Treatme.nt  of  Toxic  Symptoms  oadsbd  by  Morpuimb  or


AyTAQOyiSAI  or  MOKPHiyE  AND  ATROPINE.       343

Atropine. — I  ma^  assume,  notwithstandiag  the  objections
of  Ilurloy  nnd  tiie  results  of  experiments  on  animals  by
Brown-S^uard,  that  tlie  phydiologieal  antagonism  of  mor-
phine and  utropiiio  has  been  amply  demonstrated  by  cases.,
of  poisoning  occurring  in  man.
In  treating  coses,  the  difficulty  of  precisely  regulating
the  amount  uectssary  to  overcome  the  toxic  symptoms  is
not  easily  surmountable.  I  ascertiiined,  in  the  case  which
occurred  to  myself,  that  jij  of  a  grain  of  atropine  was
equal  in  toxic  power  to  1  grain  of  morphine.  The  state
of  the  pupil  affords  valuable  but  not  nnerring  indications;
atropine  poaseesee  more  power,  relatively,  over  the  move-
ments of  the  iris  than  morphine.
Id  a  case  of  morphine-poisoning,  subcutaneous  ii^eo-
tions  of  atropine  should  produce  the  following  resulta ;

Dilatation  of  the  pupil.
Hushing  of  the  tace  aucceeding  to  pallor.
Dryness  and  warmth  of  the  skin  succeeding  to  a  cold
and  clammy  sweat.
Rise  in  the  pulse-rate  and  Itiniperature.
Return  of  reflex  tnovemcnts  of  eyelids  and  fauoea.
The  dilatation  of  the  pupil  should  be  slightly  main-
tained, and  should  not  be  carried  to  tlie  exaggerated  de-
gree sometimes  thought  necessary.  The  mistake  should
not  be  made  of  confounding  the  sopor  produced  by  mor-
phine nnd  atropine  with  morphine  oorua.  This  caution  is
the  more  necessary  because  this  sleep  is  often  cou?^idered
ft  condition  of  danger  requiring  renewed  adtninit>tratioa
of  the  aoti<lotcs  and  the  patient  is  at  length  poisoned  by
atropine.  SufHcient  atropine  should  be  administered  to
maintain  the  action  of  the  heart  and  the  respiration.  So
long  as  these  continue  gt>od,  no  danger  id  to  be  appre-
hended from  sltep  merely.
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UrPODERMATW  MEDICATION.
