Opium : has it any use, other than a strictly medical one?

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PREFACE.
The best preface which I can submit seems to me the three following letters, in the order in which they appeared in “ The Times,” December 19th, 1893. The 1st gives my position, the 2nd Sir William Moore’s, and the 3rd that of the promoters of the petition from the native medical men of Bombay, against the opium habit.
TO THE EDITOR OF “THE TIMES.”
Sir,—In Sir George Birdwood’s letter on “ The Opium Question,” in your issue of December 6th, with special reference to “ the anti-opium petition recently presented to Parliament, purporting to be signed ‘ by 50 Indian medical men ’ ” occurs an error, which I am sure Sir George will not object to my asking you to correct. This is doubtless due to my name appearing on some of the previous publications of “ The Society for the Suppression of the Opium Trade ” as deputation secretary, as Mr. Joseph Alexander is secretary, and Sir George has concluded that I am still acting as such, whereas, since the decision of the Government to appoint a Royal Commission on Opium, the temporary duties of deputation secretary, in which I had been engaged for about eighteen months, ceased, and since then I have had no separate official connection with that society, though I have now a united one as a member of its executive committee, to which I was appointed on the cessation of my duties as deputation secretary.
In common with others, I accepted the opportunity which this Royal Commission afforded of publicly expressing our views and opinions on this burning question in a manner which secures for them a place among the Parliamentary records—and in my


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own case I did this most gratefully, as it gave me the privilege of publicly explaining my position on the anti-opium side—and which, even in the necessarily brief extract which then appeared in The Times, was clearly laid down.
The prominent (solitary as regards the Bengal Presidency) part which I have taken in this anti-opium crusade had a twofold object in view, viz. :—First, to do strict justice to the Government, whom I had served for thirty years on every public occasion throughout England, Scotland and Ireland, by dwelling, with marked emphasis, on the beneficial influence of that Government as a whole—first under my old masters the H.E.I.C., and then under the direct Government of her gracious Majesty—and pointing out how, under the peculiar conditions of a handful of men ruling millions, it incomparably surpassed in justice, mercy and judgment, any Government India has known (a fact the natives fully admit), or indeed any other country ; and, secondly, how, notwithstanding the terrible facilities for indulgence in opium, especially where the poppy is cultivated, to which the peoples of the Bengal Presidency are exposed, with the late exception of Orissa, due entirely to the pangs of hunger having been deadened during the last famine, the village—i.e., agricultural—population of the country, amounting to 95 per cent, of the whole, is, as yet, practically and visibly untouched by the opium habit. It is to conserve this condition against possible contingencies of the famine or even scarcity before which Orissa fell into the habit, that I labour on, and to get opium viewed and treated as a poison, as it is in this and all other civilised countries.
The high tone of self-respect, fostered by social and religious customs, has protected these people from indulging in a forbidden pleasure, while their splendid industry, unequalled, I suppose, in the world, has warned them, that though opium may impart a temporary stimulus towards special or increased exertion, yet this would be fatal to their continuous labour throughout the whole year. The opium victims seen in the slums of the large inland cities are the bad characters and dregs of the community, while in the seaport towns they people the coolie depots, as planters and others find to their cost. These opium victims are those in whom the habit, either from excess or increased susceptibility, has interfered with the digestion,


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and ultimately led to conditions which preclude the possibility of remunerative labour, in which state, there being no place for poor drones in an Indian village, they drift to the large inland cities, or to Calcutta and Bombay, where they are gathered into the coolie emigration net, and despatched either to tea gardens, &c., or shipped to some of our colonies ; and the condition of these poor creatures, as captains and medical officers can certify, when the opium supply runs short, forms the best illustration of the injurious effects of the opium habit, when carried to excess and the appetite fails. Implicitly believing the first, as a truly loyal British subject, I have ever done my best to remove the blots on this otherwise beneficent rule, summed up in the liquor and opium traffic, as lately and now carried on, and, fully appreciating and admiring the second, have taken every opportunity in my power of making known the fact that the peoples of India, and certainly those in the Bengal Presidency, which I know well, from Juggernauth on the Bay of Bengal to Gungoo-tree, in the Himalayas, owing to their strictly abstemious and industrious habits as regards agriculture, are worthy of all that can be done for them.
In conclusion, I would only say that, as I have unquestionably made use of the petition seriously discredited by Sir George Birdwood—which, however, he fully admits “ that our London Society for the Suppression of the Opium Trade are in no way responsible for ”—I shall use my best endeavours to probe the petition to its origin, as no cause can prosper when supported on baseless data.
I remain, yours faithfully,
ROBT. PRINGLE, M.D., Brigade Surgeon.
Blackheath, S.E., Dec. 12.
P.S.—Will you allow me to add in this P.S. that at the meeting of the Society for the Study of Inebriety (from whatever cause), to be held on Thursday, January 4th, 1894, I purpose opening a discussion by a brief paper, entitled “ Opium —has it any use other than a strictly medicinal one ? ” to which I invite by card, which I will gladly supply, all those interested in the subject ?—R. P.


