Chapter II: Part 2

It should have been stated before, that when the daily allowance had been reduced to six grains that quantity was divided into twelve pills, and that as this was diminished the size of the pills became gradually smaller till each of them only represented an eighth of a grain. As the daily amount of opium became smaller, although its general effect on the system was necessarily diminished, the conscious relief obtained from each of its fractional parts was for a few minutes more apparent than when these sub-divisions were first made. In this way it was possible so to time the effect as to throw their brief anodyne relief upon the dinner-hour or any other time when it might be convenient to have the agony of the struggle a little alleviated.

While I am not desirous of going into needless detail respecting all the particular phenomena of the process through which I was now passing, it may yet give the reader a more definite idea of the extremely nervous state to which I was reduced, if I mention that so nearly incapable had my hand become of holding a pen, that whenever it was absolutely necessary for me to write a few lines I could only manage it by taking the pen in one quivering hand, then grasp it with the other to give it a little steadiness, watching for an interval in the nervous twitching of the arm and hand, and then, making an uncertain dash at the paper, scrawl a word or two at long intervals. In this way I continued for several weeks to prepare the few brief notes I was obliged to write. My signature at this period I regard with some curiosity and more pride. It is certainly better than that of Guido Faux, affixed to his examination after torture, though it is hardly equal to the signature of Stephen Hopkins to the Declaration of Independence.

Christmas Day found me in a deplorable condition. No symptom of dissolving nature seemed alleviated; indeed the aggravation of the previous ones, especially of the already unendurable irritation of the stomach, was very obvious. In addition to this, the protracted wakefulness at night began to tell upon the brain, and I resolved to make my case known to a physician. I should have done this long before, but I had been deterred by two things--a long-settled conviction that all recovery from such habits must be essentially the patient's own resolute act, and my misfortune in never having found among my medical friends any one who had made the opium disease a special study, or who knew very much about it. The weather was excessively disagreeable, the heavens, about forty feet off, distilling the finest and most penetrating kind of moisture, while the limestone soil under the influence of the long rain had made walking almost impossible. With frantic impatience I waited until an omnibus made its appearance long after it was due, but crowded outside and in. The only unoccupied spot was the step of the carriage. How in my enfeebled condition I could hold on to this jolting standing-place for half an hour was a mystery I could not divine. With many misgivings I mounted the step, and by rousing all my energies contrived for a few minutes to retain my foot-hold. My knees seemed repeatedly ready to give way beneath me, my sight became dim, and my brain was in a whirl; but I still held on. I would gladly have left the omnibus, but I was certain that I should fall if I removed my hands from the frame-work of the door by which I was holding on. At length, a middle-aged Irish woman who had been observing me said, "You look very pale, Sir; I am afraid you are sick. You must take my seat." I thanked her, but told her I feared I had not strength enough to step inside. Two men helped me in, and a few minutes afterward an humble woman was kneeling in her wet clothing in the Church of St. ----, not the less penetrated, I trust, with the divine spirit of that commemorative day by her self-denying kindness to a stranger in his extremity. When the paved sidewalk was at last reached I started, after a few minutes' rest, in search of a physician. Purposely selecting the least-frequented streets, in dread of falling if obliged to turn from a direct course, as might be necessary in a crowded thoroughfare, I walked down to the office of the medical man whom I wished to consult; but when I arrived it seemed to me that my case was beyond human aid, and I walked on. I can, perhaps, find no better place than this in which to call the distinct attention of opium-eaters who may be induced to start out on their own reformation, to the all-important fact that no part of the body will be found so little affected by the rapid disuse of opium as the muscles used in walking. I am no physiologist, and do not pretend to explain it, but it is a most fortunate circumstance that in the general chaos and disorder of the rest of the system, the ability to walk, on which so much of the possibility of recovery rests, is by far the least affected of all the physical powers.

During the morning, however, my wretchedness drove me again to the office of the same physician. He listened courteously to my statement; said it was a very serious case, but outside of any reliable observation of his own, and recommended me to consult a physician of eminence residing in quite a different part of the city. He also expressed the hope, though I thought in no very confident tone, that I might be successful, and pretending to shut the door, watched my receding footsteps till I turned a distant corner. I now pass the house of the other physician to whom I was recommended to apply, several times every week, and I often moralize over the apprehension and anxieties with which I then viewed the two or three steps which led to his dwelling. When I arrived opposite his house I stopped and calculated the chances of mounting these steps without falling. I first rested my hand upon the wall and then endeavored to lift my feet upon the second step, but I had not the strength for such an exertion. I thought of crawling to the door, but this was hardly a decorous exhibition for the most fashionable street of the city, filled just then with gayly-dressed ladies. Why I did not ask some gentleman to aid me I can not now recall. I only recollect waiting for several minutes in blank dismay over the seeming impossibility of ever entering the door before me. Finally I went to the curbstone and walked as rapidly and steadily as possible to the lower step, and summoning all my energies made a plunge upward and fortunately caught the door-knob. The physician was at dinner, which gave me some time to recover myself from the agitation into which I had been thrown. After I had narrated my case with special reference to the suspicion of internal inflammation and its possible effect upon the brain, he assured me that no danger of the kind needs to be anticipated. He hoped I might succeed in my purpose, but thought it doubtful. An uncle of his own, a clergyman of some reputation, had died in making the effort. However, if I would take care of my own resolution, he would answer for my continued sanity. He prescribed some preparation of valerian and red pepper, I think, which I used for a week with little appreciable benefit. Finding no great relief from this prescription, or from those of other medical men whom for a few days about this time I consulted, and feeling a constant craving for something bitter, I at last prescribed for myself. Passing a store where liquor was sold, my eye accidentally rested upon a placard in the window which read "Stoughton's Bitters." This preparation gave me momentary relief, and the only appreciable relief I found in medicine during the experiment.

