Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/549

 *ministers opium in the way practised by the opium-eater; that when given in the usual therapeutic mode it rarely causes material excitement; that some professional people prefer giving it in frequent small doses, with the view of procuring its sedative effect, and undoubtedly do succeed in attaining their object; that in both of these medicinal ways of administering it, excitement is occasionally produced to a great degree and of a disagreeable kind; that the latter phenomena have been clearly traced to idiosyncrasy; and therefore that the effects on opium-eaters are probably owing either to the same cause, or to the modifying power of habit. This much at all events is certain,—that in persons unaccustomed to opium it seldom produces material excitement in a single small dose, and dose not always cause continuous excitement when taken after the manner of the opium-eater. The effect of a full medicinal dose of two or three grains of solid opium, or forty or sixty grains of the tincture, is to produce in general a transient excitement and fulness of the pulse, but in a short time afterwards torpor and sleep, commonly succeeded in six, eight, or ten hours by headache, nausea, and dry tongue.

The symptoms of poisoning with opium, administered at once in a dangerous dose, begin with giddiness and stupor, generally without any previous stimulus. The stupor rapidly increasing, the person soon becomes motionless and insensible to external impressions; he breathes slowly; generally lies still, with the eyes shut and the pupils contracted; and the whole expression of the countenance is that of deep and perfect repose. As the poisoning advances, the features become ghastly, the pulse feeble and imperceptible, the muscles excessively relaxed, and, unless assistance speedily arrive, death ensues. If recovery take place, the sopor is succeeded by prolonged sleep, which commonly ends in twenty-four or thirty-six hours, and is followed by nausea, vomiting, giddiness, and loathing of food.

The period which elapses between the taking of the poison and the commencement of the symptoms is various. A large quantity, taken in the form of tincture, on an empty stomach, may begin to act in a few minutes; but for obvious reasons it is not easy to learn the precise fact as to this particular. Dr. Meyer, late medical inspector at Berlin, has related a case of poisoning with six ounces of the saffron tincture of opium, where the person was found in a hopeless state of coma in half an hour, and M. Ollivier has described another instance of a man who was found completely soporose at the same distance of time after taking an ounce and a half of laudanum. In these cases, the symptoms must have begun in ten or fifteen minutes at farthest. In a case noticed by M. Desruelles the sopor was fairly formed in fifteen minutes after two drachms of solid opium were taken. For the most part, however, opium, taken in the solid form, does not begin to act for half an hour or even almost a whole hour,—that period being required to allow its poisonous principles to be separated and absorbed by the bibulous vessels. It is singular that