594  Pellets  for  Hypodermic  Medication,    { '"D^'xrso"™ 
quantities,  and  not  always,  at  the  pressure  of  the  moment  to  relieve 
pain,  well  or  easily  removed  from  the  paper  in  which  they  are  con- 
tained, even  if  they  should  not  have  been  previously  partly  spilled  in 
the  pocket  or  pocket-case  of  the  physician.  The  morphia  salt  in  this 
form  is  also  subject  to  the  action  of  atmospheric  moisture  or  the 
warmth  of  the  body,  and  forms  as  a  consequence  a  concrete  mass  not 
easily  dissolved,  if  not  actually  deteriorated. 
Impressed  by  these  objections,  my  attention  was  recently  called  by 
my  friend  Dr.  H.  Augustus  Wilson  to  the  advisability  of  making  the 
powders  into  small  pills,  which  I  accomplished  by  an  admixture  of  an 
equal  quantity  of  white  sugar  and  a  little  water. 
These  granules  so  prepared,  however,  were  not  readily  soluble  ;  the 
sugar,  besides,  increased  the  burning  sensation  already  experienced  in 
subcutaneous  injections. 
With  a  view  of  increasing  the  solvent  action  of  the  vi^ater  on  the 
surface  of  the  powder,  I  had  constructed  a  small  pill  press  on  the  plan 
suggested  and  described  by  Prof.  Remington  (''Amer.  Jour.  Pharm.," 
March,  1876,  page  97),  and  with  it  overcame  the  mechanical  obstacle, 
while  we  were  soon  led  to  substitute  sodium  chloride  for  the  sugar  as 
a  disintegrator  (properly  so  styled  by  Dr.  Wilson  in  his  paper  recently 
read  on  this  subject  before  the  "  Philadelphia  County  Medical  Society"), 
which  in  dilute  solutions  is  painless  and  devoid  of  irritant  action  when 
applied  to  mucous  surfaces,  forming  as  it  does  a  principal  ingredient  of 
the  liquids  of  the  organism. 
As  morphia  sulphate,  however,  seemed  to  dissolve  badly  and  tardily 
in  a  solution  of  sodium  chloride,  we  adopted  in  its  place  the  hydro- 
chlorate  of  that  alkaloid,  already  suggested  by  Trousseau  for  hypoder- 
mic injections,  and  recommended  by  English  authors,  amongst  whom 
Christison  "  gave  it  the  preference,  because  he  attributed  to  it  a  more 
constant  action,  unaccompanied  by  unpleasant  symptoms. 
With  these,  and  by  means  of  the  pill  press,  we  obtained  pellets  form- 
ing rapidly  clear  solutions  in  a  little  water,  while  by  the  presence  of 
the  sodium  chloride  the  burning  pain  of  the  injection  seemed  to  be  con- 
siderably diminished,  and  its  absorption,  probably  due  to  the  crystalloid 
nature  of  the  salt  and  its  superior  difFusibility,  seemed  to  be  promoted. 
(Pellets  here  exhibited.) 
The  full  effect  of  a  hypodermic  injection  of  morphia  is  usually 
experienced  in  from   12  to   15  minutes,  whereas  by  the  use  of  these 
