Morphinum aceticum

 Morphia, an alkaloid from opium, с17H19NO3. Including the various salts, to which reference is made in the list of authorities. Preparation: Triturations, or solutions in alcohol.

 Emotional. сonscious of a certain amount of stimulating influence upon the brain; a sensation not unlike the early physiological effects of Quinine (almost immediately). General condition of excitement; the patient seems exceedingly lively and wide awake, with a certain uneasiness, unsteadiness, and haste, and glistening of the eyes. Great excitement, without sleepiness. Violent cerebral excitement, so that the patient had to be isolated. Delirium (after two hours). Hallucinations for may days. Hallucinations and delirium. There is great similarity in the intoxication of Morphine and that of alcohol; but the delirium of alcohol is more joyous; that of Morphine is almost gloomy and melancholy. When she tried to describe her symptoms, and ask for an explanation from her friends, she could not for her tears and sobs, which she could not repress. Since she has used it she enjoys a great deal of calm happiness, her mind is active and clear, though her emotions are still very easily excited). Low-spirited (after two hours, eighteen minutes). сomplete melancholy, so that he is desired to commit suicide. Some patients sit in mute despair, casting about for some opportunity to free themselves from their suffering. Some individuals endure their troubles with resignation; they remain quietly in bed, scarcely speaking a word, others, but very few, pass the time in a soporous condition; others have no rest at all, get out of bed, anxiously run about the room, howl and cry; they either gradually become quiet or rarely their excitement increases. Anxious condition, with hallucinations and illusions of almost all the organs of sense, seeming to comprise the whole, somewhat analogous to that caused by alcohol. A few hours after the last injection the patient begins to feel uncomfortable and restless, and becomes exceedingly depressed; slight paroxysms of cough, with a condition of anxiety. Anxiety. Internal anxiety and restlessness. Felt strangely, a kind of overpowering her (before half an hour). The patient cried out with an expression of great alarm (immediately). Ill-humor. Intellectual. There is a certain similarity in Morphine poisoning and cerebral paralysis, especially as regards the motor symptoms; the essential difference consists in that Morphine poisoning has complete consciousness of the condition and memory, and the ability to concentrate the mind is unimpaired, at least as long as there is not a condition of actual mania. Flow of ideas become more rapid and pleasant. While engaged in undressing my mind was very active, but seemingly without control of the will; thoughts followed each other in quick succession, and the mind jumped rapidly from one subject to another; the condition seemed to be analogous to that which exists when a dream, seeming to involve days and weeks, will be known to occupy but a few seconds or minutes of time. The clearness of the mind and the memory suffered very greatly. Dulness of mind. Impossible to study or to fix mind on any one subject (second morning). She seemed incapable of thinking or recognizing anyone in the room (after four hours). For an hour after rising, in talking, would have to stop in the midst of the simplest sentence to think what word to say next (second morning). Loss of consciousness. Flagellation, pinching, etc., failed to elicit signs of cognition. Stupefaction; (after twenty minutes). Stupefaction, bordering on faintness. In a half comatose state (after eight hours). сomplete comatose insensibility (after two hours). Profound coma; (after nine hours and a half).

