property, which makes
it considered as a Poison; and by the Analysis of the various Powers it
contains, destroy, or in a great Measure prevent, the fatal Consequences
which often attend the immoderate and imprudent Use of this Drug.

The great Doctor _Mead_, in his Tract upon Poisons, gives an Example of
such a Power being in Opium, by pouring it, dissolved in warm Water,
into a Dog. Had that able Genius, adequate to the Task, pursued his
Experiments with that Spirit wherewith he abounded, it would have yet
added to the Obligation the World owes him; but over the Means necessary
to be used to counteract this Poison, and the Effects of it upon _human_
Bodies, he has drawn a Veil, and informs us, that the Cure is to be
compleated by acid Medicines, and lixivial Salts: Far be it from me to
comment upon the Principles of this Doctrine; he was too just not to be
sensible of what he wrote; perhaps he thought the Subject of too
delicate a Nature to be made common, and as many People might then
indiscriminately use it, it would take from that necessary Fear and
Caution, which should prevent their experiencing the extensive Power of
this Drug; for there are many Properties in it, if universally known,
that would habituate the Use, and make it more in Request with us than
the _Turks_ themselves, the Result of which Knowledge must prove a
general Misfortune.

From the Ease it affords to the Pains of Mind and Body, Opium obtained
the Name of _Laudanum_, derived from the _Latin Laudabilis_, or
_Laudatum_; yet, though it has this Property of easing Anxieties and
Torments of the most excruciating Diseases, the constant Use of it
should be rejected, as it will impair the Memory, destroy the Appetite,
bring on a Stupor, and by Relaxation, weaken the whole Frame. That it
impairs the Nerves, is manifest, for applied to the Ear, to ease Pain,
it may cause Deafness; to the Nostrils, to stop an Hæmorrhage, Loss of
Smelling; and however applied, whether internally or externally, (unless
very sparingly) it will benumb the Part most immediately in Contact with
it. When we consider the nervous Coats of the Stomach, and the Action of
Opium upon them by constant Use, the Effects may easily be judged; and
if a Person so habituated, is prudent enough to throw aside the Use of
it, before he is betrayed into some fatal Disease, the Appetite is to be
restored by nervous Stimulants, Bracers, and Cold-bathing. Doctor
_Jones_ advises gradual Decrease of the Opiate, and to use, instead of
it, generous Wine in Moderation.

The Production of Opium is from the Fruits or Seed-vessels of the
Poppy-Plants, commonly called the Heads; they are gathered while green,
which (the Seeds being taken out) are bruised and pressed. The Juice
thus collected from them is dried to a Substance, which being wrapped in
Leaves, is formed into Balls or Lumps, generally under a Pound Weight,
and in that Form transported to all the Markets of _Europe_.

Though it is a received Opinion, that Opium, with us, and other
Countries where not manufactured, has not near the Strength of that used
by the People where it grows; yet in _Turkey_ they can venture to take
it in larger Quantities; and hence it is manifest, that the Effects
would be more pernicious amongst them, if they did not use it in a most
pure State; and though Habit might conduce to the Constitution bearing
it in much larger Doses, than we in _England_ dare give it, yet
certainly the constant Use of it, unless when of a most fine Texture of
Parts, must sooner prove hurtful, than the immoderate and constant
Drinking of Wines, and Spirits; and by this Means, the Lives of the
major Part of the Eastern Countries, where it is so much requested,
would drop in the Flower of their Youth, and whole Nations, in the Space
of a Century, be depopulated.

The ancient Accounts of the Manner of gathering Opium, was, according to
_Diascorides_, by the milky Juice being collected from Time to Time,
that distilled from the wounded Head of the Poppy; thus gathered, it is
entirely pure, and being taken, gives no disagreeable Sensation to the
Stomach. This Extract being almost wholly volatile, immediately enters
into Action, and discharges itself by Perspiration, opening the Pores,
and refreshing the Spirits, without any attendant Injury; and daily
Experience will convince every one who will put it to the Tryal, that
the purer the Opium, in the greater Quantity it may be taken, unattended
with the Nausea, Vertigo, and Tremor, which are so often the
Consequences of it with us, though used in small Doses. _Tournefort_,
Page 292, _Materiæ Medicæ_, informs us, that Opium, or Laudanum, does
not only pass off freely by Perspiration, but cures those Distempers
arising from Obstructions of the Organs of Respiration in hot Countries,
without any Inconvenience whatever, which cannot be said of it, in such
Cases, in _England_, though assisted with volatile and cordial
Medicines. This seems a palpable Contradiction to the Opinion of Doctor
_Jones_, who says, that Opium may be taken in much larger Doses, in
Cold, than in hot Climates.

It is a natural Supposition, that when a Country produces a Commodity,
in a Manner peculiar to herself, the Manufacturers will embrace the most
ready Means of collecting it. The first Consideration generally is, how
to make the greatest Emolument with the least Labour; if the Opium,
which is brought into _Europe_, were to be taken from the Head of each
Poppy, by Incision, as is supposed by some Authors, the Produce would
not be sufficient to supply the Markets; for as the daily Collection of
Opium, from one Head, could not exceed one Grain in Weight, and many
might fail even of that the Labour, Time, and Hands requisite to gather
one Pound only, must necessarily make that Article, five, if not ten
Times the Price it now bears. Though it is not improbable, that Opium,
being a pure body, and wholly volatile, _may_ be gathered by Incision,
Yet it is not natural to suppose, that the Quantity of Opium, so nicely
produced can answer, in any moderate Proportion, what may be made by
gathering the Heads, while green, grinding them, and expressing the
Juice, which may be easily inspissated. _Vide Plin. Secund._ Lib. 20.
Cap. 18.

Some Authors apprehend, that common Opium is not made alone from the
Head, but from the impressed Juice of the whole Plant; and indurated by
the Sun's Heat, _See Mathiolus, Scaliger, &c._ But, if the Authority of
_Pliny_ is not thought sufficient, _Geoffroy_ further refutes this
Opinion; clearly proving, by extracting the Juice of the Leaves and Stem
of the Poppy-Plant, that on the most strict Analysis, it is many Degrees
inferior in Strength to the Properties of common Opium. This is also
confirmed by the Examination of the Fæces, or impure Parts, remaining
from the Solution of our Opium, they having no Similitude to the woody
Fibres belonging to the Plant, which might pass with the Juice, by the
Force of the Press, but to the light spongy Particles from the Apex or
Head, with some little Grit.

We have several Instances of the fæculent Parts of inspissated Vegetable
Juices increasing the Violence of their Operation; such are the Aloes of
the Shops, Scammony, and grosser Juice of the wild Cucumber, called
Elaterium. The _Fæculæ_ of Opium, in the State wherein we receive it,
will clog the more fine Parts, and prevent their ready Passage through
the Pores of the Skin; and as the Time of its Duration in the Body, by
such Means, is greatly increased, the Effects must necessarily remain
longer, and the deleterious Quality have more Power over the human
System. _Wedelius_ says, _id certissimum habemus nunquam ab Opio ulla
timenda esse incommoda si bene sit depuratum_. Lib. 1. Sect. 2. Cap. 3.

