Opium

Negative, torpid states; but little pain, secretion or reaction. Paralysis; painless; of brain, tongue, bowels, lungs, etc. Tremor. Twitchings; during sleep. Convulsions. Epilepsy, in sleep. Internal dryness. Hot, head; sweat; bed seems, hunts a cold place, etc. Stupid sleep, spasms, violent chills, etc., during. .................... PLACID; says nothing ails him. Dreamy. Sluggish. Dull. Stupid. No will power. Lying. Fears; after fright. Delirium; with terror; alcoholic. Wants to go home. Carphology. Cerebral congestion; intercurrent; apoplectic. Heavy occiput. Visual hallucinations. Inactive pupils. Red, bulging, staring eyes. Dark, turgid, sweaty or hot red face or red and pale alternatly. Old look; after cholera infantum. Mouth twitches or hangs open. Cravings, without appetite. Vomiting; in peritonitis. As of a weight in abdomen. Bowels feel obstructed. Paralytic atony of bowels and bladder; after laparotomy. Hard tympany. Colic; lead. Stools of hard, black balls. Constipation. Bloody mucus oozes from open anus. Retained urine. Lively fœtal motions. Rattling, unequal breathing. Sighing. Snoring. Stertor. Tickling cough. Pneumonia. Weak heart. Crawlings here and there. General itching. Skin rough and dirty. Painless ulcers. Tired and sleepless; drunkards. SOMNOLENCY. Heavy, stupid sleep; of the aged. Full, slow pulse (Dig.). Hot, sweaty (Samb.) and drowsy; with cold limbs. Sweaty, without relief.

EMOTIONS. FEAR. Fright. Joy. Odors. ALCOHOL. Sleep. Suppressed discharges. Receding eruptions. If heated.

Cold. Uncovering.

MIND. SENSES. NERVES: Brain. Cerebro-spinal. Sympathetic. Lungs. Respiration. Digestive tract.

Complementary: Alu. Bar-c. Bry. Pho. Plb. Related: Arn. Nux-m.

Opium

Poppy. Papaveraceae.

Especially adapted to children and old people ; diseases of first and second childhood (Bar. c.. Mill.); persons with light hair, lax muscles, and want of bodily irritability.

Want of susceptibility to remedies ; lack of vital reaction, the well chosen remedy makes no impression (Carbo v., Laur., Val.).

OPIUM ( ConiiniiecC) .

Ailments : with insensibility and partial or complete paralysis; that originate from fright, bad effects of, the fear still remaining (Acon., Hyos.) ; from charcoal vapors; from inhaling gas; of drunkards.

All complaints : with great sopor ; painless, complains of nothing ; wants nothing.

Spasms : of children, from approach of strangers ; from nursing after fright of mother (Hyos. — after anger of mother, Cham., Nux) ; from crying; eyes half open and upturned.

Screaming before or during a spasm (Apis, Hell.). Deep stertorous respiration both on inhalation and exhalation.

Delirium, constantly talking; eyes wide open, face red, puffed; or unconscious, eyes glassy, half-closed, face pale, deep coma; preceded by stupor.

Thinks she is not at home (Bry.) ; this is continually in her mind.

Picking of bed clothes during sleep (while awake, Bell., Hyos.).

Delirium tremens : in old emaciated persons ; bloated face, stupor, eyes burning, hot, dry ; with loud snoring.

Sleep: heavy, stupid; with stertorous breathing, red face, eyes half -closed, blood-shot ; skin covered with hot sweat; after convulsions.

Sleepy, but cannot sleep (Bell., Cham.), sleeplessness with acuteness of hearing, clock striking and cocks crowing at a great distance keep her awake.

Loss of breath on falling asleep (Grind., Lach.).

Bed feels so hot she cannot lie on it (bed feels hard.

Arn., Bry., Pyr.) ; moves often in search of a cool place; must be uncovered.

Digestive organs inactive: peristaltic motion reversed or paralyzed; bowels seem closed.

Constipation: of children; of corpulent, goodnatured women (Graph.) ; from inaction or paresis, no desire; from lead poisoning; stool hard, round, black balls (Chel., Plumb., Thuja) ; fseces protrude and recede (Sil., Thuja).

Stool: involuntary, especially after fright (Gels.); black and offensive; from paralysis of sphincter.

Urine : retained, with bladder full ; retention, postpartum or from excessive use of tobacco ; in nursing children, after passion of nurse; in fever or acute illness; paralysis of bladder or sphincter.

(In Stramonium we have suppression; while in Opium the secretion is not diminished, the bladder is full but fullness is unrecognized.)

Opium renders the intestines so sluggish that the most active purgatives lose their power. — Hering.