The nights now began to bring new apprehensions. A constant dread haunted my mind, in spite of the physician's assurances, that my brain might give way from the excitement under which I labored. I was especially afraid of some sudden paroxysm of mania, under the influence of which I might do myself unpremeditated injury. I never feared any settled purpose of self-injury, but I had become nervously apprehensive of possible wayward and maniacal impulses which might result in acts of violence.

My previous business had frequently detained me in the city till a late hour, sometimes as late as midnight. A part of the road that led to my house was quite solitary, with here and there a dwelling or store of the lowest kind. A railroad in process of construction had drawn to particular points on the road small collections of hovels, many of which were whisky-shops, and past these noisy drinking-places it was considered hazardous to walk alone at a late hour. In consequence of the bad reputation of this neighborhood I had purchased a large pistol which I kept ready for an emergency. Now, however, this pistol began to rest heavily upon my mind. The situation of my house was peculiarly favorable for the designs of any marauder. Directly back of it a solitary ravine extended for half a mile or more until it opened upon a populous suburb of the city. This suburb was largely occupied by persons engaged in navigation, or connected with boat-building, or by day-laborers, representing among them many nationalities. The winter of which I am writing was one of unusual stagnation in business and a hard one for the poor to get over. In the nervously susceptible state of my mind at this time, this ravine became a serious discomfort. When the stillness of night settled within and around the house, the rustling of leaves and the distant foot-falls in the ravine became distinctly audible. By some fancy of Judge ----, who built it, the house had no less than seven outside entrances. At intervals I would hear burglars at one of the doors, then at another, nearer or more remote: the prying of levers, the sound of boring, the stealthy footsteps, the carefully-raised window, the heavy breathing of an intruder. Then came the appalling sense of some strange presence, where no outward indication of such presence could be perceived, followed by gliding shaddos revealed by the occasional flicker of the waning fire.

Illusions of this nature served to keep the blood at feverheat during the hours of darkness. Night after night the pistol was placed beneath the pillow in readiness for these ghostly intruders. A few days, however, brought other apprehensions worse than those of thieves and burglars. The uncontrollable exasperation of the temper obliged me at length to draw the charge from the pistol, through fear of yielding to some sudden impulse of despair. I had also put out of reach my razors, a hammer, and whatever else might serve as an impromptu means of violence. I remember the grim satisfaction with which I looked upon the brass ornaments of the bedroom fire-place, and reflected that, if worse came to worst, I was not wholly without a resource with which to end my sufferings. For nearly a fortnight previously I had refrained from shaving, dreading I scarce knew what.

The day succeeding Christmas I rode to the city and walked the length of innumerable by-streets as my weakness would allow. When too exhausted to walk further, and looking for some place of rest, I observed a barber's sign suspended over a basement room. Fortunately the barber stood in the door-way and helped me to descend the half-dozen stone steps which led to his shop. I told the man to cut my hair, shave me, and shampoo my head. As he began his manipulations it seemed as though every separate hair was endowed with an intense vitality. It was impossible to refrain from mingled screams and groans as I repeatedly caught his arm and obliged him to desist. Luckily the barher was a man of sense, and by his extreme gentleness contrived in the course of an hour to calm down my excitement.

When he had finished his work the sense of relief and refreshment was astonishing. In this barber-shop I learned for the first time in what the perfection of earthly happiness consists. The sudden cessation of protracted and severe pain brings with it so exquisite a sense of enjoyment that I do not believe that successful ambition, or requited love, or the gratification of the wildest wishes for wealth, has a happiness to bestow at all comparable to the calm, contented, all-satisfying happiness that comes from a remission of intolerable pain. For the first time in a month I felt an emotion that could be called positively pleasant. As I left the shop I needed no assistance in reaching the sidewalk, and waiked the streets for an hour or two with something of an assured step.

