The remedy most trusted to in this disease is opium and its alkaloids, morphine and codeine.
In some abdominal conditions, for instance, opium is still preferred by the majority of practitioners, though certainly not in gastric cases, where morphine gives the relief for which opium often increases the need, owing to the irritant action of some of its constituents.
The sale and use of morphine in India and Burma is now restricted.
Piperine, conine, atropine, belladonine, cocaine, hyoscyamine and nicotine have been already synthesized; the constitution of several others requires confirmation, while there remain many important alkaloids - quinine, morphine, strychnine, &c. - whose constitution remains unknown.
(4) Isoquinoline group. The opium alkaloids: morphine, codeine, thebaine, papaverine, narcotine, narceine, &c.; and the complicated substances hydrastine and berberine.
The condition may even go on to a fatal result should morphine be continuously withheld, but injection of even a small quantity of morphine causes these symptoms to cease abruptly.
It is worse even than opium-eating, in proportion as morphine is more active than opium.
The sudden withdrawal of morphine should therefore never be practised with takers of large quantities of the drug, but gradually diminishing doses given by the physician should be substituted.
Irritation is lessened by lotions containing substances that will diminish irritability of the nerve-endings and skin, such as carbolic acid, hydrocyanic acid, morphine or opium, cocaine, belladonna or atropine.
Amongst those which lessen excitability of the brain-cells are opium, morphine, hyoscyamus, chloral, sulphonal, trional, paraldehyde, chloralamide, chloralose, hop and many others.
Irritation of sensory nerves tends to cause contraction of the vessels, and to raise the blood pressure, and where pain is ffi, present opium or morphine is the most efficient sedative.
At this meeting it was resolved that it was the duty of the respective governments to prevent the export of opium to any countries prohibiting its importation; that drastic measures should be taken against the use of morphine; that anti-opium remedies should be investigated; and that all countries having concessions in China should close the opium divans in their possessions.
A good deal of morphine is exported to Japan from Europe, and generally passes into China by way of Manchuria, where Japanese products have a virtual monopoly.
Browne finds that after smoking " chandoo," containing 8.98% of morphine, 7.63% was left in the dross, so that only 1.35% of morphia was carried over in the smoke or decomposed by the heat.
A small amount of morphine and codeine is also manufactured in India for medicinal use.
The quantity of morphine that any one may legally possess, and then only for medicinal purposes, is in India 10 grams, and in Burma five.
The possession of morphine by medical practitioners is also safeguarded by well-defined limitations.
Opium remade into cakes, at the port of shipment, to contain 7, 8, 9, or 10% of morphine, are chiefly sold.
Manufacturers' opium includes any grade yielding not less than 102% of morphine, but the Yoghourma or " pudding " opium, on account of its paste being more difficult to work, is not used for the extraction of the active principles.
The amount manufactured in 1906-1907 was 346 lb of morphine hydrochlorate, 12 lb of the acetate and 61 lb of codeia.
The alkaloids fall into two chemical groups: (i) derivatives of isoquinoline, including papaverine, narcotine, gnoscopine (racemic narcotine), narceine, laudanosine, laudanine, cotarnine, hydrocotarnine (the last two do not occur in opium), and (2) derivatives of phenanthrene, including morphine, codeine, thebaine.
Cotarnine IV.Narceine The chemistry of morphine, codeine and thebaine is exceedingly complicated, and the literature enormous.
That these alkaloids are closely related may be suspected from their empirical formulae, viz.morphine = C17H19N03, codeine = C18H21N03, thebaine = C19H21N03.
Formulae have been proposed by Pschorr and Knorr explaining this and other decompositions (in Pschorr's formula the morphine ring system is a fusion of a phenanthrene and pyridine nucleus); another formula, containing a fusion of a phenanthrene with a pyrrol ring, was proposed by Bucherer in'1907.
Soc. Morphine, or morphia, crystallizes in prisms with one molecule of water; it is soluble in woo parts of cold water and in 160 of boiling water, and may be crystallized from alcohol; it is almost insoluble in ether and chloroform.
Distilled with zinc dust morphine yields phenanthrene, pyridine and quinoline; dehydration gives, under certain conditions, apomorphine, C17H17N02, a white amorphous substance, readily soluble in alcohol, either and chloroform.
- Of the opium alkaloids only morphine and codeine are used to any extent in medicine.
The pharmacology of opium differs from that of morphine (q.v.) in a few particulars.
The chief difference between the action of opium and morphine is due to the presence in the former of thebaine, which readily affects the more irritable spinal cord of very young children.
Often it relieves vomiting, though in a few persons it may cause vomiting, but in far less degree than apomorphine, which is a powerful emetic. Opium has a more marked diaphoretic action than morphine, and is much less certain as a hypnotic and analgesic. There are a few therapeutic indications for the use of opium rather than morphine, but they are far less important than those which make the opposite demand.
Opium is often preferred to morphine in cases of diabetes, where prolonged administration is required.
