This subject has been selected for my thesis for
various reasons. It was my fortune to assist at an
Institution, in fact, I had sole charge for a time,
where such cases were treated, and therefore I had
exceptional opportunities of clinical observation and
investigation. Apparently little has been written on
this subject in this country, the chief literature
emanating from German and French physicians.
Persons suffering from the Morphia habit are
mostly treated in Institutions suitably adapted for
the purpose, therefore the general practitioner has
little opportunity of witnessing the care and patience
required in the treatment of such cases. The Opium or
Morphia habit is much more common than the majority of
people have any idea of. I shall deal chiefly with the
subject as applying to the introduction of Morphia
into the system by means of the syringe and needle.
I would include in the"Morphia Habit" the
constitutional proclivity or "neurosis" which impels
to the inordinate use of Morphia, & the injury caused
to the system by its injudicious use.
The use of opium or its alkaloids is always
perilous: in some cases, no doubt, there is a distinct
"opium diathesis." The latency or activity of tlhis diathesis will depend on certain conditions of life
and surroundings which in many cases can be traced.
The "Morphia habitub" has often a "neurotic" element
in his history, it may be associated with brain or
nerve injuries, cell starvation, faulty nutrition, or
excessive drains of nerve force: a train of predis¬
posing causes may have been gathering for an indefinite
time. There is no doubt that the toxic use of Opium
and its alkaloids is great: it is evident that the
number of cases id large. Morphia is given daily and
yet only comparatively few become addicted to its use.
Why should so many persons take Morphia continuously
for the transient relief it gives? Why should the
effects of the drug become so pleasing as to demand
its increased use irrespective of all consequences?
The only explanation is the presence of a neurotic
diathesis either inherited or acquired.
I have arrived at the conclusion that the abuse
of Morphia injections is due to a central neurotic
change, thus differing from some Continental author¬
ities. Morphia neurosis would thus seem to be not an
intoxication from the drug, but a central neurotic
change, brought about by the long perversion and
impairment of central nutrition. This I hope to prove
and also show by my clinical cases.
Certain constitutions bear up through the changes
of life fairly well, until some serious injury over¬
takes the physical organisation, such for example as
a blow on the head, a wound, or even a long or trying
illness. Irritation at once begins to do its work, the
ordinary and natural constitution gives way; it is
weak, exhausted, and weary; it has become unequal to
the requirements of ordinary life, it craves for rest
and repose. The Morphia diathesis is invoked. The mind
rushes from one extreme of emotion to another, either
showing excitement that is morbid, or degrees of
feebleness that are abject. Women are often of this
class, and persons from the wealthier circles of
social life.
