This section is from the book "Dental Medicine. A Manual Of Dental Materia Medica And Therapeutics", by Ferdinand J. S. Gorgas. Also available from Amazon: Dental Medicine.
Opium is obtained from the unripe capsules of the papaver somniferum, of the natural order Papaveracecs - poppy order, in the form of a concrete juice, which exudes from incisions, and which is permitted to evaporate spontaneously. Commercial opium is in the form of irregular masses, of from a few ounces to several pounds in weight, with a moist, brown or chestnut surface, and a peculiar odor and nauseous taste. The purest form should have a chestnut color, a strong aromatic flavor, and a dense consistence, and break with a deeply notched fracture, and when drawn across white paper leave an uninterrupted line. The alkaloid morphine is the most important of the chemical constituents of opium. (See Morphine.)
As an anodyne and hypnotic opium possesses the power of relieving pain and inducing sleep; it relaxes muscular spasm, and hence is a very efficient remedy in tetanus, spasms, nervous irritability and discharges of a morbid nature. It excites the circulation as a first action, and increases the temperature of the skin, and causes an agreeable exhilaration of the intellectual faculties, so much so as to be used by some as an habitual narcotic, which is finally destructive to both the physical and mental functions. But the stage of excitement is very transient, and is succeeded by a falling of the pulse, a diminished susceptibility to external impressions, confusion of mind and the loss of consciousness in deep sleep. Other effects are also manifested, such as dryness of the throat, thirst, and in some cases, nausea and vomiting, with an itching miliary eruption on the skin.
Taken in large or poisonous doses, opium does not cause any excitement, but giddiness and stupor rapidly supervene, with a lessening in the frequency of the pulse, but not in fulness, a tendency to sleep, which is irresistible, and finally coma, in which the breathing is heavy and stertorous, the pulse slow, and the pupils contracted, with a sinking of the pulse and relaxation of the muscles immediately preceding death; in the case of children death is often preceded by violent convulsions.
The antidotes in poisoning by opium are the stomach pump, emetics in double doses, such as sulphate of zinc, in doses of gr. xx to gr. xxx, or sulphate of copper, gr. v to gr. x; also mustard in powder, or powdered alum, answer as emetics, strong coffee, keeping the patient in motion, counter-irritation to nape of neck, flagellation to the palms of the hands and soles of the feet, and the electro-magnetic battery, which is often efficient when other measures fail, artificial respiration, and belladonna, in hypodermic injections of its alkaloid atropine, in solution. No local lesions are found after death.
Opium as an anodyne and hypnotic is employed in almost all diseases where the necessity of assuaging pain and inducing sleep is required. (See Morphine.) Opium is contra-indicated where there is a tendency to apoplexy or coma, or where an unusual susceptibility to its influence exists, and it should be administered to the very young and very old with great caution. When long administered it is necessary to increase the dose. Externally, in the form of powder, it is applied to irritable ulcers, etc., and to the rectum, as suppositories.
Of opium, in powder or pill, as an anodyne and hypnotic, gr. j.
Opium is employed as an anodyne in convulsions of teething, but must be administered with great care and in small doses ; also as an anodyne preparatory to lancing the gums of children ; also in mercurial salivation, to arrest the excessive secretion, in doses of gr. j every four hours; also in neuralgia; but it is inferior to aconite. A small lump of opium in contact with an aching tooth pulp will relieve the pain, or the powder may be used for the same purpose. In the form of wine and tincture, opium is serviceable in odontalgia, periodontitis, inflamed gums and mucous membrane of the mouth; in injections, for alveolar abscess, when it is often used in combination with tincture of iodine. The wine of opium is a more soothing and pleasant application than the tincture of opium.
Vinum Opii - Wine of Opium - is obtained by macerating two ounces of powdered opium, together with cinnamon and cloves, in one pint of white wine. Dose, to
Employed as a soothing and anodyne application to inflamed and tender gums and mucous membrane, odontalgia, ulcerations of mouth, alveolar abscess, periodontitis, pulpitis, etc. Dr. W. H. Atkinson recommended wine of opium by means of injection, into pockets and cavities, where such exist, in cases of aching gums or teeth.
Dover's Powder - Pulvis ipecacuanha et opii. Dose, gr. x. Ten grains contain one grain each of ipecac and of opium, and eight grains of sugar of milk. For influenza or "common cold," a dose of Dover's powder taken at bedtime, with such adjuncts as warm clothing, hot drinks, foot-baths, etc., to promote profuse diaphoresis, proves very effective. Ten grains at bedtime is also a very serviceable remedy for inflammations of the peridental membrane.
Tinctura Opii - Tincture of Opium - laudanum is composed of powdered opium, ; diluted alcohol, Oj. Dose, to ; 25 drops are equivalent to one grain of opium. Its strength increases with age. Tincture of opium in hot water to aquas ferv. , held for some minutes in the mouth, is useful in peridental inflammation.
One drachm of the tincture contains 120 drops. The dental uses are the same as for wine of opium, but the latter is the most pleasant application for the mouth.
Tinctura Opii Camphorata - Camphorated Tincture of Opium - paregoric elixir - is prepared by macerating sixty grains of opium in two pints of diluted alcohol, with sixty grains of benzoic acid, a fluidrachm of oil of anise, two ounces of clarified honey, and forty grains of camphor.
Dose, to or a tablespoonful, containing a little less than one grain of opium. Dose for an infant, gtt. v to xx. This is an agreeable preparation for children.
Tinctura Opii Deodorata - Deodorized Tincture of Opium - is composed of the watery extract of opium, washed with ether, which is afterward separated, and the residue dissolved in water and mixed with enough alcohol to preserve it. This preparation of opium is free from the narcotina and many other injurious ingredients of opium, and is a valuable preparation. Dose, to
A Stimulating Injection for Abscess of Antrum.
J. S. Smith.
Tinct. opii camph. .
Eau de cologne . .
For Infantile Diarrhoea During Dentition.
When there is a tendency to an acid fermentation of the food.
Dr. Jas. W. White.
If undigested food or vitiated secretions in alimentary tract are suspected, a dose of castor oil and aromatic syrup of rhubarb in equal portions - dose, a teaspoonful; if torpidity of liver, a few doses at intervals of two hours, of the twelfth or sixteenth of a grain of calomel with one or two grains of sodium bicarbonate. If the diarrhoea persists, use the following, first prohibiting the use of farinaceous or milk food:
Bismuth. subnitrat. . Mucilag. acaciae . . Aquae menth. pip. . .
A teaspoonful every 3 hours to a child 6 months old. Opium is indicated only after all offending matters have been expelled from the alimentary canal.
For Infantile Diarrhoea During Dentition. If it is due to relaxation from long continued warm weather, or following cholera infantum, and no fever is present.
Dr. Jas. W. White. Tinct. opii camph. . . Ext. haematoxyli . . Mist. cretae, Aquae cinnamoni . aa Signa. - A teaspoonful in water every 4 hours for a child 6 months old.