38 
Effects  of  Codeine. 
Am.  Jour.  Pharrru 
Jan.,  1S90. 
years.  The  majority  of  these  suffered  from  bronchitis  or  broncho- 
pneumonia, six  were  under  treatment  for  whooping-cough ;  the  re- 
mainder were  affected  with  cardiac  dyspnoea,  asthma,  or  phthisis. 
His  experience  leads  him  to  advocate  the  use  of  codeine  where  a 
milder  narcotic  than  morphia  is  wished  ;  and  although  he  thinks  that 
morphia  in  suitable  doses  may  be  given  with  safety  to  the  youngest 
children,  he  looks  upon  codeine  as  less  dangerous.  From  relatively 
large  doses,  as  for  example  of  a  grain  daily  to  a  child  nine 
months  old,  he  finds  no  unpleasant  effects,  and  2  grains  daily  were 
quite  harmless  in  adults.  He  holds  that  codeine  has  the  advantage 
over  morphia  in  not  causing  anorexia.  It  seems  in  some  cases  to 
increase  appetite,  probably  by  its  beneficial  influence  in  removing  dis- 
comfort. Whilst  relieving  irritation  it  does  not  cause  sickness  or 
catarrh,  and  slight  dizziness  and  moderate  headache  in  one  or  two 
cases  were  the  only  troubles  noticed  after  its  use.  It  may  produce 
its  effects  in  half  an  hour  or  not  for  several  hours. 
He  finds  codeine  most  useful  in  the  bronchitis  of  children,  and 
adults  with  no  fever  or  with  but  slight  rise  of  temperature.  Where 
there  is  much  fever,  rapid  breathing,  etc.,  it  gives  little  relief.  In  a 
case  of  "  pseudo-croup  "  he  found  it  without  benefit,  but  morphia 
also  failed  to  soothe.  In  phthisis  codeine  had  a  very  beneficial  effect, 
sound  sleep  following  its  use ;  the  appetite  increased,  while  the  cough 
became  somewhat  looser.  When  Dover's  powder  replaced  the  codeine 
the  same  relief  followed,  but  the  appetite  Avas  decreased.  In  an 
anaemic  individual  and  in  a  case  of  chronic  bronchitis  Dover's  powder 
caused  vomiting,  codeine  did  not.  Codeine  was  found  quite  useless 
in  an  early  stage  of  phthisis,  but  a  Dover's  powder  also  was  of  no 
service.  Here  morphia  in  i  to  §  of  a  grain  daily  quieted  the  irri- 
tating cough  without  producing  unpleasant  effects  or  sleep.  In  a  case 
of  asthma  codeine  was  completely  useless,  whilst  chloral  hydrate  given 
on  successive  nights  seemed  to  prevent  the  attacks.  In  phthisis  or 
heart  affections  the  only  effect  of  codeine  was  to  relieve  cough,  but  it 
was  without  injurious  effect  on  the  circulation.  Out  of  five  cases  of 
whooping-cough  in  which  codeine  was  tried  it  was  completely  useless 
in  four. 
The  doses  of  codeine  given  by  Rheiner  were  small ;  ^  to  of  a 
grain  in  infants  under  one  year,  and  from  the  ^  to  J-0-  of  a  grain  up 
to  five  years,  whilst  to  adults  from  J  to  h  a  grain.  On  the  whole, 
the  observations  do  not  help  much  in  the  estimation  of  the  relative 
