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SOURCE. By the action of Ammonia on Ethylene Chloride. The mixture
of bases is fractionated, and from the fraction boiling between 266 F. ; 130
C., and 356 F. ; 180 C., Piperazine separates on cooling.

CHARACTERS. It occurs in colorless, well-defined, acicular crystals,
readily soluble in water. In cold, aqueous solutions, it will dissolve twelve
times as much Uric Acid as will Lithium Carbonate.

Dose, 8 to 15 gr. ; .50 to i.oo gm.


Piperazine is believed to increase slightly the amount of urea
in the urine, while the uric acid co-efficient is diminished. The
testimony as to its diuretic action is conflicting, but the weight
of clinical evidence is in favor of its being a reliable diuretic.
In ordinary doses it does not appear to have any influence upon
the nervous, circulatory or respiratory systems ; nor does it irri-
tate the gastro-intestinal or the genito-urinary tract. There is
much clinical testimony as to the value of this drug in gout,
goutiness (uricacidaemia) and rheumatism. It is here given in
water containing carbon dioxide. It is so highly hygroscopic
that it cannot be administered as pill or powder.]



THE drags comprehended in this section may be arranged in many ways ;
but there are objections to each. Inasmuch as the medical student should be
well acquainted with the actions of these drugs in health and disease, those
which act similarly will be grouped together. In Appendix I a list of these
drugs, arranged according to their Natural Orders, will be found.

Vegetable Drugs acting chiefly on the Nervous System.

These may be classified as follows :
CLASS I. Acting on the cerebrum.

A. Cerebral depressants or soporifics :

Opium, Hops, [Lactucarium, Pellotine].

B. Cerebral excitants :

f Belladonna. "j Also act on nerve endings

I StrampTiium. > in glands and involuntary
Deliriants -j Hyoscyamus. ' muscle.


Cannabis Indica.

Caffeine, [Guarana.]

CLASS II. Acting on the spinal cord.

A. Exciting the cells of the anterior cornua. [Nux Vomica,]


B. Depressing the cells of the anterior cornua. Calabar bean,

[Muscarine], Gelsemium.

III. Acting on the nerves. w

A. Depressing the motor nerves. Conium, Tobacco.

B. Depressing the motor end plates. Cura/e. /dtf-0"" ***
c. Depressing the sensory nerves. [Coca], Cocaine.

D. Stimulating the secretory nerves. PiloCarfms.




[A. Cerebral Depressants or Soporifics.]


OPIUM. [The concrete, milky exudation obtained by incising the un-
ripe capsules of Papaver somnt/trum Linn6 (nat. ord. Papaveracete), and
yielding, in its normal, moist condition, not less than 9 per cent, of crystal-
lized morphine, when assayed. Synonym. Poppy. Habitat. Western
Asia; cultivated.]

CHARACTERS. [In irregular or subglobular cakes, with the remnants
of poppy leaves and fruits of a species of Rumex adhering to the surface ;
plastic, or of a harder consistence ; chestnut-brown or darker, and somewhat
shining ; internally showing some tears and fragments of vegetable tissue. It
has a sharp, narcotic odor, and a peculiar, bitter taste.

VARIETIES. The above is the official opium ; but the following are met
with in commerce, and may be used to prepare the alkaloids:] (a) Constanti-
nople Opium, small lenticular masses, ^ to )4 Ib. [120. to 240. gm.] in
weight, and enclosed in a poppy leaf, but without the Rumex seeds. Some-
times the terms Turkey and Levant Opium include this. (6) Egyptian Opium.
Flat, more or less circular cakes, two or three in. [5. to 7.5 cm.] in diameter,
reddish hue internally, covered with a leaf externally. Persian, Indian,
English, French and German opiums are rarely met with in England.

COMPOSITION. (i) Alkaloids. At least [nineteen] in number. Most
are combined with Meconic Acid, some with Sulphuric Acid, and some are
free. Some Morphine Salts, and Codeine are official. These two alkaloids
and Narceine and Thebaine are important. The following are the alkaloids
existing in Opium :

5. Morphine [(2.5 to 22.8 per cent.).] Hydrocotarnine

Codeine [(0.2 to 0.7 per cent.).]

Thebaine [(0.15 to I per cent).]

