OVERDOSING WITH OPIUM, A SERIOUS PEDIATRIC PROBLEM IN ENGLAND A CENTURY AND A HALF AGO

Abstract

Early nineteenth-century physicians commonly believed Sydenham's panegyric about opium—that it was a donum Dei and that the "art of physic would be defective and imperfect without it."1 Opium preparations, such as Godfrey's Cordial, a nineteenth century English proprietary preparation, contained 1¼ grain of opium in each ounce of liquid. It was readily available without prescription in England and America, and was given to infants for a variety of complaints. The severity of the problem caused by misuse of opium given to children in Nottingham, England, in 1840 is evident in the following quotation.2 The very great number of deaths amongst children, resulting from overdoses of opium, or its preparations, and from doses thereof given in mistake for other medicines, cannot fail to excite attention .... Most of the children poisoned in this way, lost their lives owing to the ignorance, carelessness, or presumption of their mothers. It cannot be too generally known, that narcotic, and anodyne drugs, powerful though they be in the adult, act with infinitely greater energy upon the more sensitive nervous system of the infant: so that even experienced medical men never administer remedies of this class to the very young, without exerting the utmost caution, and making the most accurate calculation. Two drops of laudanum have been known to kill an infant. Nay we have heard of a case in which one drop stole away the life of a newborn babe. It is evident that mothers and nurses should never dare to administer medicines of the narcotic kind, except under the immediate direction of the medical attendant.