There is dispute about the dates and correct interpretations of Western Asian and Eastern Mediterranean steles, papyri, tablets, pictographs, paintings, and the like which are cited as proof of early opium use. Some writers (Lewin, 1924; Terry and Pellens, 1928) have accepted 4000 B.c. as a date for Sumerian use, about 3500 B.C. for Egyptian use. Taylor (1963 ) sets 200 B.C. for opium use by Swiss lake,side dwellers. We have not been in a position to evaluate the primary sources cited, but it does seem clear that such early dates are subject to contest. By way of illustration, Dawson (1929), from his examination of Egyptian papyri, says it is unlikely that the Egyptians used opium medically before the first century A.D. Kritikos and Papadaki (1963) would dis-agree, as would Merrillees (1962) ; all of them present convincing evi-dence. Kritikos and Papadaki propose that opium was known in Crete, Cyprus, Greece, and the Aegean Islands—the Cretan finds, along with the Mycenian ones, being dated by Kritikos at 2000 B.C. They (citing Kramer and Levy, 1954 ) accept dates of 3000 B.c. for its presence in Sumer. They propose that it was used in religious ritual—the production of ecstatic states—since it was found in association with cult ob-jects and divinities and in medicine. It was used in oracular divina-tion and in the Asclepia. Merrillees, studying Cypriot finds, dates an active trade in liquid opium between Cyprus, as the producing coun-try, and Egypt, as the importing one in the sixteenth century. He sug-gests that Egypt began cultivation about 1300 B.C. It was used in Cyprus in religious rituals circa 1700 B.C., while Fort (1965a) gives a date of about 850 B.c. for its mention in Persian annals. Its produc-tion for medical use in seventh-century Assyria is discussed by Sonne-decker (1958). Kritikos and Papadaki, in their review, note the med-ical use for myconeum—a tea made from whole-plant infusion—as a beverage for eyewash, and for plasters. They state that opium itself was sucked as a lozenge, taken in liquid form, sniffed, eaten, and used in suppositories; they even propose that smoke from burning resin was inhaled. Used as a hypnotic and analgesic when mixed with hemlock, opium was employed to kill. Its medical uses in Greece were systema-tized by 400 B.C., as the work of Hippocrate,s suggests. It was not, how-ever, a paramount drug, for we see in Dioscorides that it was but one from among many plant remedies—some of the others of which were much more highly touted. Kolb (1962) cites a reference (which we have not seen) to the effect that in the fifth and third centuries B.c. Greek physicians were recommending avoidance of opium. Pliny and Celsus repeated the information of Dioscorides in the first century. Had it been of first-rank importance in the biblical world at that time, perhaps the wise men would have brought it as a gift to the infant Jesus along with frankincense and myrrh, which were then used as medicines, fumigants, and preservatives.

Despite its early use in religious rituals and medicine, opium was not quickly spread to other areas nor dare we assume its use was widespread even in locations where some employed it.1 There is no evidence, as Sonnedecker points out, of any widespread concern with its effects or of any awareness of its dependency-producing potentials. Nor by medieval times does such mention occur, according to Sonnedecker, although the Arabs used it widely. The general thesis is that Arab use increased as a substitute for alcohol following the prohibi-tions on the latter by Mohammed.