Narcotine [(1.3 to 10 percent.).]

Narceine [(o. I to 0.7 per cent.).]

Papaverine [(i per cent.).]

Pseudomorphine [(0.2 per cent.).]

Protopine ^

Oxynarcotine \ [in minute quantity.

Cryptopine J

[Narcotine is more properly called Anarcotine.
ficial alkaloid.]

(2) Neutral bodies. Two in number :


(3) Organic acids. Two in number :

Meconic Acid, [official in B. P.] Thebolactic Acid.

Deuteropine (not known in pure state).]

Apomorphine is an arti



(4) Water, \_abou\ 16 per cent.

(5) Mucilage, resin [pectin,~\ glucose, fats, essential oil, caoutchouc, odor-
ous substances, and ammonium, calcium and magnesium salts.

The following analysis shows how specimens vary :

Patna Opium 3.98 per cent, of Morphine, 6.36 per cent, of Anarcotine.

Smyrna " 8.27 " " 1.94 " "

IMPURITIES. Water, stones, fruits, leaves, starch, [gum, and lead balls.]
INCOMPATIBLES. Ferric chloride gives a deep red color (due to Meconic
Acid). Zinc, copper and arsenic salts, silver nitrate, lead acetate and subace-
tate, give precipitates of meconates, sulphates and coloring matters. All tan-
nin-containing preparations precipitate codeine tannate. Fixed alkalies, their
carbonates and ammonia precipitate morphine and [a]narcotine. The small
amount of glucose in opium may cause it to explode when made into a pill with
silver nitrate.

Dose, ^ to 2 gr. ; [.015 to .12 gm.]

[OPII PULVIS. Powdered Opium. Opium dried at a temperature
not exceeding 185 F. ; 85 C., and reduced to a very fine powder.

Powdered Opium, for pharmaceutical or medicinal purposes, when assayed,
should yield not less than 13 nor more than 15 per cent, of Crystallized Mor-
phine. Any Powdered Opium of a higher percentage may be brought within
these limits by admixture with Powdered Opium of a lower percentage, in
proper proportions.

Dose, j^ to 2 gr. ; .015 to .12 gm.]


1. [Extractum Opii. Extract of Opium. Powdered Opium,
loo ; Distilled Water, 1000 ; Sugar of Milk, a sufficient quantity ; by
trituration, filtration and evaporation.

Dose, ]/i to i gr. ; .008 to .06 gm.

2. Emplastrum Opii. Opium Plaster. Extract of Opium, 60 ;
Burgundy Pitch, 180 ; Lead Plaster, 780; water, 80.

3. Trochisci Glycyrrhizae et Opii. Troches of Glycyrrhiza and
Opium. Extract of Glycyrrhiza, 15 ; Powdered Opium, 0.5 ; Acacia,
12 ; Sugar, 20 gm. ; Oil of Anise, O.2 c.c. To make loo troches.
Each troche contains about ^ gr. ; .005 gm., of Opium.

Dose, i to 4 troches.

4. Vinum Opii. Wine of Opium. Synonym. Sydenham's
Laudanum. Powdered Opium, 100 ; Cassia Cinnamon, 10 ; Cloves
IO ; Alcohol, 150 ; White Wine to 1000 ; by maceration and filtration.

Dose, 3 to 20 m. ; .20 to 1.20 c.c.

5. Pilulae Opii. Pills of Opium. Powdered Opium, 6.5 ; Soap,
2 gm. To make loo pills. Each pill contains I gr. ; .06 gm., of

Dose, i to 2 pills.


6. Pulvis Ipecacuanhas et Opii. Powder of Ipecac and Opium.
Synonym. Dover's Powder. Powdered Opium, IO; Ipecac, 10;
Sugar of Milk, 80.

Dose, 3 to 15 gr. ; .20 to i.oo gm.

7. Acetum Opii. Vinegar of Opium. Synonym. Black Drop.
Powdered Opium, IOO ; Nutmeg, 30 ; Sugar, 200 ; Diluted Acetic
Acid to looo ; by maceration and percolation.

Dose, 3 to 20 m. ; .20 to 1.20 c.c.

