Studies on functional nervous disorders.

  • Jones, C. Handfield (Charles Handfield), 1819-1890.
Date:
1870
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Licence: Public Domain Mark

Credit: Studies on functional nervous disorders. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    increased by moderate doses of opium^ or at least in no wise depressed^ but after poisonous doses it becomes very feeble and failing. This results partly from the contraction of the coronary arteries admitting an insufficient supply of blood to the muscular tissue, and partly from the same state of the blood-vessels of the cardiac centres, in consequence of which they cease to supply the heart with nervous influence. In some systems there is intolerance of even the smallest amount of the drug. A lady known to me cannot take the smallest dose without becoming faint. Disease as already noticed (v. p. 206) may have the same effect, the hearths action, already feeble, becoming dangerously depressed by the opiate which is given to calm cerebral excitement or for some other purpose. It is, however, notorious how favorably opium acts when given freely in peritonitis, where the tendency is to death by asthenia. I have also used subcutaneous injection in several instances with good results where the pulse was very weak, nor can I recall to mind any where it has caused any cardiac depression. Where we apprehend any such tendency and yet wish to give it, a stimulant should be administered at the same time. Belladonna may be ranked as the physiological opposite to opium. In full doses it causes extreme flushing of the face and head with great distension of the veins, numbness of the face, dimness of sight or even blindness, confusion of head, delirium sometimes attended with great excitement, dryness of the mouth and throat, extreme dilatation of the pupils, and often an erythematous eruption. Hogg says Ophth. Surgery,^ p. 98) I have frequently seen a drop of very weak solution of atropia produce in the healthy eye a very large amount of congestion in the capillary vessels, more than sufficient to deceive the practised eye of the surgeon, and which might well be mistaken for a diseased condition.''^ The chief points of contrast in its action as compared with that of opium are the state of the pupils, the deep flushing of the face, the delirious excitement, the accelera- tion and sometimes increased strength of the pulse. Sopor is generally consecutive to delirium, and is often replaced by wakeful- ness. There can be to my mind but little question that the deep congestion of the skin of the face and head, the delirium, and the cutaneous erythema depend on arterial dilatation and increased afflux of blood in those parts. In one case the skin of the face had been as red as blood, but had quite returned to its natural state twenty- two hours later when I saw the patient; delirium had existed along with the congestion, and had disappeared with it. It is impossible