Persistent diarrhoea in those treated with large doses of the drug. — Lippe.

Sudden retrocession of acute exanthema results in paralysis of brain or convulsions (Zinc.).

Marasmus ; child with wrinkled skin, looks like a little dried up old man (Abrot.).

Relations.. — Antidotes, for poisonous doses; strong coffee, Nux, Kali per. and constant motion.

When symptoms correspond, the potencies may antidote bad effects of Opium drugging.

Compare: Apis, Bell., Hyos., Stram., and Zinc.

Aggravation. — During and after sleep (Apis,, Lach.); while perspiring; from warmth; stimulants. Amelioration. — From cold; constant walking.

Lecture XXVI — Papaveraceae — Opium

WE now proceed to study the Papaveraceae; an order of plants from which we obtain Opium, Sanguinaria Canadensis, and Chelidonium majus. As an order, they act on the circulation of the blood, tending to produce narcosis of a greater or less degree by engorging the blood-vessels of the brain. The effect thus produced on the sensorium ranges all the way from sleepiness to stupor. This, you know, is eminently true of Opium, and, to a less degree, of Sanguinaria and Chelidonium. Fumaria officinalis contains an enormous amount of potash in its ashes ; Argemone Mexicana, the Mexican poppy or yellow thistle, has been used in the treatment of tinea. It has a yellow juice, which, when exposed to the air, looks like Gamboge. We shall now take up the study of these drugs seriatim.

Opium.

( Brain. Emotions.

Spasms. Paralysis.

Marasmus.

Opium. \ Constipation. Bladder.

Sleep.

Chest. Lungs. Heart.

Defective reaction.

Opium is obtained, as you probably know, from the unripe capsules of the poppy plant, Papaver somniferum. The unripe capsules are usually employed in its manufacture, because they are more powerfully soporific. In some respects opium is the most remarkable drug in our materia medica. You know that many drugs owe the majority of their effects to active principles which they contain. Thus Belladonna contains Atropine ; Stramonium, Solanine ; Nux vomica, Strychnine, etc. ; but Opium seems to embrace an endless number of these active principles and each succeeding year adds to the list. Let me enumerate them—they are as follows :

Morphine, Protopine, Pseudo-morphine, Methylnornarcotine, Codeine, Deuteropine, Apocodeine, Laudanine, Thebain, Codamine, Cotamine, Papaverine, Hydrocotamine, Rhoeagenine, Apomorphine, Rhoeadine, Desoxymorphine, Dimethylnornarcotine, Nornarcotine, Meconidine, Thebenine, Cryptopine, Laudanisine, Narceine, Narcotine, Meconic acid, Lanthopine, Lactic acid.

These various substances are derived from Opium, by more or less complicated processes. They have more or less narcotic properties akin to those of Opium itself. The action of some of these alkaloids is well-known, while of the action of others we are as yet ignorant. Morphia (used principally in the form of the sulphate) is probably the best understood of these. It is largely used by old-school physicians in hypodermatic medication for the relief of pain. But we may make use of it as a homoeopathic remedy. In such violent diseases as cancer Morphia has been successfully given for one of its secondary symptoms, extreme susceptibility to pain ; pains are so violent as to threaten convulsions, or cause twitching and jerking of the limbs ; under these circumstances Morphia is a homoeopathic remedy. It does not cure, but relieves the pains, not as an opiate by stupefying the patient, but according to the law of Homoeopathy.

Morphia has the property of producing tympany. This is a very important fact for you to bear in mind, as you may find it necessary to differentiate incipient peritonitis from Morphia effects. Codeine, another of these alkaloids, is a useful drug in the treatment of phthisis. It is indicated in that dry, teasing cough which annoys the patient night and day.

Furthermore Codeiiie has caused and cured twitching of the muscles, especially of the eyelids. This is a very annoying symptom ; it is sometimes relieved by Crocus.

Apomorphia causes and cures vomiting. Now this vomiting is not of the kind for which you give Ipecac., Tartar emetic, Lobelia, etc. It is a reflex vomiting usually from the brain. Apomorphia produces vomiting if injected hypodermatically, long before it can have any local action on the stomach. You may utilize this effect of the drug in vomiting of cerebral origin, and also in that annoying disease from which many people suffer, and for which they get little sympathy, seasickness. In these cases of cerebral vomiting you may also think of Belladonna, Glonoin and Rhus tox.

