194 MATERIA MEDIC A AND THERAPEUTICS. 



solid opium, morphia, or better still, cocleia, may be tolerated 

 in this disease, their effect on the nervous system being re- 

 markably absent whilst the diabetes is yielding. Acute 

 inflammatory and febrile diseases are now less frequently 

 treated with opium than formerly, when a combination with 

 calomel was generally used, the opium preventing the purgative 

 action of the mercurial, and the latter preventing constipation, 

 whilst both drugs were believed to act specifically on the morbid 

 process, reducing the local general circulation, alleviating pain 

 and restlessness, and promoting healing. The combination is, 

 however, very valuable in syphilis. In the specific fevers, 

 such as typhoid, opium given with judgment relieves delirium, 

 as we have seen, checks diarrhoea, and is invaluable in 

 hsemorrhage, perforation, or peritonitis. With quinia it is 

 given in some cases of malaria. Phagedsena may call for its 

 free exhibition. 



Opium is employed in obstetrics to prevent abortion, in 

 some varieties of difficult labour, and to relieve after-pains. 



5. REMOTE LOCAL ACTION AND USES. 



The excretion of morphia commences quickly, but may not 

 be completed for forty-eight hours. It passes out of the body 

 by most of the secretions, especially the urine, where it is found 

 mainly unchanged. The quantity of urine is diminished ; its 

 evacuation sometimes disturbed or difficult, from the local 

 action of morphia on the bladder ; and sugar occasionally 

 present. These facts, and the probability of the retention and 

 accumulation of morphia in the system if the action of the 

 kidneys be deficient, indicate the necessity to give it only with 

 the greatest caution, in reduced doses, or not at all, in renal 

 disorder or disease. 



Opium in passing through the skin may cause itching, 

 heat, and sometimes eruptions. The vessels are also dilated, as 

 we have seen, and the sweat glands decidedly stimulated ; both 

 being effects of its central, not local, cutaneous action. Thus 

 opium, especially in the form of Dover's powder, is a valuable dia- 

 phoretic, and is given with great success as a refrigerant apyretic 

 in the outset of catarrh, influenza, and mild febrile or rheumatic 

 attacks caused by cold. Under certain circumstances, Dover's 

 , powder actually checks the sweating of phthisis, probably by 

 removing its cause. Being excreted in the milk, opium must 

 be prescribed with caution to nursing females. 



6. ACTION AND USES OF THE PRINCIPAL CONSTITUENTS OF OPIUM. 



1. Morphia. The action of opium depends chiefly on 

 morphia, and the description just given applies so nearly to the 



