Levenstein concludes, from his observations on patients and experiments on animals, in whom the continued use of morphia produced albuminuria, that this affection is due to varying blood pressure in the renal vessels through the nerves supplying them.
Contrary to the experience of Levenstein, I have found sugar in the urine of some (four) of my patients. This, like the albuminuria, was permanent in one case, and came and went in the other three. Its presence was undoubted, it reducing the copper of Fehling’s liquor (previously tested) and answering to the fermentation and bismuth tests. In three of the cases it disappeared after stopping the morphia. The fourth patient is still under treatment.
Levenstein finds that acute poisoning by morphia, in men and animals, is always accompanied by sugar in the urine.
Strangury and retention of urine is occasionally the result of the long continued use of the drug.
The albuminuria of morphia-mania is sometimes accompanied by dropsy of the feet and limbs, less often of the abdomen and pleural sacs. When thus occurring the case is a grave one, and it will take time to decide whether there is not real organic disease of the kidneys, in which case the breaking of the habit may cause death by convulsions.
THE EYES.
It is a rare thing to find actual disease of the eyes that can be traced directly to the abuse of morphia. It is usual to find the retina somewhat congested. Blurring of sight and double vision are sometimes complained of. Muscæ volantes, or specks floating before the eyes, are sometimes seen. One patient of mine who had been near-sighted four years, during which time she had used the drug subcutaneously, claims to have regained full power of sight since the habit has been broken.
The pupils are, as a rule, contracted and regular, occasionally of normal size and irregular.
THE MUSCULAR SYSTEM.
Locomotion is rarely affected during the continuance of the habit, save from weakness. Twitching of isolated muscles, such as the orbicularis palpebrarum of one eye, is sometimes seen. When the doses of opium or morphine become very large, co-ordination is sometimes interfered with. Wasting of the muscles is found in advanced cases, as also is trembling of the hands.