There are several other of these alkaloids of which we have some provings, but nothing that has been definitely described. There are also numerous preparations made from Opium ; these are largely used in allopathic practice ; we have nothing, however, to do with them, except to undo the mischief they produce. The various preparations of Opium enter into the composition of cough-mixtures and soothingsyrups, used largely in popular practice. Their effects are decidedly pernicious, especially in children. A prominent old-school authority says that the use of soothing-syrup for children is decidedly reprehensible. It stunts their growth, makes them irritable and cross, and interferes sadly with the brain development. Nux vomica is one of the antidotes in cases of injury from anodyne preparations. Still better, perhaps, as an antidote, is Chamomilla, which is suited when opiates have been given for some time, and have produced their secondary effects ; the little one is wakeful ; slight pains are unbearable. When this condition is present, Chamomilla is your remedy, whether the patient be child or adult.

No drug is more freely abused by both allopath and homoeopath (!) than is the one we are studying to-day. I would that I had both opportunity and ability to convince the practitioner of the old school of medicine of the absurdity of his indiscriminate use of opiates, and I could hope still more earnestly to dissuade homceopathicians from hiding their ignorance under the anodyne effects of an occasionally interpolated dose of Morphine or Laudanum. The one class, ignorant of any other means of assuaging pains, and the other class, too lazy to study their cases, seek relief for their patients in anodynes. Call them to task for their unscientific practice and they meet you with the remark, "my duty is to relieve the sick." Let me rejoin, " At any cost? Must you do what you know to be wrong? " " No, but how do you make it wrong ?

' Tet me reply by a brief resume of the modus operandi of Opium, and then if this question is not answered I make no further objections to anodynes.

In small doses, Opiit?n has primarily a transient exhilarating effect. It seems, however, to affect the emotional more than the intellectual sphere. The mind feels as if floating in the air, unincumbered by the laws of space and gravity. The imagination has full play. If now the dose be increased, either in quantity or by frequent repetition, there follows a sleepy state. This sleep varies all the way from a pleasant feeling of easy drowsiness to the most profound stupor. This narcotic and anodyne effect of Opium is the result of the increased circulation of blood in the brain, brought about not only by increasing the amount of blood supplied to the brain but also by interfering with its return to the heart. Let me digress for a few moments and speak of the physiological explanation of sleep. Hammond has shown that during this state, the quantity of blood circulating in the cranial cavity is greatly diminished. If you give Opium to produce sleep, what do you do? Do you produce ansemia of the brain? No, just the reverse. I ask you, then, is the administration of opiates for their anodyne effects at all rational ?

Returning to the effects of Opium—the face becomes deep red and swollen from the distension of the blood-vessels. The more profound the stupor, the darker red is the face. It may even become of a brownish hue. The pupils become contracted. The pulse is full and slow. Respiration is deep, and as the stupor grows in intensity it becomes heavier and finally stertorous. What is the meaning of this stertor ? It means that as the poisonous effects of Opium increase, a paretic and finally a paralytic condition of the muscles of the palate and cheeks appears. These parts, thus being thoroughly relaxed, flap back and forth with each respiration. The pulse is full, round and slow, showing you that the heart is acting with the full volume of blood, but not with the usual speed. As the case goes on hour after hour, you find a picture of complete paralysis developing. The practical application of this I will give you when speaking of typhoid fever. The sphincters lose their control, so that there is involuntary escape of urine and faeces. The pupils now are dilated and the skin is bathed in cold sweat. The lower jaw drops and finally death ensues. In these fatal cases autopsies show the cerebral convolutions to be flattened, the vessels of the cerebro-spinal axis engorged with blood; and there is effusion of serum beneath the arachnoid and into the ventricles of the brain.

These are the symptoms of acute Opium poisoning.

Now these phenomena depend upon the action of Opium on the nerves. From irritation comes the first brief excitation. From the subsequent paralyzing action come the drowsiness, muscular relaxation and coma. From the beginning, the cerebral vessels are surcharged with blood, and this gradually increases until sopor ensues. Now, gentlemen, let me ask, is it rational practice to assuage pain with a substance which paralyzes and so relieves by taking away, not the disease, but thk ability to feee, the consciousness of suffering? What are the effects produced by the habitual use of the drug? The first effect is one that I have already described to you, one of dreamy imaginative activity of the emotional mind. I^ater, as the use of the drug is continued, every tissue of the body becomes affected. The skin grows dry and sallow and hangs in folds, the limbs emaciate, and the intellect becomes dulled.

The best antidote to Opium is strong black coffee, given repeatedly until there is some sign of reaction. In addition to that you should use electricity. You should also remove any of the poison that may be in the stomach by means of an emetic or the stomach-pump, and you should force the patient to walk about to prevent stupor. Opium has so far been sufficiently described for you to see readily in what classes of disease it is indicated.

