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 Chapter 006 Input and Output

Multiple Choice Questions

1. _____ is any data or instructions that are used by a computer.

A. Digital
B. Output
C. Information
D. Input

2. The arrangement of keys on a keyboard, QWERTY reflects the keyboard layout by:
A. representing the phonetics of the alphabets most closely associated with the keyboard.
B. taking the letters of the first six alphabetic characters found on the top row of keys.
C. using the alphabetic characters most frequently used on the keyboard.
D. using the letters of the alphabetic characters that are closest to access while typing.

3. These keyboards are widely used on smartphones and other small portable devices and are
designed primarily for communicating via texting and connecting to the Web.
A. Thumb
B. Traditional
C. Notebook
D. Virtual

4. This type of keyboard uses a touch screen as the input device.

A. PDA
B. Wireless
C. Traditional
D. Virtual

5. A keyboard key, like Caps Lock, that turns a feature on or off is called a _____ key.
A. power
B. toggle
C. function
D. combination

6-1
 Chapter 006 Input and Output

6. This type of mouse emits and senses light to detect mouse movement.
A. Mechanical
B. Cordless
C. Wireless
D. Optical

7. Instead of using a mouse, you can use this pointing device to control the pointer by rotating
a ball with your thumb.
A. Pointing stick
B. Touchpad
C. Joystick
D. Trackball

8. These screens can be touched with more than one finger, which allows for interactions such
as rotating graphical objects on the screen with your hand or zooming in and out by pinching
and stretching your fingers.
A. Touch
B. CRT
C. Multitouch
D. LCD

9. Which of the following is not a type of scanning device?

A. Optical scanner
B. Bar code reader
C. Stylus
D. Character and mark recognition

10. Bar code readers use _______ embedded in them to read bar codes.
A. coprocessors
B. magnetic cells
C. RFID microchip
D. photoelectric cells

6-2
 Chapter 006 Input and Output

11. This reading device is used in banks to read the numbers on the bottom of checks and
deposit slips.
A. MICR
B. OCR
C. OMR
D. UPC

12. Which of the following types of character recognition systems is used for standardized
multiple-choice testing?
A. UPC
B. MICR
C. OMR
D. OCR

13. OMR, OCR, and MICR are all types of:

A. Radio Frequency Card Readers
B. magnetic card readers
C. bar code readers
D. character and mark recognition devices

14. _____-input devices convert sounds into a form that can be processed by the system unit.
A. Electrolyzing
B. Plotting
C. Webcam
D. Audio

15. The most widely used audio-input device is the:

A. Webcam
B. radio frequency card reader
C. microphone
D. stylus

6-3
 Chapter 006 Input and Output

16. The series of dots that form the image on a monitor are called:
A. picas
B. bits
C. pixels
D. bytes

17. This indicates the monitor's ability to display colors by comparing the light intensity of the
brightest white to the darkest black.
A. Contrast ratio
B. Dot Pitch
C. Active display area
D. Resolution

18. This is the distance between each pixel.

A. Dot pitch
B. Refresh rate
C. Resolution
D. Word size

19. The size, or _____, is measured by the diagonal length of a monitor's viewing area.
A. resolution
B. active display area
C. aspect ratio
D. dot pitch

20. The width of a monitor divided by the height of the monitor calculates the:
A. aspect ratio
B. resolution
C. dot pitch
D. clock speed

6-4
 Chapter 006 Input and Output

21. A dedicated, mobile device for storing and displaying e-books and other electronic media
including electronic newspapers and magazines.
A. E-book reader
B. Interactive whiteboard
C. HDTV
D. Flat panel monitor

22. These are specialized devices with a large display connected to a computer projector and
are widely used in classrooms and corporate board rooms.
A. Scanners
B. HDTV
C. E-books
D. Digital or interactive whiteboards

23. What kind of specialized monitor is especially useful for graphic artists, designers, and
publishers?
A. Flat-panel monitor
B. CRT monitor
C. High-definition television (HDTV)
D. E-book

24. Which of the following statements is incorrect?

A. Printer resolution is measured in dpi (dots per inch).
B. Printer output is often called hard copy.
C. Memory within a printer is used to store printing instructions and documents waiting to be
printed.
D. Printer speed is measured in the number of words printed per minute.

25. Two categories of laser printers are:

A. thermal and personal.
B. personal and shared.
C. ink-jet and high-definition.
D. active-matrix and passive matrix.

6-5
 Chapter 006 Input and Output

26. Which of the following printer features enables you to print on both sides of a sheet of
paper?
A. Simplex
B. Duplex
C. Resolution
D. Dual Matrix

27. Printers connected to the Internet that provide printing services to others on the Internet
are called:
A. dot- matrix printers.
B. thermal printers.
C. plotters.
D. cloud printers.

28. This technology allows television stations to broadcast their programming directly to
smartphones, computers, and digital media players.
A. microphones
B. headsets
C. Mobile DTV
D. faxes

29. Which of the following allows the transmission of telephone calls over computer
networks?
A. Faxing
B. Cell phones
C. PDAs
D. Voice over IP

True / False Questions

30. The most widely used input devices are monitors, printers, and keyboards.
True False

6-6
 Chapter 006 Input and Output

31. Function keys provide shortcuts for specific tasks.

True False

32. An optical mouse uses light in order to detect movement.

True False

33. A touch screen is classified as a special type of scanning device.

True False

34. A stylus uses pressure to draw images on a screen.

True False

35. Multitouch screens allow for interaction such as rotating graphical objects on the screen
with your hand.
True False

36. Optical scanners recognize individual letters or images.

True False

37. A magnetic card reader does not require the card to actually make contact with the reader.
True False

38. An MICR device senses the presence or absence of a mark, such as a pencil mark.
True False

6-7
 Chapter 006 Input and Output

39. The monitor size is measured by the diagonal length of the viewing area.
True False

40. Output devices are any hardware used to provide or to create output.
True False

41. 3-D HDTV requires special viewing glasses in order to achieve a three-dimensional
viewing experience.
True False

42. Digital or Interactive whiteboards display a computer's desktop and can be controlled
using a special pen or a finger.
True False

43. Discarded CRTs are a serious threat to the environment, given their high content levels of
lead and other hazardous materials.
True False

44. Resolution for a printer is a measure of the clarity of images produced, measured in dpi
(dots per inch).
True False

45. Shared laser printers typically support color, are more expensive, and are used by a group
of people.
True False

6-8
 Chapter 006 Input and Output

46. Cloud printers provide printing services to users without access to the Internet.
True False

47. Thermal printers use heat elements to produce images on heat sensitive paper and are used
at ATMs and gasoline pumps.
True False

48. Portable media players, also known as digital media players, are specialized devices for
storing, and playing digital media.
True False

49. Mobile DTV enables portable media players to broadcast live TV.
Page : 168
True False

50. Telephony is also known as Internet telephony, IP telephony, and Voice over IP (VoIP).
True False

51. Skype provides audio and video service that requires the installation of special hardware
and software.
True False

Fill in the Blank Questions

52. _____ keyboards are widely used on smartphones and other small portable devices.
________________________________________

6-9
 Chapter 006 Input and Output

53. Mice, Joysticks, touch screens, and styluses are all types of _____ devices.
________________________________________

54. Flatbed, document, and portable are types of _____ that accept documents and convert
them into machine-readable form.
________________________________________

55. Supermarkets use _____ code readers to scan codes printed on product containers.
________________________________________

56. The most common card reader is the _____ card reader which reads encoded information
stored on a thin magnetic strip located on the back of the card.
________________________________________

57. _____ tags are tiny chips that can be embedded into almost anything and contain
information used to track and locate lost pets; to monitor production and update inventory; to
record prices, product descriptions, and locations of retail items.
________________________________________

58. Character and _____ recognition devices are scanners that are able to recognize special
characters and marks.
________________________________________

59. _____ are specialized digital video cameras that capture images.
________________________________________

6-10
 Chapter 006 Input and Output

60. Digital _____ connect to microcomputers and project computer output and can control the
computer with the use of a special pen.
________________________________________

61. _____ printers use a technology similar to that used in a photocopy machine.
________________________________________

62. _____ printers are widely used with ATMs.

________________________________________

63. _____ printers are printers connected to the Internet that provide printing services to
others on the Internet.
________________________________________

64. _____ are special-purpose printers typically found in architectural and engineering
environments.
________________________________________

65. _____ telephones are specialized input and output devices for receiving and sending voice
communication.
________________________________________

66. _____ (acronyms not accepted) combine the capabilities of a scanner, printer, fax and
copy machine.
________________________________________

6-11
 Chapter 006 Input and Output

67. Voice over _____ is the transmission of telephone calls over computer networks.
________________________________________

68. _____ pitch is the distance between pixels on a monitor.

