yfV
PAPERS
*
ON THE
ifinttrtahitg ai
tjje
materia
Jjjebiea,
By CHAS. W. BRINK, M.
"v>
...
*,
15.5x3
D.
1854,
PAPER
ON THE
BY CHAS. W.
Mr. President
D.
moments
BRINK, M.
1S51,
its
whilst I read
Uncertaintrj
resting one
of the
and further, that
members
to
it
is
more willing
to receive,
desultory thoughts.
It
is,
and
that which
As
intellect, or
is
find, in
medical literature,
and
and
theories,
to cor-
and entirely
The substances
to he.
that
as medi-
we give
cines,
To
owes
is
application, for
its
birth; and
its
branches of what we
the relief of
were
call
it
human
science
suffering, our
other
all
No
upon
it
for
of
but
cet.
although
of
Anatomy,
Physiology, Pathology,
immense importance
to the
medical
They are mere matters of dead learnwhen galvanized into life by the application of thera-
is
is.
peutics
are produced
in
means employed
the complicated
to repair
and save
their resources
"thick darkness:" a
which, if properly cultivated, would yield abundant harvests,
comparatively neglected and barren.
What
is
shrouded
in
in,
have
this
the
field,
is left
but the
and directions
3
which are well known
effects of
the greater
number disappoint
the
still
termed a remedy.
fitly
ria
is
the
The
Such indeed
nobody can consult those writers
false conclusions.
is
Among
is
will find
According to Thompson and Edwards it is an excitant. CulChapman and Eberly say it is a sialogogue. Conradi, Bertoli
exists.
len,
among
it
to be a sedative
and
as a contra-stimulant, Brousais
it
revulsives
and Opium
his disciples
animal
over
powerful an
which
Modern
economy, and
numerous compounds
have been
Medicine has
many characters assigned
study.
authors who have made
distinguished
testimony
Dr. Bird speaking
" According
nnrcotine says
Pharmacologists
Medica
is
the catholicon of
as
it,
it
as there
their
of
of the conflicting
in
Derosne
it
relation
stimulant narcotic.
According
and according
it
says,
was an
li
to
According
to Prof.
to
Magendie
CTShaughnessy
it
it is
is
neither
to
a simple narcotic.
is
the
influence
exercises so
in its
The
no properties at all."
The
first
it
was
in fact everything,
and
of
it
It
it
in
was nothing,
for
some practi-
was
in
foundationless
speculations which
To what
errors
the
The
and
formulas,
fantastically
as
arranged."
is
nothing else
men
have made.
founded on sound experience, but who will lose his time to search
for
those few
whom
When
would
and
to
confusion
all
Iiostan declares, that "errors so abound in the most recent formularies, that truths
Ennius."
But if
we have
it
whose Materia
Medica
the
is
agents,"
of medicines are
classifications
in
palpable
instances of
in
more
absurdity,
craft
is
more
humiliating
but
is it
necessary
ments and
differ
all,
I believe
scientific attain-
all
u varied
times,
and
of them, principally,
is
is
paramount
its errors
Medica.
of medicine, because
it is
its
physician,
discharged
all
remember that
to
and reputation
is
branches
the
in
mind
the
of
be won, not
to
to other
by explaining the
so stated this
Do
were true?
Indeed
the
entirely has
absurdities
good
its
Materia Medica
and
that
is
it
its
active energies
we shrink conscious
so
So
thoroughly debauched by
made agents
of evil instead of
account
hope
for reform,
of certainty
would be at
promises of hope
it
last
the
fulfil
Enthusiasts
may
utterly powerless
To know
to
them
is
we
describe
them
names
botanically,
of drugs,
and
life.
enough
But
to
understand their
effect
at present possess.
Are not
numbers who
the
fall
medicines
as
to
for
to
as
to
life
physicians to a sense of
its
still
Yet, here
or
in
How
sick
is
often do
glowing
triumphs
man
uncertainty
and
uncertain.
all is
the
it
community,
medicine
this
of trying this
springs.
eloquence,
has achieved
it
whence
utility of
or, despairingly
hoping that
may do good
propriety
or,
sud-
denly recollecting that they have seen the other thing cure, in just
exactly such cases
Yet
we neglect
still
to
is
positively criminal.
no more
to
Not
only
is this
we
wrong, but
will continue
to
do with the practice of the healing art than has the law
is
preferred by
its
men
followers to
mere
intellec-
tual display.
