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anomalies and curiosities of medicine-第178章

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Castor oil is usually considered a harmless drug; but the castor bean; from which it is derived; contains a poisonous acrid principle; three such beans having sufficed to produce death in a man。 Doubtless some of the instances in which castor oil has produced symptoms similar to cholera are the results of the administration of contaminated oil。

The untoward effects of opium and its derivatives are quite numerous Gaubius treated an old woman in whom; after three days; a single grain of opium produced a general desquamation of the epidermis; this peculiarity was not accidental; as it was verified on several other occasions。 Hargens speaks of a woman in whom the slightest bit of opium in any form produced considerable salivation。 Gastric disturbances are quite common; severe vomiting being produced by minimum doses; not infrequently; intense mental confusion; vertigo; and headache; lasting hours and even days; sometimes referable to the frontal region and sometimes to the occipital; are seen in certain nervous individuals after a dose of from 1/4 to 5/6 gr。 of opium。 These symptoms were familiar to the ancient physicians; and; according to Lewin; Tralles reports an observation with reference to this in a man; and says regarding it in rather unclassical Latin:  〃 。 。 。 per multos dies ponderosissimum caput circumgestasse。〃 Convulsions are said to be observed after medicinal doses of opium。 Albers states that twitching in the tendons tremors of the hands; and even paralysis; have been noticed after the ingestion of opium in even ordinary doses。 The 〃pruritus opii;〃 so familiar to physicians; is spoken of in the older writings。 Dioscorides; Paulus Aegineta; and nearly all the writers of the last century describe this symptom as an annoying and unbearable affection。 In some instances the ingestion of opium provokes an eruption in the form of small; isolated red spots; which; in their general character; resemble roseola。 Rieken remarks that when these spots spread over all the body they present a scarlatiniform appearance; and he adds that even the mucous membranes of the mouth and throat may be attacked with erethematous inflammation。 Behrend observed an opium exanthem; which was attended by intolerable itching; after the exhibition of a quarter of a grain。 It was seen on the chest; on the inner surfaces of the arms; on the flexor surfaces of the forearms and wrists; on the thighs; and posterior and inner surfaces of the legs; terminating at the ankles in a stripe…like discoloration about the breadth of three fingers。 It consisted of closely disposed papules of the size of a pin…head; and several days after the disappearance of the eruption a fine; bran…like desquamation of the epidermis ensued。 Brand has also seen an eruption on the trunk and flexor surfaces; accompanied with fever; from the ingestion of opium。 Billroth mentions the case of a lady in whom appeared a feeling of anxiety; nausea; and vomiting after ingestion of a small fraction of a grain of opium; she would rather endure her intense pain than suffer the untoward action of the drug。 According to Lewin; Brochin reported a case in which the idiosyncrasy to morphin was so great that 1/25 of a grain of the drug administered hypodermically caused irregularity of the respiration; suspension of the heart…beat; and profound narcosis。 According to the same authority; Wernich has called attention to paresthesia of the sense of taste after the employment of morphin; which; according to his observation; is particularly prone to supervene in patients who are much reduced and in persons otherwise healthy who have suffered from prolonged inanition。 These effects are probably due to a central excitation of a similar nature to that produced by santonin。 Persons thus attacked complain; shortly after the injection; of an intensely sour or bitter taste; which for the most part ceases after elimination of the morphin。 Von Graefe and Sommerfrodt speak of a spasm of accommodation occurring after ingestion of medicinal doses of morphin。 There are several cases on record in which death has been produced in an adult by the use of 1/2 to 1/6 grain of morphin。 According to Wood; the maximum doses from which recovery has occurred without emesis are 55 grains of solid opium; and six ounces of laudanum。 According to the same authority; in 1854 there was a case in which a babe one day old was killed by one minim of laudanum; and in another case a few drops of paregoric proved fatal to a child of nine months。 Doubtful instances of death from opium are given; one in an adult female after 30 grains of Dover's powder given in divided doses; and another after a dose of 1/4 grain of morphin。 Yavorski cites a rather remarkable instance of morphin…poisoning with recovery: a female took 30 grains of acetate of morphin; and as it did not act quickly enough she took an additional dose of 1/2 ounce of laudanum。 After this she slept a few hours; and awoke complaining of being ill。 Yavorski saw her about an hour later; and by producing emesis; and giving coffee; atropin; and tincture of musk; he saved her life。 Pyle describes a pugilist of twenty…two who; in a fit of despondency after a debauch (in which he had taken repeated doses of morphin sulphate); took with suicidal intent three teaspoonfuls of morphin; after rigorous treatment he revived and was discharged on the next day perfectly well。 Potassium permanganate was used in this case。 Chaffee speaks of recovery after the ingestion of 18 grains of morphin without vomiting。

In chronic opium eating the amount of this drug which can be ingested with safety assumes astounding proportions。 In his 〃Confessions〃 De Quincey remarks: 〃Strange as it may sound; I had a little before this time descended suddenly and without considerable effort from 320 grains of opium (8000 drops of laudanum) per day to 40 grains; or 1/8 part。 Instantaneously; and as if by magic; the cloud of profoundest melancholy which rested on my brain; like some black vapors that I have seen roll away from the summits of the mountains; drew off in one day;passed off with its murky banners as simultaneously as a ship that has been stranded and is floated off by a spring…tide

     'That moveth altogether if it move at all。'

Now; then; I was again happy; I took only a thousand drops of Laudanum per day; and what was that? A latter spring had come to close up the season of youth; my brain performed its functions as healthily as ever before; I read Kant again; and again I understood him; or fancied that I did。〃 There have been many authors who; in condemning De Quincey for unjustly throwing about the opium habit a halo of literary beauty which has tempted many to destruction; absolutely deny the truth of his statements。 No one has any stable reason on which to found denial of De Quincey's statements as to the magnitude of the doses he was able to take; and his frankness and truthfulness is equal to that of any of his detractors。 William Rosse Cobbe; in a volume entitled 〃Dr。 Judas; or Portrayal of the Opium Habit;〃 gives with great frankness of confession and considerable purity of diction a record of his own experiences with the drug。 One entire chapter of Mr。 Cobb's book and several portions o
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