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TO THE EDITOR OF “THE TIMES.”
Sir,—In his letter published in The Times of the 15th inst., Sir J. Pease asks : “ If opium is such a blessing to India why
do the Indian Government........take credit for keeping the
consumption of opium within the smallest practical limits ?” Sir J. Pease also puts other queries of a similar nature. The answers are, that the British Government has been weak enough to apply pressure to the Government of India, in deference to the clamour, sensational agitation, and fallacies, so persistently urged by the small section of the people in this country composing the Anti-Opium Society, who have not hesitated to use the religious element as a lever.
I am, Sir, yours faithfully, WILLIAM MOORE, Surgeon-General.
15 Portland Place, Dec. 16.
TO THE EDITOR OF “THE TIMES.”
Sir,—As one cognizant of the facts concerning the petition of 49 medical men in Bombay deploring the use of opium by natives of India, which is alluded to in a telegram published by you, and dated Calcutta, December 3rd, I wish to deny that the petition was in any sense a fraud.
In April, 1891, a large meeting was held in the Framji Cowasji Hall, Bombay, to support Sir Joseph Pease’s motion on the opium question. The Bishop of Bombay occupied the chair, and an anti-opium committee for Bombay was formed as a result of that meeting. Among the speakers was a Parsee doctor, who also joined the committee. It was he who suggested and drafted the petition in question, under the auspices of the committee and with the help of its hon. secretary. He obtained several of the signatures personally, and the remainder were got in the usual way by a person who took the petition round to the houses of the medical men of Bombay. This person was paid for his time simply and not by the result of his work. The names (which I saw) had every appearance of being genuine.


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The petition was completed and sent to the House of Commons in February or March, 1892. It was first published in the Sentinel for April, 1892, and has since been published and circulated both in India and England without any challenge.
I hear from Bombay that strong official pressure was being put upon the signatories to this petition to induce them to recant. This makes it easier to understand the report that so many of the signatures have been “ repudiated.” The lapse of time and the impossibility of recovering the original document make their retreat more easy.
I am, Sir, yours &c.,
HELEN S. DYER (Wife of the Editor of the Bombay Guardian).
16 Mercers’ Road, Holloway, N., Dec. 12.
OPIUM—HAS IT ANY USE. OTHER THAN A STRICTLY MEDICINAL ONEP
By Brigade-Surgeon Robert Pringle, M.D. Edin.
Late Sanitary Department, H.M. Bengal Army.
Judged by the line which the evidence before the Royal Commission on opium has taken, both in this country and in India to date (Dec. 23rd, 1893), the answer to the question contained in the heading of this communication can only be in the affirmative. Believing as I do, that the negative is the only answer possible, either from a moral or physical point of view, taking these terms in their highest and fullest sense, I shall now proceed to support the negative, by as brief as possible, but pointed evidence, and for this purpose I will discuss the subject under two heads or divisions, viz., Medicinal and Non-Medicinal use.


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I am the more anxious to do this, as I was the. one medical officer, out of the four signatories to the appeal to the profession, against the practically unrestricted sale of opium in India, whose knowledge of the subject had been acquired in that country, during an Indian service of thirty years—twenty years of which were spent continuously in districts where the poppy had been cultivated, then abandoned, and again resumed. I feel, therefore, that this action on my part is necessary in simple justice to the 5,300 medical men, who signed that appeal, now that the combat is raging round the non-medicinal uses of opium which, in the short sharp terms of that appeal is absolutely disputed, as these uses are made by the pro-opiumists the bases of a justification for a limited indulgence in the drug in certain localities, and under certain conditions, and mode of living.
1. Medicinal use.
Here at the very outset, I would point out in the clearest manner, that, however great these medicinal benefits are, they nevertheless are always regarded as invariably such as to give cause for the greatest care, both in the quantity, and frequency in the administration of this drug. This is due wholly to the insidious mode of action of opium, an action absolutely peculiar to itself, viz., in luring those using it to continued indulgence, after the necessity for its use has passed, and this to an extent certainly peculiar to this drug. To illustrate this the following, as well known, as fully admitted a fact, bears unquestionable evidence, viz., that, with but very rare exceptions, the subsequent continued indulgence in opium has been traced to the beneficial effects and sensations of the strictly medicinal administration of the drug—and further, in no train of febrile symptoms is this relief more marked, or more beneficial, than in those which accompany the malarial fever, due to causes inseparable from the supersaturation of the soil with water, whether artificially or naturally produced ; and yet more so, when to these exciting causes are added those connected with the deposit of silt, largely composed of decaying vegetation, acted on by a tropical sun, and increased by the rise and fall of the tide. Here unquestionably the relief afforded by opium, when the body is racked with malarial rheumatism, or tortured with the agony of malarial dysentery is such, that one hardly wonders, that the sufferer from these painful symptoms longs


