Compliments of the author. THE OPIUM HABIT; Its Successful Treatment by the Avena Sativa. A PAPER READ BEFORE THE NEW YORK STATE MEDICAL SOCIETY, FEBRUARY 9, 1882, BY S' S E. II. M, SEW-AJL, M.D., FELLOW OF THE AMERICAN ACADEMY OF MEDICINE, OV THE NEW YORK ACADEMY OF MEDICINE, MEMBER OF THE AMERICAN MEDICAL ASSOCIATION, ETC. REPRINT FROM THE MEDICAL GAZETTE, APRIL 22, 1882. JERSEY CITY : The Evening Journal Print, 27 Montgomery Street. 1882. THE OPIUM HABIT, ITS SUCCESSFUL TREATMENT BY-THg AVENA SATIVA* BY E. II. M. SELL, A. M., M. D., Fellow of the American Academy of Medicine, etc. The subject which I desire to discuss to-day is of such vital impor- tance, that I cannot expect to do it justice in the limited time allot- ted to me. If the practical facts, however, which I shall present, will tend to awaken inquiry, and that lead to beneficial results, the object of my paper will have been attained. The remedy to which I shall call your attention is the Concentrated Tincture Ave?ia Sativa,our common oats. The avena sativa is one of the genera of the tribe Aveneee, belonging to the natural order Graminece. The avena sativa is a highly important grain, one of our staple produc- tions. A most common variety is said to be indigenous to the Island of Juan Fernandez, while another sort, resembling it, is found growing wild in California. According to Pliny (Hist. nat. XVIII. p. 17) it was known to the Egyp- tians, Hebrews, Greeks and Romans. However uncertain its native land may be, there seems to be no doubt but that the Celts and Germans culti- vated oats along the Danube two thousand years ago. It was introduced into the North American colonies soon after their settlement by Euro- peans. Tt was sown by Gosnold on Cuttyhunk, one of the Elizabeth Islands, in Buzzard Bay in 1602, cultivatedin Newfoundland in 1622, and introduced by colonists on Massachusetts Bay in 1629. Oats forms one of the principal sources of sustenance of the inhabitants of Norway and Sweden, of a part of Siberia and of Scotland. In the latter country and in Friesland, its cultivation attains the highest perfection, and forms considerably more than hall of the annual grain crops. According to one analysis oats contains fully 7 p. c. of oil or fat, and 17 p. c. of avenine—a proteine compound, as the gluten of wheat—making together 24 p. c. of really nutritive matter. Davy found in 1000 parts of Scotch oats 743 of soluble or nutritive matter, containing 641 of mucilage or starch, 15 saccharine matter, and 87 gluten or albumen. Mr. Norton’s analysis demonstrates the pre-eminent value of oats, both to gratify the olfactories, to please the palate, to build up the bones, and to give body and vigor to the whole animal system. It seems most re- markable, that an article of so much importance, so extensively cultivated for many centuries, should escape the notice of medical men through all these years. Until recently, very little, if any, progress has been made in our knowledge of oats as a medicinal agent since the day of Pliny, when at least one variety of oats was cultivated on account of its superior fitness as an article of diet for the sick. Many works on Materia Medica and Therapeutics, among the most recent as well as the oldest, either do not mention it, or else speak of the Arena Farina—oatmeal—simply as an ar- CUI.TIVATION AND USES OF OATS. * Read before the N.Y. State Medical Society, Feb. 9th, 1882 2 tide of food, being somewhat laxative, hence appropriate in cases of hab- itual constipation from inertia of the intestines. Works of less pretension, speak of a decoction of oats as possessing decided diuretic properties, and useful in dropsy and recent colds and coughs, and as poultices. All the uses of oats have evidently been taken from domestic practice. The de- coction spoken of is known in Scotland by the name of water-gruel and in Ireland by that of oat-tneal tea. Certain botanical works speak of gruels and decoctions of groats or grits, mixed with water and good certv’s milk as excellent for infants, so much so as to be one of the best possible sub- stitutes for breastmilk ; and either used plain or sweetened with sugar, or acidulated or acified, as acting admirably as demulcents, and as being therefore suitable in many cases of fever, inflammation, calculus, dysentery, diarrhoea and cholera. Plain gruel of groats is in clysters. A small volume on domestic medicine, published in London nearly a century ago (1794), has about as much on the medical use of oats, as all -other medical works combined that I had time to consult?' It remained for Dr. Keith to prepare the active principle of the avena sativa, in 1858, and after having