We
we have
to
God
of
dynamic
forces, the
and which
human ken where
alone
his
life,
and prevent
which the mal-administration of
Now,
physic
if
is
disease"
true,
is
it
as
if
of Dr. Radcliffe,
this
and
subject,
if
the
remedy
In proportion as
to
it
it
to
latter discover
we wish
therefore,
if,
we must
carefully
(than
whom
By
this
We
all
more accurate
know and
There
is
Human
disease
is
tides, or the
No
effort of
fore, is impossible
highest possible
standard.
tainty,
its
still it
ought
to be
The administration
to
it
to the
of mediciue would
its
cer-
PAPER
ON THE
UNCERTAINTY OF OPIUM,
BY CHAS. W. BRINK,
Mr. President
In
M. D.
when we
authorities,
upon a
met, I have
last
That
this
paper
is
much foundation
it treats, I
in truth.
am
well aware.
pared
in haste,
and presented
in
hope that
may be
it
followed by
in
is
treated I have
but as mine
may
may be
who
doctrines promulgated
I merely
sought by experience
10
Than Opium, and
the history of
its effects in
diseases, there is no
and none,
facts,
I think,
may be
to Hippocrates, it
use
and from the reign of Galen, through the darkest eras of medi-
down
cine
to the
time of Pereira,
it
presence.
its
to aid the
endeavor of the
scientific physician
all
and nation, we
sects.
trace
ever invoked
it is
Whenever
seen.
presence of quackery,
Opium
is
polluted
presents itself in
is
by the unhallowed
lozenge, syrup
pill,
or pectoral.
To
the
consummate
skill,
for natu-
ral
life-
this
they
have
failed
notwithstanding
this
the
light
subject,
labors
their
is
it
but
have
dark and
still
doubtful.
The testimony
we
are without
if,
therefore,
Upon
this
worthless
ease
ground
not that
uncertain remedy.
it
it is
all
To
not that
Opium
is
artificial
this conclusion
agencies
we
we employ,
it is
an
as in the character of
men, the vices and virtues, praised and blamed by friends or enemies,
often agree.
Thus, the courage and firmness of one, correspond to
the rashness and pride of the other. Collateral evidence is therefore
necessary to justify doubt.
11
But
is
it
Opium
not so with
there
is
The sources
its uncertainty.
even
that
it
of this
there
if
some of them.
The limited sphere of individual experience, from -which we draw
were time,
were unnecessary
it
our knowledge
wise
men
the fate, as
to
would seem
it
at
to be, of writers, be
they
subject of investigation, the ever varying phases of disease, the idiosyncratic insusceptibility, or morbid sensitiveness of some
besides
pro-
make
it
its
its
and
action,
disease.
So impressed with
fact
this
"
It
is
this
remedy
in a certain
disease)
which, were
it
my
much
in the ocean,
it
my own
has been,
whose eminent
devotion
talents,
to science,
enthusiastic
unlike, however,
deal not in darkness and ambiguity, but their responses (upon this
subject at least) are clear and unequivocal.
From them, we
shall
which
its
action depends.
In defining narcotics,
opium, and
is
(at
the type of
the
the class,)
They
are
12
of the
action of the
is
is
To
secondary or depressant
of pagan mythology)
effect,
was
Now,
who
for
"
says,
and inability
of this
accounted
remedy.
so positively asserted
by Cullen,
as a
is
excitement,
of a
is
all that is
accounted
once, advanced.
large
To both
doses
are
generally
however exceptions, small doses being sometimes followed by narcotism without any previous excitement, and large doses by excite-
ment.
to
fell
the ground, or
day only
generally followed the rising sun, the grand laws of nature would be
uncertain.
1 need not recall the sweeping denunciation of
that
De Quincy pronounced
the subject of
Medicine
Opium, by
against
all
that
"
Turkey, or by Professors of
travellers in
produced
is
necessarily followed
all
by
of our
proportionate
depression."
subject,
and says that " even those who have written expressly on the .Materia
Medica, make it evident that their experimental knowledge of its
action is none at all" a
remark not
less true of
many
other reme-
its
mode
" These
known
ourselves
whom
examples, se-
how
we
little is
shall save
Driven to hypothesis
says,
13
which medicines can
change
in the
"We arc obliged, therefore, to assume that opium changes the qualities
of actions."
