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Updated: June 24, 2025
"It is serious. You should have a surgeon. But why have you not used the temporary remedy? Of course you know the effect of drugs?" "I know that atropin is ruin, right enough," said Kingozi grimly. "But the pilocarpin " "Of course. I only wish I had some." "But you have!" came Winkleman's astonished voice. "There is of it a large vial!" Kingozi gripped the arm of his chair for a full minute.
It should be remembered that atropin is not a sleep-producer; it may stimulate the cerebrum. Therefore at night it might well be combined with a possible necessary hypodermic injection of morphin. The question of the advisability of strychnin is a constant subject for discussion. Strychnin is overused in the cases of most patients who are seriously ill.
A small dose of it, not more than one-eighth grain, especially if combined with atropin, will often quiet and brace a weak heart, especially when there is cardiac pain. Just which drug or drugs should be used and just which are not indicated can never be specifically outlined in a textbook, a lecture or a paper.
Nowhere else in the body should pain be so speedily combated as when it occurs in the region of the heart. Morphin, with or without atropin, as deemed best, should be administered hypodermically in the amount and with the frequency necessary to stop the pain and quiet the restlessness. As stated above, the frequent need for morphin may be prevented by use of the ice bag.
Also, atropin sometimes quiets cardiac pain, but it will not steady the heart, may irritate it, and will increase vasomotor tension, although peripheral nerve irritation may be diminished. Hence a fair dose of morphin hypodermicaly with a small dose of atropin, if respiratory depression is feared, is a physiologic method of bettering the condition.
So that's why I have it." She was examining the bottles. "But you have atropin also. Why is that?" "There's a good deal of ophthalmia or trachoma floating around some native districts. I thought I might experiment." "And this" she picked up a third bottle "ah, yes, morphia. But how much alike they all are."
"Because the poison was atropin belladonna. That is common. I've read of any number of crimes where that was used. Do you think for a moment that the mind which figured out how to use snake venom, and botulin toxin, would descend to anything as ordinary as all this?" "Well, if it was not an attempt at murder, what was it?" "Suicide! It's as plain as the nose on your face.
At the same end of the case were the receptacles also of the atropin and the morphia. He remembered the Leopard Woman's remarking how much alike they all were. Kingozi seemed to see plainly in his mind's eye the precise arrangement, to visualize even the exact appearance of the labels on the bottles first the morphia, next to it the pilocarpin, and last the atropin.
Atropin should not be given, as it may increase the cardiac disturbance. If an attack lasts more than an hour or so, one of the best treatments is the bromids, which should be given either by potassium or sodium bromid in a dose of 2 or 3 gm.
During these heart attacks it is more than useless to administer any drug by the stomach, as in this condition there will be no absorption, even if there is no vomiting. The addition of atropin to the morphin will prevent depression from the morphin.
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