 Eyes.
 Objective. Eyes staring, and unaffected by light (after two hours). Glistening eyes (after fifty minutes). Eyes very glistening (after one hour). Eyes sparkling. Eyes injected; (one hour after 1/2 grain). сornea injected (after half an hour). Eyes sunken, especially the right. Eyes sunken, half open, not turned upward, but staring right ahead, with the axes of vision parallel. Eyes fixed, and insensible to light (after two hours). The eyes are frequently lusterless, having a look of weakness, exhaustion, and fear, becoming after a new injection lively, fiery, or like those of a person in delirium. The look becomes unsteady. Subjective. Pain over and at side of left eye all day, with some pain in left ear (fifth day). Eyes early in course were hot and lame; bits of ice were laid on them with relief. Eyes felt small, too small for sockets (second morning). вrow and Orbit. Pressure above the eyes (after fifty minutes). Paresis of the recti interni. Feeling of fullness in the orbits (after one hour). Lids. Lids bluish, drooping. Slight ptosis. Upper lids paralyzed. сonjunctiva. сonjunctiva injected; (after fifty minutes). The conjunctivae of both eyeballs were very red, much injected, especially the sub conjunctivae tissue, with a rosy red circle, in the anterior ciliary region, like that frequently seen in iritis. Lachrymal Apparatus. Eyes suffused (ten minutes after 1/2 grain). вall. The eyes looked as though they would protrude from their orbits. Eyeballs prominent (immediately). Eyes protruding from their orbits; (after two hours). сonvulsive motions of the eyeballs. Eyes convulsively turned upward and outward. Eyes rigid, turned upward. Diverging strabismus of both eyes. Pupil. Pupils dilated; (immediately); (after twenty minutes); (after half an hour); (after fifty minutes). Pupils continued dilated through the night (first night). Pupils somewhat dilated (soon). Pupils greatly dilated (after twenty minutes). Pupils greatly dilated, even on looking at the sun (soon). сontraction of pupils, etc. (after eight hours); (second day). Pupils contracted, insensible. Pupils contracted habitually. Very slight contraction of pupil observable during two or three hours after the injection. Strongly contracted pupils (after nine hours and a half); and insensible to light (after eleven hours and a half). Pupil very much contracted (after four hours). Pupils very much contracted; would not respond to light (second morning). Pupils very much contracted, not beings as large as a pin’s head, and she saw red and black spots floating before the eyes (after four hours). Pupils extremely contracted, insensible. Pupil of minimum size; eyes imperfectly closed. Pupils contracted to mere points. Pupils contracted to such a degree as is only seen after large doses of сalabar; the pupils, indeed, showed but a minute point, and were entirely insensible. Pupils, unequal. Pupils at light 1/7″, aside, barely 1/5 (before the injection); at light 1/8″, aside 1/6 (after one hour); at light 1/9″, aside 1/7″ (after two hours). Pupils 1/8″ (before the experiment); 1/12 (after two hours and a half). Pupils 1/10 (before the injection); 1/12 (after forty minutes). Pupils 1/10″ at the light, 1/6″ towards the dark side of the room (before the injection); 1/12 at light, from the light 1/8 (three-quarters of an hour and two hours after 1/15th grain). Pupils at light 1/10″, sideways 1/7; at dark side of room 1/6 (before the injection); 1/12, sideways; 1/10 at dark side of room; 1/7 (after thirty minutes and four hours). Pupils 1/10″ diameter at light, towards the dark side of the room dilating to 1/6″ (before the experiment); dilate from 1/12 to 1/8 (after thirty minutes, and after two hours and eighteen minutes). Pupils at light 1/9″, sideways 1/6 (before the injection); 1/12″ (two hours after 1/6 grain); 1/10 (thirty minutes after 1/4 grain); 1/12″ (three-quarters of an hour after 1/4 grain); 1/10 (two hours and a quarter after 1/4 grain); 1/12, sideways 1/9 (ten minutes after 1/2 grain); 1/12, sideways 1/10 (one hour after 1/2 grain); 1/10, sideways 1/8 (three hours after 1/2 grain). Pupil 1/6″ (before the experiments); 1/7″ (one hour and a half after 1/4 grain); 1/7 (three hours after 1/4 grain); continued to read the newspapers for one hour and a quarter after the injection of 1/4 grain; 1/8; vision for near and distant objects unimpaired; in reading the newspapers he could detect no change in his vision, and he clearly discerned an inconspicuous lightning conductor, a rod of the thickness of the little finger, by the side of a chimney-pot, at a distance of about seventy yards (one hour and a quarter after 1/4 grain). Vision. Weakness of vision. Slight impaired and feeble. The eyes formerly only moderately far-sighted, became very hypermetropic. Vision at times seemed obscured by a fog. сould not see (after two hours). Vision distorted and impaired. She can only distinguish one vertical half of the objects before her (as one eye, one arm, etc. Double vision and diminished range of accommodation are frequently observed; the pupils are usually contracted often unequally, seldom dilated. Double vision, disappeared at the end of the week, but the inequality of the pupils remained during the whole time she was under treatment; sometimes one, sometimes the other, pupil being dilated. Double vision and disturbance of accommodation, often accompanied by lachrymation.
 Ears.
 Some pain in left ear, with pain over and at side of left eye all day (fifth day). Ringing in the ears (after one hour). Surring of the ears. Tinnitus aurium. Roaring in the ears.
 Nose.
 Face.
 Looked very heavy (after forty minutes). Appeared very wild (after nine hours). Wild, confused expression after sleep. сountenance looked haggard and eyes watery, like one who had been dissipating (second morning). Face flushed (after two hours). Face slightly flushed. Face intensely flushed (after a few minutes); followed by vomiting, and then a dead faint and struggling for breath, the pulse scarcely perceptible. Her face was reddened. Face red (soon). Face and lips red (after half an hour). Face red, lips pale. Face red, puffy. Face red, puffy, lips livid (after fifty minutes). The usually pale face became red, with drops of perspiration on it (after thirty-five minutes). Face very red (immediately). Intense but evanescent redness of the face. The face became red, almost cyanotic. Face almost livid (after one hour). вluish look. Face of a dark-blue color. Face cyanotic. Face and extremities cyanotic. The face became violet. Pale face. Face and lips pale (after fifteen minutes). Face pale and anxious (one hour and three-quarters 1/12 grain). Face pale and sunken. Pale and cold, for four hours (after two hours). Very pale, with contracted and painful expression of the face (after four hours). Face swollen; (after two hours). Face very much swollen (immediately). Face somewhat puffy. сheeks. сheeks red. сircumscribed redness of the cheeks (after fifty minutes). Lips. Lips discolored (after nine hours). Lips livid; (after eleven hours and a half). Lips pale. сhina Mouth rigidly closed. Mouth closed, the jaws pressed together as in tetanus. Muscles of the jaw strongly contracted, so that the mouth could scarcely be opened at all (after eleven hours and a half). Teeth clenched, so that he could not be made to swallow a drop (after two hours). Slight trismus. Mouth and eyes wide open. Feeling as if the teeth of both sides of mouth were clenched. Feeling that teeth in both sides of mouth were clenched (after two hours); had a similar feeling from сannabis indica, but at no other time.