The dependence
conditions
themselves
variable
which
it
its
proves
it
operation upon
to be,
the fact of
its
admi-
to
obtain
offered,
is
expected results.
to
classifications
nistration,
certain
more eminently
its
troversion.
Of
its
influence
is
is
experienced."
Yet we
know many who use it, never experience the pleasurable sensations
described by De Quincy and others, nor when taken as an article
of luxury is Opium always unfavorable to longevity.
"We are told that
means uniform
its
effects
and
is
its
it
be an
agent,
to
serting that
it
increases, others
that
it
some
as-
istration, so constantly
ture,
and
is
of the
in
all
these
may be
pernicious drug."
have been known to act like opium, and opium to have proeffect," arc instances of its want of uniform operapurgative
duced a
convince the most credulous sticklers for its
might
which
tion
som
salts
14
Wc
certainty.
have
all
The
pill,
Academy
it.
"
fidence.
large dose of opium, with the intention of despatching him, but the
him
it
restored
to health."
There
than
no
is
effect of
this
article
its
Christian, says
<
Constipation
Dr.
yet,
by no means a general
is
effect of
Castle,
liver ;
it,
to act
constipation which
always follows the use of opium, " depends upon the diminished secretion of bile."
Now
us,
and
diarrhoea,"'
if,
and
phlogistic treatment,"
There
is
no
its
if
its
it will
open
bowels,
,the
less difference
whilst
Miller
among
says,
"
it
by the mouth
anti-
in lead
colic
is
is
and
depends
opinion
it
sufficient
an error
to
is
Pereira's
the same,
admin-
certainly not
greater."
Even
there
is
a variety of opinion.
One
says,
easily settled
application of
allege that
all
or
operation
no effect."
when given
the salutary or
dangerous
effects
of its
which
it
has
anomalous
15
disturbed sleep and other disagreeable consequences, and in some
cases
it
As
of this
uncertainty
its
is
remedy
as conclusive, as the
amount
is
As
overwhelming.
this
About
in
specific in Syphilis,
to
Opium acquired
it is
its
most
questioned.
a great reputation as a
many denied
its
efficacy,
and the
my
Opium
the
is
remedy
is
this
effected
is
Wm.
by sarsaparilla.
son
new remedy."
and maintains
celebrated authority
tells
that in all
convidsive diseases
it is
notoriously variable?''
it
Watson
Gregory
tells
us " in
all
" the
exanthema-
disease
dysentery
but there
is
much
Enough testimony
16
remedy under consideration, might be cited to fill volumes
employment
after examining a few more witnesses upon its
febrile affections, I will
flammatory and
delhium and
in the
cularly
its
in-
have done.
in
and,
in
known
opium
more
is
as fevers, parti-
attend, and
symptoms, which
so
find
to
for its
but
and agreement among authors, as to its
which
testimony
met
by
instead of unanimity of opinion, we are
challenges the most sagacious and penetrating judgment for an
utility
exhibition,
impartial decision.
fail
even
of fever,
stances."
Even
in cases
On
symptom
Latham
it
is
says,
for the
v,
akefulness,
Yet he
objects to
sleeplessness, (the
Dr.
this point,
its
" but
to call for a
conside-
same quantity
produce fatal coma, from which the patient has never been roused."
Upon
its
"
to stupify the
sensibility to pain,
it
produces that
effect,
or to
often but to
when
is
its
which
it
operation
is
uncertain
and
To
narcotize a patient,
is to
much
is
too
like
on
Disease
entitle
his
In his
Opium would
17
be to place a mask between the physician and the disease, behind
which the
latter
he preferred
measure, but rather by quelling the inflammation which was its cause.
We are sure," says his biographer, " the plan of Dr. Chambers
"
Now, notwithstanding
it
to
common and
much
or essential to
them
employment
our race,
fatal to
recklessness as though
it
we
were not
as though
it
it
fail
as though it
have in
this
their reckless
admi-
Indeed,
nistration,
I believe
is,
if
Statistics of
the United States, and both his labor and his fears
lady, residing in
Grand
from odontalgia,
pain
Pectoris
many
may be
cited.
