On the use of codeine to relieve pain in abdominal disease / by T. Lauder Brunton.
- Brunton, Thomas Lauder, Sir, 1844-1916.
- Date:
- 1888
Licence: Public Domain Mark
Credit: On the use of codeine to relieve pain in abdominal disease / by T. Lauder Brunton. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![[Reprinted for the Author from the British Medical Journal, June 9,1888.] By T. LAUDER BRUNTON, M.D., F.R.S. Lecturer on Materia Medica and Therapeutics, and Assistant Physician, St. Bartholomew’s Hospital. 1 had intended to bring the subject of this paper before the British Medical Association at its last meeting, but I was unfor- tunately prevented from attending, and delayed publication of this paper for several reasons, one of which was the desire to ob- tain a larger experience of the utility of the drug. The relief of pain may be classed next to the saving of life, and must perhaps sometimes be even put before it as the chief duty of the physi- cian. As yet no drug has taken the place of opium as a general analgesic, though the use of crude opium is now frequently re- placed by the subcutaneous injection of morphine, the most active of the alkaloids it contains. In abdominal pain many practi- tioners still have a preference for the use of opium, as compared with that of morphine, and this very preference is sufficient to make one ask whether it may not have some foundation in the pre- sence of other active principles along with morphine in opium, and if so, to inquire which active principle it is that helps to allay pain. Thanks to its recommendation by Dr. Pavy, codeine is largely used in the treatment of cases of diabetes, but at present its use is almost confined to this disease, and it is rarely employed for other purposes, excepting perhaps that of soothing cough or irri- tation in the throat. Codeine was discovered by Robiquet in 1832, and two years afterwards its action was tested upon himself by Gregory,1 who found that instead of causing sleep, it rather caused excite- ment, and had also a slight laxative tendency. It was applied therapeutically by Barbier2 in 1834, who noticed that it seemed to have a special action upon the sympathetic system, and found that it was of great use in lessening pain in persons presenting symptoms of irritation in the solar plexus. Such symptoms are pain in the epigastrium, spreading to the sides and back, and associated with a feeling of burning, anxiety, depression, more or les3 tenderness of the epigastrium, with sighing, lack of energy and tendency to faint. Occasionally the pain may cause sym- Stoms of collapse, palpitation, and vomiting. In such cases arbier gave a grain of codeine in a tablespoonful of syrup, and repeated it if necessary in one or two hours with the best results. From his observations he came to the conclusion that codeine 1 Gregory, Joum. de Pharm., February, 1834.](https://iiif.wellcomecollection.org/image/b22429505_0003.jp2/full/800%2C/0/default.jpg)
