his previous history, I gave one grain of the drug at once to allay the nervousness, which had the desired effect. The skull was trephined, clots of blood were removed from off the brain, and then there was a slight improvement in his condition. He lay unconscious for fifteen days, and was given morphine at intervals of eight to ten hours. The dose was gradually reduced to one-quarter of a grain a day, although he had been taking eight to ten grains a day. This reduction in the dose did not have any effect towards weakening his heart whatever. He regained consciousness fifteen days from date of injury, and made a good recovery, and now, seven years later, he still lives, hale and strong, and continues to take morphine.

The third state of the effect of morphine is one of prostration and exhaustion of the sensory nervous system. Why opium is so exciting and stimulating to the nervous system is not clearly understood, but I think it more than probable that it is because the primary effect of the drug is to dilate the capillary vessels, causing a more diffuse rush of blood to all parts of the body, giving rise to its more thorough oxygenation, and thereby rendering it more vivifying and of far greater force to nerve centers. After the effects of the morphine have died out, a contraction of the blood-vessels takes place, the supply of oxygen is lessened, and the withdrawal of this unnatural stimulant will produce a lowering of the vital forces below the normal condition. Nausea and vomiting, which is a common symptom in the third stage, may go on to an alarming extent, to counteract which I will name some remedies that have acted well with me: atropia and strychnine (these given hypodermically), and bromidia, which may be used by enema, if vomiting is excessive.

Now I do not wish to be understood as an advocate of the morphine habit; far from it. But many doctors have said to me, "I do not like to give morphine; it will get my patients in the habit." I wish to say that in an active prae

tice of thirteen years, with a free use of the drug, I have never made a morphine-eater. But I will say in some cases I would advise the use of the drug continually, because it prolongs life, lessens tissue waste, retards the activity of the cells, and sustains the vital forces, especially the heart; producing a contented and tranquilizing effect upon the mind, more satisfactory than any other drug. Morphine and alcohol do not go harmoniously together. I mean alcohol will not be tolerated by the system with morphine continually for a very long period of time. Morphine, checking the secretions of the system, making the system less active, prevents, or at least retards, the elimination of the alcohol, and by keeping it stored up in the system, it does not take it long, directly or indirectly, to produce a poison sufficient to destroy life.

A few cases I have gathered together will illustrate my position as to opium's prolonging life:

Mrs. H. became an invalid at the age of 25; began taking morphine continuously; grew active and strong, and attended to household duties and took morphine for thirty years.

Mr. F. was stricken with a partial paralysis; began taking morphine to relieve pain; grew active and strong (but did not cure paralysis), and continued the use of the drug for twenty years.

Mrs. C. always appeared delicate; began the use of opium; was able to attend to household duties, and continued the use of the drug for twenty-five years.

Mrs. H., very active, stout and robust; began taking morphine twenty years ago, and is now apparently enjoying the blessing of perfect health.

Mrs. C. always appeared delicate; took opium for twentyfive years; attended to household duties; active and possessed clear mental faculties during life.

Mrs. H., stout and robust and very active; has taken

morphine for twenty years; a woman of unusual business capacity and a successful financier.

Mr. H. was stricken with paralysis; took morphine for twenty years, and attended to a mercantile business successfully.

The profession, I am sure, is aware that morphine is now being used to an alarming extent by the masses, and that this use is growing daily. Numerous institutions exist for the treatment of the morphine-eater; and physicians everywhere have come to regard the habit as a disease, to be combated as any other. It becomes imperative upon us, therefore, to take steps toward stopping the promiscuous sale of the drug. The problem that confronts us is, "How can this be done?"

MORPHINE HABITUÉS WHO DRANK WHISKEY.
F. took morphine 4 to 5 years; active. Dead.
O. took morphine 3 to 4 years; active. Dead.
G. took morphine 3 years; active. Dead.
K. took morphine 10 years; invalid. Dead.
G. took morphine 12 years; active. Dead.
T. took morphine 1 year; active.

B. took morphine 1 year; invalid.

Dead.

Dead.

MORPHINE HABITUÉS WHO DID NOT DRINK WHISKEY. Mrs. H. took morphine 30 years; active and strong. Dead.

Mrs. H. took morphine 25 years; active and strong. Living.

Mrs. C. took morphine 35 years; delicate. Dead.

Mr. F. took morphine 20 years hypodermically; active. Dead.

Mrs. B. took opium 30 years; strong and active. Dead. Mrs. H. took morphine 15 years; strong and active. Living.

Mr. C. took morphine 12 years; strong and active. Living.

Miss H. took morphine 10 years; strong and active. Living.

ATROPIA POISONING.

BY A. K. BELL, MADISON, GA.

I also have a case of accidental poisoning by atropia, which I would like to report:

Mrs. T., aged twenty-five, delicate constitution, highly educated. Drug clerk made mistake and filled prescription with 1-6 grain sulp. atropia; dose was taken at 7 p.m.; in fifteen minutes began feeling queer and dizzy; constriction in throat and fauces; she was conscious that the medicine was wrong and tried to vomit, but could not. Becoming alarmed, she sent at once for me; in the meantime, with wonderful fortitude, she kept moving about all the time, feeling that if she were to be still her senses would be overcome and she would become unconscious. At 8:30 I saw her, she was very much excited and feared that she would soon die. I found pulse about 180, thready and feeble, face pale, pupils dilated to their utmost, very excited and talkative; respiration hurried and shallow. tried to produce vomiting but could not; realizing I had only a short time to work in, I at once gave two ounces of cognac brandy, followed in five minutes by 1-4 grain of morphine hypodermically; in five minutes more she be came unconscious with low muttering delirium, sense of hearing paralyzed, could not swallow, eyes wide open and no response to strong light whatever; after remaining quiet for four hours, she became violent; morphine 1-4 grain was administered again, which had the desired effect of quieting her; surface was cold and moist; she was wrapped in blankets and hot bottles were used. The capillary vessels

I

filled again, warmth and color returned, pulse improved; she lay unconscious for twelve hours and then regained consciousness. The after-effects were prostration of respiratory muscle and heart; was confined to her bed for two months, but made recovery to normal condition.