experimented with it in various classes of nervous diseases, to find that it had great stimulating powers. In 1874 the doctor had a concentrated tincture of the avena for paraly- sis, from the effects of which he himself suffered for years, and in three weeks, having taken the avena in 15 drop doses three or four times a day, he was not only free from paralysis, but relieved from many serious symp- toms, both mental and physical. I commenced experimenting with the so-called active principle, i.e. with the powder of avena sativa, in 1873, but the results were not flattering, whether due to the preparation or to my employment of the same, I am un- able to say. Later, however, after the concentrated tincture was prepared, and I had learned of the results of the above case, I commenced using the tincture, and have ever since found it a most useful and reliable remedy. I attribute to it the following properties': Diuretic, slightly laxative, tonic, stimulant, but especially nerve-stimulant. It exerts a most powerful influ- ence upon and through the nervous system. I have found it a most valu- able adjuvant to other medicines, in the treatment of different diseases, but especially when the nervous and circulatory systems are at fault. Many serious cases of the various female diseases gradually but slowly improved under one or more of the many uterine or ovarian remedies, if properly adapted to them, but frequently the patients would remark, that, as soon as the avena was extended to them, along with the other remedies, that they found themselves grow fleshy and improve in health more rapidly. It is an excellent substitute for intoxicating drinks, and will in many cases cure inebriety, provided the patient can be kept from his old associ- ates. It is an antidote to opium poisoning, as verified in a case of attempt- ed suicide by laudanum. Nervous headache and prostration, due to men- tal strain or worry, are easily brought under its curative effect. The avena possesses no narcotic nor anodyne effect, yet it readily relieves many cases of insomnia. Some of the worst cases of neuralgia, including those forms so common in patients who suffer from hemiplegia, have been cured by this remedy. Epilepsy has been brought under subjection by it more effectively than by other remedies, and traumatic cases in particular. It is one of the best remedies in hysteria, melancholia, neurasthenia, and 3 in all forms of nervous prostration, whether caused by inebriety, by the abuse of tobacco, opium or morphine, by sexual excess, masturbation, or mental strain. However interesting some of these cases are, to me at least, I shall for- bear giving the history of any, being.content to merely mention the fact that I am constantly using this remedial agent in such diseases with great satisfaction. I shall close my remarks for to-day by mentioning the last but not the least affection for which the avena has proven itself an effica- cious remedy. It was during the summer of our centennial year, that I made what I consider a no small discovery in therapeutics, namely, that the concentrated tincture avena sativa is the very best remedy in the distress- ful, and in many cases hopeless, malady of the opium or morphine habit. To show you that I do not overdraw the picture, and that I do not speak hyperbolical!}’, you will indulge me while I relate a brief history of a few cases. To those of you who have seen a single absolutely bad case, I need not say, by way of preface, that I consider such a one, as for himself or herself, worse than an inebriate, and in some instances this holds even true to other members of the household. Most inebriates have lucid in- tervals, when they are not only good wives or kind husbands, but also thrifty; whereas an inveterate opium eater is a perfect blank to himself and to others, and of the two his drug is the more expensive. 1. First, then, look at the slave of this dreadful habit, made so by his own physician, who was supposed to be treating him for some neuralgic affection. The patient, a German of middle age, had gradually, at the end of three years, brought himself to this most deplorable condition, that he injected two large hypodermic syringefuls of Magendie’s solution every three hours. These had to be injected amidst sores and ulcers, for he was literally covered with them, as the effect of the injections. These large doses of morphine, the minimum and maximum quantities actually used during the twenty-four hours being twelve and forty-eight or fifty grains, had no more effect upon the patient than to produce fifteen min- utes of sleep with his eyes wide open. He kept to his bed, and was a constant nuisance to himself and others. All attempts at curing him of this lamentable habit had utterly failed. The avena was given him in twelve to twenty drop doses, being ordered at once to reduce the quantity of morphine one-half, and as rapidly as possible to stop it altogether. When two drachms of the con. tine, avena had been administered, I was informed that the patient slept the greater part of the time, fully two hours at one time, and now with his eyes completely closed. Although this looked very encouraging, the patient was not cured, and perhaps simply because one did not wish to have him cured, all I positively know is, that one refused to procure and give him the remedy. 