MORPHINUM.
EAR.
►
Some pain in left ear, with pain over and at side of left eye all day
(fifth day), [28]. ► Ringing in the ears (after one hour), [3]. ►
Surring of the ears, [40]. ► Tinnitus aurium, [37]. ►
Roaring in the ears, [44a].
NOSE.
►
Sneezing, [62], [64]. ►
Paroxysms of sneezing, [63]. [170.] ►
Peculiar tickling sensation in the nose, œsophagus, and larynx, as when
one has to sneeze, felt after every injection, [40]. ►
Coryza, [73].
FACE.
►
Looked very heavy (after forty minutes), [57].
► Appeared very wild (after nine
hours), [24]. ► Wild, confused expression after sleep, [6c]. ►
Countenance looked haggard and eyes watery, like one who had been
dissipating (second morning), [50].
► Face flushed (after two hours), [23]. ►
Face slightly flushed, [54], [58]. ►
Face intensely flushed (after a few minutes); followed by vomiting, and
then a dead faint and struggling for breath, the pulse scarcely
perceptible, [70]. ► Her face was reddened, [62]. [180.] ► Face red (soon), [1]. ► Face
and lips red (after half an hour), [6a].
► Face red, lips pale, [8b]. ► Face
red, puffy, [9a]. ► Face red, puffy, lips livid (after fifty
minutes), [8]. ► The usually pale face became red, with
drops of perspiration on it (after thirty-five minutes), [11]. ► Face
very red (immediately), [42]. ► Intense but evanescent redness of the
face, [40]. ►
The face became red, almost cyanotic, [68].
► Face almost livid (after one hour),
[11]. [190.]
► Bluish look, [5]. ► Face of
a dark-blue color, [34]. ► Face cyanotic, [48]. ► Face
and extremities cyanotic, [31]. ► The face became violet, [17]. ► Pale
face, [18]. ►
Face and lips pale (after fifteen minutes), [33]. ► Face
pale and anxious (one hour and three-quarters after 1/12 grain), [58]. ►
Face pale and sunken, [66]. ► Pale and cold, for four hours (after two
hours), [57]. [200.] ►
Very pale, with contracted and painful expression of the face (after
four hours), [36]. ► Face swollen, [11b]; (after two hours), [43]. ► Face
very much swollen (immediately), [12].
► Face somewhat puffy, [25]. ► Cheeks.
► Cheeks red, [22]. ►
Circumscribed redness of the cheeks (after fifty minutes), [9]. ►
Lips. ► Lips discolored
(after nine hours), [24]. ► Lips livid, [8a], [25],
[29]; (after eleven hours and a
half), [71]. ►
Lips pale, [11a]. ► Chin. ►
Mouth rigidly closed, [34]. [210.] ►
Mouth closed, the jaws pressed together as in tetanus, [41]. ►
Muscles of the jaw strongly contracted, so that the mouth could scarcely
be opened at all (after eleven hours and a half), [71]. ► Teeth
clenched, so that he could not be made to swallow a drop (after two
hours), [23]. ► Slight trismus, [31]. ► Mouth
and eyes wide open, [29]. ► Feeling as if the teeth of both sides of
mouth were clenched, [65]. ► Feeling that teeth in both sides of mouth
were clenched (after two hours); had a similar feeling from Cannabis
indica, but at no other time, [60].
MOUTH.
►
Tongue. ► Dry brown
tongue, [37]. ► Redness of the tongue, [10a], [11b];
(after twenty minutes), [8a], [9a], etc. ►
Tip and margins of the tongue red, [10].
[220.] ►
Tip of the tongue red, palate scarlet-red, somewhat painful, [8b]. ►
Tongue red on the margin, violet in the middle, [6]. ► Tongue
red at the tip and margins, and violet in the middle, [11a]. ►
Tongue livid, [41]. ► Tongue pale (second morning), [8b]. ►
Tongue foul (second morning), [43].