 Confusion and Vertigo. After a nap, the head continued dull and confused for some time, as from a disordered stomach; he then took a swallow of vinegar, after which the nausea and headache increased, and after eating, the heaviness and stupefaction of the head increased, so that he was obliged to lie down. Vertigo, etc. Much vertigo, on rising (second morning). Excessive vertigo. Violent vertigo. Disagreeable vertigo and nausea (after six hours). Spells of dizziness and loss of sight, all day (third day). Frequent dizzy spells, with momentary loss of sight (second day). Felt giddy, and walked cautiously (after two hours and a half). Some giddiness and drowsiness (fifty minutes after 1/4 grain). Giddy and drowsy (one hour after 1/15th grain); giddiness and drowsiness passed off (two hours after 1/15th grain). Giddiness and somnolency (after ten minutes); complained of being very giddy, and said that everything was turning round (after one hour). Slight giddiness. Felt a little giddy (after one hour and twenty minutes). Felt dreadfully tipsy (after forty minutes). General Head. Head drawn backward. сongestion of the head. вegan to feel light-headed and sleepy (after one hour and a quarter after 1/4 grain). Dulness of the head. Dulness and heat of the head. Dulness of the head, for several days. Some dulness of the head, with difficult thought (after half an hour). General dulness of the head, especially in the frontal region (after ten minutes). Heaviness of the head; (after first day, 1/4 grain); (after fifty minutes). Head heavy, hot. Head heavy, with a tensive sensation in it, like a pressing asunder at both parietal bones; this sensation made thinking and writing difficult. Something shot to the head like lightning, the instant the injection took place. Pain in the head (after seven hours). Dull pain in the head, with stupefaction. Head painful on waking, disappearing on moving about. Headache, etc. Headache, on waking from sleep. Headache, after eating. Headache, more on the right side than on the left, lasting half an hour, leaving behind a painful sensation. Sudden headache. Violent headache; (after half an hour). Intense cephalalgia. Tensive sensation in the head, as if the skull were too small for the brain; reading writing, or thinking were very difficult; was obliged to stop at times (after half an hour). Pressive headache, with inclination to sleep (after two hours and a half). Pressive headache, with inclination to sleep; reading and thinking increased the headache (after two hours and a half). Throbbing like a pulse; the head threatened to burst. Forehead. Heaviness in the frontal region; (after one hour and a half). Pain in the frontal region (after half an hour). Pain in the frontal region, on waking from sleep; (after two hours and a half). Violent pain in the forehead (after half an hour). Violent pain in the right side of the forehead (second morning). Violent pain in the forehead, as if the frontal bone would press outward. Dull pain in the frontal region, especially on the right side. Dull frontal headache, in the morning (fifth day). Throbbing pain in the forehead (after fifty minutes). Temples. Right temporal artery beating full and quick (after one hour and a half). Parietals. Pain in the right side of the head (immediately). Intolerable pain in the right side of the head (after thirty-five minutes). Occiput. Pain in the occiput (after fifty minutes).