The history of opium in India is well described by Chopra and Chopra (1965). It was first mentioned by Barbosa in 1511, and its cultivation appears in the same century. During the Mogul (Timerud) period, opium trade with China was of great importance and was a state monopoly; in 1757, the monopoly passed into the hands of the East India Company and from there to, first, the British and then to the Indian governments. During the time of the Moguls, beginning with Babur and continuing with Akbar, opium taking was popular among all classes. The nobility drank "charburgha," which was a mix-ture of hemp, opium, wine, and kuknar; opium was also taken with water or in pill form. In 1893, the Royal Commission issued its vo-luminous report on opium (and one on cannabis), which concluded that opium smoking was rare but adult drinking and pill use were common and that it was used to treat ailing infants or given to them when their mothers left them to work. Generally, dosages were small and use was irregular; chronic opium eating was limited to older per-sons. Its folk medical use was paralleled by and probably derived from its employment in traditional Ayurvedic and Unani (Tibbi) medicine, probably being adopted in these systems in the fourteenth and fifteenth centuries. It continues to be used in Indian traditional medicine and in folk medicine (only occasionally including dosing infants) and is now eaten and smoked by what is reportedly a very small sector of the lower classes, where Chopra and Chopra state it is a group rather than an individual activity. Opium smoking was also practiced in social ceremonies--for example, at marriages and funerals and some Hindu religious rituals—but these practices are said to have disappeared. At no time has India been described as having an opium problem in the sense that China did, in spite of the fact that India has been and is an opium-producing country and one in which access to and use of the drug have been widespread. Official reports may well be suspect in terms of accuracy, but we do take them to reflect at least the level of concern if not of use, assuming the accuracy of observer accounts. A considerable mystery remains as to why the Chinese instead of the Indians came either to decide abuse was present and/or to suffer more adverse effects in fact. Poverty, nutritional deficit, and social disorgani-zation cannot be differentially invoked as explanatory concepts. As will be seen, the role of local merchants, local government, and trading nations did differ. In India, merchandising locally was directed to traditional medical and folk medical use and, secularly, to organized social or group use; licit distribution was limited to forms suitable for eating rather than for smoking. International trading was directed toward China (and now Persia and the United States illicitly) rather than internally. Nowadays, opium for eating is still legal, but the sale of opium for smoking and the vdstence of smoking dens are prohibited. Only registered addicts may smoke legally. What accounts for the In-dian/Chinese differences? Was it the Indian advertising and merchan-dising patterns, coupled with government restrictions on kinds of prep-arations legally available and kind.s of settings tolerated for use, plus official Indian government support for production and sales (and im-plidt use), as contrasted to official Chinese disapproval on economic-political-attitudinal grounds? This remains an open and interesting historical question.

It was certainly not in India that opium was first labeled a dangerous drug or a source of trouble. When that judgment was first rendered is difficult to ascertain. That remarkable traveler and writer Richard Burton observed in 1858, and wrote a year later about, the work disability and ill health present among Muslims and natives of East and Central Africa, commenting that locally their ailments and failings were attributed to their opium use. Regardless of whether or not the Arabs first recognized opium-induced disabilities, they cer-tainly were the major early traders in the stuff and responsible for its diffusion throughout Asia and Africa. They are credited with intro-ducing opium into China about the seventh century (Lewin, 1924; Williams, 1923), where the most flamboyant events in the political history of any drug later occurred. The Chinese themselves had no name for opium. Their term as well as ours is Arabic and that in turn is derived from the Greek for "vegetable juice." Sonnedecker (1958), citing Merrillees (and Terry and Peliens, 1928, as well as Williams, 1923), says there is no trace of intoxication mentioned in China and that its use was medical for nearly a thousand years. Only in the sev-enteenth century when, despite Ming prohibition, tobacco smoking had become well established, after being introduced by the Portuguese, did recreational use of opium smoking become popular. Although it was first mixed with tobacco ostensibly for folk medical use, later the proportion of opium was increased. In the 1840's, there were an estimated million users (Kolb, 1962)., and after the 1850's, purportedly many millions smoked. The activity spread to all social levels; among the affluent it was a formal sodal ritual—for example, a ceremonial pipe smoking preceded business dealings. Doctors smoked while in con-sultation, diplomats and mandarins smoked at the conference table. Coolies enjoyed a pipe after the day's work. Some of the constabulary demanded a pipeful as a treat, prepayment, or bribe from the victim before investigating his complaint of a crime (Doolittle, 1867).

