308 poisons : their effects and detection. [§ 367 . 
narcotic effects may be produced by external applications, whether a 
wound is present or not. A case of absorption of opium by a wound is 
related in Chever’s Jurisprudence. 1 A Burmese boy, about 9 or 10 years 
of age, was struck on the forehead by a brickbat, causing a gaping 
wound about an inch long ; his parents stuffed the wound with opium. 
On the third day after the accident, and the opium still remaining in the 
wound, he became semi-comatose, and, in short, had all the symptoms 
of opium narcosis ; with treatment he recovered. The unbroken skin 
also readily absorbs the drug. Tardieu states that he has seen 30 grms. 
of laudanum, applied on a poultice to the abdomen, produce death. 
Christison has also cited a case in which a soldier suffered from erysipelas 
and died in a narcotic state, apparently produced from the too free 
application of laudanum to the inflamed part. 
To these cases may be added the one cited by Taylor, in which a 
druggist applied 30 grains of morphine to the surface of an ulcerated 
breast, and the woman died with all the symptoms of narcotic poisoning 
ten hours after the application—an event scarcely surprising. It is a 
curious question whether sufficient of the poison enters into the secre¬ 
tions— e.g. the milk—to have a poisonous effect. An inquest was held 
in Manchester, November 1875, on the body of a male child 2 days 
old, in which it seemed probable that death had occurred through the 
mother’s milk. She was a confirmed opium-eater, taking a solid ounce 
per week. 
§ 367. Diagnosis of Opium Poisoning. —The diagnosis is at times 
between poisoning by opium or other narcotic substances ; at others, 
between opium and disease. Insensibility from chloral, from alcohol, 
from belladonna or atropine, and from carbon monoxide gas are all more 
or less like opium poisoning. With regard to chloral, it may be that only 
chemical analysis and surrounding circumstances can clear up the matter. 
In alcohol poisoning, the breath commonly smells very strongly of 
alcohol, and there is no difficulty in separating it from the contents of 
the stomach, etc. ; besides which the stomach is usually red and inflamed. 
Atropine and belladonna invariably dilate the pupil, and although just 
before death opium has the same effect, yet we must hold that mostly 
opium contracts, and that a widely dilated pupil during life would, per se, 
lead us to suspect that opium had not been used, although, as before 
mentioned, too much stress must not be laid upon the state of the pupils. 
In carbon monoxide, the peculiar rose-red condition of the body affords a 
striking contrast to the pallor which, for the most part, accompanies 
opium poisoning. In the rare cases in which convulsions are a prominent 
symptom, it may be doubtful whether opium or strychnine has been 
taken ; but the convulsions hitherto noticed in opium poisoning seem to 
have been rather of an epileptiform character, and very different from the 
1 Third ed., p. 228. 
