Cooley's Cyclopaedia of Practical Receipts Volume Ii Part 103

Medical opinion is in some measure divided as to the origin of this disease; for whilst there are authorities who believe that its propagation is due to contagion a.s.sisted by insanitary environments, there are others who incline to the supposition that these latter conditions alone are sufficient to produce it. Whether this is so or not there can be no question that impure air, overcrowding, filth, and deficient water supply, which implies insufficient ablution, serve to intensify and perpetuate it.

So strongly and confidently impressed are Messrs Welch and Marston of the connection between unhealthy surroundings and prevalent ophthalmia, that they regard the two as cause and effect, and state their belief "that the presence or absence of 'sago grains' affords a delicate test of the sanitary state of a school, a regiment, or any similar community."

Ample and painful confirmation of these views is afforded by the prevalence of the disease amongst the children, more particularly those who live in very poor and crowded districts. The pitiable, blear-eyed little creatures that one meets with in these localities are very frequently the victims of purulent ophthalmia, and as such bear unfailing testimony to the insalubrity and squalor of the homes in which they dwell.

Stromeyer states that he has met with the 'sago grains' in the eyelids of many domestic animals, more particularly pigs, the granules being always in proportion to the more or less dirty condition in which the animals were kept.

The above statements plainly indicate the means by which the disease is to be combated. Of these, thorough ventilation and pure air are the most important. Stromeyer records how, by simply ventilating some barracks, he reduced to an amazing extent a number of cases of the disease, which had broken out in the Hanoverian army. Possibly this result was due to the removal, by the current of air from the apartment of the dried particles of contagious matter.

Ablution, which, carefully performed, is, in addition to ventilation, an important curative agent, may, through the neglect of certain precautions, a.s.sist to spread the disease.

This it will a.s.suredly do if the basins employed by the patients for washing their eyes are not thoroughly cleansed and disinfected after being used. Furthermore, the towels may be made to spread the infection, unless they too are thrown into some disinfecting solution after use, and unless a separate towel is appropriated to each patient. The danger of reinoculation may ensue if each towel is not changed sufficiently often.

The bed-clothes of the affected persons, as well as the pillowcases, should be frequently renewed, the latter every day, since they collect and disseminate the discharges falling on them from the patient.

Medical authorities also strongly recommend the isolation of the patient, and then consequent separation from healthy persons as soon as ever the disease shows itself in a regiment, a school, or amongst any body of persons congregated together; a daily inspection of the eyes of each is recommended, so that whenever the "sago grains" develop themselves, the individuals so attacked may be removed, and placed under proper treatment.

The after effects of the various forms of contagious ophthalmia are thickening and distortion of the eyelids, more or less serious defect of vision, and not unfrequently total blindness.

During the course of the disease relapses from the most trifling causes frequently occur, and Warmolow states that a person who has once been affected with it is not safe against a recurrence, and should be a.s.siduously watched.

=Ophthalmia, Infantile, Purulent.= This disease very frequently attacks infants of 3 or 4 days old. It is distinguished by redness of the edges of the eyes, the lids of which are often glued together. Upon looking into the eye the lining membrane is seen to be swollen and red. Infantile purulent ophthalmia, although yielding much more readily to proper treatment than that which attacks adults, makes rapid progress if neglected, and may jeopardise the sight of the babe; hence the great importance of calling in efficient medical aid as soon as ever it makes its appearance.

=Ophthalmia, Strumous, or Scrofulous.= This form of ophthalmia is generally met with in children of scrofulous habit of from 4 to 10 or 11 years of age. Its most distinctive characteristic is the inability of the sufferer to bear the light, the effect of which is that the eyes are kept spasmodically partially closed. If the eyes are examined, a slight fulness of the vessels usually stopping at the edge of the cornea is observable, and about the line dividing the cornea and sclerotic coat small opaque pimples or pustules are visible. This variety of ophthalmia, being the outcome of a const.i.tutional taint, is frequently very obstinate, and yields with difficulty to medical treatment, besides being very liable to reappear. It is not unfrequently accompanied with a troublesome cutaneous affection known as _Crusta lactea_, which occurs on the cheeks, and arises from the irritation caused by the flow down the cheeks of the acrid lachrymal secretion. The usual treatment consists in improving the general health and strength of the patient by means of tonics, such as quinine, quinine and iron, cod-liver oil, or syrup of iodide of iron. The diet should be nutritious and easy of digestion, and there should be no stint of fresh air.

