Chapter 4
When the clock struck twelve at midnight, and I knew that for the first time in many years I had lived for an entire day without opium, it excited no surprise or exultation. The capacity for an emotion of any kind was exhausted. I seemed as little capable of a sentiment as a man well could be, this side of his winding-sheet. I knew, of course, that in these forty days save one, I had worked out the problem, How to leave off opium, and that I had apparently attained a final deliverance: but it was several weeks before I appreciated with any confidence the completion of the task I had undertaken.
Although the opium habit was broken, it was only to leave me in a condition of much feebleness and suffering. I could not sleep, I could not sit quietly, I could not lie in any one posture for many minutes together. The nervous system was thoroughly deranged. Weak as I had become, I felt a continual desire to walk. The weather was unfavorable, but I managed to get several miles of exercise almost daily. But this relief was limited to four or five hours at most, and left the remainder of the day a weary weight upon my hands. The aversion to reading had become such that some months elapsed before I took up a book with any pleasure. Even the daily papers were more than I could well fix my attention upon, except in the briefest and most cursory way. Within a week, however, the sense of acute pain rapidly diminished, but the irritability, impatience, and incapacity to do any thing long remained unrelieved. The disordered liver became apparently more disordered with the progress of time, producing such effects upon the bowels as may with more fitness be told a physician than recorded here. The tonsils of the throat were swollen, the throat itself inflamed, while the chest was penetrated with what seemed like pulsations of prickly heat. There was also a sense of fullness in the muscles of the arms and legs which seemed to be permeated, if I may so express it, with heated electricity. The general condition of the nervous system will be sufficiently indicated by the statement that it was between three or four months before I could hold a pen with any degree of steadiness. Meantime, singular as it may seem, the appearance of health and vigor had astonishingly increased. I had gained more than twenty pounds in weight, partly, I suppose, the result of leaving off opium and tobacco, and partly the consequence of the insatiable appetite with which I was constantly followed. Within a month after the close of the opium strife, I was repeatedly congratulated upon my healthy, vigorous condition. Few men in the entire city bore about them more of the appearance of perfect health, and fewer still were probably in such a state of exhausted vitality.
During the time I was leaving off opium I had labored under the impression that the habit once mastered, a speedy restoration to health would follow. I was by no means prepared, therefore, for the almost inappreciable gain in the weeks which succeeded, and in some anxiety consulted a number of physicians, who each suggested in a timid way the trial, some of strychnine, some of valerian, some of lupuline, hyoscyamus, ignatia, belladonna, and what not. I do not know that I derived the slightest benefit from any of these prescriptions, or from any other therapeutic agency, unless I except the good effects for a few days of bitters, and of cold shower-baths from a tank in which ice was floating.
The most judicious of the medical gentlemen whose aid I invoked, was, I think, the one who replied to my inquiry for his bill, "What for? I have done you no good, and have learned more from you than you have from me."
This constitutes the entire history of my medical experience, and is mentioned as being the only, and a very small adjunct to the great remedy--patient, persistent, obstinate endurance. So exceeding slow has been the process toward the restoration of a natural condition of the system, that writing now, at the expiration of more than a year since opium was finally abandoned, it seems to me very uncertain when, if ever, this result will be reached. Between four and five months elapsed before I was at all capable of commanding my attention or controlling the nervous impatience of mind and body. I then assented to a proposal which involved the necessity of a good deal of steady work, in the hope that constant occupation would divert the attention from the nervousness under which I suffered and would restore the self-reliance which had so long failed me. It was a foolish experiment, and might have proved a fatal one. The business I had undertaken required a clear head and average health, and I had neither. The sleep was short and imperfect, rarely exceeding two or three hours. The chest was in a constant heat and very sore, while the previous bilious difficulties seemed in no way overcome. The mouth was parched, the tongue swollen, and a low fever seemed to have taken entire possession of the system, with special and peculiar exasperations in the muscles of the arms and legs.
The difficulty of thinking to any purpose was only equalled by the reluctance with which I could bring myself to the task of holding a pen. For a few weeks, however, the necessity of not wholly disgracing myself forced me on after a poor fashion; but at the end of two months I was a used-up man. I would sit for hours looking listlessly upon a sheet of paper, helpless of originating an idea upon the commonest of subjects, and with a prevailing sensation of owning a large emptiness in the brain, which seemed chiefly filled with a stupid wonder when all this would end.