________________________________________

69. _____ ratio indicates a monitor's ability to display colors by comparing the light intensity
of the brightest white to the darkest black.
________________________________________

70. _____ ratio is determined by the width of a monitor divided by its height.
________________________________________

Essay Questions

71. Describe alternatives to a traditional mouse.

72. How does an optical scanner work?

6-12
 Chapter 006 Input and Output

73. How does a bar code reader work?

74. What are character and mark recognition devices? Describe their uses.

75. How is voice recognition technology being used today?

76. Describe the basic distinguishing features of monitors that affect clarity including
resolution, dot pitch, contrast ratio, size, and aspect ratio.

6-13
 Chapter 006 Input and Output

77. What is HDTV? What is 3D HDTV?

78. What is a multifunctional device? What are the advantages/disadvantages of such a

device?

79. What is VoIP and how does it work?

6-14
 Chapter 006 Input and Output Key

Multiple Choice Questions

1. (p. 154) _____ is any data or instructions that are used by a computer.
A. Digital
B. Output
C. Information
D. Input

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-01
Topic: What Is Input?

2. (p. 155) The arrangement of keys on a keyboard, QWERTY reflects the keyboard layout by:
A. representing the phonetics of the alphabets most closely associated with the keyboard.
B. taking the letters of the first six alphabetic characters found on the top row of keys.
C. using the alphabetic characters most frequently used on the keyboard.
D. using the letters of the alphabetic characters that are closest to access while typing.

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-02
Topic: Keyboard Entry

6-15
 Chapter 006 Input and Output Key

3. (p. 155) These keyboards are widely used on smartphones and other small portable devices
and are designed primarily for communicating via texting and connecting to the Web.
A. Thumb
B. Traditional
C. Notebook
D. Virtual

AACSB: Communication
AACSB: Technology
Blooms: Remember
Difficulty: 2 Medium
Learning Outcome: 06-02
Topic: Keyboards

4. (p. 155) This type of keyboard uses a touch screen as the input device.
A. PDA
B. Wireless
C. Traditional
D. Virtual

AACSB: Technology
Blooms: Remember
Difficulty: 2 Medium
Learning Outcome: 06-02
Topic: Keyboards

5. (p. 155) A keyboard key, like Caps Lock, that turns a feature on or off is called a _____ key.
A. power
B. toggle
C. function
D. combination

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-02
Topic: Keyboards

6-16
 Chapter 006 Input and Output Key

6. (p. 156) This type of mouse emits and senses light to detect mouse movement.
A. Mechanical
B. Cordless
C. Wireless
D. Optical

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-03
Topic: Mice

7. (p. 156) Instead of using a mouse, you can use this pointing device to control the pointer by
rotating a ball with your thumb.
A. Pointing stick
B. Touchpad
C. Joystick
D. Trackball

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-03
Topic: Mice

8. (p. 157) These screens can be touched with more than one finger, which allows for
interactions such as rotating graphical objects on the screen with your hand or zooming in and
out by pinching and stretching your fingers.
A. Touch
B. CRT
C. Multitouch
D. LCD

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-03
Topic: Touch Screens

6-17
 Chapter 006 Input and Output Key

9. (p. 157) Which of the following is not a type of scanning device?

A. Optical scanner
B. Bar code reader
C. Stylus
D. Character and mark recognition

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-03
Topic: Stylus

10. (p. 159) Bar code readers use _______ embedded in them to read bar codes.
A. coprocessors
B. magnetic cells
C. RFID microchip
D. photoelectric cells

AACSB: Technology
Blooms: Remember
Difficulty: 3 Hard
Learning Outcome: 06-04
Topic: Bar Code Readers

11. (p. 160) This reading device is used in banks to read the numbers on the bottom of checks
and deposit slips.
A. MICR
B. OCR
C. OMR
D. UPC

AACSB: Technology
Blooms: Remember
Difficulty: 2 Medium
Learning Outcome: 06-04
Topic: Character and Mark Recognition Devices

6-18
 Chapter 006 Input and Output Key

12. (p. 160) Which of the following types of character recognition systems is used for
standardized multiple-choice testing?
A. UPC
B. MICR
C. OMR
D. OCR

AACSB: Technology
Blooms: Remember
Difficulty: 2 Medium
Learning Outcome: 06-04
Topic: Character and Mark Recognition Devices

13. (p. 160) OMR, OCR, and MICR are all types of:
A. Radio Frequency Card Readers
B. magnetic card readers
C. bar code readers
D. character and mark recognition devices

AACSB: Technology
Blooms: Remember
Difficulty: 2 Medium
Learning Outcome: 06-04
Topic: Character and Mark Recognition Devices

14. (p. 161) _____-input devices convert sounds into a form that can be processed by the system
unit.
A. Electrolyzing
B. Plotting
C. Webcam
D. Audio

AACSB: Technology
Blooms: Remember
Difficulty: 2 Medium
Learning Outcome: 06-05
Topic: Audio-Input Devices

6-19
 Chapter 006 Input and Output Key

15. (p. 161) The most widely used audio-input device is the:
A. Webcam
B. radio frequency card reader
C. microphone
D. stylus

AACSB: Communication
AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-05
Topic: Audio-Input Devices

16. (p. 162) The series of dots that form the image on a monitor are called:
A. picas
B. bits
C. pixels
D. bytes

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-07
Topic: Features

17. (p. 163) This indicates the monitor's ability to display colors by comparing the light intensity
of the brightest white to the darkest black.
A. Contrast ratio
B. Dot Pitch
C. Active display area
D. Resolution

AACSB: Technology
Blooms: Remember
Difficulty: 1 Easy
Learning Outcome: 06-07
Topic: Features

6-20
Another Random Scribd Document
with Unrelated Content
 Suicide.

65 and
Ages, 5-15 15-25 25-65 Total
above
Males, 1 26 269 34 330
Females, ... 24 126 17 167
Total, 1 50 395 51 497

Of European countries, England has the greatest proportional

number of opium poisonings. In France, opium or morphine
poisoning accounts for about 1 per cent. of the whole; and
Denmark, Sweden, Switzerland, Germany, all give very small
proportional numbers; arsenic, phosphorus, and the acids taking the
place of opiates. The more considerable mortality arises, in great
measure, from the pernicious practice—both of the hard-working
English mother and of the baby-farmer—of giving infants various
forms of opium sold under the name of “soothing syrups,” “infants’
friends,” “infants’ preservatives,” “nurses’ drops” and the like, to allay
restlessness, and to keep them during the greater part of their
existence asleep. Another fertile cause of accidental poisoning is
mistakes in dispensing; but these mistakes seem to happen more
frequently on the Continent than in England. This is in some degree
due to the decimal system, which has its dangers as well as its
advantages, e.g.:—A physician ordered ·5 decigrm. of morphine
acetate in a mixture for a child, but omitted the decimal point, and
the apothecary, therefore, gave ten times the dose desired, with
fatal effect. Again, morphine hydrochlorate, acetate, and similar
soluble salts are liable to be mistaken for other white powders, and
in this way unfortunate accidents have occurred—accidents that,
with proper dispensing arrangements, should be impossible.
§ 349. Poisoning of Children by Opium.—The drugging of
children by opium—sometimes with a view to destroy life, sometimes
merely for the sake of the continual narcotism of the infant—is
especially rife in India.[377] A little solid opium is applied to the roof
of the mouth, or smeared on the tongue, and some Indian mothers
have been known to plaster the nipples with opium, so that the child
imbibes it with the milk. Europeans, again and again, have
discovered the native nurses administering opiates to the infants
under their care, and it is feared that in many cases detection is
avoided.

[377] See Dr. Chevers’s Jurisprudence, 3rd ed., 232 et seq.

The ignorant use of poppy-tea has frequently caused the death of

young children; thus in 1875 an inquest was held at Chelsea on the
body of a little boy two years and a half old. He had been suffering
from whooping-cough and enlargement of the bowels, and poppy-
tea was by the advice of a neighbour given to him. Two poppy-heads
were used in making a quart of tea, and the boy, after drinking a
great portion of it, fell into a deep sleep, and died with all the
symptoms of narcotic poisoning.
§ 350. Doses of Opium and Morphia.—Opium in the solid state is
prescribed for adults in quantities not exceeding 3 grains, the usual
dose being from 16·2 mgrms. to 64·8 mgrms. (1⁄4 to 1 grain). The
extract of opium is given in exactly the same proportions (special
circumstances, such as the habitual use of opium, excepted); the
dose of all the compounds of opium is mainly regulated by the
proportion of opium contained in them.
The dose for children (who bear opium ill) is usually very small;
single drops of laudanum are given to infants at the breast, and the
dose cautiously increased according to age. Most practitioners would
consider half a grain a very full dose, and, in cases requiring it,
would seldom prescribe at first more than 1⁄16 to 1⁄4 grain.