► Tongue clean and moist (before the
injection); moist, a slight whitish fur, indented (after two hours), [56]. ►
Tongue heavy, pale (after fifteen minutes), [11]. ► Tongue
dry, with thick dirty mucus, [35].
► Anterior part of the tongue dryish
(three hours and a half after 1/2 grain), [53].
[230.] ►
(The tongue symptoms, for which Quinine was prescribed, a thickened
feeling, and inability to articulate distinctly, disappeared entirely), [49]. ►
General Mouth. ► Some
mucus in the mouth, [5]. ► Dryness of the mouth and throat, [13]. ►
Mouth dry, in the morning, and after eating (fifth day), [28]. ► Mouth
and fauces dry, after sleeping, [7a].
► Mouth pasty, [6], [6a]. ► The mucous membrane of the mouth is
usually dry, the patient complains of thirst, nausea, vomiting, aversion
to meat, loss of appetite. The tongue at times trembles on extending it.
The stool is almost always retarded, diarrhœa is seldom, [73]. ► Saliva.
► Discharge of watery saliva from the
mouth, [29]. ► Taste. ►
Perverted taste, [62]. ► Mouth bitter, sticky (second day), [8b]. ►
Speech. [240.] ► Made a strange noise in his mouth (after
nine hours), [24]. ► Speech hasty, [66]. ►
Disturbances of speech, for example, stammering, [73]. ► Speech
embarrassed and feeble, [37]. ► Muscles of tongue so much affected that
articulation was almost impossible (after fourth dose), [19].
THROAT.
►
Dryness and constriction in the throat (after half an hour), [6a]. ►
Pain and obstruction (?) in the posterior portion of the throat (second
morning), [11a]. ► Irritation in the throat, [6b]. ►
Peculiar sensation about the fauces (almost immediately), [47]. ► Fauces and
Pharynx. ► Burning in the
posterior portion of the fauces (after five minutes), [9a]. [250.] ► Paralysis of the pharynx, [35]. ►
Muscles of fauces and glottis so much affected that deglutition was
almost impossible (after fourth dose), [19].
► Swallowing. ► Complained that he could not swallow, [17]. ►
External Throat. ► Jugular
veins swollen, [34]. ► Violent pulsations in the cervical and
temporal arteries, [25].
STOMACH.
►
Appetite. ► Diminished
appetite, [64]. ► Loss of appetite, [66], [68];
(second day), [3]. ► Complete loss of appetite, [69]. ► Entire
aversion to food (second day), [30].
► Thirst. ► Thirst, [13].
[260.] ►
Much thirst, [64]. ► Great thirst, [8a]; (after one hour), [8]. ► Burning
thirst, [6b], [6c]; (second day), [23]. ►
Eructations and Hiccough. ►
Eructations and vomiting for two days, [44b].
► Frequent eructations and nausea,
with uprisings of some acid mucus, [7a].
► Violent eructations, [44b]. ►
Hiccough, [62]; lasting
three-quarters of an hour, [12]. ► Long-continuing singultus (frequently), [40]. ►
Nausea and Vomiting. ►
Nausea, [11a]; (after four
minutes), [9]; (after a quarter of
an hour), [6], etc. ► Nausea and eructations (after two hours
and a half), [7]. [270.] ►
Distressed with nausea, faintness, and constant retchings, with
alternate flushes of heat and cold, for five hours (after two hours), [56]. ►
Nausea and inclination to vomit (after four hours), [8]. ►
Awakened from slumber by nausea and inclination to vomit, [3]. ► Nausea
and inclination to vomit soon after eating, [8b]. ►
Constant nausea (after four hours), [11].
► Slight nausea, with increased
warmth of the face, [7]. ► A little nausea (at first); gone (after
one hour and twenty minutes), [51];
(between five and six hours after injection), [55]. ► Sick
and faint, [57], [58]. ► Slight
sickness (after seven hours), [43].
► Very sick, after a large quantity
of warm water (after two hours), [43].
