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OPIUM.
491
tetanus, spasms, nervous irritability and discharges of a morbid
nature. It excites the circulation as a first action, and increases
the temperature of the skin, and causes an agreeable exhilaration
of the intellectual faculties, so much so as to be used by some as
an habitual narcotic, which is finally destructive to both the phys-
ical and mental functions. But the stage of excitement is very
transient, and is succeeded by a falling of the pulse, a diminished
susceptibility to external impressions, confusion of mind and the
loss of consciousness in deep sleep. Other effects are also mani-
fested, such as dryness of the throat, thirst, and in some cases,
nausea and vomiting, with an itching miliary eruption on the
skin.
Taken in large or poisonous doses, opium does not cause any
excitement, but giddiness and stupor rapidly supervene, with a
lessening in the frequency of the pulse, but not in fulness, a tend-
ency to sleep, which is irresistible, and finally coma, in which
the breathing is heavy and stertorous, the pulse slow, and the
pupils contracted, with a sinking of the pulse and relaxation of
the muscles immediately preceding death ; in the case of children
death is often preceded by violent convulsions.
The antidotes in poisoning by opium are the stomach pump,
emetics in double doses, such as sulphate of zinc, in doses of gr.
XX to gr. XXX, or sulphate of copper, gr. v to gr. x ; also mustard
in powder, .5ss, or powdered alum, answer as emetics, strong
coffee, keeping the patient in motion, counter-irritation to nape
of neck, flagellation to the palms of the hands and soles of the
feet, and the electro-magnetic battery, which is often efficient
when other measures fail, artificial respiration, and belladonna, in
hypodermic injections of its alkaloid atropine, in solution. No
local lesions are found after death.
Therapeutic Uses.—Opium as an anodyne and hypnotic is em-
ployed in almost all diseases where the necessity of assuaging
pain and inducing sleep is required. (See Morphine.) Opium is
contra-indicated where there is a tendency to apoplexy or coma,
or where an unusual susceptibility to its influence exists, and it
should be administered to the very young and very old with great
caution. When long administered it is necessary to increase the