250 
ON  THE  EMPLOYMENT  OF  NARCEINE. 
nervous  system  appears  to  resemble  that  of  other  narcotics,  and 
produces  its  effects  directly  when  used  hypodermicallv,  and  in- 
directly, by  acting  on  the  centres,  when  given  internally.  The 
repeated  use  of  internal  doses  often  produces  from  one  to  two 
stools,  sometimes  even  diarrhoea.  On  the  other  hand,  it  appears 
to  retard  the  appearance  of  the  menses.  M.  Eulenburg  con- 
cludes that,  for  sedative  and  hypnotic  effects,  narceine  is  pre- 
ferable to  every  other  substance.  Besides  its  employment  in  some 
essentially  neuralgic  affections,  its  use  is  indicated  in  all  cases 
where  pain  is  a  prominent  symptom,  as  in  articular  affections, 
phlegmons,  ocular  lesions,  (iritis,  keratitis,  etc.),  orchitis,  blen- 
norrhagic  epididymitis,  cystitis  cirrhosis  of  the  liver,  and 
in  wounds,  or  after  painful  operations.  In  all  these  cases,  nar- 
ceine, when  employed  either  internally  or  externally  in  the  doses 
before  mentioned,  rapidly  lessens  the  pain,  and  often  produces 
a  sleep  of  four,  five,  and  even  nine  hours, — sleep  which  is  soft, 
tranquil,  uninterrupted,  and  followed  by  a  quiet  awaking. 
These  doses  never  give  rise  to  any  derangements  or  any  poisonous 
effects.  Although,  by  the  use  of  morphia,  in  numerous  cases 
we  obtain  the  same  effects,  it  often  fails;  many  diseases  (es- 
pecially among  women)  present,  in  fact,  a  kind  of  idiosyncrasy 
which  renders  the  employment  of  morphia  impossible ;  thus, 
by  its  internal  use  vomiting  is  produced,  or  else  the  medicine 
causes,  instead  of  a  refreshing  sleep,  a  state  of  great  excitement, 
with  distressing  dreams,  delirium,  and  convulsions ;  while,  in 
some  other  diseases,  morphia,  without  appreciable  cause,  pro- 
duces only  a  very  slight  effect,  or  one  of  very  short  duration. 
The  hypodermic  employment  of  morphia  renders  it  more  active 
and  more  trustworthy,  but  it  increases  in  a  like  degree  all  the 
inconveniences,  and  often  gives  rise  to  cephalalgia,  faintings, 
vomitings,  or  profound  collapse ;  often  the  sleep  is  very  pro- 
longed (according  to  Semeleder,  fifty-four  hours) ;  and  sometimes 
the  effects  of  morphia  are  prolonged  even  for  some  days  after 
the  awaking. 
Narceine,  as  an  anodyne  and  narcotic,  may  be  always  employed 
in  place  of  morphia,  and  is  in  every  respect  equal  to  it  in  value, 
and  even  in  a  great  many  cases  is  to  be  preferred  to  it. 
M.  Eulenberg  has  not  as  yet  had  many  opportunities  of  em- 
