Morphinae Acetas - Morphinae Acetatis - Morphine Acetate. - A white or faintly yellowish-white, crystalline or amorphous powder, having a faint, acetous odor and a bitter taste. Soluble in 2.5 parts of water and in 21.6 parts of alcohol. On protracted exposure to the air the salt gradually loses some acetic acid, becoming less soluble. It should be kept in dark amber-colored, well-stoppered bottles. Dose, 1/8 - 1/4 grain (0.008-0.015 Gm.).

Morphinae Hydrochlridum - Morphinae Hydrochlridi - Morphine Hydro-chlorate. - White, feathery needles, of a silky luster, or minute, colorless, cubical crystals, odorless, having a bitter taste, permanent in the air. Soluble in 17.2 parts of water and in 42 parts of alcohol at 250 C. Dose, 1/8 - 1/4 grain (0.008-0.015 Gm.).

Morphinae Slphas - Morphinae Sulphatis - Morphine Sulphate. - White, feathery, acicular crystals, of a silky luster or in cubical masses, odorless, of a bitter taste, permanent in air. Soluble in 15.3 parts of water and in 465 parts of alcohol at 250 C. Dose, 1/8 - 1/4 grain (0.008-0.015 Gm.).

Codeina - Codeinae - Codeine. - White or nearly translucent, orthorhombic prisms, or octahedral crystals, or a crystalline powder, odorless, having a faintly bitter taste, and slightly efflorescent in warm air. Soluble in 88 parts of water and in 1.6 parts of alcohol at 250 C. Dose, 1/2-2 grains (0.03-0.12 Gm.).

Codenae Phtsphas - Codenae Phosphtis - Codeine Phosphate. - Fine white crystals. Bitter taste. Soluble in 2.25 parts of water and 261 parts of alcohol at 25 C. Dose, 1/2 grain (0.03 Gm.), U. S. P.

Codenae Slphas - Codenae Sulptis - Codeine Sulphate. - Long glistening white crystals, efflorescing in the air. Soluble in 30 parts of water and 6.25 parts of alcohol at 250 C. Dose, 1/2 grain (0.03 Gm.), U. S. P.

Plvis Morphnae Compsitus - Plveris Mrphinae Compsiti - Compound Powder of Morphine (Tully's Powder). - Dose, 5-15 grains (0.3-1.0 Gm.).

Formula: Morphine Sulphate, 1.5; Camphor, 32; Glycyrrhiza, 33; Precipitated Calcium Carbonate, 33; Alcohol, q. s. to 100.

Antagonists and Incompatibles of Opium and its Alkaloids. - The physiological antagonists are atropine, strychnine, coffee or caffeine. Quinine antagonizes some of the cerebral effects of the drug, while tartrate of antimony and potassa (tartar emetic) and digitalis oppose its action on the intracranial circulation. The incompatibles are alkalies, tannic acid and infusions containing it, and salts of lead, iron, copper, mercury, and zinc.

The following are incompatible with morphine and its salts: iodine and iodides, bromine and bromides, Fowler's solution, and sodium borate.

Synergists. - The hypnotic action of opium is aided by the hypnotics; its anodyne influence is enhanced by belladonna and cocaine, and its sudoriferous effects by ipecacuanha.

The physiological action of opium differs in some respects from that of morphine or codeine, and will therefore be described first.

Externally and Locally. - Applied to the unbroken skin, opium possesses feeble analgesic properties, and from mucous membranes or raw surfaces it is readily absorbed, producing slight anodyne effects.

Internally. - Digestive System. - Its prominent action is upon the secretions - checking that from the salivary glands, causing great dryness of the mouth and consequent thirst - largely diminishing those from the stomach, and reducing the bile and pancreatic juice secreted. In fact, every secretion of the body is lessened except the perspiration, the cause being the depressing influence of the drug upon the secretory centers in the medulla. It may be added that the peristaltic movements of the digestive apparatus are reduced, which, together with diminished secretions, impair digestion and produce constipation.

The sensation of hunger is invariably diminished under its administration.

The action upon the intestines, however, varies with the dose administered, moderate or full medicinal doses checking peristalsis and promoting constipation. On the other hand, very large or very small doses increase peristalsis, the former augmenting this effect, and producing violent movement of the bowels through the drug's paralyzing action on the splanchnic inhibitory fibers of the intestine, so that inhibition is removed and peristalsis reinforced. Very small doses act as purgatives when by some reflex disturbance, such as a tender ovary, the peristalsis is inhibited. It is not yet certain whether this action is largely due to local causes, as morphine is excreted into the intestines, or is of central origin. Minute quantities, by partially benumbing the inhibitory nerves or diverting the stimulus from them to the stimulating fibers, relieve constipation. This action is rendered serviceable in the similar constipation accompanying lead poisoning, the metal constipating the patient not only by its astringent action, but also by the tetanic spasm of the intestines caused by the irritating action of the lead upon the mucous membrane. The feces are held by spasmodic intestinal contraction, relief of which by a small dose of opium, sufficient to induce peristalsis, will be followed by evacuation.

Circulatory System. - Small doses accelerate the pulse, rendering it fuller and firmer, and dilate the arterioles, though increasing arterial tension. The chief activity of opium is on the central nervous system. Large doses, while primarily quickening, soon retard the heart's action, rendering the pulse slow. This influence is occasioned by stimulation of both ends of the vagus. Should the dose be lethal, the pulse may become rapid and weak from over-stimulation, and consequent exhaustion of the vasomotor center and pneumogastric nerves. As asphyxia deepens, the heart grows weaker, but usually continues beating after respiratory failure.

Nervous System. - One of the early symptoms of taking opium is a condition of well-being - a euphoria. In it the patient is in a state of dreamy consciousness; the skin is warm and pleasant, and all outside worries, cares, pains, or distresses are cut offfrom the attention. This is narrowed to the patient's own feeling of happiness. Preceding the full development of the euphoria there is little doubt that a certain amount of primary stimulation takes place, This may be due to the increased blood-supply, frequently manifesting itself in the skin by itching, or it may result from primary irritation, although experiments on lower animals have induced many observers to question the occurrence of any primary stimulation. In the habitue there is no doubt of the stimulation of the initial stages, but in this class an entirely different series of physiological and psychological activities is at work. In the stage of euphoria a certain heightening of the imagination occurs, particularly in certain types of mental organization. This readily becomes incoordinated, however, and very frequently highly exaggerated, leading to the characteristic fantasies colloquially termed "pipe dreams." Sleep follows or intermits in this stage. In the light grades of sleep, the patient may be easily aroused, and, as a rule, when the outside irritant is sufficiently acute to enter into the field of attention, the sleeper is suddenly and usually thoroughly aroused. He often awakens with a sudden start - is keenly alive to the surroundings, and if unnecessary to bestir himself, sinks back into slumber. Very often the sleep is a fitful, restless sleep, with semi-waking periods and short naps seeming to extend over very great periods of time. In the more profound sleep, awakening is difficult and the patient, after being aroused, sinks back into a profound coma.