Treatment. — In morphine-inebriety, in whatever form the narcotic has been taken, it is desirable to withdraw the poison as speedily as may be practicable.
But the difficulty here lies in the prac ticability. The narcotic has been sud denly withheld, and it has been gradually tapered off. Among other distressing symptoms after sudden withdrawal, the following have been observed in an aggra vated form: Rigors, nausea, vomiting, exhaustive diarrhcea, convulsions, delir ium, prostration, and collapse. Languor and sneezing are minor troubles. The agony is in many cases indescribable, and the symptoms are so alarming that the full narcotic dose of the drug has had to be given to avert a fatal issue.
The prisoners at the Ahmedabad Jail addicted to opium, whose opium was stopped, lost weight only slightly in the beginning, and ultimately gained in weight. J. Benjamin (Der prakt. Aerzt, Aug. I, '93).
Six eases of morphinomania treated by sudden withdrawal of the drug with success. Comby (Le Bull. MM., June 24, '94).
Cases reported showing that sudden and complete withdrawal of the. drug is not followed by deleterious results. Al. V. Ball (Med. News, June 29, '95); .M. E. Hughes (N. Y. :Med. Jour., Mar. 2, '95); J. AI. Taylor (N. Y. Med. Jour., Apr. 20, '95); Gaillard (Revue Inter. de 7.‘fi-d., etc., Feb. 10, '95); Hod& (ThGse de Paris, '95); Rendu (La Tribune M6(1., Nov. 8, '94).
The violent diarrhma and vomiting. fol lowing sudden demorphinization are not usually 1n-willful, being due to sudden re newal of hepatic action, and the conse quent elimination of bile problably con taining stored-up morphine. The Ilow should be allowed to continue, but under strict medieal supervision, lest. bulbar asphyxia ensue. Sotiler (1.a SCI113 hie MM., Aug. 17, '95).
Sudden method of withdrawal in healthy patients who arc Inking an amount of morphine eNeeeding S to 10 grains per day favored. Giles de la Tourette (Bull. de Tlor.r., Sept. 15, '95).
In hospital-practice opium or its prep arations may be withdrawn at onee ab solutely, but in private prnetiee this is impossible. Under the latter conditions • ..• 4 1+ 11111 grad11.111y and ' n, gkett hypo . .11.1 •qual parts of red eiti • • n 1 fluid e‘tinet of coca --I
..1 t..is athniniitered by the ..„ t w nen on. paroxsnis are •. -.• I tassimit bromide must be ., I , atient should lw kept ill : •i .1 ;he amount of the opiate • . .1 1 of iis final discontinuance. No‘Ns, Aug. :2,7, 1, • ..;1.oluol no thod of suppressing the •I,1 uld illy be employed in patients . a marked morphine L.:Idle:6a.
Th. rill t thod may be used when a -Lion is at hand to administer a dose o•f .1g• lit in case of :serious collapse, •:..I suitable for eases that are not of -t in ling. or in which the patient is 2, and fat: from cardiac or other ral le-kits. In most cases an inter n - bate no thud, that oi Erlenmeyer, is - 1.-11 rapi I method, but not ab r•.• • illniff tilt. safety of the gradual t1-1 the quickness of the other.
14-e 1 ati. Intl-it first be put into a con 'lit. n to sustain the process of demor n by appropriate treatment, end than cacti day a half of the daily r ay 10 cut otT; when the dose has %(ry -mall the drug may be t r di- -ortinued. For severe cases, • t • ten days are usually sufficient; r co,ses, six to eight days. fr,,y flaz. llebdom., Dec. 10, '99).
,yillatilies are with the heroic . ',ut the sufrerinizs undergone, -v ri,kz (..,uch as paralysis) conse on the penfrriptory stoppage of La“. forced me to the conclu - t zradual diminution of the dose •r. t)lf: rule. Especially is this _ indieet, (1 when WC are dealing i•li prtur'Pnt hgbituics and with their T r--« of abstinence symptoms in no. 1 orr. children of opium-taking - u., rs. t o were unable to nurse them.
rn .n v of Insanity and -..13 DisPasP, Mar., '91).
Tr,r• fu•tus in utPro may survive despite s• fart that large doses of morphine are taken into the mother's circulation. Alorphinisni may bt• transmitted directly from mother to child in HOT°, should the fo,tus survive gestation.
Delivery of a morphine habitue who had been taking daily 5 grains of mor phine hypodermically, of a well-developed child, which gradually became irritable, and fretful, and finally refused food. One-twentieth of a grain of morphine was administered hypodermically with no other than a soothing etrect. Under small doses the child has continued to grow rapidly. P. C. Layne (Cincinnati Lancet-Clinic, July 9, '98).