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