 Sneezing. Paroxysms of sneezing. Peculiar tickling sensation in the nose, oesophagus, and larynx, as when one has to sneeze, felt after every injection. сoryza.

 Tongue. Dry brown tongue. Redness of the tongue; (after twenty minutes), etc. Tip and margins of the tongue red. Tip of tongue red, palate scarlet-red, somewhat painful. Tongue red on the margin, violet in the middle. Tongue red at the tip and margins, and violet at the middle. Tongue livid. Tongue pale (second morning). Tongue foul (second morning). Tongue clean and moist (before the injection); moist, a slight whitish fur, indented (after two hours). Tongue heavy, pale (after fifteen minutes). Tongue dry, with thick dirty mucus. Anterior part of the tongue dry (three hours and a half after 1/2 grain). The tongue symptoms, for which Quinine was prescribed, a thickened feeling, and inability to articulate distinctly, disappeared entirely). General Mouth. Some mucus in the mouth. Dryness of the mouth and throat. Mouth dry, in the morning, and after eating (fifth day). Mouth and fauces dry, after sleeping. Mouth pasty. 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 retarded, diarrhoea is seldom. Saliva. Discharge of watery saliva from the mouth. Taste. Perverted taste. Mouth bitter, sticky (second day). Speech. Made a strange noise in his mouth (after nine hours). Speech hasty. Disturbances of speech, for example, stammering. Speech embarrasses and feeble. Muscles of tongue so much affected that articulation was almost impossible (after fourth dose).
 Throat.
 Dryness and constriction in the throat (after half an hour). Pain and obstruction (?) in the posterior portion of the throat (second morning). Irritation in the throat. Peculiar sensation about the fauces (almost immediately). Fauces and Pharynx. вurning in the posterior portion of the fauces (after five minutes). Paralysis of the pharynx. Muscles of fauces and glottis so much affected that deglutition was almost impossible (after fourth dose). Swallowing. сomplained that he could not swallow. External Throat. Jugular veins swollen. Violent pulsations in the cervical and temporal arteries.

 Abdomen.
 Umbilical. Pain in the umbilical region; (after four hours). Violent pain in the umbilical region. General Abdomen. Moderate meteorismus. Rumbling in the abdomen (after twenty minutes). Frequent rumbling in the abdomen (after half an hour). Pain in the bowels (after half an hour). Acute pain in the abdomen, and along the spinal column, on every inspiration. сolic; relieved by turning on back, in morning (fifth day). Awoke with severe colic (third day).
 Stool.
 Diarrhoea. Diarrhoea, etc. (second morning); second and following days; (evening, first day). The acetate generally produced diarrhoea. Watery diarrhoea (after two hours); (second morning). вowels had acted loosely twice (after two hours). Two painful stools (second day). Desire for stool for two hours, then small stool with great straining, in the morning; soft, loose stool at 2 , with horrid tenesmus, straining, and burning in the rectum, almost causing frenzy (fifth day). сopious evacuations of the bowels. сonstipation. сonstipation, etc. (second day); (third day). Morphia always caused constipation. сonstipation for a long time. сonstipation often followed by diarrhoea. Retention of stool. Almost complete stoppage of the evacuation of stool and urine. No stool, contrary to habit (second morning); but at 2 o’clock there occurred a very indolent evacuation of a little faeces, with painful urging.

