In purulent Ophthalmia, the Vinum Opii was first advised by Mr. Ware. who directs that it should be placed on the inner angles of the eyelids, and gradually made to glide along the eye, by gently drawing down the lower lid. It is particularly advised where there is much scalding pain, lachrymation, and intolerance of light.
* Med. Gaz., Dec. 1, 1848.
Obs. on the Eye, Lond. 1805.
It is an excellent application in the relaxed condition of the conjunctiva, which frequently remains after the acute inflammatory symptoms have disappeared, and the puriform discharge has ceased. It ought not to interfere with constitutional or other treatment. In Pustular or Aphthous Inflammation of the Conjunctiva, Vinum Opii is a valuable adjunct to other remedies. Mr. Morgan* advises one of the following collyria: - ℞ Liq. Plumb. Diacet. e vj., Aq. f3xiv., Liq. Opii Sed. vel T. Opii f3ij., M.; or Argent. Nit. vel Zinci Sulph. vel Cupri Sulph. gr. ij., Aq. f3x., Vin. Opii f3ij., M. In Scrofulous Ophthalmia, these collyria may also be used with advantage; or the eye may be bathed with a tepid aqueous solution of Opium. In Variolous Ophthalmia, the undiluted Vinum Opii may be applied with advantage, when acute inflammation has been subdued. In catarrho-rheumatic Ophthalmia, and in Ophthalmia Tarsi, the local application of Vinum Opii, pure or diluted, may be used with advantage. In all the above cases, it should be borne in mind that the collyrium should not be of a strength sufficient to cause severe pain.
1998. Otalgia is often greatly relieved by the introduction into the external meatus of a piece of cotton soaked in equal parts of T. Opii and Ol. OlivAe. In Otitis, Opium is inadmissible, as it frequently causes distressing headache, &c. In some forms of Atonic. Deafness, the endermic use of Opium proves serviceable. (See Morphia.)
Christison states that Opium, given at an early stage, will have the effect of cutting it short, or, at any rate, of greatly relieving the distressing symptoms. He relates two cases in which Opium, in the form of Dover's Powder, was attended with the best effects. In Coryza, also, he has seen a full dose of Opium, at the outset of the disease, signally useful.
Opii, introduced into the carious tooth, frequently affords temporary ease.
2001. Violent Spasmodic Hiccough may often be effectually arrested by friction on the spine with an opiate liniment.
2002. In internal HAemorrhages, Opium is a valuable adjuvant to astringents, as Acetate of Lead, Alum, &c. It proves highly serviceable in allaying the nervous excitement which so often accompanies profuse hAemorrhage; it should then be given with cordials.
Corrigan,* of Dublin, and others. The doses advised by Dr. Corrigan are very large: thus, in one case, he gave during the first day, gr. viij. of solid Opium; on the second, third, and fourth days, this was increased to gr. xij. daily. In another case, 200 grains were given in about a fortnight. Dr. Corrigan remarks that there appears to be a peculiar tolerance of Opium in this disease, and that he never saw the head affected by the large doses administered; occasionally he found it produce diarrhoea, which required astringents to check it. He directs that the Opium should always be increased in dose, both as to frequency and quantity, until the patient feels decided relief; and it should then be kept up at that dose, until the disease is steadily declining. He concludes his observations on eight cases successfully treated by this remedy, by remarking that the most important rule to be remembered in employing Opium for the cure of Acute Rheumatism, is that full and sufficient doses shall be exhibited. He found it fail in Rheumatism associated with Gout, or in which an hereditary taint existed. The above treatment has not proved generally successful; although as an adjunct to other treatment, Opium, in doses of gr. ij. - iv., proves highly serviceable. Dr. Todd advises the following modification of the above, which is reported to be very successful: - ℞ Opii gr. j., Pulv. Ipecac. Rad. gr. j., Potas. Nit. gr. v., M. This is given every two, three, or four hours, as the urgency of the symptoms requires. "The Opium," he observes, " quiets the nervous system, procures sleep, and, with the Ipecacuan, promotes sweating; while the Nitre acts upon the kidneys. At the same time, the bowels should be regulated by alkaline purgatives and the painful parts enveloped in wool." Twenty-six cases of Acute Rheumatism, successfully treated by large and repeated doses of Opium, are related as occurring in the practice of Dr. Sibson. The tolerance of Opium in these cases was very remarkable, one man taking 141 grains of the drug in the space of twelve days.
* Diseases of the Eye, 8vo, Lond. 1839.
Edin. Monthly Journ. of Med. Science, No. 2.