On the action of apomorphine and apocodeine : with reference to their value as expectorants in the treatment of chronic bronchitis / by William Murrell.

  • Murrell, William, 1853-1912.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: On the action of apomorphine and apocodeine : with reference to their value as expectorants in the treatment of chronic bronchitis / by William Murrell. 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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    cough. He recommends it hypodermically in doses of i grain and by the mouth in doses of } grain. I have been unable to find any other account of the use of the drug in the treatment of disease. In 1881, whilst working at apomorphine, I made some ob- servations with apocodeine with the view of ascertaining its possible value as an emetic in cases of poisoning. I took care to obtain a reliable specimen, and administered to two patients hypodermically 16 minims of a freshly prepared 1 in 60 solution, but without exciting either nausea or vomiting. Both patients vomited promptly after an injection of 6 minims of a 1 in 60 solution of hydi-oclilorate of apomorphine. The hydrochlorate of apocodeine employed was amorphous. During the last few months I have repeated these observa- tions. A patient, aged 48, was under my care suffering from chronic bronchitis. His cough was very violent, he was emphysematous, and moist rhonchus was to be heard in abundance over both front and back. On November 6th I gave him an injection of 5 minims of a 1 per cent, solution of hydrochlorate of apocodeine, but no effect was produced. On November 8th I gave him an injection of 15 minims of the same solution. In eleven minutes he commenced expectorat- ing freely, and the expectoration continued during the rest of the day. He was not sick, and there was no irritation at the seat of injection. On November 12th he was given an injec- tion of 15 minims of the solution in the right arm, and 5 minims in the left. He again expectorated freely, but there was neither nausea nor vomiting. This time he complained that the injection made his arm sore. There was a good deal of tenderness and swelling, which persisted for some days, but there was no abscess. I tested the solution with litmus paper, and found that it was acid. I then reverted to the specimen of apocodeine used in 1881, and had a 1 in 50 solu- tion prepared which was perfectly neutral. The same patient was given an injection of 20 minims of this solution—10 in the right arm and 10 in the left. This, too, acted as a power- ful expectorant, but fortunately produced very little local irritation. A freshly prepared specimen of the salt having been placed at my disposal, it was made into a 1 in 50 solution, and used in the case of a man aged 31, a gas stoker, who for many years had suffered from chronic bronchitis. On January 6th a hypo- dermic injection was given of 10 minims in each arm, or | of a grain. He reported that he felt a little bit queer after the injection just for a moment, but it did not make him, feel sick. The arms smarted just a little for about an hour, but he did not notice anything the matter with them after that. On January 9th the same solution was used, and he was given a hypodermic injection of 10 minims in the right arm, and 15 in the left, or j of a grain in al 1. It caused him to expectorate very freely, but he suffered no inconvenience and the smarting in the arms was very slight. The solution employed in the case was perfectly neutral. In the face of these observations I cannot confirm Dr. Wickham Legg's statement that apocodeine is wholly unfitted for subcu- taneous injection. All that is necessary is to use a neutral solution. In six cases I have used apocodeine by mouth as an expec- torant with satisfactory results. The first patient was TOyears of age, and had long been under treatment. On Septtmber