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"WMS: Snow on morphia, Raspail, and Magendie"

(15 December 1838)

"Mr. Chance invited the attention of the members to a statement of M. Raspail, recently copied by a medical periodical in this town, in which that physiologist asserts that one or two grains of opium will produce sleep, but a few grains more would cause death; but that as much as fifty-nine gains of the acetate of morphia might be injected into a vein with impunity.

Dr. Addison condemned such rash statements as that of Raspail, just quoted. He had known a case in which one grain of the acetate of morphia brought on symptoms of poisoning.

Mr. Verrall thought that much of the effect would depend upon the idiosyncrasy and habits of the patient.

Mr. Home's experience had proved to his satisfaction the truth of a general principle, that persons habituated to the taking of morphia were after a time compelled to diminish the dose.

Dr. C. B. Williams thought the modus operandi of morphia would show that such a quantity as fifty-nine grains could not be taken with safety. This medicine acted [486/487] directly upon the sensibility, and such an excessive quantity would destroy that of the nerves of respiration, and destroy life. In this respect it differed from belladonna, in which, when beyond a certain quantity was administered, no increased effect was produced. When as much as a drachm of the extract of belladonna was given, the effects did not implicate the vital function..

Mr. Snow was disposed to believe that Raspail was right, because morphia was separated from the narcotine, the most poisonous constituent of opium. He thought that morphia, like belladonna, acted as a mere sedative.

Mr. Hale Thomson considered the statement of Raspail perfectly incredible. He himself had administered morphia very largely, and with the best effects, but never to any thing like the extent recommended by the Frenchman. In a case of acute tic douloureux, accompanied with spasmodic action of the intercostal muscles, occurring in a man accustomed to the use of opium, he had given six grains of morphia, and again four grains three hours afterwards. The patient enjoyed a tranquil night afterwards, and felt refreshed in the morning. This patient could not afterwards bear such large doses, and he (Mr. H. T.) felt inclined to admit the truth of the principle advanced by Mr. Horne-that the power of this medicine over the patient was gradually aggravated, instead of, as was the ordinary rule with medicine, being gradually diminished.

Mr. Streeter thought the statement of M. Raspail might be a printer's error. The effects of opium and its constituent elements differed according to the constitution of the patient. He had known an instance of a drachm and a half of Battley's liquor proving fatal to a madman, and twenty minims of the same fluid proved fatal to an old woman who had compound fracture of the femur.

Dr. Addison remembered that M. Magendie had given a grain of narcotine to a dog, and that the animal speedily perished. Dr. Roots, however, had employed narcotine in doses of several grains, as a tonic, and had found its administration not only unattended with danger, but productive of great benefit. There was an inconsistency between the experience of Dr. Roots and of M. Magendie. Could the narcotine be poisonous to animals, and inert or even beneficial to the human frame?

Mr. Chinnock said a few words in favor of the use of morphia, and Mr. Streeter proceeded to read his promised paper on Paralysis of the Portia Dura.

. . . . . . . . . . . . . . . . . . . .

A pupil of Dr. Marshall Hall now commented very severely upon the ungenerous enemies of Dr. Hall. He repeated some of the arguments so often published by his teacher, and which are now as familiar to the ears of professional readers, as the air of "Jim Crow" is to the Dii Penates of the Adelphi.

Dr. Marshall Hall next made a pathetic address to the society, in which he detailed the hardships to which he had been exposed by the cruelty of adverse critics. "Could I have foreseen," quoth he, "the persecution which my discoveries have brought upon me, I would never have written a single line upon physiology." The Doctor paid a high compliment to Mr. Streeter's essay, and said he had but one fault to find with it, and that was the doubt which had been thrown upon the truth of the excito-motor system. The Doctor's system consisted of nothing but a detail of experiments; how, therefore, could there be any doubt on the subject. To doubt his experiments was to doubt that physiology existed. He would ask whether any member had seen thorough paralysis of the facial nerve in hemiplegia, that is, arising from disease of the cerebrum? And he would ask if division of the trifacial, or of the facial nerve, or of the medulla oblongata, does not destroy the function of the orbicularis palpebræ, as evidenced by touching the eyelash. Magendie, in his experiments, knew that he had succeeded in dividing the trifacial [488/489] nerve within the cranium, by the fact that the eyelids fail to close when the lashes or the skin is touched. Every one knows that this action is destroyed by the division of the portio dura or medulla oblongata; in short, we have the true spinal system demonstrated by a series of facts known to all the world.