There are several Plants which have a sleeping Property, though not in
so great a Degree as the inspissated Juice of the Poppy, yet more
poisonous, because they are not endued with that volatile Power to carry
themselves off. Thus we find the Juice of Hemlock, Mandrake, Nightshade,
and several others of this Class, loaded with an acrid Salt, which, when
inwardly taken, will corrode, vellicate, and cause an immediate
Inflammation in the Primæ Viæ, to which the Nerves consent by a general
Convulsion; and if any of these venene Powers remain long enough in the
Body, to insinuate themselves into the Circulation, the debilitated
Blood will become stagnant in, or lacerate, the capillary Vessels.
Examples of these have been seen in _Indians_, who have taken Poison,
which, though not of immediate Power to destroy Life, has manifested
itself in Ulcers over the whole Body; and what is related of the Poison
of the Seps Hæmorrhous, or Hæmorrhoid Serpent, is very extraordinary,
that it will make the Blood flow out from several Parts of the Body;
which can only be accounted for by an extream Fluidity of the Blood, and
a consequent Velocity in Circulation, increased to such a Degree, as to
lacerate the capillary Vessels, and thereby force them to part with
their Contents.

From the various and violent Effects I have observed to arise from the
Use of different Parcels of Opium, I am inclined to think, that the
Juice of some Narcotic Plant is frequently added to that of the Poppy,
in order to increase the Quantity of the Drug; and _Bellonius_ observes,
that Traders in Opium have so far adulterated it, that four Ounces of
the pure Drug have sometimes been multiplied to a Pound. I myself have
observed, in the Use of two different Opiums upon one Subject, that the
one had a mild and proper Effect, and the other, through its
Churlishness of Operation in the first Passages and Symptoms, on the
following Day, had the Appearance of Poison, though in an inferior
Degree. Such may always be suspected of Adulteration with the acrid
Juice of some other Plant, and when a Purging ensues the taking of
Opium, it most probably arises from a Mixture with the milky Juice of
_Spurge_; there being nothing in the Principles or Effects of the pure
Drug, to excite Purgation. This I apprehend to be the Reason why solid
Opium sometimes purges, and the Tincture very seldom, the Menstruum
used, dissolving only the finer Powers.

To judge of pure Opium in the Lump, is a great Nicety, and what the
Buyer ought to be very careful of, that it may answer his Intention of
easing, and not injuring his Patient, if he designs using it inwardly;
for this Intent, some Authors have given Instructions; but how few are
they, who are assiduous to know the different Degrees of Strength each
different Lump may contain! It is thought enough, if it has the
Appearance of Opium, and the stronger it is in Smell and Taste (provided
it is not drossy) they think it will go furthest, and consequently is
best.

This Drug is to be chosen by Colour, Smell and Taste; the best Sort is
of a Reddish-Brown; that which is deepened to Blackness, being fit only
for external Use, as we may expect it to be mixed with some other
narcotic Extract. To the Smell it should be pungent, almost to
Volatility, without Fœtidness. When it proves very powerfully
acrimonious to the Tongue (which the Opium we use, too often does) the
inward Use of it should be rejected. The Right Sort is very bitter, and
as such will be pungent to the Tongue, but will not leave a Soreness
behind, in the Manner of corrosive Bodies; it should not be chosen
heavy, lest it should be mixt with Sand, to increase the Weight; nor
very dry, as some of its finer Powers might be then lost; and when cut
in thin Slices, it may, by holding it to the Light, be easily
discovered, if drossy.

Burning it, in order to try the Purity, is recommended by some Authors;
the best, emitting a clear Flame; to which let me add, that being a
resinous Body, it may, if pure, be moulded by Heat into any Form, and
answers the Characteristic observed of it by _Pliny_, Lib. 20. Cap. 18.
_Sed maxime mirum, Æstivo sole deprehendi. Syncerum enim sudat, & se
diluit, donec succo recenti simile fiat._

All authors agree, that Opium is very volatile, which Volatility must be
the Cause of its immediate action on the Stomach; this is likewise
manifest, by the following simple Experiment:

"Take a Portion of Opium, either sliced or grated, place it before the
Fire, near enough to dry without scorching; after remaining some time,
you will find the Strength of it considerably abated."

This Process was directed by the Ancients, to deprive it of its supposed
poisonous Quality, but that is left behind in the grosser Body. The
effects of it, thus managed, would not be so sudden, though used in
large Doses, yet would prove, for Reasons given in a former Page, more
severe and permanent; by this Means, the fixt Salts and Fæculæ remain,
and the volatile Spirit, which occasions the soft refreshing Sleep, is
in a great Measure, evaporated.

Unless Opium were a resinous Body, it could not retain its volatile
Power, to bear transporting in the Form it does, much less endure to be
kept in the Shops with little Loss. The burning of it proves the Truth
of this Assertion, and if it were a mucous Gum, or viscous juice, it
would not flow by Heat, nor import its Strength to a spirituous, but to
an aqueous Menstruum, after the Manner of Gum Arabic. It may be asked
here, in Opposition to this, how the Extract from Opium is made, in
which Process the Opium, according to the College, is ordered to be
dissolved in Water? In Answer to it, I presume, the Water is only an
Agent, that prevents the Adustion of the Parts so exposed to intense
Heat, which Menstruum, being partly imbibed by the Impurities of the
Drug, causes a sufficient Separation, for the resinous Parts to become
soft enough to be pressed through a Bolter; by such Management, the
fæcæs are entirely separated from the purer Parts, and the Water, though
used most cautiously, and in as sparing a Quantity as possible, by the
necessary Evaporation, in order to reduce the pure Body to the former
Substance, loses more than it gains; and after all, in my Opinion, is
not so much to be depended upon, or has so mild an Effect as good Opium;
notwithstanding Doctor _Jones_'s Opinion to the to the contrary, and his
partial Fondness, in giving the Name _Panacea_ to his Solution in Water.

The College of Physicians have ordered only two Preparations that retain
the Name of Opium, wisely considering, that those of the Ancients were
so numerous, and so variously combined with other Substances, under the
Title of Correctors, that the Bulk in administering them was greatly
encreased, and an Inconvenience arose oftentimes to the Patient, who not
being able to take the Quantity of the Opiate required, thereby rendered
the Effect frequently precarious.

One Preparation, directed by them, is by Solution, as mentioned above,
merely to purify it from heterogeneous Particles, and thence called
_Extractum Thebaicum_, or Extract of Opium; the other a Tincture or
Re-Solution of that Extract, to be preserved in a fluid State with Wine,
in the Proportion of two Ounces to one Pound, with an Addition of
Aromatics. This last Preparation, which is in more general Use than the
Extract, is commonly known by the Name of _Laudanum_; though that
Epithet was formerly used by Authors for various Preparations of the
Drug, with the Appendage of Opiatum, Tartarizatum, _&c._ to characterise
their Differences.

I shall not enlarge upon Opium in a physical Sense, further than is
necessary to shew the poisonous Effects of it in over-large Doses, and
as such, I confine myself to the Sort within every one's Knowledge, and
to be commonly met with in the Shops.

The poisonous Effects of Opium, whether in a solid or fluid State, may
be considered in the same Light, as Ebriety from spirituous Liquors; a
very small Quantity will overcome a weak Constitution, while a strong
one will require much more; nevertheless, a weak Constitution, used to
Opium, will bear as much, uninjured, as the strongest, if unaccustomed
to the Use of it. In a general Sense, however, even in the most robust,
a Dose, exceeding three Grains, may be truly pronounced to be of
dangerous and poisonous Consequence; and in some Cases, half that
Quantity will prove sufficient. It operates sooner in a liquid, than in
a solid Form; in the former, admitting the Doses are too large, in half
an Hour, and often in fifteen, or ten Minutes, unless Exercise
intervenes; In the latter, in two Hours, sometimes in one, sometimes in
half an Hour; the Injury produced by the Liquid, being more sudden and
transient, that of the Solid, more slow and lasting.