You see the picture of Opium in typhoid fever with profound cerebral congestion resulting in paralysis of the brain, dropping of the lower jaw and stertorous breathing. Often when Opium is called for in this disease, the body is bathed in a hot sweat. This sweat is not critical. It is a bad omen. It is a symptom of approaching death, in that it is a result of paralysis of the sweat glands. This symptom is also found under Stramonium.

In typhoid fever with threatening paralysis of the brain, you should remember Lachesis, the symptoms of which I described to you w Then lecturing on that drug ; also Hyoscyamus, which has the stertorous breathing; but there are differences, as you will learn in a future lecture. Opium must be considered in the treatment of apoplexy. It is natural to suppose that a remedy producing such fulness of the cerebral blood-vessels might, in persons predisposed, readily cause their rupture, and the consequent symptoms of extravasation of blood into the cerebral substance. Opium is indicated by the color of the face, by the stertorous breathing, and by tetanic rigidity of the body. Especially is it indicated in the apoplexy of drunkards. Opium follows Belladonna in apoplexy.

In apoplexy occurring in drunkards, you should think also of Baryta carb. and Lachesis.

Arnica suits in apoplexy, when the pulse is full and strong. The paralysis is on the left side and there is stertorous breathing. Apis is called for when the coma fails to yield to Opium. For apoplexy with convulsions, think of Belladonna, Hyoscyamus, Lachesis and Opium.

For apoplexy followed by paralysis, Arnica, Belladonna, Lachesis, Nux vomica and Rhus tox.

When followed by idiocy, Helleborus.

In apoplectic congestion with sleepiness after meals Opium should be compared with Nux vomica and Arnica.

Opium is useful in mania a potu or delirium tremens. Especially is it indicated in "old sinners;" in those whose long lives of excess have thoroughly destroyed their constitutions ; in those who have had the disease time after time. It takes but a small quantity of liquor to throw them again into the delirium. The face wears a constant expression of fright or terror. . They have visions of animals springing up from various parts of the room. They imagine that they see ghosts, devils, etc., with whom they converse, though they are terrified by the subjects of their visions. If they succeed in obtaining sleep, it is of the stertorous character already referred to. There are several remedies which, if given soon enough, will enable you to carry your patients with delirium tremens safely through the attack. I have already mentioned Opium ; another is Lachesis ; especially is this indicated when the patients have visions of snakes and other hideous objects; sensation in the throat as if choking; and springing out of sleep suddenly as if from a dream.

Another remedy is Stramoniitm, to which you will be guided by the violence of the symptoms. The patient starts from sleep in perfect horror, with visions of animals coming toward him from every corner of the room ; he makes efforts to escape ; his face is bright red.

Still another remedy is Cannabis Indica, or the hashish. This is one of the best. It has thus far been given only in low potency. The symptoms which seem to characterize it are, ideas of grandeur and errors of perception as to space and as to time.

In other cases we have to use Arsenicum, when there is fear of death and the patient will not permit himself to be left alone. A remedy often forgotten, but useful, nevertheless, is Calcarea ostrearum. The minute the patient closes his eyes he sees visions which compel him to open them again in affright.

You may use Opium in cholera infantum when the face is red or pale, and is associated with fatally advancing stupor ; the pupils react to the stimulus of light either not at all or else very sluggishly. The disease seems to begin by involving the brain, or such a mishap threatens during its course ; as yet there is neither diarrhoea nor vomiting ; the child appears as if it had been drugged. Opium administered in a case like this will restore the patient to consciousness. Diarrhoea sets in, and the disease proceeds naturally to recovery. This remedy may also be given when there is a lack of vitality, and the well-selected remedy refuses to act. The patient is either sluggish or drowsy. It is just as useful in these cases as are Carbo veg.

t Sulphur, Valerian, Ambra grisea, Psoiinum, or any of the other drugs called for in defective reaction.

There is a remedy which I wish to give you here, but with some caution, because it is what has been termed a "breech-presentation," that is, it was used clinically before provings of it were made. That remedy is frerrum phos. It is called for in cholera infantum when the discharges from the bowels are frequent; within twenty-four hours the child is greatly reduced, and falls into a stupor, with red face, dilated pupils, rolling of the head, and soft, full-flowing pulse. We know that Iron has that kind of a pulse ; we know that congestion belongs. to all the preparations of Iron. In one of my cases with the above symptoms, Belladonna and Sulphur-were each given in turn, but failed. I then gave Ferrum phos. , and in twelve hours the child returned to consciousness, and is alive to-day.

You may also use Opium in suppuration of the lungs occurring in those greatly addicted to the use of intoxicating liquors; the breathing is labored, and is attended with rattling and snoring. Cough is very difficult, and is attended with smothering spells ; the face becomes blue during the cough.

