On the antagonism between medicines and between remedies and diseases : being the Cartwright Lectures for the year 1880 / by Roberts Bartholow.

  • Bartholow, Roberts, 1831-1904.
Date:
1881
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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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    more striking than its favorable influence on the respiration. Dr. Johnston, of Shanghai, whose experience of opium poisoning has reached to hundreds of cases, says that the effect of the atropia is simply marvelous in stimulating the respiratory function and remov- ing the carbonic-acid narcosis. In the fatal case of atropia poison- ing narrated by Dr. Gross, the injection of morphia induced stertor. I have already suggested that the more gradual introduction of the morphia influence would have prevented this accident, which seems to have been an idiosyncrasy, rather. In a case narrated by Dr. Fothergill,* the influence of the antagonist on the respiratory func- tion is most conspicuous. A woman had taken, at 11 A. m., lauda- num containing from 12 to 17 grains of opium. At 2 p. M. the respiration was almost gone, but the pulse, though small, was rhyth- mical and regular. One grain of sulphate (of atropia was then injected subcutaneously. In a half hour the respiration was becom- ing well established, and, in an hour and a half after the injection, was going on steadily, 13 to the minute, and long and deep. ISTo further use of the antagonist was necessary to overcome the effects of the poison. It is probable, indeed, that the quantity of atropia used was rather in excess, as an emetic had caused the discharge of some opium, and the subsequent account shows a preponderating action of atropia. An equally instructive ease, as showing the power of atropia to overcome the respiratory depression caused by morphia, is narrated by Dr. McGee.f A stout, muscular man of 40 years swallowed 30 grains of opium in 10 or 12 ounces of whisky. He became profoundly comatose. In two hours an eighth of a grain of atropia was injected, and, this having no effect, in a half an hour the same quantity was repeated. The respirations were then nearly suspended, the face being livid, but under the influence of the atropia the respirations increased greatly ; the pulse rose to 140, the pupils became widely dilated, and consciousness was so far restored that the patient could be roused. He then slept profoundly for a number of hours, but his pulse continued at 81, with the res- pirations full and deep, and Dr. McGee, wisely trusting to the antagonistic action, did not exhaust his patient by ambulation, fla- gellation, artificial respiration, and other ingenious devices for keep- ing awake those who need the restorative effects of sleep and quiet. I might narrate many examples from the collection of cases made for this study, showing the importance of the antagonism exerted * “ The Antagonism of Therapeutic Agents.” Philadelphia: IT. C. Lea, 1878, p. 132. f “Am. Jour, of the Med. Sci.,” July, 1869, p. 282.