The dose of solid opium for a horse is from 1·77 grm. to 7·08 grms.
(1⁄2 drachm to 2 drachms); in extreme cases, however, 4 drachms
(14·16 grms.) have been given.
The dose for large cattle is from ·648 grm. to 3·88 grms. (10 to 60
grains); for calves, ·648 grm. (10 grains); for dogs it is greatly
regulated by the size of the animal, 16·2 to 129·6 mgrms. (1⁄4 grain
to 2 grains).
Fatal Dose.—Cases are recorded of infants dying from extremely
small doses of opium, e.g., ·7, 4·3, and 8·1 mgrms. (1⁄90, 1⁄15, and
1⁄8 of a grain); but in such instances one cannot help suspecting

some mistake. It may, however, be freely conceded that a very small

quantity might be fatal to infants, and that 3 mgrms. given to a child
under one year would probably develop serious symptoms.
The smallest dose of solid opium known to have proved fatal to
adults was equal to 259 mgrms. (4 grains) of crude opium (Taylor),
and the smallest dose of the tincture (laudanum), 7·0 c.c. (2
drachms), (Taylor); the latter is, however, as already shown,
uncertain in its composition.
A dangerous dose (save under special circumstances) is:—For a
horse, 14·17 grms. (4 drachms); for cattle, 7·04 grms. (2 drachms);
for a dog of the size and strength of a foxhound, 204 mgrms. (3
grains).
Enormous and otherwise fatal doses may be taken under certain
conditions by persons who are not opium-eaters. I have seen 13
cgrms. (2 grains) of morphine acetate injected hypodermically in a
strong man suffering from rabies with but little effect. Tetanus,
strychnine, convulsions, and excessive pain all decrease the
sensibility of the nervous system to opium.
§ 351. General Method for the Detection of Opium.—It is
usually laid down in forensic works that, where poisoning by opium
is suspected, it is sufficient to detect the presence of meconic acid in
order to establish that of opium. In a case of adult poisoning there is
generally substance enough available to obtain one or more
alkaloids, and the presence of opium may, without a reasonable
doubt, be proved, if meconic acid (as well as either morphine,
narcotine, thebaine, or other opium alkaloid) has been detected. Pills
containing either solid opium or the tincture usually betray the
presence of the drug by the odour, and in such a case there can be
no possible difficulty in isolating morphine and meconic acid, with
probably one or two other alkaloids. The method of extraction from
organic fluids is the same as before described, but it may, of course,
be modified for any special purpose. If opium, or a preparation of
opium, be submitted to Dragendorff’s process (see p. 242), the
following is a sketch of the chief points to be noticed.
If the solution is acid—
(1.) Benzene mainly extracts meconin, which dissolves in sulphuric
acid very gradually (in twenty-four to forty-eight hours), with a
green colour passing into red. Meconin has no alkaloidal reaction.
(2.) Amyl alcohol dissolves small quantities of meconic acid,
identified by striking a blood-red colour with ferric chloride.
If now the amyl alcohol is removed with the aid of petroleum ether,
and the fluid made alkaline by ammonia—
(1.) Benzene extracts narcotine, codeine, and thebaine. On
evaporation of the benzene the alkaloidal residue may be dissolved
in water, acidified with sulphuric acid, and after filtration, on adding
ammonia in excess, thebaine and narcotine are precipitated, codeine
remaining in solution. The dried precipitate, if it contain thebaine,
becomes blood-red when treated with cold concentrated sulphuric
acid, while narcotine is shown by a violet colour developing gradually
when the substance is dissolved in dilute sulphuric acid 1 : 5, and
gently warmed. The codeine in the ammoniacal solution can be
recovered by shaking up with benzene, and recognised by the red
colour which the solid substance gives when treated with a little
sugar and sulphuric acid.
(2.) Chloroform especially dissolves the narceine, which, on
evaporation of the chloroform, may be identified by its general
characters, and by its solution in Fröhde’s reagent becoming a
beautiful blue colour. Small quantities of morphine may be extracted
with codeine.
(3.) Amyl alcohol extracts from the alkaline solution morphine,
identified by its physical characters, by its forming a crystalline
precipitate with iodine and hydriodic acid, and the reaction with iodic
acid to be described.
§ 352. Morphine (C17H17NO(OH)2 + H2O).—Morphine occurs in
commerce as a white powder, sp. gr. 1·205, usually in the form of
more or less perfect six-sided prisms, but sometimes in that of white
silky needles. When heated in the subliming cell (described at pp.
257-8), faint nebulæ, resolved by high microscopic powers into
minute dots, appear on the upper disc at 150°. As the temperature
is raised the spots become coarser, and at 188° distinct crystals may
be obtained, the best being formed at nearly 200°, at which
temperature morphine begins distinctly to brown, melt, and
carbonise. At temperatures below 188°, instead of minute dots, the
sublimate may consist of white circular spots or foliated patterns.
One part of morphine, according to P. Chastaing, is soluble at a
temperature of 3° in 33,333 parts of water; at 22°, in 4545 parts; at
42°, 4280; and at 100°, 4562. It is scarcely soluble in ether or
benzene. Absolute alcohol, according to Pettenkofer, dissolves in the
cold one-fortieth of its weight; boiling, one-thirtieth. Amyl alcohol, in
the cold, dissolves one-fourth per cent., and still more if the alkaloid
be thrown out of an aqueous acid solution by ammonia in the
presence of amyl alcohol; for under such circumstances the
morphine has no time to become crystalline. According to
Schlimpert, 1 part of morphine requires 60 of chloroform for
solution; according to Pettenkofer, 175.
Morphine is easily soluble in dilute acids, as well as in solutions of
the caustic alkalies and alkaline earths; carbonated alkalies and
chloride of ammonium also dissolve small quantities. The acid
watery, and the alcoholic solutions, turn the plane of polarisation to
the left; for sulphuric, nitric, and hydrochloric acids [α]r = 89·8°; in
alkaline solution the polarisation is less, [α]r = 45·22°. It is alkaline
in reaction, neutralising acids fully; and, in fact, a convenient method
of titrating morphine is by the use of a centinormal sulphuric acid—
each c.c. equals 2·85 mgrms. of anhydrous morphine.
§ 353. The salts of morphine are for the most part crystalline, and
are all bitter, neutral, and poisonous. They are insoluble in amylic
alcohol, ether, chloroform, benzene, or petroleum ether.
Morphine meconate is one of the most soluble of the morphine
salts; it is freely soluble in water. Of all salts this is most suitable for
subcutaneous injection; it is the form in which the alkaloid exists in
opium.
Morphine hydrochlorate (C17H19NO3HCl) crystallises in silky fibres;
it is readily soluble in alcohol, and is soluble in cold, more freely in
boiling water. The purest morphine hydrochlorate is colourless, but
that which is most frequently met with in commerce is fawn or buff-
coloured.
Morphine acetate is a crystallisable salt, soluble in water or
alcohol; it is in part decomposed by boiling the aqueous solution,
some of the acetic acid escaping.
Morphine Tartrates.—These are readily soluble salts, and it is
important to note that the morphine might escape detection, if the
expert trusted alone to the usual test of an alkaloidal salt giving a
precipitate when the solution is alkalised by the fixed or volatile
alkalies; for the tartrates of morphine do not give this reaction, nor
do they give any precipitate with calcic chloride. By adding a solution
of potassium acetate in spirit, and also alcohol and a little acetic acid
to the concentrated solution, the tartrate is decomposed, and acid
tartrate of potassium is precipitated in the insoluble form; the
morphine in the form of acetate remains in solution, and then gives
the usual reactions.
The solubility of morphine salts in water and alcohol has been
investigated by Mr. J. U. Lloyd. His results are as follows:—
 Morphine Acetate.

11·70 parts of water by weight at 15·0° dissolve 1 part of

morphine acetate.
61·5 parts of water by weight at 100° dissolve 1 part of morphine
acetate.
68·30 parts of alcohol by weight (·820 specific gravity) at 15·0°
dissolve 1 part of morphine acetate.
13·30 parts of alcohol by weight (·820 specific gravity) at 100°
dissolve 1 part of morphine acetate.

Morphine Hydrochlorate.

23·40 parts of water dissolve at 15° 1 morphine hydrochlorate.

·51 part of water dissolves at 100° 1 morphine hydrochlorate.
62·70 parts of alcohol (·820 specific gravity) dissolve at 15° 1
morphine hydrochlorate.
30·80 parts of alcohol (·820 specific gravity) dissolve at 100° 1
morphine hydrochlorate.

Morphine Sulphate.

21·60 parts of water at 15° dissolve 1 morphine sulphate.

·75 part of water at 100° dissolves 1 morphine sulphate.
701·5 parts of alcohol (·820) at 15° dissolve 1 morphine sulphate.
144·00 parts of alcohol (·820) at 100° dissolve 1 morphine
sulphate.

