Apomorphine used after antitoxin in jections in laryngeal diphtheria when the swelling and softening of the false mem brane cause signs of suffocation. A hypodermic dose of grain induces vomiting and clears the larynx. Am stein (Med. News, Apr. S, '99).
It is an expectorant, in doses ranging from to grain. As such it affords great relief in cases of bronchitis, tracheitis, and catarrhal pneumonia.
A spray of apomorphine in weak solu tion is sometimes recommended, but its use in this manner is hardly safe. It has been found valuable in whooping cough to relax spasmodic attacks. (In gram.) It has recently received much praise as a soporific—especially in acute alco holism.
Apomorphine, mixed with lanolin and applied to the skin, is a most valuable expectorant. For infants the strength of the ointment should be 1 grain to the ounce, the ointment being rubbed over the body three times a day, the skin being previously thoroughly cleansed. C. Smith (Texas Courier Record, Apr., '91).
Case of a man suffering from paroxys mal tonic convulsions with flushed face and bounding pulse. The condition was assumed to have been caused by excess ive indulgence in alcohol. A hypodermic containing 1/10 grain of apomorphine hydrochlorate caused free emesis, and was followed by rapid improvement. J. Edward Tompkins (Med. Record, Jan. 14, '99).
Apomorphine as an hypnotic found equally useful in all forms of insomnia regardless of the cause. It should be given in a single dose of about grain, injected subcutaneously. The object is to give a dose that, on the one hand, is large enough to produce sleep, and, on the other, is so small that nausea and vomiting are avoided. Hence, individual susceptibility must be considered. It should be given when the patient is in bed, for its effect is very rapid and the patient will usually fall into a restful sleep within five to twenty-five minutes. If no results are observed within one-half hour the dose is too small. The effect persists for from one to two hours, but in many cases of insomnia the patient will sleep all night. C. J. Douglas (N. Y. Med. Jour., Mar. 17, 1900).
Apomorphine acts as a prompt and well-nigh infallible hypnotic if injected subcutaneously in doses of about 'I,, grain. Although this is about the aver age dose, yet for some patients this is too large, as it produces nausea, while hi others a larger amount will cause no dis agreeable symptoms. The dose should be so adjusted as to be large enough to produce sleep and small enough to avoid nausea. Douglas (Merck's Archives, June, 1900).
recommends that apomorphine be given in large doses as an expectorant in this disease: '/2 to 1 grains. He also obtained excellent results from an ointment of: apomorphine, 1 grain; lard or lanolin. 1 ounce; the half of which is rubbed into the chest: a point of very great practical importance, especially in the treatment of children. Murrell also ob served the expectorant effect in many by using the apomorphine as a spray. It was very marked when the drug was used in large doses, and a dose which would act as an emetic, if administered hypo dermically, can be used as an inhalation without giving rise to this result.
CROUP.—In croup, where the case is urgent or where an expectorant effect is desired,/ 1.00 or grain every fifteen minutes gives the happiest effect. As relief comes, the time of dosing is ex tended to one or two hours, but the minimum dose is continued. When it is desirable to evacuate the stomach promptly, no remedy meets the case better than apomorphine. Cardiac de pression following the use of the remedy should be promptly met by suitable stimulants and tonics.
GASTRALGIA.—From the fact that it produces emesis by its action through the spinal nerve-centres, and not by irritation of the mucous membrane, it is a preferable remedy in inflammatory conditions of the stomach where emetics are indicated.
Case of indigestion and violent gastral gift in which apomorphine was given hyp odermically to produce emesis. Within two minutes the patient was entirely free from pain, fell asleep and slept for an hour, and was perfectly comfortable afterward. S. F. Morris (N. Y. Med. Jour., Nov. 10, '94).