Among other indications of the change taking place at this time in the system was the increased freezing perspiration perpetually going on, especially down the spine. This sense of dampness and icy coldness has now continued for many months, and for nearly a year was accompanied with a heavy cold. During the opium-eating years I do not remember to have been affected at all in this latter way; but a severe cold at this time settled upon the lungs, one indication of which was frequent sternutation, consequent apparently upon the inflammation of the mucous membrane.

In the entire week from Christmas to New Year's the progress in abandonment of opium was but a single grain. I am sure there was no want of resolution at this trying time. Day by day I exhausted all my resources in the vain endeavor to get on with half, three-quarters, even seven-eighths of a grain; but moans and groans, and biting the tongue till the blood came, as it repeatedly did, would not carry me over the twenty-four hours without the full grain. It seemed as if tortured nature would collapse under any further effort to bring the matter to a final issue.

Brandy and bitters after a few day's use had been abandoned, under the apprehension that they were connected with the tendency to internal inflammation which I have noticed as possibly affecting the brain. For a day or two I resorted to ale, but a disagreeable sweetness about it induced the substitution of Schenck beer, a weak kind of _lager_. This I found satisfied the craving for a bitter liquid, and it became for two or three weeks my chief drink. I should have mentioned that the day subsequent to the disuse of tobacco I had also given up tea and coffee, partly from a disposition to test the strength of my resolution, and partly from the belief that they might have some connection with a constant sensation in the mouth as if salivated with mercury. I soon learned that the real difficulty lay in the liver, and that this organ is powerfully affected in persons abandoning the long-continued use of opium. Had I known this fact at an earlier day it would have been of service in teaching me to control the diseased longing for rich and highly-seasoned food which had now become a passion. Eat as much as I would, however, the sense of hunger never left me; and this diseased craving, in ignorance of its injurious effects, was gratified in a way that might have taxed unimpaired powers of digestion.

At length the long-anticipated New Year's Day, on which I was to be emancipated forever from the tyranny of opium, arrived. For five weeks of such steady suffering as the wealth of all the world would not induce me to encounter a second time, I had kept my eye steadily fixed upon this day as the beginning of a new life. This was also the day on which I was to dine with my friend. As the dinner-hour approached it became evident that no opium meant no dinner, and a little later, that dinner or no dinner the opium was still a necessity. A half grain I thought might carry me through the day, but in this I was mistaken. As I lay upon my friend's sofa, suffering from a strange medley of hunger, pain, and weakness, it seemed that years must elapse before the system could regain its tone or the bodily sensations become at all endurable. Soon after dinner I felt obliged to take another half-grain. My humiliation in failing to triumph when and how I had resolved to do, was excessive. In spite of the strongest resolutions, I was still an opium-eater. I somehow felt that after all I had gone through I ought, to have succeeded. I was in no mood to speculate about the causes of the failure; it was enough to know that I had failed, and what was worse, that apparently nothing whatever had been gained in the last four days. While I certainly felt no temptation to give in, I thought it possible that some of the functions of the body, from the long use of opium, might have completely lost their powers of normal action, and that I should be obliged to continue a very moderate use of the drug during the remainder of my life. I saw, in dismal perspective, that small fractional part of the opium of years which was now represented by a single grain, looming up in endless distance, not unlike that puzzling metaphysical necessity in the perpetual subdivision of a unit, which, carried as far as it may be, always leaves a final half undisposed of. But in this I did myself injustice. I had really gained much in these few days, and the proof of it lay in the use of but half a grain on the day which succeeded New Year's. The third day of January, greatly to my surprise, a quarter-grain I found carried me through the twenty-four hours with apparently some slight remission of suffering.

As I now look back upon it, the worst of the experiment lay in the three weeks intervening between the 10th and the 31st of December. So far as mere pain of body was concerned, there was little to choose between the agony of one day and another; but the apprehension that insanity might set in, certainly aggravated the distress of the later stages of the trial. When a man knows that he is practicing self-control to the very utmost, and holding himself up steadily to his work in spite of the gravest discouragements, the consciousness that a large vacuum is being gradually formed in his brain is not exhilarating.

The next day--to me a very memorable one--the fourth of January, I sat for most of the day rocking backward and forward on a sofa or a chair, speaking occasionally a few words in a low sepulchral voice, but with the one bitter feeling, penetrating my whole nature, that come what would, on that day _I would not_.

When the clock struck twelve at midnight, and I knew that for the first time in many years I had lived for an entire day without opium, it excited no surprise or exultation. The capacity for an emotion of any kind was exhausted. I seemed as little capable of a sentiment as a man well could be, this side of his winding-sheet. I knew, of course, that in these forty days save one, I had worked out the problem, How to leave off opium, and that I had apparently attained a final deliverance: but it was several weeks before I appreciated with any confidence the completion of the task I had undertaken.