§ 354. Constitution of Morphine.—The chief facts bearing on the

constitution of morphine are as follows:—
It certainly contains two hydroxyl groups, because by the action of
acetic anhydride, acetyl morphine and diacetyl morphine,
C17H18(CH3CO)NO3 and C17H17(CH3CO)2NO3 are produced. The
formation of the monomethyl ether of morphine (codeine),
C17H17(OH)(OCH3)NO, is also a testimony to the existence of
hydroxyl groups. One of the hydroxyl groups has phenolic functions,
the other alcoholic functions. By suitable oxidation morphine yields
trinitrophenol (picric acid), and by fusion with an alkali,
protocatechuic acid; both of these reactions suggest a benzene ring.
On distilling with zinc dust phenanthrene, pyridine, pyrrol,
trimethylamine, and ammonia are formed; evidence of a pyridine
nucleus. If morphine is mixed with 10 to 15 times its weight of a 20
per cent. solution of potash, and heated at 180° for from four to six
hours, air being excluded, a phenol-like compound is formed, and a
volatile amine, ethylmethylamine (the amine boils at 34° to 35°, and
its hydrochloride melts at 133°). This reaction is interpreted by Z. H.
Skrauk[378] and L. Wiegmann to indicate that the nitrogen is directly
connected with two alkyl groups—that is, ethyl and methyl.

[378] Monatsb., x. 110-114.

G. N. Vis,[379] after a careful review of the whole of the reactions of

morphine, has proposed the following constitutional formula as the
one that agrees best with the facts:—

[379] J. pr. Chemie (2), xlvii. 584. Knorr’s formula is—

Ber., xxii. 1113-1119.

§ 355. Tests for Morphine.—(1.) One hundredth of a milligrm. of

pure morphine gives a blue colour to a paste of ammonium
molybdate in sulphuric acid; 20 mgrms. of ammonium molybdate are
rubbed with a glass rod in a porcelain dish, and well mixed with 5
drops of pure strong sulphuric acid and the morphine in a solid form
applied; titanic acid and tungstates give similar reactions.
(2.) Morphine possesses strong reducing properties; a little solid
morphine dissolved in a solution of ferric chloride gives a Prussian
blue precipitate when ferridcyanide solution is added. A number of
ptomaines and other substances also respond to this test, so that in
itself it is not conclusive.
(3.) Iodic Acid Test.—The substance supposed to be morphine is
converted into a soluble salt by adding to acid reaction a few drops
of hydrochloric acid, and then evaporating to dryness. The salt thus
obtained is dissolved in as little water as possible—this, as in
toxicological researches only small quantities are recovered, will
probably be but a few drops. A little of the solution is now mixed
with a very small quantity of starch paste, and evaporated to
dryness at a gentle heat in a porcelain dish. After cooling, a drop of
a solution of 1 part of iodic acid in 15 of water is added to the dry
residue; and if even the 1⁄20000 of a grain of morphine be present, a
blue colour will be developed.
Another way of working the iodic acid test is to add the iodic acid
solution to the liquid in which morphine is supposed to be dissolved,
and then shake the liquid up with a few drops of carbon disulphide.
If morphine be present, the carbon disulphide floats to the top
distinctly coloured pink. Other substances, however, also set free
iodine from iodic acid, and it has, therefore, been proposed to
distinguish morphine from these by the after addition of ammonia. If
ammonia is added to the solution, which has been shaken up with
carbon disulphide, the pink or red colour of the carbon disulphide is
deepened, if morphine was present; on the contrary, if morphine
was not present, it is either discharged or much weakened.
Other Reactions.—There are some very interesting reactions
besides the two characteristic tests just mentioned. If a saturated
solution of chloride of zinc be added to a little solid morphine, and
heated over the water-bath for from fifteen minutes to half-an-hour,
the liquid develops a beautiful and persistent green colour. This
would be an excellent test for morphine were it not for the fact that
the colour is produced with only pure morphine. For example, I was
unable to get the reaction from morphine in very well-formed
crystals precipitated from ordinary laudanum by ammonia, the least
trace of resinous or colouring-matter seriously interfering. By the
action of nitric acid on morphine, the liquid becomes orange-red,
and an acid product of the formula C10H9NO9 is produced, which,
when heated in a closed tube with water at 100°, yields
trinitrophenol or picric acid. This interesting reaction points very
decidedly to the phenolic character of morphine. On adding a drop
of sulphuric acid to solid morphine in the cold, the morphine solution
becomes of a faint pink; on gently warming and continuing the heat
until the acid begins to volatilise, the colour changes through a
series of brownish and indefinite hues up to black. On cooling and
treating the black spot with water, a green solution is obtained,
agreeing in hue with the same green produced by chloride of zinc.
Vidali[380] has proposed the following test:—Morphine is dissolved in
strong sulphuric acid, and a little arsenate of sodium is added; on
gently warming, a passing blue colour develops; on raising the
temperature higher, the liquid changes into green, then into blue,
and finally again into green. Codeine acts very similarly. The
following test originated with Siebold (American Journal of
Pharmacy, 1873, p. 544):—The supposed morphine is heated gently
with a few drops of concentrated sulphuric acid and a little pure
potassic perchlorate. If morphine be present the liquid immediately
takes a pronounced brown colour—a reaction said to be peculiar to
morphine, and to succeed with 1⁄10 of a mgrm. In order to obtain
absolutely pure perchlorate, potassic perchlorate is heated with
hydrochloric acid so long as it disengages chlorine; it is then washed
with distilled water, dried, and preserved for use. There is also a test
known as “Pellagri’s”; it depends on the production of apomorphine.
The suspected alkaloid is dissolved in a little strong hydrochloric
acid, and then a drop of concentrated sulphuric acid is added, and
the mixture heated for a little time from 100° to 120°, until it
assumes a purple-black colour. It is now cooled, some hydrochloric
acid again added, and the mixture neutralised with sodic carbonate.
If morphine be present, on the addition of iodine in hydriodic acid, a
cherry-red colour is produced, passing into green. Morphine and
codeine are believed alone to give this reaction.

D. Vidali, Bull. Farmaceut., Milano, 1881, p. 197; D. E. Dott, Year

[380]
Book of Pharmacy, 1882.

The acetate of morphine, and morphine itself, when added to ferric

chloride solution, develop a blue colour. When 1 molecule of
morphine is dissolved in alcohol, containing 1 molecule of sodium
hydroxide, and 2 vols. of methyl iodide are added, and the mixture
gently heated, a violent reaction sets in and the main product is
codeine methiodide (C17H18NO2OCH,MeI). If only half the quantity of
methyl iodide is added, then free codeine is in small quantity
produced; if ethyl iodide be substituted for methyl, a new base is
formed homologous with codeine—codeine is therefore the methyl
ether of morphine. If morphine is heated with iodide of methyl and
absolute alcohol in a closed tube for half an hour at 100°, methyl
iodide of morphine is obtained in colourless, glittering, quadratic
crystals, easily soluble in water (C17H19NO3MeI + H2O); similarly the
ethyl iodide compound can be produced.
If morphine is heated for from two to three hours in a closed tube
with dilute hydrochloric acid, water is eliminated—

(C17H19NO3 = C17H17NO2 + H2O),

and the hydrochlorate of apomorphine is produced. This succeeds

when even 1⁄2 mgrm. is heated with 1⁄10 c.c. of strong HCl, and the
tests for apomorphine applied.
If concentrated sulphuric acid be digested on morphine for twelve to
fifteen hours (or heated for half an hour at 100°), on adding to the
cooled violet-coloured solution either a crystal of nitrate of potash or
of chlorate of potash, or a drop of dilute nitric acid, a beautiful
violet-blue colour is produced, which passes gradually into a dark
blood-red. 1⁄100 of a mgrm. will respond distinctly to this test.
Fröhde’s reagent strikes with morphine a beautiful violet colour,
passing from blue into dirty green, and finally almost vanishing. 1⁄200
of a mgrm. will respond to the test, but it is not itself conclusive,
since papaverine and certain glucosides give an identical reaction.
§ 356. Symptoms of Opium and Morphine Poisoning.—The
symptoms of opium and morphine poisoning are so much alike, that
clinically it is impossible to distinguish them; therefore they may be
considered together.
Action on Animals—Frogs.—The action of morphine or opium on
frogs is peculiar: the animal at first springs restlessly about, and
then falls into a condition extremely analogous to that seen in
strychnine poisoning, every motion or external irritation producing a
tetanic convulsion. This condition is, however, sometimes not
observed. The tetanic stage is followed by paralysis of reflex
movements and cessation of breathing, the heart continuing to beat.
Dogs.—0·2 to 0·5 grm. of morphine meconate, or acetate, injected
directly into the circulation of a dog, shows its effects almost
immediately. The dog becomes uneasy, and moves its jaws and
tongue as if some peculiar taste were experienced; it may bark or
utter a whine, and then in a minute or two falls into a profound
sleep, which is often so deep that while it lasts—usually several
hours—an operation may be performed. In whatever attitude the
limbs are placed, they remain. The respiration is rapid and
stertorous, and most reflex actions are extinguished. Towards the
end of the sleep, any sudden noise may startle the animal, and
when he wakes his faculties are evidently confused. A partial
paralysis of the hind legs has often been noticed, and then the dog,
with his tail and pelvis low, has something the attitude of the hyena.
Hence this condition (first, I believe, noticed by Bernard) has been
called the “hyenoid” state. If the dose is larger than 2 to 3 grms. (31
to 46 grains), the symptoms are not dissimilar, save that they
terminate in death, which is generally preceded by convulsions.[381]