More than an entire year has now passed, in which I have done little else than to put the preceding details into shape from brief memoranda made at the time of the experiment. While the physical agony ceased almost immediately after the opium was abandoned, the irritation of the system still continues. I do not know how better to describe my present state than by the use of language which professional men may regard as neither scientific nor accurate, but which will express, I hope, to unprofessional readers the idea I wish to convey, when I say that the entire system seems to me not merely to have been poisoned, but saturated with poison. Had some virus been transfused into the blood, which carried with it to every nerve of sensation a sense of painful, exasperating unnaturalness, the feeling would not, I imagine, be unlike what I am endeavoring to indicate.
ADDENDA.--At the time of writing the preceding narrative I had supposed that the entire story was told, and that the intelligent reader, should this record ever see the light, would naturally infer, as I myself imagined would be the case, that the unnatural condition of the body would soon become changed into a state of average health. In this I was mistaken. So tenacious and obstinate in its hold upon its victim is the opium disease, that even after the lapse of ten years its poisonous agency is still felt. Without some reference to these remoter consequences of the hasty abandonment of confirmed habits of opium-eating, the chief object of this narrative as a guide to others (who will certainly need all the information on the subject that can be given them) would fail of being secured. While unquestionably the heaviest part of the suffering resulting from such a change of habit belongs to the few weeks in which the patient is abandoning opium, it ought not to be concealed that this brief period by no means comprises the limit within which he will find himself obliged to maintain the most rigid watch over himself, lest the feeling of desperation which at times assaults him from the hope of immediate physical restoration disappointed and indefinitely postponed, should drive him back to his old habits. Indeed, with some temperaments, the greatest danger of a relapse comes in, not during the process of abandonment, but after the habit has been broken. Great bodily pain serves only to rouse up some natures to a more earnest strife, and, as their sufferings become more intense, the determination not to yield gains an unnatural strength. The mind is vindicating itself as the master of the body. While in this state, tortures and the fagot are powerless to extort groans or confessions from the racked or half-consumed martyr. Many a sufferer has borne the agony of the boots or the thumb-screw without flinching, whose courage has given way under the less painful but more unendurable punishment of prolonged imprisonment. In the one case all a man's powers of resistance are roused; he feels that his manhood is at stake, and he endures as men will endure when they see that the question how far they are their own masters, is at issue. There are, I think, a great number of men and women who would go unflinchingly to the stake in vindication of a principle, whose resolution, somewhere in the course of a long, solitary, and indefinite imprisonment, would break down into a discreditable compromise of opinions for which they were unquestionably willing to die.
In the same way a man will for a time endure even frightful suffering in relinquishing a pernicious habit, while he may fail to hold up his determination against the assaults of the apparently never-ending irritation, discomfort, pain, and sleeplessness which may be counted on as being, sometimes at least, among the remoter consequences of the struggle in which he has engaged. I wish it, however, distinctly understood that I do not suppose that the experience of others whose use of opium had been similar to my own, would necessarily correspond to mine in all or even in many respects. Opium is the Proteus of medicine, and science has not yet succeeded in tearing away the many masks it wears, nor in tracing the marvellously diversified aspects it is capable of assuming. Among many cases of the relinquishment of opium with which I have been made acquainted, nothing is more perplexing than the difference of the specific consequences, as they are exhibited in persons of different temperaments and habits. For such differences I do not pretend to account. That is the business of the thoroughly educated physician, and no unprofessional man, however wide his personal experience, has the right to dogmatize or even to express with much confidence settled opinions upon the subject. My object will be fully attained if I succeed in giving a just and truthful impression of the more marked final consequences of the hasty disuse of opium in this single case, leaving it to medical men to explain the complicated relations of an opium-saturated constitution to the free and healthy functions of life.
In my own case, the most marked among the later consequences of the disease of opium, some of which remain to the present time and seem to be permanently engrafted upon the constitution, have been these:
1. Pressure upon the muscles of the limbs and in the extremities, sometimes as of electricity apparently accumulated there under a strong mechanical force.
2. A disordered condition of the liver, exhibiting itself in the variety of uncomfortable modes in which that organ, when acting irregularly, is accustomed to assert its grievances.
3. A sensitive condition of the stomach, rejecting many kinds of food which are regarded by medical men as simple and easy of digestion.
4. Acute shooting pains, confined to no one part of the body.
5. An unnatural sensitiveness to cold.
6. Frequent cold perspiration in parts of the body.
7. A tendency to impatience and irritability of temper, with paroxysms of excitement wholly foreign to the natural disposition.
