o an
alarming degree. The psychotherapeutic treatment of such drug habits
demands much patience and much skillful adjustment to the psychological
conditions. Its general difference from the treatment of alcoholism is
given by the circumstance that any too rapid withdrawing of the drug is
certainly dangerous, if the organism is adjusted to a relatively strong
dose. On the other hand, I may say that I have not seen a single case
in which a really patient and insistent treatment of morphinism has not
been successful, even if the destructive dose of forty grains a day had
become habitual. The condition is only that the patient himself have the
best will, a will which yet is not strong enough to win the fight
without psychotherapeutic help. But no one ought to expect that the
psychotherapist can secure miracles like some of the pill cures which
treat the drug fiend in three days. Moreover neither physician nor
patient ought to believe that the worst is to come at the beginning. On
the contrary, it is the end which is hardest, the reduction of the small
dose to nothing. As illustration, I give an extreme case.

A man who was formerly station master on a railroad had been
operated on in a hospital after an accident, and as some pain in
the hip remained which disturbed his sleep, the physician of the
hospital gave him some morphine and provided him with the material
for morphine injection after leaving the hospital. Then began the
usual story. He became more and more dependent upon his injection,
the dose was steadily increased, he found unscrupulous physicians
who yielded to his demand for morphine prescriptions; he lost his
position with the railway by the growing effects of the morphine
poisoning, he became divorced, sank lower and lower, his daily dose
fluctuating between thirty-five and forty grains a day, and when he
came to me, he presented a picture of the lowest type of hopeless
manhood. He spent practically the whole day in bed and was only
able to totter slowly along with a cane. He assured me that life
was hell for him. He could not sleep, he could not eat, he could
not think, he had made up his mind to commit suicide if I could not
help him. I foresaw that it would in the best case demand months of
insistent energy to make a man out of that unfortunate wreck. He
had gone through three different morphine cures in three