INDICATIONS FOR THE INTERNAL USE OF OPIUM: 369 



by astringents, alkalies, mineral acids, and intestinal antisep- 

 tics in various combinations suited to the particular case. 



Peritonitis, enteritis, and acute obstruction of the bowels 

 are treated most successfully -with opium, which quiets the 

 bowels, relieves pain and facilitates the vis medatrix naturse, 

 besides acting as an antiphlogistic in the first-mentioned 

 diseases. By preventing muscular activity and allaying 

 general excitability, opium is the most effective haemostatic 

 in all internal hemorrhages, and it quiets the heart most 

 effectively in. acute endocarditis. 



Cough, as a symptom of irritation within the res- 

 piratory tract, is more commonly treated by some form of 

 opium than by any other drug. When cough is irrita- 

 tive or excessive, and is not remedial in removing secre- 

 tion, then it is very properly controlled by opium. If, 

 on the other hand, respiratory movements are weak, or 

 cyanosis threatens from retained secretions, opium is dis- 

 tinctly contraindicated, since it depresses the respiratory 

 centres and lessens the irritation produced by the secre- 

 tions in the bronchial tubes, which would otherwise cause 

 coughing and expulsion of the exudate. 



Opium, especially when combined with belladonna, 

 notably diminishes secretions, so that this combination is 

 peculiarly appropriate in the treatment of cough and exuda- 

 tion, and it is only when increasing moist rales are found to 

 exist during this medication that it should be stopped. 

 Pleuritic cough causes intense pain and accomplishes 

 nothing, so that opium here affords great relief without 

 inducing bad results. . 



4 Opium possesses antiphlogistic action in aborting 

 and combating inflammation. Reflex excitability is less- 

 ened by opium, and therefore irritation of nerve centres, 

 which would otherwise cause vascular dilatation, stasis, and 

 inflammation, is prevented by the drug. This is at least 

 the theory. Opium and quinine are the two remedies having 

 the most popular clinical reputation for aborting colds and 

 inflammation, and the latter agent also diminishes reflex 

 excitability. Inflammation of sferous membranes is thought 



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