Within a short time, the setting for opium smoking among the working classes was institutionalized. Dens, divans, and clubs ap-peared. Although most opium taking was social in the sense that it was done in the company of others and was taught by one person to another (or imitated), its use by the lower classes did not seem to have facilitated social intercourse. Descriptions by contemporary observers (Fort, 1965a, b; Hess, 1965) emphasize dulling effects. On the other hand, even contemporary use by the wretched poor—the case in Hong Kong today--seems to have a self-medicating component; it is con-sidered a cure for disease, a means for overcoming fatigue, and an aphrodisiac. Hess reports that today the majority of arrested Hong Kong addicts cite medical needs; about one third speak of it as a social experiencé—taken with other people for euphoric effects.

The assessment of ill-effects from opium smoking created con-troversy from the beginning. Not only merchants but physicians argued it did little harm—no more than tobacco or alcohol. When class and personality variables are considered, it is evident that the argument is not yet over. Testimony before the Philippine Opium Commission in 1905 cited moderate and nondamaging use by the Chinese, especially among better-off persons with established patterns of self-control and social adjustment and the need to buy opium so that withdrawal will never occur. A Formosan study in 1935 (Tu, cited by Kolb, 1962) showed most users then to be working in good jobs and without bad effects. The Hong Kong user, to the contrary, is poor and sick, ac-cording to Hess. Today, evidence shows successful maintenance of ad-dicts (Schur, 1962), provided those addicts are initially nondelinquent and motivated toward the conventional world. On the other hand, most "susceptibles" to personal and social use do not appear to be so fortu-nate in birth and rearing.

There was a general consensus among observers through the years that the poor, once they took to the pipe—with the choice between opium and food—becatne more undernourished and ill than ever. Moderate use, however, did occur among those with intact minds, healthy bodies, and the means to afford both opium and food. Ad-mittedly a small per cent of Chinese society, they nevertheless corre-sponded to those Americans who before the Harrison Act ( our 1914 narcotic-control endeavor) used medicines containing opium or mor-phine' without observable personal decline—at least until the opium was withdrawn.

China, the importing nation with its millions of poor addicts, is to be compared with India, the exporting country. Once opium smoking began, Chinese use was personal or social—that is, unregu-lated, informal, and nontraditional rather than medicinal as such. In India, on the other hand, medicinal use was paramount after opium's introduction by the Moslems, and opium remains an important feature of Ayurvedic medicine (Dwarakanath, 1965 Y. There are Indian refer-ences to its use to keep political enemies out of circulation (doping them up)' or indeed to keep profligate sons from gambling and wench-ing (P. N. Chopra, 1955 )' by sedating them. But most applications seemed to have been for insomnia, nervousness, upset stomach, diar-rhoea, rheumatic pains, and the like. Infants left by their mothers were (and are) given opium to lull them. It was advertised as a prolonger of sexual intercourse and for refreshing the weary. India, with this traditional orientation, never attempted country-wide bans. It has sought to reduce its use and availability. R. N. Chopra (1933, 1934, 1935 )' has described those who suffer ill effects as coming from lower economic brackets, especially those undergoing the abstinence syn-drome. As with many other descriptions of untoward effects, those of withdrawal are said to be far more noticeable than those of sustained use.3 In any event, at the same point in time, two nations with an im-mense population of poor responded quite differently to opium; in one it was smoked and became a problem; in the other, use remained, for the most part, traditional and no problem or problem orientation appeared.

By the 1850's, millions of Chinese men—but very few women —had become opium smokers and were reported to be drug addicts. Agreement on addiction was by no means unanimous, for although opium's withdrawal effects had been described by 1701 and compulsive use by large numbers of Asians (Turks and Persians). had been de-scribed later in that same century, it was not until late in the 1850's that there was agreement about opium's "addicting" potentials. Sonne-decker's (1958) review of the development of the concept of addiction provides an interesting commentary. In China itself opium was ad-vertised as having an exhilarating effect and as being an aphrodisiac. Since its effects are more pronounced when it is smoked (it is absorbed through the lungs) than when eaten, the change in method of use provided an impetus for the rapid increase in its popularity--even if neither of the prime claims for it were found to be its major immediate effects or its long-term actual effects.