[280.] ►
Very sickish and drowsy (after two hours), [56]. ► On
rising in morning my stomach gave way and I was forced to throw myself
on the bed to keep from vomiting; felt perfectly well in bed, but it was
not till 4 P.M. that the stomach would suffer the head to remain erect
(second day), [30]. ► Inclination to vomit, [6c]; (after a quarter of an hour), [9b]. ►
Vomiting, [64], [70]; rarely, [40].
► Vomiting half an hour after fresh
milk (second morning), [5]. ► Nausea and vomiting, [14]; (after a few doses), [28]; (after two hours), [11b]. ►
Retching and vomiting, [62]; for
six hours (after 1/2 gr.), [58]. ► Vomiting for three days, [2]. ►
Obstinate vomiting, [2]. ► Vomiting and diarrhœa, [73]. [290.] ► Had suffered constant nausea, and vomited
twice (after two hours); continued in this state for four hours; did not
recover from tendency to nausea for a week, [57]. ►
Vomiting of coffee, [39]. ► Became nauseated and vomited a small
amount of frothy liquid (after four hours), [49]. ►
Vomiting of green matter, [11a]. ► Nausea and qualmishness; and, after some
hours, actual vomiting of a sour, bright-green fluid, followed by
transient relief of the nausea, [7a].
► Vomiting of bile, [67]. ► Stomach.
► Irregular digestion, [66]. ►
Dyspepsia, [62]. ► Pain in stomach, [14]; immediately, [8b];
for three days, [11b]; aggravated
by taking food, [11]. ► Pains in the stomach, umbilicus, and
bladder, in the evening (first day), [11].
[300.] ►
Pain in the pit of the stomach, [8b],
[10b]; immediately, [9a], [11a];
(after five minutes), [8]; (after
two hours), [9]. ► Pain in the epigastric region, [1], [11b];
(second day), [23]. ► Pain in the epigastric region, and
afterwards about the umbilicus, and then about the loins, [12]. ►
Painful sensation in the pit of the stomach, extending as far down as
the bladder (immediately), [11]. ► Painful sensation in the stomach, navel,
and bladder, [11a]. ► Violent pain in the pit of the stomach
(after four hours), [8]. ► Violent pain in the pit of the stomach,
or in the intestines, [2]. ► Violent pain in the pit of the stomach,
and in the bladder, waking from sleep (after four hours), [11]. ►
Violent pain in the stomach after eating, so that he had to go to bed, [11b]. ►
Feeling of constriction and pressure in the stomach, [44b]. [310.]
► Awoke with cramp in epigastrium, as
if clenched by a hand (fourth day), [28].
► Coliclike pains in the stomach, [6b]. ►
Crawling in the stomach, [44b].
ABDOMEN.
►
Umbilical. ► Pain in the
umbilical region, [5]; (after four
hours), [8], [11]. ►
Violent pain in the umbilical region, [9b].
► General Abdomen. ► Moderate meteorismus, [31]. ►
Rumbling in the abdomen (after twenty minutes), [9]. ►
Frequent rumbling in the abdomen (after half an hour), [7a]. ► Pain
in the bowels (after half an hour), [43].
► Acute pain in the abdomen, and
along the spinal column, on every inspiration, [6b]. [320.] ► Colic, [14],
[45]; relieved by turning on back,
in morning (fifth day), [28]. ► Awoke with severe colic (third day), [28].
STOOL.
►
Diarrhœa. ► Diarrhœa, [62], [64],
etc.; (second morning), [11];
second and following days, [11b];
(evening, first day), [11]. ► The acetate generally produced diarrhœa,
[13]. ►
Watery diarrhœa (after two hours), [9];
(second morning), [8b]. ► Bowels had acted loosely twice (after two
hours), [57]. ► Two painful stools (second day), [8b]. ►
Desire for stool for two hours, then small stool with great straining,
in the morning; soft, loose stool at 2 P.M., with
horrid tenesmus, straining, and burning in the rectum, almost
causing frenzy (fifth day), [28]. ► Copious evacuations of the bowels, [5]. ►
Constipation. ►
Constipation, [2], [3], [18],
etc.; (second day), [23]; (third
day), [30]. [330.] ►
Morphia always caused constipation, [13].