The Liquid, by a speedy Expansion, is frequently, and almost instantly,
rejected by the Stomach, the other not; by which it is easily
discoverable, that though the Effects of Opium, in a liquid State, are
more immediate, they are sooner counteracted, and more easily overcome;
for which Reason, every Vender of Medicines ought to be extreamly
cautious to whom he sells this Drug, that it may not be converted to a
wrong Use. However it is seldom known that a Person attempts to poison
himself with solid Opium, though frequently with the Tincture.

The general Effects of Opium, are as follow, _viz._ Upon almost
immediate taking, the first Symptoms are a Heat and Weight at the
Stomach, succeeded by an Extravagance of Spirits, even to violent
Laughter, Listlesness of the Limbs, Giddiness, Head-ache, Loss of
Memory, dead Look of the Eyes, imperfect Speech, Drowsiness, slow and
full Pulse, short and quick Breathing, Nauseas, and an extream florid
Complexion. These Symptoms are the common Consequences of Drunkenness,
as well as Opium, though not all at the same Time in one and the same
Object, the Symptoms varying according to the Strength of the
Constitution. The more violent and extream Effects are Itchings of the
Skin, Madness, Vertigoes, Vomitings, Hickups, heavy and dead Sleeps,
unequal Pulse, Contraction of the Jaw, Convulsions, profuse Sweats,
universal Relaxation, Faintings, Coldness of the extreme Parts; and
lastly, a cold Breath, a certain Indication of Death.

Before we treat of the Cure of these too violent and, too frequently,
fatal Effects, it will be requisite to explain the Cause of this
Poison's Power in the Primæ Viæ, or Stomach. First then, let us consider
the component Parts, which, when examined by a chemical Analysis, are
found to contain a very large Portion of volatile Salt and Spirit; a
fœtid; corrosive, and sulphureous Oil; some little of a fixed Salt; and
a small Quantity of indolent Earth. Vide _Lemery_, _Mead_, _Geoffroy_,
&c.

The Principle of Action Consists of a volatile alkaline Salt, intimately
united to, and enveloped in, a corrosive sulphureous Oyl.

The Sensations of the Stomach are most evidently exquisite, by Hunger
and Thirst; with which those other Senses of Smelling and Tasting are in
immediate Contact and Agency, which the wise Ordination of a supream
Hand, for the Preservation of Life, has proportionally distributed
through every Part of the Creation, from Man down to the most small and
apparently insignificant Insect.

By the nice Sense of the Palate, we are able to judge in general, what
is, and what is not essential to the Nutriment of the Body; which
Nutriment the Stomach, for the most Part, rejects when noxious. Some
Things, indeed, are almost void of Smell or Taste, therefore not
seemingly injurious to the external Senses, and thus may be accidentally
taken into the Stomach; or when those Senses are depraved; as Hemlock
has been often mistaken, and eat for Parsley; but when a Poison is
taken, the nocent Power is put into Action by the internal Heat, and
proves a Stimulus on the nervous Coat of the Stomach. "_Porro hujus
tunicæ altior in Ventriculum insertio, intimum ac Citissimum illud inter
Stomachum & Gulam Commercium_ _facit; ita ut, si pars alter utra in
Vomitionem cieatur, mox altera in _σύμπραξιν_ adducatur: cumque eadem
tunica, palatum aliasque Oris partes investiat, etiam hæ cum illis circa
Vomitionem mutuo consensu afficiuntur. Willis Pharmac. Rationalis_, Sec.
2. Page 5. _Primarum Viarum Descriptio._" Upon this Stimulus, Nature
immediately takes the Alarm, and sickens, which Sickness increases with
the Vellications, till the offending Power is discharged, or by sudden
and violent Inflammation, the Stomach is withheld from discharging the
Virus, when the human Mechanism suffers an universal Convulsion. If
therefore, by such powerful Efforts of the nervous System, the grosser
Parts of the Poison received, cannot be disengaged by proper and timely
Assistance, the Nerves lose their Power; the Muscles can no more be
brought into Action, but remain in a State of Relaxation, and the whole
Body must sink under the Calamity.

Thus the Actions of most Poisons, especially the Vegetable, when taken
into the Stomach, are nearly the same; all vellicating and inflaming the
first Passages, yet the Analysis of them is materially necessary to
discover the acting Principles wherewith they are compounded, that we
may more exactly point out their separate Cures. Dr. _Mead_ describes
the Effects of Poisons in the Primæ Viæ, in so accurate and concise a
Manner, that I cannot do better than transcribe his own Words.

"Upon the Sense of a violent _Irritation_ and _Pain_, the Fluid of the
Nerves is presently, and in large Quantities determined to the Part
affected; and this, if the _Stimulus_ be not over-great, will only be to
such a Degree as is sufficient, by contracting the Fibres of the
Stomach, and Muscles of the Abdomen, to throw off the Cause of the
disagreeable _Sensation_; but the uneasy _Twitching_ being too terrible
to be borne, the Mind, by a Kind of Surprize, does with _Haste_ and
_Fury_ as it were, command the Spirits thither; thus the Business is
overdone, and the Action of the Fibres becomes so strong, that the
Orifices of the Stomach are quite closed; so that, instead of
discharging the noxious Matter, the _Torment_ is made greater, and the
whole _Oeconomy_ put into Confusion."

The Proportions of the volatile Parts of Opium are so very great, that
when received into the Stomach, they presently enter into Action, which
Parts, being of an innate soporiferous, and stupefactive Quality,
peculiar to this Poison, make some Progress before Nature is materially
excited to reject them, and is the Reason why the afflicted Person has
Symptoms, at first, common only to Ebriety.

The combined Powers of Opium, consisting of Salts and Sulphurs, must be
corrosive to a certain Degree; on this Account it is reckoned a
Depilatory; and when expanded in the Stomach, the innate active
Principle, or volatile Salt, must necessarily inflame the Coats of it,
as much as any other Poison of equal Power. To this Quality are owing
all the dreadful Symptoms of Vertigoes, Vomitings, Madness, Sopors,
Convulsions, &c. On the same Principles, the pleasing Sensations of a
moderate Dose may be explained; for, when taken into the Stomach, in so
small a Quantity as may be requisite only to procure Rest or ease Pain,
the Divisibility of it, especially in a fluid State, is almost
immediate, the volatile Salts are presently brought into Action by the
Heat of the Stomach, which, by their Rarefaction, cause an agreeable
Plenitude, and in a much more eminent Degree, than the Effects produced
by an hearty Meal, and arise from that grateful Sense of a moderate
Fullness of the Stomach, which so frequently inclines us to sleep; the
corrosive Power being so broke likewise, and expanded, cannot do more
than stupify the Part, and thereby induce the Subject meerly to rest,
without any consequent Misfortune.

The first and most powerful Action of Opium being in the Stomach, the
Cure is to be begun by _evacuating and blunting the Acrimony of it_ as
quickly as possible.

