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MORPHINE. 465

When the narcotic effects of morphine decline, there is generally
experienced headache, confusion of mind, anorexia and nausea.
When a poisonous dose is administered, a profound state of nar-
cotism quickly ensues, the pulse becomes slow and feeble, the
respiration slow and indistinct, the skin cold and covered with
perspiration, the face pale, blue and ghastly, the conjunctiva
deeply injected, the pupils greatly contracted, the reflex move-
ments entirely destroyed. Half a grain of morphia is the small-
est dose which has proved fatal to an adult, but other cases are
recorded where one grain destroyed life. It chiefly affects the
cerebro-spinal functions, and causes death by paralyzing the res-
piratory muscles.
The antidotes in cases of poisoning are the stomach pump,
emetics, cold effusions, counter-irritation, strong coffee, active
stimulants, atropine by hypodermic injection, electro-magnetism
and artificial respiration.
Therapeutic Uses.—The salts of morphine are employed in all
neuralgic affections, for the relief of pain from whatever cause,
and to induce sleep ; also in diseases of the heart, chronic gas-
tritis, delirium tremens, tetanus, colic, spasms, dysentery, cholera,
cough of pulmonary affections, cerebro-spinal meningitis, puer-
pural fever, convulsive diseases, vomiting, colica pictonum,
diarrhoea, diabetes, gangrene, etc., etc. For hypodermic injec-
tion, the acetate of morphine is supposed to possess some advan-
tages over the other salts, such as the sulphate and muriate, one
of which is its greater solubility. Morphine is contra-indicated
where there is a tendency to apoplexy and coma.
Dose.—Of the salts of morphine, gr. i to grain i. One-sixth
of a grain of either of the salts of morphine is equivalent to a
grain of opium, or twenty-five drops of the tincture of opium
(laudanum).
For hypodermic injections the dose of salts of morphia is gr.
to The use of morphine hypodermically frequently leads to
I I.
the morphine habit, which, once formed, is rarely abandoned ;
and which, independent of its fatal systemic effects, has very in-
jurious effects upon the teeth—the enamel and dentine becoming
thoroughly disintegrated, owing to the presence of erosive acids.
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