Commerce in the drug was of major international importance and no spread of use would have been possible unless adequate supplies existed. The Portuguese, Dutch, and Indians offered that supply in its early phase,s, but because opium was cultivated primarily in India, British trading interests in the eighteenth century gained a near monop-oly, although American "China Clippers"—many of which would more accurately have been called "Opium Clippers"—also did a lively trade. In China, total prohibition alternated with heavily taxed legal importation. The former spawned a number of smugglers—"scuttling crabs and fast dragons"—plying rivers and coast, while the latter came under the jurisdiction of frequently corrupt officials whom the government designated as wholesalers. The first edict against opium was that of the emperor in 1729; as the boom developed, nevertheless, the emperors were made more aware of its cost in terms of a disastrous revival in the balance of payments, which, due to tea and silk exports, had favored China. The official imprecations—"a devilish foreign sub-stance"—no more discouraged traffic in the mid-1800's than had the first imperial prohibitions. Laws continued to be passed by the Chinese as control efforts, but did not affect opium consumption or importa-tion. What happened was comparable to prohibition in the United States with the added fillip that the Chinese were quietly encouraging opium-poppy production internally, but their morphine content re-mained inferior to the Indian variety. Chinese resistance to imp6rted opium led to the two Opium Wars with England in 1842 and 1858, which enabled English merchants to continue their profitable trade.

As the nineteenth century grew older, a shift occurred and the worm began to turn. What had been pressure for importing opium to China—the Opium Wars as a supreme example—and grounds for arguing that opium was a comfort and benefit were reversed as opium, and the Chinese, appeared in the West. The shift was due in part to the literary endeavors which told of the risks—real and fancied—of opium; De Quincey led the field, beginning in 1821. The growing re-sistance to opium was also due to a public response to official Chinese sentiments. The Emperor Yung-Cheng, unable to control public de-mand, official corruption, or merchant smuggling at home, appealed instead to the English conscience. By mid-nineteenth century, opium had become, for the first time anywhere, a moral issue with the Chris-tian church, ladies' aid societies, and some journalists as advocates. There were other important events as well. Physicians were becoming more scientific and observant, morphine was isolated, and, in 1853, the hypodermic needle was invented. When the Crimean, American Civil, and Franco-Prussian Wars occurred (1854-1856, 1861-1865, 1870-1871), the wounded were given morphine, increasingly by means of injection. Wounded veterans became a visible habituated popula-tion. Coolie labor was simultaneously being imported into the United States, Canada, Europe, and Oceania, and with the laborers came their pipes. The "Yellow Peril"—those strangers who represented com-petitive labor with odd ways and opium—became Western-world in-habitants. Opium came to San Francisco in 1851.

The response to the Chinese neighbor and to opium was nega-tive. The reform and the missionary saving of heathens at a distance were popular enough, but "heathen" habits at home were frightful. Tracts and broadsides, lurid artides, and pious "eye-witness" accounts of degenerate, drug-sodden, sex-crazed dope fiends fascinated and hor-rified the public. Most were interested in the reportage, not the drug, but a few citizens became interested in the latter and, for the first time in the West, not just for medical reasons. Artists looking for new ex-periences, distraught widows (so it is said) for whom alcohol was taboo, gamblers, miners, prostitutes, and soldiers of fortune took mor-phine, relied on "soothing syrups" loaded with opiates, or picked up the pipe. The literate continued to entertain with their terrible experi-ences, even as they do now (Burroughs in Ebin, 1961; Cocteau, 1957).. Lobbies were formed, physicians identified addiction as such, and temperance (meaning abstinence) societies took to the field.

