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Analgesia
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The question considered : is it justifiable to administer chloroform in surgical operations, after its having already proved suddenly fatal in upwards of fifty cases, when pain can be safely prevented, without loss of consciousness, by momentary benumbing cold? / by James Arnott.
Arnott, James (James Moncrieff), 1794-1885.Date: 1854
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Papaver somniferum L. Papaveraceae Opium Poppy Distribution: Asia minor, but has been dated to 5000BC in Spanish caves. Now grows almost everywhere. The oldest medicine in continuous use, described in the Ebers' papyrus (1550 BC), called Meconium, Laudanum, Paregoric and syrup of poppies. Culpeper (1650) on Meconium '...the juyce of English Poppies boyled till it be thick' and 'I am of the opinion that Opium is nothing else but the juyce of poppies growing in hotter countries, for such Opium as Authors talk of comes from Utopia.[he means an imaginary land, I suspect]’]. He cautions 'Syrups of Poppies provoke sleep, but in that I desire they may be used with a great deal of caution and wariness...' and warns in particular about giving syrup of poppies to children to get them to sleep. The alkaloids in the sap include: Morphine 12% - affects ?-opioid receptors in the brain and causes happiness, sleepiness, pain relief, suppresses cough and causes constipation. Codeine 3% – mild opiate actions – converted to morphine in the body. Papaverine, relaxes smooth muscle spasm in arteries of heart and brain, and also for intestinal spasm, migraine and erectile dysfunction. Not analgesic. Thebaine mildly analgesic, stimulatory, is made into oxycodone and oxymorphone which are analgesics, and naloxone for treatment of opiate overdose – ?-opioid receptor competitive antagonist – it displaces morphine from ?-opioid receptors, and constipation caused by opiates. Protopine – analgesic, antihistamine so relieves pain of inflammation. Noscapine – anti-tussive (anti-cough). In 2006 the world production of opium was 6,610 metric tons, in 1906 it was over 30,000 tons when 25% of Chinese males were regular users. The Opium wars of the end of the 19th century were caused by Britain selling huge quantities of Opium to China to restore the balance of payments deficit. Laudanum: 10mg of morphine (as opium) per ml. Paregoric: camphorated opium tincture. 0.4mg morphine per ml. Gee’s Linctus: up to 60 mg in a bottle. J Collis Browne’s chlorodyne: cannabis, morphine, alcohol etc. Kaolin and Morph. - up to 60 mg in a bottle. Dover’s Powders – contained Ipecacuana and morphine. Heroin is made from morphine, but converted back into morphine in the body (Oakeley, 2012). One gram of poppy seeds contains 0.250mgm of morphine, and while one poppy seed bagel will make a urine test positive for morphine for a week, one would need 30-40 bagels to have any discernible effect. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
Dr Henry Oakeley- Books
Pain and sensory symptoms / [written by James Bailey ;edited by Sarah Westlake].
Bailey, James.Date: 2006- Books
The conquest of pain / Peter Fairley.
Fairley, Peter, 1930-Date: 1978- Books
Cancer pain management / edited by Deborah B. McGuire and Connie Henke Yarbro.
Date: [1987], ©1987