Although the opium habit was broken, it was only to leave me in a condition of much feebleness and suffering. I could not sleep, I could not sit quietly, I could not lie in any one posture for many minutes together. The nervous system was thoroughly deranged. Weak as I had become, I felt a continual desire to walk. The weather was unfavorable, but I managed to get several miles of exercise almost daily. But this relief was limited to four or five hours at most, and left the remainder of the day a weary weight upon my hands. The aversion to reading had become such that some months elapsed before I took up a book with any pleasure. Even the daily papers were more than I could well fix my attention upon, except in the briefest and most cursory way. Within a week, however, the sense of acute pain rapidly diminished, but the irritability, impatience, and incapacity to do any thing long remained unrelieved. The disordered liver became apparently more disordered with the progress of time, producing such effects upon the bowels as may with more fitness be told a physician than recorded here. The tonsils of the throat were swollen, the throat itself inflamed, while the chest was penetrated with what seemed like pulsations of prickly heat. There was also a sense of fullness in the muscles of the arms and legs which seemed to be permeated, if I may so express it, with heated electricity. The general condition of the nervous system will be sufficiently indicated by the statement that it was between three or four months before I could hold a pen with any degree of steadiness. Meantime, singular as it may seem, the appearance of health and vigor had astonishingly increased. I had gained more than twenty pounds in weight, partly, I suppose, the result of leaving off opium and tobacco, and partly the consequence of the insatiable appetite with which I was constantly followed. Within a month after the close of the opium strife, I was repeatedly congratulated upon my healthy, vigorous condition. Few men in the entire city bore about them more of the appearance of perfect health, and fewer still were probably in such a state of exhausted vitality.

During the time I was leaving off opium I had labored under the impression that the habit once mastered, a speedy restoration to health would follow. I was by no means prepared, therefore, for the almost inappreciable gain in the weeks which succeeded, and in some anxiety consulted a number of physicians, who each suggested in a timid way the trial, some of strychnine, some of valerian, some of lupuline, hyoscyamus, ignatia, belladonna, and what not. I do not know that I derived the slightest benefit from any of these prescriptions, or from any other therapeutic agency, unless I except the good effects for a few days of bitters, and of cold shower-baths from a tank in which ice was floating.

The most judicious of the medical gentlemen whose aid I invoked, was, I think, the one who replied to my inquiry for his bill, "What for? I have done you no good, and have learned more from you than you have from me."

This constitutes the entire history of my medical experience, and is mentioned as being the only, and a very small adjunct to the great remedy--patient, persistent, obstinate endurance. So exceeding slow has been the process toward the restoration of a natural condition of the system, that writing now, at the expiration of more than a year since opium was finally abandoned, it seems to me very uncertain when, if ever, this result will be reached. Between four and five months elapsed before I was at all capable of commanding my attention or controlling the nervous impatience of mind and body. I then assented to a proposal which involved the necessity of a good deal of steady work, in the hope that constant occupation would divert the attention from the nervousness under which I suffered and would restore the self-reliance which had so long failed me. It was a foolish experiment, and might have proved a fatal one. The business I had undertaken required a clear head and average health, and I had neither. The sleep was short and imperfect, rarely exceeding two or three hours. The chest was in a constant heat and very sore, while the previous bilious difficulties seemed in no way overcome. The mouth was parched, the tongue swollen, and a low fever seemed to have taken entire possession of the system, with special and peculiar exasperations in the muscles of the arms and legs.

The difficulty of thinking to any purpose was only equalled by the reluctance with which I could bring myself to the task of holding a pen. For a few weeks, however, the necessity of not wholly disgracing myself forced me on after a poor fashion; but at the end of two months I was a used-up man. I would sit for hours looking listlessly upon a sheet of paper, helpless of originating an idea upon the commonest of subjects, and with a prevailing sensation of owning a large emptiness in the brain, which seemed chiefly filled with a stupid wonder when all this would end.

More than an entire year has now passed, in which I have done little else than to put the preceding details into shape from brief memoranda made at the time of the experiment. While the physical agony ceased almost immediately after the opium was abandoned, the irritation of the system still continues. I do not know how better to describe my present state than by the use of language which professional men may regard as neither scientific nor accurate, but which will express, I hope, to unprofessional readers the idea I wish to convey, when I say that the entire system seems to me not merely to have been poisoned, but saturated with poison. Had some virus been transfused into the blood, which carried with it to every nerve of sensation a sense of painful, exasperating unnaturalness, the feeling would not, I imagine, be unlike what I am endeavoring to indicate.