The first narcotics-control act was passed in San Francisco in 1875 to suppress opium smoking (Kolb in United States Public Health Report, 1964 ). Between 1897 and 1922, every state except one had regulated opiate distribution. After the report of the Philippine Opium Commission in 1905, the United States in 1909 prohibited the importa-tion of smoking opium; international action had begun with the Shanghai Conference in 1901 and with the 1912 Hague Conference. International cooperation in control of opium trade had begun and continues today under the auspices of the United Nations Narcotics Bureau. With law came criminals: users who would not stop, mer-chants who would not quit. The drug market went underground and, in the Western world, the narcotics underworld was born.

Enter heroin!

Some expected morphine to cure the dependent opium eater. It did not. Heroin, expected to be the "heroic" cure for morphine de-pendency and so named, came on the scene in 1898. Requiring no pipe, easily administered, light to carry, and much more powerful than opium, it gave quick relief for anyone suffering withdrawal distress. As a cure for opium smoking, it was too late. Control of imports in China had reduced opium smoking in that country by the turn of the century; only older wealthier folk continued, as did the Southern hill tribesmen, who continued to grow their own. Kolb (1962) states that by 1917 China was nearly free of opium use; however, if so, a latent demand must have remained because cultivation was resumed and opium, now supplemented by heroin and morphine, was back in use by the 1930's. On the other hand, Fort (1965a) estimates eight million users in the same years. By 1937, one estimate was of fifteen million Chinese opium smokers, although Fort estimates ten million. Some of this use was social; opium parties akin to cocktail parties were held. In spite of local controversy as to ill effects, the Chinese government instituted the death penalty for addicts who failed to be cured, and many were executed. There are no data on modern China; the govern-ment claims no more use, although it is evident that hill tribesmen are still smoking and exporting opium.

In the Western world the sodal and private use of opiates had not expanded remarkably except by those frontiersmen and delinquents who took them up in their small societies (see Stevenson, 1956, for a superb study of its diffusion in Vancouver, British Columbia). Opium importation and distribution controls led to changes in the content of remedies; Lydia Pinkham's alcohol replaced Dover's Powders and Sydenham's Syrup on the chemists' shelves. For a short and remarkable period in history, ladies rather than gentlemen appear to have been the predominant sex using a mind-altering substance (see Brown in O'Don-nell and Ball, 1966)—a trend which continues today since women predominate in the use of tranquilizers. For this brief period, the fe-males were seeking opium out, not simply receiving it from doctors—or so the reports tell us. If that be so, it was the only period in history in which female drug use in informal settings (albeit self-medicating and, in that sense, traditional folk-medical) was greater than male use. As to how many Americans used opium in pre-Harrison Act days, we shall never know. Use varied by locality, and statistics varied by case-finding method. The range of rates of use seems to have been from 1/1000 to 16/100 (O'Donnell and Ball; also Terry and Pellens, 1928).

Heroin was another story. Easily smuggled, easily hidden, it met the demand of the delinquent, unstable poor, or adventuresome public (Chein, Gerard, Lee, and Rosenfeld, 1964; Wakefield, 1964; Chein, 1956; Freedman, 1963; Finestone, 1960)—a public still in-volved in illicit-drug activities. It remains popular with these groups whose using numbers although small—an estimated maximum of 200,000 in the United States (see Blum, 1967c)—nevertheless remain an object of great public concern. Elsewhere in the world, opium smoking is on the decline but where it has been outlawed in Asia (O'Donnell and Ball; also Radji, 1959), heroin has become a more dangerous substitute. Opium itself is still in use in Southeast Asia and among some now old-fashioned Chinese elsewhere. In Asia, as in the Western world, the urban dweller using opiates tends to rely on heroin or sometimes on heroin-cocaine combinations. It may be injected or inhaled as in "chasing the dragon." (See Hess, 1965.)

