Remarks on two cases of poisoning by opium in young children / by J. Jardine Murray.

  • Murray, J. Jardine.
Date:
1858
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Licence: Public Domain Mark

Credit: Remarks on two cases of poisoning by opium in young children / by J. Jardine Murray. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    and contractility of the digestive organs and muscular system generally. It is worthy of remark that the symptoms appeared to be alleviat- ed when the cutaneous excretion became copious. 1 incline to the belief that there is something more than coincidence here, for I have observed the same in several other instances. No doubt, copious perspiration does occur in fatal cases ; but certainly these cases do not terminate unfavourably on this account. And though in some cases of poisoning by opium the skin is moist from an early period, I believe that alleviation of the symptoms may be observed when more copious diaphoresis sets in. Is the opium excreted by the skin ? This seems at least pro- bable ; for while, under the influence of this narcotic the discharge of every other secretion is impeded, the cutaneous secretion is certainly increased. Both in medicinal and in poisonous doses, opium is a powerful sudorific. It frequently happens that, on a post-mortem examination of persons destroyed by opium, no trace of the poison can be obtained—( tJcreira II., 210-4; Christison on Poisons, 4th Edit., p. 698.) Either, therefore, the constituents of opium are really present in the dead body, but cannot be detected by any known tests ; or they are digestible and assimilable ; or they are got rid of by cutaneous excretion. The probability of this last ex- planation led to the persevering application of relays of hot blankets in the above case ; and, as has been already mentioned, very copious diaphoresis was induced, apparently with the best results. Case II.—At 11 p.m. on the 19th September 1857, I was culled by an engraver-on-wood in this town to see his child, James , aged seventeen months and two weeks, who had accidentally received a poisonous dose of solution of the Muriate of Morphia. Labouring under chronic diarrhoea, he had been receiving during the day an occasional tea-spoonful of lime-water, at the recommenda- History. tion of Mr Colahan, student of medicine, who resided in the house. In the room occupied by this gentleman were a number of six-ounce bottles, from which he was wont to replenish the small phials of his pocket-case for midwifery and dispensary practice. One of these six-ounce phials contained lime water, and another the solution of the muriate of morphia ; and these two clear liquids were unfortunately allowed to stand in juxta-position on the sideboard. At 7 p.m., the mother gave her child what she believed to be a tea-spoonful of lime-water. About half an hour afterwards, while having his usual warm bath preparatory to being put to bed, she noticed that the child breathed hurriedly and was unusually drowsy. Fearing that some mistake had been committed, she immediately examined the bottles, but was unable to decide from which she had taken the dose. Being alarmed, how- ever, she persevered, with the assistance of her friends, in keeping the child awake. This was becoming a matter of some difficulty at 9 o'clock, when Mr Colahan returned home. He observed that the pupils were very much con- tracted; and, having heard the mother's account of what had happened, he examined the spoon, which retained the intensely bitter taste peculiar to the salts of morphia. Very properly concluding that the sopor was due to the administration of this drug, he endeavoured to excite vomiting by giving a drachm of Ipecaeuan Wine, and repeating the dose at intervals of twenty minutes, till four such doses had been given. Considerable retching followed.