174 
OPIUM  AND  ACETATE  OF  LEAD  IN  CHOLERA. 
But  acetate  of  morphia  is  not  the  representative  of  opium ; 
beside  morphia,  opium  contains  codeine,  an  efficient  sedative  and 
hypnotic.  Codeine  exerts  a  specific  action  on  the  semilunar 
ganglion  and  solar  plexus  which  supplies  the  intestinal  canal, 
and  on  the  branches  of  the  great  sympathetic,  which,  with  so 
many  others,  supplies  the  stomach.  In  its  pure  state  codeine  is 
much  less  active  than  when  combined  with  an  acid.  It  should 
therefore  be  employed  in  the  state  of  an  acetate ;  for  this  salt 
does  not  decompose  acetate  of  lead ;  the  dose  may  be  an  eighth 
of  a  grain,  repeated  at  intervals. 
Dr.  Gregory's  hydrochlorate  of  morphia-and-codeine  would  be 
an  admirable  sedative  with  acetate  of  lead  but  for  the  production 
on  mixture  of  the  difficulty  soluble  chloride  of  lead. 
But  it  is  said  that  acetate  of  morphia  is  sometimes  of  uncertain 
effect,  on  account  of  the  spontaneous  evolution  of  a  portion  of 
its  acetic  acid,  and  even  its  partial  decomposition  by  water.  To 
obviate  this  loss  of  power,  if  such  take  place,  some  free  acetic 
acid  should  be  added  to  the  mixture.  Such  addition  is  also  ad- 
visable on  another  account ;  acetate  of  lead  sometimes  contains 
carbonate  of  lead,  and  this  is  believed  to  be  the  most  noxious 
portion  of  the  salt ;  but  the  carbonate  cannot  exist  in  presence 
of  acetic  acid.  Little  fear  need  be  entertained  about  the  action 
of  acetate  of  lead  thus  purified :  Sir  Henry  Marsh  informs  me 
that  he  has  frequently  given  twelve  grains  in  the  day  in  three- 
grain  doses,  and  never  could  perceive  any  ill  effect;  larger  doses 
have  been  reported  by  others. 
The  following  will  afford  a  liquid  representative  of  opium  and 
acetate  of  lead  : — 
Take  of 
Acetate  of  lead    ....    Two  grains. 
Acetate  of  morphia 
Acetate  of  codeine 
Distilled  vinegar  . 
Distilled  water .  . 
One-twelfth  of  a  grain. 
One-eighth  of  a  grain. 
Half  a  drachm. 
One  drachm. 
Mix  for  a  draught.  Such  draughts  commence  their  action  as 
soon  as  swallowed ;  they  may  be  repeated  at  proper  intervals ; 
or  immediately,  if  rejected  from  the  stomach  Annals  of 
Pharmacy,  Dec.  1854. 