Aside from the urban poor—especially the disorganized, male, minority poor in the United States—there are particular groups who risk opiate use. One group is immense and uses it almost without any difficulty. These are patients receiving opiates or their synthetic ana-logues in supervised medical treatment. In the United States, for example, it is estimated (Blum, 1967c) that in 1963 over a billion doses of these true narcotics were administered or prescribed. Few, if any, cases of dependency were reported. On the other hand, those who did the prescribing—physicians—get in trouble at a rate much greater than any other group. The presumption is not of any economic privation and related social distress. The obvious feature is their un-supervised access to the drug. Other features, according to Modlin and Montes (1964), are a point of vocational and life crisis, neurotic fatigue, and a background of alcoholic fathers and childhood illness. Inferred but not yet demonstrated must be an unusual reaction to opiates as well, for Beecher (1959) reports that most well persons who are given morphine do not enjoy its effects.

There is recent evidence of an increase in heroin use among populations with whom it has been unpopular before. In Western Canada, for example (Stevenson, 1956), the number of users has tripled over a thirty-year period (whereas Canada on the whole has showed a decline) ; similarly, in England, which has long enjoyed very little opiate use, there has been a recent dramatic increase (Bewley, 1965, 1966; Chapple, 1965)—from about 20 new cases of heroin de-pendency in 1959 to 270 cases in 1965 and to over 500 case,s in 1966.

The new population of users in England are young, some are female; occasionally, upper as well as middle and lower classes are represented; and nearly all users have had prior experience with a variety of other drugs without medical supervision. After heroin use they continue with other drugs as well. Sources are said to be overprescription by physicians, which in turn allows proselytization by users with a supply among their own social groups. In the United States, as our student data in the companion volume (Blum and Associates, 1969) show, there is also experimentation with heroin by some middle- and upper-class high school and college students—a pattern which seems to par-allel the English phenomenon and is not explicable on the grounds either of easy access or social deprivation but which, rather, emerges as part of a willingness to experiment with a variety of mind-altering substances regardless of legal restraint or Establishment warnings of the undesirability of drug-oriented life styles.

As for the contemporary means of diffusion of heroin, opium, and other illicit drugs, these are through criminal channels. The study of these operations is outside the scope of this chapter. In brief, how-ever, it may be said that for any drug in demand there has never been a shortage of persons willing to engage in traffic for gain (see Walker, 1960)'. Economic gain is obviously not a sufficient motive for criminal commerce, since most citizens do not engage themselves in it. What social, psychological, economic, and political circumstances account for the emergence of criminals trafficking in drugs is a subject of con-tinuing interest. In terms of the world-wide scene, it is clear that the levels of criminal organization, sophistication, and culturally defined criminality vary markedly and are intimately related to other features of both the drug trafficker's aim in life and to the setting in which he lives.

SUMMARY

Probably used medically and in religious ceremonies in Western Asia and the Eastern Mediterranean before 2000 B.c., opium has con-tinued in systematic use in folk cultures throughout Asia. Its ritual religious use disappeared before being described in any literature, al-though its potential for producing mental states interpreted as mystical or religious is occasionally affirmed today by individuals. Distributed to Eastern Asia by Arabs, it remained in medical use in China and India until tobacco smoking was taught (in the 1600's). The Chinese became the first nation with a drug-abuse problem when opium was mixed with tobacco and the social and personal, as well as the medi-cally sanctioned, use of opium became widespread. Ill effects were associated mostly with poverty, especially since withdrawal symptoms were more likely to be seen in those who could not afford to maintain themselves on the drug. In those countries where traditional folk medi-cal patterns were stable, neither a problem nor a social reaction occurred.

The concept of physical dependency was slow to develop, as was the concern with the social aspects of opium use; both appeared in the 1800's, and by 1900 opium was considered medically to be a danger, socially to be a menace, and morally to be a vice. These de-velopments were associated with sociopolitical, economic, and reformist changes in the Western world. Campaigns invoking morality and criminal law developed with the subsequent and partial control of drug traffic,. This control was made more difficult by the discovery of heroin, which is more easily smuggled and is more potent than opium. Its use—now primarily by means of injection following discovery of the hypo-dermic syringe—is still considered a major social, criminal, and moral threat, even though in the Western world only a relatively few persons are involved and most of them are already members of deprived and disaffected groups. Heroin use is centered among male urban dwellers, apparently young more often than old (although our statistics may play us false) and more often (in the United States) minority members. Data from other countries are scarce, except for rare studies such as that of Hess (1965) in Hong Kong.

