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Increasing the Strength of Opium:

Despite opium's known dangers, people continued to seek ways of increasing its intoxicating properties for both medicinal and recreational uses as the centuries passed. During the 1500s, after traders and explorers brought tobacco and the tobacco pipe to Europe from the Caribbean, European opium users experimented with opium smoking, and found that it provided far stronger and more immediate effects than did either eating or drinking the drug. However, smoking increased the risk of overdose and addiction, as well as the severity of the drug's undesirable effects. Addiction to opium smoking quickly spread throughout Europe and the Middle East, and by the 1700s it had a tremendous impact in the Far East.

Though the eating and drinking of opium had not been as popular in China as elsewhere, the practice of opium smoking for both recreational and medicinal purposes quickly caught on there (and would continue to cause addiction of truly epidemic proportions until 1949, when the Communist Revolution in China brought a halt to the country's opium trade).

Unlike their counterparts in the Middle East, European physicians and surgeons of the 1500s did not generally prescribe opium smoking to their patients. Potency among the batches of opium that were imported from the Middle East widely varied, making it impossible for Western physicians and surgeons to dispense safe and measured opium dosages through this method. Instead, they continued to dispense opium in the same way that had been used for centuries. They provided their patients with a moderately useful "sleeping sponge" soaked in water and opium. The sponge was placed on patients' tongues or over their nostrils for extended pain relief and surgical anesthesia.

In 1527, however, a Swiss physician and alchemist named Paracelsus created a more measurable (yet potent) form of medicinal opium than had previously been known. He dissolved a measured amount of powdered opium in wine and then added citrus juice and a trace of gold powder. Paracelsus found that opium retains far more of its potency when it is dissolved in alcohol than when it is in water. The resulting concoction, which he called "laudanum," either could be bottled as a tincture, or the black, gummy pulp that remained after the alcohol evaporated could be fashioned into pills of relatively uniform size and potency. He dubbed these pills "stones of immortality." Though a very primitive surgical anesthetic by modern standards, laudanum was a breakthrough for sixteenth-century surgeons who were accustomed to operating on patients who were conscious and physically restrained. Modern-day anesthesiologist Michael A.E.

Ramsay explains that before the advent of laudanum, "surgeons became very adept at performing fast operations. . . . 'Pitilessness' was expounded as an essential characteristic of a surgeon. Pain was considered a symptom of importance only in differential diagnosis, not as a problem related to surgical procedures." Laudanum became the primary surgical anesthetic and pain reliever in European medicine, as well as the most common method of opium abuse in the West, for over three centuries.

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