1296

ELEMENTS OF MATERIA MEDICA.

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first, the same condition of the vascular system may be induced by various 8 f<‘ ropposite causes, for some of which opium may be an appropriate remedy, ' j^iiothers it may prove au injurious agent; secondly, the effects of opium on the t | |fr etion are not uniform, and hence not to be relied on. The following conclusion 8 ’ pH fore, are submitted with considerable hesitation as to the universality of thencation :— 0 tver» 0?

(a.) That in increased activity of the vascular system with considerable /vascu! 8rwith diminished secretions and exhalations, and in morbid conditions of thesystem with a tendency to sopor or coma, opium is an objectionable remedy- s fte r(S.) That in vascular excitement with great diminution of power, ‘hemorrhage ; in rapidity of pulse with nervous excitement, but without febrile °!’. j 0 „s 0matory symptoms, as in some forms of hysteria ; and in various morbid con 1 - 0lJ> b 11 *the pulse attended with acute pain, spasm, or profuse secretion and exbaiawithout visceral inflammation, opium often proves a serviceable agent.

c. On the Respiratory System .—In studying the effects of op’^'^ioii

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respiration, we must remember that the mechanical part of this n* j.g

is effected by muscular agency; and as the contractility of the at e

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fibre is powerfully influenced by opium, so the respiratory inoveui ellts .

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also necessarily modified. Occasionally the primary effect is a gl »increase in their frequency ; but the secondary effect is almost ah'an opposite kind, the respiration being slower than usual; anc f .coma is present, the breathing is usually gentle, so as scarcely to jj[joPceived; but in some cases it is stertorous. In fact, a paralytic c ° u - f; rof the respiratory muscles takes place, in consequence of whichtion becomes gradually more and more difficult, until eventually asp jis induced, which is usually the immediate cause of death. . . .podAnother effect ascribed to opium is, that it checks the arterial 1of the blood, by diminishing the supply of nervous agency, without jtthe decarbonization or oxygenization of this fluid cannot takeis difficult, however, to distinguish the consequences of this eu cCthose of asphyxia produced by paralysis of the respiratory muscle • 0 fThe third point of view under which we have to examine the imf 11 ? . ffifopium on the respiratory system is, its effect on the membrane , lU . j g ltf strachea and bronchial tubes and cells. In the first place, it ( h' u all J,the sensibility of this in common with other parts of the body >secondly, it checks exhalation and mucous secretion.

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A knowledge of these effects of opium on the organs of respiration leadslowing conclusions :— cm 8 i'

(a.) That this agent is contra-indicated in difficulty of breathing arising r °|, er e 4 .cient supply of nervous energy, as in apoplectic cases; that it is improper v e rvenous is imperfectly converted into arterial blood ; and, lastly, that it is 1 • j fi't' 11the first stage of catarrh and peripneumony, both from its checking secretion,its influence over the process of arterialization. 1 to pr cfCl *

( b.) That in cases of poisoning by opium, artificial respiration is indicated

asphyxia. ■■■ u the co^l

(c.) That opium may, under proper regulations, be useful to dimmish 11 s j,i sp 8! ftility of the muscles of respiration, or of the muscular fibres of the air tubes, ^modic asthma; to diminish the sensibility of the bronchia, in the secon . f . aU lcatarrh, and thereby to allay cough by lessening the influence of the collastly, to counteract excessive bronchial secretion. ^ ^ 0 f

£. On the Urinary System . —Authors are not agreed as to tne j ja t itopium on the kidneys; some asserting that it increases, othei sdiminishes, the quantity of urine secreted. Thus, Ur. Michael 1 ^ j,cComm. i. p. 307,1784) asserts, that in giving opium in venereal c ^ ffit’has sometimes found the secretion of urine exceeding in quant if' ^ ,^ 0 'lluitls drank. It cannot, however, be doubted, that in most cas