Opium

Authorities. (351 to 353, from Franklin Scott, Inaug. Diss., Philad., 1803, p. 18); 351, gave Mr. J. A., set. twenty-three years, 40 drops of tincture ; 352, I took 2 grains, rubbed down, with a little water; 353, Mrs. FI. took 6 drachms of tincture ; 354, Di-. Dufresne, Bib. Horn., vol. i, 1833, p. 227 ; 355, J. B. Middle, M.D., South. Med. and Surg. Journ., July, 1851, p. 427, a woman took 2 fluid ounces of Laudanum ; 356, A. Hadden, M.D., Amer. Med. Times, vol. i, 1860, p. 149, Mary Med., set. twenty-eight years, took a dose of Laudanum ; 357, H. J. Morton, M.D., IMed. and Surg. Reporter, vol. XV, 1866, p. 225, Mr. E. H., ait. thirty years, took 3 ounces of Opium ; 358, same, ibid., vol. xiv, p. 336, a child, two weeks old, took 6 drops of Laudanum; 359, Henry Gibbons, M.D., Pacific Med. and Surg. Journ., 1868, p. 163, Mrs.-swallowed a gill of brandy, and immediately after ^ an ounce of Laudanum ; 360, J. E. O’Brien, M.D., Chicago IMed. Journ., vol. xxvi, 1869, p. 720, Emmy C., tet. Pvo years, swallowed 13 pills of gum Opium, each containing about I grain ; 361, F. W. Campbell, M.D., Canada Med. Journ., vol. vi, 1870, p. 62, A. B., set. thirty-two years, took about 2 ounces of Laudanum ; 362, J. B. Chagrin, M.D., ibid., p. 409, Mr. A. G. took same quantity ; 363, S. W. Morrison, M.U.„ Philad. JMed. Times, November, 1875, p. 106, a child, set. four weeks, took an indefinite amount; 364, J. C. Morse, IM.D., Pacific Med. and Surg. Journ., 1876, p. 56, a man swallowed between 40 and 70 grains of Opium; 365, omitted ; 366, C. H. Morfit, M.D., Phil. Med. and Surg. Rep., 1877 (2), p. 466,poisoning front swallowing ^ ounce of Laudanum ; 367, Wm. T. Plant, IM.U., New York Med. Rec., vol. xii, 1877, p. 717, a man, while intoxicated, took 1 ounce of Laudanum, and died; 368, Dr. Janvrin, Amer. Journ. of Obstet., vol. xi, 1877, p. 780, a child, set. five weeks, took 10 drops of Squibb’s liq. Opii. com. ; 369, T. G. Smyth, M.B., Edinb. Med. Journ., December, 1878, p. 505, a woman swallowed about 12 drachms of Laudanum, and died in thirty-six hours; 370, F. A. Southern, Brit. Med. Journ., 1878 fl), p. 824, a man, set. thirty-eight years, took a quantity of Laudanum; 371, North Carolina Med. Journ., 1879, p. 65, Bettie K., set. thirty years, swallowed upwards of H fluid ounces of officinal tincture of Opium ; 372, Dr. Miclucho Malay, Chemist and Druggist (Nature, vol. xix, 1879, p. 492), observations of Dr. Clouth.

Mind p. 606

In the forenoon of the second day her mind was very much disturbed at intervals and by paroxysms; during one of these she would leap out of bed, and, notwithstanding all opposition made by the nurse, would run downstairs and escape from the doors. These exertions would exhaust her strength, and before she could get far would become faint, fall down, and beg to be carried to her bed; she would then be composed for a time, till seized with a second paroxysm. These were repeated several times during the day

Hallucinations

The sleep which he had that night was not natural; he passed the night in some jactitation, attended with delirium and frightful dreams

Exhilaration of spirits (after forty-five minutes)

A sensation which he compared to intoxication (after thirty minutes); had subsided considerably (after sixty minutes)

The stupor and lethargy were so great that he went to bed at 9 oclock (after three hours and a quarter)

Stupor

Stupid, livid, and unable to stand

Unconscious

Perfect insensibility; be could not be roused in the slightest degree by rough handling or loud shouting (after three hours)

Insensible and snoring loudly (after two hours)

Deep coma,®®® ®®®, etc.

Head p. 606

Vertigo (after thirty minutes)

Vertigo, much worse on trying to walk (after two hours)

Whenever an attempt was made to walk I staggered a little, and felt as if intoxicated with wine (after five hours)

Turgescence in the head (after ten minutes)

Sensations of turgescence in the head (after forty minutes)

Pain in the head (after two hours)

Pain in the head and over the eyes (second morning)

At 10 A.M. the pain in the head increased, attended with a sensation of throbbing in the brain, which was almost intolerable (second day)