► Constipation for a long time, [4]. ►
Constipation often followed by diarrhœa, [14].
► Retention of stool, [44b]. ►
Almost complete stoppage of the evacuation of stool and urine, [69]. ►
No stool, contrary to habit (second morning); but at 2 o’clock there
occurred a very indolent evacuation of a little fæces, with painful
urging, [7].
URINARY ORGANS.
►
Bladder. ► Paresis of the
bladder, [61]. ► Slight paresis of the bladder, [62]. ►
Pain in the region of the bladder (after one hour), [8]. ► Pain in
the bladder, [8b]; (after two
hours), [9]. ► Micturition. [340.]
► Emission of scanty urine, with
great urging (after four hours), [11].
► Passed very little urine, with
great difficulty (first night), [43].
► Ineffectual efforts to urinate
(after seven hours); he succeeded in urinating (nine hours later), [3]. ►
Constant desire to urinate, and inability to do so for twelve hours, [44b]. ►
Complete ischuria, [18]. ► Strangury is often caused, [13]. ►
Retention of urine, [2]. ► Urine. ►
Urine high-colored and scanty, [66].
► Urine scanty, [25]. ►
Diminished secretion of urine, [14].
[350.] ►
Frequently the secretion is diminished, though at times it is increased,
[13]. ►
Suppression of urine (second day), [23].
► Suppression of urine and fæces, [35]. ►
Complete suppression of urine, [4].
► Urine turbid and slimy, [6b]. ►
The urine yielded albumen, without structural elements, [64]. ► Passed
3ix urine, sp. gr. 1010.4 (on rising, before injection); 3xviiiss.
urine, alkaline, sp. gr. 1008.8 (after two hours); 3vij, freely acid,
sp. gr. 1009.2 (after four hours), [55].
► The kidneys excrete albuminous
urine, in severe cases. The evacuation of urine is often difficult, and
the amount frequently scanty; the specific gravity varies within the
most extreme limits; I have found urine of 1004 to 1038; generally the
urine at first has the highest specific gravity; towards the end of the
cure the specific gravity diminishes; naturally this varies according to
the amount of urine passed. The urine of nearly all suffering from
Morphine intoxication reduces an alkaline solution of Cuprum sulphate
without precipitating it as an oxide, at the same time the urine usually
turns the polarization ray to the left, [73].
► Urine acid, sp. gr. 1022, about 3ij
in the hour (before the injection); during two hours and a quarter, 3iv
of bright acid urine, sp. gr. 1029, was secreted (after 1/4 gr.); 3ij
pale acid urine, sp. gr. 1009.2, in the hour (before 1/2 gr.); 3vss. of
bright acid urine, sp. gr. 1022.0, during the three hours (after 1/2
gr.), [53]. ►
At first the specific gravity of the urine, although the quantity was
only moderate, was 1000; and in three weeks it rose to 1014; during
about three weeks the quantity of albumen was very abundant; it then
slowly diminished, and disappeared in the fourth month; no formed
elements were found, [61]. [360.] ►
The specific gravity of the urine varied from 1007 to 1012; the urine
reduced alkaline solution of Sulphate of copper, turned the plane of
polarization to the left, and showed a remarkable amount of albumen;
microscopical examination, during the first fourteen days of her stay in
the hospital, detected waxy cylinders and white blood-corpuscles; five
weeks later, there were only a few traces of albumen, [62]. ► The
specific gravity of the urine varied from 1026 to 1035; sugar was tested
for, but was not found; albumen was distinctly present, but in small
quantities; no structural elements were present; after the albumen had
disappeared for some days, it was again observed for a short time, [63]. ►
The urinary organs are generally more affected in men than in women, [13]. ►
Urine diabetic, possessing reducing and levogyrating properties, in
cases of chronic poisoning; this fact had already been established, but
its occurrence in acute poisoning now noticed, is new, [73]. ►
Albumen is frequently found in the urine in cases of Morphine
intoxication, both during the continued use of Morphine and the period
of abstinence. This albumen, which appears during the long-continued use
of Morphine, either as a transient symptom that occurs irregularly,