This Poison acts differently upon different Bodies, in Proportion to the
Strength or Weakness of the Subject, the Time it has been taken, whether
upon a full or empty Stomach, before or after plentiful Eating or
Drinking; and indeed, through these Circumstances, the Power of it is so
much varied, that they cannot be too particularly attended to. The
Quantity taken should be known, as nearly as possible, if in a solid or
liquid State, and whether the Party ever was habituated to the Use of
this Drug.

These Particulars are often difficult to be ascertained, owing either to
the Ignorance or Fright of the Bystanders; and it rarely happens that
the Patient is in a Condition to inform you himself; notwithstanding,
Nature in this, as in many other Cases, indicates a Cure. She must first
be assisted in disengaging herself from the Poison, by Vomit; though
this, if the Stimulus should be very violent, will encrease, rather than
diminish, the Inflammation of the Stomach; yet even an Excess in that
Particular is better than to hazard the Opium remaining any Length of
Time undisturbed, which would more endanger the Life of the Patient,
unless of a very strong Constitution.——The Symptoms therefore, as before
mentioned, alone can direct us, namely, whether in the first Degree they
are similar to those of Ebriety, in the second and more violent,
consisting of a heavy unnatural Stupor, &c. or third, and most extream,
in Vertigoes, Convulsions, cold Sweats, &c.

Doctor _Jones_ attributes the Sensations from, and indeed the whole
Action of this Poison, to so close an Adhesion of the resinous Parts to
the internal Coats of the Stomach, that though the Stimulus thereby
occasions frequent Vomitings, they cannot be disengaged from it, but
must necessarily be dissolved and digested, and therefore, where the
Patient recovers, are carried off by Stool.

Now, that the Poison cannot be attributed to the Resin it contains, as
this Author asserts throughout his Treatise, appears to me manifest; for
upon an Analysis, the Power of Action consists in a volatile Salt,
minutely blended with a corrosive Oil; which being expanded over the
whole Stomach, villicates and inflames the nervous Membrane thereof,
communicating her Affects to the Brain, even to the Destruction of Life;
unless overcome by Art.—Were it the Resin only which occasioned the
Mischief, the Resin of any other Vegetable would probably perform the
same; but a Person may take a Quantity of any common Resin, which is a
vegetable Production from the Pine, without these violent and dangerous
Effects, therefore we cannot advise, with Dr. _Jones_, the taking of
highly sulphurous and rectified Spirits, in order to dissolve the Resin
in the Stomach, lest, by such an additional Corrosiveness, the Stimulus
and Contraction, instead of being diminished, should become more
violent. Nor can I more approve his recommending the Use of Lixivial or
Alkaline Salts, unless formed into a saponaceous Body, with Water and
Oil.

We certainly know, that Lixivial and Alkali Salts will disunite and
dissolve resinous Bodies, but not so expeditiously as these Cases must
require; nor are we ignorant, that such Salts are greatly corrosive; as
we experience in the Composition of Cauteries; must they not therefore
further encrease the Abrasion of the Vessels? We have read likewise, and
indeed Experience confirms, that lixivial Bodies augment the Power of
Volatiles; in that Sense, what can be expected from their Use, but
Expansion, and an Encrease of the corrosive Power? Should we not rather
endeavour to check the Activity of those Principles, by clogging and
weakening their Powers, and to strengthen the fibrous Coats of the
Stomach, against the repeated Attacks of such an active Enemy?

As the Author before us, has been very minute and prolix upon this
Subject, it may be necessary to examine his Principles, relative to the
Cure, somewhat further. The first Thing he judges most proper, and to be
given with all possible Speed, is Salt of Tartar one Scruple, in a
Spoonful or two of Brandy, or some other hot cordial Spirit, if Spirit
of Wine be too hot. Herein we find, lest the Corrosiveness of the fixt
Salt should not prove sufficient, if given separately, their Powers are
to be united; and thus to be repeated even to every two Minutes. There
is something whimsical in his directing the Person to be placed in the
very same Position as he was when he took the Opium, that the Spirit, or
rather combined Solvent, should fall immediately upon the Resin, and
thus instantaneously, as he expresses himself, dissolve and disengage it
from the Coats of the Stomach.

Why a fixed Salt is to be given in a spirituous Body, I cannot
comprehend; the Salt being, in such a Liquid, indissoluble, and
certainly more corrosive. I fear too, that if it should immediately
dissolve the Resin (which is a very improbable Supposition) it would
only encrease the Corrosiveness and Expansion of the Poison, whereby the
Stimulus would become excessive, and would inflame and contract the
Orifices of the Stomach so powerfully, as to prevent the Benefit that
might arise from Vomiting, and so throw the Party into an immediate
Convulsion; for this same Reason, I think his subsequent Direction, to
take the Alkali Salt and Spirit after every Vomiting, lest it should
return from the Stomach without any Effect, very unnecessary; for the
Inflammation of the Oesophagus and Larynx would undoubtedly prevent such
a Kind of Remedy being administered very often.

The taking the Yolk of an Egg, to sheath the Salts of the Opium, and
confine their Power, and the Sapo Tartareus, stand both recommended by
Dr. _Jones_; the Egg particularly, with this additional Assertion, "That
it will be found by Experience (which is yet much wanted, because it has
not been used) "to be the very best Help in these Cases."

Notwithstanding this conjectural Opinion of his, he again recommends
Lixivial Salts and Spirit; and that their Use might not be neglected,
tells you, if you should not have Salt of Tartar at hand, other Alkaline
Salts will serve the Purpose; as of Wormwood, &c. but these being of a
weaker Nature, their Quantity is to be encreased, at least, one third;
and in great Urgency, from a Deficiency of them, their Ashes, or those
of any Vegetable, may be taken; provided they are joined with Brandy, or
old Wine; and that the Roughness of the Ashes will contribute not a
little to wear off the Resin.

_Geoffroy_ informs us, that the first Thing necessary to remedy this
Poison, is to empty the Vessels by copious Bleeding, if Strength will
admit.

Though this is a Practice I do not condemn, yet, as not having
experienced the Use, I cannot recommend it; for instead of relieving
Nature thereby, I should fear a Relaxation might be hurried on, which
ought to be prevented as much as possible.——In Fact, the Stomach is the
Place of Action, and present Relief can only be obtained, rationally, by
immediate Applications to that Part.

The Effect of Opium upon the Venous Fluid, is not immediate, but
secondary; for when injected into a Vein, it will neither encrease the
Motion of the Blood, nor coagulate it. Sir _Christopher Wren_ gives us
an Instance of this, by transfusing a Solution of Opium into the Blood
of a Dog, which, he observed, had no Effect upon the Animal, until it
had Time to reach his Brain, when the Dog became drowsy, and staggered;
from which he was relieved, by being forced into Motion, and in a short
Time afterwards grew fat. This, I think, proves, that the violent
Effects of Opium are on the Nerves, and not upon the Blood, which, by a
Consent of Parts, it can only rarify, and make more fluid. By
diminishing the Quantity of Blood in the Veins, the Secretions of Sweat
and Urine are interrupted, and the Relaxation, so much to be dreaded, is
forwarded.——The great _Boyle_, and Dr. _Willis_, likewise mention
Experiments of this Kind, made upon a Dog, but differ in their Accounts;
_Willis_ asserting, that a Dog can bear a large Quantity of Opium, and
overcome the Poison: He gives an Account of one that had received, by
Transfusion, three Ounces of liquid Laudanum into his Veins, and without
any very violent Symptoms, or other Help, than the Exercise of a Whip,
to keep the Dog in Motion, he perfectly recovered. The Effect which
followed Laudanum, being poured into a Dog's Stomach, as Dr. _Mead_
experimented, is very different from that by Transfusion, for it
presently convulsed and killed him; and upon Dissection, he found that
the Poison had not only inflamed the Coats of the Stomach, but abraded
the finer Vessels of the Brain.