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for the time of his opiate, or, when he is off the sick list, and yet exposed to these malarious influences, is tempted to indulge in it, when the rheumatic pains return, with the chill of sunset, and increase with the cold. In such cases, I have known what seemed the strongest will-power fail in resisting these influences, and the sufferer become enslaved to the syren effects of the drug, until at last, he becomes its helpless, I might almost say, hopeless victim. I enter into these details, which I know so well, because I feel that I am not dealing with an ordinary drug, but with one which I fully admit is specially suited to the medical needs of the malarial swamps of Bengal, or those districts where the land from various causes is supersaturated with water. The value of the medicinal use of opium cannot be exaggerated in the treatment of all tropical fevers, and the diseased conditions connected with or directly resulting from them.
A. The chief Medicinal use of opium undoubtedly is as a Febrifuge, and I may safely say it is such independent of the cause to which this febrile condition is due. Before going further I would here clearly differentiate between the febrifuge virtues of opium, and its credited by some prophylactic (as regards malaria) properties, the latter owing to the presence of narcotine. In a word febrifuge in this sense means driving the fever out, and prophylactic (as regards malaria) preventing its coming in. I as fully accept the first, as I reject the second, for reasons I will give hereafter when discussing this prophylactic property. Opium in its febrifuge virtues occupies a remarkable position ; whether we view it separately in its sodorific, anodyne, or soporific properties; or when we consider how it not only possesses all three, but in the case of malarial fever complicated with rheumatism and dysentery, has the power of practically exhibiting all three, if need be, in the same case at the same time, it is not too much to say that this febrifuge property in the case of opium is simply unique.
B. Lately valuable Dietetic virtues have been claimed for opium, in the case of those whose diet is almost wholly vegetable ; though how when it is a drug, which interferes with all secretions except that of the skin, and very particularly so with those secretions called into play in the production of what is known as a good digestion, which interference is the first step on the road


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to the destruction of the powers of assimilation of food, is a point on which I expect some light to be thrown during the discussion which will follow this paper.
C. The Stringent properties of opium, due greatly to its anodyne and soporific action, in checking the diarrhoea or laxity, too frequently a constant condition of those feeding largely on a vegetable diet, in which, in certain places and seasons, the various species of the cucumber predominate, must surely be more than counterbalanced by the tendency to diarrhoea and dysentery, so markedly met with among the opium-eating prisoners in Bengal, due to conditions graphically described in the jail reports of that staunch pro-opiumist, Dr. Mouat, as follows : “ The chief mortality was from dysentery. Among broken-down opium-eaters, a form of disease particularly unmanageable, as the whole of the intestinal canal is frequently found in a state of disorganisation.” I can only hope that here also in the discussion some light will be shed on what seems so strangely incompatible as a dietetic action, with the results visible in these fatal cases.
D. The Prophylactic virtues of opium have in the case of malarial fever been so lauded lately, that those of us who served in India nearly forty years ago, are tempted to ask ourselves, how was it that this valuable property, due to the presence of narcotine, was not impressed upon us then, when quinine was thirty-two shillings an ounce, instead of one shilling and four-pence as it now is, or how is it that we have failed to notice this valuable property before, or that no one has thought of urging the importance of it on the Government until this antiopium agitation reached a climax, which made it necessary to press every kind of weapon into the service. For the first time, however, as far as I am aware, the explanation of this valuable property has been laid before the profession, in what may be called the journal of the British Medical profession, and I for one am very glad that such an authority on the subject, as the author of “Opium, its Use and Abuse,” has so clearly laid down the lines on which this prophylaxis is obtained. In case, however, I might fail to convey its full meaning, I will give it in Sir William Moore’s own words, as taken from the British Medical Journal, December 2nd, 1893, P* ii:96-
“ How does opium act as a preventive ? ” (against malarial