often lasting only a few days, or as a constant symptom that only
disappears after weeks or months following the total withdrawal of the
drug. Albumen is much more frequently found during the period of
abstinence than during the continued use of Morphine, as observed in
nearly all cases; it makes its appearance in three to six days after the
beginning of the abstinence, and disappears in two to four days. It
varies from the slightest turbidity to a flocculent sediment. Before I
had observed cases of the latter character, I had considered the slight
turbidity as accidental, dependent upon a slight catarrhal condition of
the uro-genital organs; the presence of the deposit leaves no doubt that
we have here to deal with pathological changes in the uro-poietic
system. In the chemical action of the urine, all the reagents (Nitric
acid, Acetic acid, Carbolic acid, Potassium ferrocyanide, and Sodium
sulphate) promptly indicate albumen. In some cases the action of Nitric
acid was noteworthy, and called to mind the case of Bence Jones and his
acid albuminate. When the Nitric acid was used freely, and the urine
heated, no albumen was precipitated while hot, but after the urine
became cold, and it was again dissolved by heat, [73].
SEXUAL ORGANS.
►
Male. ► Impotency; the
testimony of all men suffering from Morphine intoxication is uniform in
that their sexual power is affected by the drug. Sometimes the sexual
excitement, voluptuous sensations, and in part erections are incomplete,
less energetic, and of shorter duration, or they do not occur at all. So
in this case all grades may be found, from simple sexual weakness to
complete impotency. The great majority refrain from sexual intercourse,
either from lack of interest or from inability, owing to the fact that
erections are incomplete or wanting altogether. Unmarried men become
impotent sooner than married men. In many men the first effect of
Morphine is excitement of the sexual sphere, afterwards the usual
paralysis. Many unmarried men make use of this fact to smother their
sexual desires when they become aroused during the interval free from
Morphine. The question arises whether there may not be other causes than
that of Morphine for the impotency. The condition of depression which is
induced in many persons might be supposed to be a psychical impotency,
but there are also cases in which there was a condition of eutropia, and
also still others upon whose emotional nature Morphine has no influence
whatever, that are more or less impotent. Whether the power of erection
ceases sooner, or since the emissions are not of a frequent occurrence
the function of the seminiferous organs ceases sooner, is uncertain from
want of sufficient data. The testimony of men is usually not clear; many
dislike to speak of their impotency; many healthy men are, indeed,
unaware of this condition, or pass it over lightly, or are silent about
it. In the register of the Morphine poisonings in Maison de Santé, it
is found that the wives of none of the men who had injected large doses
of Morphine have had a normal pregnancy during the last two years,
although they were young women, and, previous to the use of Morphine by
their husbands, had had children every year, [73]. ►
Impotence, [61]. ► He had become impotent since he used
Morphia, [64]. ► Pain in the genitals and urinary organs,
especially in the right spermatic cord (after one hour and a half), [8]. ►
Diminished sexual desire, [66], [68]. ►
Female. [370.] ► Amenorrhœa. In all the women treated by
me for Morphine intoxication, menstruation had been irregular, or
suppressed for months or years. These women varied in age from
twenty-five to thirty-five, and had used subcutaneous infections of
Morphine for a long time. The symptoms noticed at the commencement and
during the course of the amenorrhœa, such as headache, vertigo,
disinclination to work, loss of appetite, vomiting, constipation,
palpitation, hysterical attacks, etc., coincide with those of Morphine
intoxication, so that it is often difficult to distinguish whether they