[381] MM. Grasset and Amblard have studied the action of morphine in
causing convulsions in the mammalia. They found that if small doses of
hydrochlorate of morphine (from 1 to 15 centigrammes) are administered
to dogs, the brief sleep which is produced may be accompanied by partial
muscular contractions (in one paw, for instance), which are renewed at
variable intervals. Then occur true convulsive shocks in the whole body or
in the hind limbs. After an interval, the phenomena recur in more intense
degree, and are followed by true convulsions. Regularly, ten or sixteen
times a minute, at each inspiration, the hind limbs present a series of
convulsive movements, which may become general. Sometimes they are
excited by external stimulation, but they are usually spontaneous. The
sleep may continue profound during this convulsive period, or it may
become distinctly lighter. These convulsive phenomena may continue, with
intervals, for an hour. Differences are observed with different animals; but
the chief characters of the phenomena are as described. In certain
animals, and with small doses, there may be a brief convulsive phase at
the commencement of the sleep, but it is much less constant than the
later period of spasm. These convulsions, the authors believe, have not
previously been described, except as a consequence of very large doses,
amounting to grammes. The period of cerebral excitement, described by
Claude Bernard as occurring at the commencement of the sleep from
morphine, is a phenomenon of a different order. The conclusions drawn
from the experiments are—(1) That morphia is not diametrically opposed
to thebaine, as is often stated, since it has, to a certain degree, the
convulsive properties of the latter alkaloid. (2) That the excitomotor action
of opium cannot be exclusively attributed to the convulsive alkaloids, but
is, in fact, due to those which are soporific. According to the ordinary
composition of opium, 5 centigrammes of morphine represent about a
milligramme of thebaine. But these experiments show that the quantity of
morphine has a much more powerful convulsive action than a milligramme
of thebaine. (3) There is not the supposed antagonism between the action
of morphine on the frog and on the mammalia. (4) The researches
hitherto undertaken on the antagonism between morphine and other
agents need to be repeated, and a separate study made of the substances
which antagonise the convulsive and soporific action.
Goats.—According to Guinard, goats are proof against the narcotic
influence of morphine. Large doses kill goats, but death is caused by
interference with the respiratory function. A young goat weighing 30
kilos, showed little effect beyond a slightly increased cerebral
excitability after two doses of 8 and 8·5 grms. respectively of
morphine hydrochlorate had been administered by intravenous
injection, the second being given an hour and a half after the first.
To the same animal two days afterwards 195 grms. were
administered in the same way, yet the goat recovered. The lethal
dose for a goat seems to be no less than 1000 times that which will
produce narcotism in man, and lies somewhere between 0·25 to
0·30 per kilo. of the body weight.[382]

[382] Compt. Rend., t. cxvi. pp. 520-522.

Cats and the Felidæ.—According to Guinard,[383] morphine

injected subcutaneously or intravenously into cats, in doses varying
from 0·4 mgrm. to 90 mgrms. per kilo., never produces sleep or
narcotic prostration. On the contrary, it causes a remarkable degree
of excitement, increasing in intensity with the dose given. This
excitement is evidently accompanied by disorder in the functions of
the brain, and if the dose is large convulsions set in, ending in
death. According to Milne-Edwards, the same symptoms are
produced in lions and tigers.

[383] Compt. Rend., t. cxi. pp. 981-983. The bovine animals also get
excited, and no narcotic effect is produced by dosing them with morphine.
—Compt. Rend. Soc. de Biologie, t. iv., v.

Birds, especially pigeons, are able to eat almost incredible

quantities of opium. A pigeon is said[384] to have consumed 801
grains of opium, mixed with its food, in fourteen days. The
explanation of this is that the poison is not absorbed; for
subcutaneous injections of salts of morphine act rapidly on all birds
hitherto experimented upon.
 [384] Hermann’s Lehrbuch der exper. Toxicologie, p. 374.

§ 357. Physiological Action.—From experiments on animals, the

essential action of morphine on the nervous and arterial systems has
in some measure been examined. There is no very considerable
action on the heart. The beats are first accelerated, then diminished
in frequency; but very large doses introduced directly into the
circulation at once diminish the pulsations, and no acceleration is
noticed. The slowing may go on to heart-paralysis. The slowing is
central in its origin, for on the vagi being cut, morphine always
quickens. With regard to the peripheric ends of the vagi, small doses
excite, large paralyse. If all the nerves going to the heart are
divided, there is first a considerable acceleration, and then a slowing
and weakening of the pulsations. The arterial blood-pressure, at first
increased, is afterwards diminished. This increase of blood-pressure
is noticed during the acceleration of the pulse, and also during some
portion of the time during which the pulse is slowed. Stockman and
D. B. Dott,[385] experimenting on rabbits and frogs, consider that a
medium dose of morphine first of all depresses the spinal cord and
then excites it, for tetanus follows. If morphine is in sufficient
quantity thrown into the circulation then tetanus at once occurs. It
would thus appear that depression and stimulation is entirely a
matter of dosage. Gescheidlen, in his researches on the frog, found
the motor nerves at first excited, and then depressed. When the
doses were large, there was scarcely any excitement, but the
reverse effect, in the neighbourhood of the place of application.
According to other observers, the function of the motor nerves may
be annihilated.[386] According to Meihuizen, reflex action, at first
much diminished, is later, after several hours, normal, and later still
again increased. The intestinal movements are transitorily increased.
In the dog there has been noticed a greater flow of saliva than
usual, and the flow of bile from the gall-bladder is diminished. The
pupils in animals are mostly contracted, but, if convulsions occur
towards death, they are dilated.
 [385] Brit. Med. Journ. (2), 1890, 189-192.
[386] Arch. f. d. Ges. Physiol., vii. p. 201.

§ 358. Physiological Effect of Morphine Derivatives.—By

introducing methyl, or amyl, or ethyl, into the morphine molecule,
the narcotic action is diminished, while the tetanic effects are
increased. Acetyl, diacetyl, benzoyl, and dibenzoyl morphine,
morphine sulphuric ether, and nitrosomorphine are all weaker
narcotics than morphine, but, on the other hand, they depress the
functions of the spinal cord and bring on, in large doses, tetanus.
The introduction of two methyl groups into morphine, as in metho-
codeine, C17H17MeNO(OH)-Me, entirely alters the physiological effect.
This compound has an action on voluntary muscle causing gradual
paralysis.
The chlorine derivatives, trichlormorphine and chlorcodeine, have
the characteristic action of the morphine group on the central
nervous system and, in addition, act energetically as muscle poisons,
soon destroying the contractile power of the voluntary muscles with
which they first come into contact at the place of injection, and more
gradually affecting the other muscles of the body.[387]

[387] R. Stockman and Dott, Brit. Med. Journ. (2), 1890, 189-192.

§ 359. Action on Man.—There are at least three forms of opium

poisoning:—(1) The common form, as seen in about 99 per cent. of
cases; (2) A very sudden form, in which death takes place with
fearful rapidity (the foudroyante variety of the French);[388] and (3) a
very rare entirely abnormal form, in which there is no coma, but
convulsions.

[388] Tardieu, Étude Méd. Légale sur l’Empoisonnement.

In the common form there are three stages, viz.:—(1) Excitement;
(2) Narcosis; (3) Coma. In from half an hour to an hour[389] the first
symptoms commence, the pulse is quickened, the pupils are
contracted, the face flushes, and the hands and feet reddened,—in
other words, the capillary circulation is active. This stage has some
analogy to the action of alcohol; the ideas mostly flow with great
rapidity, and instead of a feeling of sleepiness, the reverse is the
case. It, however, insensibly, and more or less rapidly, passes into
the next stage of heaviness and stupor. There is an irresistible
tendency to sleep; the pulse and the respiration become slower; the
conjunctivæ are reddened; the face and head often flushed. In some
cases there is great irritability of the skin, and an eruption of nettle-
rash. If the poison has been taken by the mouth, vomiting may be
present. The bowels are usually—in fact almost invariably—
constipated. There is also some loss of power over the bladder.

[389]In a remarkable case related by Taylor, a lady took a large dose

(supposed to be 11⁄2 oz.) of laudanum, and there were no symptoms for
four and a half hours. She died in twenty-two hours.