=O"PIATES.= _Syn._ OPIATA, L. Preparations containing opium. The word is often applied in a general sense to anodynes and soporifics. In French pharmacy the name is commonly used synonymously with confections, as in the following preparations:--

ANTI-DYSENTERIC OPIATE--Quarin. Purified opium, 4 gr.; ipecacuanha, 1/2 dr.; tormentilla, 1 dr.; syrup of whortleberries and conserve of red roses, of each 6 dr.--_Dose._ A teaspoonful every hour.

ANTI-HYSTERICAL OPIATE--Trousseau and Reveil. Powdered indigo, 1 oz.; white honey, 3 oz.--_Dose_, 1 tablespoonful daily, gradually increased until the whole is taken in a day. In hysteria, epilepsy, and nervous affections of an epileptic character.

BALSAMIC OPIATE--Trousseau and Reveil. Oleo-resin (balsam) of copaiba, 1 oz.; cubebs (in powder), 3 oz.; pota.s.sio-tartrate of iron, 2-1/2 dr.; syrup of quince, q. s. In gleet.--_Dose_, 3 boluses the size of a nut, thrice daily.

CHARCOAL OPIATE--Ratier. Willow charcoal (recent), 1 oz.; prepared chalk, 1 dr.; powdered white sugar, 2 oz.: rose water, q. s. to form an electuary. In diarrha and incipient cholera, in dysentery with fetid stools, and in gastralgia, flatulence, &c. By subst.i.tuting calcined magnesia for chalk it becomes an excellent remedy for habitual constipation.

CUBEB OPIATE--Deyeaux. Powdered cubebs, 4 dr.; powdered camphor, 1 dr.; mix, and divide it into 18 powders.--_Dose._ One, 3 or 4 times daily, in gleet, painful and scalding micturition. &c.

=O"PIUM.= _Syn._ OPIUM (B. P., Ph. L., E, & D.), L. The juice insp.i.s.sated by spontaneous evaporation, obtained by incision from the unripe capsules of the _Papaver somniferum_, grown in Asia Minor.

_Hist._--"It is uncertain at what period opium was first known and introduced into medicine. Hippocrates recommends the _meconion_ or _poppy juice_, in a disease of the uterus; and Dioscorides, on the authority of Erasistratus, tells us that Diagoras (who was contemporary, it is supposed, with Hippocrates) condemned the use of opium. These are, I believe, the most ancient Greek authorities who speak of this substance; and it is impossible, I think, to arrive at any accurate conclusion from their remarks whether opium had, or had not, been known long before their time, though Alston infers, from the little use made of it by Hippocrates, as well as from Diagoras condemning its use in diseases of the eyes, that its virtues were not known long before him. Dioscorides and Pliny mention that the expressed juice of the heads and leaves is termed _meconium_, and that it is much weaker than opium. Theodore Zwinger, Sprengel, and others have supposed that the _nepenthes_ of Homer was opium. It would appear that opium was not much employed until the time of the Arabs, except in the form of the confections known as Theriaca, Mithridatica, &c. The word opium is derived from _otos, the juice_."[71]

[Footnote 71: Pereira.]

_Var._--1. EGYPTIAN; in roundish flattened lumps; inferior to Turkish opium.--2. ENGLISH; often equal to the best Smyrna.--3. FRENCH; resembles the last.--4. GERMAN; similar to English opium,--5. INDIAN;--_a._ BENARES; in large b.a.l.l.s;--_b._ MALWA; in roundish flattened cakes, of 9 or 10 oz.

in weight each;--_c._ PATNA, in b.a.l.l.s or square cakes; inferior to Turkey opium.--6. LEVANT; same as Smyrna opium.--7. PERSIAN; in rolls or sticks, 6 1/2 inch; inferior; resembles hepatic aloes in appearance.--8. SMYRNA; in irregular, rounded, flattened pieces, varying in weight from 2 or 3 lbs. to only as many oz. It forms the best variety of Turkey opium, and is particularly rich in morphia. It is the only one adapted for the manufacture of the salts of morphia, as it contains on the average from 7 to 9% of that alkaloid, and usually yields about 12 to 125% of hydrochlorate of morphia, which is more than can be obtained from any other variety of opium.[72]--9. TURKEY; of which two varieties are known in commerce, viz. Constantinople opium and Levant or Smyrna opium, noticed above. Constantinople opium is generally in small, flattened, roundish cakes, 2 to 2-1/2 inches in diameter, and covered with poppy leaves. It is more mucilaginous and less esteemed than Smyrna opium, from which it may be distinguished by the last being always covered with the reddish capsules of a species of Rumex.

