Codeine

“ Second, heroin is a derivative of opium and can be manufactured from opium or from morphine or codeine, which are also derived from opium. [15] Whether heroin can be synthesized is disputed, but there is no evidence that it is being synthesized in this country. ”

“ All this despite the fact that heroin is three times stronger than morphine, and despite the fact that physicians know that anything [Pg 22] which will do the work of an opiate is an opiate. Codeine, notwithstanding the fact that it is weaker than morphine, is likewise habit-forming; yet doctors prescribe it on account of its relative mildness, even though they know that it is the cumulative effect of continued doses, and not the quantity of morphine in the dose, which results in habit. ”

“ Later, when degeneration of the liver has reached an extreme point, these will be of no avail. Cadeac recommends acetanilid, antipyrine, and benzo-naphthol largely on their antiseptic merits, and Jong claims a recovery in a horse under daily doses of 12 grains of codeine. Opium has long been employed in man with partially good results, and croton chloral, strychnia, phosphoric acid, iodoform and ergot are recommended in different cases. ”

“ They use various derivatives of opium, like morphine and heroin, also codeine, dionin, narcein, ethyl chloride and bromide, nitrite of amyl, amylin,—and the skill that they have acquired in the manipulation of these powerful drugs stamps them as the most dangerous coterie of criminals in existence. Now," he concluded, "doubt it or not, we have to deal with a man who is a proficient student of these sleepmakers. Who is he, where is he, and when will he strike?"
Garrick was now pacing excitedly up and down the room. ”

“ I am quite convinced that every Chemist who has kept up his knowledge as to analysis, will not only succeed in detecting their presence, but even in determining the nature of that which he has discovered, provided that the alkaloid in question is one of that class of bodies, the properties of which have been suitably studied. Thus he will be able to discover conia, nicotine, aniline, picoline, petinine, morphine, codeine, narcotine, strychnine, brucine, veratrine, colchicine, delphine, emetine, solanine, aconitine, atropine, hyoscyamine. ”

“ Subsequent experimenters found what Bernard does not mention—viz., that codeine produced epileptiform convulsions. Falck made some very careful experiments on pigeons, frogs, and rabbits. To all these in high enough doses it was fatal. Falk puts the minimum lethal dose for a rabbit at 51·2 mgrms. per kilo. Given to man, it produces a sleep very similar to that described by Claude Bernard—that is, a sleep which is very natural, and does not leave any after-effect. ”

“ In some groups of natural organic compounds our efforts to obtain them by synthesis have hitherto almost utterly failed. Our knowledge of alkaloids, many of which, by their great physiological effects, are of prominent therapeutic importance, has advanced so far as to permit us to convert some of them into others—for instance, to transform morphine into codeine ”

“ Heroin surpasses both morphine and codeine therapeutically in many ways. It increases markedly the inspiratory and expiratory force, while lessening the number of the respiratory movements and exerts a special sedative influence on the respiratory mucous membranes. The drug acts also as a general motor depressant, hypnotic and analgesic, but is not comparable to morphine in these respects. Heroin is about five times more toxic for dogs than morphine. Heroin is particularly valuable in the treatment of all varieties of coughs affecting the dog. ”

“ Actions and Uses.—It is claimed that this compound acts like morphine without producing constipation, nausea or lassitude. It is the conclusion of some good observers that it possesses no advantage over codeine. Applied to the eye, it causes a local vasodilation, leading to acute conjunctival edema. Dionin is recommended to relieve pain, especially in respiratory affections, as an antispasmodic in whooping-cough, for insomnia and externally in the treatment of corneal affections, conjunctivitis, iritis, etc. Dosage.—0·015 to 0·06 gramme (1⁄4 to 1 grain) . ”

“ Operation May 14, 1905. Area sterilized. Small area of skin infiltrated with a one percent solution of cocain. Paraffin melting point 108, injected over area of prominence of bubonocele and into upper portion of canal. Two punctures made a dram and a half of paraffin injected. Parts sensitive for three days so that patient walked without bending thigh at hip joint. No temperature. Local applications. Codeine given in quarter grain doses every two hours. Fourth day parts much less sensitive, can bend leg freely in sitting or walking. ”