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fever). “ Opium (I especially refer to smoking) ” but eating is the prevalent habit in India, where it exists —not smoking, for surely Sir William does not mean us to suppose, that the small quantity of inferior opium smoked in the hookah will of itself produce these prophylactic benefits at the close of the day. But to return to the quotation. “ Opium (I especially refer to smoking) in small quantities excites the circulation, and produces a glow throughout the whole system. In large quantities it soothes the system, and blunts nervous sensibility. Both actions are antagonistic to chill, and chill is the first stage of malarious fevers, especially of ague. The Indian, after working and perspiring all day under a tropical sun, is very likely to become chilled by the night fall of temperature, and this liability is increased by his carelessness in not using extra garments. But he comes home, and after or sometimes before his evening meal he takes his opium. As a consequence, instead of feeling cold, and shivering, he remains warm and glowing, and so escapes chill, which, if not the real, and only cause of malarious fever, is certainly the cause of many repetitions of attack.”
“ From recent Indian newspapers I learn of a great increase of malarious fever in certain parts of India ” (it would have been well if they had been named). “ Naturally the question presents—Is this due to the abolition of opium shops ? and to the limitation of the possession of opium per person to one tola’s weight, rather less than half an ounce.” I offer no apology for these two full quotations the whole medical case of The Opium Question lies in them, viz., the causes in the first, and the no doubt implied effect in the second. Now I maintain the first is theory, pure and simple, and the second, well, it is not easy to say what it is, because Sir William has not told us how long it is since the quantity each person (age not given) could buy at various periods during the day has been reduced from ten tolas or 1800 grains, i.e., three and three-quarter ounces, (vide Bombay opium license) to one tola, 180 grains or nearly half an ounce, nor yet where this reduction has been made, as regards the malarious character of the districts. However, let the latter rest—if I can dispose of the data of the first, I can afford to leave the second alone. As regards the “ chill, which, if not the real and only cause of malarious fever, is certainly the cause of many repetitions of attack.” I presume I have seen as much malarial



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fever, and its results, as most medical officers of thirty years Indian service ; firstly, eight years in the swamps of Orissa, including the salt lands of Pooree and the hill districts of Cuttack, then two years in Central India, and twenty years continuously in the waterlogged districts in the upper portion of the Mesopotamia of the Ganges and Jumna, and I am prepared to prove, that a chill, though it may frequently be the cause of malarial fever, is most certainly neither “ the only cause ” of it nor yet of “ the repetitions of attack.” In the pestilential malarial fever of the swamps, or salt lands of Orissa, a chill is certainly neither the primary invariable symptom, nor cause of malarial fever, the irritability of the stomach, and the terrible fits of retching, which tartar emetic and ipecacuanha, aided by tepid water, seem to have a special power in relieving, point to the attack being due, not so much to the chill, acting externally, as to some specific poison taken internally, and acting there, and nature’s efforts to emit it. Here I am describing my own case. I certainly had no chill being warmly clad and protected, but I was travelling in a palki on duty through a swamp, and I felt I had swallowed some poisonous substance, or gas, just as I once did in Greenwich from a drain, and though the former resulted in an attack of malarial fever, and the latter in a sharp attack of diarrhoea, yet there was no chill in either case, because I was in a healthy glow from warm clothing.
This sickness and retching symptom of malarial fever in the swamps of Bengal, may perhaps be unknown to Sir William Moore in his practice in Rajpootana and Central India, as the physical conditions of Central India, and the swamps of Bengal are as different as it is possible to be—and the vicissitudes of temperature must consequently be very different in the case of the dry heat of Central India, and the most pestilential, at times almost foetid air of the swamps, and soonderbunds of Bengal.
Now, how about this chill theory, and its prevention or prophylaxis due to the Indian’s “ carelessness in not using extra garments” which should I think be said to be due, for the reason I shall give after, to the poverty in not having extra garments. Does Sir William wish it to be understood—that the “ consequence, instead of feeling cold and shivering, he (the Indian cultivator) remains warm and glowing and so escapes a chill,” is due to the fact, that the stimulation caused by opium is not followed by any




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depression, tending to produce, and increase the susceptibility to malarious influences, or injurious effects from changes of temperature as is the case with alcohol ? Then I can only say his experience is not mine, and that, so far from there being any prophylaxis against malarial influences, after the opiate stimulation, the very reverse is the case, and that, as with alcohol so with the opium, the depression which must follow stimulation is a condition of special susceptibility to all noxious influences, as is too often the case with troops, when any considerable number of them are under the influence of alcohol, when placed in trains for a night journey, in the cold season in India, in carriages specially built for the hot season. How often is this followed by outbreaks of pneumonia, or dysentery apparently unaccounted for. I can name a Regiment entrained at Delhi in which these sad consequences were manifested till half-way on its voyage to England.
But what are the real facts of the case, when judged by the action of those most interested, viz., the Indian cultivator, and
< here I speak from an experience which I fully recorded at the
time, in my annual reports as Sanitary officer of the Circle, little thinking that thirty years after, it would be brought forward in support of the non-prophylactic virtue of opium in the case of malarial fever. After the American War of 1862 the price of cotton rose to such an extent, that the natives in the districts through which the railway passed, actually took the cotton out of their wadded garments, and, teasing it again, sold it largely for inferior cotton. Now the districts in which this was practised to the greatest extent happen to be those, which for years have persistently refused the highly favourable cash advances for poppy cultivation, viz., the Agra, Muttra, and Alighur districts, and no one knows better than I do how they were repeatedly decimated by malarial fever, and, during the period in question, due to a great extent to cold, owing to the loss of these
4 wadded garments, the mortality was very high. The population
of these districts was over three millions and the density of it five hundred to the square mile. Thus this prophylactic theory of opium in the case of prevention of chill, if we may judge by the experience and practice of those most interested in the subject, in these densely populated districts was either unknown, or, not accepted, and yet in these very districts the, poppy was once cul-


