Therapeutics.—Opium is used to re lieve pain, to check inflammation and allay irritation, to produce sleep, to in hibit undue action of the organs of se cretion, and to relieve the effects of temic strain and shock. In meeting these indications it covers an extensive field — so extensive, indeed, that the reader must be referred to almost all the affections considered in this work, to properly portray its usefulness. To re peat all these indications under this head would require about fifty pages, which the editor rightly prefers to de vote to new matter.
Heroin is not so harmless as was for merly supposed. It has a far greater depressant action on respiration than is seen in the case of morphine. Heroin is also a cardiac depressant, and in addition gives rise to muscular twitchings and convulsions. The maximum adult dose at present should not exceed grain. Harnack (Miinchener med. Woeh., July 4, '99).
Heroin is a very valuable therapeutic agent. It principally allays cough and eases respiration, but it has also general analgesic properties which render it of benefit in most painful affections. Ex cept slight dizziness and occasionally dryness in the throat, which was person ally found but rarely, no unpleasant symptoms even from a prolonged use of heroin have been seen. Max Einhom (Phila. Med. Jour., Oct. 2S, '99).
Heroin hydrochloride, a neutral salt of heroin, a new morphine derivative, is a white, odorless, crystalline powder of slightly bitter taste, freely soluble in water, acetic and dilute sulphuric acids. Its action in relieving cough and dysp Tuna is prompt; and its ready solubility renders it peculiarly suited for hypoder mic administration, especially where im mediate results are required.
Respiration is profoundly influenced in all cases. There is a decided diminution in the frequency of the respiratory move ments, with a prolongation of the in spiration and an increase of the force of expiration. The elimination of bronchial secretion is promoted, thus aiding in the relief of dysimma. The pulse becomes slightly diminished in frequency and like wise somewhat fuller. In therapeutic doses there is no disturbance of the gas tric functions. Except for a slight nau sea noticed in one case, no ill effects were observed. Its action on the intestine seemed to he a slightly constipating one.
The drug is well borne in both the young and the old, especially so in the former. As an anodyne in painful affec tions, it ranks much below either mor phine or codeine.
The after-effects personally noticed have been a slight nausea in one case, dizziness in two cases, languidness in two cases, and a pharyngeal irritation, with constant desire to clear the throat. None
of these sequelm was of a serious nature.
In cases marked by a diminution in the expectoration the drug may with ad vantage be combined with either the iodide of potash, ipecac, tenpin hydrate, or squill. In cases attended with con stipation the addition of cascara sagrada is effective.
The average dosage by mouth is from to V, grain, three times daily. It is preferably given after meals, especially when there is a diminution of gastric se cretion, in which condition if dissolved in an acid medium and taken after the ingestion of food it fulfills all require ments. It may be given in powder, pill, tablet, or solution. After the prolonged use of the drug, as in tuberculosis, larger closes are required. For prompt effect it is employed by hypodermic injection. Four to S minims of a 2-per-cent. solution represent V„ to grain, the smaller dose being the average amount necessary. The incompatibilities to its use internally are alkalies and apomorphine. Benno Hyams (Med. News, Dee. I, 1900).
Heroin and heroin hydrochloride can be used with very good results in all disorders of the respiratory organs; they combat the cough and dyspmea. In hremoptysis they will often cheek haem orrhage where other remedies fail. To avoid unpleasant after-effects, which are very rare in adults, heroin should be given always after meals. Heroin is also a very valuable drug in diseases of chil dren, but the dose should be as small as possible. Heroin should be tried in whooping-cough, being of decided benefit in many eases, reducing the number of attacks, or at least influencing their duration and severity. Heroin and her oin hydrochloride, especially the latter, when used hypodermically, act promptly in bronchial asthma. I. J. Martinson (N. Y. Med. Times, Jan., 1901).
In corneal diseases dionin is very bene ficial; nlcers heal rapidly and pain is prevented. It is best applied in combina tion with mydriatics. A 5- to 10-per cent. solution may be used. Dionin acts chiefly by increasing the flow of lymph. Ludwig Verifies (Klin-therap. Wochen., Feb. 10, 1901).
Heroin is considerably less poisonous than morphine or cocaine. It may be given with safety in doses of to grain. It quiets cough and increases the depth of respiration. It is particularly useful in tuberculosis of the larynx. .Nusch (Mtinebener med. Wochen., Mar. 19, 1901).