Whenever opium is used to relieve pain, to procure sleep, to relax spasm — there being no inflammatory action present — belladonna should be combined with it, unless some contraindication should exist to the action of the latter. This formulated expression is more especially applicable to the hypodermatic use of morphine.

In the various psychical disorders, in which the general condition is sthenic, opium or morphine should be used alone. When power is deficient, the forces depressed, the temperature rather below than above the normal, belladonna or atropine should be combined with the opium or morphine. For the relief of insomnia the combined action of these agents is much more effective than either singly. The proportion in which the alkaloids should be used is about as follows: 1/120—1/100 of a grain of atropine to ½ and ¼ of a grain of morphine.

In the various convulsive disorders in which opium or morphine may be used, especially hypodermatically, atropine should be combined with it.

The neuralgiae, are best treated by morphine and atropine combined, for the following reasons: the combination is more effective, the after-unpleasant effects of either are prevented to a considerable extent.

The neuroses of the respiratory organs, of the abdominal viscera, etc., are, as a rule, more successfully treated by morphine and atropine in combination, than by either separately.

In surgical diseases and operations of various kinds, the combination of morphine and atropine has most important and varied applications, among which may be enumerated: to render safer and to prolong ether or chloroform narcosis; to prevent or relieve shock; to save suffering; to relax muscles; to facilitate operative procedures.

The combined administration of morphine and atropine is of the greatest service in obstetric practice: to relieve the teasing pains of the first stage; to procure sleep in the course of an exhausting labor; to quiet after-pains; to facilitate the performance of various obstetric operations; to arrest puerperal convulsions.

Authorities referred to:

Albers, Dr. J. H. F. Virchow's Archiv, Band xxvi, p. 229.

Allbutt, Dr. T. C. The Practitioner, vol. iii, p. 342. Ibid., vol. v, p. 327.

Anstie, Dr. F. E. Stimulants and Narcotics, American edition. Article Alcoholismus, Reynolds's System of Medicine. The Practitioner, vol. i, No. 1, etc.

Asche, Dr. Schmidt's Jahrbücher, Band cxxv, pp. 331-337.

Bartholow, Dr. Roberts. Manual of Hypodermatic Medication, fourth edition.

Bernard, Claude. Bulletin Général de Thérapeutique, vol. lxxvii, p. 241, et seq.

Ibid. Archives Générales de Médecine, 1864.

Bois, Dr. A. De la Méthode des Injections Sous-cutanées, Paris, 1864, p. 17.

Courtenay, Dr. E. M. West Riding Lunatic Asylum Reports, vol. ii, p. 254.

Da Costa, Dr. J. M. Pennsylvania Hospital Reports, 1868.

Demarquay, Dr. Bulletin Général de Thérapeutique, October 15, 1871, p. 229, et seq.

Erlenmeyer, Dr. A. Die subcutanen Injectionen der Arzneimittel, dritte Auflage, Neuwied, 1866.

Eulenburg, Dr. A. Die hypodermatischen Injectionen der Arzneimittel, zweite Auflage, Berlin, 1867, p. 96, et seq.

Ibid. Lehrbuch der functionellen Nervenkrankheiten, Berlin, 1871, p. 166, etc.

Fluckiger and Hanbury. Pharmacographia, p. 40, et seq.

Fronmuller, Dr. Klinische Studien über die schlafmachende Wirkung der narkotischen Arzneimittel, Erlangen, 1869.

Harley, Dr. John. The Old Vegetable Neurotics.

Hunter, Charles. On the Speedy Belief of Pain and other Nervous Affections by means of the Hypodermic Method, Churchill, London, 1865.

Husemann, Drs. Aug. und Theod. Die Pflanzenstoffe, p. 111, et seq.

Husemann, Dr. Theodor. Handbuch der gesammten Arzneimittellehre, Berlin, 1875, zweiter Band, p. 1055, et seq.

Hutchison, Dr. James H. Pennsylvania Hospital Reports.

Krafft-Ebing, Dr. R. von. Bulletin Général de Thérapeutique, January 30, 1870, p. 474.

Lawson, Dr. Henry. Sciatica, Lumbago, and Brachialgia, London, 1872.

Loomis, Dr. A. L. Lectures on Diseases of the Respiratory Organs, Heart, and Kidneys, New York, 1875, p. 450.

Maudsley, Dr. H. The Physiology and Pathology of the Nervous System, and Reynolds's System of Medicine.

Medico-Chirurgical Transactions, vol. 1, p. 561, et seq.

Mitchell, Dr. S. Weir. American Journal of Medical Sciences, 1869-'70, also in conjunction with Morehouse and Keen.

Ibid. Injuries of Nerves and their Consequences.

Nothnagel, Dr. Hermann. Handbuch der Arzneimittellehre, p. 1, et seq

Reissner, Dr. Bulletin Général de Thérapeutique, January 30, 1870, p. 89.

Robertson, Dr. C. Lockhart. The Practitioner, May, 1869, p. 272.

Rosenthal, M. Klinik der Nervenkrankheiten, Stuttgart, 1875.

StillÉ, Dr. Alfred. Epidemic Meningitis, and Therapeutics and Materia Medica.

Taylor, Dr. A. S. On Poisons, third edition, London, 1875, p. 547.

Trousseau, A. Clinique Médicale, vol. ii, p. 196.

Ward, Dr. J. Bywater. West Riding Lunatic Asylum Reports, vol. i, p. 152.

Wolff, Dr. 0. J. B. Archiv für Psychiatrie und Nervenkrankheiten, Band ii.