Another affection of the lungs occurring in drunkards, namely, haemoptysis, calls for Opium when the chest is hot and the limbs are cold ; the cough is violent, and is attended with an expectoration of frothy mucus and blood ; the patient is drowsy with the cough. Antimonium tartaricum also has cough with drowsiness and gaping. We find Opium sometimes indicated in spasms, especially when they occur as the immediate result of fright or anger ; or when a nursing infant has a convulsion after its wet-nurse has been frightened ; the body is in a condition of tetanic rigidity ; opisthotonos ; the spasm is ushered in with a loud shriek ; there is foaming at the mouth ; the face becomes dark red, or even purple, and the body is often bathed in a hot sweat ; deep, snoring sleep follows the spasm.

Opium causes and cures constipation ; a constipation in which there is inertia of the rectum and the entire intestinal tract ; there is no inclination whatever for the bowels to move ; thus the bowels become impacted with faeces ; flatus accumulates in the upper portion of the intestines and presses upward against the chest. This symptom is very common after diseases that are debilitating or long-lasting. In such cases I have been in the habit of giving Opium in repeated doses until colicky pains are produced ; this indicates restoration of peristaltic action of the bowels. I then order an injection of cocoa-nut oil or soap and water to soften the faecal masses, when an easy evacuation of the bowels follows. The Opium stool in its complete picture consists of little hard, dry, black balls. This form of constipation reminds us of that of Alumina, Plumbum and Bryonia.

Bryonia has constipation with inertia of the rectum and lack of intestinal secretion ; the stools are large and dry.

Plumbum closely resembles Opium, but there is some spasmodic constriction of the anus ; the stools consist of hard, black balls. Alumina has inertia of the rectum with hard, dry, knotty stools, but often attended with soft faeces.

In tympanites or accumulation of flatus, especially in advanced stages of peritonitis, compare Opium with Terebinthina, Lycopodium, Carbo veg., Colchicum, and Raphanus.

The characteristic symptom calling for the last-named remedy in tympanites is, that the patient passes flatus neither upward nor downward for days.

Opium may be used in bladder troubles, especially in retention of urine. It is indicated when this retention has resulted from fright, and when it follows parturition. This last-named symptom I have twice confirmed.

In this retention of urine after labor, compare with Opium, Hyoscyamus, Causticum, and Arsenicum.

In suppression of urine you may think of Stramonium, Zingiber, Lycopodium, and Pulsatilla.

The power of Opium to cause shriveling of every fibre of the body suggests its use in marasmus in children. The patient is wrinkled and like a little dried-up old man ; the characteristic Opium stupor is present.

When the above-named condition has been produced by Opium, Sulphur, Argentum nitricum, or Sarsaparilla may be used as an antidote. Muriatic acid is the remedy for the continued muscular debility following the use of Opium.

We may find Opium indicated in that very dangerous condition, strangulation of the bowels. There are violent colicky pains and vomiting of matters having a faecal odor.

In colic it may be given when there is great tympany and pressure downward on the rectum and bladder ; there is a great deal of belching without relief.

Compare here Nux vomica, China and Lycopodium.

Veratrum album has colic as if the bowels were twisted; abdomen tense. The longer delayed is the emission of flatus, the more difficult is it to pass. Opium has been of service in incarcerated hernia, ileus and typhlitis, with complete constipation, vomiting of faecal matter or at least of substances of a faecal odor.

Sometimes we find Opium useful in metrorrhagia, whether after labor or not. The patient is restless; the sheets feel hot to her; she is sleepy, but cannot sleep.

In fevers other than typhoid, it may be given when the chill is accompanied by heat of the head and great drowsiness ; the body is burning hot, even when covered with a copious sweat ; desire to uncover ; unconsciousness ; feels as if his legs belonged to some one else. (Compare Baptisia and Stramonium.)

Puerperal fever sometimes calls for Opium, especially when caused by fright. There is over-excitement of all the senses ; even distant sounds annoy the patient ; the discharge from the uterus is very foetid. The case approaches a condition of stupor.

In haemorrhage from the uterus, compare Belladonna, which has a flow of bright blood feeling hot to both physician and patient. Hyoscyamus also has this. But under this remedy there is a great deal of spasmodic jerking of the body.

You will see from what I have said that Opium is an invaluable remedy for the bad effects of fright, whether that emotion produces convulsions or diarrhoea.

Gelsemium, Pulsatilla, and Veratrum album, you will recall as being useful in diarrhoea after fright.

For the remote consequences of fright Opium does not always suffice; you should then remember Natrum muriaticum, Silicea, and Phosphoric acid ; the first named especially for chorea or paralytic weakness of this origin.

Opium, like Bovista and Arnica, is useful for the bad effects of inhalation of charcoal vapors.

