15. Unguentum Gallae Cum Opio (Ointment Of Galls Oz

j.; Powdered Opium grs. xxxij.).

16. Vinum Opii (Powdered Opium Oz

iss.; Sherry Oj. Prepared by maceration and expression). Dose, ev. - xl. or even fl. drm. j. It is of the same strength as Tinct. Opii. The Vinum Opii of the Pharm. Lond. contained Cinnamon and Cloves.

Other Preparations, not officinal Solution of Bimeconate of Morphia (prepared by Squire). Same strength and dose as Tinct. Opii. According to the late Dr. Roots, this preparation disturbs the head less, distresses the stomach less, and constipates the bowels less, than any other preparation of Opium.*

Liquor Opii Sedativus (Battley). A valuable sedative and anodyne, fifty per cent, stronger than Tinct Opii. Dose, eiij. - exx.

Black Drop. Originally prepared by Cook, of Manchester. One drop is equal to four drops of Tinct. Opii.

Nepenthe. Prepared by Ferris, of Bristol. Same dose as Tinct. Opii

Dose of Powdered Opium, gr. 1/4 - gr. ij., or more. 1939. Remark) On The Use Of Opium

1. Some persons are peculiarly susceptible to the action of Opium, and are unable to take even the smallest dose without its occasioning delirium, a high state of nervous irritability, vomiting, diarrhoea, &c. Where this idiosyncrasy exists, Opium should not be given, unless some more than ordinary circumstances demand it. When, however, its exhibition is necessary in these subjects, it is sometimes tolerated, if given in the form of an enema; or, if given by mouth, a few grains of Capsicum will be found to allay the vomiting, and the addition of Camphor, or Tartar Emetic, will in a great measure obviate the nervous irritability. As a general rule, however, Opium should not be given in any form in these cases.

2. Infants And Young Children Bear The Exhibition Of Opium Badly

Numerous are the instances on record, in which two or three drops of Laudanum have produced fatal results in young children; and Opium in every form should be avoided, unless it is imperatively called for, and should never be given without the greatest caution. It should be laid down as a rule, that when it is necessary to prescribe opiates for children, those preparations whose strength is regulated by a certain standard should be preferred to those whose strength is variable and uncertain. Thus, Tinctura Opii, Tiuctura CamphoAe cum Opio, and Dover's Powder are preferable to Syrup of Poppies, the strength of which is very variable.

3. Those persons who are unaccustomed to Opium require a much smaller quantity of the drug, to produce a certain effect, than those who are habituated to its use.

4. Combination With Other Drugs Greatly Modifies The Action Of Opium

Ipecacuanha increases its action on the skin; mercurials obviate its constipating influence; and Tartar Emetic lessens the action which it would otherwise excite in the nervous system.

5. When a large dose of Opium has been administered, and the patient is still suffering intense pain, how long should we wait before it would be considered safe to repeat it? This question, put by Dr. Griffin, is answered by him, that half an hour is the limit within which crude Opium will be found to manifest its effects; and that the dose may be safely repeated, if the pain or spasm be not relieved, however often it may be given. The liquid preparations of Opium act rather sooner than the solid drug.

6. When Opium is given for the relief of a pain, particularly of a periodical character, a third part of the dose which was required to relieve the paroxysm, is required to prevent its recurrence. In fact, a moderate dose given in the interval will sometimes prevent the accession of the fit, when no quantity, however great, can control it, after it has once set in.

* Squire's Comp. to Pharm., p. 135. Medical Problems, art. x., from which this and the three following remarks are drawn.

7. When Opium or opiates have been given for any length of time, or in large doses, a period of exhaustion and sinking almost invariably ensues, from twelve to twenty-four hours after the drug has been discontinued. A great amount of exhaustion and sinking has been observed to follow the omission of even a very reduced dose, particularly in children. A little nourishment, or some slight stimulant, is here necessary.

8. An over-dose of Opium will produce effects very similar to those of an under-dose. Where a restless night has resulted from an over-dose having been given, sound sleep may occur next night without any Opium whatever. Again, if the doses of Opium given with advantage during the existence of inflammation, be continued when this has subsided, stupor or troubled sleep, according to the degree of surplus Opium given, will result.

9. In order to procure sleep, Opium should be given an hour or two before the usual hour of retiring to rest, in order to allow the stage of excitement to pass off, previous to that time.

10. When, from irritability of the stomach or from some other cause, Opium cannot be administered by mouth, it may often be advantageously administered in the form of enema; a larger dose, a third or half larger, is required when it is exhibited in the latter mode. It may also prove of the highest service when applied externally, in allaying pain, irritation, and inordinate action, not only of the skin, but of the subjacent tissues.