To consider Opium in a true Light, respecting the primary Action of it
in the Stomach, is, in my Opinion, to suppose it similar in Corrosivity
to any other succulent vegetable Poison, with a peculiar _stupefactive
Power, that characterizes it_.

The Effect then is to be counteracted, _by disengaging the Stomach from
the Poison as fast as possible, by every Means of Secretion, checking
the Virus of it, and exciting and supporting Nature with warm nervous
Stimulants_, untill she has freed herself entirely from the dangerous
Effects of this powerful Drug.

These Circumstances considered, the ensuing Process is what I should
recommend.—In the first State, before the Poison has had Power to act,
and only Symptoms common to Ebriety appear (which is generally very soon
after it has been taken) let a Vomit be administered, to provoke the
Discharge of it; as soon as possible; for Instance;

Take of simple Spearmint-Water,

Oxymel of Squills; each one Ounce;

Powder of Ipecacuanha-Root, half a Scruple; mix them for a Vomiting
Potion.

The Person should, if possible, be diverted from immediate Sitting, or
lying down, and frequent Draughts of a Water-Gruel; not too thin, be
given to assist the Operation; which, if repeated, so as to procure four
or five Vomitings, will bring with it the major Part of the Opium. This
happy Effect may be presently guessed by the Smell of what is discharged
from the Stomach, and will be sufficient for the Time, if the Poison
taken was in a liquid State; but if in a Solid, the Vomiting should be
continued, by giving fresh Gruel, even to six or seven Times; for by the
compact Form, and through the stupefying Power of Opium, it will be the
last Thing disengaged from the Stomach. The Strength of the vomiting
Potion, if not deemed sufficient, may be encreased, according to the
Strength of the Patient, with an Addition of the Powder of
Ipecacuanha-Root.

This Operation may soon be over, as it depends upon the Assiduity of
administering the Gruel; nor need there be much Time spent in making it,
an Handful of Oatmeal being sufficient, mixing it in cold Water, and
pouring warm to it, without standing to settle, or straining; Broth,
Beer-Wort, or even Water alone might do; but the Gruel being easily and
quickly attainable by every one, I would recommend that, as the most
proper; if the Patient's Stomach had been charged with Food, but a short
Time before taking the Poison, this Vomiting may be found sufficient to
perform the Cure; yet is, in my Opinion, too precarious to be solely
depended on. I mention this chiefly as a favourable Symptom, since the
Power of Opium is to be much feared, when alone, in an empty Stomach, or
one, at most, charged with Fluids.

The next Thing requisite, is to place the Patient in a Bed, or Chair,
not in a lying, but sitting Posture, his Head supported, and Body
covered very warm, to promote a Sweat, but not so as to incumber him
with their Weight.

This is quite different from the Opinion of Dr. _Jones_, who recommends
the Patient to be kept cold, in Proportion to the Stupor, in order to
brace the relaxed Parts. If the Symptoms are extream, he advises the
Person to be exposed, stark naked, to the coldest Air, or thrown into
cold Water; and when you have not the Conveniency of a Vessel large
enough, you are to pump or dash cold Water over the naked Body. To this
extraordinary Opinion, I shall beg Leave to oppose that of _Grevinus_.
Lib. 2. _de Venenis_, Cap. 16. Pag. 208. _Balnea cum sint Calida &
Humida, cutim extendunt, Partes refrigeratas et exsiccatas corroborant,
& per insensibilem transpirationem exhalare faciunt id, quod inter
Carnem & Cutim relinqui potuit, Sanguinemque pristino vigori suo
restituunt._ Baccius likewise, Lib. 7. _de Thermis_, Cap. 23. Pag. 474.
particularly recommends the Use of warm Bathing, to the Recovery of
those who have taken Opium, and have appeared almost dead. Add to these,
the Opinions of most Authors for promoting the Secretions; which Opium
powerfully interrupts, especially in cold Climates, according to
_Tournefort_'s Observation; and _Willis_, _de Opii Nocumentis_, Page
188. Who gives an Account of a robust Man, dying in four Hours, from the
Time of taking the Laudanum, without the least Sleep or Evacuation.——How
does Dr. _Jones_ himself account for the Itching of the Skin, as a
Symptom of Opium having been taken to Excess, but by the Obstruction of
the Pores? And what will open them so soon, and promote the other
necessary Secretions so readily, as a _warm_ Bath? I should never fail
therefore to advise the Use of a warm Bath, would Time admit of the
Preparing it; the Recovery of the Patient depending much upon the most
expeditious Applications.

To return to the Point in View. We must correct what remaining Powers of
the Poison are left in the Body, after the Evacuations by Vomit, which
are to be carried _off by Sweat_, observing the Use of cordial
Medicines, to _support_, _strengthen_, and _brace the Frame_, using
likewise Blisters, which will not only rouse Nature by their Stimulus,
but derive a Portion of the Humours to themselves.

Take of simple Penny-Royal-Water, one Ounce and a Half, Strong
Nutmeg-Water, Distilled Vinegar; each two Drachms. The Cardiac
Confection, Powder of Mountain Valerian; each half a Drachm. Syrup of
Saffron, two Drachms; Tincture of Castor; twenty Drops; mix these for
one Dose, to be taken immediately, and repeated every half Hour, to four
Times, and afterwards every second, third, or fourth Hour, as the
Exigency of the Case may require.

The Sickness of the Stomach, occasioned by a large Dose of Opium, brings
me to consider the Power of Stimulants in the first Passages. As soon as
the Stomach becomes sensible of the Vellication therefrom, a nervous
Fluid is derived to the Part, and the Pectoral Muscles called into
Action; this Struggle in the first Passages being excited, yet so
discretionally as to avoid an Inflammation, puts the Party into a gentle
Sweat, by which, if promoted by Warmth and Diluents, Nature will breathe
off the Virus.

Thus we may account for the Operations of alterative Medicines; these
consisting in a Stimulus, excited to such a Degree, as is just
sufficient to bring the nervous Coats of the Stomach and Muscles into
Action, and corresponds with that brought on by Exercise. _Vide_ Dr.
_Willis. Phar. Ration. de Sudatione._ Pag. 117. A Diaphoresis is
introduced and promoted by the Consent of the arterial Fluid, which may
be practiced to a greater or less Degree, according to the Proportion of
the Stimulus; thus are the profuse Sweats brought on by Opium, according
to the Quantity used, as likewise by the different Preparations of
Mercury and Antimony, and in fact, every other mineral or vegetable
Production, that may prove a Stimulative in the Primæ Viæ.

To return to the Cure of the milder Effects of this Poison; the Patient,
during Vomiting, probably will be excited to Stool, by the Help of the
Oxymel of Squills first taken; if not, give a Sufficiency, according to
the Strength of the Subject, of Powder of Jalap, corrected with some few
Grains of the Aromatic Species, to procure Stools; but not to any
Excess, nor before some of the nervous cordial Medicines have been
taken, lest the necessary Sweats should be interrupted, and an immediate
Relaxation introduced. Jalap, as a Purge, is to be preferred, it being
more certain in Effect, and a Root loaded with a Resin, that may carry
down with itself any mucous Part of the Opium, which may adhere to the
Coats of the Stomach after Vomiting; for this Reason, both _Wedelius_
and _Jones_ recommend aloetic Purges. Opium interrupts, for the most
Part, the present Action of purging Medicines, wherefore they should be
given in encreased Doses, to produce the desired Effect.