In spasms of the lungs, compare Moschus and Ipecac.

Drosera is likewise indicated in the spasmodic cough of consumption, coming on in the evening, and perhaps again after midnight. Every effort to raise a little phlegm ends in retching and vomiting.

Patient wants nothing. Complete loss of consciousness; apoplectic state. Frightful fancies, daring, gay, bright. Unable to understand or appreciate his sufferings. Thinks he is not at home. Delirious talking, with wide open eyes.

Dried Latex of the Poppy Papaver somniferum Hahnemann says that it is much more difficult to estimate the action of Opium than of almost any other drug. The effects of Opium as shown in the insensibility of the nervous system, the depression, drowsy stupor, painlessness, and torpor, the general sluggishness and lack of vital reaction, constitute the main indications for the drug when used homeopathically. All complaints are characterized by sopor. They are painless, and are accompanied by heavy, stupid sleep, stertorous breathing. Sweaty skin. Dark, mahogany-brown face. Serous apoplexy-venous, passive congestion. Want of sensitiveness to the action of medicines. Reappearance and aggravation from becoming heated. Opium lessens voluntary movements, contracts pupils, depresses higher intellectual powers, lessens self-control and power of concentration, judgment; stimulates the

imagination, checks all secretions except that of the skin. Want of susceptibility to remedies even though indicated. Diseases that originate from fright.

Worse, heat, during and after sleep (Apis; Lach.). Better, cold things, constant walking.

Vertigo; lightness of head in old people. Dull, heavy, stupid. Delirium. Vertigo after fright. Pain in back of head; great weight there (Gels). Bursting feeling. Complete insensibility; no mental grasp for anything. Paralysis of brain.

Red, bloated, swollen, dark suffused, hot. Looks intoxicated, besotted (Bapt; Lach). Spasmodic facial twitching, especially corners of mouth. Veins of face distended. Hanging down of lower jaw. Distorted.

Half-closed, dilated; pupils insensible, contracted. Ptosis (Gels; Caust). Staring glassy.

Dry. Tongue black, paralyzed bloody froth. Intense thirst. Blubbering op lips. Difficult articulation and swallowing.

Vomiting, with colic and convulsions. Fecal vomiting. Incarcerated hernia. Hungry; no desire to eat.

Hard, bloated, tympanitic. Lead colic during colic, urging to stool and discharge of hard feces.

Obstinate constipation; no desire to go to stool. Round, hard, black balls. Feces protrude and recede (Thuj; Sil). Spasmodic retention of feces in small intestines. Stools involuntary, black, offensive, frothy. Violent pain in rectum, as if pressed asunder.

Slow to start; feeble stream. Retained or involuntary, after fright. Loss of power or sensibility of bladder.

Suppressed menses from fright. Cessation of labor-pains with coma between paroxysms. Threatened abortion and suppression of lochia, from fright, with sopor. Horrible labor-like pains in uterus, with urging to stool.

Breathing stops on going to sleep; must be shaken to start it again (Grindelia). Hoarse. Deep snoring; rattling, stertorous breathing. Difficult, intermittent, deep, unequal respiration. Heat in chest; burning about heart. Cough, with dyspnœa and blue face; with bloody expectoration.

Hot, damp, sweating, Constant desire to uncover. Hot perspiration over whole body except lower limbs.

Great drowsiness (Gels.; Nux mosch). Falls into a heavy stupid sleep. Profound coma. Loss of breath on falling asleep (Grind). Coma vigil. Picking at bedclothes. Very sleepy, but cannot go to sleep. Distant noise, cocks crowing, etc, keep him awake. Child dreams of cats, dogs, black forms. Bed feels so hot cannot lie on it. Pleasant, fantastic, amorous dreams. Shaking chill; then heat, with sleep and sweat. Thirst only during heat.

Pulse full and slow. Heat extending over body. Hot perspiration. Fever characterized by stupor, snoring respiration, twitching of limbs, intense thirst

and sleepiness. General low temperature with inclination to stupor. Back and Extremities.––Opisthotonos. Swollen veins of neck. Painless paralysis (Oleand). Twitching of limbs. Numbness. Jerks as if flexors were overacting. Convulsions; worse from glare of light; coldness of limbs.

Compare: Apis; Bell; Gels; Nux mosch; Morphinum (extreme susceptibility to pain; twitching; tympanities; much itching); Codein (dry, teasing, incessant cough; twitching of muscles, especially those of eyelids); Eschscholtzia-Cal California Poppy––(a harmless soporific). Antidote: Acute Opium poisoning. Atropin and Black Coffee. Chronic Opium poisoning. Ipecac; Nux; Passiflora. Berberis is useful to counteract opium habit.