2. The next case is a Mrs. L., middle-aged, who had been the slave of this habit for seven years, and had taken twelve grains of morphine daily; she was radically cured with the avena. Her history is briefly this: For a number of years she had been troubled with pain in her back, together with soreness and weakness in her bowels, suffering at times very much. She consulted physician after physician until she had seen seven, and here comes the old story again, none was able to relieve her pain save by mor- phine, and thus they not only did not cure her of her ailments,but made her infinitely worse, by making her the slave of a most cruel taskmaster from whom they could not release her. After suffering the most intense pain, at times so severe that she could neither walk nor stand, using the differ- ent remedies prescribed by her physicians, besides liniments and strength- 4 ening plasters to no purpose, until she many times thought she would pre- fer to die to taking the morphine all her life, she became utterly heart-sick and discouraged. At last an advertisement of one of the so-called opium curers fell into her hands, and then she, like a drowning person catching at a straw, took Dr. B’s dirtv'Iooking morphine preparation for four months, for which sne paid eighty dollars, then she discovered that she was no nearer being cured than the first day she took it. This discouraged her more than ever, and she concluded that she never would try to stop it again, but take it and die as soon as possible. However, in the summer of 1876, being very sick and confined to her bed (I happening to be in the town where she lives), she called me to see her. I treated her other ail- ments, and at the same time gave her the avena for her morphine habit, and six months afterwards she writes me : “ I have not taken a particle of morphine or anything of the kind since the first day I saw you. The nervine (avena) took the place of the mor- phine, making me comfortable and keeping my nerves quiet. At the end of two weeks I got along nicely without the nervine. Under your treat- ment I have regained my health. I have not been as well for ten years. I feel twenty years younger, and weigh twenty-five pounds more than ever before. I can hardly realize to-day that I have not taken any morphine in six months, after I had taken it seven years. I am now able to do my own housework, and feel well.” 3. The next case has been treated by Dr. W. A. D., of Bloomington, 111., and I will let him give you the facts of the same. On Sept. 20th, 1881, he wrote to me as follows: “ After the lapse of two months I write you the results of the use of the avena in the case of my wife. You will probably recollect that I stated that she had used morphine for twenty years, that she took an ounce in 15 days " (being 32 grains per day), and that she seemed a perfect wreck, as you can readily suppose. After receiving your kind letter in reply to my inquiries, I sent for the tincture and commenced its administration in accordance with your suggestions, and have the extreme satisfaction of reporting complete success—that the patient has used no morphine since she commenced the tincture, except for the first two weeks, when she occasionally took small amounts to relieve extreme distress. Since that time she has used none— now two months. She is much improved, both mentally and physically, and indeed is hardly like the same woman, and really bids fair to become her former self. I consider it one of the most remarkable cures on record, and must do myself the justice to tender to you my sincere thanks for the kind letter and suggestions which I received from you. If you should feel interest in further investigating the case, I will be most happy to hear from yon at any time.” In reply to a letter of inquiry from me, he wrote, Oct. 1st, 1881, thus: “ My wife is 46 years old, is slender, rather tall, light complected. Was taken in the summer of 1858 with what was thought to be scirrhus