Mr. Snow supported Dr. Marshall Hall.

Mr. Streeter concurred entirely in the opinions expressed by Dr. Addison; he was aware that, in hemiplegia, paralysis of the eyelids did not exist. Mr. Streeter pronounced a panegyric on Dr. Hall; but, nevertheless, he should continue to look upon the Doctor's system as hypothetical, until some evidence of the existence of the excito-motory fibres could he furnished, if not in the complicated structure of the human frame, at least in some rank of the lower animals. He thought but little satisfaction attended the bloody experiments of Magendie and other continental inquirers, in whose proceedings the conclusions were vitiated not merely by the great loss of blood incurred, but by the total disregard of the influence upon the results exercised by the great principle of sympathy.

Dr. Hall denied having ever asserted the existence of distinct cerebral and spinal nervous fibres; he had simply made incidental allusion to his own opinion on the subject; but this opinion had no relation to the the spinal or excito-motory system, for the truth of that is based upon experiment.

...

"Westminster Medical Society." LMG 23 (1838-39): 486-89.

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[15 December 1838; same meeting as above, but from a different reporter's perspective: "Mr. Chance inquired what was the experience of members respecting the doses of morphia, and called the attention of the Society to a statement made by M. Raspail, and inserted at page 409 of The Lancet, in which he states that one or two grains of opium will produce sleep, and a few grains more will cause death; that 29.5, and even 59 grains, of the acetate of morphia might be given or injected into a vein without causing death.

Dr. Addison deprecated the promulgation of statements so vague as that put forth by Raspail, he thought they were calculated to do mischief, and furnish an excuse for giving dangerous doses. He (Dr. Addison) had given ordinary doses of pure morphia, which was less soluble than any of its salts. He had known an instance in which a dose under a grain produced all the symptoms of poisoning. Raspail was a clever man, but bold in his statements, and not particularly cautious.

Mr. Varrall said, that much would depend on the habit of the individual who took so large a dose as that mentioned by Raspail. Was the person an opium-eater? * (*The person was neither an opium-eater nor a drunkard; neither a Turk nor a Christian; but simply one of Magendie's dogs, who has thus unexpectedly excited so much interest in a learned Society.-ED. L.)

Mr. Horne had found that persons in the habit of taking morphia, were, after a certain time, not only unable to increase the dose, but were obliged to diminish it.

Dr. Williams considered that the assertions made by Raspail were to be taken cum grano salis. He was undoubtedly a clever man, but liable, out of mere opposition, to make statements not altogether warranted. The mode of action of morphia would, he considered, render the quantity in question impossible to be taken with impunity. It acted directly on sensibility, and such a quantity would quickly destroy that of the nerves of respiration, and produce death. In this respect it differed from belladonna [484/485] and some other vegetable poisons. Belladonna, for instance, when given in large doses, such as a drachm of the extract, did not produce effects beyond a certain extent; and these effects did not seem to implicate the vital functions. He was not aware that any animals had been poisoned by belladonna, but cases were recorded in which small doses of morphia had proved fatal to them.

Mr. Snow thought that, as morphia did not contain narcotine, which is the most poisonous property of opium, it might be possible that Raspail was right. He was inclined to think that morphia acted in a similar manner to belladonna, and was a mere sedative. He recollected reading a case in which a dog was poisoned by belladonna.

Mr. Hale Thomson thought that every one who had had much experience in the employment of morphia, would at once perceive the impossibility of the truth of Raspail's statement. He had seen morphia administered in many surgical cases for the purpose of relieving pain, but never to anything like the extent mentioned by Raspail. In a case of acute tic douloureux, with violent action of the intercostal muscles, occurring in a man who had been in the habit of taking large doses of opium, he had, on one occasion, prescribed a draught containing six grains of morphia, and another containing four grains, to be taken two or three hours after, if the pain was not relieved. The draughts were taken according to the prescription, and he enjoyed a tranquil night. He had not since been able to take doses near as large, and he (Mr. Thomson) had found that this fact generally held good, that patients who had been debilitated by the use of opium were not able to bear doses so large as they had formerly been accustomed to."

"Westminster Medical Society." Lancet 1 (1838-39): 484-85.


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