This section is from the book "The London Dispensatory", by Anthony Todd Thomson. Also available from Amazon: PDR: Physicians Desk Reference.
When opium has been taken in an over-dose, the first thing to be done for counteracting its bad effect, is to empty the stomach with the stomach pump, or, if that be not at hand, by the exhibition of a powerful emetic; and for this purpose 3 ss. of sulphate of zinc, or from grs. x. to grs. xv. of sulphate of copper dissolved in water should be immediately swallowed, and the vomiting kept up for a considerable time, and urged by irritation of the fauces; but as these substances sometimes
1 The inhabitants of these countries regard it also as an aphrodisiac. "Ad venerem enim ciere integrae nationes norunt, et in hunc usum adhibent: sic Japonenses, Chinenses, magis Indiae, Persae, Aegyptii, et Turcae aplirodisiacum opium, referentibus Pr. Alpino, Saar (Itinerar. Ind. orient.), Cleyer (Eph. N. C. 11. x. 35.) Foeminas Turcias opio viros incitare refert Jahn (Mat. Med. ii. 265.). Vide Opium Hist. Chem. atque Pharm. invest, per C. A. Christen. 8vo. p. 53. In China opium is smoked, but the custom is illegal; and so late as 1796 the punishment was pilloring and the bamboo : at present pecuniary penalties are inflicted, but nevertheless the custom prevails, and gains ground. Those who indulge in it are said rarely to live beyond fifty years of age.
2 History of Aleppo, i. 128.
3 Mustapha Shatoor, an opium eater in Smyrna, took daily three drachms of crude opium. The visible effects at the time were the sparkling of his eyes, and great exhilaration of spirits. He found the desire of increasing his dose growing upon him. He seemed twenty years older than he really was; his complexion was very sallow, his legs small, his gums eaten away, and the teeth laid bare to the sockets. He could not rise without first swallowing half a drachm of opium. (Phil. Trans, xix. 289.) Some years ago I was consulted by a lady who took a wine pint and a half of laudanum every week, and who, as she began to experience its bad effects on her constitution, was anxious to discontinue it, but was uncertain how to proceed. I recommended her to get a three-pint bottle of the drug, and to continue her usual dose; but, after taking each portion out of the bottle, always to replace it with water; so that in the progress of time, the bottle would contain water only, and her propensity would be cured. She continued the plan for one week only, and having left my neighbourhood, I have had no opportunity of knowing the consequence of her return to the abuse of opium.
Opium appears to have no detrimental effect on white ants, who eat it freely and in large quantities.
fail in producing vomiting, the following draught has been recommended:
Ammonias Subcarbonatis, Э j.; Pulv.
Ipecacuanhae, 3 ss.; Aquas Menthae pip. f
iij.; Tinct. Capsici, f 3 ij.1 This has certainly the advantage of rousing the system, at the same time that it evacuates the stomach. Large draughts of vinegar and water, or other acidulated fluids, should be frequently taken, after the stomach has been completely evacuated, and the powers of the habit must be supported by brandy, coffee, and cordials. The sufferer should be kept awake, and, if possible, in continued gentle motion. Currie recommends the effusion of warm water at 106° or 108° 2, for removing the drowsiness. The costive-ness, which supervenes, when the patient recovers, should be treated with aromatic purges, and the tone of the habit restored by stimulating tonics and the shower-bath. In some idiosyncrasies even the external application of opium will produce poisoning. In a case related by M. Guiand, jun. of Marseilles, an ounce of laudanum, applied in a poultice to the limb of a soldier in the Hospital St. Louis, at Paris, affected with erysipelas, produced all the symptoms which follow from a large dose taken into the stomach, and occasioned death.
The only appearance observed on the dissection were a few red injected spots in the arachnoid; but a strong odour of opium exhaled from the body.3 When either simple morphia, or the acetate of that salt is taken in an over-dose, say two or three grains, it operates as a virulent poison. The symptons are headache, frightful reveries, vertigo, dimness of sight, subsultus, violent agitation, and obstinate vomiting. The pupil in the majority of cases is contracted. There is pain also in the epigastric region, and in the course of the intestines, but the breathing is not much affected. Pruritus of the skin is almost a constant symptom of poisoning by morphia.4 M. J. L. Lassaigne has proposed the following method of detecting it when it has proved fatal. Digest the stomach or its contents, evaporating nearly to dryness in alcohol, and precipitate by the subacetate of lead. Filter the solution, and pass through it a stream of hydrosulphureted gas to precipitate any excess of the salt of lead; then evaporate the solution in vacuo, and add to the residue nitric acid.
If morphia or its acetate be present, a yellow-orange colour, which changes to a bloodred, will be produced.1 Another method proposed by Serullas is to evaporate a portion of the suspected fluid, then to mix it with a small portion of a neutral iodate of potassa, and some mucilage of starch : on adding a drop or two of sulphuric acid, if the mixture contain morphia, the blue colour will be instantly produced. In this case the iodic acid of the iodate is decomposed, and iodine being set at liberty strikes the blue colour. When the quantity is very small, it may be detected by precipitating the suspected fluid with acetate of lead, washing the meconate of lead thus procured, and then decomposing it by sulphuric acid. Meconic acid is thus set free, and readily detected by a solution of perchloride of iron.
1 See a paper by Mr. Sprague, Medical Repository, vol. xviii. p. 125.
2 Reports on Water, i. 80.
3 Observateur des Sciences Med. Marseilles, Aout, 1825. 4 Lond. Med. Repos. vol. i. New Ser. p. 80.
Officinal preparations. - Of the Poppy Capsules : Decoctum Papaveris, L. D. Extractum Papaveris, L.E. Syrupus Papaveris, L. E. D.-Of Opium : Opium purificatum, D. Confectio Opii, L. D. Elect. Opii, E. Elect. Catechu, E. Elect. Catechu comp., D. Extractum Opii, L. E. D. Pilulae Opii, E. Pilulae Saponis cum Opio, L. D. Pulvis Opiatus, E. Pulvis Cornu usti cum Opio, L. Pulvis Cretae comp. cum Opio, L. D. Pulvis Ipecacuanhae comp., L. E. D. Acetum Opii, D. Tinctura Opii, L. E. D. Tinctura Camphorae composita, L. D. Tinctura Opii ammoniata, E. Tro-chisci Glycyrrhizae cum Opio, E. Vinum Opii, L. Emplastrum Opii, D. Enema Opii, D. Linimentum Saponis cum Opio, D.
 
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