of the stomach, and morphine was found to be a palliative, and as such was continued until the drug, produced its own disease, which has kept the “ cas- tle” until it was routed by the use of the avena. About the 1st of last June I commenced the administration of the medicine as you so kindly suggested, and since which time she has used no narcotic, except during the first two weeks, as before stated, since which time she has used none, and for the last month has used none of the avena, and to day is improv- 5 ed beyond the most sanguine expectation of her friends, both mentally and physically. When I commenced to give her the avena, I felt and said if it cured her, it would certainly cure any case of opium habit, and I still think so.” Feb. ist, 1882, the Dr. writes: “ My wife is radically cured of the opium habit; has used none since June last, either of opium or avena.” 4. I shall relate but one more case, treated by Dr. J. G., of Blue Grass, Iowa. I shall give some of the facts contained in letters dated Oct. 26th, 1881, and Jan. 27th, 1882. “ Please accept my thanks for the informa- tion I have already received from you relative to the con. tine, avena sativa. “ I have one of the most remarkable cases of the cpii-morphio’ mania that I have seen on record. The patient has been a slave to the habit for over 16 years. He has been using sulph. morphia from 20 to 40 grams per day, two drachms lasting about three days on an average. “He has been trying every remedy that he has heard of—he has tried some eight or ten different doctors who claimed to have cured every case treated. “ The first one was a Dr. S. Collins, of La Porte, Ind. The first thirty dollars sent him for a cure did him more harm than good. Sixteen dollars more were sent for a new supply, which acted no better, but dried up the secretions so much that he was compelled to abandon its use. A Dr. Squires, of some point in Indiana, received the next five dollars for a trial bottle of medicine, which contained morphine and had to be abandoned on account of the high price. Berien Springs, Michigan, was the next place of note, but sixty-five dollars spent there left him no nearer cured than when he commenced. “ Dr. Beck of Cincinnati,Ohio, received the next one hundred and thirteen dollars, but with his slushy looking medicine, containing morphine, the patient was still compelled to use a certain quantity of morphine about eight or nine times every twenty-four hours, and hence had to abandon the Beck remedy. He has tried others and has spent a large amount of money. The avena meets more nearly the requirements than anything he has ever tried. It satisfies and dissipates all desire for morphine, but he has paroxysms of weakness, which he himself expresses as an entire goneness and an unearthly feeling and restlessness at night, at such times he resorts to morphine. One dose of which soon allays that weakness, its influence often lasting 36 hours. I tried sulph. quin, and other salts of cinchona, but they seemed to aggravate his weakness or prostration. But for these two troubles he would feel perfectly happy. If you could suggest anything to aid in overcoming them, the victory would be ours. Should we succeed, it will be the greatest victory yet obtained.” This victory, gentlemen, I believe will be obtained in this case as soon as the remedy is properly given and sufficiently pushed. The ordinary dose and frequency of taking this remedy, will not suffice in such a case as I have just related. In cases of extreme debility, and as a rule in cases of paralysis, as well as in most of the diseases to which I have summarily referred, a dose of from six to thirty drops, three to four times a day will suffice, about half an hour before each meal in hot water, and in cold water at bed-time. When given in hot water its action is al- most immediate. In the Opium or Morphine habit as well as in Inebriety or Alcoholism, the best rule is to give the avena in hot water with the same frequency that the patient was accustomed to take his opium or morphine, i.e., as often 6 as the system demands it, and in doses sufficient to produce the desired effect. As all cases do not require the same amount, trial and experience will be the best guides. It is necessary, however, to bear in mind the physiological action of this remedy, which is to produce congestion of the base of the brain. A fulness at the base of the brain will indicate that the dose dare not be increased, and a pain in that region suggests that an overdose has been given. The diminution of the dose regulates itself by the above symptoms. As long as the system demands the remedy, it must be administered