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Opium in InflammationAuthor(s): Richard ChambersSource: Provincial Medical and Surgical Journal (1844-1852), Vol. 11, No. 2 (Jan. 27, 1847), p.54Published by: BMJStable URL: http://www.jstor.org/stable/25499687 .

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54 OPIUM IN INFLAMMATION

that there is no sufficient apparent difference between

burns before and burns after death, and thus the ques tion can only be determined by a dissection of the skin,

and that the distinction laid down by Christison fails in

the case of an cedematous corpse.--(Gazette Medicale

de Paris, No. 40. 1846.

OPIUM IN INFLAMMATION.

TO THE EDITOR OF THE PROVINCIAL MEDICAL AND SURGICAL JOURNAL.

SIR,

Permit me to remove a misconception that occurs

in Dr. Ranking's valuable paper on the employment of opium in inflammation. In regard to my views

on that subject, he says, "The constipated bowels

which Dr. Chambers, in the last number of your Journal, seems to regard as indncing the necessity for

hesitation in the use of this medicine, I regard as of

the least importance in the generality of inflammations." I did not apply that particular remark to its use in

inflammation, nor did I for one moment wish to say that such an effect would contraindicate its use in any

inflammation, in which it was otherwise indicated. But on the contrary, I look upon constipation as salutary in cases of enteric and peritoneal inflamma

tion, and the purgative treatment of these diseaes to be both vicious in principle and bad in practice. In

consequence of observing that the constipation attend ant upon enteric inflammation yields paripassu with the removal of the inflammatory symptoms, it was supposed that the relief was owing to the soluble state of the

bowels; whereas, I believe we must only regard this state as the consequence of the amendment in the

inflammatory symptoms. My observations on the constipating effects of opium

were as follows:-" In reference to the employment of

opium generally, I may remark, that the constipation which it causes, renders it obnoxious to some con

stitutions." There are several diseases not altogether of an inflammatory type in which the influence of

opium is urgently required either to relieve pain, or

to procure sleep. I would more particularly mention

cases of common continued and irritative fevers, and

cases of neuralgia. It frequently happens, however, that in consequence of the constipation which opium

produces, its employment causes the patient as much

discomfort as more than counterpoises whatever relief it may afford. In some cases this effect becomes at

once apparent by the furred tongue, dry skin, and

headache ; in other cases the effects exhibit themselves

by a long-continued derangement of the digestive function. If, then, it is possible to prevent all these

effects without interfering with the physiological action

of opium, is it not desirable to do so ?

It would, indeed, be taking a very limited view of

the matter to direct our attention merely to the consti

pation; we must look beyond the effect to the cause

itself, which I believe to be an arrest of the biliary

secretion; and, when we remember the influence

which an arrest of secretion in so large a depurating

organ as the liver must exercise over the quality of the blood, I consider its removal or prevention

of the first importance. It appears to me that the coma of jaundice, to a certain extent, proves the correctness of my views of the subject.

In conclusion, allow me to say that I feel con vinced that Dr. Ranking's misconception of my views was unintentional, and I should not have occupied your pages, only that the importance of the subject itself required it.

I m, Sir,

Your obedient servant,

RICHARD CHAMBERS, M.D. Physician to the Essex and Colchester Hospital.

Colchester.

SPONGIO-PILINE. TO THE EDITOR OF -THE PROVINCIAL MEDICAL AND

SURGICAL JOURNAL. SIR,

Having seen Markwick's patent Spongio - Piine

advertised, I ordered some of it to be procured, and feel

bound in justice to state that, it has proved remarkably beneficial as well as comfortable to a patient of mine

who was suffering severely from acute bursal rheuma

tism, affecting several of the joints. I ordered it to be

steeped in a warm spirit-lotion and kept constantly

applied, and am so entirely satisfied with the result

that I venture to recommend its employment to the

readers of your valuable Journal.

I have the honour to be, Sir, Your obedient Servant,

J. C. BADELEY, M.D.

Chelmsford, Dec. 26, 1846.

INHALATION OF AETHER IN SURGICAL OPERATIONS.

TO THE EDITOR OF THE PROVINCIAL MEDICAL AND SURGICAL JOURNAL.

SIR,

Having now administered the vapour of ether for the purpose of rendering surgical operations painless in a great number of cases, at our Metropolitan

Hospitals and at my own private residence, with perfect success, by means of an apparatus invented by myself and Dr. Boott, and now manufactured by

Mr. Hooper, of Pall-Mall, &c., permit me, if not

encroaching too much on your valuable columns, briefly to state the appearance of the patient when under the influence of the vapour that indicates the proper time for the operation to commence.

As my own operations on the teeth have now

become numerous and satisfactory to those medical men who daily witness them, I will not occupy the time of your readers by entering into details.

I am, Sir, Your obedient servant,

JAMES ROBINSON. 7, Gower Street, Bedford Square,

January 18, 1847.

"At the commencement of the inhalation always allow the patient to inhale the vapour three or four

times without closing the nose; the aose beizg

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