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The morphia habit

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HirdTA_1900redux.pdf (26.36Mb)
Date
1900
Author
Hird, Thomas Alfred
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Abstract
 
 
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.
 
URI
http://hdl.handle.net/1842/26609
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  • Edinburgh Medical School thesis and dissertation collection

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