8. Tinctura Opii. Tincture of Opium. Synonym. Laudanum,
Powdered Opium, loo ; Alcohol, 400 ; Water, 400 ; Diluted Alcohol
to 1000 ; by maceration with Precipitated Calcium Phosphate, 50 ; and

Dose, 3 to 20 m. ; .20 to 1.20 c.c.

9. Tinctura Opii Camphorata. Camphorated Tincture of
Opium. Synonym. Paregoric. Powdered Opium, 4 ; Benzoic Acid,
4 ; Camphor, 4 ; Oil of Anise, 4 ; Glycerin, 4 ; Diluted Alcohol to
looo ; by maceration and percolation.

Dose, i to 4 fl. dr. ; 4. to 15. c.c.

10. Opium Deodoratum. Deodorized Opium. Synonym.
Opium Denarcotisatum. Powdered Opium (containing 13 to 15 per
cent, of Morphine), loo ; macerated with Ether, 700 ; the clear solu-
tion poured off, and macerated twice with Ether, 350. The residue is
dried and mixed with Sugar of Milk by trituration to weigh loo parts.

Dose, % to 2 gr. ; .015 to .12 gm.

n. Tinctura Opii Deodorati. Tincture of Deodorized Opium.
Powdered Opium, loo ; Ether, 200 ; Alcohol, 200 ; Water to looo.
By maceration with Precipitated Calcium Phosphate, 50 ; by percola-
tion and evaporation.

Dose, 3 to 20 m. ; .20 to 1.20 c.c.

12. Tinctura Ipecacuanhas et Opii. Tincture of Ipecac and
Opium. Tincture of Deodorized Opium, looo ; Fluid Extract of Ipe-
cac, loo ; Diluted Alcohol to looo ; by evaporation and filtration.

Dose, 3 to 15 m. ; .20 to i.oo c.c.]

It will be noticed that from [Extract of Opium there is prepared Emplas-
trum Opii, and from the Deodorized Tincture, Tinctura Ipecacuanhas et Opii.

The following non-official preparations are sometimes used : Nepenthe, of
the same strength as Laudanum, Liquor Opii Sedativus (Battley's solution),
which is about 50 per cent, stronger than Laudanum, Acetum Opii Crocatum
(black drop), four times as strong as Laudanum, and Tinctura Opii Ammon-
iata, B. P. (Scotch Paregoric), about two and one-half times as strong as the
Camphorated Tincture.]

The following list, in which the doses are arranged, may assist the student :


Name. Dose.

[Extractum Opii ^ to I gr. ; [.008 to .06 gm.]

~? HPU T \ ViS , 1 * to 2 gr.; [.015 to .12 pi.]

Opium Deodoratum . . . . J /4

Pulvis Ipecacuanhas et Opii . 3 to 15 gr. ; [.20 to l.oo gin.]

Tinctura Ipecac et Opii] . . 3 to 15 m. ; [.20 to l.oo c.c.]

Vinum Opii |

Tinctura Opii r -.

r-r- r> ^ .- ^ 3 to 2O m. ; [.2O to I.2O C.C.]

[Tinctura Opu Deodorati . .

Acetum Opii

Tinctura Opii Camphorata . . I to 4 fl. dr. ; [4. to 15. c.c.]

Pilulse Opii I to 2 pills.

Trochisci Glycyrrhizse et Opii] I to 4 troches.

Emplastrum Opii .... Externally.

[ACIDUM MECONICUM. Meconic Acid (not official). H 3 C 7 HO T

SOURCE. Calcium Meconate, which is precipitated in the manufacture of
Morphine Hydrochlorate, is placed in hot water and treated with Hydrochloric
Acid. On cooling, Meconic Acid crystallizes out.

CHARACTERS. Almost colorless, micaceous crystals. Solubility. In 150
parts of water ; in 45 parts of Alcohol ; it is decomposed by boiling water.

Preparation (not official).

Liquor Morphinae Bimeconatis. Solution of Morphine Bime-
conate. Morphine is precipitated by Ammonia from a solution of the
hydrochlorate. It is dissolved in water, Alcohol and Meconic Acid.
Strength, I in 80.

Dose, 5 to 40 m. ; .30 to 2.50 c.c.]

[MORPHINA. Morphine. C, 7 H, 9 NO 3 +H 2 O=3O2.34.

