Oils, Part 2

Anomalies and Curiosities of Medicine
by George M. Gould, M.D., Walter L. Pyle, M.D.

(Page 28 of 44)

According to Lewin, Brochin reported a case in which the idiosyncrasy to morphin was so great that 1/25 of a grain of the drug administered hypodermically caused irregularity of the respiration, suspension of the heart-beat, and profound narcosis. According to the same authority, Wernich has called attention to paresthesia of the sense of taste after the employment of morphin, which, according to his observation, is particularly prone to supervene in patients who are much reduced and in persons otherwise healthy who have suffered from prolonged inanition. These effects are probably due to a central excitation of a similar nature to that produced by santonin. Persons thus attacked complain, shortly after the injection, of an intensely sour or bitter taste, which for the most part ceases after elimination of the morphin. Von Graefe and Sommerfrodt speak of a spasm of accommodation occurring after ingestion of medicinal doses of morphin. There are several cases on record in which death has been produced in an adult by the use of 1/2 to 1/6 grain of morphin.

According to Wood, the maximum doses from which recovery has occurred without emesis are 55 grains of solid opium, and six ounces of laudanum. According to the same authority, in 1854 there was a case in which a babe one day old was killed by one minim of laudanum, and in another case a few drops of paregoric proved fatal to a child of nine months. Doubtful instances of death from opium are given, one in an adult female after 30 grains of Dover's powder given in divided doses, and another after a dose of 1/4 grain of morphin. Yavorski cites a rather remarkable instance of morphin-poisoning with recovery: a female took 30 grains of acetate of morphin, and as it did not act quickly enough she took an additional dose of 1/2 ounce of laudanum. After this she slept a few hours, and awoke complaining of being ill. Yavorski saw her about an hour later, and by producing emesis, and giving coffee, atropin, and tincture of musk, he saved her life. Pyle describes a pugilist of twenty-two who, in a fit of despondency after a debauch (in which he had taken repeated doses of morphin sulphate), took with suicidal intent three teaspoonfuls of morphin; after rigorous treatment he revived and was discharged on the next day perfectly well. Potassium permanganate was used in this case. Chaffee speaks of recovery after the ingestion of 18 grains of morphin without vomiting.

In chronic opium eating the amount of this drug which can be ingested with safety assumes astounding proportions. In his "Confessions" De Quincey remarks: "Strange as it may sound, I had a little before this time descended suddenly and without considerable effort from 320 grains of opium (8000 drops of laudanum) per day to 40 grains, or 1/8 part. Instantaneously, and as if by magic, the cloud of profoundest melancholy which rested on my brain, like some black vapors that I have seen roll away from the summits of the mountains, drew off in one day, - passed off with its murky banners as simultaneously as a ship that has been stranded and is floated off by a spring-tide -

'That moveth altogether if it move at all.'

Now, then, I was again happy; I took only a thousand drops of Laudanum per day, and what was that? A latter spring had come to close up the season of youth; my brain performed its functions as healthily as ever before; I read Kant again, and again I understood him, or fancied that I did." There have been many authors who, in condemning De Quincey for unjustly throwing about the opium habit a halo of literary beauty which has tempted many to destruction, absolutely deny the truth of his statements. No one has any stable reason on which to found denial of De Quincey's statements as to the magnitude of the doses he was able to take; and his frankness and truthfulness is equal to that of any of his detractors. William Rosse Cobbe, in a volume entitled "Dr. Judas, or Portrayal of the Opium Habit," gives with great frankness of confession and considerable purity of diction a record of his own experiences with the drug. One entire chapter of Mr. Cobb's book and several portions of other chapters are devoted to showing that De Quincey was wrong in some of his statements, but notwithstanding his criticism of De Quincey, Mr. Cobbe seems to have experienced the same adventures in his dreams, showing, after all, that De Quincey knew the effects of opium even if he seemed to idealize it. According to Mr. Cobbe, there are in the United States upward of two millions of victims of enslaving drugs entirely exclusive of alcohol. Cobbe mentions several instances in which De Quincey's dose of 320 grains of opium daily has been surpassed.

One man, a resident of Southern Illinois, consumed 1072 grains a day; another in the same State contented himself with 1685 grains daily; and still another is given whose daily consumption amounted to 2345 grains per day. In all cases of laudanum-takers it is probable that analysis of the commercial laudanum taken would show the amount of opium to be greatly below that of the official proportion, and little faith can be put in the records of large amounts of opium taken when the deduction has been made from the laudanum used. Dealers soon begin to know opium victims, and find them ready dupes for adulteration. According to Lewin, Samter mentions a case of morphin-habit which was continued for three years, during which, in a period of about three, hundred and twenty-three days, upward of 2 1/2 ounces of morphin was taken daily. According to the same authority, Eder reports still larger doses. In the case observed by him the patient took laudanum for six years in increasing doses up to one ounce per day; for eighteen months, pure opium, commencing with 15 grains and increasing to 2 1/4 drams daily; and for eighteen months morphin, in commencing quantities of six grains, which were later increased to 40 grains a day. When deprived of their accustomed dose of morphin the sufferings which these patients experience are terrific, and they pursue all sorts of deceptions to enable them to get their enslaving drug. Patients have been known to conceal tubes in their mouths, and even swallow them, and the authors know of a fatal instance in which a tube of hypodermic tablets of the drug was found concealed in the rectum.

The administration of such an inert substance as the infusion of orange-peel has been sufficient to invariably produce nervous excitement in a patient afflicted with carcinoma.

Sonnenschein refers to a case of an infant of five weeks who died from the effects of one phosphorous match head containing only 1/100 grain of phosphorus. There are certain people who by reason of a special susceptibility cannot tolerate phosphorus, and the exhibition of it causes in them nausea, oppression, and a feeling of pain in the epigastric region, tormina and tenesmus, accompanied with diarrhea, and in rare cases jaundice, sometimes lasting several months. In such persons 1/30 grain is capable of causing the foregoing symptoms. In 1882 a man was admitted to Guy's Hospital, London, after he had taken half of a sixpenny pot of phosphorous paste in whiskey, and was subsequently discharged completely recovered.