Apomorphinum

Authorities. 2, J. G. Blacker, M.B., Brit. Journ. of Horn., 1873, p. 497, injected 10 minims of 10 per cent, solution under the skin of the left arm ; 3, same, injected grain Hydrochlorate of apomorph., under the skin of the arm of William J., aged twenty-eight years; 4, Dr. Jurasz, Deutsche Arch. fur. Khu. Med., 187-5, p. 52 ; 5, M. Chouppe, Gaz. Hr-hom., Dec. 1874 (Loud. Med. Rev., vol. iii, p. 57), general effects; 6, Dr. Brochin, Gaz. des Hop., Jan. 16th (ibid., p. 58), effects of the hydrochlorate.

Pulse 76; temperature 98.3° (normal); feels giddy; complains of pressure at epigastrium; pulse 88, weak, but regular; pupils moderately dilated (in four minutes); began to vomit slightly (in five minutes); vomiting profusely, this continued for three minutes (in six minutes) ; ceased vomiting; took a drink of water, which came up immediately; milk was rejected in like manner ; pulse 80, weak ; temperature 98.6° (in nine minutes) ; still feels very giddy, and looks pale; pupils dilated (in sixteen minutes),®.—Pulse 72 (before experiment); 80 (in five minutes); 65 (in twelve minutes); 70 (second day),'(—[10.] Temperature 98° (before experiment) ; 99.2° (in five minutes); 99.2° (in twelve minutes); 97.8° (second day),®.—After three minutes the pulse began to rise slightly, and the respirations became slightly accelerated. At the end of four minutes I felt a sudden qualmishness, which was almost immediately followed by nausea and profuse vomiting. This continued for several minutes, and was followed as soon as the contents of the stomach had been evacuated by severe retching. On taking a draught of water with a little brandy in it this was immediately rejected, and on drinking cold water this too returned at once. Xo bile, however, came up in the vomited matters. At the end of seven or eight minutes from the commencement of the experiment I began to feel very faint and was compelled to lie down, and almost on doing so fainted entirely, and remained in a state of syncope for about five minutes. On awaking from this I felt giddy and chilly, and was obliged to take a little brandy and water. This was retained, and as I began to feel slightly drowsy, 1 remained lying for the space of about one hour, during which time 1 perspired profusely. On rising I still felt slight giddiness, but no inclination to vomit. I went to bed and slept soundly all night, awaking about 8 a.m., in my usual health, slightly pale, but very hungry,®.—In two to seven minutes after the injection of a solution of 1 milligram under the skin the symptoms begin, usually with dulness of the head, sometimes described as a headache, sometimes as a simple heaviness or vertigo, often associated with roaring in the ears and feeling of heat. At times the patient is suddenly attacked by a feeling of anxiety in the precordial region, or by a pressure in the chest. With the reaction there is generally an inclination to sleep, prostration, and loss of strength, and ill a few cases nausea and retching, beginning without warning. The relaxation during the prodromal state is at times very great, Reminding one of collapse, frequently associated with profuse perspiration, salivation, and paleness, especially of the face. The vomiting comes on in from four to twenty-six minutes after the injection, usually in ten to fifteen minutes after a dose of 5 milligrams. Vomiting is very easy, without effort, or after the stomach has been emptied very difficult, and associated with eructations and retching. The vomiting will occur once or be repeated two to eight times, with greater or less intensity. Between the acts of vomiting the patient is usually quiet, feels very weak,.yawns or perspires very freely. Sleepiness is frequently noted. The nausea continues, frequently associated with retching or eructations, and only ceases when there is no more to vomit. Between the acts of vomiting there is very great prostration and apathy. The whole stage of vomiting varies according to the frequency of the act and the length of intervals between the acts, lasting from one to fifty minutes. After the cessation of vomiting the symptoms gradually disappear; restoration is slow, the patient feels nauseated for some time, and weak and sleepy—It appears from many experiments that Apomorphia produces vomiting by what channel soever it reaches the organism, but that its effects are more prompt and more certain when it is introduced directly into the blood by intravenous or subcutaneous injection. If given by the mouth, the dose must be increased, and the effects are less certain. During the two or three minutes immediately following the injection, the patient does not feel anything. Soon a sensation of weight at the stomach, followed by a slight pain in the head, comes on. Then salivation becomes copious, the body is covered with perspiration, one or two efforts at vomiting without any result occur, and at the thii'd, or more rarely the fourth effort, the patient vomits three or four times successfully; then comes a period of calm. The vomitings return after an interruption of five or six minutes, followed by another interval of calm, and the same scene is repeated five or six different times, to terminate definitely at the end of about half an hour, and to give place to a very quiet sleep, lasting from half an hour to an hour,®.—A woman, forty years of age, complained of gastric troubles without fever. After some days she was attacked by sore throat and complete anorexia. The tonsils were red and swollen and the tongue very much furred. A hypodermic injection of three or four milligrams of Hydrochlorate of apomorphia was administered to her in the sternal region. The pulse was full, and marked 100 beats. In four minutes the patient felt slight uneasiness and a little vertigo; she said she felt her head turning round and becoming stupid. She turned pale, became insensible, her pulse became extremely weak, intermittent, and then imperceptible; the pupils were dilated, and the respiration seemed to be entirely suspended. Slight tonic convulsions showed themselves in the left corner of the mouth and in the left cheek. The patient became inert and did not answer to the questions put to her. After sprinkling with cold water, inhalations of ammonia, frictions, mustard poultices, etc., she recovered consciousness in three minutes and vomited twice, after which she again fainted, became extremely pallid, and the pupils were alternately dilated and contracted ; these symptoms were afterwards repeated,**.