ADDENDA.--At the time of writing the preceding narrative I had supposed that the entire story was told, and that the intelligent reader, should this record ever see the light, would naturally infer, as I myself imagined would be the case, that the unnatural condition of the body would soon become changed into a state of average health. In this I was mistaken. So tenacious and obstinate in its hold upon its victim is the opium disease, that even after the lapse of ten years its poisonous agency is still felt. Without some reference to these remoter consequences of the hasty abandonment of confirmed habits of opium-eating, the chief object of this narrative as a guide to others (who will certainly need all the information on the subject that can be given them) would fail of being secured. While unquestionably the heaviest part of the suffering resulting from such a change of habit belongs to the few weeks in which the patient is abandoning opium, it ought not to be concealed that this brief period by no means comprises the limit within which he will find himself obliged to maintain the most rigid watch over himself, lest the feeling of desperation which at times assaults him from the hope of immediate physical restoration disappointed and indefinitely postponed, should drive him back to his old habits. Indeed, with some temperaments, the greatest danger of a relapse comes in, not during the process of abandonment, but after the habit has been broken. Great bodily pain serves only to rouse up some natures to a more earnest strife, and, as their sufferings become more intense, the determination not to yield gains an unnatural strength. The mind is vindicating itself as the master of the body. While in this state, tortures and the fagot are powerless to extort groans or confessions from the racked or half-consumed martyr. Many a sufferer has borne the agony of the boots or the thumb-screw without flinching, whose courage has given way under the less painful but more unendurable punishment of prolonged imprisonment. In the one case all a man's powers of resistance are roused; he feels that his manhood is at stake, and he endures as men will endure when they see that the question how far they are their own masters, is at issue. There are, I think, a great number of men and women who would go unflinchingly to the stake in vindication of a principle, whose resolution, somewhere in the course of a long, solitary, and indefinite imprisonment, would break down into a discreditable compromise of opinions for which they were unquestionably willing to die.

In the same way a man will for a time endure even frightful suffering in relinquishing a pernicious habit, while he may fail to hold up his determination against the assaults of the apparently never-ending irritation, discomfort, pain, and sleeplessness which may be counted on as being, sometimes at least, among the remoter consequences of the struggle in which he has engaged. I wish it, however, distinctly understood that I do not suppose that the experience of others whose use of opium had been similar to my own, would necessarily correspond to mine in all or even in many respects. Opium is the Proteus of medicine, and science has not yet succeeded in tearing away the many masks it wears, nor in tracing the marvellously diversified aspects it is capable of assuming. Among many cases of the relinquishment of opium with which I have been made acquainted, nothing is more perplexing than the difference of the specific consequences, as they are exhibited in persons of different temperaments and habits. For such differences I do not pretend to account. That is the business of the thoroughly educated physician, and no unprofessional man, however wide his personal experience, has the right to dogmatize or even to express with much confidence settled opinions upon the subject. My object will be fully attained if I succeed in giving a just and truthful impression of the more marked final consequences of the hasty disuse of opium in this single case, leaving it to medical men to explain the complicated relations of an opium-saturated constitution to the free and healthy functions of life.

In my own case, the most marked among the later consequences of the disease of opium, some of which remain to the present time and seem to be permanently engrafted upon the constitution, have been these:

1. Pressure upon the muscles of the limbs and in the extremities, sometimes as of electricity apparently accumulated there under a strong mechanical force.

2. A disordered condition of the liver, exhibiting itself in the variety of uncomfortable modes in which that organ, when acting irregularly, is accustomed to assert its grievances.

3. A sensitive condition of the stomach, rejecting many kinds of food which are regarded by medical men as simple and easy of digestion.

4. Acute shooting pains, confined to no one part of the body.

5. An unnatural sensitiveness to cold.

6. Frequent cold perspiration in parts of the body.

7. A tendency to impatience and irritability of temper, with paroxysms of excitement wholly foreign to the natural disposition.

8. Deficiency and irregularity of sleep.

9. Occasional prostration of strength.

10. Inaptitude for steady exertion.

I mention without hesitancy these consequences of the abandonment of opium, from the belief that any person really in earnest in his desire to relinquish the habit will be more likely to persevere by knowing at the start exactly what obstacles he may meet in his progress toward perfect recovery, than by having it gradually revealed to him, and that at times when his body and mind are both enfeebled by what he has passed through. With a single exception, the dismost serious one I have been obliged to encounter. Whether it is one of the specific effects of the disuse of opium, or only one of the many general results of a disordered constitution, I do not know.

I can only say in my own case, that after the lapse of years, this particular difficulty is not wholly overcome. This electric condition, so to call it, still continues a serious annoyance. But when it occurs, the pain is of less duration, and gradually, but very slowly, is of diminished frequency. Violent exercise will sometimes relieve it; a long walk has often the same effect. The use of stimulants brings alleviation for a time, but there seems to be no permanent remedy except in the perfect restoration of the system by time from this effect of the wear and tear of opium upon the nerves. Irregularity in the action of the liver, while singularly marked in the earlier stages of the experiment, and continuing for years to make its agency manifestly felt, is in a considerable degree checked and controlled by a judicious use of calomel.