It is formed when the vapours of toluene, stilbene, dibenzyl, ortho-ditolyl, or coumarone and benzene are passed through a red-hot tube; by distilling morphine with zinc dust; and, with anthracene, by the action of sodium on ortho-brombenzyl bromide (C. L.
This tincture contains chloroform, morphine and prussic acid, and must be used with the greatest care.
It is to be noted that children, who are particularly susceptible to the influence of certain of the other potent alkaloids, such as morphine and strychnine, will take relatively large doses of atropine without ill-effect.
Do not employ such physiological antagonists as pilocarpine or morphine, for the lethal actions of all these drugs exhibit not mutual antagonism but coincidence.
MORPHINE, the chief alkaloid of opium, to which the medicinal action of the former is mainly due.
The preparations of morphine are incompatible with salts of iron, copper and mercury, also with lime water and alkaline earths and substances containing tannin.
The preparations of morphine in the British Pharmacopoeia are as follow: from Morphinae Hydrochloridum are made five subpreparations: (1) Liquor Morphinae Hydrochloridi, strength 1% or about 44 grs.
Of morphine hydrochloride in each; (3) Tinctura Chloroformi et Morphinae, strength gr.
Of morphine hydrochloride and gr.
From Morphinae Tartras, a white crystalline powder, are prepared, Injectio Morphinae Hypodermica, containing 5% of morphine tartrate, and Liquor Morphinae Tartratis.
Hypodermic tabloids of morphine sulphate either alone or combined with atropine are much in use.
Various non-official preparations of morphine are in use, such as dionin, heroin, glycaphorm and peronin.
Morphine is an analgesic and hypnotic, relieving pain and producing deep sleep. As contrasted with opium it differs in being less astringent and constipating.
Morphine is the greatest anodyne we possess, and no drug yet discovered equals it in pain-relieving power.
In pain due to violent sciatica relief and even permanent cure has been obtained by the injection of morphine directly into the muscle of the affected part, and in the treatment of renal and hepatic colic morphine given subcutaneously will relieve the acute pain consequent on the passage of biliary and urinary calculi.
A violent paroxysm of asthma may be arrested by the administration of morphine subcutaneously, but the practice should not be continued, as there is great danger in a chronic disease that the patient may become the victim of morphinism.
Morphine is recognized as one of the most useful drugs in the treatment of eclampsia, early injection often arresting the fits.
In the cough of phthisis minute doses are of service, but in this particular disease morphine is frequently better replaced by codeine or by heroin, which checks irritable coughs without the narcotism following upon the administration of morphine.
In bronchitis with profuse expectoration the use of morphine is particularly dangerous, as it is likely to check the cough so necessary for getting rid of the secretion, but in the converse condition it usefully allays the harassing cough by diminishing the excitability of the respiratory centre.
In the dyspnoea of advanced valvular disease of the heart morphine relieves the distress and restlessness, and induces sleep. It should however be withheld if the heart has undergone fatty degeneration.
Morphine is a sheet anchor in the later stages of cancer and other painful diseases, rendering the life of the patient one of comparative comfort.
It is also excreted in the milk; hence the danger in the administration of large doses of morphine to nursing mothers.
Morphine-scopolamine anaesthesia was introduced in 1902 by Steinbiickel.
Morphinism (Morphinomania).-Chronic morphine poisoning is very common, as morphine taken constantly creates a habit.
The total amount of morphine indulged in by the habitual morphinist may reach an astonishing figure; 15 grs.
The sudden withdrawal of the drug from a morphine habitué is followed by a train of alarming symptoms. As the time approaches for the usual dose there is marked restlessness, followed by excitement and later by chills, pallor, sinking, nausea, with perhaps vomiting and diarrhoea.
Thus carbolic acid or carbolized ammonia are sniffed into the nose to destroy the microbes there, or the nose is washed out by an antiseptic solution as a nasal douche; bismuth or morphine are insufflated, or zinc ointment is applied, to cover the mucous membrane, and protect it from further irritation; and various antiseptic gargles, paints and powders applied to the pharynx in order to prevent the microbic inflammation from extending to the pharynx and down the trachea and bronchi, for many a severe bronchitis begins first by sneezing and nasal irritation.
Under the name of anti-opium cure various remedies containing morphine in the form of powder, or of little pills, have been introduced, as well as the subcutaneous injection of the alkaloid, so that the use of morphine is increasing in China to an alarming extent, and considerable difficulty is experienced in controlling the illicit traffic in it, especially that sent through the post.
Unless the indirect importation of morphine into China from Europe and the United States is stopped, a worse habit and more difficult to cure than any other (except perhaps that.
Of the other alkaloids narceine is hypnotic, like morphine and codeine, whilst thebaine, papaverine and narcotine have an action which resembles that of strychnine, and is, generally speaking, undesirable or dangerous if at all well marked.
The tincture often known as " paregoric " is also largely used in bronchial conditions, and morphine shows no sign of displacing it in favour.
Opium rather than morphine is also usually employed to relieve the pain of haemorrhoids or fissure of the rectum.
The effects of morphine are much more deleterious than those of opiumsmoking.