“ CONINE, or Coniine (α-propyl piperidine) , C8H17N, an alkaloid occurring, associated with γ-coniceine, conhydrine, pseudoconhydrine and methyl conine, in hemlock (Conium maculatum) . It is a colourless oily liquid of specific gravity 0.845 (20° C.) , boiling at 166° C., almost insoluble in water, soluble in ether and in alcohol. It has a sharp burning taste and a penetrating smell, and acts as a violent poison. It is dextro-rotatory. The alkaloid is a strong base and is very readily oxidized ”

“ It may be admitted that to prescribe a single dose, or even a number of doses, may not bring a physician within the penalties of the act; but what is here charged is that the defendant physician by means of prescriptions has enabled one, known by him to be an addict, to obtain from a pharmacist the enormous number of doses contained in 150 grains of heroin, 360 grains of morphine, and 210 grains of cocaine'-3,000 ordinary doses! ”

“ Louis, U.S. A.'
'Also seventy other packages, more or less, of said drug, labeled and branded as follows: 'Antikamnia and Codein Tablets. Contain 296 grains acetphenetidin, U.S. P. per ounce. Contain 18 grains sulp. codein per ounce. Guaranteed by the Antikamnia Chemical Company, under the the food and drugs act, June 30, 1906. U.S. Serial Number 10. The Antikamnia and Codein tablets in this original ounce package contain no acetanilid, antifebrin, antipyrin, morphin, opium, heroin, cocaine, alpha or beta eucaine, arsenic, strychnin, chloroform, cannabis indica, or chloral hydrate. ”

“ Petitioner, a first-time offender, was convicted of possession of 672 grams of cocaine. The statute under which he was convicted, Mich.Comp.Laws § 333.7403 (2) (a) (i) (1980) , provides that a person who knowingly or intentionally possesses any of various narcotics, including cocaine, " [w] hich is in an amount of 650 grams or more of any mixture containing that substance is guilty of a felony and shall be imprisoned for life." No particular degree of drug purity is required for a conviction. ”

“ The drugs in themselves are useful, but they often lead to evil results. Now in the use of all such drugs as are apt to be beneficial in one way and injurious in another, we must ever be guided by the rules formerly explained concerning evil indirectly willed, or rather permitted to result, while good results are directly willed or intended. If the Doctor is satisfied that a dose of morphine or an application of cocaine will do more good than harm, he can, of course, prescribe or apply it. ”

“ It was testified at the trial that conine, the active principle of hemlock, is intensely poisonous. No chemical antidote is known. A fifth of a grain has serious results; a drop is fatal. An injection of a most minute quantity of real conine will kill a mouse, for instance, almost instantly. But the conine which I have isolated in the body is inert!"
It came like a bombshell to the prosecution, so bewildering was the discovery.
"Inert?" cried Kilgore and Hollins almost together. "It can't be. You are making sport of the best chemical experts that money could obtain. ”

“ Action.—Cocaine in small doses is a cerebral, cardiac, respiratory and nervous stimulant and dieuretic; overdoses cause delirium with cardiac and respiratory failure. Cocaine is a powerful local anaesthetic; used for all animals in 4 to 10 per cent solution, usually a 4 to 6 per cent solution is strong enough for ordinary operations. Inject under the skin, into the muscular tissue or over nerve trunks for minor operations. Applied to such structures as the eye, penis, tongue and other delicate mucous surfaces as the uterus, vagina, rectum, etc. ”

“ Aconitine as met with in commerce has been found to vary greatly in purity, and therefore in physiological effect. It is of the utmost importance that a definite strength should uniformly attach to so powerful a drug, and this is secured in the ‘Wellcome’ Brand product, which is free from pseudaconitine and japaconitine, and from the non-toxic aconine and benzaconine.
Atropine Cocaine
The alkaloid Atropine is, under this brand, issued free from hyoscine and hyoscyamine. Cocaine and its hydrochloride are prepared in a state of purity answering fully the most rigid tests. ”

“ Why, this physician plenipotentiary and coroner extraordinary that I have referred to, didn't know when he got a call whether to take his morphine syringe or his venire for a jury. He very frequently went to see a patient with a lung tester under one arm and the revised statutes under the other. People never knew when they saw him going to a neighbor's house, whether the case had yielded to the coroner's treatment or not. No one ever knew just when over-taxed nature would yield to the statutes in such case made and provided. ”