In the next stage, the narcosis deepens into dangerous coma; the
patient can no longer be roused by noises, shaking, or external
stimuli; the breathing is loud and stertorous; the face often pale; the
body covered with a clammy sweat. The pupils are still contracted,
but they may in the last hours of life dilate: and it is generally
agreed that, if a corpse is found with the pupils dilated, this
circumstance, taken in itself, does not contra-indicate opium or
morphine poisoning. Death occasionally terminates by convulsion.
The sudden form is that in which the individual sinks into a deep
sleep almost immediately—that is, within five or ten minutes—and
dies in a few hours. In these rapid cases the pupils are said to be
constantly dilated.
Examples of the convulsive form are to be sought among opium-
eaters, or persons under otherwise abnormal conditions.
A man, forty years old, who had taken opiates daily since his twenty-
second year—his dose being 6 grms. (92·4 grains) of solid opium—
when out hunting, of which sport he was passionately fond, took
cold, and, as a remedy, administered to himself three times his
accustomed dose. Very shortly there was contraction of the left arm,
disturbance of vision, pain in the stomach, faintness, inability to
speak, and unconsciousness which lasted half an hour. Intermittent
convulsions now set in, and pains in the limbs. There was neither
somnolence nor delirium, but great agitation; repeated vomiting and
diarrhœa followed. After five hours these symptoms ceased; but he
was excessively prostrate.[390] There was complete recovery.

[390] Demontporcellet, De l’Usage Quotidien de l’Opium, Paris, 1874.

One may hazard a surmise that, in such a case, tolerance has been
established for morphine, but not for other morphine alkaloids in the
same degree, and that the marked nervous symptoms were in no
small degree the effect of some of the homologous alkaloids, which,
in such an enormous dose, would be taken in sufficient quantity to
have a physiological action.
There are several instances of a relapsing or remittent form of
poisoning—a form in which the patient more or less completely
recovers consciousness, and then sinks back into a fatal slumber.
One of the best known is the case of the Hon. Mrs Anson (January
1859), who swallowed an ounce and a half of laudanum by mistake.
After remaining in a comatose condition for more than nine hours,
she revived. The face became natural, the pulse steady. She was
able to recognise her daughter, and in a thick voice to give an
account of the mistake. But this lasted only ten minutes, when she
again became comatose, and died in fourteen hours.[391]

[391] Taylor, op. cit.

In a Swedish case quoted by Maschka,[392] a girl, nine years old, in
weak health and suffering from slight bronchitis, had been given a
non-officinal acetate of morphia lozenge, which was supposed to
contain 5 mgrms. (·075 grain) of morphine acetate. She took the
lozenge at eight in the evening; soon slept, woke at ten, got out of
bed, laughed, talked, and joked with the nurse, again got into bed,
and very quickly fell asleep. At four A.M. the nurse came and found
her breathing with a rattling sound, and the physician, who arrived
an hour later, found the girl in a state of coma, with contracted
pupils, breathing stertorously, and the pulse scarcely to be felt.
Despite all attempts to rouse the patient, she died at eight in the
morning, twelve hours after taking the lozenge.

[392]Maschka’s Handbuch, Band ii. p. 438; also Svenska, Läk-Sällsk.

Förhandl., Apr. 1, p. 90; Apr. 8, p. 160, 1873. For other cases see
Nasmyth, Edin. Med. Journ., Dec. 1878; Kirby, Dub. Med. Press, Dec. 24,
1845; W. Boyd Muschet, Med. Times and Gaz., March 20, 1858.

The post-mortem examination showed some hyperæmia of the brain

and serous effusion in the ventricles, and there was also tubercle in
the pleura. Three lozenges similar to the one taken by the patient
were chemically investigated by Hamberg, who found that the
amount of acetate was very small, and that the lozenges, instead of
morphine acetate, might be considered as prepared with almost
pure morphine; the content in the three of morphine being
respectively 35, 37, and 42 mgrms. (that is, from half a grain to
three-fifths of a grain). There was a difference of opinion among the
experts as to whether in this case the child died from morphine
poisoning or not—a difference solely to be attributed to the waking
up of the child two hours after taking the poison. Now, considering
the great probability that a large dose for a weakly child of that age
had been taken, and that this is not the only case in which a relapse
has occurred, it seems just to infer that it was really a case of
poisoning.
As unusual symptoms (or rather sequelæ) may be noted in a few
cases, hemiplegia, which soon passes off; a weakness of the lower
extremities may also be left, and inability to empty the bladder
thoroughly; but usually on recovery from a large dose of opium,
there is simply heaviness of the head, a dry tongue, constipation,
and loss of appetite. All these symptoms in healthy people vanish in
a day or two. There have also been noticed slight albuminuria,
eruptions on the skin, loss of taste, and numbness of parts of the
body.
Opium, whether taken in substance, or still more by subcutaneous
injection, in some individuals constantly causes faintness. In my own
case, I have several times taken a single grain of opium to relieve
either pain or a catarrh; almost invariably within an hour afterwards
there has been great coldness of the hands and feet, lividity of the
face, a feeling of deadly faintness followed by vomiting; this stage
(which has seldom lasted more than half an hour) passed, the usual
narcotic effects have been produced.
Some years ago I injected one-sixth of a grain of morphine
hydrochlorate subcutaneously into an old gentleman, who was
suffering from acute lumbago, but was otherwise healthy, and had
no heart disease which could be detected; the malady was instantly
relieved, and he called out, “I am well; it is most extraordinary.” He
went out of the front door, and walked some fifty yards, and then
was observed to reel about like a drunken man. He was supported
back and laid in the horizontal posture; the face was livid, the pulse
could scarcely be felt, and there was complete loss of consciousness.
This state lasted about an hour, and without a doubt the man nearly
died. Medical men in practice, who have been in the habit of using
hypodermic injections of morphine, have had experiences very
similar to this and other cases, and although I know of no actual
death, yet it is evident that morphine, when injected hypodermically
even in a moderate dose, may kill by syncope, and within a few
minutes.[393] Absorption by hypodermic administration is so rapid
that by the time, or even before the needle of the syringe is
withdrawn, a contraction of the pupil may be observed.

[393] See a case of morphia poisoning by hypodermic injection, and

recovery, by Philip E. Hill, M.R.C.S., Lancet, Sept. 30, 1882. In this
instance a third of a grain introduced subcutaneously caused most
dangerous symptoms in a gardener, aged 48.

Opium or morphine is poisonous by whatever channel it gains access

to the system, the intestinal mucous membrane absorbs it readily,
and narcotic effects may be produced by external applications,
whether a wound is present or not. A case of absorption of opium by
a wound is related in Chevers’s Jurisprudence.[394] A Burman boy,
about nine or ten years of age, was struck on the forehead by a
brick-bat, causing a gaping wound about an inch long; his parents
stuffed the wound with opium. On the third day after the accident,
and the opium still remaining in the wound, he became semi-
comatose, and, in short, had all the symptoms of opium narcosis;
with treatment he recovered. The unbroken skin also readily absorbs
the drug. Tardieu states that he had seen 30 grms. of laudanum,
applied on a poultice to the abdomen, produce death. Christison has
also cited a case in which a soldier suffered from erysipelas, and
died in a narcotic state, apparently produced from the too free
application of laudanum to the inflamed part.

[394] Third ed., p. 228.