First proving: After preparing the 2d cent, trituration, put 1 grain on the tongue. There were no marked symptoms through the day, except a constant sensation of frontal headache, which I attributed to the heat of the day, and not to the Opium. At night I slept badly, and much less than usual. The next morning I took a new dose of the 1st trituration. The frontal malaise increased, the head was heavy, and I experienced loss of energy. That night I slept none at all, but there were no disagreeable symptoms. During the whole time that I remained in bed I had no sensation in the head, but on rising in the morning the malaise returned. Towards 11 A.M. I was seized with vertigo, which seemed to me the precursor of the migraine to which I had been subject for more than twenty years. It disappeared and gave place to a headache, which passed olf in about three-quarters of an hour. After this I experienced precordial anxiety, with pain in the stomach, to which I had formerly been subject with the migraine. I was soon obliged to sit down and rest, and I found myself covered with cold sweat, excessively fatigued, succeeded by nausea. All this, however, was nothing new to me, although I had not suffered from so severe an attack for more than fifteen years, and it was entirely out of proportion to the severity of the head symptoms. These distressing sensations did not last long, and I returned to my house and lay down and rested

Eyes p. 607

Eyes red (after eighty minutes)

Eyes very red (after two hours)

Eyes glazed, half open, pupils moderately dilated, and immovable (in half an hour)

Eyes half open aud fixed

Eyelids closed (after two hours)

Heaviness over his eyes (after thirty minutes)

Conjunctivce considerably injected (after two hours)

Conjunctivse insensible

No reflex action was excited by touching the eye itself (after three hours)

-Pupils insensible to light (after seven hours)

Pupils very much contracted and insensible to light (after one hour aud a half); (after three hours)

Pupils contracted to a point (after ten hours),®*® ®®®, etc.

Head p. 607

Ears and back of neck livid (after two hours)

Tinnitus aurium (after sixty-five minutes)

Nose p. 607

Nose pinched like a cadaver, and could not inspire through it (after three hours and a half)

Face p. 607

Face pale (after two hours)

Face pale and ghastly (after two hours)

Face suffused (after forty minutes)

Complexion somewhat cyanotic

Lividity of countenance

Face and lips swollen and livid (after one hour and a half)

Countenance of leaden, deathlike hue

Livid lips

Lips and tips of ears livid (after three hours)

Jaws clenched (after two hours)

Throat p. 607

Teeth clenched (after two hours)

Tongue projected, tumefied, and blue (after three hours)

Tongue swollen aud thrust between the lips, and trembling (after ten hours)

Throat p. 607

Spasm of the throat

Inability to swallow

Stomach p. 607

No appetite (after three hours)

Nausea (after forty-five minutes) ; increased (after seventy-five minutes)

Slight nausea (after twenty-five minutes)

In the forenoon of the second day the stomach became much affected with nausea aud vomiting, everything she swallowed was soon rejected

In five hours had vomited two or three times, in consequence I felt much relieved, though I continued very stupid. The next day a deadly nausea came on me every half hour, and a puking, at first of phlegm, but soon after a copious discharge of bile ensued ; every kind of drink was thrown off tuy stomach soon after it was taken. At 1 oclock took a draught of a mixture of a solution of salt of tartar, with lime-juice ; this, however, was puked up immediately ; it increased the nausea aud sickness. I vomited at last a dark-greenish liquid, which deposited in the bottom of the vessel a sediment of the same color

In the course of the second night her stomach became much swelled with flatus

Unpleasant sensation about the region of the stomach (after two hours),®*®. * Fesi)it‘atorfj Orujaas.

Respiration slow, but not stertorous (after two hours)

The breathing 9 respirations per minute (after seven hours)

Respiration stertorous, irregular, aud even sometimes interrupted for a considerable time (after three hours)

Breathing was loudly stertorous; respirations only 3 per minute (after two hours) ; 5^ per minute, jerking and stertorous (after three hours)

Respirations consisted of a series of two or three feeble gasps, with complete intermissions of from one to three minutes (in half an hour)

Breathing stertorous

Res{)ration irregular aud not full

Respirations about 4 a minute, very feeble

Respiration slow and difficult (second morning)

Breathing extremely slow aud interrupted, stertorous, and gasping

Respiration feeble and irregular (after ten hours)

DifficuUy of breathing (after two hours)

Respiration difficult, as if almost suffocated (second night)

Heart and Anxiety at the prsecordia (after two hours)

Sense of heaviness and oppression of heart (after eighty minutes),'

Strong pulsation in the carotid arteries (second day)

Heart’s sounds very weak (after three hours)

Pulse iinperceptiide, the heart’s action feebly dicrotic, irregular, with not more than 40 contractions in the minute (in half an hour)

Pulse very quick and irregular, and so weak as to be with difficulty perceptible,^™.