When supplies are controlled, administration is supervised, per-sonal expectations are limited and defined by those in authority, and recipients are healthy and well adjusted, dependency, a deviant label, or untoward consequences are unlikely to appear in those to whom opium, its derivatives, or synthetic analogues are administered. How-ever, when these conditions are not met, the risk of a troublesome out-come is increased. Who will fall victim to what risk is still but poorly understood; situational crises, psychological deficiencies, learning in a peer group, the presence of pain and anxiety, disaffection from con-trolling norms of virtue, lack of ordinary gratifications from life and work, nutritional deficiency, special "autonomic" learning—all have been implicated. To these complex and interacting variables the fol-lowing must also be added : reasonably straightforward pharmacological considerations such as potency of substance, frequency of use, man-ner of administration, and condition of the person receiving the drug. What risks we are talking about is another matter. Physical depend-ency, compulsive use, associated illness and malnutrition, correlated membership in deviant groups, accidental death, mental clouding, criminal involvement, arrest and imprisonment, failure of treatment—each is a kind of risk. There is no reason to lump them together or to expect that the determinants of one are determinants of another. These considerations of effects are beyond our immediate concern, but an awareness that there are differing kinds of risks, each with considerable argument associated with it, cannot be divorced from an epidemiological history. The reason is that both sanctions for use and reactions against use affect patterns of use and that sanctions of either kind, positive or negative, rest upon either an appraisal of effects or an in-ference as to their correlates.

1 In folklore research on a Greek island (Blum and Blum, 1965), we found that some islanders used the juice from the pod as a hypnotic and anal-gesic for infants, whereas other villagers, not more than a kilometer away, were not employing it in this manner; still others were ignorant of the practice. There was no evidence of folk medical use among adults or of any adult self-administration of any kind.

2 United States, Philippines Commission, Report of the Committee to Investigate the Use of Opium in the Far East, 59th Congres.s, First Session, 1905, Govt. Document #265 (Washington, D.C.: Government Printing Office, 1905). This is important because it is largely at variance with most published work on the so-called opium problem in nineteenth-century Asia. This collection of testi-mony points to the fact that the tide of reformism in the Western world coin-cided with the American victory in the Spanish-American War (1898):' This left the United States with jurisdiction over many areas in the Pacific where opium-smoking Chinese minorities resided.

A vocal minority of the missionaries testifying before the committee admitted that most Chinese used opium moderately and that its effects were less destructive than those of alcohol. Insurance executives admitted asking whether Chinese applicants for insurance smoked opium, but stated they would insure moderate smokers. The United States Consul at Nanking, Mr. W. Martin, stated that men of wealth used opium for a lifetime without ill effects of any kind. Reverend Timothy Richards, in China for thirty-three years, testified that many Chinese use opium as moderately as people in the United States do tea or coffee. Doctors and businessmen generally agreed in their testimony that moderate use was frequent and abuse, both in quantity and quality, was no greater than abuse of alcohol in America and Europe.

Te-Duc-Luat (1925), an Indo-Chinese medical doctor, further questions the thesis that opium is an unadulterated vice and evil. At age seventy-four he made daily rounds, on foot, to some twenty patients, was the father of twenty-two healthy children (opiates are generally supposed to have anaphrodisiac effects, and heroin use is frequently associated with virtual sterility by research-ers today), and since puberty he claims to have smoked "thirty pipes of opium daily . . ." Luat's conclusions are that the Chinese "moral" war against opium was economically motivated. Unable to grow their own opium in sufficient quan-ity or to stop the drain of silver from the country, he believes they enlisted the aid of the Puritan ethic and the Western reform movement to cast opium in the role of the ultimate evil.

3 Withdrawal distress, of course, cannot occur unless there has been sustained use, so that initiation and use remain problem areas even if acute symptomatology is associated only with the absence of the drug.