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tivated, but rejected by the cultivators, as admitted by government documents, for the more profitable Motivation of wheat, potatoes, &=c. ; though if we were to test these reasons more closely we should find that the tyranny of the right of poppy search, and the risk of members of the family acquiring the habit of eating or smoking opium, were the true causes of the rejection of that which was made most acceptable by large and continuous cash advances, leaving often, at the day of settling, but little if any sum to pay back, and this among a chronically impecunious people.
2. The Non-Medicinal use of opium.
It is round this point the battle is now raging, and it is well it should be clearly laid down, what the bases of this line of argument really are, and, as these are supposed to be very special in their relation to India, and therefore indirectly perhaps to all Eastern nations, it will not do to dismiss the subject by saying the false-strength giving, and life-sustaining on limited food properties of opium, being not recognised in the medical practice of the West, can therefore be hardly considered such in the East, though the dilemma in which the excess in the opium habit in Burmah has placed the authorities is such, that the government has to rest on the horns of it, viz., that opium in any form, and for any condition or disease is not suitable for the Burmans on the East of the Bay of Bengal, and must therefore be prohibited, but it is essentially necessary to the well-being of the Orryiah on the West Coast of the Bay, though the malarial influences are similar on both sides of it, and that it would be most unfair to restrict the sale or possession of it in Orissa !
The Non-Medicinal uses of opium may be classed under the following heads:—
A. Tonic for ordinary labour.
B. Specially stimulant for increased exertion whether mental or physical.
C. Sustaining life on a minimum amount of food.
D. Aphrodisiac in impotence or sterility.
E. Sensuous in debauchery.
F. Control over the action of ganja for endurance in fasting and self-inflicted pain, such as that of the swinging festival, for imparting false-courage, for drugging purposes to rob, kill, violate, or produce symptoms, so similar to insanity, as to procure incarceration in a lunatic asylum.




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A. Tonic for ordinary labour.—This I can dismiss at once, by the simple fact, of which there is abundant evidence, that the hard working cultivator of the North West Provinces neither believes in its necessity, nor is at all anxious to give it a trial, having evidence of what it might lead to.
Here, perhaps, I might mention, with marked emphasis, that the indulgence in any thing that intoxicates is in direct opposition to the social, and religious customs of all Hindus, or Mohammedans laying any claim to respectability. Those who know the natives best, are fully aware, how all of them who have the real good of their country at heart, grieve over the terrible laxity of the social and religious customs on this point, now spreading over the country, but no amount of prevalence of the breach of these safeguards will ever remove the religious scruples of either Hindu or Mohammedan, who, in the former instance, for the sake of self-preservation, and the latter for military control, and discipline, laid down the lines of a total abstaining nation, which, I can bear ample evidence to, is as rigidly carried out by all true followers of “ The Institutes of Manu” or the dictates of the prophet today, as when it was first enacted.
B. Specially stimulant for increased exertion, whether mental or physical.—This non-medicinal use of opium is one regarding which much has been said, and not a few supporters of opium have added that withotit the regular use of this drug, the natives of India could not undertake the great exertion they are in the habit of undergoing. A native who is dependent on opium for increased exertion is a most untrustworthy person to rely on, and in the case of a soldier, a most inefficient one, as the condition of a man, after the opiate stimulation, is most unsatisfactory for watchfulness or any sudden emergency, and the occasional helplessness of native seamen “ lascars” at such times is due doubtless to opium, eaten if not smoked. The case given in an Evening Daily, of the faithlessness of a Native Regiment, during the siege of Lucknow, because they could not get opium in the entrenchments, is I maintain the strongest argument against the use of opium, instead of being one as quoted in its favour. As a medical officer, I would no more pass a man as fit for active service, who was useless without his opium, than I would one who was dependent on alcoholic stimulation for the performance of his daily ordinary duties.