[Footnote 72: Of five kinds of Smyrna opium examined by Merk, the worst were found to yield 3 to 4 per cent. of morphia, and the best from 13 to 135 per cent.]

The following account of the method of opium collection, adopted in Asia Minor, is extracted from a paper in the 'Pharmaceutical Journal,'

contributed by Messrs Malta.s.s and Wilkin.[73] About the end of May the plants arrive at maturity, and the flowers expand. A few days after the petals have fallen the capsule is ready for incision.

[Footnote 73: First series, 14th volume.]

This operation is performed in the afternoon of the day and in the following manner:--A transverse incision is made with a knife in the lower part of the capsule, the incision being carried round until it arrives nearly at the part where it commenced; sometimes it is continued spirally to half way down its starting point. The greatest nicety is required to avoid cutting too deep, and penetrating the interior coating of the capsule, as this would cause the exuding milky juice to flow into the inside.

The following morning those engaged in collecting the opium lay a large poppy leaf on the palm of the left hand, and having a knife in the right hand, they sc.r.a.pe the opium which has exuded from the incision in each capsule, and then transfer it from the knife to the leaf, until a ma.s.s of sufficient size has been formed, when a second poppy leaf is placed over the top of the ma.s.s. If the dew has been heavy during the night the yield is greater, but the opium is dark in colour; if, on the contrary, there has been no dew, the yield is less, but the opium is of a lighter colour.

A high wind is prejudicial, as the dust raised from the pulverised soil adheres to the exudation, and cannot be separated. The poppy capsules are cut but once, but as each plant will from one stem produce several branches, and each branch produce a flower, it is usual to pa.s.s over the field a second or a third time, to cut such capsules as were not ready at the first cutting. After the opium is collected it is dried in the shade.

The proceeds arising from the sale of the opium crop in British India form a considerable item in the revenues of our Eastern Empire; hence the poppy as the source of this valuable export, almost the whole of which goes to China, is very extensively cultivated in India.

In the year ending March 31st, 1872, 93,364 chests, valued at 13,365,228, were exported from British India. Of this quant.i.ty 49,455 chests were from Bengal, and Bombay 43,909. They were distributed thus:--

To China 85,470 chests.

" the Straits Settlements 7,845 "

" Ceylon, Java, Mauritius, and Bourbon 38 "

" the United Kingdom 4 "

" other countries 7 "

------ 93,364 ------

The net revenue to the Indian Government from this source in the year 1871-72 was 7,657,213.[74]

[Footnote 74: Fluckiger and Hanbury.]

A large track of country in Bengal, some 600 miles in length and 200 in breadth, watered by the Ganges, embraces the chief opium district of India. A comparatively small quant.i.ty of opium is obtained from the mountain parts of the North of India. This latter is yielded by the _Papaver somniferum_, whilst that from the plains is the produce of the _Papaver officinale_.

In India the plant is reared in a rich and well-manured soil, and thrives best in mild moist localities. It requires careful weeding and thinning whilst growing, and when necessary the ground is irrigated. As in Asia Minor, when the time comes for making incisions in the capsules for the purpose of collecting the exuding juice, this latter is always found to be less in quant.i.ty if it be rainy weather. In India the poppy begins to flower at the end of January, or the commencement of February and about three or four weeks after its effervescence the capsule, which is about as large as a hen's egg, is in a condition to be tapped. This operation is always performed at early morn, before sunrise, by means of a little iron instrument notched at the smaller end like a saw.

The treatment to which the milky exudation, which subsequently hardens into opium, is subjected differs only in details from that followed in Asia Minor, and in being more carefully and elaborately carried out. For instance, it is first allowed to stand for some time in a shallow bra.s.s dish tilted on one side, by which means there drains away a thin watery fluid, the presence of which seriously impairs the quality of the opium.

After this it is dried equably by three or four weeks' exposure to the air, and in this condition is packed in earthen jars and taken by the native cultivators to the factory. Here, after being tested and weighed, it is thrown into immense vats, which contain the acc.u.mulated produce of whole districts; and when the several samples have been kneaded together it is removed, and formed into b.a.l.l.s or cakes. The soft opium is made into b.a.l.l.s by being pressed into bra.s.s cup-shaped moulds, lined throughout with petals of the poppy, which are made to adhere to each other as well as to the ball of opium by means of an adhesive fluid obtained from an inferior kind of opium; other petals are then by the same means stuck on to the upper part of the ball so that the whole of this is covered with a thin layer of them. The b.a.l.l.s are next removed to the drying-room of the factory, where they are arranged in tiers on lattice-work shelves. During the process of drying they are carefully watched and examined by boys, to keep them from the ravages of insects. When sufficiently desiccated the cakes of opium are packed in casks, and are ready for the market.