8. Deficiency and irregularity of sleep.
9. Occasional prostration of strength.
10. Inaptitude for steady exertion.
I mention without hesitancy these consequences of the abandonment of opium, from the belief that any person really in earnest in his desire to relinquish the habit will be more likely to persevere by knowing at the start exactly what obstacles he may meet in his progress toward perfect recovery, than by having it gradually revealed to him, and that at times when his body and mind are both enfeebled by what he has passed through. With a single exception, the dismost serious one I have been obliged to encounter. Whether it is one of the specific effects of the disuse of opium, or only one of the many general results of a disordered constitution, I do not know.
I can only say in my own case, that after the lapse of years, this particular difficulty is not wholly overcome. This electric condition, so to call it, still continues a serious annoyance. But when it occurs, the pain is of less duration, and gradually, but very slowly, is of diminished frequency. Violent exercise will sometimes relieve it; a long walk has often the same effect. The use of stimulants brings alleviation for a time, but there seems to be no permanent remedy except in the perfect restoration of the system by time from this effect of the wear and tear of opium upon the nerves. Irregularity in the action of the liver, while singularly marked in the earlier stages of the experiment, and continuing for years to make its agency manifestly felt, is in a considerable degree checked and controlled by a judicious use of calomel.
The condition of the digestive organs is less impaired than I should have supposed possible, judging from the experience of others. A moderate degree of attention to the quality of what is eaten, with proper care to avoid what is not easily digested, with the exercise of habitual self-control in respect to quantity, suffices to prevent, for the most part, all unendurable feelings of discomfort in this part of the system. Whether the habitually febrile condition of the mouth, and the swollen state of the tongue, is referable to a disturbed action of the stomach or of the liver I can not say. It is certain that none of the effects of opium-eating are more marked or more obstinately tenacious in their hold upon the system than these. I barely advert to the frequent impossibility of retaining some kinds of food upon the stomach, which has been one unpleasant part of my experience, because I doubt whether this return of a difficulty which began in childhood has any necessary connection with the use of opium. For many years before I knew any thing of the drug I had been a daily sufferer from this cause. Indeed the use of opium seemed to control this tendency, and it was only when the remedy was abandoned that the old annoyance returned. For a few months the stomach rejected every kind of food; but in less than a year, and subsequently to the present time, this has been of only occasional ocurrence.
I am also at a loss how far to connect the disuse of opium with the lancinating pains which have troubled me since the time to which I refer. These pains began long before I had recourse to opium, they did not cease their frequent attacks while opium was used, nor have they failed to make their potency felt since opium was abandoned. While it is not improbable that the neuralgic difficulties of my childhood might have remained to the present time, even if I had never made use of opium, I think that the experience of all who have undergone the trial shows that similar pains are invariably attendant upon the disuse of opium. How long their presence might be protracted with persons not antecedently troubled in this way, is a question I can not answer. I infer from what little has been recorded, and from what I have learned in other ways, that the reforming opium-eater must make up his mind to a protracted encounter with this great enemy to his peace. That the struggle of others with this difficulty will be prolonged as mine has been I do not believe, unless they have been subjected for a lifetime to pains connected with disorder in the nervous system.
The unnatural sensitiveness to cold to which I have alluded is rather a discomfort than any thing else. It merely makes a higher temperature necessary for enjoyment, but in no other respect can it be regarded as deserving special mention. With the thermometer standing at 80° to 85° the sensation of agreeable warmth is perfect; with the mercury at 70° or even higher, there is a good deal of the feeling that the bones are inadequately protected by the flesh, that the clothing is too limited in quantity, and in winter that the coal-dealer is hardly doing you justice.
The cold perspiration down the spine, which was so marked a sensation during the worst of the trial, has not yet wholly left the system, but is greatly limited in the extent of surface it affects and in the frequency of its return.
The tendency to impatience and irritability of temper to which I have adverted is by far the most humiliating of the effects resulting from the abandonment of opium. Men differ very widely both in their liability to these excesses of temper as well as in their power to control them; but under the aggravations which necessarily attend an entire change of habit, this natural tendency, whether it be small or great, to hastiness of mind is greatly increased. So long as the disturbing causes remain, whether these be the state of the liver or the stomach, or a want of sufficient sleep, or the excited condition of the nervous system, the patient will find himself called upon for the exercise of all his self-control to keep in check his exaggerated sensibility to the daily annoyances of life.
