THE OPIUM PROBLEM
BY CHARLES E. TERRY AND MILDRED PELLENS
1928
TABLE OF CONTENTS
PREFACE TO THE ORIGINAL EDITION
Personnel of committee-Objects-Scope of work-Procedure.
INTRODUCTION
The problem-In the United States-Controversial aspects-Method
of study-Terminology.
Numbers involved-Difficulties of determination-Current
statements- Estimates from importations-Estimates from
surveys-Early statements, 1867-1871-Michigan survey, 1878-Chicago
study, 1880-lowa study, 1885-Massachusetts study, 1888--Vermont
study, 1900-Jacksonville Survey, 1913--Tennessee survey,
1915--Treasury Committee, 1918-New York City Clinic,
1919-Narcotic Drug Control Commission, 1920-Los Angeles Clinic,
1920-Shreveport Clinic, 1919-1923-Summary survey and estimate
table-Recent analysis of certain surveys, Kolb and Du
Mez-Analysis and discussions.
CHAPTER II-DEVELOPMENT OF THE PROBLEM
Historical review of use of opium-Use by Sumerians and
Assyrians, Mention in Eber's Papyri-Homer's Iliad-Known to
Hippocrates, Theophrastus, Virgil-Virtues described by
Galen-Discovery of alkaloids--Therapeutic uses-Appreciation of
euphoric effect-De Quincey -The hypodermic syringe-Influence of
Civil and other wars-Influence of opium smoking-Patent medicine
industry as factor-Secret addiction remedies--Medical
education-Professional indifference-Production of heroin-Views on
safety and dangers of heroin-Early warnings -Effect of
prohibitory laws-Underworld traffic-Effect of professional
attitude and training.
CHAPTER III-ETIOLOGY
Incompleteness of studies-Faulty generalizations-Racial and
individual tendencies-Effect of climate-Influences of medical
use-Use in infancy and childhood-Use of hypodermic-Painful
illnesses--Use for pain and for euphoria-Massachusetts study as
to causes-Pichon's studies-Psychical influence-Patent medicines
and self-medication Evil
associations-Dissipation-Chinatown-"Contagion'--Influence of
personality make-up -Curiosity-Craving for stimulants and
sedatives-Report of British Departmental Committee on Morphine
and Heroin Addiction-Table, replies to questionnaires, Treasury
committee reports Replies to questionnaires of Committee on Drug
Addictions-Criminal tendencies and associations.
CHAPTER IV-GENERAL NATURE
Definitions, effect on control measures-Early opinions and
terms-Psychical and ethical effect-Like alcoholism-Morphinism not
morphinomania-A vice, habit, appetite-Mental and physical
disease-An uncontrollable craving-A real disease-A
psycho-physical disorder-A psychosomatic affection-A true
disease-A drug, auto- and intestinal intoxication-A true organic
disease-A Psychical disturbance-A functional poisoning-A neurosis
or psychosis--A pernicious habit-A definite physical disease-A
pathologic entity.
CHAPTER V-PATHOLOGY-SOMATIC AND PSYCHIC CHANGES
Reports of findings scanty-Incompleteness of
studies-Functional disturbances-Individual tolerance and
intolerance-Fatty degeneration of heart and liver-Morphin in
liver-Mental deterioration-Ethical changes -Crystals in
blood-Effect on leukocytes--Epithelial changes-Lowering of
resistance-Arrest of phagocytosis,-Character
changes-Hallucinations and delusions-Brain cell changes-Effect on
endocrine system Pleasure and deterioration-Generative functions
depressed-Changes in cortical cells--Changes entirely
functional-The blood in morphinists and
heroinists-Coagulability-Number of red cells-Number and changes
in white cells--White cell resistance The blood during
withdrawal-Number and varieties of red cells-Hemoglobin
percentage Red cell resistance-Leukocytosis--Differential
findings--Leukocytic resistance-Similarity to infectious
processes-Changes in liver morphologic and functional-Digestive
tract-Albuminuria and sediment findings Nature of
albuminuria-Abscesses--The skin and teeth-Sexual
apparatus-Eliminatory crises-Stages of psychic changes--Pulse in
tolerance ,and withdrawal-Relapse due to psychic changes--Other
causes of psychic changes than the drug-Effect of opium on dog's
intestine-Effect on respiration in dogs--Lipoid
changes-Constitutional make-up of users Excretion of
morphin-Mental effects-Inhibitory effect of opium
Auto-intoxication-Allergic reaction-Changes in viscosity of blood
Withdrawal phenomena due to organic causes-Digestive hemoclastic
reaction-Morphin delirium-Effect of chronic poisoning on growth
of rats-Effect on vegetative nervous system-Resulting Psychical
changes -Lowered biotonus-Resemblance to manic-depressive
states-Relationship to hyper- and hypothyroidism-Selective
absorption by nervous system-Effect on basal metabolism-Effect on
nutrition-Review of mechanism of tolerance-Conditioned salivary
reflex-Somatic and psychic habituation-Specificity of
habituation-Evidence of diphasic poisoning-Vagus-sympathetic
balance of vegetative nervous system Relationship of tolerance to
uremic changes-Effect on unstriped muscle -Sensitiveness of
intestinal muscles not lost-Brain cell changes Calcium and
potassium blood concentration-blood changes in dogs.