“ A yellowish-white to light brown powder, odorless or having a faint, characteristic odor and a strongly astringent taste. Freely soluble in glycerin (1:1) and very soluble in water and in alcohol. Incompatible with soluble preparations of iron.
Action and Uses: Astringent; local hemostatic; antidote for certain alkaloidal and metallic poisons.
Dosage: 0.5 Gm. or 8 grains (U.S.P.) .
Collodium Stypticum (Collod. Stypt.) , Styptic Collodion, N.F.—Tannic acid (20%) and flexible collodion. There is no advantage in applying tannin as collodion. ”

“ Other Coniine Bases.—Methyl- and ethyl-coniine have been prepared synthetically, and are both similar in action to coniine, but somewhat more like curarine. By the reduction of coniine with zinc dust conyrine (C8H11N) is formed; between coniine and conyrine stands coniceine (C8H15NO) . De Coninck has made synthetically by the addition of 6 atoms of hydrogen to β collidine, a new fluid alkaloid (C8H11N + 6H = C8H17N) , which he has called isocicutine: it has the same formula as coniine. Paraconiine Schiff prepared synthetically from ammonia and normal butyl aldehyde ”

“ Whatever there may have been in the body before, certainly they produced a cadaveric ptomaine conine. For many animal tissues and fluids, especially if somewhat decomposed, yield not infrequently compounds of an oily nature with a mousey odour, fuming with hydrochloric acid and in short, acting just like conine. There is ample evidence, I have found, that conine or a substance possessing most, if not all, of its properties is at times actually produced in animal tissues by decomposition. ”

“ Quinine and urea hydrochloride is one of the new substitutes which has found much favor. Among the synthetic derivatives may be mentioned alypin, novocaine, stovaine, betaeucaine, tropacocaine, anesthesin, subcutin and many others. Each of these has its advocates and all of them have some advantage over cocaine; they have disadvantages as well, which, however, in the hands of skilled operators, may be overcome. ”

“ Counsel. "Do you wish to go out to the world as saying that you have never diagnosed a case of morphine poisoning excepting when you had an autopsy to exclude kidney disease?"
Witness. "I do not. I have not said so."
Counsel. "Then you have diagnosed a case on the symptoms alone, yes? or no? I want a categorical answer."
Witness (sparring) . "I would refuse to answer that question categorically; the word 'diagnosed' is used with two different meanings. One has to make what is known as a 'working diagnosis' when he is called to a case, not a positive diagnosis." ”

“ Conine is a deadly poison, killing all animals, death resulting from asphyxia. Neutralised with an acid, its activity is increased, and it becomes more soluble in water. Almost instant death resulted in a dog from injecting two grains of conine, neutralised with hydrochloric acid, into the femoral vein.
Symptoms in Man.—The symptoms in some cases resemble those of poisoning with opium; in others, the patient complains of dryness and constriction of the throat, and drowsiness. ”

“ Graves had taken a poisonous dose of morphine."
"And who gave him that poisonous dose?"
"I very strongly suspect—"
"That's no good, sir," interrupted the officer. "Suspicion isn't evidence. We should want you to swear an information and give us enough facts to make out a primâ facie case against some definite person. And you couldn't do it. Your information amounts to this: that a certain person has taken a poisonous dose of morphine and apparently recovered. That's all. You can't swear that the names given to you are real names, and you can't give us any address or even any locality." ”

“ The fact that the certificate states that 'muriate of cocaine is a medicinal preparation, and is known as such by the physician, the chemist, the druggist, and in commerce, and was so known, definitely, generally, and uniformly, at and prior to the enactment of the tariff law of 1890,' becomes a factor, adding cogency to the demonstration that the article falls with more definite certainty under the classification of a medicinal preparation than it does under that of a chemical salt. ”

“ Slowly but completely soluble in a mixture of three volumes of ether and one volume of alcohol. Also soluble in acetone and in glacial acetic acid. Practically insoluble in alcohol or water.
[Pg 176]
Action and Uses: Basis for collodions.
*Collodium (Collod.) , Collodion, U.S.P.—Pyroxylin (4%) in a mixture of ether and alcohol.
Uses: Used to form a protective film and as a vehicle for external applications.
*Collodium Flexile (Collod. Flex.) , Flexible Collodion, U.S.P.—A mixture of collodion (95%) with camphor (2%) and castor oil (3%) . ”