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The administration of opium in the case of animals, such as horses, camels, bullocks, and even elephants, during or after unusual and prolonged exertion, is a medicinal, and certainly necessary, not a non-medicinal and unnecessary use. It is given mixed up with various spices to secure a continued rest, wherein to recoup the loss sustained in the increased and continuous exertion, but is only given on these occasions, and doubtless the driver of these animals takes a little for himself.
I would add a few words here regarding the opiate stimulation in the case of great mental strain. It would be idle to contend that opium, taken under these conditions, does not increase intellectual brilliancy, which shows itself in the style, and above all, facility with which the article is, so to speak, written off; but it is possible to attain this excellence at too great a cost. Those whose duties in connection with the press generally convert night into day, and the reverse, unquestionably find this can be done with greater ease by the use of opiate stimulants, but this is the most insidious and hence dangerous method of getting into the embrace of the opiate syren, and an early mental wreck or excessive indulgence in alcoholic stimulation, in the hopes of overcoming the subsequent languor, is the price to be paid for this violent strain, and stimulation on the mental faculties, and these are the cases in which the injurious effects of the drug are,seen in the great nerve centres in paralysis, and not in the shrivelling up of the internal organs.
The Coolie depots in Calcutta, &c., from which the emigrants are largely drawn, are chiefly made up of men, who have dropped out of regular work from their dependence on opium, and its effect on the digestion. Indulgence in opium, no matter how moderate, requires one condition for its apparently harmless effect, and that is, if not a perfect, yet a sufficient assimilation of food to retain the appetite, and an abundant and good quality of food to nourish the body. Reduce this latter, and opium quickly asserts her sway, and then acquires the property of
C. Sustaining life on a minimum amount of food.—Independent of the highly questionable, financial, or physical morality of this supposed virtue in opium, it happens to be opposed to actual fact. If opium succeeds in this instance, it puts the case hopelessly out of the condition of ever again resuming ordinary work, with or without opium, and thus leaves the poor wretch to carry


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on a life of almost suspended animation, like the bear in the Himalayas throughout the winter months, when he lives on the fat stored up in the summer. The present prevalence of the opium habit in Orissa is entirely due to this dependence on opium to relieve, and deaden the pangs of hunger during the famine, and I consider that nothing could conceivably be more disastrous for a country, than a plea being found for the production of opium, and its unrestricted sale, than one based on this deadening property to the pangs of hunger. At the great pro-opium meeting of the Calcutta Medical Society, if there was one point more forcibly dwelt on than another, it was the absolute necessity of a good, and generous diet, if, according to these authorities, the opium habit is to be carried on harmlessly. Why do not those, who persistently support this property in opium, suggest the despatch of opium to the poor famine stricken districts of Central Asia, so that the limited supply of food may be made to go as far as possible, or are they prepared to explain how the Government, at their suggestion, did not' distribute gratuitously large quantities of opium throughout the districts visited with famine or scarcity, during the past thirty years, as they did quinine under similar conditions of malarial fever. If the poppy cultivation in India leans on a support like this, it, like the rule of the nation which endorses it, had better cease, and the country be entrusted to a nation whose code of government and honour is of a higher standard. But no Government that I have ever served under, has ever thought of this mode of relieving the horrors of famine, and it is another of the weapons, which the supporters of opium are driven to, in their dire straits for pro-opium arguments.
D. Aphrodisiac in impotence or sterility.—Nations whose social customs, as they relate to marriage, are such as seriously to induce and then confirm impotence and sterility, are much given to indulgence in aphrodisiac remedies, and no drug is more in request for this than opium, though, while it excites the function, it only does so to destroy it ultimately, and among the poorer and disreputable classes these form a very large proportion of the frequenters of the opium dens alluded to under the next head, E. The desire of paternity among Eastern nations, largely conduces to the administration of aphrodisiacs among the inmates of the Zenana, and opium unquestionably is the drug most


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used, as it is by those engaged in horse-breeding operations in various districts in Northern India.
E. Sensuous in debauchery.—Sir William Moore, in the abstract of the paper which he read at the Imperial Institute on the 23rd Nov., 1893 “ On Opium,” is made to state the following :— “ It was said that using opium was wicked and immoral, and destructive of health. He had often smoked opium, and really did not see where the wickedness and immorality came in.” Surely Sir William must have forgotten what he said, at the discussion which followed my paper on “ Opium from a Public Health Point of View,” at the meeting of the British Medical Association at Bournemouth in 1891, when, alluding to one of the charges brought against opium, viz., that the opium habit in excess led to impotence, he said, so far from this being the case, all the first class opium smoking saloons in Bombay, had a brothel attached to them ! Exactly so, and it is here the unutterable debauchery takes place among the wrecks of sexual and other indulgence, whose condition, if we are to accept the statements of some observers, is due to “ painful affections of many years’ standing! ” and not to the habit of opium smoking. To contend therefore that their presence in the opium saloons in Bombay or dens in Calcutta, which Surgeon Lieut.-Col. Crombie visited with the police, was to find relief in the oblivion of the opium trance, and not for sensuous purposes, must rest on different data, else why the presence of one woman in each den, and the brothel attached to the smoking saloon in Bombay ? Sir William Moore obliges me to unmask the horrid truth. These women are there in both cases for the express purpose of leading the thoughts into sensual channels during the opium trance in which the misery of impotence is obliterated. More I need not say, except to add that if this is questioned, I hope to have one present in the meeting, who will describe the objects sought format one of these dens in Akyab, and the reason why women, if only one, and she a withered old hag, are present. I repeat, it, is the hope of obtaining relief from the opium crave together with sensual pleasures, that urges these poor creatures into these dens, and not the painful affections of years, and while there, as in the alcoholic trance, the condition described in Prov. xxiii., 33, is experienced, when in the opium-trance in these dens of sin, “their eyes shall behold strange women.”