Pulse 146, irregular in volume and rhythm (after two hours); 140, very feeble, compressible, and irregular (after three hours),^“b

Pulse 110 and intermittent tatter three hours and a half),®“h

Pulse 100 (after one hour and a half)

Pulse 80 on taking the drug; 84 (after five to fifteen minutes); 8‘2 (after twenty minutes); 80 (after twenty-five minutes); 72 (after thirty minutes); 80 (after thirty-five minutes) ; 76 (after forty to sixty minutes); 80 (after sixty-five and seventy minutes)

Pulse 72, before taking; same (after five to twenty minutes); 78 (after twenty-five and thirty minutes); 80 (after thirty-five to forty-five minutes) ; 84 (after fifty and fifty-five minutes); decline in force, but was full (after fifty minutes) ; 72 (after sixty minutes); 68 (after sixty-five minutes); 76 (after seventy minutes); 80 (after seventy-five to eighty-five minutes); 84 (after ninety minutes); 80 (after ninety-five minutes); 76 (after one hundred to one hundred and ten minutes); 72 (alter one hundred and fifteen and one hundred and twenty minutes) ; slow and full, without much tension (second morning)

Pulse small and frequent (second night)

Pulse feeble and quick (after two hours)

Pulse scarcely perceptible at the wrist

Pulse slow and full (after ten hours)

Pulse almost imperceptible and also irregular (after three hours)

Pulseless at wrists and temples (after two hours)

Eyes p. 608

Weakness in those muscles which support the head erect (after one hundred minutes)

Upper Extremities p. 608

Considerable rigidity of the muscles of the arms and legs (alter two hours)

Power of muscular motion diminished; slight pains were felt in the recti and vast muscles of the thigh ; also pain in the arms and legs when I attempted to move them (after eighty minutes)

Superior Extremities p. 608

Fingers and nails congested (after two hours)

Nails greatly congested (after three hours)

Thumbs of both hands rigidly extended at right angles (after two hours)

Generalities p. 608

Finding no relief I lost sixteen ounces of blood ; in a short time after I felt much better. The blood which was drawn had an inflammatory crust formed on the surface; it coagulated very firmly, and the edges by retracting within the bowl and turning up, exhibited the cupped appearance; there was a large proportion of serum

He was in normal health, and had fasted eighteen hours before commencing the experiment. He had never smoked tobacco. Twenty-seven pipes, equivalent to 107 grains of the Opium used by the Chinese, were smoked in two hours and three-quarters, at tolerably regular intervals. The third removed the feeling of hunger caused by his long fast, and his pulse rose from 72 to 80. The fourth and fifth caused slight heaviness and desire for sleep, but there was no hesitation in giving correct answers, though he could not guide himself about the room. After the seventh pipe the pulse fell to 70. The twelfth pipe was followed by singing in the ears, and after the thirteenth he laughed heartily, though without any cause that he can remember. Questions asked at this time were answered only after a pause, and not always correctly. He had for some time ceased to be conscious of his actions. After the twenty-fifth pipe, questions asked in aloud tone were not answered. After the last pipe had been smoked, he remarked I do not hear well Fort}' minutes later there was a slight return of consciousness, and he said I am quite bewildered. May I smoke some more? Is the man with the pipe gone already?” Fifteen minutes later (4.55 p.M.) he was able to go home, and then retired to bed. He woke next morning at 3 A.M., and made a hearty meal, after his fast of thirtythree hours. During the next day he felt as if he had bees in a great hollow in his head, as well as a slight headache. The organs of locomotion were first affected, next came sight and hearing, but Herr Malay is very positive that there were no dreams, hallucinations, or visions of any sort whatever

Spasms of the muscles

Twitching of the tendons (after ten hours)

Violent convulsions, the face, neck, and extremities becoming turgid, livid, and cold

Frequent fearful spasms ; eyes shut, pupils closely contracted, and breathing stertorous. In the interval between the spasm, he was perfectly limp, and had no control over his extremities, and his head drooped forward or fell backward in a heavy, ungovernable way

Relaxation in the muscular system (after one hundred minutes)

Muscular system entirely flaccid

Very much agitated, frequently rising from the bed, and walking with haste across the floor (after two hours)

Began to feel languid (after fifty minutes)

Weak and languid (second day)

Considerable debility (after three hours)

Debility was great, and such languor and lassitude that I could scarcely walk across the room (second morning)

Tendency to syncope (second day)

No sensibility to external impressions

Complete ausesthesia and muscular relaxation (in half an hour)

Skill p. 609

Skin dry (after three hours)

The skin appears more full, as if elevated or swollen, particularly on the face and hands (after two hours)

About noon of the second day erysipelas of the face began to be developed, and extended from the face to the head quite rapidly

Sleep p. 609

Drowsiness (after two hours)

While an emetic of Sulphate of zinc was operating, there was a great propensity to sleep, but this was of short duration ; she did not sleep till some time in the night ensuing, which was seventeen hours after the Opium was taken ; she then slept four hours, after this was much relieved and tranquil for several hours

Profound sleep, from which it could not be aroused (after two hours)

Fever p. 609

Skin cold (after three hours)

Slight rigors were frequent (second day)

Face and extremities cold and livid (in half an hour)

Skin cold and moist

Extremities cold,®®® ®®*, etc.

Extremities cold and clammy (after one hour and a half Surface hot (after two hours)

Heat on the skin, particularly of the face (after ten minutes)

Covered with cold clammy sweat (after three hours and a half)

Slight perspiration on forehead, of a cold, clammy character (after two hours)