2. Stomach is washed out with No. 2 solution until washings come back pink, the solution being retained in the stom ach for 1 minute each time.
3. The No. 1 solution is introduced and left in the stomach.
4. No. 1 solution is to be repeated twice, at intervals of half an hour.
5. Then No. 2 solution is to be given every half-horn- until complete recovery.
It is better to use a tube entirely open at the stomach end—an ordinary half-inch drainage-tube answers the pur pose. The amount of permanganate re quired depends upon the amount of drug taken. The washings must be con tinued until the solution returns pink. Maynard (Brit. Med. Jour., May 16, '96).
More than 90 instances of successful use of potassium permanganate in opium poisoning have been reported. Seven or S grains in diluted solution should be given to antidote the opium or mor phine in the stomach, and this is to be followed by 1 grain in solution at fre quent intervals, to antagonize the mor phine subsequently eliminated by the gastric mucous membrane. The sub cutaneous injection of a 1-per-cent. solu tion is also recommended as a physio logical antidote. Moor (Then Woch.. No. 7, '97).
There are but three possible ways in which potassium permanganate may overcome the poisonous effects of opium: 1. Chemically, by coining in contact with the alkaloids in the blood, and thereby oxidizing them. 2. By acting as a physi ological antagonist. 3. Mechanically, by giving rise to severe pain, which follows the ingestion of potassium perman ganate, thereby assisting in keeping the patient awake. Experiments tried on dogs lead to most serious doubt as to the efficacy of potassium permanganate as an antidote to opium or any of its alkaloids when hypodermically injected. E. Q. Thornton and C. A. Holder (Ther. Caz., No. 1, p. 11, '95).
In morphine poisoning good effects ob tained by the sodium salt are shown to be not inferior to those of the potassium salt. The stomach should be previously washed out with a 0.2-per-cent.-sodium permanganate solution. This should he done even if the poison have been taken some hours previously. After this, half
a litre of the same solution is taken, or it may be passed through the tube into the stomach. The washing out should be repeated again in a few hours. If washing out is not possible, apomorphine should be injected, as emetics adminis tered by the mouth interfere with the permanganate. Where the emetic Must be given by the mouth, half a litre of sodium permanganate is given immedi ately afterward, and then another half litre after the vomiting. The usual remedies must not be omitted if there be any evidence of absorption having taken place from the stomach, because permanganate is of little service after the poison is absorbed. Schreiber (Cen tralb. f. Inn. Med., June '9S).
In morphine poisoning coma is very quickly relieved by the introduction of ice into the rectum. It was found also useful in chloral poisoning, suffocation from coal-gas, and diabetic coma. Willis Cummings (Merek's Archives, Alar., 1901).
Tickling the patient is a very efficient procedure, much more so than flagella tion, and less cruel. It acts remarkably, not only wakening the patient, but angering him nearly to the point of fighting. W. II. Lyrae (Va. Med. Semi monthly, No 22, 1901).
Four cases of morphine poisoning, in which potassium permanganate was em ployed hypodermically, a 10-per-cent. so lution being used. In one of the eases some time elapsed before potassium per manganate could be procured, the pa tient having in the meantime become so deeply unconscious as to make all at tempts at arousing him futile. Five grains (0.33 gramme) of the antidote in solution were administered by the mouth, but lie vomited the dose. An injection containing 2 grains (0.13 gramme) of the salt was now given in the scapular region and re peated. Half an hour afterward the man could be aroused. The injections were repeated every ten minutes for six tunes, and the patient kept awake for three hours, when he was out of danger. With the exception of a very sore back, clue to the injections, his recovery was uneventful. T. H. Marable (Medical Age. Oct. 25, 1901).