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THE POPULAR SCIENCE MONTHLY 



bear. An excessive quantity of morphia 

 given by the mouth may be removed if the 

 accident is discovered immediately, but the 

 only resource in case of excessive injection 

 lies in antidotes, the operation of which is 

 very uncertain. According to the collection 

 of facts on this subject which has been pub- 

 lished by Dr. Kane, of this city, the smallest 

 single dose which has appeared to have alone 

 been the cause of death was a quarter of a 

 grain. In a case in which death apparently 

 resulted from the administration of a twelfth 

 of a grain by the skin, a quarter of a grain 

 had previously been given by the mouth. In 

 three of the cases cited by Dr. Kane, includ- 

 ing one in which a quarter of a grain caused 

 death, the patients were suffering from de- 

 lirium tremens ; in the majority of the cases 

 the fatal effect was due to the repetition of 

 the hypodermic injection, or to its employ- 

 ment after a fair dose of opium had been 

 given by the mouth. It is impossible to 

 predict, or to estimate with any approach to 

 safety, what the effect of an injection will 

 be. Tolerance of opium by the mouth does 

 not prove that it will be tolerated equally 

 well by the skin ; and tolerance of morphia 

 by hypodermic injection at one time is no 

 ground for inferring that at another time 

 the same dose would be equally well borne. 

 The use of morphia is peculiarly dangerous 

 in certain morbid states, foremost among 

 which is alcoholism. The existence of 

 chronic Bright's disease increases the dan- 

 ger, as does also the existence of disease of 

 the heart or lungs, interfering with circula- 

 tion and respiration. The fact also seems 

 to be established that the existence of se- 

 vere pain does not render large doses better 

 borne. Atropine is capable to some extent 

 of counteracting the influence of morphia, 

 but can not be relied upon alone. It needs 

 to be supplemented by other remedies, and 

 is assisted by the hypodermic injection of 

 strychnia. It also will kill, and should not 

 be used in a larger proportion than one 

 twenty-fifth of a grain of atropine to every 

 grain of morphia. Strychnia should not be 

 used in a larger total quantity than one twen- 

 tieth of a grain, and a much smaller dose 

 should be first administered. Artificial res- 

 piration, electricity, and coffee or caffeine, 

 remedies in common use, may also be neces- 

 sary in addition. Whenever there is rea- 

 son to think that the injection has been di- 



rectly into a vein, the circulation in the limb 

 should be arrested by a ligature above the 

 place of injection ; and the " Lancet " sug- 

 gests that it is possible, when the fact of an 

 overdose is at once discovered, that some- 

 thing may be done by local treatment to ar- 

 rest absorption. The whole of the morphia 

 can hardly be taken up instantaneously, and 

 it is probable that, if a ligature were at once 

 placed on the limb, an incision made through 

 the skin at the scat of the injection, and the 

 part freely washed, or even freely cauter- 

 ized, the amount of morphia absorbed might 

 be reduced to so small a degree that it would 

 be possible to antagonize it, and thus save 

 the patient's life. 



Sanitary Perils at Watering-PIaces. 



The " Lancet" has uttered a warning against 

 the sanitary dangers to which populous 

 health resorts are liable, which receives sup- 

 port from several incidents that have hap- 

 pened within a few years past. It is incum- 

 bent upon every one who goes to the sea- 

 side, to take care that he does not leave a 

 comparatively healthy home to seek recrea- 

 tion in a place which may be a nursery of 

 disease. Watering-places are peculiarly 

 liable to have two kinds of perils : to the 

 danger that infection may be brought to 

 them by visitors, and to the risks that may 

 arise from the insufficiency of their sanitary 

 arrangements to meet the demands that are 

 made upon them by the accession of large 

 crowds. It has sometimes happened that, 

 as soon as a child has become convalescent 

 from an infectious disease, it has been hur- 

 ried off to the seaside, and been received 

 at lodgings without question. The sanitary 

 precautions now carried out at many places 

 make this a matter of more difficulty than 

 formerly, but the danger is still hardly di- 

 minished that arises from sending off the 

 unaffected members of an affected family to 

 the seaside as soon as contagious disease 

 breaks out. The " Lancet " tells of a case 

 as having come under its own notice, in 

 which, when a child was taken ill with a 

 sore-throat of a suspicious character, an- 

 other child in the family was sent to the 

 seaside, was taken ill with diphtheria on 

 the day after his arrival, and communicated 

 the disease to other children with whom he 

 had played. When disease breaks out in 

 the height of the season, the fact is apt to 