Upon
Dupuy-
state, following
traumatic or nervous delirium, as he styles a peculiar
its
character be
if
which,
and complicating injuries, a condition in
18
certain,
"
some suppose,
as
ought
it
to
he
favorably,
act
says,
always appeared
less
This imputation does not apply alone to Opium, but to other re-
class.
to
As
Hyoscyamus has
remedy
in rigidity
of the os uteri,
to
much recommended
as a relaxant
but
it is
and
effects,"
totally
he says, "
for inertness,
Opium
Again,
it
may
relaxing
uterus completely."
and
its
it
paralize the
in
to be
Speaking of
consistent with
man
their theory,)
author
the
this,
is
decidedly wrong.
Professor
Gril-
doses,
is
Yet we
all
know
and
failed
the
ovum.
foetal life,
We
find,
too,
that
full
doses
are
recommended
in
threatened abortion.
is
endowed,
to
it
to
procedure
as though
to exist, as rules of
it
19
Is
all
true that
it
the world,
mal beings
that
conditions which
prove
Opium
and adapting
causes
it
it
emhracc
it
it
itself to the
all this,
may
reason.
is
power of opium
standing
its
prolific
parents
Resorting to
it,
(notwith-
pertenacious
invariability, as
Tea
they become
so familiar with
it,
as
to
activity
(one
of the
As
it is
to the
its
professional willingness to
whether
neglect to observe
humor popular
necessary or not.
grounds I have
for skepticism,
vertible.
authors, whose
means of observation
were few or limited, but eminent writers and teachers, whose intellects have illuminated some of the darkest paths of our science. And
I ask whether their conflicting testimony does not justify doubt in
almost universal applicability to the cure of disease, and prove
its
generally, and
" In the early ages of medicine," says Dr. Gregory, " when descriptions of disease were imperfect, when pathology was in its infancy, and statistics were unknown, Physicians arrogated to themselves
a,
to be wholly unwarrantable."
Notwithstanding the contradictory testimony we have about remeas Old Burton
dial agents, I am not without faith in their virtues
we now know
20
has
it,
my
for
am
part, I
Nor do
as
Dougald Stewart
calls
as implicit confidence
is.
it,
which
is
Pyrrhoic Philosophy
is to
is
Who
We
be preferred.
torch
the true
Did not
the pioneer
ries of truth
by doubt
is
'tis
recollect
of science."
the portal,
the
French
Descartes
Where
guard
skepticism,"
or unlimited
her shadow."
Was
and
has not distrust in old doctrines, always been the precursor of new
It
To no study
will this
a-
for the
in
study
suspense,"
state of doubt.
When thus prepared, attention is aroused, we industriously examine, and carefully weigh facts as they are presented, and do not
allow them to glide unquestioned into the memory.
By
humbug
proof.
at a glance to
facts
conflicting testimony
it is
fact,
when
Out
of the conflicting
21
we compelled but
that
to
prove which, I
am
contending, viz
in
all
the uncertainty
is
That
The
it
must remain
so,
seems to
The ever-varying
influence
conditions,
I have attempted.
a self-evident proposition.
intrinsic,
is
me
is
conditions of the
supposed
to exert
may
change, and which are almost never alike in any two individuals,
system over
others
all
their
dependence upon
the rapid,
and what we
it for
the performance
call,
but improperly,
another
administer,
disease
so
and,
as to render
the
finally,
this
inexperience
aggravated
evils
all
some
of
of
the
observers,
upon
its
effects
all
these,
want
to
cure
must
system or organ to
the
it
its effects
in disease
drug
we can create at will the necessary condiwe can change climate alter habit correct idiosyn-
so remain, until
until
we can
itself,
until
or antimony (agents
Opium,
We
may
ecpually
reliable
ground
uncertain in
their
operations)
with
results,
we can
obtain
totally
22
one.
When we
other
potent
c:m do
all
agents of the
But
to
is
this,
and not
till
then, will
now given
to
the
to
them by practitioners.
included
Opium and
among
Medica
is
not
for,
still,
now envelope
whether our
and whether
circle
all
hung
is to
be preferred to the
made
in a
to
be
TU