FOOT-NOTE FOR PAGE 16.
As the gentleman alluded to above was unable, though invited, to be present at this meeting, to endorse the following, I have his permission to place it on record here.
The statement is taken from notes, which I wrote down at the time, when, as unexpected, as unsolicited, this gentleman spoke as one of the audience at that meeting, in support of the anti-opium movement, at which meeting only gentleman were present. I repeat, however, that the “ woe ” which must follow the “offence” inseparable from entering into these details, must come on those only, who have rendered it necessary, by their persistent suppression of the whole truth regarding these opium dens, or their re-iterated and distinct denial of any immorality in connection with them, or the habit of opium smoking in such environments.
Mr.------said : “ I can corroborate all that Dr. Pringle has
said about the immorality connected with these opium dens, for when in Akyab I was tempted with some others to go into a large opium den. There were about fifty or sixty men present, and four or five women ; as Dr. Pringle said, they walked up and down among the smokers, and stopped opposite those looking at them. I was told to look at them, just as I was dozing off, and the effect was a trance in a paradise of “ hooris ”— nothing could exceed their beauty, and yet the women in the den were old hags ! ”




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F. Controlling power over the action of “ ganja."—This is a non-medicinal use of opium, regarding which little is said, but I fear much is concealed, and as I have paid considerable attention to this subject in its bearing on crime and insanity, I am glad of this public opportunity of exposing the dangers of the lately supposed harmless substance called opium, in its reference to crime, and its share in the production of insanity. The statistics of Indian lunatic asylums would lead us to suppose, that opium figures so slightly in the credited causes of insanity, that for practical purposes, it may be excluded from the category of admitted causes of insanity, and alcohol and “ganja” may be considered as the chief, if not the only causes of insanity in India. Now those who have made close inquiries into the subject will have found that the union in the administration of these drugs, which commences in the shop in which they are sold, under license, where “ganja” and opium may be seen together, seems designedly continuous for the following reasons: “ganja” is never taken or administered uncontrolled by the judicious mixture of opium, except to run “ amok,” or to do some murderous deed at once, and were all these cases carefully investigated, I have little doubt some would be found, in which the victim of “ganja” had (forgetful of its consequences) taken the drug in an uncontrolled condition, and perpetrated the crimes for which he is charged, though hardly knowing what he was doing, and certainly not with a murderous intention. Of course it is quite different when a man has a blood feud to settle, or a grudge to carry into effect, what he then does, he does with a fixed intention; but apparently meaningless and aimless slaughter of innocent human beings, like that of the man in Northern India a short time ago, who cut down fatally seven men before he was overpowered, and disarmed, is due to the maddening influence of uncontrolled “ ganja.”
No crime produced by opium forsooth! I purposely leave out the petty thefts committed to secure money to buy opium wherewith to allay the pangs of the opium crave, as they are too manifest to need allusion to, but the criminal use of opium in the practice of Thugs and professional murderers demands our careful consideration. With the single exception of sulphate of copper, I believe there is no drug more used for criminal purposes than opium. The effects of professional criminal poisoning in that land of choleraic


