Year: 1866

eAiu, instead OF taxing tnem lntO the stomach,
The physician has little syringe with a
point almost as sharp as needle. This
point he sticks into the arm, leg or body, as
the case may be, and forces a solution of
morphine, or some other medicine into the
flesh. where it is absorbed by the veins and
carried through the body. In cases of neu.
ralgia and rheumatism, the hypodermic
treatment, as it is called. is generally pre-
ferred to all others. This subject being one
of the most interesting to the people, we
copy the following extracts from an article
BY DR.. Henry Gibbons in the San Francis
co Pacific Medical and Surgical Journal for
October:


ITO save life is the principal design of
medical science. Scarcely of minor i'm.
portance however, is the relief of pain and
suffering. The physician who does not
recognize the latter as an essential purpose
of his vocation, is false to his profes. ion and
false to humanity. Of all means of relieving
pain, the inhalation of anasthetics and the
subcutaneous injection of morphia and other
agents stand foremost. Were there no other
benefit than this derived from hypodermic
medication, the neglect of it were highly
censurable. But when testimony abounds
in support of its curative powers, the argu-





A man enters your Office with his hand
pressed to the side of his chest, stepping as
gently as possible, but not daring to breathe
freely. screaming almost at every inspiration,
and begging you in broken whispers, for
Gods sake, to do something for his imme.
diate relief, or he shall die. You order an
opiate, with lamentations or cupping you
send him home to bed and follow him with
the lancet if necessary, and apply such other
treatment as the course of things may de-
mand. In an hour or two he is in measur-
ably relieved. and by continuous active
treatment he is able to resume employment
in three or four days. That is one method.
Now for another. Take your little syringe
for you perceive what Gils him before his
story is half told-bid him turn up his sleeve,
and inject half a grain of morphia in his
arm. He regards all this with some sur
prise, and whilst you are putting away the
instrument inquiries what you have DONE
In three minutes from the operation you
ask: How is the pain p He raises his
arm experimentally, initiates his chest with
extreme caution, and in readiness to cry out
US before, but instead of crying out in pain,
he exclaims with astonishment and delight,
tossing his arm freely up and down, Why.
don't you see? the pain is all gonel' The
relief may not be entirely permanent. 1t
may be necessary to repeat the opera ton the
next day. But there is no return of acute
pain, especially if suitable topical applica
tions be made. The patient appreciates
your treatment without argument from you.
lie gives you credit for a miracle


have not yet met with a case of neural.
gia which was not materially benefited by
the treatment. Recent cases are nearly
always cured by few repettions of the in.
lection. Often single injection is enough.
No other treatment is necessary, unless there
be special indications for it. The time to re.
peat the injection must be determined by
observation. 1t should be done when the
pain commences to return-generally in
twenty-fOur hours sometimes in forty-eight
hours. The quantity of morphia may be
diminished in most instances.


l have encountered quite a number of
cases OF chronic neuralgia, which had en-
dured for some months, and several for more
than year, and which had gone through all
the rounds of treatment bv other means
without relief. In all such cases, the first
hypodermic injection Of morphia gives such
decided relief as to inspire the patient with
hope of cure. He is invariably delighted
with the result, and as the pain returns, he
is sure to present himself for repetition of
the process. The difficulty in such cases is
to induce him to wait long enough, and to be
content with it once a day. Again and
again, when have made the injection in the
the morning, patients have returned in the
evening to solicit its repetition lest their
sufferings should recur in the night.


In the most inveterate cases of chronic
neuralgia, 1T Is necessary to persevere for
months in the daily use of the means.
have thus far encountered no cases in which
perseverance was not rewarded by final sue
cess, so far at least as to effect decided i'm
provement. One thing is tolerably certain
you will have no trouble in persuading the
patient to continue the treatment. The
trouble, if any, will be in the other direc
tion.


1t is seldom necessary to increase the dose.
The system does not become Injured to the
treatment as when the medicine is given in.
ternally. Perhaps the stomach learns to
digest opiates and thus prevent their alb.
sorption. On the other hand, when they are
introduced beneath the skin they must be
taken into the circulation.


The narcotic influence of a hypodermic
dose is more lasting. We often observe the
anodyne effects of morphia, internally ad.
ministersd, to be dissipated in few hours
by severe pain. The effects of opium is
somewhat more lasting. But the same
quantity of morphia injected beneath the
skin will exert its hypnotic power twice or
thrice as long as either. 1t is seldom neces-.
sary to repeat it within eighteen or twenty.
four hours.


The quantity have generally used if the
pain be severe is half o grain The extreme
amount ever administered BY me was one
grain and that was in q case of. excessive
pain. supposed to result from spasm of the
gall ducts. In no one instance have failed
to give relief by single injection, and in no
one instance has there been occasion to re-
peat it within twelve hours. In NEURALGIA
sciatica, lumbago and all local rheumatisms.
depend mainly on the hypodermic treat
ment alone, unless there are decided indica.
tions for the use Of additional MEANS
Chronic rheumatism of long standing often
yields speedily to the treatment. A gentle.
man had suffered from lumbago in a mild
form for more than two years, being fire.
quently required to leave his business before
night for the purpose of rest. His malady,
though not often severe, was source of
daily annoyance. An injection of one third
of grain of sulph. morph. in the lumbar
region relieved him com pletely in twenty
four hours. 1t was repeated daily for three