CHAPTER VI - PATHOLOGY (continued) - TOLERANCE -
DEPENDENCE-WITHDRAWAL
Tolerance-formation admitted-Dependence questioned-Codein
toIerance, committee report-Elimination of codein--Codein not
addiction forming-Codein addiction-forming-Contradictory
opinions-Case reports, codein addiction-Dual action of opium
alkaloids-Tolerance to eukodal-Effect of eukodal and parakodin on
animals--Questionnaire study on codein addiction--Oxidimorphin
theory-Hyperacidity in morphinism-Tolerance similar to true
immunity-Specific antitoxin formed Morphin storage in brain and
liver-Inhibition of glandular function Release of
inhibition-Hypersecretion and glandular engorgement-Enithelial
desquamation-Eliminatory crises-Increased power of organism to
destroy morphin as explanation of tolerance-Denial of antitoxin
formation-Increased ability of body cells to withstand
morphin-Brain extract of morphinized animals,
properties-Precipitation reaction of morphin serum-Increased
ability of organism to destroy and cell immunity both reasons for
tolerance-Complement fixation tests and anticomplementary action
in morphin serum-Ability of liver to destroy morphin-Withdrawal
symptoms due to retained excrementitious matter-Aggressins
produced by morphin-Progressive cell adaptivity Effect on
circulation of injections of morphinized serum-Loss of cell
sensitiveness in chronic poisoning-Specificity of morphin
poisoning Effect on vegetative nervous system of chronic
poisoning and of withdrawal-Tolerance and withdrawal due to
antitoxic substance in blood Chemical changes in nerve cell
composition cause of withdrawal-Personality changes and sensation
obtunding with reactions-Metabolic changes in rats caused by
thyroid, thyroidectorny and morphinism-Psychiatric
aspects-Lowering of threshold of resistance-Effect on brain
lipoids--Relationship to permeability of cell membrane-Reaction
to intradermic injections-Congenital addiction-Effect of
withdrawal on pregnancy-Withdrawal symptoms in new-born-Case
reports-Prolongation of pregnancy-Morphin in placental
circulation-Transmission to fcetus--Questionnaire studies of
Committee on Drug Addictions-Tables
CHAPTER VII-SYMPTOMATOLOGY
Detection of chronic use-Classification of symptoms
unsatisfactory Abstinence symptoms diagnostic-Symptoms in
smokers-Symptoms in chronic poisoning and in withdrawal-Mental
symptoms-The skin and mucous membranes--Pupils-Kidneys &
organs-Nervous system-
Vasomotor symptoms---Reflex
irritability-Lachrymation-Coryza-Neuralgic
pains--Insomnia-Vomiting and purging-Constipation-Pulse
irregularity-Collapse-Effects vary in individual salivation in
dogs-Nutrition in dogs--Withdrawal symptoms in dogs-Withdrawal
like an infectious disease-The "vital need'--Mental state in
withdrawalRespiration-Circulatory symptoms---Syncope-Oliguria and
anuria-Albuminuria-Glycosuria--Casts--Memory damaged-Character
changes-Effect on volition-Interference with secretion and
excretion-Fever Circulatory disturbances in dogs--Vegetative
nervous system and endocrine disturbances-Addiction and
withdrawal symptoms in dogs.