To these cases may be added the one cited by Taylor, in which a

druggist applied 30 grains of morphine to the surface of an ulcerated
breast, and the woman died with all the symptoms of narcotic
poisoning ten hours after the application—an event scarcely
surprising. It is a curious question whether sufficient of the poison
enters into the secretions—e.g., the milk—to render it poisonous. An
inquest was held in Manchester, Nov. 1875, on the body of a male
child two days old, in which it seemed probable that death had
occurred through the mother’s milk. She was a confirmed opium-
eater, taking a solid ounce per week.
§ 360. Diagnosis of Opium Poisoning.—The diagnosis is at times
between poisoning by opium or other narcotic substances, at others,
between opium and disease. Insensibility from chloral, from alcohol,
from belladonna or atropine, and from carbon oxide gas, are all
more or less like opium poisoning. With regard to chloral, it may be
that only chemical analysis and surrounding circumstances can clear
up the matter. In alcohol poisoning, the breath commonly smells
very strongly of alcohol, and there is no difficulty in separating it
from the contents of the stomach, &c., besides which the stomach is
usually red and inflamed. Atropine and belladonna invariably dilate
the pupil, and although just before death opium has the same effect,
yet we must hold that mostly opium contracts, and that a widely-
dilated pupil during life would, per se, lead us to suspect that opium
had not been used, although, as before mentioned, too much stress
must not be laid upon the state of the pupils. In carbon oxide, the
peculiar rose-red condition of the body affords a striking contrast to
the pallor which, for the most part, accompanies opium poisoning. In
the rare cases in which convulsions are a prominent symptom, it
may be doubtful whether opium or strychnine has been taken, but
the convulsions hitherto noticed in opium poisoning seem to me to
have been rather of an epileptiform character, and very different
from the effects of strychnine. No rules can be laid down for cases
which do not run a normal course; in medicine such are being
constantly met with, and require all the care and acumen of the
trained observer. Cases of disease render a diagnosis often
extremely difficult, and the more so in those instances in which a
dose of laudanum or other opiate has been administered. In a case
under my own observation, a woman, suffering from emphysema
and bronchitis, sent to a chemist for a sleeping draught, which she
took directly it arrived. A short time afterwards she fell into a
profound slumber, and died within six hours. The draught had been
contained in an ounce-and-a-half bottle; the bottle was empty, and
the druggist stated in evidence that it only contained 20 minims of
laudanum, 10 grains of potassic bromide, and water. On, however,
diluting the single drop remaining in the bottle, and imitating its
colour with several samples of laudanum diluted in the same way, I
came to the conclusion that the quantity of laudanum which the
bottle originally contained was far in excess of that which had been
stated, and that it was over 1 drachm and under 2 drachms. The
body was pallid, the pupils strongly contracted, the vessels of the
brain membranes were filled with fluid blood, and there was about
an ounce of serous fluid in each ventricle. The lungs were
excessively emphysematous, and there was much secretion in the
bronchi; the liver was slightly cirrhotic. The blood, the liver, and the
contents of the stomach were exhaustively analysed with the
greatest care, but no trace of morphine, narcotine, or meconic acid
could be separated, although the woman did not live more than six
hours after taking the draught. I gave the opinion that it was, in the
woman’s state, improper to prescribe a sedative of that kind, and
that probably death had been accelerated, if not directly caused, by
opium.
Deaths by apoplexy will only simulate opium-poisoning during life; a
post-mortem examination will at once reveal the true nature of the
malady. In epilepsy, however, it is different, and more than once an
epileptic fit has occurred and been followed by coma—a coma which
certainly cannot be distinguished from that produced by a narcotic
poison. Death in this stage may follow, and on examining the body
no lesion may be found.
§ 361. Opium-eating.—The consumption of opium is a very ancient
practice among Eastern nations, and the picture, drawn by novelist
and traveller, of poor, dried-up, yellow mortals addicted to this vice,
with their faculties torpid, their skin hanging in wrinkles on their
wasted bodies, the conjunctivæ tinged with bile, the bowels so
inactive that there is scarcely an excretion in the course of a week,
the mental faculties verging on idiocy and imbecility, is only true of a
percentage of those who are addicted to the habit. In the British
Medical Journal for 1894, Jan. 13 and 20, will be found a careful
digest of the evidence collated from 100 Indian medical officers,
from which it appears that opium is taken habitually by a very large
number of the population throughout India, those who are
accustomed to the drug taking it in quantities of from 10 to 20
grains in the twenty-four hours; so long as this amount is not
exceeded they do not appear to suffer ill-health or any injurious
effect. The native wrestlers even use it whilst training. The habitual
consumption of opium by individuals has a direct medico-legal
bearing. Thus in India, among the Rajpoots, from time immemorial,
infused opium has been the drink both of reconciliation and of
ordinary greeting, and it is no evidence of death by poison if even a
considerable quantity of opium be found in the stomach after death,
for this circumstance taken alone would, unless the history of the
case was further known, be considered insufficient proof. So, again,
in all climates, and among all races, it is entirely unknown what
quantity of an opiate should be considered a poisonous dose for an
opium-eater. Almost incredible quantities have, indeed, been
consumed by such persons, and the commonly-received explanation,
that the drug, in these cases, passes out unabsorbed, can scarcely
be correct, for Hermann mentions the case of a lady of Zurich who
daily injected subcutaneously 1 to 2 grms. (15-31 grains) of a
morphine salt. In a case of uterine cancer, recorded by Dr. W. C.
Cass,[395] 20 grains of morphine in the twelve hours were frequently
used subcutaneously; during thirteen months the hypodermic
syringe was used 1350 times, the dose each time being 5 grains. It
is not credible that an alkaloid introduced into the body
hypodermically should not be absorbed.

[395]Lancet, March 25, 1882. See also Dr. Boulton’s case, Lancet, March
18, 1882.

Opium-smoking is another form in which the drug is used, but it is

an open question as to what poisonous alkaloids are in opium
smoke. It is scarcely probable that morphine should be a
constituent, for its subliming point is high, and it will rather be
deposited in the cooler portion of the pipe. Opium, specially
prepared for smoking, is called “Chandoo”; it is dried at a
temperature not exceeding 240°. H. Moissan[396] has investigated
the products of smoking chandoo, but only found a small quantity of
morphine. N. Gréhant and E. Martin[397] have also experimented
with opium smoke; they found it to have no appreciable effect on a
dog; one of the writers smoked twenty pipes in succession,
containing altogether 4 grms. of chandoo. After the fourth pipe there
was some headache, at the tenth pipe and onwards giddiness. Half
an hour after the last pipe the giddiness and headache rapidly went
off. In any case, opium-smoking seems to injure the health of
Asiatics but little. Mr. Vice-Consul King, of Kew-Kiang, in a tour
through Upper Yangtse and Stechnan, was thrown much into the
company of junk sailors and others, “almost every adult of whom
smoked more or less.” He says:—“Their work was of the hardest and
rudest, rising at four and working with hardly any intermission till
dark, having constantly to strip and plunge into the stream in all
seasons, and this often in the most dangerous parts. The quantity of
food they eat was simply prodigious, and from this and their work it
seems fairly to be inferred that their constitution was robust. The
two most addicted to the habit were the pilot and the ship’s cook.
On the incessant watchfulness and steady nerve of the former the
safety of the junk and all on board depended, while the second
worked so hard from 3 A.M. to 10 P.M., and often longer, and seemed
so independent of sleep or rest, that to catch him seated or idle was
sufficient cause for good-humoured banter. This latter had a
conserve of opium and sugar which he chewed during the day, as he
was only able to smoke at night.”

[396] Compt. Rend., cxv. 988-992.

[397] Compt. Rend., 1012-1014.

§ 362. Treatment of Opium or Morphine Poisoning.—The first

thing to be done is doubtless to empty the stomach by means of the
flexible stomach tube; the end of a sufficiently long piece of
indiarubber tubing is passed down into the pharynx and allowed to
be carried into the stomach by means of the natural involuntary
movements of the muscles of the pharynx and gullet; suction is then
applied to the free end and the contents syphoned out; the stomach
is, by means of a funnel attached to the tube, washed out with
warm water, and then some coffee administered in the same way.
Should morphine have been taken, and permanganate of potash be
at hand, it has been shown that under such circumstances potassic
permanganate is a perfect antidote, decomposing at once any
morphine remaining in the stomach, but it, of course, will have no
effect upon any morphine which has already been absorbed. In a
case of opium poisoning, reported in the Lancet of June 2, 1894, by
W. J. C. Merry, M.B., inhalations of oxygen, preceded by emptying
the stomach and other means, appeared to save a man, who, three
hours before the treatment, had drank 2 ozs. of chlorodyne. It is
also the received treatment to ward off the fatal sleep by
stimulation; the patient is walked about, flicked with a towel, made
to smell strong ammonia, and so forth. This stimulation must,
however, be an addition, but must never replace the measures first
detailed.
§ 363. Post-mortem Appearances.—There are no characteristic
appearances after death save hyperæmia of the brain and blood-
vessels of the membranes, with generally serous effusion into the
ventricles. The pupils are sometimes contracted, sometimes dilated,
the dilatation occurring, as before mentioned, in the act of dying.
The external surface of the body is either livid or pale. The lungs are
commonly hyperæmic, the bladder full of urine; still, in not a few
cases, there is nothing abnormal, and in no single case could a
pathologist, from the appearance of the organs only, declare the
cause of death with confidence.
§ 364. Separation of Morphine from Animal Tissues and
Fluids.—Formerly a large proportion of the opium and morphine
cases submitted to chemical experts led to no results; but owing to
the improved processes now adopted, failure, though still common,
is less frequent. The constituents of opium taken into the blood
undergo partial destruction in the animal body, but a portion may be
found in the secretions, more especially in the urine and fæces. First
Bouchardat[398] and then Lefort[399] ascertained the excretion of
morphine by the urine after medicinal doses; Dragendorff and
Kauzmann showed that the appearance of morphine in the urine was
constant, and that it could be easily ascertained and separated from
the urine of men and animals; and Levinstein[400] has also shown
that the elimination from a single dose may extend over five or six
days. The method used by Dragendorff to extract morphine from
either urine or blood is to shake the liquid (acidified with a mineral
acid) several times with amyl alcohol, which, on removal, separates
urea and any bile acids. The liquid thus purified is then alkalised,
and shaken up with amyl alcohol, and this amyl alcohol should
contain any morphine that was present. On evaporation it may be
pure enough to admit of identification, but if not, it may be
redissolved and purified on the usual principles. Considerable variety
of results seems to be obtained by different experimenters.
Landsberg[401] injected hypodermically doses of ·2 to ·4 grm. of
morphine hydrochlorate into dogs, making four experiments in all,
but failed to detect morphine in the urine. A large dose with 2·4
mgrms. of the salt gave the same result. On the other hand, ·8 grm.
of morphine hydrochlorate injected direct into the jugular vein, was
partly excreted by the kidneys, for 90 c.c. of the urine yielded a
small quantity of morphine. Voit, again, examined the urine and
fæces of a man who had taken morphine for years; he could detect
none in the urine, but separated morphine from the fæces.[402]
Morphine may occasionally be recognised in the blood.
Dragendorff[403] found it in the blood of a cat twenty-five minutes
after a subcutaneous dose, and he also separated it from the blood
of a man who died of morphine poisoning in six hours. Haidlen[404]
recognised morphine in the blood of a suicide who had taken opium
extract.

