NON-OFFICIAL FLUID PREPARATIONS. —Liquor morphinm bimeconatis (B. P.), 5 to 40 minims.
Liquor morphim? sulphatis Majendie (16 grains to fluidounce), 3 to 10 min ims by hypodermic injection.
Mistura magnesim et asafcetid (De wee's carminative—magnesium carb., 5 parts; tincture of asafoetida, 7 parts; tincture of opium, 1 part; sugar, 10 parts; water, to make 100 parts), to 4 drachms.
Mistura opii et ipecacuanlue compos itus (Swedish cholera drops, or Thiele mann's cholera drops), 1 to 2 drachms.
Morphinie oleatum (10 per cent. mor phine), for external use.
Oleum papaveris seminis (poppy-seed oil—bland oil; adulterant of olive-oil).
Syrupus papaveris (syrup of poppy capsules—strength variable).
Syrupus rhteados (syrup of red poppy flowers—non-narcotic), used as vehicle.
Tinctura ehloroformi et morphinw, B. P. (chloroform, 1 '/, minims; ether, minim; alcohol, 1 minims; morphine hydrochlorate, I„ grain; dilute hydro cyanic acid, minim; oil of pepper mint, minim; fluid extract of lic orice, 1 minims; treacle and syrup, to make 10 minims), used externally.
Physiological Action.—One of the main factors in the physiological action of opium is its inhibitory influence upon tissue-waste. The reduced elimination of urea and other waste-products attend ing its use tend to practically sustain the results of experimental researches. Its baneful influence upon gastric diges tion and intestinal action is, in part, due to this effect, which involves depression of motor activity. The slowing of the pulse noted is at present ascribed to stimulation of the pneumogastric, and therefore of the inhibitory powers of this nerve upon cardiac action; the drug is also credited with a stimulating effect upon the muscles of the heart itself. When a powerful dose is taken the con ditions are reversed; the inhibitory in fluence of the vagus is counteracted, the vasomotor centres arc depressed and a rapid pulse and marked depression fol low. The same influence obtains upon the temperature, which may be slightly raised by small doses and lowered by large ones, Respiration follows suit, large closes of opium acting powerfully upon the respiratory centres. What its well-known influence upon the pupil depends upon is not clearly defined. bus it is theoretically ascribed to its depress ing effects upon the sympathetic system.
The same influence upon the splanchnic nerves reduces peristaltic action indi rectly, and gives rise to constipation; large doses, by totally paralyzing these inhibitory fibres, may thus totally arrest intestinal activity. A large proportion of opium when taken by the mouth is absorbed from the stomach; hence the importance of washing out this viscus in cases of acute poisoning. The intes tines and kidneys are the main channels of elimination for what proportion of the drug ingested or absorbed after hypodermic use is not destroyed in the organism.
Acute Poisoning by Opium.—Acute poisoning by opium may occur by intent or accident, through an overdose of one of the official preparations of opium or morphine, but not infrequently through the careless use of certain proprietary medicines. Children, being very sus ceptible to the action of opium, are often profoundly affected by seemingly small and appropriate doses. Soothing syrups and carminatives containing opium have contributed their share in increasing infant-mortality. Idiosyncrasy, in the adult, will sometimes cause profound ef fects to follow the administration of a moderate dose of this drug.
A full dose of opium or one of its prep arations is followed by a well-defined train of symptoms. We notice first a preliminary stage of mental excitement, which is accompanied by a feeling of well-being and content and an accelera tion of the heart's action. This is soon followed by headache, weariness, a sen sation of weight in the limbs, and drowsi ness. With these feelings we observe a diminished sensibility of the skin, con tracted pupils, deeper and slower respira tion (sometimes not more than eight to ten to the minute); slow, full pulse; suf fused or even cyanotic face; and warm, dry skin. The breathing may now be come puffing and stertorous. In this stage the person may be aroused by being loudly called or violently shaken; but if left alone he falls asleep at once. When the patient is aroused, the respirations become more frequent, the blood better aerated, and the duskiness of the face disappears. Death seldom, if ever, occurs in this stage from the action of the poi son alone, but death may take place if a complicating disease be present.