• Painlessness with almost all complaints
• All complaints are accompanied by a heavy, stupid, comatose sleep
• Lack of vital reaction with want of susceptibility to the action of medicines
• Obstinate constipation; stools like round, hard, black balls
• Checks all secretions of the body except skin. Sweaty, hot perspiration

Source: Vegetable kingdom
Synonyms: Poppy, Papaver somniferum
Family: Papaveraceae
Prover: Dr Haremann in 1805
Duration of Action: 7 days
Miasmatic Background: Psora
Temperament: Nervous
Thermal Relationship: Hot patient

Introduction and History: Opium is a long acting, constitutional, polychrest medicine. Hahnemann remarked that, ‘No medicine in the world has done more harm (with preliminary apparent relief) than this Opium.’ Hahnemann distinguished the primary effects of the drugs from the secondary ones and was of the opinion that the primary action of drugs is to be recognised for homeopathic prescriptions and not the secondary effects. One of the most notable features of the remedy revealed in its primary symptoms is painlessness associated with all complaints. But, Opium as proved by Hahnemann has in its pathogenesis symptoms characterised by severe pains. Followers of Hahnemann make no distinction between the primary and secondary effects of drugs, provided that they are produced by potencies. Hence, the distinction between the early and the last effects of drugs is what maybe called as distinction without a difference. Opium is the Latin name. The word ‘papaver’ is derived from the word ‘pap’ because it was used with pap and given to children. The word ‘somniferum’ means induce the sleep. In ancient days, its juice was given to children to induce sleep which has carried thousands to the grave. The meaning of ‘pap’ is soft food for infants or a nipple. The medical properties of Opium were known before the Christian era.

Habit and Habitat: It is an annual plant which flowers in February. The root is white with several strong fibres. The stem is up right. The leaves are alternate, large, wavy and irregularly lobed. The flowers are large. The whole plant is glaucous and smooth except the flower stalks. It is found in Turkey, Persia, India, Europe, Great Britain, etc.

Preparation and Parts Used: Mother tincture is prepared from the exudation. Higher potencies are prepared from the tincture.

Constitution and Physiognomy

1. Especially adapted to children and old people – disease of first and second childhood.
2. Indicated in persons with light hair, lax muscles and want of physical irritability.

Ailments From: Fright, anger, fear, sudden joy, shame, sun, lead, charcoal fumes, alcohol, inhaling gas.

Seat of Action (Pharmacodynamics): Mind, senses, nerves, lungs, digestive tract, mucous membranes, skin, urinary tract, respiratory tract, etc.

Active Principles (Chemical Constituents): It mainly contains about twenty five alkaloids like morphine, apomorphine, narcotine, papaverine, codeine, iodine, ethyl morphine, nalorphine, heroine, hydromorphone, hydrocodeine, oxymorphone, etc.

Physio-pathological Changes (Pathology)

1. Opium belongs to the category of hypnotic sedatives and analgesics in which the action is mainly due to morphine. Morphine is a potent analgesic. Due to its central narcotic effects, it causes addiction, hence, it is given only in severe pains.
2. Morphine has a bi-phasic action on the central nervous system. It sedates the cerebrum and has a mixed effect of stimulation and sedation on the medulla. In the medulla, it sedates the respiratory centre, emetic centre and the cough reflex.
3. It also stimulates the chemo-receptor trigger Zone in the medulla, which leads to nausea and vomiting. This is considered as a side effect.
4. Morphine also produces respiratory depression and constipation.
5. Codeine relieves local irritation in the bronchial tract and is used in various cough medicines.
6. It acts upon the cerebrospinal and sympathetic nervous system producing brief excitation rapidly followed by depression and paralysis of all functional activity.
7. It is a stimulant in a moderate dose but a narcotic in a large one. The effects are, especially felt in depressed and chilly conditions of the body.
8. As a result of the depression of the sympathetic nervous system, the circulation is increased and its functional energy for the time is exalted or at any rate, more rapid and there is congestion everywhere. Hence, there is general torpidity of the entire system. The cerebral powers are overcome and stupor ensues, motions are destroyed.
9. Secretions of the mucous membrane and in fact, all secretions except sweat are diminished: the mucous surfaces become dry and congested, and the breathing becomes sighing and irregular.
10. It acts on the urinary system causing retention of urine.
11. It acts on the heart and retards its action.

Characteristic Mental Symptoms (Psychology)

1. Imagines parts of the body are very large.
2. Unconsciousness; eyes are glassy, half closed, face is pale, is in deep coma.
3. The patient complains of nothing, wants nothing.
4. Delirious; talks with wide open eyes. Thinks she is not at home. This is continuously on her mind.
5. Sees animals coming towards her; dullness of thoughts.
6. Drunkenness with deep stupor, eyes burn and are dry. Complete loss of consciousness; apoplectic state.
7. During delirium, the patient is constantly talking, especially when aroused.
8. Bed feels so hot that she cannot lie on it; moves often in search of a cold place.
9. Great sensibility to sound, light and fainting odours.
10. Screaming before or during a spasm.
11. Picking of bed clothes during sleep.
12. Frightful fancies, daring, gay, bright. Unable to understand or appreciate his sufferings.
13. Careless and very anxious. Stupidity. Strong tendency to get alarmed.
14. Visual hallucinations of mice, scorpions, etc. with a desire to run away.

Characteristic Physical Guiding Symaptoms

Painlessness: Painlessness with almost all complains. Complains of nothing, asks for nothing.