are caused by the toxication of Morphine, or are the consequence of the
amenorrhœa. I have never observed swelling of the breasts or vicarious
hæmorrhages in my cases. The amenorrhœa of Morphine is gradually
developed from dysmenorrhœa, or it occurs suddenly. Conception has
never been noticed in amenorrhœic women, while some of the women have
been repeatedly pregnant previous to the use of Morphine. Therefore, it
seems probable that the cessation of menstruation is dependent upon
anomalies of the ovaries, in that they seem inactive. According of Pflüger’s
theory, in the amenorrhœa of Morphine, the growth of the cells of the
ovaries ceases from one period to another, and in consequence, the
irritability that is transmitted by the ovarian cells and causes, on the
one hand, bursting of the Graafian follicles, and on the other,
determines the reflex condition of congestion of the sexual organs, is
wanting. As a consequence, Morphine affects the ovaries as it does other
secretory glands, namely, it renders them unable to perform their
functions. It is most probable that menstruation ceases because
ovulation ceases, and this also explains the sterility. The supposition
that Morphine injection causes the arrest of the function of the organs
of generation is justified by the fact that, after the cessation of
Morphine, these organs recover their activity. The sexual desire is at
first increased by the habitual use of Morphine, but after the graver
symptoms of poisoning have been developed it almost entirely disappears,
as in men. It is also noteworthy that women who have suffered from fluor
albus, are generally free from it during the prolonged use of Morphine;
this reappears only after the withdrawal of the drug, often with labor
like pains. Women suffering from Morphine intoxication, in whom
menstruation continues normal, may conceive; but I have noticed that the
pregnancy runs a normal course only when the women use small doses; they
abort from large doses, [73]. ► Menstruation too early, [66]. ►
Menstruation generally more profuse and too early, [13].
RESPIRATORY ORGANS.
►
Slight rattling of mucus in the trachea, [31].
► Voice. ►
More or less hoarseness, [15]. ► Frequently hoarseness when speaking for
any length of time, whereas her voice is usually extremely clear, [40]. ►
Speech indistinct (inaudible), (soon, after fifteen minutes), [33]. ►
Respiration. ► Breathing
loud and rattling (after eleven hours and a half), [71]. ►
Respiration stertorous, [34]. ► Breathing stertorous, amounting to no
more than 4 or 5 per minute, [20].
[380.] ►
Respirations increased, with acute pains in the chest, [6b]. ►
Respiration 19, 20 (before the injection); 15, regular (three-quarters
of an hour after 1/4 gr.); 16, regular (ten minutes after 1/2 gr.); 14,
regular (three hours and a half after 1/2 gr.), [53]. ►
Respiration 9 and 10 all day (second day), [30]. ►
Respiration rattling, slow, 8 to the minute, [29]. ►
Respiration very superficial, occurring only every twelve or fifteen
seconds, [41]. ► Respiration short and irregular, [35]. ►
Respiration irregular, with frequent sighs (one hour and three-quarters
after 1/2 gr.), [58]. ► Respiration indescribable, thoracic
respiration being apparently entirely suspended, [48]. ►
Respiration difficult, [68];
(after five minutes), [8]; (after
fifteen minutes), [11]. ► Respiration slow and difficult (after
four hours), [36]. [390.] ►
Slight difficulty in breathing (after third dose); respiration greatly
obstructed (after fourth dose), [19].
► Very difficult respiration, [5]. ►
Struggling for breath, [70].
CHEST.
►
Tightness of the chest and difficulty in breathing, and she asked to be
raised, saying she felt as if she were dying (after fifteen minutes), [33]. ►
Great pain in the chest, and could not take a long breath (after half an
hour); pain principally in the middle of the sternum, the breathing was
short and quick, and she sighed often (after four hours), [43]. ► Felt
very ill, with “an indescribable sensation, worse to bear than any
pain,” behind the lower half of the sternum (after one hour), [57].® 2000
Article