Apomorphinum muriaticum

Volume I — Special Symptomatology

An alkaloid of Opium, differing from Morphia only in having one less atom of water. Its chemical composition is expressed C17H17NO2HC1 It may be made by treating Morphia under pressure with strong hydrochloric acid.

Apomorphia differs, in its reactions, from Morphia in giving a blood-red color, in place of an orange-yellow, with Nitric acid, and in giving a dense yellow precipitate with bichromate of potassium, no precipitate being produced by Morphia.

Officinal Preparations— Tincture with strong alcohol. Triturations, to the 8c, for higher attenuations.

Spiiere of Action.— Probably the great sympathetic, and reflex nervous system.

Analogues. — Cocculus, (?) Ipecac. (?)

Brain and Cord. Slight deafness, giddiness, singing in the ears.

±9

Great excitement.

[Epileptiform convulsions, brought on by touching.] [Tetanic condition, running round and round the room, scaling

walls, and turning summersaults.] [Partial paralysis of the hinder extremities, clawing, natatory

movements.]

[Diminution of reflex irritability, continuous workings of the

stomach, depression.] [Uncomfortable sensation in the head.]

The symptoms in brackets were observed in animals.

Eyes.

Pupils dilated ; no action when applied locally in powder.

Ears.

Dullness of hearing.

Circulation.

Pulse accelerated, or accelerated and then retarded. Syncope; lessening of blood pressure. Fall of bodily temperature.

Gastric.

• Qualmishness, nausea, vomiting and retching. Vomiting in from three to eight minutes. Convulsive movements of the stomach. Precordial pain.

Salivation. Diarrhoea (in cats).

• A feeling of nausea coming on at intervals, especially after

taking food; no pain, clean tongue, and no headache.

• Sudden vomiting, almost without nausea; vomiting of food,.

mucus, rarely of bile.

Volume II — Special Therapeutics

This new alkaloid of Opium was discovered by Dr. Mathieson.

It is a snow-white powder, which is permanent when dry, but when moist soon becomes green. A solution suffers this change in a few hours, and in a few weeks the green color turns to black. For homoeopathic use triturations should be made with pure, dry sugar of milk, and kept closely corked. I ought to say that Dr. Dyce Brown says the 3d centesimal dilution does keep its virtues a long time.

One of the most remarkable effects of this alkaloid is sudden vomiting. As small a quantity as one-twentieth or one-fifteenth of a grain injected under the skin of an adult man will cause copious vomiting in five or ten minutes.

Dr. Blackley (“British Journal of Homoeopathy,” 1873) gives a graphic account of its action. He injected ten minims of a ten per cent, solution of Apomorphin under the skin of his left arm. During the first two minutes no effect was produced. After about ten minutes the pulse began to rise slightly, and the respirations became slightly accelerated. At the end of four minutes he felt a sudden qualmishness, which was almost immediately followed by nausea and profuse vomiting. This continued for several minutes, and was followed, as soon as the contents of the stomach had been evacuated, by severe retching. On taking a draught of water with a little brandy in it this was immediately rejected ; the same occurred after drinking cold water. No bile, however, came up in the vomited matter. At the end of seven or eight minutes from the commencement of the experiment he began to feel very faint, and was compelled to lie down, and almost immediately on doing so fainted entirely, and remained in a state of syncope for about five minutes. On awaking from this he felt giddy and chilly. He took a little brandy and water, which was retained. He then became drowsy, and slept an hour, during which he perspired profusely. On rising, he felt slight giddiness, but no desire to vomit ; slept soundly all night; awoke pale and hungry.

Dr. Blackley made several experiments on animals, in which it developed more grave symptoms, convulsive and cerebral ; but I doubt if they are useful to us.

The question arises: What use can we make of such a powerful drug? It will be noted that the vomiting is marked by suddenness, completeness, and the absence of pain, or continued nausea. It

occurs to me that we shall find it the safest and quickest emetic in cases of 'poisoning, when the object is to evacuate the poison as soon as possible. In such cases inject hypodermically one-tenth or onefifth of a grain in a few drops of a recent aqueous solution, or give internally, in solution, one-fifth to one-third grain of the pure drug. Next to the mustard-water emetic it seems preferable to all others.

Dr. Blackley says it does not interfere with digestion, as a man to whom he gave it, vomiting at 8 p.m., at 9 p.m. ate a hearty supper and digested it. “This,” says Dr. D. Brown, “ coincides with what I find to be its sphere of action on the stomach. The cases where I have used it with success are chiefly those where sickness or vomiting constitute the disease under which the patient is laboring. The tongue is clean, the bowels are regular, there are no headaches, the patient has a desire more or less for food, and has no pain after eating, but a feeling of nausea comes on at intervals, especially after taking food, which may or may not be omitted. In other cases, when there is marked dyspepsia, and when Nux or Pulsatilla is indicated, I find Apomorphin very valuable, given at the time of the onset of the sick feeling, and repeated every ten or fifteen minutes until it is relieved. In other cases still, when the vomiting is sympathetic, as in the case of neuralgic headache, gallstones, a cerebral affection, or uterine disease, Apomorphin is equally useful.” Dr. Cooper states that he had seen it cause immediate cessation of vomiting in a distressing case where a tumor pressed on the brain.

Dr. Brown thinks it resembles Ipecac. I do not agree with him ; for Ipecac, is useless in vomiting from cerebral and nearly all other remote irritations. Apomorphin will not cause vomiting in animals if the vagus is cut, or if the subject is chloroformed. Some authorities assert that so small a quantity as one-five- hundredth of a grain causes vomiting. This seems to prove, with Dr. Cooper’s case, that the action of Apomorphin is central. If such be the case, it ought to cure or palliate all cases of vomiting from cerebral disease or irritation. I do not see how this can agree with the statement of Brown that it removes vomiting from uterine and hepatic disorder, but such seems to be the case.

Dr. Brown reports thirteen cases of nausea or vomiting cured

by Apomorphin (“British Journal of Homoeopathy,” July, 1874), viz. :

(1.) Case of nausea, with disgust for food; white tongue.

(2.) Case of a child vomiting for three days, bowels slightly loose, stools whitish, tongue white.

(3.) A woman of sixty vomits her food about an hour after taking it; nausea all the time.

(4.) Frequent vomiting, and almost constant nausea, in a woman.

(5.) A woman of fifty, constant nausea and vomiting, with pain and tenderness in the region of the liver, which was enlarged. He gave Bryonia and Apomorphin in alternation. He thinks the latter cured the sickness, as it was better after two doses.

(6.) A young lady with displacement of the uterus had almost constant feeling of sickness, with frequent attacks of violent retching, followed by intense prostration. This medicine relieved the vomiting after all others failed.

(7.) A lady of forty-two, with large ovarian tumor, had persistent vomiting; got immediate relief, after a fruitless trial of all other remedies.

(8.) Sickness and incessant vomiting in a sailor, tenderness over the liver, but no enlargement. Three doses cured.

(9, 10, and 12.) Vomiting of food in children.

(11 and 13.) Morning sickness and vomiting (the patients did not report, but he thinks they were cured or they would have returned).

Dr. Brown further says : “ I have found Apomorphin successful in removing nausea which frequently presented between attacks of gallstones, and in a case of long-standing supraorbital neuralgia.”

I have had no personal experience with this remedy, but would advise a trial of it in seasickness, and in the vomiting from riding in a carriage or in railway cars. Some points of its action remind me of Cocculus. Dr. Brown used the 3d cent. dil. invariably.