ANTIDOTES 479 



The spinal cord is more notably affected than the brain ; 

 vomiting, nausea, restlessness, and delirium are the usual 

 symptoms. 



Post-mortem examination discovers the results of 

 asphyxia. The blood is fluid and dark-coloured, but it 

 does not yield on analysis any indications of the poison. 

 There is general venous engorgement ; the lungs and 

 brain are markedly congested. The ventricles of the brain 

 and subarachnoid spaces contain more fluid than usual. 



ANTIDOTES. Opium is not very quickly absorbed ; when 

 a poisonous dose has been swallowed, the stomach should 

 be emptied as soon as possible, preferably by the stomach 

 pump, and washed with solution of potassium permanganate. 

 Administration of nitrites, and of small doses of atropine, 

 hypodermically, maintain cardiac action ; but the atropine 

 must be used cautiously, as full doses are apt to intensify 

 paralysis both of the heart and cord. Even better than 

 atropine is caffeine, and the lethal tendency can be further 

 combated by strychnine, used hypodermically, and by arti- 

 ficial respiration. Coma is prevented by giving strong 

 coffee and stimulant enemata, and keeping the patient 

 moving. Tincture of galls and other chemical antidotes 

 are of little avail. 



MEDICINAL USES. Opium and morphine are used to 

 relieve symptoms rather than to remove the conditions 

 on which they depend. Small doses are nerve stimulants, 

 and retard digestion and metabolism. The Cutch horsemen 

 share their opium with their jaded steeds, and increased 

 capability of endurance is observed alike in man and beast. 

 In the lower animals, as already indicated, they do not 

 produce the general calmative and hypnotic effects which 

 characterise their use in man. In human patients opiates 

 cause notable vascular dilatation in the skin, and hence 

 relieve congestion and inflammation (Brunton). But in 

 the lower animals this vascular dilatation occurs only when 

 toxic doses are used (Frohner), and accordingly the anti- 

 pyretic and anti-inflammatory power of opiates must be 

 considerably less than in man. Moreover, owing to the 

 greater excitant action in veterinary patients, the adminis- 

 tration of opium does not blunt the perception of pain as 



