Before describing the action of Opium, I want to draw the attention of my readers to the importance of having it good, and of not using Morphia as a substitute. Never buy Opium in powder, and in selecting the gum, take that which when broken gives the characteristic odor. Lastly, prepare your own tincture of Opium.
Opium in medicinal doses is a cerebral stimulant, and we will find this its most important use. From this stimulation comes sleep and rest to the nervous system.
In less degree it is a stimulant to the spinal-cord, and increases functional activity of all parts supplied from it.
Opium or its salts may be administered for the relief of pain, to produce sleep, or as a general stimulant to the vegetative processes, when the following conditions are present A soft, open pulse, or where there is not the element of hardness and smallness; a soft (not dry) skin; a moist tongue; pallid face; and eyes dull, immobile or dilated pupils. It is contra-indicated, where there is a dry, contracted skin; small hard pulse; dry tongue; flushed face; bright eye, with contracted pupils.
There is no remedy that has been so much or so badly used as this. It is highly prized by the profession, and yet every physician can recall cases where its administration has proven injurious rather than beneficial. It has gained this extensive use because of the marked relief it gives from pain, and even though it fails so frequently, the successes are estimated, not the failures.
I believe the reader, by carefully studying the above indications and contra-indications, will be enabled to use the remedy so as to obtain its full palliative and curative action; not having the unpleasantness of failure to accomplish the desired object, or injury to the patient, to regret.
Hypodermic Use of Morphia.—In this connection we may consider the advantages to be obtained from the hypodermic use of Morphia. It has been extensively employed for the relief of pain, and many physicians would hardly practice medicine if forced to give up their hypodermic syringes.
The advantages to be obtained from this use of Morphia has not been over-estimated. But every one who has employed it, will recollect cases of failure, sometimes of injury, which were very mortifying. Why the failure?
The indications for the hypodermic use of Morphia are the same as those just given for Opium, and where there is present the contra-indications, the use will not give the expected results, and may prove injurious. Fortunately, in the majority of cases of neuralgia, there is a soft, open pulse, the cool pallid skin, and the evidence of an enfeebled cerebro-spinal circulation. In such cases, the hypodermic use of Morphia gives present relief, and from its topical stimulation, may effect a radical cure.
We never employ the hypodermic injection of Morphia where there is a hard, small pulse, dryness and constriction of skin, dry tongue, flushed face, bright eyes and contracted pupils. He who uses it in such cases, will very certainly be disappointed in its action. In many cases of fever and inflammation, though the patient suffers pain, and the ordinary influence of Morphia in this way would be very desirable, we withhold it.