SOURCE. An Alkaloid obtained from Opium. Opium is macerated with
distilled water, and strained, the infusion is evaporated and filtered. To the
filtrate Alcohol and Water of Ammonia are added, and the Morphine crystal-
lizes out. To purify the crystals, they are boiled with Alcohol, the solution
filtered, when hot, through Animal Charcoal, and set aside to crystallize.

CHARACTERS. Colorless or white, shining prismatic crystals, or fine
needles, or a crystalline powder, having a bitter taste. Solubility. In 4350
parts of water.

Dose, y$ to % gr. ; .008 to .015 gm.]

MORPHINAE HYDROCHLORAS. [Morphine Hydrochlorate.
C 17 H 19 N0 3 HCl+ 3 H.p=37 4 .6 3 .

SOURCE. (i) Take a cold concentrated watery solution of Opium, pre-
cipitate the Meconic acid and resins with Calcium Chloride. The solution



contains Morphine Hydrochlorate. (2) Evaporate the solution till it is solid,
press to remove coloring matter, exhaust with boiling water, filter, and again
evaporate and press ; repeat this till the solution is nearly colorless. (3) Com-
plete the decolorization by digesting with Charcoal. (4) Precipitate the
Morphine with Ammonia and wash. (5) Dissolve in Hydrochloric Acid and
crystallize out.

CHARACTERS. White, feathery needles of a silky lustre, or minute,
cubical crystals, having a bitter taste. Solubility. In 24 parts of water ; in
62 of Alcohol.]

INCOMPATIBLE^. Lead, iron, copper, mercury and zinc salts ; alkaline
carbonates ; lime water ; liquor potassii arsenitis ; all substances containing

[Morphine Hydrochlorate is used in Tinctura Chloroformi et Morphinae
Composita. (See p. 291. [)

Dose, ^ to X T r - J [- 008 to - OI 5 g-]

MORPHINE ACETAS. Morphine Acetate. C 1T H 19 NO S C I H 4 O 1 +

SOURCE. Morphine is precipitated with Ammonia from a solution of the
Hydrochlorate. It is dissolved in Acetic Acid and water, and the neutral so-
lution is evaporated.

CHARACTERS. [A white, or faintly yellowish white, crystalline or amor-
phous powder, having a faint, acetous odor, and a bitter taste. Solubility.
In 2.5 parts of water ; in 47.6 parts of Alcohol.] Many specimens are not so
soluble as this. The use of this salt is diminishing as it is unstable, losing
Acetic Acid on exposure to air.

Dose, ^ to X S 1 "- > [- 008 to - OI 5 g m O

MORPHINE SULPHAS. Morphine Sulphate. (C 17 H 19 NO,) !1 H 2 SO 4

SOURCE. Morphine is dissolved in boiling distilled water ; diluted Sul-
phuric Acid is added to neutralization, and on cooling the Sulphate appears
in crystals.

CHARACTERS. White, feathery, acicular crystals of a silky lustre, and
having a bitter taste. Solubility. In 2 parts of water ; sparingly in Alcohol.

Dose, y$ to ^ gr. ; .008 to .015 gm.

Prepa rations.

1. Pulvis Morphinae Compositus. Compound Powder of Mor-
phine. Synonym. Tully's Powder. Morphine Sulphate, I ; Cam-
phor, 19; Glycyrrhiza, 20; precipitated Calcium Carbonate, 20; Al-
cohol, a sufficient quantity. By trituration.

Dose, 5. to 15. gr. ; .30 to i.oo gm.

2. Trochisci Morphinae et Ipecacuanha. Troches of Mor-
phine and Ipecac. Morphine Sulphate, o. 16 ; Ipecac, 0.50; Sugar,


65 gm. ; Oil of Gaultheria, 0.2 c.c. ; Mucilage of Tragacanth, a suf-
ficient quantity to make 100 troches. Strength. About -fa gr. ; .0016
gm. of Morphine in each.
Dose, i to 5 troches.

