Interstate medical journal . in,etc., does not have sufficient rest, and in one who is irritable. In order to better understand the therapeutics of morphine asapplied to the intestine I have presented a rough sketch. The morphine inhibits impulses and reflexes from the serouscoat, the first structure involved in peritonitis; as a consequence therespirations become deeper and less rapid. This is probably more 934 INTERSTATE MEDICAL JOURNAL of a disadvantage than an advantage. The only time such anaction may be of value it would seem, is when because of the rapidand inefficient respirations the
Interstate medical journal . in,etc., does not have sufficient rest, and in one who is irritable. In order to better understand the therapeutics of morphine asapplied to the intestine I have presented a rough sketch. The morphine inhibits impulses and reflexes from the serouscoat, the first structure involved in peritonitis; as a consequence therespirations become deeper and less rapid. This is probably more 934 INTERSTATE MEDICAL JOURNAL of a disadvantage than an advantage. The only time such anaction may be of value it would seem, is when because of the rapidand inefficient respirations the patient is not receiving sufficientoxygen as is indicated by his cyanosis and increased CO, contentin the blood. In this respect morphine may be of value in the casesof general peritonitis with extremely rapid respiration. It has beenshown by Henderson that CO, increases peristalsis, therefore any-thing which would reduce the C02 content in the blood would reduceperistalsis and aid to a certain extent in adhesion Diagrammatic cross-section of small intestine. 1. —External longitudinal muscular layer, supplied by the vagus. Stimulation produces pendulum peristaltic movement. Atropine inhibits external longi-tudinal layer, morphine stimulates external longitudinal layer, and pituitrinstimulates external longitudinal layer. 2. —Internal circular muscular layer, supplied by Auerbachs plexus. Nicotine stimulates, atropine In small doses stimulates, atropine in large doses para-lyses, and strychnine and pituitrin stimulate. 3. —Vagus stimulates peristalsis. Morphine and atropine inhibit vagus, and physostigminr and pilocarpine stimulate —Sympathetic inhibits peristalsis. Morphine, adrenalin, and nicotine stimulatethe sympathetic. Morphine in ordinary doses stimulates the intestinal muscledirectly, and therefore increases the bowel contraction (tonus). In this early stage of peritonitis morphine does however relievethe pain, and thus conserves the patient
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