Therapeutic Action of Meconine or Opianyl. - This may be referred to for completeness' sake, since there is some prospect, from John Harley's experiments on animals, that opianyl may prove a valuable tranquillizing hypnotic, without unpleasant after-effects.

I must conclude these remarks on the therapeutic use of opium and its alkaloids with the offer of a few cautions. The most important of these is the lesson, which ought never to be forgotten, as to the extreme susceptibility of young children - at any rate during the first two or three years of life - to the poisonous influence of opium and also of morphia. Instances are by no means uncommon in which so small a dose as a single drop of laudanum, given to a child three or four months old, has produced profound stupor lasting for many hours; and, in one case within my knowledge, the 1/20 th grain of acetate of morphia produced coma and convulsions in an infant of seven weeks. These are doubtless extreme cases, but they serve to show what the possibilities are, and, at any rate, there is always need for the greatest caution in administering any kind of opiate to children. Another caution may be useful in regard to the possible formation of the opium-habit. It is a familiar fact that the continued use of opium sets up in the system, in the first place, a tolerance of the drug, and finally a violent craving for it. It is much easier to point out this danger than to say how it can be avoided, since many patients, suffering from severely painful and incurable diseases, must and will have opium daily. All that can be said is that we may greatly postpone and mitigate the otherwise inevitably large and constant increase in the doses required to relieve pain, by commencing with the smallest quantities, and never sanctioning a needlessly large advance. As a rule, the hypodermic injection secures the greatest economy in keeping down the doses, but it is often impossible to trust the discretion of the patient's attendants in the management of so potent an agent, and equally impossible for the medical man always to administer it himself. On the subject of the hypodermic injection it is indeed necessary to speak very strongly; for, unfortunately, this remedy has passed with wonderful rapidity into the hands of that portion of the public who persist in being their own doctors, and great mischief and many serious and even fatal accidents have occurred. If ever it should become necessary to entrust the performance of hypodermic injection to the patient, or to an attendant, it is the practitioner's duty to satisfy himself, by the evidence of his own eyes, that the person undertaking it thoroughly understands what he has to do, and will most implicitly obey orders, and never increase the dose without medical authority.

1 See also Bouchut: Bull. de thérapeutique, i., p. 87, 1865.

Preparations And Dose. - The following preparations are officinal:

Pulvis Opii, gr. ss. - ij. (.03 - .12);

Acetum Opii,

Vinum Opii,

Tinctura Opii,

Tinct. Opii Acetata,

Tinct. Opii Deodorata, mx. - xx. (.60 - 1.20);

Tinct. Opii Camphorata, 3 i. - ij. (4. - 8.); Extract. Opii, gr. ss.- i. (.03 - .06); Piluae Opii, No. 1-2; Pilula Saponis Composita, gr. v. (.32); Pulv. Ipecac, co., gr. x. (.65).; Confectio Opii, 3 ss. (2.); Trochisci Glycyrrhizae et Opii; Suppos. Opii, No. 1; Suppos. Opii et Plumbi, No. 1; , Emplastrum Opii;

Morphiae Acetas, Morphiae Murias, Morphiae Sulphas, gr. 1/6 - 1/2 (.01 - .03);

Liquor Morphias Sulph., 3 i. (4.); Trochisci Morphiae et Ipecac; Suppos. Morphiae, No. 1; Codeiae Sulphas, gr.1/6 - 1/2 (.01 - .03).