North Carolina Medical Journal. Vol. 3. No. 4. April, 1879Various
Science
North Carolina Medical Journal. Vol. 3. No. 4. April, 1879
Various
Medicine -- North Carolina -- Periodicals; Medicine -- Periodicals
During the next seven hours, I injected into the bowel ½ oz. of whiskey
every half hour. All of it was retained. During this time, the patient
occasionally made an unconscious effort to swallow the mucus which
accumulated in the fauces, and succeeded so far as to diminish
temporarily the rattling and gurgling which now accompanied every
respiration. Several times after this effort at swallowing, respiration
had to be stimulated by the electrical current. At midnight there was a
slight convulsion, after recovery from which the patient again lapsed
into the same condition. Gradually there was an increase in the rate
both of circulation and respiration, until at 4 A. M., the heart beat
150, and the breathing was 36 per minute. There was no dicrotism, but
the heart’s contraction was steadily becoming more feeble and imperfect.
The pupils were still widely dilated, the extremities warm, and the
temperature 101°. Fifteen minutes later the heart ceased to beat, and
death supervened without a struggle.
For my own sake, as well as for the good of the profession, I invite the
most rigid criticism of the above report. The case in many ways is both
interesting and instructive. Was this a case of opium poisoning? The
symptoms appear to answer this question in the affirmative. I have so
frequently given a similar, and even a larger dose in pressing
emergencies, without the least unpleasant effect, that I find it
difficult to realize the fact that this patient was fatally poisoned by
½ grain of morphia. Such an unlooked for result has given a terrible
shock to my confidence in the safety of large doses of morphia under any
circumstances. The heart lesion of it before existed, evidently did not
influence the result, as all signs of it were gone when I examined,
three hours after the administration of the morphia, and they were not
reproduced, even under the stimulation of electricity, atropia and
whiskey.
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