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                                   AN

                                 ESSAY

                                 ON THE

                           EFFECTS of OPIUM,

                        Considered as a POISON.

                   [Price One Shilling and Sixpence.]




                   AN ESSAY ON THE EFFECTS of OPIUM.

                             Considered as

                               A POISON.

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

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

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

                           By JOHN  AWSITER,

             Apothecary to the Royal Hospital at Greenwich.

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

                       HORAT. Epist. VI. Lib. I.

                                LONDON:

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




                                 TO THE

                         President and Fellows

                                 OF THE

                      Royal College of Physicians.


    Gentlemen,

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

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

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

    Gentlemen,

      Your most obedient,

          Humble Servant,

                                                             J. AWSITER.

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




                          PREFATORY DISCOURSE.


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

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

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




                                  THE

                                EFFECTS

                                   OF

                                 OPIUM,

                      Considered as a POISON, &c.


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By the nice Sense of the Palate, we are able to judge in general, what
is, and what is not essential to the Nutriment of the Body; which
Nutriment the Stomach, for the most Part, rejects when noxious. Some
Things, indeed, are almost void of Smell or Taste, therefore not
seemingly injurious to the external Senses, and thus may be accidentally
taken into the Stomach; or when those Senses are depraved; as Hemlock
has been often mistaken, and eat for Pars