The condition of the digestive organs is less impaired than I should have supposed possible, judging from the experience of others. A moderate degree of attention to the quality of what is eaten, with proper care to avoid what is not easily digested, with the exercise of habitual self-control in respect to quantity, suffices to prevent, for the most part, all unendurable feelings of discomfort in this part of the system. Whether the habitually febrile condition of the mouth, and the swollen state of the tongue, is referable to a disturbed action of the stomach or of the liver I can not say. It is certain that none of the effects of opium-eating are more marked or more obstinately tenacious in their hold upon the system than these. I barely advert to the frequent impossibility of retaining some kinds of food upon the stomach, which has been one unpleasant part of my experience, because I doubt whether this return of a difficulty which began in childhood has any necessary connection with the use of opium. For many years before I knew any thing of the drug I had been a daily sufferer from this cause. Indeed the use of opium seemed to control this tendency, and it was only when the remedy was abandoned that the old annoyance returned. For a few months the stomach rejected every kind of food; but in less than a year, and subsequently to the present time, this has been of only occasional ocurrence.

I am also at a loss how far to connect the disuse of opium with the lancinating pains which have troubled me since the time to which I refer. These pains began long before I had recourse to opium, they did not cease their frequent attacks while opium was used, nor have they failed to make their potency felt since opium was abandoned. While it is not improbable that the neuralgic difficulties of my childhood might have remained to the present time, even if I had never made use of opium, I think that the experience of all who have undergone the trial shows that similar pains are invariably attendant upon the disuse of opium. How long their presence might be protracted with persons not antecedently troubled in this way, is a question I can not answer. I infer from what little has been recorded, and from what I have learned in other ways, that the reforming opium-eater must make up his mind to a protracted encounter with this great enemy to his peace. That the struggle of others with this difficulty will be prolonged as mine has been I do not believe, unless they have been subjected for a lifetime to pains connected with disorder in the nervous system.

The unnatural sensitiveness to cold to which I have alluded is rather a discomfort than any thing else. It merely makes a higher temperature necessary for enjoyment, but in no other respect can it be regarded as deserving special mention. With the thermometer standing at 80° to 85° the sensation of agreeable warmth is perfect; with the mercury at 70° or even higher, there is a good deal of the feeling that the bones are inadequately protected by the flesh, that the clothing is too limited in quantity, and in winter that the coal-dealer is hardly doing you justice.

The cold perspiration down the spine, which was so marked a sensation during the worst of the trial, has not yet wholly left the system, but is greatly limited in the extent of surface it affects and in the frequency of its return.

The tendency to impatience and irritability of temper to which I have adverted is by far the most humiliating of the effects resulting from the abandonment of opium. Men differ very widely both in their liability to these excesses of temper as well as in their power to control them; but under the aggravations which necessarily attend an entire change of habit, this natural tendency, whether it be small or great, to hastiness of mind is greatly increased. So long as the disturbing causes remain, whether these be the state of the liver or the stomach, or a want of sufficient sleep, or the excited condition of the nervous system, the patient will find himself called upon for the exercise of all his self-control to keep in check his exaggerated sensibility to the daily annoyances of life.

Intimately connected with the preceding is the frequent recurrence of sleepless nights, which seem invariably to attend upon the abandonment of the habit. Possibly some part of this state of agitated wakefulness may pertain to the natural temperament of the patient, but this tendency is greatly aggravated by the condition of the nerves, so thoroughly shattered by the violent struggle to oblige the system to dispense with the soothing influence of the drug upon which it has so long relied. Whatever method others may have found to counteract this infirmity, I have been able as yet to find no remedy for it. Especially are those nights made long and weary which _precede_ any long continuance of wet weather. A moist condition of the atmosphere still serves the double purpose of setting in play the nervous sensibilities, and, as a concomitant or a consequence, of greatly disturbing, if not destroying sleep.

In connection with this matter something should be said on the subject of dreaming, to which De Quincey has given so marked a prominence in his "Confessions" and "Suspiris de Profundis." In my own case, neither when beginning the use of opium, nor while making use of it in the largest quantities and after the habit had long been established, nor while engaged in the painful process of relinquishing it, nor at any time subsequently, have I had any experience worth narrating of the influence of the drug over the dreaming faculty. On the contrary, I doubt whether many men of mature age know so little of this peculiar state of mind as myself. The conditions in this respect, imposed by my own peculiarities of constitution, have been either no sleep sufficiently sound as to interfere with the consciousness of what was passing, or mere restlessness, or sleep so profound as to leave behind it no trace of the mind's activity. While it is therefore certain that this exaggeration of the dreaming faculty is not necessarily connected with the use of opium, but is rather to be referred to some peculiarity of temperament or organization in De Quincey himself, I find myself in turn at a loss to know how far to regard other phenomena to which I have previously alluded as the natural and necessary consequences of opium, or how far they may be owing to peculiarities of constitution in myself. Opium-eaters have said but little on the subject. The medical profession, so far as I have conversed with them, and I have consulted with some of the most eminent, are not generally well informed on any thing beyond the specific effects of the drug as witnessed in ordinary medication. In the absence of sufficient authority, it may be safer to say that the remoter consequences of the disuse of opium consist in a general disorder and derangement of the nervous system, exhibiting itself in such particular symptoms as are most accordant with the temperament, constitutional weaknesses, and personal idiosyncrasies of the patient. That some considerable suffering must be regarded as unavoidable seems to be placed beyond question from the nature of the trial to which the body has been subjected, as well as from what little has been said on the subject by those who have relinquished the habit.

