Page:The American Cyclopædia (1879) Volume XII.djvu/663

 OPIUM 649 ble in about 1,000 parts of cold and 400 parts of boiling water, and in 14 parts of boiling and 20 parts of cold alcohol ; they are readily dissolved by the fixed alkalies, but very sparing- ly by ammonia. With acids morphia forms salts soluble in water, of which the sulphate is the most important and most used in the Uni- ted States. This forms beautiful white, mi- nute, feathery crystals, soluble in two parts of cold water, and still more soluble in boiling water. One eighth of a grain is equivalent to one grain of powdered opium. In England the muriate is most used. The acetate is also considerably used in both countries. Morphia and its salts are characterized by striking a blue color with neutral ferric chloride, and by giving a red color with nitric acid, passing into yellow. Narcotina is an alkaloid, and forms salts with the acids which are very bitter, but is itself tasteless. It exists in opium for the most part free. It is easily obtained in fine large crystals, which are insoluble in cold water, soluble in 400 parts of boiling water, and in 100 parts of cold and in 24 parts of boiling alcohol, which deposits in crystals on cooling; it is very soluble in ether, which is its best solvent. Oodeia was discovered by Eobiquet in 1832, and has been to some ex- tent used as a substitute for morphia, but is far less active. Narceia was discovered by Pelletier in 1832. It has been employed to a limited extent, but its great cost, $50 an ounce, will always prevent its general employ- ment. The following statement of the propor- tionate quantity of the more important con- stituents of opium is given on the authority of Messrs. T. and H. Smith : from 100 parts of opium, 10 parts of morphia, 6 of narcotina, 0*15 of thebaina, 1 of papaverina, 0*30 of codeia, 0*02 of narceia, O'Ol of meconine, 4 of meconic acid, and 1*25 of thebolactic acid. Meconic acid is of some consequence as the acid with which the alkaloids are in part naturally com- bined, which combination is restored in the preparation known as bimeconate of morphia. It also gives certain characteristic color reac- tions, which may be of value in detecting the presence of opium in mixtures. To the volatile odorous principle is due the unpleasant smell of the drug, and perhaps some of its disagree- able after effects, since the deodorized tincture or elixir of opium agrees with some persons who cannot bear the ordinary non-deodorized tincture or laudanum. The physiological and therapeutical action of opium is represented, with no very important variations, by that of morphia, the other constituents being present in opium in so small quantity as not very ma- terially to affect its operation. It is custom- ary and convenient, in speaking of the action of opium or morphia, to divide it into two stages, a primary one of excitement or stimu- lation, and a secondary one of narcotism. A small dose of morphia produces at first a slight mental excitation, which is usually quiet and dreamy, with but few external manifestations. The pulse is somewhat accelerated and the temperature slightly raised. This condition of tranquillity and comfort may last for several hours, or sooner or later pass into a quiet sleep, which in the daytime is likely to be short, but at night may be continued into the usual sleep. Some headache, nausea, and lassitude may fol- low the awakening ; but these vary much with the dose and the individual. The secretions, excepting that of the skin, are diminished. Females are somewhat more liable than males to the unpleasant after effects, and nervous, excitable individuals than those of an opposite disposition. As the dose increases, the stage of stimulation becomes shorter, the sleep be- comes more heavy or deepens into coma, the pulse and respiration become slow, the face pale or livid, the skin covered with a cold per- spiration, and the pupil contracted. From this condition the patient may recover, or, the breathing becoming more shallow and the aeration of the blood less perfect, death en- sues. Violent stimulants may arouse a per- son from the condition last described for a few moments, only to sink again into uncon- sciousness as soon as left to himself. When pain is present, it disappears or diminishes under the influence of the drug, and the dose may be increased almost in direct proportion to the severity of the pain. But it is by no means necessary for the relief of pain in all cases to induce a condition of unconsciousness or anything approaching it. Severe neuralgic or spasmodic pain will often entirely disappear under a dose which merely excites the patient, or indeed simply restores him to his normal condition of comfort and cheerfulness. It is impossible to state with accuracy the fatal dose, so wide are the limits fixed by age, hab- it, and idiosyncrasy. The usual commencing dose of morphia is from the eighth to the third of a grain, although smaller doses are by no means without effect, and larger ones are often used in cases of severe pain. Children are peculiarly susceptible to the poisonous ac- tion of the drug. The treatment of opium poisoning consists in evacuating the stomach, the use of strong coffee, the application of pow- erful irritants, as flagellation, the cold douche, or the galvanic battery, and occasionally small doses of atropia or tincture of belladonna. The patient should not be permitted to sleep. In therapeutic doses opium differs from morphia in its somewhat greater liability to produce head- ache, nausea, and constipation. Their poison- ous action is practically identical. The thera- peutic uses of morphia and opium are to relieve pain, cause sleep, relax spasm, check over-se- cretion, and in small doses to act as stimulants in various morbid conditions. The special dis- eases in which they may be used are too numer- ous to mention, but may be inferred from the foregoing. Opium may be administered by the mouth or by the rectum ; morphia, in addi- tion, by application to a blistered surface, or more conveniently and efficiently by injection