in doses sufficient to supply that demand, and whenever given in larger doses than required, it will manifest itself by its symptoms. Dr. G. of Iowa, informed me Jan. 27th, that the avena did not affect his patient, as it does most people, indicating that he had not yet supplied his demand, and hence, most likely, the “ restless nights ” and “ weak spells.” Let it be borne in mind, that it is not proposed to cure all manner of diseases by the avena, much less such diseases as have generally been held to be incurable. Let the physician use his intelligence and ingenuity in ad- ministering remedies which will actually relieve the malady, instead of giving opiates which are generally mere make-believes, and leave the disease no better and the patient in most instances worse for having taken them. It is a grave question with me whether all the good that opium has ever done, can be compared with the mischief and intense harm that its abuse has inflicted upon the human race. There is an awful responsibility resting upon those who have been aiding and abet- ting in constituting and establishing a large army of miserable wretches, who are enslaved soul and body by this direful opium habit. Any remedial agent, then, that will aid us in breaking the bonds of this opium slavery should be hailed by the medical profession as a most wel- come guest. And however the medical profession may view this sub- ject, for myself I feel as though I had not lived in vain were I to have accomplished nothing else in life, than to have discovered that the avena sativa is a cure for the “opium habit,” unless the patient is afflicted with some other incurable disease, and even then by far the majority will get along better and live longer without than with opium, provided they receive proper treatment. I invite thorough and faithful investigation of this remedy, and correct reports of cases treated thereby, whether favorable or unfavorable, will be thankfully acknowledged. My favorable results stand thus far corroborated by the two typical cases herein reported, the one treated by Dr. W. A. D., of Illinois, the other by Dr. S. G., of Iowa. Since this paper was prepared the following case came to the notice of the author: Dr. G. E. S., of Cleveland, O., writes, February 20, 1882, as follows: “I see by reading the proceedings of the New York State Medical So- ciety that you read a paper upon the medicinal effect of the avena sativa in the cure of the opium habit. I have a case of that kind which I have not succeeded in curing, and I would like very much to get your expe- rience with that drug. The case is not very bad as yet, as only about two grains of morphia is used daily, but it seems as hard to break the habit as if more were taken. I will give you the history of this case from my note-book, as follows: G. B. C., male, aged 58 years, began the use of morphia two years ago to allay the pain in chronic rheumatism. He began by using orie-fourth to one-half grain twice per day, but gradually increased until he got up to two grains per day, which dose he has been taking during the last six months. About the 1st of February he applied to 7 tne for assistance to break the habit which, at this time had got com- plete control of him. Although he said he would not increase the dose on any account, yet there was a strong tendency that way. When he stops for a day he claims the pain is as bad as ever. Please let me hear from you on this subject.” March 24, 1882, the doctor writes: “Time has now passed sufficiently long for me to give a full statement to you relative to my opium patient. I procured the remedy, and used it as follows: I ordered fifteen drops, to be taken as often as he felt the desire for the morphia. He took the first day four doses of fifteen drops each, without any mor- phia. Second day same size and number of doses, but in consecpience of the severe pain and lack of the morphia stimulant he took one-fourth grain morphia. Third day I increased the avena to twenty drops four times and no morphia. Fourth day, same amount and one-fourth grain morphia was taken. Fifth day, avena the same and no morphia. Sixth day, twenty-five drops three times and no morphia. No morphia has been taken since the fourth day, but three doses per day of the avena up to the 20th of March, since which time he has discontinued the medicine al- together. I am satisfied that if a patient will steadily pursue the course of treatment with the avena he can rid himself of this most terrible habit. I hope others will be induced to try this medicine, and report their expe- rience with it, that the profession may know that there is hope for those afflicted with