The Hypodermic Injection of Morphia in Insanity

In 1843 the subcutaneous injection of morphia was introduced into this country by Dr. Alex. Wood, of Edinburgh, as a means of treating nervous disease. He found it remarkably efficacious in relieving neuralgia, but believed its action to be almost, if not entirely, local. His results as to the relief of pain have received almost universal confirmation; but subsequent experiments have shown that the drug acts on the nerve-centres, and thus indirectly soothes the pain of an irritated nerve, and not by causing direct anæsthesia of the seat of pain. To Dr. C. Hunter is due the credit of having first demonstrated that local injection is not necessary for the relief of local pain. He employed the hypodermic injection of morphia very successfully in controlling the spasms of chorea, in subduing the excitement and overcoming the sleeplessness of Delirium Tremens and Acute Mania, and in alleviating the restless wakefulness of traumatic inflammation. (His experiments were published in the “Med. Times and Gazette,” for 1859.) Two years later, in 1861, Dr. W. C. McIntosh, now Superintendent of the Perth District Asylum, then Assistant Physician of Murray's Royal Asylum, Perth, employed morphia, subcutaneously, in almost all forms of insanity, and found it, to use his own words, “a sedative to the furious, a calmative to the depressed and despairing.” His observations were published in the “Journal of Mental Science” for 1861; and although this mode of using morphia rapidly became known, employed, and esteemed in many asylums, and by many alienists, the results, so far as I am aware, were published only as isolated notes till Dr. J. B. Ward's paper appeared in the “West Biding Asylum Medical Reports” for 1871.