Two solutions of Morphine Sulphate should be carefully distinguished :
(l) The U. S. P. Solution (l to 480 of water), and (2) Magendie's (l to 30
of water). Magendie' s Solution as prepared in France is made from the ace-
tate and is somewhat weaker ( I to 3 grs). ]


The action and uses of opium are due almost entirely to its
morphine, and therefore they may be studied together. Codeine
[and other alkaloids will be considered on p. 366. Meconic
acid appears to be nearly free from physiological properties.]

External. Opium probably has no action when applied to
the unbroken skin, but it has been said to be slightly anodyne.
It can be absorbed from and relieve the pain of raw surfaces.

Internal. Alimentary canal. Opium diminishes all the
secretions of the body except the sweat. The mouth conse-
quently becomes dry, and the patient feels thirsty, but after a
small dose not markedly so. This effect is partly due to the
direct action of the opium on the mouth, but to a less extent to
its influence exerted after it has been absorbed. In the stomach
and intestines, by the same double action, the secretion of the
gastric and intestinal juices is diminished. The drug also para-
lyzes the peristaltic movements of the stomach and intestines.
This is due to its action on the nervous or muscular structures in
the wall of the intestine itself. The result of the diminution of
secretion and peristalsis is that opium appeases hunger, often
causes indigestion, almost always gives rise to constipation,
and if vomiting or diarrhrea is present, it may prevent it. These
actions are also in part due to its general sedative influence on
the nervous system. If pain exists in the abdomen or elsewhere,
opium is a powerful anodyne. Most of it is absorbed, but
rather slowly. If injected subcutaneously it is excreted into the
stomach. With some persons it causes vomiting. Whether
the biliary and pancreatic secretions are diminished is not


Blood. Morphine for the most part circulates in the blood as
such, and is excreted by the kidneys, but a small part of it is
destroyed in the liver. The fate of the other alkaloids is not
known, nor are we aware of any direct action of any of the con-
stituents of opium on the blood itself.

Circulation. In an ordinary healthy man small doses of opium
hardly affect the heart or vessels. Large doses diminish the
force and frequency of the heart, which finally stops in diastole.
These effects can be produced by applying the drug to the organ ;
it therefore directly affects either the cardiac muscle or the nerves
in it. But this local action is said to be helped by the less im-
portant influence of opium on the vagal centre ; this is at first
stimulated, and about the time at which the heart itself is de-
pressed, so that both these actions make the pulse slow.
Patients rarely die from the effect of opium on the heart and its
nervous apparatus, this being much less important than the in-
fluence on respiration, and some of the cardiac depression may
be secondary to asphyxia.

The vaso-motor centres are slightly depressed by moderate
doses, hence the vessels, particularly those of the skin, dilate ;
with large doses the depression is considerable.

Respiration. Opium is a direct poison to the respiratory
centre. Breathing therefore becomes slow, less air is taken in
at each inspiration, and death takes place from asphyxia. The
secretion of bronchial mucus is decreased.

Nervous system. Brain. The higher faculties are at first
excited even by small doses. In a few persons there is no inco-
ordination in this excitement. The intellectual power and
mental vigor are increased, and therefore the drug is taken by
some people to enable them to do their mental work. Usually,
however, the excitation does not affect the mind evenly ; gener-
ally the imagination is powerfully and pleasantly excited, much
more so than the faculties of reason and judgment, which are a
little dulled. The expression on the face is one of happiness
and comfort, and this corresponds with the condition of the
mind, which is in a state of peace, calm and happiness. This is
soon succeeded by sleep, which is accompanied by pleasant


dreams, generally of an impossible nature. With some persons,
however, the sleep is quite dreamless. This, which is the be-
ginning of the depression of the highest centres, is soon followed
by depression of the others, the higher being influenced before
the lower, so that soon the sleeper does not respond to any
sound, light, or cutaneous stimulation, nor does he feel pain.
It is this last fact that makes the drug so invaluable. The dose
requisite to annul pain depends, of course, upon the severity
of it. If a large amount is given, often there is no primary ex-
citement, and then the first symptom that opium has been taken
is drowsiness. On waking from sleep induced by opium some
persons feel quite well, but usually there is a little languor,
headache, and nausea. Opium-eaters take it for its stimulant
effect. It is given medicinally as a hypnotic and anodyne. The
pupil is contracted ; this is due to the effect of the drug on
the pupillary centre in the floor of the aqueduct of Sylvius. In
man, just as the stimulation of the intellectual centres is brief, so
is that of the cerebral motor centres in fact, it is often difficult
to detect any evidence of it. Their subsequent depression is
never so marked as that of the intellectual faculties ; for although
there is languor and muscular weakness, and the patient always
lies down, yet he can be walked about if he is supported. Vomit-
ing is occasionally caused by transient irritation of the vomiting
centre, but soon it is depressed, and therefore emetics do not act
well in cases of opium poisoning.

