1304

ELEMENTS OF MATERIA MEDICA.

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of exhibition. This plan of treatment is well adapted for the <hff 11 'fibrous forms of acute rheumatism; but it does not prove equally - ccessful in the synovial forms of the disease. It is also valuable in c))rheumatism. ■ ia J

3. In Diseases of the Brain and Spinal Cord. —In some cerebro-sp^ gSdiseases great benefit arises from the use of opium ; while in ot ^ er t0 \,einjury only can result from its employment. The latter effect is ^ ctexpected in inflammation of the brain, and in apoplectic cases. I n °^ en twords, in those cerebral maladies obviously connected with, or dep eI |on, an excited condition of the vascular system of the brain, opium a . ,jjuriously. But there are many disordered conditions of the cerebro-sf ^functions, the intensity of which bears no proportion to that of t | eV j a -rangement of the vascular system of the brain; and there are other [ ^tions from the healthy functions in which no change in the cere* 51 ^culation can be detected. In these cases opium or morphia fr et F ; a -evinces its happiest effects. In insanity its value has been propel' v ^sisted on by Dr. Seymour, ( Lond. Med. Gaz. vol. ix. p. 114 ; aim jChir. Trans, vol. xix. p. 167). He, as well as Messrs. Bevei'l) ^Phillips, employed the acetate of morphia. Its good effects vverc 111 )^^fested rather in the low, desponding, or melancholic forms of the dis ‘than in the excited conditions. Opium is sometimes employ 6 ^ ^drunkards to relieve intoxication. I knew a medical man addich 3 ^^drinking, and who, for many years, was accustomed to take a l al 'S c . ^t,of laudanum whenever he was intoxicated and was called to see a p a a)1On one occasion, being more than ordinarily inebriated, he swallowexcessive dose of laudanum, and died in a few hours of apoplexy- ^

In delirium tremens the efficacy of opium is almost universal. ^mitted. Its effects, however, require to be carefully watched ; j )a Jdoses of it, frequently repeated, sometimes hasten coma and otn . gilsymptoms. If there be much fever, or evident marks of detenu 1 ^ j c >of blood to the head, it should be used with great caution, and °^ ra irbe preceded by loss of blood, cold applications to the head, and ot 1 ^

tiphlogistic measures. Though opium is to be looked on as aremedy in this disease, yet it is not to be regarded as a specific-Law {Lond. Med. Gaz. xviii. 538 and 694) speaks in high terms ■„association with emetic tartar. I have before noticed the use of op 1alleviating some of the cerebral symptoms which occur during f ever [^ j-e-In spasmodic and convulsive diseases opium is a most imp 01 ’*' 3 ' 1 p,]emedy. In local spasms produced by topical irritants, it is a most' a ^agent, as I have already stated: for example, in spasm of the g al ^j jjjor of the ureters, brought on by the presence of calculi; in colic, j apainful spasmodic contractions of the bladder, or rectum, or u ^ erllS ' 11i0 dit

spasmodic stricture opium is sometimes useful. In genuine spasthma , which probably depends on a spasmodic conditioncular fibres investing the bronchial tubes, a full dose of opium S e ^j^u 1gives temporary relief; but the recurrence of the paroxysms is s 0l) einfluenced by opium. There are several reasons for believing 1 . n 0 ji.effect of narcotics in dyspnoea is to diminish the necessity for res fij llC l lD>Laennec {Treat, on the Diseases of the Chest, by Forbes, p- 7? al uC oU s1827) states, that when given to relieve the extreme dyspnoea of rI L. p )ecatarrh, it frequently produces a speedy but temporary cessation j jtdisease; and if we explore the respiration by the stethoscope, "' e