[398] Bull. Gén. de Thérap., Dec. 1861.

 [399] Journ. de Chim., xi. 93, 1861.
[400] Berl. klin. Wochenschr., 1876, 27.
[401] Pflüger’s Archiv., 23, 433, 413-433. Chem. Soc. Journ., May 1882,
543.
[402] Arch. Pharm., pp. [3], vii. pp. 23-26.
[403] Kauzmann, Beiträge für den gerichtlich-chemischen Nachweis des
Morphia u. Narcotins, Dissert., Dorpat, 1868. Dragendorff, Pharm. Zeitschr.
f. Russland, 1868, Hft. 4.
[404] Würtbg. Correspondenzbl., xxxiv. 16, 1863.

On the other hand, in a case recorded at p. 304, where a woman

died in six hours from a moderate dose, probably of laudanum,
although the quantity of blood operated upon was over a pound in
weight, and every care was taken, the results were entirely negative.
In poisoning by laudanum there may be some remaining in the
stomach, and also if large doses of morphine have been taken by
the mouth; but when morphine has been administered
hypodermically, and in all cases in which several hours have elapsed,
one may almost say that the organ in which there is the least
probability of finding the poison is the stomach. It may, in some
cases, be necessary to operate on a very large scale;—to examine
the fæces, mince up the whole liver, the kidney, spleen, and lungs,
and treat them with acid alcohol. The urine will also have to be
examined, and as much blood as can be obtained. In cases where all
the evidence points to a minute quantity (under a grain) of
morphine, it is decidedly best to add these various extracts together,
to distil off the alcohol at a very gentle heat, to dry the residue in a
vacuum, to dissolve again in absolute alcohol, filter, evaporate again
to dryness, dissolve in water, and then use the following process:—
§ 365. Extraction of Morphine.—To specially search for morphine
in such a fluid as the urine, it is, according to the author’s
experience, best to proceed strictly as follows:—The urine is
precipitated with acetate of lead, the powdered lead salt being
added to the warm urine contained in a beaker on the water-bath,
until a further addition no longer produces a precipitate; the urine is
then filtered, the lead precipitate washed, and the excess of lead
thrown down by SH2; the lead having been filtered off, and the
precipitate washed, the urine is concentrated down to a syrup in a
vacuum. The syrup is now placed in a separating tube (if not acid, it
is acidified with hydrochloric acid), and shaken up successively with
petroleum ether, chloroform, ether, and, lastly, with amylic alcohol
(the latter should be warm); finally, the small amount of amylic
alcohol left dissolved in the liquid is got rid of by shaking it up with
petroleum ether. To get rid of the last traces of petroleum ether, it
may be necessary to turn the liquid into an evaporating dish, and
gently heat for a little time over the water-bath. The acid liquid is
now again transferred to the separating tube, and shaken up with
ether, after being made alkaline with ammonia; this will remove
nearly all alkaloids save morphine,—under the circumstances, a very
small quantity of morphine may indeed be taken up by the ether, but
not the main bulk. After separating the ether, the liquid is again
made slightly acid, so as to be able to precipitate morphine in the
presence of the solvent; the tube is warmed on the water-bath, at
least its own bulk of hot amylic alcohol added and the liquid made
alkaline, and the whole well shaken. The amylic alcohol is removed
in the usual way, and shaken with a small quantity of decinormal
sulphuric acid; this washes out the alkaloid from the amyl alcohol,
and the same amyl alcohol can be used again and again. It is best to
extract the liquid for morphine at least thrice, and to operate with
both the solution and the amyl hot. The decinormal acid liquid is
made slightly alkaline with ammonia, and allowed to stand for at
least twelve hours; any precipitate is collected and washed with
ether, and then with water; the alkaline liquid from which the
morphine has been separated is concentrated to the bulk of 5 c.c. on
the water bath, and again allowed to stand for twelve hours; a little
more morphine may often in this way be obtained.
The author in some test experiments, in which weighed small
quantities of morphine (60-80 mgrms.) were dissolved in a little
decinormal sulphuric acid, and added to large quantities of urine,
found the process given to yield from 80 to 85 per cent. of the
alkaloid added, and it was always recovered in fine crystals of a
slight brown tint, which responded well to tests.
Various other methods were tried, but the best was the one given;
the method not only separates the alkaloid with but little loss, but
also in a sufficiently pure state to admit of identification.
From the tissues the alkaloid may be dissolved out by the general
method given at p. 239, and the ultimate aqueous solution, reduced
to a bulk of not more than 25 c.c., treated by the ethereal solvents
in the way just described.
§ 366. Narcotine (C22H23NO7) crystallises out of alcohol or ether in
colourless, transparent, glittering needles, or groups of needles,
belonging to the orthorhombic system.
It is only slightly soluble in boiling, and almost insoluble in cold
water. One part requires 100 parts of cold, and 20 of boiling 84 per
cent. alcohol; 126 parts of cold, 48 of boiling ether (specific gravity
0·735); 2·69 parts of chloroform; 400 of olive oil; 60 of acetic ether;
300 of amyl alcohol; and 22 parts of benzene, for solution. The
neutral solution of narcotine turns the plane of polarisation to the
left [α]r = 130·6; the acid solution to the right. Narcotine has no
effect on red litmus paper.
Narcotine gives no crystalline sublimate; its behaviour in the
subliming cell is described at p. 259. Its melting-point, taken in a
tube, is about 176°.
Behaviour of Narcotine with Reagents.—Narcotine, dissolved in
dilute hydrochloric acid, and then treated with a little bromine, gives
a yellow precipitate, which on boiling is dissolved; by gradually
adding solution of bromine and boiling, a fine rose colour is
produced, readily destroyed by excess of bromine. This is perhaps
the best test for the presence of narcotine. Concentrated sulphuric
acid dissolves narcotine; the solution in the cold is at first colourless,
after a few minutes yellow, and in the course of a day or longer the
tints gradually deepen. If the solution is warmed, it first becomes
orange-red, then at the margin violet-blue; and if heated until hydric
sulphate begins to volatilise, the colour is an intense red-violet. If
the heating is not carried so far, but the solution allowed to cool, a
delicate cherry-red hue slowly develops. If the sulphuric acid solution
contains 1 : 2000 of the alkaloid, this test is very evident; with 1 :
40,000, the colour is only a faint carmine.—A. Husemann.
A solution of narcotine in pure sulphuric acid, to which a drop of
nitric acid has been added, becomes of a red colour; if the solution
is warmed to 150°, hypochlorite of soda develops a carmine-red;
and chloride of iron, first a violet, then a cherry-red. The precipitants
of narcotine are—phosphomolybdic acid, picric acid, sulphocyanide
of potash, potassio cadmic iodide, mercuric chloride, platinic
chloride, auric chloride, and several other reagents.
From the brown mass left after heating narcotine above 200°,
hydrochloric acid extracts a small portion of a base but little studied.
The residue consists of humopic acid (C40H19O14), which can be
obtained by dissolving in caustic potash, precipitating with HCl,
dissolving the precipitate in boiling alcohol, and finally throwing it
down by water.
§ 367. Effects.—Narcotine in itself has toxic action only in rather
large doses; from 1 to 2 grms. have been given to man, and slight
hypnotic effects have followed. It is poisonous in very large doses;
an ordinary-sized cat is killed by 3 grms. The symptoms are mainly
convulsions.
§ 368. Codeine (Codomethylene), C17H17OCH3(OH)NO + H2O, is
the methyl of morphine; it is an alkaloid contained in opium in small
quantity only. Mulder, indeed, quotes ·66 to ·77 per cent. as present
in Smyrna opium, but Merck and Schindler give ·25 per cent.
Schindler found in Constantinople, ·5 per cent.; and Merck, in
Bengal, ·5 per cent. also.
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