The inspissated juice obtained by incision from the unripe capsules of Papaver Somniferum. There are four important varieties met with in commerce, named after their respective sources: - 1, Turkey or Smyrna (offic.) (the best kind, yielding the largest proportion of Morphia); 2, East Indian, or Bengal; 3, Egyptian; 4, European.
Med. Prop. and Action. The primary effect of a small dose of Opium is stimulant; the pulse is increased in force and frequency, the countenance is flushed, the eye bright, and the mind filled with cheerful images. The secondary effects are drowsiness, depression of the arterial action, loss of appetite, and constipation, with great mental languor. In larger doses, after the first stage of excitement has subsided, Opium proves narcotic, anodyne, and anti-spasmodic. The dose requisite for the production of these effects differs in almost every individual, being greatly influenced by the age, sex, and strength of the patient, the severity and character of the disease to subdue which Opium is given, and, above all by the patient being accustomed or not to the habitual use of the drug. The principal seat on which Opium operates is the cerebro-spinal system, and, through the nerves arising therefrom, it affects more or less every organ of the body. The following excellent summary of the effects of Opium in poisonous doses we give in the words of Dr. Guy.* " The insensibility produced by Opium differs, except on the near approach of death, from that present in Apoplexy or Epilepsy. At first, the patient is easily roused; but, in the more advanced stages, this can be effected only by violent shaking, loud speaking, tickling the nostrils, injecting water into the ear, or flecking the hands and feet with a towel. Convulsions are of comparatively rare occurrence, but have been observed in more than one case in a marked form, sometimes constituting the most prominent symptoms, at other times alternating with stupor. Locked-jaw and violent tetanic spasms have also been present in a few cases. The reflex function is often extremely active, the leg being forcibly retracted when the foot is tickled, though the patient lies quite insensible. Delirium is of rare occurrence, but has existed either with or without convulsions. The pupils are almost always contracted, and nearly or altogether insensible to light. The countenance is commonly pale and calm, as in a person in a profound sleep; but it has been observed flushed and excited. The breathing is generally slow, except in some instances in the first stage. In the long sleep which follows recovery from the urgent symptoms, the respiration is remarkably slow. In one case it was only six in the minute, while the pulse was upwards of 80. The pulse sometimes is nearly natural in frequency and force; in other cases, it is full and accelerated, but this happens chiefly in the first stage. In the stage of insensibility, while the patient can still be roused, the pulse is generally full and slow; but towards the fatal termination, it becomes small, frequent, and irregular. The secretions, with the exception of the perspiration, which is sometimes very abundant, are diminished, and the bowels are generally inactive; but cases are recorded in which both diarrhoea and diuresis were present. Vomiting is sometimes present from the first; but, in other cases, is among the early signs of recovery. It also follows the successful application of remedies."
* Brit. and For. Med. Rev., vol. xx.
The post-mortem appearances in poisoning by Opium are neither constant nor well marked. Turgescence of the vessels of the brain, with or without serous effusion into the ventricles, and at the base, and very rarely accompanied by extravasation of blood, forms the most marked morbid appearance. Lividity of the skin, congestion of the lungs, a fluid state of the blood, and early putrefaction of the body, are among the less constant appearances. (Guy.)
The shortest period within which Opium or its preparations have proved fatal is three hours; few cases are prolonged twenty-four hours: the average may be stated at from seven to twelve hours. When a patient survives twelve hours, there is good hope of his recovery.
The smallest dose which has proved fatal is four grains in an adult, and two drops of T. Opii in an infant. Enormous quantities have been taken by adults with impunity. In one instance, recovery took place after no less than eight ounces of solid Opium!
1936. Opium Smoking, a vice originating in China, has gained a strong hold amongst the lower orders, and the debased, of most Eastern nations. Sir W. O'shaughnessy gives the following graphic description of those samples so constantly met with in Calcutta: - " Stupor, reverie, and voluptuous listless-ness are the immediate effects produced. In this state, the patient can be at once and easily aroused to exertion or business. No sickness, or constipation, or any other functional disturbance, supervenes on each indulgence; gradually, however, the appetite diminishes, the bowels become irregular, emaciation takes place, sexual tendencies are destroyed, and premature old age comes on." "This," he continues, "is an extreme case; when the habit is but moderately followed, it appears to occasion no greater evil than a proportionate indulgence in wine, or other spirituous liquors." From this opinion I beg to dissent; nor do I consider the above picture in the least exaggerated, even for a "moderate " Opium-smoker, if, indeed, such a being exists; for, when once the practice is commenced, it becomes rapidly an all-absorbing passion. In all the patients, who have been smokers of Opium, who have been under my care, i have found a cachectic state of the body, a premature decay both of mind and body, derangement of most of the functions; and in them, the slightest scratch often degenerates into a foul and ill-conditioned ulcer. Opium-smoking has been said not to shorten the term of life, but good statistics are yet wanting to support the assertion. Alibert* considers that the use of Opium renders the body less susceptible to the influence of miasmatic and other morbific actions.
* Medical Jurisprudence, p. 522. Bengal Dispensatory, p. 180.