Intimately connected with the preceding is the frequent recurrence of sleepless nights, which seem invariably to attend upon the abandonment of the habit. Possibly some part of this state of agitated wakefulness may pertain to the natural temperament of the patient, but this tendency is greatly aggravated by the condition of the nerves, so thoroughly shattered by the violent struggle to oblige the system to dispense with the soothing influence of the drug upon which it has so long relied. Whatever method others may have found to counteract this infirmity, I have been able as yet to find no remedy for it. Especially are those nights made long and weary which _precede_ any long continuance of wet weather. A moist condition of the atmosphere still serves the double purpose of setting in play the nervous sensibilities, and, as a concomitant or a consequence, of greatly disturbing, if not destroying sleep.
In connection with this matter something should be said on the subject of dreaming, to which De Quincey has given so marked a prominence in his "Confessions" and "Suspiris de Profundis." In my own case, neither when beginning the use of opium, nor while making use of it in the largest quantities and after the habit had long been established, nor while engaged in the painful process of relinquishing it, nor at any time subsequently, have I had any experience worth narrating of the influence of the drug over the dreaming faculty. On the contrary, I doubt whether many men of mature age know so little of this peculiar state of mind as myself. The conditions in this respect, imposed by my own peculiarities of constitution, have been either no sleep sufficiently sound as to interfere with the consciousness of what was passing, or mere restlessness, or sleep so profound as to leave behind it no trace of the mind's activity. While it is therefore certain that this exaggeration of the dreaming faculty is not necessarily connected with the use of opium, but is rather to be referred to some peculiarity of temperament or organization in De Quincey himself, I find myself in turn at a loss to know how far to regard other phenomena to which I have previously alluded as the natural and necessary consequences of opium, or how far they may be owing to peculiarities of constitution in myself. Opium-eaters have said but little on the subject. The medical profession, so far as I have conversed with them, and I have consulted with some of the most eminent, are not generally well informed on any thing beyond the specific effects of the drug as witnessed in ordinary medication. In the absence of sufficient authority, it may be safer to say that the remoter consequences of the disuse of opium consist in a general disorder and derangement of the nervous system, exhibiting itself in such particular symptoms as are most accordant with the temperament, constitutional weaknesses, and personal idiosyncrasies of the patient. That some considerable suffering must be regarded as unavoidable seems to be placed beyond question from the nature of the trial to which the body has been subjected, as well as from what little has been said on the subject by those who have relinquished the habit.
I close this brief reference to the remoter consequences of the habits of the opium-eater by calling the attention of the reader to the physical weakness with consequent inaptitude for continuous exertion which forms a part of my own experience. Unable as I am to refer it to any _immediate_ cause, frequent and sudden prostration of strength occurs, accompanied by slight dizziness, impaired sight, and a sense of overwhelming weakness, though never going to the extent of absolute faintness. Its recurrence seems to be governed by no rule. It sometimes comes with great frequency, and sometimes weeks will elapse without a return. Neither the state of the weather, nor any particular condition of the body, appears to call it out. It sometimes is relieved by a glass of water, by the entrance of a stranger, by the very slightest excitement, and it sometimes resists the strongest stimulants and every other attempt to combat it. I can record nothing else respecting this visitant except that its presence is always accompanied with a singular sensation in the stomach, and that the entire nervous system is affected by its attack.
The inaptitude for steady exertion is not merely the consequence of this occasional feeling of exhaustion, but is for a time the inevitable result of the accumulated pain and weakness to which his system, not yet restored to health, is still subject. This impatience of continued application to work, which is common to all opium-eaters, and which does not cease with the abandonment of the habit, seems to result in the first case from some specific relation between the drug and the meditative faculties, promoting a state of habitual reverie and day-dreaming, utterly indisposing the opium-user for any occupation which will disturb the calm current of his thoughts, and in the other, proceeding from the direct disorder of the nervous organization itself. Strange as it may seem, the very thought of exertion will often waken in the reforming opium-eater acute nervous pains, which cease only as the purpose is abandoned. In other cases, where there is no special nervous suffering at the time, work is easy and pleasant even beyond what is natural.
One effect of opium upon the _mind_ deserves to be mentioned; its influence upon the faculty of memory. The logical memory, De Quincey says, seems in no way to be weakened by its use, but rather the contrary. His own devotion to the abstract principles of political economy; the character of Coleridge's literary labors between the years 1804-16, when his use of opium was most inordinate; together with the cast of mind of many other well-known opium-eaters, confirms this suggestion of De Quincey. His further statement that the memory of dates, isolated events, and particular facts, is greatly weakened by opium, is confirmed by my own experience. However physiologists may explain this fact, a knowledge of it may not be without its use to those who desire to be made thoroughly acquainted with all the consequences of the opium habit.