On the antagonism between medicines and between remedies and diseases : being the Cartwright Lectures for the year 1880 / by Roberts Bartholow.
- Roberts Bartholow
- Date:
- 1881
Licence: Public Domain Mark
Credit: On the antagonism between medicines and between remedies and diseases : being the Cartwright Lectures for the year 1880 / by Roberts Bartholow. Source: Wellcome Collection.
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![by the month brought on suffocative attacks. Half a grain of sulphate of mor- phia was then given subcutaneously. The effect of this was a scarcely percepti- ble contraction of the pupil, reduction of the respiration to 20, slight stertor, no change in the pulse. The stomach-pump was then used, the faradaic current was applied, and artificial respiration was carried on. After the stomach was washed out, whisky and ammonia were injected. At 12 m., a third injection of a half grain of morphia was inserted under the skin. In fifteen minutes the res- piration was at 14, but very decidedly stertorous j the pulse 102, full, but rather weak. On account of the stertor, no more morphia was given, and the treat- ment subsequently consisted of flagellation, artificial respiration, and faradiza- tion. Whenever artificial respiration was suspended, the breathing became labored, and threatened to cease entirely. At 6.30 p. m., however, the breathing became more natural, and at 7.45 all the measures were suspended, as the patient appeared to be in a quiet sleep, respiration 18, pulse 108, weak, but of pretty good volume. At 8.45 p. m. the respiration increased, rales became audible in the chest, the face turned livid, and respiration was about to cease, when the measures before used were resorted to, and veratria ointment was in addition vigorously rubbed in over the spine and chest. At 9 p. m. the pulse was at 128, respiration 28, and she executed various voluntary movements when hurt by the flagellation. At 10 p. m. she cried out, “ Oh, my! ” and turned on ber side. At 11 p. m., in response to the question, she replied that she was “ better.” Ar- tificial respiration had been kept up at intervals. Some urine was drawn off, and a small quantity was injected into the family cat, producing decided dilata- tion of the pupil. At 11.10 p. m. symptoms of suffocation suddenly set in, and, notwithstanding the vigorous application of the methods before used, she soon expired. At the autopsy, the superficial veins of the body were found gorged, and there were extensive suggillations posteriorly. The veins of the brain were very full, there was much serum in the sub-arachnoid space, and the cerebral tissue was generally softened [by imbibition, probably]. The lungs were deeply congested, and the tissue of the heart was soft and easily torn. Commentary: Although I have placed this among the unsuc- cessful examples of atropia poisoning treated by morphia, it can only be so regarded with some distinct limitations. The quantity of morphia required to antagonize such a dose of atropia is hardly less than six grains. The first injection was given in three hours after the atropia was taken, the last one in four hours, and nearly twelve hours before death. After the first injection the pulse was reduced to 108, the trismus had ceased, the skin was cool and moist, and the respirations were 20, without stertor. These were very fa- vorable indications, and were produced by one half a grain of mor- phia only. Under these circumstances, it seems to me it would have been better to await the further antagonistic action of morphia, for, although the amount given was insufficient to antagonize the quantity of atropia taken, it will be shown hereafter that the con- dition of the respiration and circulation was such as to justify the](https://iiif.wellcomecollection.org/image/b28059220_0031.jp2/full/800%2C/0/default.jpg)