Third to thirtieth and 200th potency. Non-Homeopathic Preparations and Uses.––Palliative only in great pain, sleeplessness, peritonitis, and to check excess secretion in diarrhœa, diabetes, etc. Opium (crude).––Official dose, 1 grain. Laudanum (tincture)-Dose, 5 to 20 drops. Extract of Opium 1/4 to 1 grain. Paregoric-Tinctura Camphora Composita. Contains in each dram 1/4 grain of Opium equal to 1/30 grain of Morphine. Dose 1/2 to 1 fluid dram for adults. For an infant 3 to 5 drops. Dover's Powder consists of Opium, Ipecac and Sulphate of Potash. It contains 10% each of Opium and Ipecac. Dose 5 to 15 grains. Morphine-1/8 to 1/4 grain. Magendie's solution-16 grains to 1 oz or 5 drops equal to 1/6 grain. Codein-1/2 to 1 grain. Apomorphia-1/20 to 1/10 grain hypodermically.

Opium

Generals: Among the striking features of Opium is a class of complaints marked by painlessness, inactivity, and torpor.

Many of the provers taking small doses had torpor, inability to realize or feel their surroundings, or to take in the nature of states and judge of things.

Deception in vision, taste, touch; deception of the state he exists in; in his own realization; a perversion of all the senses with much deception. The general characteristic is painlessness, but now and then an alternate state is produced, in which a small dose of Opium will cause pain, sleeplessness, inquietude, nervous excitability; the very opposite state from that produced in the majority of cases.

The majority are constipated, but in some there is dysentery and tenesmus. The patient is sleepy, yet at times the drug is characterized by sleepless nights, anxiety, increased sensitiveness to noise, so that he says ho can almost hear the flies walking on the wall, and hears the clock striking in the distant steeple.

It is generally supposed that in these opposite conditions one is primary and the other is secondary. This is true, e. g., those exhibiting stupor and painlessness will go into a state of increased insensibility, inquietude, anxiety, and irritability, and also one who has a state of increased sensibility first will have a docile state following.

Head and mind: Some oversensitive provers will get a basilar headache in the first hour after taking a dose, so that they cannot raise the head from the pillow; they are paralyzed from it; the pain holds them down. This does not come on in most provers until the waning of a large dose. This has been debated over as the primary and secondary actions. What is the action in one is the reaction in another, but all are the effects of the drug, and all the actions that follow are the symptoms of the remedy.

The sluggishness and painlessness are most striking. The inaction is shown in the lack of reaction to the properly selected homeopathic remedy. It here competes with Sulphur. On studying the case you may find many Opium symptoms, and when given thus indicated, it rouses the system out of the state of sluggishness and causes reaction.

Ulcers which are perfectly painless, which do not granulate, and do not eat or spread, with numbness or lack of sensibility in the ulcer that ought to be sensitive; Opium will often heal insensibility in parts that are in a high grade of inflammation.

Paralytic conditions or paresis, partial paralysis; inactivity, sluggishness. Such a condition is found in the bowels so that they do not move, and rectum fills with round, hard, black balls, which can be dug out with the finger or spoon. There is no activity, no ability to strain at stool. The bladder is in a similar state. There is no ability to use the abdominal muscles; he cannot strain to urinate retention of accelerator muscles are in a state of paresis.

When drinking the oesophagus seems to have no action and the fluid does not go down but passes out through the nose; a paresis fluids go down the wrong way or out through the nose. Weakness of limbs and muscles; weakness and paralysis.

Often there is a state of peace. Wants to be let alone. She tells you she is not sick; and yet she has a temperature of 105-106∞, is covered with a scorching hot sweat, has a rapid pulse; is delirious. You ask her how she is and she says she is perfectly well and happy; no pains or aches; wants nothing and has no symptoms. But the nurse tells you that the patient has passed no stool or urine.

Face: The face looks besotted, bloated, purple; the eyes are glassy and the pupils contracted. The brain is in a state of confusion, yet she can answer questions. Or the mental symptoms may be more marked and the physical condition less prominent; there is confusion of mind, delirium, loquacity, but this is rare, more commonly only talks when aroused; a condition of stupor in which the patient will say nothing and do nothing. Delirium with a happy turn of mind. The stomach is in a state of undue warmth, sinking, all-gone, hungry, and this is not relieved by eating. He fills the stomach full and yet the faint feeling remains. The food sours in the stomach and is vomited. He can take no more food. He becomes covered with a cold sweat; great exhaustion; nausea, retching and the vomiting continues. This nausea is a troublesome symptom following the administration of Opium or Morphine. It is a prolonged vomiting and nausea. He can take nothing into the stomach and nothing will stop the vomiting for him. The homoeopath knows the use of Chamomilla and one dose will give wonderful relief at once and stop the deathly sinking and nausea. There is never any use for the crude Opium in the sick room. In surgery at times it is admitted that something seems necessary, and we will not quarrel with the surgeon. But in disease, in sick people, it is not necessary. It performs no use and in the end it is an injury; it prevents finding the homoeopathic remedy. It has masked the symptoms and spoiled the case, and you cannot do anything for days.