this disease, for it is nothing more than a disease.” April 1st the doctor writes: “ The patient still suffers with rheumatic pains, but feels himself perfectly cured of the opium habit.” The following affidavits, from the manufacturer of the preparations which I have been using will show that the preparation is in no sense 4. nostrum, and that any person is free to manufacture the same and place it upon the market under the same name. I also append sworn state- ments giving the working formulae for making both the concentrated tincturt and the active principle. State of New York, 1 * v City and County of New York, \ “ George H. Keith, being duly sworn, says that he is a member of thq firm of B. Keith & Co., doing business at No. 41 Liberty St., in the City of New York. That said firm do not claim the words “concentrated tinctures” or the abbreviated form thereof, to wit “con. tine.” although they have used words “ concentrated tinctures ”, and said form “ con. tine.” during the past twenty-six years, and that they have no trademark as connected with their concentrated medicines. Sworn to before me this 25th ) Tx T,„T~TT day of February, .882 f GE0' H' kEI 1 H- Pearce Barnes, Notary Public, City and Co. of N. Y. State of New York, ) City and County of New York, j ss‘ George H. Keith, being duly sworn, says that he is a member of the firm of B. Keith & Co., doing business at No. 41 Liberty St.t in the City of New York. That the “con. tine, avena ”, as prepared by said firm, is 8 made by dissolving in alcohol the active principle of common oats (grain); also that there is no admixture of any kind whatever with “ con. tine avena ” as so prepared (as above stated). That said firm make no com- pounds or mixtures except as stated upon their labels. Sworn to before me this 23rd ) GEO H KE1XH day of .February, 1882 ) Pearce Barnes, Notary Public, New York Co'. State of New York, I ’ V gg City and County of New York, ) George II. Keith, being duly sworn, says that he is one of the members of the firm of B. Keith & Co., which firm does business at No. 41 Liberty St., in theCity of New York. That said firm, in manufacturing the active principle of the avena sativa (common oats), tincture the grain of commerce with alcohol, withdraw alcohol from the same, and distill off alcohol, leaving as result, extract impure. As different extracts from the article require different treatment, the re-agents for precipitation must be left to judgment of chemist. That said firm then take the resulting precipitation and dissolve one ounce thereof in ten ounces of alcohol to make “ con. tine, avena sativa.” Sworn to before me this 24th [ jq KEITH day of March, 1882. J 1 Pearce Barnes, Notary Public, City and Co., of N. Y. CON. TINC. AVENA SATIVA. Derived from—Avena Sativa. Common name—Oats. Part used—The grain. Properties—Nerve stimulant, (tonic, laxative and sol- vent, we believe by increase of nerve power.) Employment—We first prepared the active principle from the Oats in i858, since which time we have been ex- perimenting with it in different diseases, but as space will not allow, can name only a few of the most important, among which are paralysis, and all cases where there is a deficiency of nerve power. It is of great value in sick head- ache, constipation, kidney troubles, chorea, neuralgia of the stomach and bowels, and almost a specific in cases of neural- gia of the uterus, coldness of different parts of the body depending upon want of nerve force—being given with podo- phyllin and quinine, or podophyllin and hydrastin, it will give relief found from no other combination. In painful and deficient menstruation it is invaluable, especially in com- bination. (See Con. Helonias Comp.) Specially recom- mended in diseases of females when they have a burning feeling on top of the head. Epileptic fits are greatly re- lieved by its use. Lancinating pains, cramps, alcoholism, sterility of females when not of an organic character, diph- theria, measles, scarlet fever, whooping cough, dysentery, diarrhoea, sleeplessness, as an antidote for the opium habit, in all congestive difficulties, for loss of nerve power so com- mon among ministers, lawyers, public speakers and writers, and in fact in the convalescent stage of all acute diseases. Dose, from ten to thirty drops, three or four times a day. Would especially recommend its administration in hot water during the day (as its action is so much quicker) and in cold water at night on retiring, as it has a more extended in- fluence. When given in hot water its action is almost in- stantaneous. An overdose causes pain at base of the beam. PUT UP ONLY IN POTTLES AS BELOW : 2 oz.—Price