OPIUM  AND  ACETATE  OF  LEAD  IN  CHOLERA. 
173 
consisted  of  two  grains  of  acetate  of  lead  and  a  quarter  of  a 
grain  of  opium  made  into  a  mass  with  mucilage  ;  they  were  al- 
lowed to  dry  in  the  air.  Such  pills  required  more  than  an  hour 
to  soften  in  water,  and  they  were  then  far  from  being  dissolved. 
These  facts  are  unfavorable  to  the  choice  of  pills  as  a  form 
calculated  for  the  emergencies  of  cholera.  But  it  may  be  objected 
against  the  liquid  form,  that  the  stomach  will  not  retain  the 
remedy  in  that  state.  If  the  stomach  will  not  endure  a  teaspoonful 
of  a  liquid,  it  is  probable  that  it  will  not  retain  anything  ;  frequent 
repetitions  of  the  dose,  although  each  may  be  rejected,  will 
amount  at  least  to  the  continued  action  of  one  retained  dose.  If 
these  arguments  fail  to  convince,  it  will  probably  be  conceded 
that  if  pills  are  to  be  used,  they  should  be  made  immediately  be- 
fore they  are  wanted,  and  as  soft  as  is  consistent  with  retaining 
their  shape ;  in  a  few  hours  they  will  become  hard.  A  very 
small  bolus  were  still  better. 
We  have  now  to  consider  whether  the  combination  of  opium 
and  acetate  of  lead  is  not  open  to  a  chemical  objection  which 
ought  to  have  some  influence  with  the  practitioner.  Opium  con- 
sists of  a  variety  of  substances  ;  thirteen  at  least  are  known — 
viz.,  morphia,  codeine,  narcotine,  thebaine,  pseudomorphine, 
porphyroxine,  narceine,  papaverine,  meconine,  caoutchouc, 
coloring  matter,  sulphates,  and  meconic  acid.  The  two  last,  es- 
pecially, and  some  of  the  others,  decompose  acetate  of  lead. 
The  sulphate  and  meconate  of  lead,  and  some  of  the  other  com- 
pounds thus  produced,  are  insoluble.  Insolubility  is  a  great 
obstacle  to  the  exertion  of  medicinal  power ;  morphia  in  its  un- 
combined  state  is  scarcely  soluble,  and  hence  is  comparatively 
inactive ;  but  every  oue  knows  how  different  the  case  is  when  it 
is  rendered  soluble  by  combination  with  an  acid.  Sulphate  of 
barytes  is  insoluble  and  inert ;  but  the  soluble  salts  of  bary  tes 
are  poisons.  It  is  therefore  probable  that  the  insoluble  compounds 
formed  in  the  case  of  opium  and  acetate  of  lead  possess  activity 
in  a  very  inferior  degree.  Would  it  not  be  preferable  to  use  a 
formula  in  which  all  the  active  ingredients  are  allowed  to  act 
with  full  energy  ?  A  mixture  of  solution  of  acetate  of  lead  with 
solution  of  acetate  of  morphia  undergoes  no  decomposition,  and 
both  salts  would  act  without  any  diminution  of  power. 