Relaxation: Relaxation of all muscles; like that of the face, so that the lower lip and jaw hang down. Diminished sexual desire and impotence. Involuntary stools.

Emaciation or marasmus: Child has wrinkled skin; looks like a little, dried up, old man.

Susceptibility: There is lack of vital reaction and want of susceptibility to remedies, even though indicated. No response to the effect of medicines.

Distension: Distended veins of hands. Face bloated, dark red and hot; fingers dark red, swelling of veins in face and head. Lips swollen.

Sweat: Hot perspiration over the whole body except lower limbs. Complaints appearing with perspiration.

Sleep: Sleepy, but cannot sleep; sleeplessness with acuteness of hearing. Sleep is heavy, stupid, with stertorous breathing, red face, half closed eyes and skin is covered with hot sweat; after convulsions. Loss of breath on falling asleep.

Stool: Involuntary stools, especially after fright; black and offensive; from paralysis of sphincter.

Constipation: Constipation of children, in corpulent, good natured women, from inaction or paresis, no desire; stool hard, round like black balls.

Urine: Urine retained, with full bladder; retention, post-partum or from excessive use of tobacco; in nursing children; paralysis of bladder or sphincter.

Diarrhoea: Persistent diarrhoea in those treated with large doses of the drug.

Spasms: Spasms of children; from approach of strangers; from nursing: after fright in mother; from crying; eyes half open and up turned.

Screaming: Screaming before or during a spasm; deep stertorous respiration, both on inhalation and exhalation.

Torpor: Actions of Opium are characterized by torpor, embracing the ideas; dullness, sluggishness, inactivity, stupidity. State of stupor.

Sensation: Bed feels so hot that she cannot lie on it and she moves often in search of a cold place.

Digestive organs: Digestive organs are inactive, peristaltic motion is reserved or paralysed, bowels seem closed.

Important Characteristic Features

Constipation: A very good remedy for constipation, especially if the cause is lead poisoning. Inaction or paretic condition of the intestines. Opium is almost incomparable in chronic constipation. Opium renders the intestines so sluggish that the most active purgatives lose their power. Constipation of children and of corpulent, good natured women. There is no activity, no desire to go to stool. Stools are hard, dry, round, black balls. Faeces protrude and recede.

Gastrointestinal tract: Dryness of the mouth. Tongue black, paralysed.
Intense thirst. Difficulty in articulation and swallowing. Abdomen is hard, bloated, tympanitic. During colic there is urging to pass stool which is hard. Obstinate constipation; faeces are round, hard, in black balls. Sometimes there is diarrhoea in which there is involuntary stool which is black, offensive, frothy and associated with severe pain in the rectum. Vomiting is associated with colic and convulsions. Faecal vomiting is also marked. Patient is hungry but has no desire to eat.

Fever: A very good medicine for fever. Fever with a besotted countenance. Face is red and bloated with half closed eyes. There may below temperature or high temperature of 105-106 degree F but still the patient says that he is not sick. Wants nothing. The pulse is full and slow; hot sensation all over the body associated with hot perspiration. Fever is characterized by snoring respiration, stuporous condition, twitching of limbs, profuse thirst and sleepiness. Delirium constantly, thinks he is not at home. Bed feels so hot that she cannot lie on it; moves often in search of a cool place. Wants to be uncovered.

General Modalities

Aggravation: From heat, hot bath, during and after sleep, from stimulants, fright, joy.

Amelioration: Cold, uncovering, constant walking.

Remedy Relationships

Complementary: Alum, Bar-c, Bry, Phos, Plb.

Follows well: Acon, Ant-t, Bell, Bry, Hyos, Nat-m, Nux-v, Samb.

Antidotes: Acet-ac, Bell, Cham, Cic, Cupr, Gels, Ip, Merc, Nux-v, Puls, Zinc.

Compare: Apis, Bell, Gels, Nux-m, Morph.

Comparison

Marasmus; face old, pale, wrinkled: Abrot, Op.

Constipation of old people: Alum, Lyc, Op.

Constipation with horribly offensive breath: Carb-ac, Op., Psor.

Constipation; stool hard, like round balls: Chel, Op., Plb.

Constipation with complete inertia: Op, Pyrog, Sanic.

Urging to urinate, has to sit hours after difficult labour: Op, Staph.

Great sleepiness with nearly all complaints: Ant-t, Nux-m, Op.

Retention or incontinence of urine after labour: Arn, Op, Hyos.

Sleepy but cannot sleep: Bell, Cham, Op.

Convulsions of children from nursing after a fright in mother: Op.

Convulsions of children after anger: Nux-v.

Haemoptysis of drunkards: Nux-v, Op.

Sleep with stertorous breathing: Op.

Sleep without stertorous breathing: Nux-m.

Vomiting – brownish, coffee ground, offensive, stercoraceous with impacted faeces or in intestinal obstruction: Op, Plb, Pyrog.

Potency: 3x, 6x, 12x, 30, 200, 1000.

Dosage: Low to high potencies.

Repetition: Single dose to be repeated when the symptoms call for it. Repeated doses in apoplexy.

Therapeutic Value: Apoplexy, Brain affections, Colic, Constipation, Effects of marasmus, Epilepsy, Paralysis, Sleeplessness, Sunstroke, Typhoid, Urinary complaints, etc.

Note

1. Opium is not indicated when the stertorous breathing is just an occasional affair. It must be a continuous process.
2. Opium maybe given when the system fails to respond to the indicated remedy and is then often followed by Lachesis mutus.