I close this brief reference to the remoter consequences of the habits of the opium-eater by calling the attention of the reader to the physical weakness with consequent inaptitude for continuous exertion which forms a part of my own experience. Unable as I am to refer it to any _immediate_ cause, frequent and sudden prostration of strength occurs, accompanied by slight dizziness, impaired sight, and a sense of overwhelming weakness, though never going to the extent of absolute faintness. Its recurrence seems to be governed by no rule. It sometimes comes with great frequency, and sometimes weeks will elapse without a return. Neither the state of the weather, nor any particular condition of the body, appears to call it out. It sometimes is relieved by a glass of water, by the entrance of a stranger, by the very slightest excitement, and it sometimes resists the strongest stimulants and every other attempt to combat it. I can record nothing else respecting this visitant except that its presence is always accompanied with a singular sensation in the stomach, and that the entire nervous system is affected by its attack.

The inaptitude for steady exertion is not merely the consequence of this occasional feeling of exhaustion, but is for a time the inevitable result of the accumulated pain and weakness to which his system, not yet restored to health, is still subject. This impatience of continued application to work, which is common to all opium-eaters, and which does not cease with the abandonment of the habit, seems to result in the first case from some specific relation between the drug and the meditative faculties, promoting a state of habitual reverie and day-dreaming, utterly indisposing the opium-user for any occupation which will disturb the calm current of his thoughts, and in the other, proceeding from the direct disorder of the nervous organization itself. Strange as it may seem, the very thought of exertion will often waken in the reforming opium-eater acute nervous pains, which cease only as the purpose is abandoned. In other cases, where there is no special nervous suffering at the time, work is easy and pleasant even beyond what is natural.

One effect of opium upon the _mind_ deserves to be mentioned; its influence upon the faculty of memory. The logical memory, De Quincey says, seems in no way to be weakened by its use, but rather the contrary. His own devotion to the abstract principles of political economy; the character of Coleridge's literary labors between the years 1804-16, when his use of opium was most inordinate; together with the cast of mind of many other well-known opium-eaters, confirms this suggestion of De Quincey. His further statement that the memory of dates, isolated events, and particular facts, is greatly weakened by opium, is confirmed by my own experience. However physiologists may explain this fact, a knowledge of it may not be without its use to those who desire to be made thoroughly acquainted with all the consequences of the opium habit.

If to these discomforts be added a prevailing tendency to a febrile condition of body, together with permanent disorder in portions of the secretory system, the catalogue of annoyances with which the long-reformed opium-eater may have to contend is completed. This statement is not made to exaggerate the suffering consequent upon the disuse of opium, but is made on the ground that a full apprehension of what the patient may be called upon to go through will best enable him to make up his mind to one resolute, unflinching effort for the redemption of himself from his bad habits.

So far as the body is concerned, there is much in my experience which induces me to give a general assent to the opinion expressed by a medical man of great reputation whom I repeatedly consulted in reference to the discouraging slowness of my own restoration to perfect health. "I can not see," he said, "that your constitution has been permanently injured; but you were a great many years getting into this state, and I think it will take nearly as many to get you out of it."

It may not be amiss to add that those opium-eaters whose circumstances exempt them from harassing cares, who meet only with kindness and sympathy from friends, and who have resources for enjoyment within themselves, have in respect to these subsequent inconveniences greatly the advantage of those whose position and circumstances are less fortunate.

These free and almost confidential personal statements have been made, not without doing some violence to that instinctive sense of propriety which prompts men to shrink from giving publicity to their weaknesses and from the vanity of seeming to imply that their individual experience of life is of special value to others. Leaving undecided the question whether under any circumstances a departure from the general rule of good sense and good taste in such matters is justifiable, I have, nevertheless, done what I could to give to opium-eaters a truthful statement of the consequences that may ensue from their abandonment of the habit. The path toward perfect recovery is certainly a weary one to travel; but in all these long years, with nervous sensibilities unnaturally active, in much pain of body, through innumerable sleepless nights, with hope deferred and the expectation of complete restoration indefinitely prolonged, I have never lost faith in the final triumph of a patient and persistent resolution. Many men seem to know little of the wonderful power which simple endurance has, in determining every conflict between good and evil. The triumph which is achieved in a single day is a triumph hardly worth the having; but when all impatience, unreasonableness, weaknesses and vanities have been burned out of our natures by the heat of suffering; when the resolution never falters to endure patiently whatever may come in the endeavor to measure one's own case justly, and exactly as it is; and when time has been allowed to exert its legitimate influence in calming whatever has been disturbed and correcting whatever has been prejudiced, a conscious strength is developed far beyond what is natural to men possessed only of ordinary powers of endurance. It is chiefly through patient waiting that the confirmed victim of opium can look for relief. All who have made heroic efforts to this end, and yet have failed in their attempt, have done so through the absence of adequate confidence in the efficacy of time to bring them relief. The _one_ lesson, however, which the reforming opium-eater must learn is, never to relinquish any gain, however slight, which he may make upon his bad habit. Patience will bring him relief at last, and though he may and will find his progress continually thwarted and himself often tempted to give over the contest in despair, he may be sure that year by year he is steadily advancing to the perfect recovery of all that he has lost.

