Treatment of Ilyoscyamus Poisoning. —If seen early enough, emetics or warm drinks should be administered, followed by the use of the stomach-tube. Tannin and charcoal may be used if a stomach tube is not at hand and absorption has not taken place. Among the antidotes advised are coffee, alcohol, pilocarpine to 1/4 grain), muscarine nitrate to grain), morphine sulphate (1/8 to,2 grain), or eserine to grain). The violent action of the drug should be restrained by the use of the foregoing antidotes given by hypodermic injection, in moderate doses, and re peated at intervals, as indicated by the condition of the patient and the urgency of the symptoms.
Case of poisoning with grain of the hydrobromate of hyoscine in a very large man, weighing not less than 200 pounds. He was at the time in an irritable and susceptible condition, and the drug was given for sleeplessness, which had re sisted other hypnotics. In five minutes after the injection dryness of the mouth and throat was noticed, attended with a constant desire, but at the same time an inability, to swallow. In a few min utes his speech became thick and was accompanied by complete paralysis of the soft palate and upper lip, the latter being limp and immovable over the up per teeth, and gave the already much impaired voice a muffled sound. The pupils at this time were noticed to be slightly dilated. S. W. Morton (Therap. Gaz., Feb., 'SO).
The writer's personal experience with the grain of hyoscine, followed, in two hours, by another dose of the same size recounted: Soon after the second dose, poisonous symptoms, consisting of extreme dryness of the mouth, muscular tremors, accelerated respirations, imper fect vision, mild delirium, and visual de lusions, were present. There was also an intense desire to urinate, though the attempt was unsuccessful. The urine passed next morning was opaque and of a peculiar odor. All the effects of the drug had passed off in thirty-six hours, with the exception of sensitiveness of the eyes. W. A. Carey (Univ. Med. Mag., Apr., 'SO).
Case reported in which the administra tion of ',/,„ grain of hyoscine hydrobro mate to a patient with chronic intestinal nephritis and obscure brain-symptoms was followed by toxic symptoms. \V. A. Edwards (Univ. Med. Mag., June, 'SO).
Case of poisoning by 6 drachms of the tincture of hyoscyamns observed, marked by symptoms very similar to those of belladonna poisoning. The respiration was, however, entirely unaffected. A. H. Dodd (Brit. Med. Jour., Sept. 21, 'SO).
Case in which one grain of the hydro bromate of hyoseine was made up to a 1-per-cent. solution in water. Two drops
of this solution were put into one eye, and as the patient felt no pain she put 2 drops into the other eye as well.
Five minutes afterward she complained of giddiness and a feeling of lightness in the head; she staggered, and had to be assisted to bed. Then great dryness of the mouth and throat with thirst super vened. The giddiness increased, gradu ally the senses became confused, and the power of speech was lost. Complete mus cular relaxation became pronounced and she became rapidly unconscious. The breathing was slow and occasionally deep sighing. The face was flushed, the pulse full and regular.
This unconscious stage lasted for about four hours, and was succeeded by a period of semiconsciousness. At times the patient seemed to have perfectly re covered; at other times she was quite delirious. She talked incessantly, was occasionally irritable. although, on the whole, it took the form of a pleasant. delirium.
After about two hours of this delirium she became gradually calmer, and then dropped off into a sound and seemingly natural sleep, which lasted for about an hour and a half. When she awoke she remarked that she had not slept so well for a long time. She had no remem brance of the events of the night further than being assisted to bed. There were no evil after-effects. The adhesions have. stretched slightly. R. A. Morton (Brit. Med. Jour., Feb. 8, '96).
Therapeutics.—The chief use of hyos cyamus is as a sedative to the nervous system. Spasmodic conditions, vesical pain and irritation, pertussis, and nerv ous coughs are relieved by preparations of hyoscyamus. In insanity hyoscine hydrobromate is given to allay acute or chronic maniacal excitement (by mouth, '/„, grain to grain; by injection, to grain). It is indicated in general paresis, melancholia, epileptic insanity, or quiet forms of mental aber ration. In spermatorrhcea and nocturnal emissions hyoscine is of great value.
Chloride of hyoscine to be given in doses of to grain. In various forms of chronic psychoses, in which other narcotics had proved themselves of no value, the drug was continued as long as six months, with but slight in terruption, and gave, as a rule, eight hours' rest. In 25 per cent. of the cases, however, it could not be used, either on account of the dryness of the mouth, be cause the patients became accustomed to its use, or because an exciting instead of a quieting effect was produced. Oringe (Ilospitalstidende, .vol. ix, No. Di, '91).