Opium has been much abused and much has been learned about it, but this abuse has not helped much in its proving, for the individualizing symptoms are not obtained. Big doses cause gross effects, and the symptoms thus obtained are sometimes useful, e. g., in cerebral apoplexy with stertorous breathing, jaw dropped, pupils dilated or contracted, generally the latter, face mottled, purple, or hot, hot sweat, one sided paralysis.

You would wonder on seeing such a case whether be had been paralyzed, had Opium, injured himself in a fall or bad been indulging in the bottle, and you would.. examine the case to distinguish. This is a mechanical trouble, there is pressure of blood on the brain. This alone may not kill but later on inflammatory action is set up around the clot.

Opium causes a flow of blood to the brain, and when given homeopathically it checks this, and in six hours he will become rational, his skin cool, face normal color, pulse normal. We thus see the usefulness of the crude effects of Opium in giving us a picture of apoplexy.

Nervous headaches beginning in the back of the head and spreading over the whole face; worse in the morning. He feels as if his head were held down to the pillow by the intense aching pain in the base of the brain and yet when he gets up he is unable to lie down again.

Women: This is common in women; a false plethora; excitable; going through pregnancy or menstruation; headache. The patient sits up and is unable to lie down. The pain begins in the morning and is so violent that the patient cannot move, cannot wink the eye, turn the head, cannot bear the least jar or the ticking of the clock; face is mottled, purple, blue; eyes injected. It is difficult to get symptoms from her. Opium will relieve at once.

But most of the complaints are painless. It takes on the appearance of drinkers, besotted; fever with besotted countenance. Delirium tremens with awful anxiety, vomiting, congestive headache, contracted pupils; violent headache after drinking, exhaustion; not able to get out of bed; delirium. Most of the complaints are attended with stupor; lies in a stupor like apoplexy, cannot be aroused.

Convulsions: The Opium patient is full of convulsions. The patient wants to be uncovered, wants the cool air, the open air. Convulsions if the room, is too warm. Opisthotonos; head drawn back, cerebro-spinal meningitis. In a case of cerebro-spinal meningitis we find convulsions approaching, opisthotonos, head drawn back, kicks the covers off, wants a cool room; skin red; face red and mottled, pupils contracted. Now if the mother puts that child into a hot bath, to relieve the convulsions, it will become unconscious and cold as death. If you are called to see such a case be sure to give Opium, and in twelve hours you will be astonished to see the state of quietude. It competes here with Apis. Puerperal convulsions. A mental state appears in these constitutions. Fear and its results. The Opium patient, when not too stupid, rouses up as if startled, rouses up with the appearance of awful fear or anxiety. The old Opium eater is overwhelmed with anxiety and fear. If a dog jump at him suddenly, he will be thrown into convulsions, have diarrhea, fits of some sort, and it will be days and weeks before that fear is gone.

Complaints from fear when the fear remains, or the idea of the fear remains, or the cause of it comes before the eyes. A pregnant woman is frightened and an abortion is impending, and the object of the fright continually looms up before her eyes. Epilepsy dating back, to a fright, and that object comes up before the eyes before the attack comes on, and the fear of the fright remains.

Hysterical attack; physical shock with diarrhea and sometimes constipation; retention of urine or return of the menstrual flow as results, or it may stop the menses for months. In these conditions there is great fear and the object of the fear remains before the eyes.

An Opium prover, when coming out from under the influence of the drug, sees frightful images, black forms, visions of devils, fire, ghosts, someone carrying her off, murder. Imagines that parts swell and that he is going to burst. There is also a sensation of bodily well being; great happiness great state of confidence in the first hours of the drug. Hence, complaints from sudden joy, anger, shame, sudden fright. Coffea has a similar state of beatitude. It is both a physical and mental beatitude in Opium. Opium and Coffea are related; they antidote each other. Opium eaters like whisky drinkers are constitutional liars. They have no conscience left. "Great sensibility to sound, light, and faintest odors."

"Drowsiness with headache, amounting almost to stupor."

"Marasmus; child wrinkled and looks like a little dried up old man; stupor."

Old cases of lead poisoning. Pulsatilla cures the diarrhea following the abuse of Opium.