The opium-eater will not regard as amiss some few suggestions as to the mode in which his habit may most easily be abandoned. The best advice that can be given--the _only_ advice that will ever be given by an opium-eater--is, never to begin the habit. The objection at once occurs, both to the medical man and to the patient suffering from extreme nervous disorder, What remedy then shall be given in those numerous cases in which the protracted use of opium, laudanum, or morphine is found necessary? The obvious answer is, that no medical man ever intends to give this drug in such quantities or for so long a time as to establish in the patient a confirmed habit. The frequent, if not the usual history of confirmed opium-eaters is this: A physician prescribes opium as an anodyne, and the patient finds from its use the relief which was anticipated. Very frequently he finds not merely that his pain has been relieved, but that with this relief has been associated a feeling of positive, perhaps of extreme enjoyment. A recurrence of the same pain infallibly suggests a recurrence to the same remedy. The advice of the medical man is not invoked, because the patient knows that morphine or laudanum was the simple remedy that proved so efficacious before, and this he can procure as well without as with the direction of his physician. He becomes his own doctor, prescribes the same remedy the medical man has prescribed, and charges nothing for his advice. The resort to this pleasant medication after no long time becomes habitual, and the patient finds that the remedy, whose use he had supposed was sanctioned by his physician, has become his tyrant. If patients exhibited the same reluctance to the administration of opium that they do to drugs that are nauseous, if the collateral effects of the former were no more pleasurable than lobelia or castor oil, nothing more could be said against self-medication in one case than the other. Opium-eaters are made such, not by the physician's prescription of opium to patients in whose cases its use is indispensable, but by their not giving together with such prescriptions emphatic and earnest caution that the remedy is not to be taken except when specially ordered, in consequence of the hazard that a habit may be formed which it will be difficult to break. Patients to whom it is regularly administered are not at first generally aware how easily this habit is acquired, nor with what difficulty it is relinquished, especially by persons of nervous temperament and enfeebled health. The number of cases, I suspect, is small in which the use of opium has become a necessity, where the direction of a physician may not be pleaded as justifying its original employment.

The object I have in view is not, however, so much to make suggestions to medical men as it is to awaken in the victims of opium the feeling that they can master the tyrant by such acts of resolution, patience, and self-control as most men are fully capable of exhibiting. Certain conditions, however, seem to be the almost indispensable preliminaries to success in relinquishing opium by those who have been _long_ habituated to its use. The first and most important of these is a firm conviction on the part of the patient that the task can be accomplished. Without this he can do nothing. The narratives given in this volume show its entire practicability. In addition to this, it should be remembered that these experiments were most of them made in the absence of any sufficient guidance, from the experience of others, as to the method and alleviations with which the task can be accomplished. A second condition necessary to success, is sufficient physical health, with sufficient firmness of character to undergo, as a matter of course, the inevitable suffering of the body, and to resist the equally inevitable temptation to the mind to give up the strife under some paroxysm of impatience, or in some moment of dark despondency. With a very moderate share of vigor of constitution, and with a will, capable under other circumstances of strenuous and sustained exertion, there is no occasion to anticipate a failure here. Even in cases of impaired health, and with a diminished capacity for resolute endeavor, success is, I believe, attainable, provided sufficient time be taken for the trial.

A further condition lies in the attempt being made under the most favorable circumstances in respect to absolute leisure from business of every kind. That nothing can be accomplished by persons whose time is not at their own command, by a graduated effort protracted through many months, I do not say, for I do not believe it; but any speedy relinquishment of opium--that is, within a month or two--seems to me to be wholly impossible, except to those who are so situated that they can give up their whole time and attention to the effort.

This effort should be made with the advice and under the eye of an intelligent physician. So far as I have had opportunity to know, the profession generally is not well informed on the subject. In my own case I certainly found no one who seemed familiar with the phenomena pertaining to the relinquishment of opium, or whose suggestions indicated even in cases where the physician has had no experience whatever in this class of disorders, he can, if a well-educated man, bring his medical knowledge and medical reasoning to bear upon the various states, both of body and mind, which the varying sufferings of the patient may make known to him. Were there, indeed, no professional helps to be secured by such consultation, it is still of infinite service to the patient to know some one to whom he can frequently impart the history of his struggle and the progress he is making. Such confidence may do much to encourage the patient, and no one is so proper a person in whom to repose this confidence as an intelligent physician.