CHAPTER VIII-TYPES OF USERS
Classification desirable--Factors to be
considered-Incompleteness of data-Dangers of generalizing from
available material-Sex Distribution-Michigan survey-Chicago
study-Iowa study-Jacksonville survey-Tennessee
survey-Philadelphia series--Treasury committee-New York City
prison cases--New York City clinic series--Discussion-Age
Distribution-Chicago cases--Iowa case Jacksonville
series-Tennessee series--Philadelphia hospital cases--Bellevue
Hospital cases, New York New York City clinic cases--Lambert's
cases - -Court cases, New York Teachers College questionnaire
study, New York-School children--Juvenile court studies--Use by
children exaggerated or unfounded-Age of convicted addicts in
certain prisons--Form of Drug Used-Therapeutic choice-Individual
selection-Influence of illicit traffic, reasons--Heroin among
young males--Effect of prohibitory laws on use of heroin-Table by
drugs used-Other Classifications-Conditions in England,
1871-Individual opinions of types involved by authors from 1871
to 1922-Contradictory views due to studies of selected
cases--Effects of other drugs, "mixed addiction'--Effect of
environmental factors on "type" determination-Dangers
of conclusions based on insufficient data-No one type of user-All
groups susceptible-Relation to crime
CHAPTER IX-TREATMENT
Early efforts-Influence on treatment of current views on
nature-Prophylactic considerations--Gradual reduction-Abrupt
withdrawal-Rapid reduction--Substitution-Levinstein's
method-Rapid withdrawal with bromideg--Erinmeyer's
method-Jennings' method-Rapid detoxication, Sollier-Hyoscine
treatment, Lott-Pettey's treatment-Use of heroin,
Morel-Lavall6e-Lambert-Towns treatment-Bishop's principles,
interval of dosage, elimination, rational therapeutic
considerations, individual adaptation of procedures-Comparative
values of certain methods Sceleth's method-Dercurn's
method-Riverside Hospital method-Effect of albumen and
venesection in detoxicating dogs-Wholey's method Methods of
Dupouy, Wuth, Mignard, Itemer, David, Krauss, Rojas and
Belbe-Narcosan treatment-British Departmental Committee on
Morphine and Heroin Addiction-Narcosan compared with abrupt
withdrawal, Johnson-Kolb-Vegetable protein treatment.
CHAPTER X-CONTROL-INTERNATIONAL
Slizoighai Conference-Countries represented-Early treaties
with Siam and China-Treaty with Japan-Philippines Opium
Commission-Wright's letter to the President-Resolutions of
commission-Response to U. S. Circular-Report of American
delegates-Comment on Hague Opium Convention of 1912-Powers
signing the convention-Resolution presented-Countries not signing
the convention-Final Protocol of Second Opium Conference-Exports
from U. S. prohibited-Third International Opium
Conference-Instruction to American delegates--Report of American
delegates-Final Protocol of Third International Opium
Conference--Peace Conference articles on Opium
Conventions-Article 23 of the covenant of the League of
Nations-Resolution of League- Advisory Committee on Traffic in
Opium-Resolutions of Council-Requirements; of countries-Reports
and resolutions of Council and various committees-Action of Third
Assembly on import and export certificate system-Fourth session
of Advisory Committee-Abuse defined-Causes of abuse-Determination
of abuse-Amounts required for medical and scientific
purposes-Prevention of abuse-Hearings and Resolutions of
Committee on Foreign Affairs--Resolution as passed by Senate and
House of Representatives-American Delegation to Fifth Session of
Advisory Committee 1923-American proposals-Resolutions of
Advisory Committee-Reservations of Indian Government-Resolutions
of Fourth Assembly, Sept. 1923-Extracts from minutes of
Assembly-Resolutions of Council Dec. 1923-Sixth Session Aug.
1924-Recommendations of Conference-Resolutions of meetings of
Mixed Sub-Committee-Second International Opium Conference Nov.
1924.
CHAPTER XI-CONTROL (continued)-NATIONAL
Act of 1909-Treaty of 1880--Tariff laws-Results of Act of
1909-Bills presented but not passed-Harrison Act and
Amendments----Regulations of Secretary of the Treasury-Treasury
decisions-Court decisions -Discussion of law and
regulations-Jones-Miller Act-Federal Narcotics Control
Board-Amendment of June 7, 1924-Creation of Bureau and
Commissioner of Prohibition-Control of narcotics vested in
Prohibition Bureau-Estimates for medical needs, discussion-Proper
method for determining needs,-Maryland study-Studies of Committee
on Drug Addictions-Discussions-Needs based on sales by
manufacturers, discussion.
CHAPTER XII-CONTROL (continued)-STATE
Historical-Drugs included-Exceptions-Channels of
distribution-Records required-Smoking opium-First anti-opium
laws--Special provisions-Provision for addicts-Registration of
addicts-Definition of addicts-Enforcing
agency-Penalties--Legislation in New York State -Whitney
Hearings-Department of narcotic drug control-Provisions of
Whitney Law-Regulations under law-Annual report of commissioner
-New Orleans clinic-Objects of dispensary-Treatment-Legal status
of clinic.
CHAPTER XIII-CONTROL (continued)-MUNICIPAL
Jacksonville clinic-New York City clinic-Hospital
treatment-Health department regulations New York City-Comments of
Judge Collins- Court cases of addiction-Ages-Numbers
committed-Sex distribution of court cases-Report to New York
State Association of Magistrates- Present conditions-Shreveport
clinic-Historical sketch-The dispensary-Results-Resolutions of
medical society-Los Angeles clinic-Reports of director-List of
clinics.
CHAPTER XIV-CONTROL (continued)-MISCELLANEOUS SUGGESTIONS
Opinions of committees and individuals taken from current
literature from 1915 to 1927-
APPENDICES
BIBLIOGRAPHY
INDEX
|