The Patient, though on the Bed, must, by every Art imaginable, be kept
from immediate Sleep, by giving him Wine-Whey, frequently shaking him,
and such like Methods, applying to the Nostrils and Temples, Oil of
Amber, or other Antispasmodics, such as the Tincture of Assafœtida,
Soot, Valerian, &c. and this more or less, as there may be Occasion, by
which, and the Power of the Medicines already taken, and the continuing
the Use of _Correctors and Nervous Stimulants_, his Sweat will grow
profuse, and the Party not so inclinable to Sleep; or, if he should,
those Sleeps would not be permanent; which his Attendants should
endeavour to prevent, never permitting any one to continue so long as
half an Hour at a Time, between Whiles repeating the nervous Medicines,
and the Draughts of strong Wine-Whey, in Proportion to such Inclination.
If, on the other Hand, the Sleep should be so powerful, as that the
Party cannot easily be roused, Blisters must be applied to the Arms.
This Process, I persuade myself, will prove sufficient, in the first
Instance, where the Opium has been recently taken, especially if the
Quantity was not very large, and in such Cases, the Camphire Julip may
be very advantageously added to the above Regimen.

It is necessary to remember, that an _universal Relaxation_ must be the
Consequence of a Conflict of the whole Mechanism; and from these several
Evacuations in so small a Space, the human Frame must be weakened, by
her Endeavours to extricate herself from the deleterious Effects of this
Poison. This Inconvenience is easily repairable, by persevering in the
Use of _cordial and bracing Medicines_, which should likewise be
continued some Days, to bring the Frame to its pristine State; the
Patient must live upon light, but good Nutriment, drink after Meals, in
Moderation, of generous Wine, and avoid Sauces with Butter, that all
Danger of nervous Tremors, and Loss of Appetite, may be, as much as
possible, prevented; but if such should happen to be the Consequence,
the Tincture of the _Peruvian_ Bark, with Elixir of Vitriol, in small
Doses, will certainly remove them.

As I have condemned the Use of Alkalious Medicines, by endeavouring to
prove the Impropriety of them, and as the great _Mead_ has mentioned
them indefinitely, it may be proper to examine their Antithesis, or
contrary Principle of Acids, the Use of which, as Sudorifics and
Bracers, to compleat the Cure, are indispensably necessary.

As we find, upon the Examination of Opium, by chemical Analysis, that it
contains a very large Proportion of a volatile Salt, and corrosive Oil,
Alkalies will undoubtedly encrease the Volatility of the one, and
Corrosivity of the other, and thereby assist their Expansion. On the
other Hand, Acids condense Volatiles, and destroy their Power; and
furthermore, will prevent the Expansion of the corrosive Oil, by
checking the Activity of the Salts. We see, by putting the mineral Acids
to volatile Spirits, they destroy their Volatility, and produce fixt
Bodies. _Vide Boerhave, de Regeneratione Salis Armoniaci, &c. process.
20. Partis 3. de Operationibus Chemiæ._ Likewise by a vegetable Acid,
thus, when distilled Vinegar is poured to the Volatile Spirit of Sal
Armoniac, the Volatility is destroyed, as in making the Spiritus
Mindereri. The Antients, sensible of this, used frequently to prepare
Opium with vegetable Acids, to correct its Power; and by that Means
could give it in larger Doses; but this Practice, being in many Cases
inconvenient, was laid aside.

Acids are of two Sorts, either Mineral or Vegetable; the Mineral are the
stronger, and very corrosive, being drawn from Fossils by the Help of
intense Heat, as Vitriol, Nitre, _&c._ the Vegetable are Native, in
Fruits, as Citrons, Oranges, Limons, Limes, _&c._ in some Plants, as
Sorrell, &c. or produced by Fermentation, as Tartar and Vinegar.

Opium being a vegetable Production, replete with a volatile, urinous
Salt, what can be more efficacious to counteract the Power of it, than a
vegetable Acid, which is not of a corrosive Nature, so as to prevent the
taking of it, even alone, into the Stomach without Injury? and this
surely cannot be said of a mineral Acid. _Wedelius_, Lib. I. Sect. 2. p.
53. strenuously asserts the Use of Acids, _Acida enim Sulphura tum
Salium tum aliorum obtundunt, præcipitant, invertuntque ac exhalationem
et resolutionem remorantur, quod infinitis Experimentis Chimicis
demonstrari posset_. And, he further says, p. 59. "That Vinegar is a
most powerful Remedy for such as are poisoned with Opium, that it will
correct the Acrimony and Heat of it, and thereby the volatile Parts will
become mild, and as it were fixed."

The Affect of Opium upon the Nerves, being by Stupefaction, and a
subsequent Relaxation, what Principle can so readily restore them, as
light fermented Acids, and so soon promote, by their gentle Pungency, a
Disposition to Sweat? The crude Acids of Fruits and Herbs are more sharp
and contracting, than those by Fermentation; nor can they be used with
Safety in such Quantities, though they stand particularly recommended. I
prefer, therefore, the Acetum Stillatitium, or distilled Vinegar, it
being an Acid of sufficient Strength, and of a pure Nature, which,
joined with nervous and cordial Medicines, has fully answered my
Expectations.

Doctor _Jones_ mentions Acids in a secondary Degree, recommending the
fixed and unfermented to be used, "when the Resin is not at Stomach," as
he phrases it. That is, in other Words (as he places the whole noxious
Power inherent in the Resin) when the Patient is not in Danger.

Nervous and cardiac Medicines have a known Property of comforting the
Stomach; the former, by a soft balsamic Power, sheathing the Acrimony,
such are Valerian and Castor; and the other, by a warm stimulating
Nature, including Volatiles and Aromatics——The Antients were very
industrious in the Use of Simples, and attributed many Cures to certain
specific Properties of Individuals, which saved them much Trouble in
Ratiocination of Time, Place, and other accidental Circumstances, that
might arise; of these there are numerous Instances, and among the
Number, some are distinguished as _Specifics_, for the Cure of those
poisoned with Opium; the best of which, are Camphire, Castor, and
Coffee; the former two are recommended by many Authors; the latter, by
Doctor _Willis_, as is the Semen Elephantiasis by _Pliny_.

I think, according to what has been said of the Action of Opium on the
Stomach and nervous System, that the Evacuations by Vomit, Sweat, and
Stool, with the Use of Acids and Cardiacs, become indispensably
necessary to expel the Virus, and prevent an after Relaxation. Can any
one nervous Principle produce all these combined Effects? I think
neither of the abovementioned can; Nor do I know of any other that is
singly capable of it. The strong Power of Castor upon the Womb is so
well known, especially where the Party is pregnant, (which is generally,
I presume, the Case, when Women take this Poison) that the Use of it
ought to be rejected; and I may almost venture to affirm, that, where a
person recovers by taking one kind of Medicine only, the Cure cannot
rationally be accounted for, but through the native Strength of the
Constitution; and, whoever depends upon that alone, must often fail of
Success.

