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Thursday, April 18, 2013

Inserting Morphine Directly Into Wounds

by Alfred Jay Bollet, M.D.

Medical Director Henry Hewit reported on his order regarding the use of morphine in wounds during the Atlanta campaign:

"The insertion of morphine into wounds of the chest, attended by pain and dyspnoea, has been of the utmost advantage. I made the insertion of morphine into all painful wounds standing order of the medical department, and it has acted so admirably as to enlist every surgeon in favor of the practice. Its good effects are especially remarkable in painful wounds of the joints, abdomen, and chest. From one to three grains are inserted on the point of the finger. I desire especially to call the attention of the profession to this practice, which is simply a generalization of the well recognized application of morphine hypodermically."

Studies conducted in the early 1900s erroneously suggested that putting opium or morphine directly into a wound was useless, since the drugs worked only after reaching the brain. More recent studies, however, have demonstrated that there are opiate receptors in peripheral tissues which makes topical applications effective. In addition, some of the morphine applied to bleeding wounds probably enters the bloodstream and reaches the brain.

FROM: "Civil War Medicine: Challenges and Triumphs"

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