[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.