By the Method laid down for the Cure of the milder Effects of this
Poison, the rational Means of treating the most inveterate is
discovered, it being requisite only to encrease the Strength of the
Medicines, in proportion to the opposing Power of the Poison, the
Constitution of the Party, or other concomitant Circumstances.

These being premised; in the second Degree of Symptoms, and in the most
violent, I cannot do better (as I have happily experienced Success in
both) than recite the manner of Cure, as Circumstances occurred to me.

In the second Degree, _viz._ Convulsive Twitchings, Madness, Suppression
of Breath, florid Complexion, fixt Eye, and faultering Speech——The Party
had taken one Ounce of Laudanum, in different Proportions, with small
Punch, in the Space of an Hour, and this upon an empty Stomach; being
thus taken at Intervals, the Vellications in the Stomach were not so
immediately violent, as to make it be rejected; the Party conscious of
his Error, and fearful of the Consequences, when the Poison began its
Operation (he being possessed of a strong Constitution) endeavoured to
counteract the Power of it by violent and incessant Walking, till
Nature, overcome by the Conflict, was no longer able to support herself.
The sleeping Power of the Opium being withstood, the Operation upon the
animal Spirits produced a Delirium; the Eyes were distorted, the Speech
inarticulate, notwithstanding, his Pulse moved slowly, but with great
Distention of the Vessel; I found also a cold, flaccid Moisture of the
extream Parts, with convulsive Twitchings, and a violent Tremor, arising
from excessive Exercise, and the Effect of the Poison upon the whole
nervous System; and from the Length of Time the Poison had been taken,
an almost immediate Solution was to be apprehended, after the Manner
observed by Doctor _Willis_, quoted in a former Page.

I gave him a vomiting Potion, which, by the Help of a Quantity of Gruel,
soon operated; and presently after (the Vomiting being ended) a nervous
cordial Draught, of the same Nature of that already described,
encreasing the Quantity of Acid with Castor, (being a more powerful
Antispasmodic) instead of Valerian. He was placed upright in Bed, and
being covered warm, through the Assistance of the Medicines, in a short
Time, fell into a profuse Sweat; he drank plentifully and frequently of
warm Whey; Blisters were soon after applied to the Arms: The first four
Draughts were taken within the Space of two Hours: His Pulse thereupon
grew full, and regular, and the extream Parts warm. AS I perceived he
laboured under an Astringency of Body, and the Virulence of the Poison
being now, in some Degree, carried off by Sweat, I gave him, of the
Powder of Jalap, one Scruple, properly corrected as before; which
performed its desired Office. The Virus thus subdued, I reduced the
Quantity of Acid in each Draught, and repeated them Night and Morning
for some few Days, with a Cordial Julep to take of, at Intervals, when
oppressed with a Languor of Spirits. By this Process the Patient
perfectly recovered his Health.

Doctor _Jones_ has observed, that when Opium causes a Purging, the
Patient generally recovers; but is an Evacuation that rarely happens,
without Art. A Constipation or bound State of Body is the general
Consequence that ensues the taking this Poison; which to remove,
requires the Aid of brisk Purges, and those, for the most Part, in
encreased Doses.

In the most extream and violent Degree, when a large Quantity of this
Poison has been taken, and gained its full Power of Action, the Symptoms
are, an Inclination, but Inability, to vomit, from the great
Inflammation of the Parts, Hickupings, heavy and dead Sleeps, unequal
Pulse, Convulsions, Contraction of the Jaw, profuse and cold Sweats,
with a total Relaxation of the extream Parts. In this State, I found a
Patient, who had taken the Poison upwards of an Hour; she was lying on
the Bed, in a profound Stupor, interrupted only with Convulsions.—She
did not exceed the Age of Eighteen, of a slender and delicate
Constitution. I ordered her immediately to be raised to a sitting
Posture in Bed, supported by Attendants on each Side; and then gave the
following Powder, mixed with warm Water, in a Spoon; as that was the
readiest Way the Medicine could be got down, some Force being requisite,
and half of it, even then, was lost, by running out at the Sides of the
Mouth; yet the Stimulus of the remaining Quantity, which reached the
Oesophagus, or Mouth of the Stomach, was sufficient to cause an
immediate Inclination to vomit, and gave Opportunity for pouring down
Fluids.

The Powder was of Ipecacuanha, and _Russia_ Castor, each half a Drachm
in fine Powder, mix them for one Dose. In the Space of ten Minutes I
might get down, I suppose, about one half of this Powder, and the warm
Water, which we forced into her at the last, in some Quantity,
occasioned her to vomit plentifully five or six different Times; her
Senses yet were in no Degree returned; her Head falling upon the
Shoulder, as if lifeless; the Convulsions, however, ceased, and she grew
warm. I caused her then to be roused as much as possible, by a continual
Movement of her Arms and Body; but to little Purpose. The following
Medicines were then given:

Take of the Powder of _Russia_ Castor, Mountain Valerian Root, each half
a Scruple, Aromatic Species, five Grains; and with a sufficient Quantity
of Sir _Walter Raleigh_'s Cordial, mix them into a Bolus, to be taken
directly, and repeated every half Hour, or oftener, as the Urgency of
the Case might require.

Take of simple Spear-Mint Water six Ounces; strong Cinnamon Water,
distilled Vinegar, each one Ounce; Syrup of Clove Gilly-Flowers six
Drams; mix them together into a Julep, of which give the Patient four
Spoonfuls with each of the above Bolusses, and between whiles, when
faint.

Assafœtida Drops were used likewise to her Nostrils and Temples, and
Blisters applied to the Arms as expeditiously as possible.

These Bolusses being given as directed, and the Julep, or Wine Whey,
(every two or three Minutes) she went into a profuse Sweat; and, in
little more than an Hour from the Time I first saw her, recovered her
Senses and Speech. These, however, were imperfect; then ensued Stools,
and an universal Relaxation, with frequent, and almost continual
Faintings; she was relieved from these by quick Repetitions of the
Julep, which had been some little time neglected by those about her. She
continued the Use of the Bolus, leaving out the Castor, and encreasing
the Quantity of the Valerian to a Scruple, with the Julep, for some
Days; and in a Week was free from every bad Consequence. The Vertigo and
Tremor had entirely left her, and no Remains of the Disorder apparent,
but in the sallow Look of her Skin, and that continued some time. She
was with Child, and did not miscarry, notwithstanding the Quantity of
Laudanum taken was one Ounce.

In these Cases, when the Virus of the Poison is weakened, it would be
wrong immediately to omit the use of Medicines, since the future Illness
that would probably arise, might be prevented by the Power and Quantity
of them being gradually decreased; for which Reason I shall lay down no
Rule, but leave to the Discretion of the Gentleman employed to act, as
the Weakness, or other consequent Symptoms attending the Patient, may
direct.

I shall recite yet another Case of a Child, about eighteen Months old.

The Reader may very naturally doubt, how it was possible for a Child, so
young as this, to be poisoned with Laudanum. Sorry am I to say, nothing
is so easy; the Practice among Nurses to give to their Children the
Syrup of the Sleeping Poppy, or other quieting Medicines, is too common;
and particularly, one that goes by the Name of _Godfrey_'s Cordial;
which is a Composition very binding, has Opium in it, and was never
designed by the Author for such Purposes; but was calculated principally
for the Cure of Fluxes. By the Administration of such Things, a Nursery
may be kept quiet, which is Inducement enough to some Nurses, as they
will be enabled thereby to pursue their various Employments without
Interruption, which could not be done with the same Ease, were the Child
waking.

