Digitalis, sulphate of strychnine, and belladonna are the most effective reme dies, but ether and ammonia should first be employed, owing to their great diffu sibility. All these remedies should be used hypodermically, the stomach being unable to perform its functions. A drachm of ether, ammonia, brandy, or whisky should at once be injected, and, after a few minutes, tincture of digitalis, 15 minims; strychnine sulphate, grain; or tincture of belladonna, 10 minims, according to what the practi tioner may have. The dosage should be regulated so as to reach the point of physiological action by frequently repeated doses. Nitrate of amyl may be given by inhalation, and warm, very strong coffee be injected into the rectum.
If the patient is seen when the stage of depression has begun through absorp tion of the poison, the stomach-pump should alone be used, emetics at this stage being liable to cause arrest of the heart's action. Tincture of digitalis, in 20-minim doses, should be injected hypodermically and repeated as required, besides the other measures indicated. Frictions under cover, the rubbing being directed toward the heart, serve a useful purpose.
Twenty cases, six of which were fatal, found in the literature of the last ten years:— Case 1. Tincture, 7 drachms. Recov ery. Emetics; morphine, '/, grain; fluid extract of digitalis. 6 drops; strychnine sulphate, grain; brandy, 1 ounce; all hypodermically. By the mouth, 2 gallons of warm water; fluid extract of digitalis, 20 drops; coffee, 11 pints; whisky, 3 pints; extract nucis vomica, fluidrachm; Port wine, 'I, pint. P. F. Brick (Jour. Amer. Med. Assoc., vol. viii, p. 567, '87).
Case 2. About 8 drops of concentrated fluid extract. Recovery. Emetics, coffee, whisky (dessertspoonful). Heat. Eric ' tion and sinapism. T. H. P. Baker (Amer. Pract. and News, vol. iv, N. S., p. 122, '87).
Case 3. Fleming's tincture, ounces. Recovery. Emetics, brandy, ether, digi talis, ammonia carbonate. Amyl-nitrite and warmth. C. C. Bradley (N. Y. Med. Record, vol. xxxii, p. 155, '87).
Case 4. Tincture, ounce. Recovery.
Brandy by mouth and hypodermically. Ether. One quart of cold, black coffee. Heat and posture. S. Barnett (N. Y. Med. Record, vol. xxxii, p. 761, '87).
Case 5. Amount not known. Patient intoxicated at the time. Symptoms of acute poisoning. Recovery. Emetics, brandy, ammonia, and digitalis by the mouth. Sixty minims of tincture of
digitalis hypodermically. Heat. Clara T. Dercum (Med. and Surg. Reporter, vol. lxi, p. 376, '89).
Case 6. Tincture, amount not known. Child, 16 months. Marked toxic symp toms. Recovery. Brandy and fluid ex tract of digitalis frequently repeated in spite of vomiting. Byron F. Dawson (Med. and Surg. Reporter, vol. lxii, p. 7, '90).
Case 7. Tincture, 2 drachms. Death. Benjamin Edson (N. Y. Med. Record. vol. xxxviii, p. 365, '90).
Cases 8, 9, and 10. Dr. Edson men tions certain other eases known of, hut not treated by him, three of which died.
The amounts taken in these were from 1 to 4 drachms.
Case 11. Tincture (B. P.), 1 ounce. Death in sixty-five minutes. Mustard, lavage, heat, ether, and brandy subcu taneously. L. M. Whannel (Brit. Med. Jour., vol. ii, p. 791, '90).
Case 12. Fleming's tincture, 1 drachm. Recovery. Sulphate of zinc, tincture of digitalis, 20 minims hypodermically. Whisky, 1 ounce, by the mouth, followed by calomel, S grains. L. M. Whannel (Brit. Med. Jour., vol. ii, p. 791, '90).
Case 13. Fleming's tincture, 1 tea spoonful. Recovery. Mustard, spirit of ammonia comp. (B. P.), tincture of bella donna, brandy. T. P. II. Smith (Brit. Med. Jour., vol. i, p. 1109, '93).
Case 14. Fluid extract, 4 drachms. Recovery. Emetics, atropine and brandy subcutaneously. Henri E. R. Altenloh (N. Y. Med. Jour., vol. lxvii, p. 358, '93).
Case 15. Tincture, 7 'I, drachms. Re covery. Mustard, digitalis, and brandy subcutaneously; digitalis, nun: vomica, and brandy by rectum; ether and am monia by inhalation; brandy and am monia carbonate by mouth later. G. H. Tuttle (Boston Med. and Surg. Jour., vol. xxv, p. 678, '91).
Case 16. Mentioned by, but not seen by, Dr. Tuttle. Tincture, 5 V, drachms. Death. G. H. Tuttle (Boston Med. and Surg. Jour., vol. xxv, p. 678, '91).
Case 17. Preparation not noted. Four teaspoonfuls. Recovery. Sulphate of copper, digitalis, wine by mouth; whisky by rectum; whisky, V„ grain strychnine, and digitaline,V,, grain, hypodermically. M. A. Warriner (N. Y. Med. Record, vol.
xxxix, p. 521, '91).
Case 18. Tincture, 2 drachms. Recov ery. Apomorphine, stomach-tube, tinct ure of digitalis, 25 minims; aromatic spirit of ammonia, 45 minims; brandy, 2 drachms subcutaneously, heaters, sina pism to prncordia. S. Q. Robinson (Bos ton Med. and Surg. Jour., vol. cxxvii, p. 192, '92).