nor flatulence pass for many days. Flatus began to pass before the diarrhoea set in. Hahnemann
- ▸(M.
- ▸M.
- ▸P.
- ▸) sums up the action of Opium thus: "In the primary action of small and moderate
doses, in which the organism passively, as it were, lets itself be affected by the medicine, it
appears to exalt the irritability and activity of the voluntary muscles for a short time, but to
diminish those of the involuntary muscles for a longer period; and while it exalts the fancy and
courage in its primary action, it appears at the same time to dull and stupefy the external senses,
general sensibility and consciousness. Therefore the living organism in its active counteraction
produces the opposite of this in the secondary action: Diminished irritability and inactivity of the
voluntary and morbidly exalted excitability of the involuntary muscles, and loss of ideas and
obtuseness of the fancy, with faintheartedness along with over-sensitiveness of the general
sensibility." It is right to say that Hahnemann prefaces the above with the remark that, "It is more
difficult to estimate the action of Opium than of almost any other drug." This is quite true if we
conceive it necessary to divide the effects of the drug into primary and secondary. For my part I
have never yet been able to turn to practical account this division into primary and secondary in
respect of any drug; and, except for the occasional purpose of arranging the actions of a drug in
rememberable form I do not attempt it. I find that whether an Action is "primary" or "secondary"
depends on the prover or the patient. I know some people who are made absolutely sleepless by
Opium in all sorts of doses; and Op. 30 has helped me in case of sleeplessness as often as Coffea.
My experience goes to show that whether the drug-effect is primary or secondary, it is a drug-
effect and is good for prescribing on. Hahnemann describes as a rare and transient effect of
Opium in excitable subjects, occurring primarily but really a sort of reflexion of the secondary
state: "Deathly paleness, coldness of the limbs and whole body, cold perspiration, timorous
anxiety, trembling and despair, mucous stools, transient vomiting and short cough, and very
rarely certain kinds of pain." The last remark is to be taken in connection with a previous one to
the effect that Opium "does not cause in its primary action one single pain." Here again
Hahnemann's negative must be taken with caution. No doubt abnormal painlessness is a grand
keynote for Opium; but in the pathogenesis many acute pains will be found, and among them this
recorded by Hahnemann himself: "Horrible labour-like pains in uterus, which compelled her to
bend the abdomen double, with anxious, almost ineffectual urging to stool." Whether this be
"primary" or "secondary" I know not; but in one of the worst cases of painful menstruation I
have ever had to treat Op. 30 gave greater and more lasting relief than any other remedy. In one
patient to whom I gave Op. 30 for constipation, it caused with the onset of the next period "sharp
- ▸pain which caused vomiting and a desire to sit doubled up and keep warm.
- ▸" J.
- ▸P.
- ▸Willard (1.
- ▸W.
- ▸,
Xxxil. 168) has repeatedly given permanent relief in cases of suffering with Op. 2x without
producing any narcotic effect. Opium can cause cramps and even tetanus as well as the opposite
state, the tetanic properties chiefly existing in the alkaloid Thebain. Opium causes tetanus in
frogs but has no effect whatever on birds. The grand characteristic of Opium is the drowsiness,
inertia, torpor, absence of sensation, absence of reaction, which appears is its general effects. In
all complaints with great sopor; painlessness; complaining of nothing and wanting nothing,
Opium may be required. I remember reading of the cure of an ulcer of the leg. There were no
sensations on which a remedy could be diagnosed, but the absence of sensations indicated
Opium, and Opium cured. "Want of susceptibility, trembling," is another feature of the same
state; lack of vital reaction. Inertia of the intestines results in constipation; of the bladder, in
retention; of the uterus, in suspension of the menses. Generally speaking, all secretions are
checked except that of the skin, which is excited. This arrest of action seems to explain the
sensation of obstruction which occurs in inner parts; and in intestinal obstruction Opium has won