A Girl, at the Age of eighteen Months, had the Whooping Cough; to remedy
which, her Mother was advised to get of a sleeping Medicine, called
Elixir Paregoricum, and to give the Child a certain Quantity of it every
Night. What that Quantity was, or how much was given, I cannot
positively say; but am certain, that it was sufficient to be in Effect
very violent; for a Struggle of Nature immediately ensued the swallowing
of the Medicine to overcome Strangulation, caused by the Heat and
confining Power of it; presently after, the Child sunk into a heavy
Sleep, which continued near twenty-four Hours; and she bore, during that
Time, all the progressive Symptoms of the Power of Opium, which
encreased, as usual, to Convulsions.

The Use of Acid in this Case was, in a manner, forbid me, from the
natural Tendency of the Humours in young Children to such Ferments; I
therefore avoided it, till obliged by the Violence of the Effects
(acting after _Harris de Morbis acutis Infantum_, p. 102. _Quod ad
convulsiones spectat, ab Acrimonia Materiæ Morbificæ propaginem Nervosam
Extimulante ut plurimum pendentes, Testacea nostra, et maxime, si
Castoreum iis adjiciatur, &c._

As my Patient had the nocent Dose given her at Night, the Effect was not
perceived until the next Morning, when they found her, with her Eyes
closed, and insensible to the taking of Aliment and Drinks, in
consequence of which, I was called to her, and ordered as follows:

Take of Castor Water, one Ounce and a half; Crabs Claws and Cordial
Confection, each one Scruple; Syrup of Saffron, two Drachms; Tincture of
Castor, twenty Drops; mix them, and give a large Spoonful often.

A Blister was applied to the Back, notwithstanding which, the
Convulsions encreased, with short Intervals of a total Relaxation, to
which Infants are very liable in most Illnesses, owing to the natural
Moisture of their Bodies; I then gave the following:

Take of simple Pennyroyal Water, two Drachms; the Cordial Confection,
half a Scruple; Powder of _Russia_ Castor, three Grains; strong Cinnamon
Water and distilled Vinegar, each half a Drachm; mix them for a Draught,
to be given as soon as possible.

Soon after taking this Medicine, my little Patient recovered from her
Convulsions, opened her Eyes, and cried.

I then gave her a Powder of Rhubarb and Jalap corrected, which, in the
Course of the Day, produced several Stools, that smelt inexpressibly
strong; the Fits left the Child that Evening, and, in a few Days, she
was entirely recovered.

It is necessary to observe, that I continued her Testacea Powders for
several Days, to correct any Disposition there might be to Acid Ferments
in the first Passages, after their being so injured by the Power of the
Sleeping Medicine.

It is also remarkable, that, in this Case, the Effect of the Poison upon
the Child was not so sudden or violent, as on an Adult; for, I observed,
the Power of it was encreased the ensuing Day; whereas a grown Person,
if he escapes the extream Action of the Opiate for the first twelve
Hours (which was about the Interval of Rest, from the Time of her taking
it, until I saw her) his Symptoms afterwards grow mild, and he, in a
Manner, out of Danger. I presume that this After-operation of the Opium
on the Child, might be occasioned by a great quantity of Phlegm, that
had invested, at that Time, the Coats of the Stomach. The Phlegm raised
by young Children, is commonly deglutiated, and thereby might defend her
Stomach from the Violence of the Poison, until such Time as a Portion of
that Phlegm had passed into the Intestines, and thence had given the
Opiate Room to penetrate and cummunicate its full Power to the Body.

I have now passed through the whole Process, which I have experienced in
this Poison; yet, shall further add, some general Rules, for the Use of
Places, where Physical Advice cannot be immediately obtained; and, as
this may sometimes be the Case in Villages remote from Market-Towns, I
have held it my Duty to give every Insight, that might tend to the
Preservation of Life in such Exigencies; though I would not recommend
this Method solely to be depended upon, without further Advice, where
physical Assistance is obtainable.

A Person who has taken Opium to Excess, should forthwith be made to
vomit several Times, by every Art imaginable, remembering the more quick
and copious the Draughts of Liquor are given, the better Chance there is
for Success.

Let the Party affected be kept as much as possible in continual Motion,
giving him, when he has done vomiting, a Glass of Sack or Mountain Wine,
with a Table Spoon-full of good Vinegar in it, especially when in
Tremors; in a languid and relaxed State, the Vinegar thus mixed should
be repeated frequently, (The Use of rich generous Wines were esteemed
Specific in this Case by the Antients; and among the rest _Hoffman_ and
_Rondoletius_) and where Wine is not to be got readily, Water may be
used, with Honey or Sugar dissolved in it, 'till the Liquor will bear an
Egg.

If the Person is not capable of Motion, cover him very warm to promote
Sweat; to which the abovementioned Liquors, and strong Whey, will
greatly contribute. Use every Stratagem to keep him from Sleep, until he
has sweated an Hour, or thereabouts; he may then be suffered to sleep a
little; but not for a Continuance, rousing him forcibly every fifteen or
twenty Minutes; if he should faint, or grow cold, add some grated
Ginger, or beaten Pepper, to each Draught of the Wine and Vinegar. If
Beer or Ale Wort can be got, it may much help, by its mucilaginous
Parts, to check the Activity of Opium, and carry it off by Stool;
likewise the swallowing of Yolks of raw Eggs may contribute, as Doctor
_Jones_ observes, and the drinking of Coffee, as recommended by the
learned Dr. _Willis_.

I have endeavoured, throughout these Pages, to trace the exact Power of
this Poison——I began with the natural History of the Plant from which it
is collected, in order to reconcile different Opinions, by pointout the
most easy and rational Method of gathering it; which likewise
contributes to render the Analysis of the Drug more compleat. Thus we
discover the Principles whereby Opium acts upon our Bodies, and are
consequently enabled more fully to counteract the obnoxious Parts of it.
Without enlarging upon the different Effects of Alkalis and Acids, I
have recited several Experiments in favour of the latter; and without
interfering with Specifics, and Antidotes, have pointed out a regular
Method, whereby the different Degrees of Power this Poison may have,
when taken into the Body, may be remedied. Thus the Gentlemen of the
Faculty have a kind of Rule how to act upon Emergencies of the kind,
which the Rareness of the Case may not have given some of them an
Opportunity to be acquainted with. That Knowledge which I have attained
from my Experience, may undoubtedly be yet much improved by those
Practitioners, who have Talents superior to mine; but for the
unexperienced and retired, where physical Assistance is not readily
attainable, a Method is here laid down, so easily practicable, that a
Life, perhaps, may be saved thereby. This Consideration alone, that I
may possibly, some Time or other, be serviceable to a Fellow-Creature, I
esteem an ample Return for disclosing my Sentiments upon this Subject,
and a sufficient Satisfaction for the Trouble I have taken in the
foregoing Pages.

FINIS.


Transcriber's Notes.

This Book is 300 years old and the advice given has been superceded and
is of historical value only.

The original spelling and punctuation has been retained.

I have been informed that some of the latin as printed is incorrect, but
have retained it as in the original Pamphlet.

Italicized words and phrases are presented by surrounding the text with
underscores.





End of the Project Gutenberg EBook of An Essay on the Effects of Opium.
Considered as a Poison, by John Awsiter

*** 