SPASMODIC AFFECTIONS. 



time, the use of opium retards or suspends the peristaltic mo- 

 tion so much, as to allow the intestines to fall into constrictions ; 

 and may therefore, while it relieves the pain, render the cause 

 of the disease more obstinate. On this account, .and further as 

 opium prevents the operation of purgatives so often necessary 

 in this disease, many practitioners are averse to the use of it, 

 and some entirely reject the use of it as hurtful. There are, 

 however, others who think they can employ opium in this dis- 

 ease with much advantage. 



In all cases where the colic comes on without any previous 

 costiveness, and arises from cold, from passions of the mind, or 

 other causes which operate especially on the nervous system, 

 opium proves a safe and certain remedy ; but in cases which have 

 been preceded by long costiveness, or where the colic, though not 

 preceded by costiveness, has however continued for some days 

 without a stool, so that a stagnation of faeces in the colon is to 

 be suspected, the use of opium is of doubtful effect. In such 

 cases, unless a stool has been first procured by medicine, opium 

 cannot be employed but with some hazard of aggravating the 

 disease. However, even in those circumstances of costiveness, 

 when, without inflammation, the violence of the spasm is to be 

 suspected, when vomiting prevents the exhibition of purgatives, 

 and when with all this the pain is extremely urgent, opium is 

 to be employed, not only as an anodyne, but also as an anti- 

 spasmodic, necessary to favour the operation of purgatives ; 

 and may be so employed, when, either at the same time with 

 the opiate, or not long after it, a purgative can be exhibited. 

 " If opium can be employed so as not to interfere with the 

 operation of purgatives, it may as an antispasmodic even fa- 

 vour the operation of these, and contribute to the cure of cer- 

 tain cases of colic. For this purpose some practitioners have ex- 

 hibited the opium and the purgatives at the same time ; but this 

 has been seldom found to answer ; and it has always appeared 

 better in the urgency of pain, to exhibit the opiate by itself; 

 and in four, five, or six hours after, when the power of it was 

 somewhat diminished, to exhibit the purgative. In this man- 

 ner of managing, it is commonly necessary to employ a purga- 

 tive of the powerful kind, and one that commonly operates soon 

 after its exhibition : and these considerations will, on the one 



