A Combination of Gelsemium and Morphine.

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Editor Ellingwood's Therapeutist:

I have made a combination of Gelsemium and morphine in certain conditions and I have found it exceedingly valuable. I combine one grain of morphine with four drams of specific Gelsemium. To arrest premature labor pains, this combination has no equal. I give it in doses of from ten to fifteen drops, and repeat it every hour or two hours, until the patient is resting easily and comfortably.

In certain forms of lumbago, where the muscles are swollen and sensitive, and where the patient cannot bear to be moved, I have never found anything equal to this combination. I give it here in doses of from ten to twenty drops, repeated every hour or two, provided, of course, that Gelsemium is not contraindicated, which usually is not the case.

In prostatitis in old men, complicated with spasmodic stricture where a catheter cannot be introduced, this combination, given from ten to twenty drops every hour, will soon relieve the condition, and the catheter can be introduced with all ease. Recently I had a patient under treatment, a man 75 years of age, who took fifteen drops of this combination every hour for six hours, making ninety drops in all of the Gelsemium and three-tenths of a grain of morphine. when the stricture became relaxed, and the urine was readily drawn off. No unpleasant effects followed.

It should be borne in mind that Gelsemium is a powerful drug, and the well known influence of morphine makes this an active combination, quieting the motor nerves, and relaxing muscular spasm. It is useful in many conditions. It has something of an anesthetic effect, making the patient feel comfortable and pleasant.

In treating lumbago, we frequently find that the patient was taken suddenly with a sharp stitch in the back, so severe that he had to be helped into bed; he cannot move without great pain. Ordinary treatment does but little good in such cases, but if twenty drops of specific Gelsemium and one-sixth of a grain of morphine be given in combination, repeating the dose every two hours, until the patient is relieved, a quick and satisfactory cure results. The patient will often be up the next day. F. W. OWEN, M. D. Lamasco, Texas.

COMMENT: A number of our writers advise Gelsemium for the same conditions advised by Dr. Owen, but seldom, however, in as large doses. Personally, I have avoided combining Gelsemium with morphine. In many particulars their action is harmonious, and I am convinced that the doctor is perfectly correct in stating that this combination overcomes pain quickly. It seems to me reasonable to believe that there is pain from neuralgic conditions, from nerve irritation, and from spasms, where both an antispasmodic, as Gelsemium, and a pain-relieving remedy, as morphine will work better together than either will alone.

I give morphine in combination with a bromide and obtain splended results, just as the doctor claims he obtains from very small doses of morphine with Gelsemium. I trust that others will give us the reports of their observations from this combination. I am satisfied that there are conditions of feebleness, where this combination could be given with perfect safety, if combined with capsicum or some other similar stimulant, or with cactus to support the heart. There are some of our readers who will consider this dose of Gelsemium very large. We are all learning that we have been giving Gelsemium in doses too small to obtain the best results, and as any unpleasant effect is quickly announced, we are justified in pushing it strongly in many cases.

Ellingwood's Therapeutist, Vol. 3, 1909, was edited by Finley Ellingwood M.D.