The yield of morphia from East Indian opium is usually very small, a circ.u.mstance which Messrs Fluckiger and Hanbury conceived to be partly due to the climate and partly to the defective method of cultivation.

He believed that the period, three or four weeks, during which the juice was allowed to remain in the wet state was much too long, and exercised a destructive influence on its const.i.tuents.

Opium from England, France, and Germany is occasionally met with, but never in considerable quant.i.ty. The cultivation of the opium poppy, however, in these three countries is chiefly carried on for the sake of the capsules which are largely employed in medicine; and the oil extracted from the seed, which is highly valued and extensively employed by artists.

_Pur._ The opium of commerce is not unfrequently adulterated with extract of poppies, extract of lettuce, lactucarium, mucilage of gum tragacanth, dried leaves, starch, water, clay, sand, gravel, and other substances, in order to increase its weight. This fraud is readily detected by inspection, by chemical a.n.a.lysis, and the microscope; and indirectly, with the greatest certainty, by a simple a.s.say of the sample for its morphia (morphiometry). This may be effected by one or other of the following methods:--

1. (Couerbe.) Opium, 4 parts, and quicklime, 1 part, made into a milk with water, q. s., are boiled together, and the solution filtered whilst hot; the filtrate is then saturated with dilute hydrochloric acid and the morphia precipitated by the addition of ammonia, any excess of the latter being expelled by heat; the precipitate is then collected, dried, and weighed. If 100 gr. have been operated on, the given weight will represent (nearly) the per-centage richness of the sample in morphia.

2. (Guilliermond.) 100 gr. of opium are triturated for some time in a mortar along with 4 times its weight of rectified spirit, and the tincture strained through linen, with expression, into a wide-mouthed bottle; the marc is triturated a second time with about 3 times its weight of alcohol, and the tincture strained into the bottle as before; to the mixed tincture is added a fl. dr. of liquor of ammonia, and the whole is agitated for a short time. In about 12 hours the morphia spontaneously separates, accompanied with some narcotina and meconate of ammonium; the morphia covering the interior of the vessel with large, coloured, and gritty crystals, feeling like sand, and the narcotina crystallising in very light, small, white, and pearly needles. These crystals are washed with water, either through a paper filter or linen, to free them from the meconate of ammonia which they contain; after which the narcotina is separated from the morphia by decantation in water, which removes the narcotina, which is the lighter of the two. According to M. Mialhe, however, the morphia is more effectually removed by washing the crystals with 1 to 1-1/2 fl. dr. of ether, by triturating the two together, when the morphia is left in an insoluble state, and may then be dried and weighed.

3. (B. Ph.) Take of opium, 100 gr., slaked lime, 100 gr., distilled water, 4 oz. Break down the opium and steep it in an ounce of the water for 24 hours, stirring the mixture frequently. Transfer it to a displacement apparatus, and pour on the remainder of the water in successive portions, so as to exhaust the opium by percolation. To the infusion thus obtained, placed in a flask, add the lime, boil for ten minutes, place the undissolved matter on a filter, and wash it with an ounce of boiling water. Acidulate the filtered fluid slightly with hydrochloric acid, evaporate it to the bulk of 1/2 an ounce, and let it cool. Neutralise it cautiously with solution of ammonia, carefully avoiding an excess; remove by filtration the brown matter which separates, wash it with an ounce of hot water, mix the washings with the filtrate, concentrate the whole to the bulk of 1/2 an ounce, and add now solution of ammonia in slight excess. After 24 hours collect the precipitated morphia on a weighed filter, wash it with cold water, and dry it at 212. It ought to weigh at least from 6 to 8 grains.

4. (Cleaver.) Commenting on the above method of opium a.s.say, Mr Cleaver[75] remarks:--"This process, if properly and carefully carried out, is one of the best, as, by the use of lime, the resin and meconate of calcium, also meconic acid, are removed from solution. The objections to it are--

[Footnote 75: 'Pharmaceutical Year Book,' 1876.]

"_a._ That the large quant.i.ty of water used, and the subsequent evaporation, cause loss of morphia.