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tion, as for example: A person taken down with all the symptoms of La Grippe is given morphia in small doses for days and sometimes weeks. He recovers, but complains of symptoms which have all the appearance of derangements from morphia poisoning: such as nutrient disturbances of the stomach and bowels with periods of depression, irritability and emotional sensitiveness. The appetite is variable and the brain is easily exhausted by the slightest over-exertion. While all these symptoms are usually attributed to the influenza, they resemble closely the withdrawal symptoms of morphinism and sustain the belief that they are in a large measure due to the poison action of morphia. More familiar examples are the neurotic persons who are suddenly affected with chills and coryza called colds, accompanied with mental fears of pneumonia, pleurisy and other diseases and morbid dreads concerning the symptoms and their meaning. Morphia used in these cases with syrups is a common remedy and is sometimes used for weeks. When discontinued, the same symptoms of nutrient disturbances, with mental and motor irritability seen in the withdrawal of morphia follow. In an example of this kind, the patient continued to be a nervous invalid for a year or more then found a specific in a quack medicine containing morphia. Later this patient became a morphomaniac. The order of sequencies was clear from the time of the first morphia prescription for the cold, up to the development of morphinism. The patient was not aware of the nature of the drug, but only conscious of the good effects. Other equally common examples are those of rheumatism, nutrient and neurotic disturbances or states of toxemias in which morphia is given, alone or with other drugs. While the pain symptoms are checked, new sources of poison and new derangements follow evidently due to the action of morphia. Malarious affections for which morphia may

be given are frequently followed by equally significant and almost pathognomonic symptoms. After a period of continuous use of this drug, either concealed or known to the patient, its withdrawal is followed by neuralgias, depressions and obscure psychopathic symptoms, for which the physician prescribes wines and tonics containing alcohols, and inebriety and alcoholism are almost sure to follow. Cough mixtures containing morphia have been condemned by many authorities. There is not only the danger of the addiction, but marked nerve and nutrient disturbances which lead to very serious diseases later. Continual narcotism of the pain centers leaves a degree of susceptibility and feebleness of control that may continue a long time. States of neurasthenia, marked by obscure pains, both physical and psychical, with morbid fears of disease and irritability, credulity and skepticism, when treated with morphia are supposed to be cured. The temporary subsidence of the irritation and pain is followed by an increased debility and exhaustion. Cases so treated often become alcoholics and morphinists. And later the effects of this continued narcotism and covering up of the pain symptoms may culminate in pneumo-paresis with death in a few hours or tuberculosis ending fatally in a few days. The sudden pneumonias and tuberculosis so often noticed are frequently traceable to narcotism from either alcohol or opium. The routine treatment of our fathers, using calomel and venesection for all forms of disease, was infinitely superior and scientific when compared with the present use of morphia by the needle for all aches and pains. The first fact I wish to make prominent is that, while morphia is a most valuable remedy and cannot be dispensed with in medicine to-day, it is an exceedingly dangerous one and should be used with great caution and never continued long except for special reason and under special conditions. In cases of carcinoma or fulminating diseases that are curable to a large extent, it is

invaluable. Even here the derangement that follows its use is apparent, but this is insignificant compared with the comfort it brings. There are other diseases often successfully controlled and managed largely by the use of morphia, but the wise physician anticipates and provides for the dangers and lessens them. The second fact I wish to emphasize is that morphia, given to neurotics and psychopaths is almost certain to increase the brain and nerve degeneration, and even if it does not produce an addiction, will increase the instability of control and the hyper-sensitiveness of the nerve centers. The possibility of narcomania including spirit addictions is greatly increased, no matter for what purpose morphia is given. The third fact is that morphia, while relieving the pain incident to the common dsorders of the functional activities of the body, actually increases the disturbances of metabolism and favors the growth of toxins. The pain symptoms which it checks, obscure the disease and make the treatment more difficult. By paralyzing the sensory centers, diverting nerve energies and breaking up their nutrition this checking is therefore always dangerous. Our knowledge of the good effects of the drug on the brain centers is obscure, but the injuries which follow from its use can be clearly mapped out in any clinical study.

Another fact,

although well known to all physicians cannot be too strongly emphasized, namely, that proprietary drugs given for the purpose of controlling pain always contain dangerous and uncertain narcotics and their use should be condemned. Reckless prescriptions over the counters of drug stores for sudden symptoms of pain are equally hazardous. Physicians should be more cautions in the use of narcotic drugs, particularly opium and its alkaloids and should remember that many obscure diseases can be traced to reckless medication, and are the direct result of poisons from morphia.

THE BIOLOGICAL TEST TO DETERMINE THE

SPECIES OF BLOOD.

(WITH DEMONSTRATION).

C. J. BARTLETT, M.D.,

NEW HAVEN.

During the past year and a half, there has been developed a method of differentiating the blood of any given species of animals from that of all other animals except those very closely related. My excuse for offering a brief paper on the subject, in spite of several that have appeared during the past few months, and without myself having any new results to report, must be the importance that attaches to any means by which in doubtful cases of medico-legal importance, a given specimen of blood may be definitely determined to be or not to be human blood; the interest felt in the subject by physi cians in general; and the close connection, as regards the method of production at least, between the substance giving this reaction and that of numerous other antibodies, the most important of which as yet are, of course, the anti-toxins of certain of the infectious diseases.

Briefly stated, this biological or serum test is as follows: Into a rabbit (that being the animal found most generally useful) defibrinated blood or blood serum from some other species of animal is injected subcutaneously, or better intra-peritoneally, in doses of from 5 to 10 c. c., at intervals of from two days to one week, depending upon the effect produced upon the animal. After five or six injections it is found that upon drawing blood from the rabbit, allowing it to clot and obtaining the serum from it, this latter when added to blood or serum diluted with physiological salt solution gives a precipitate only when this diluted blood or serum comes from the same

species of animals as originally furnished the blood which was injected into the rabbit. The reaction thus appears to be specific with such exceptions as are referred to below.

The recognition that some substance giving rise to a precipitate, and called a precipitin, is formed in the blood of rabbits injected as above is a part of the general result of the study of the various anti-bodies which may be formed in animals, and certain of the preliminary steps leading up to this may not be without interest here. Among the more important communications that have appeared on the subject of specific precipitins is that of Nuttall (Journal of Hygiene, July, 1901), and of Biondi (Vierteljahrsschrift für gerichtliche Medicin, Medicin, XXIII, Supplement-heft, April, 1902). shall quote freely.

Band

From these I

In 1897, Kraus showed that the anti-sera of cholera, plague and typhoid fever, when added to the clear filtrates from cultures of the corresponding germs, produced a precipitate.

In the following year, July, 1898, two Italian observers, Belfonti and Carbone, reported that substances toxic for an animal were produced by injection of its blood into an animal of another species. These substances were in the serum of the second animal and to such serum the term anti-serum is applied. Following them Bordet (October, 1898), confirmed this and showed that the toxic action of the serum of the second animal was one of agglutinating and bringing into solution the corpuscles of the first animal, and that this action was specific, that is only producing the agglutination when the blood to which it was added was from an animal of the same species as that from which the blood was originally obtained for injection. Deutsch (1900) attempted to apply this specific property of agglutinating of the red corpuscles for medico-legal purposes, but this is evidently applicable only where the blood-corpuscles have

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