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diarrhoea, and dysentery, by very small but continuous doses of sulphate of copper are incredible, and the facility, and secrecy with which life can be taken either in old, or young is almost beyond belief, and cholera and diarrhoea, like snake-bite, are credited with an amount of deaths to which they have no claim whatever. The following happened in my own experience, when in medical charge of a troop of R. H. Artillery at Morar Gwalior thirty years ago, and will show how possible it is to conceal this process of slow but sure murderous poisoning. On the occasion in question, I was the means of saving the life of the child of the officer commanding the artillery division at Gwalior, Central India, by unexpectedly examining the food, and detecting what was hoped to be the final dose of sulphate of copper! One of the servants in the kitchen was no doubt the poisoner in this case, but who of them it was impossible to decide, and as the child recovered when the administration of the poison was stopped, it was useless to press the case further. By the cautious administration of opium, it might be quite possible to produce the opium-craving, while the controlling influence of opium in the case of “ ganja ” can produce symptoms so resembling insanity as to deceive the most skilful observer, and when once the victim is confined in a lunatic asylum, if the case is one whose permanent seclusion, or even death is desired, the facilities for attaining this are both simple and numerous.
The Government in India has successfully stamped out the system of Thugism in that vast Empire, and though organised, and subsidised bands of Thugs do not now, after due performance of special religious observances to their patron, goddess Kali, sally out on their mission of murder, yet we may rest assured, the facilities of obtaining a narcotic like opium is taken advantage of to the full, by those who set but a small value on human life, when its removal may bring in a few rupees. One case that I know of only realized eighteen rupees, to be divided among some eight persons concerned in the murder ! But if Thugism has been banished from India, it has found a not uncongenial soil in this vast city ; where the professional drugger plies his trade, in conjunction with the bully and garotter, by means of the poor unfortunate, who, as in India among the Thugs of old, acted as decoy, and perhaps also the


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secret introducer of the narcotic into the liquor to be drunk ! No crime due to opium I repeat! Listen to the following which happened in my own experience at the Charing Cross Railway Station, and to the murder of a poor professional brother in the Borough last year. Could the narcotically-drugged-liquor tell its tale in London, we should then know something more of what opium can, and does do, to aid crime of every description. The case of the poor trooper of the ioth Hussars, whom I rescued from his, if need be, murderers, as was the case with doctor in the Borough, exhibited a knowledge of the power of drugging, for which I was hardly prepared, and the case-book of the London Police Station, to which I took this trooper in a helpless condition of opiate stupor, will amply confirm this. The case of the doctor in the Borough is a very instructive one, wThen compared with this. The condition in which this trooper was made over by me to the police, was one in which anything could have been done to him ; not so with the poor doctor in the Borough. In his case the narcotic had not been pushed far enough, and after submitting to a certain amount of robbery, he left the public house, and when in the lane resisted another attempt to rob, but this was soon silenced by the garotter, and the victim of the harmless drug—opium, lay a corpse in the lane. Could every story of the poor young men who come to London for the first time, and are robbed, either in a public house, or less respectable place, while under the influence of a narcotic, given in some liquor, it might even be coffee, reach the public ear or eye, as I saw it in the Strand, instead of “shame concealing what justice could disclose,” we should then know, what opium has to answer for. The case of the murderer Neal is just one of those in which opium was at first used for its aphrodisiac properties, and after some time the monstrous method of black-mailing, originating in the opiate trance was commenced, and the strychnine, which Neal had taken himself, first as an anti-opiate stimulant, and finally used for his murderous purposes, led to his detection. The condition produced by this indulgence in opium was such, that, like the blood in Macbeth, the strychnine and its victims haunted Neal night and day, to such an extent, that one of the police engaged in the investigation told me, this strychnine was the clue that led to his conviction and execution.


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The crime which follows the drugging of the intended victim is in exact proportion to the extent to which the narcotic is pushed; if resistance is offered, the Thug’s cord, or the knuckles, as in the case of the poor doctor, close the scene, or, when the dark silent river flows near, after the robbery or crime has been effected, the throat is cut, to lead suspicion into the line of suicide, and the body thrown into the river, and the verdict perhaps “ suicide when of unsound mind ” !
Is no crime traceable to opium ? That which woman has proved to be dearer than life has been lost at a time when the friendly meal, or cup, have, by means of this narcotic secretly added, placed her in the condition in which I made over the Hussar to the police, and left her in the hands of one, who under the guise of love, seeks to gratify his lust, though it may often ruin his victim body and soul.
The use of opium in combination with ganja, as a means of endurance of the physical pain to which many of the devotees in India subject themselves is well known, but not a few of these poor people ultimately find their way into the lunatic asylums from the destructive action of this ganja on the brain; but such stimulant narcotics are not needed by the men and women who will go through all they do in their pilgrimages, and who would scorn the use of opium or ganja to help them, those therefore who do use these drugs are for the most part a debauched disreputable lot. As regards the property of imparting courage (after all only a false-courage and little creditable to Sikh or Rajpoot) opium with ganja is very unsatisfactory, for while a false-courage may be felt, a very real want of self-protection is manifested, and those who have engaged these men in mortal combat soon find them easy to defeat on this very ground. The loss of true self-protection can never make up for any amount of false-courage, and a feint or two soon leads the subject of this Dutch courage to his own defeat, as, in an unguarded or reckless moment he exposes himself to the fatal cut or thrust.
There is one use for opium—a medicinal one—all other use is vicious, from the peculiar character of the drug.