CHLORODYNE AND ITS INVESTIGATORS. 
631 
regards the actual composition of this remedy, and the same objection may be 
made to “A Provincial’s” reasoning, which he brings against Dr. Dowse (in 
regard to belladonna), viz. “ We must not draw too large inferences from a 
solitary case.”* His suggestion, however, that chlorodyne contains two ingre¬ 
dients which tend respectively to contract and expand the pupil, and so ba¬ 
lance and neutralize each other,” is, no doubt, as Dr. Dowse remarks, a rational 
conjecture ; but this, instead of following from and supporting his reasoning, 
appears to be in direct contradiction to it. . 
2. “ Chlorodyne judged Physiologically.”—In this valuable communication 
to the Journal for November last, Dr. Dowse objects to the statement of u A 
Provincial,” “that the efficacy of chlorodyne is due to morphia modified by 
chloroform.”— u On the contrary,” he says ; “lam quite certain this is not 
the case.” He attributes its efficacy to opium, or rather morphia, modified by 
belladonna. (Perhaps we should rather say to belladonna modified by morphia.) 
On reading his paper I was struck with the coincidence between his remarks 
and the opinion I have long entertained as to the composition of this remedy. 
The case he brings forward seems to bear out pretty conclusively his account of 
the active ingredients contained in chlorodyne, which, with one or two slight 
modifications given below, I have good reason for believing to be correct.i" 
It is, moreover, highly probable that the theory Dr. Dowse suggests as to the 
action of this medicine is the right one. Its normal effects are, no doubt, produced 
by a balance between substances that, when separately administered, give rise 
to opposite results. Such a balance appears to exist in the case of opium and 
belladonna, which, as Dr. Dowse shows, are entirely opposed in their action on 
the system. It might be expected, therefore, that when combined, they should 
be mutually counter-active and antipathic. Not that they neutralize each other, 
but produce a mean effect; in some respects increasing each other s action, in 
others lessening it. It is, I believe, generally admitted that this is the case, and 
that the action of belladonna is masked, as to its injurious or dangerous fea¬ 
tures, by the administration of opium. On this point I may refer to a course 
of three lectures, delivered at the Royal College of Physicians, in the spring of 
1868, by Dr. John Harley, which have been brought under my notice by a me¬ 
dical’ friend. In these lectures it is maintained that opium and belladonna 
(taken in combination) do not antagonize each other’s action, but, on the con¬ 
trary, produce heightened effects, both stimulant and narcotic. At the same 
time, belladonna counteracts the nauseant effect so frequently produced by 
opium given internally, or occasionally even by morphia injected subcutane¬ 
ously.^ It is in this way probably that the efficacy of chlorodyne, in ordinary 
* Had the morphia solution been substituted for chlorodyne after a few weeks’ trial, the re¬ 
sult would probably have been different; at any rate the inference drawn from it would have 
ha + My observation would lead me to modify the list of ingredients given by Dr. Dowse, as 
follows, substituting (as he suggests) tobacco for Indian hemp, and adding sulphuric ethei: 
Chlorof inn. 
Hydrochlorate of Morphia. 
Extract of Belladonna. 
Hydrocyanic Acid. 
Tobacco. 
Capsicine. 
Sulphuric Ether. 
Ess. of Peppermint. 
Water (or Spirit and Water) and 
Treacle. 
I To support the statement that the action of belladonna with opium is not antagonistic, 
one experiment (out of many) was as follows: - . , _• j 
(1.) One-twelfth grain of sulphate of atropia, given alone, produced m one hour (hesides 
other results) acceleration of the pulse by twenty-eight beats, and full dilatation of the 
PU (2.) Four grains of morphia, given alone, caused, in one hour (besides other effects), accele¬ 
ration of the pulse by twenty and twenty-eight beats, and contraction ot the pupils. 
(3.) Four grains of morphia given with one-twelfth gram ot sulphate ot atropia, pioduced 