The motor cells of the spinal cord are at first slightly
stimulated, and consequently reflex excitability is exaggerated;
but they are soon depressed, and it is difficult to obtain reflex

The excitability of motor and sensory nerves is, perhaps, a
little increased at first, but in the later stages of opium poison-
ing they are depressed, the sensory before the motor. The
muscles remain irritable to the last.

Opium, in its action on the nervous system, illustrates the
common fact that functions at first stimulated by a drug are
usually subsequently paralyzed by it ; and it affords an excellent
example of the law of dissolution, for higher functions, such as


the intellectual and imaginative, are first affected ; motion is
then disordered ; next the pupillary centre, and then the medul-
lary centres, for respiration and cardiac action are implicated.
The spinal cord is influenced to a less degree, the nerves very
slightly, and the muscles not at all.

In man the peculiarities of the action of morphine are its
predominating influence on the higher mental functions, and the
slight affection of the motor and the vaso-motor centres, the cord,
the nerves, and the muscles. In frogs morphine produces violent
convulsions, because its predominating action is to stimulate the
spinal cord. Birds are peculiarly insusceptible to morphine.
Mammals are for the most part affected in the same way as
man, except that the first or excitement stage is more marked ;
hence with many mammals, especially cats, morphine is a vio-
lent convulsant ; dogs and rabbits require large doses to pro-
duce symptoms.

Kidneys. Sometimes opium slightly increases, sometimes it
slightly decreases, the urinary flow. Perhaps morphine is de-
composed in the body, for oxydimorphine has been found in the
urine of those taking morphine.

Skin. Opium is a mild diaphoretic. It may cause itching.

Metabolism. If the person taking opium has glycosuria, the
amount of sugar he passes in the urine is diminished. General
metabolism appears to be decreased also, for it is stated that the
amounts of uric acid and carbon [dioxide] excreted are lessened,
but some experimenters contradict this statement.

Temperature. Large doses depress this, probably from the
effect of the drug upon the thermogenetic nerve centres.

Persistent use of large doses decreases the secretion of milk
and the menstrual discharge. It is excreted by the milk, and so
may affect the child.

Peculiarities. There are few drugs which have such different
effects upon different people. The above description states the
manner in which most human beings are affected ; but in some
the stage of excitation is very evident, so that they become deli-
rious and cannot sleep. In others, vomiting and indigestion are
very marked. Some of these peculiarities are due, no doubt, to


the varying composition of opium. Children are easily poisoned
by it, and therefore only small doses should be administered
to them ; women are more readily affected than men. Persons
who take it habitually soon tolerate enormous quantities. It
may produce an erythematous eruption on the skin.

Differences in action between opium and morphine. (i) Mor-
phine being more readily absorbed, acts more quickly. It is
especially suitable for subcutaneous injection ; given in this way
it acts very rapidly. (2) Opium is more liable to upset the diges-
tion and to cause constipation ; but this last fact often makes it
the more valuable in many abdominal diseases. (3) Opium is
the better diaphoretic. (4) Morphine is more certain in its ac-
tion as an anodyne and soporific ; possibly this is because of the
other powerful alkaloids in opium. (5) [It is less convulsant.]
(6) Opium is stated to act more powerfully in reducing the
amount of sugar present in the urine in glycosuria. [(7) Opium
affects the bladder sphincter less. (8) Morphine causes more
pruritus than opium.]


External. Hot fomentations or poultices sprinkled with
laudanum are often applied to painful parts ; but probably it is
the heat and not the opium which relieves the pain. Linimentum
Opii [B. P., tincture of opium and soap liniment, equal parts],

Online LibraryWilliam Hale-WhiteMateria medica, pharmacy, pharmacology and therapeutics → online text (page 31 of 67)