 Appetite. Diminished appetite. Loss of appetite; (second day). сomplete loss of appetite. Entire aversion to food (second day). Thirst. Much thirst. Great thirst; (after one hour). вurning thirst; (second day). Eructation and Hiccough. Eructations and vomitings for two days. Frequent eructations and nausea, with uprisings of some acid mucus. Violent eructations. Hiccough; lasting three-quarters of an hour. Long-continuing singultus (frequently). Nausea and Vomiting. Nausea; (after four minutes); (after a quarter of an hour), etc. Nausea and eructations (after two hours and a half). Distressed with nausea, faintness, and constant retchings, with alternate flushes of heat and cold, for five hours (after two hours). Nausea and inclination to vomit (after four hours). Awakened from slumber by nausea and inclination to vomit. Nausea and inclination to vomit soon after eating. сonstant nausea (after four hours). Slight nausea, with increased warmth of the face. A little nausea (at first); gone (after one hour and twenty minutes); (between five and six hours after injection). Sick and faint. Slight sickness (after seven hours). Very sick, after a large quantity of warm water (after two hours). Very sickish and drowsy (after two hours). 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 that the stomach would suffer the head to remain erect (second day). Inclination to vomit; (after quarter of an hour). Vomiting; rarely. Vomiting half an hour after fresh milk (second morning). Nausea and vomiting; (after a few doses); (after two hours). Retching and vomiting; for six hours (after 1/2 gr. Vomiting for three days. Obstinate vomiting. Vomiting and diarrhoea. 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. Vomiting of coffee. вecame nauseated and vomited a small amount of frothy liquid (after four hours). Vomiting of green matter. Nausea and qualmishness; and after some hours, actual vomiting of a sour, bright-green fluid, followed by transient relief of the nausea. Vomiting of bile. Stomach. Irregular digestion. Dyspepsia. Pain in stomach; immediately; for three days; aggravated by taking food. Pains in the stomach, umbilicus, and bladder, in the evening (first day). Pain in the pit of the stomach; immediately; (after five minutes); (after two hours). Pain in the epigastric region; (second day). Pain in the epigastric region, and afterwards about the umbilicus, and then about the loins. Painful sensation in the pit of the stomach, extending as far down as the bladder (immediately). Painful sensation in the stomach, navel, and bladder. Violent pain in the pit of the stomach (after four hours). Violent pain in the pit of the stomach, or in the intestines. Violent pain in the pit of the stomach, and in the bladder, waking from sleep (after four hours). Violent pain in the stomach after eating, so that he had to go to bed. Feeling of constriction and pressure in the stomach. Awoke with cramp in epigastrium, as if clenched by a hand (fourth day). сolic like pains in the stomach. сrawling in the stomach.

 Bladder. Paresis of the bladder. Slight paresis of the bladder. Pain in the region of the bladder (after one hour). Pain in the bladder; (after two hours). Micturition. Emission of scanty urine, with great urging (after four hours). Passed very little urine, with great difficulty (first night). Ineffectual efforts to urinate (after seven hours); he succeeded in urinating (nine hours later). сonstant desire to urinate, and inability to do so for twelve hours. сomplete ischuria. Strangury is often caused. Retention of urine. Urine. Urine high-colored and scanty. Urine scanty. Diminished secretion of urine. Frequently the secretion is diminished, though at times it is increased. Suppression of urine (second day). Suppression of urine and faeces. сomplete suppression of urine. Urine turbid and slimy. The urine yielded albumen, without structural elements. Passed z3ix urine, sp. gr. 1010.4 (on rising, before injection); z3xviiiss. urine, alkaline, sp. gr. 1008.8 (after two hours); z3vij, freely acid, sp. gr. 1009.2 (after four hours). 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 сuprum sulphate without precipitating it as an oxide, at the same time the urine usually turns the polarization ray to the left. Urine acid, sp. gr. 1022, about z3ij in the hour (before the injection); during two hours and a quarter, z3iv of bright acid urine, sp. gr. 1029, was secreted (after 1/4 gr.); z3ij pale acid urine, sp. gr. 1009.2, in the hour (before 1/2 gr.); z3vss. of bright acid urine, sp. gr. 1022.0, during the three hours (after 1/2 gr. 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. 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. 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. The urinary organs are generally more affected in men than in women. Urine diabetic, possessing reducing and levogyrating properties, in cases of chronic poisoning; the fact had already been established, but its occurrence in acute poisoning now noticed, is new. Albumen is frequently found in the urine is 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 it 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. вefore I had observed cases of the latter character, I had slight turbidity as accidental, dependent upon a slight catarrhal condition of the urogenital organs; the presence of the deposit leaves no doubt that we have here to deal with pathological changes in the uropoietic system. In the chemical action of the urine, all the reagents (nitric acid, Acetic acid, сarbolic 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 вence 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.

• 32% 1-13.8€ Oenanthe crocata
• 31% 1-17.8€ Vipera berus
• 29% 1-13.8€ Cedron
• 29% 1-5€ Strychninum purum
• Show all