1993. In Puerperal Fever, Opium Is A Very Valuable Remedy

It tends in a marked degree to allay the pain, and to reduce the excitement of the nervous and vascular systems. Dr. Churchill* speaks highly of its efficacy. He states that he has seen cases yield to the administration of one grain of Opium repeated every hour, until the symptoms have subsided. Dr. Stokes was the first to point out the value of Opium in these cases, and Dr. Churchill states that he has repeatedly verified his remarks on its value. The treatment of Puerperal Fever by large and repeated doses of Opium has more recently been advocated by Dr. A. Clark, of New York. He regards it as chiefly useful when Peritonitis is a prominent element; and to be successful, he adds, it should be commenced early, and the patient brought under its influence as rapidly as is consistent with safety. The tolerance of Opium in this disease is very marked.

1994. In Puerperal Intestinal Irritation, after the bowels have been well cleared out, Opium, either alone or combined with alteratives, is highly serviceable. It may also be given in the form of enema. (Locock.)

1995. Puerperal Diarrhoea May Often Be Effectually Arrested By A Few Drops Of T

Opii, either alone or in combination with the mineral acids.

* Midwifery, p. 471.

Banking's Abstract, xxii. p. 186.

Lib. of Med., vol. i. p. 363.

1996. In Uterine HAemorrhage, whether occurring in the earlier months of gestation, or the latter; depending either upon the position of the placenta, or its partial separation; whether the loss take place after the birth of the child, and the throwing off the placenta; whether this be retained by irregular contraction or morbid adhesion; or whether the haemorrhage take place after the complete evacuation of the uterus. Opium is a powerful and valuable remedy. The dose, however, requires to be carefully regulated according to the urgency of the symptoms, the amount of haemorrhage, &c. "It should always be borne in mind," observes Prof. Murphy,* "that Opium possesses a twofold action; namely, sedative in large, and stimulant in small doses; and that one effect or another is produced, according to the relation existing between the nervous energy of the uterus and the dose of the medicine given. If nervous irritability be not impaired, or if it be increased, a very small dose of Opium would stimulate, and a larger one would exhibit its sedative effects; but if, on the contrary, the irritability be destroyed and the uterus atonic, the same large dose would only act as a stimu -lant, nor will the sedative property of the medicine be observed until the nervous energy be restored. When, therefore, the loss of blood is slight, or at least not sufficient to impair the tone of the uterus, a large dose of Opium would be dangerous, lest it might act as a sedative, overcome the influence of the nerves, and cause the uterus to relax. When the loss of blood is great, and followed by exhaustion, then the very same quantity will produce an opposite effect; it will act as a stimulant, and cause contraction of the uterus." These are the principles which should guide us in the regulation of the dose. When the haemorrhage is slight, and the tone of the uterus unimpaired, half a grain or a grain of Opium may be sufficient; whereas, if the loss be very great, two or three grains of Opium, or even 3j. - 3ij. of the Tincture, will be necessary. Its operation, when the patient is apparently sinking fast into the grave from excessive haemorrhage, is often, indeed in the majority of cases, very striking; in such cases it is superior to all other remedies. In other forms of excessive HAemorrhage, causing great exhaustion, Opium is a most powerful remedy, particularly when combined with cordials, &c.