The best routine emetic, and one which the physician should carry in his emergency case, is 3o grs. Sulphate of Zinc. This may be given dissolved in half a tumblerful of tepid water ; the mistake is often made of diluting the emetic too much, as this retards its action somewhat. to grs. Sulphate of Copper comes next in value, and may be administered when dissolved in a tumblerful of water.
Apomorphine when injected hypodermically in doses of r5 gr. is also a most valuable drug, and possesses the advantage over all other emetics in being available when the power of swallowing is lost and the patient is insensible. A larger'dose should never he given by the skin, though gr. and even r gr. has been given by the mouth without depressing the heart.
Mustard is nearly always at hand, and is a most efficacious emetic. By giving a large dessert-spoonful in a pint of tepid water soon after the poison has been swallowed the absorption of the latter is instantly retarded, and the emesis will bring up the greater portion of the poison along with the mustard.
Antimony, Ipecacuanha, Squill, Carbonate of Ammonia, Alum, &c., are too slow in their action to he depended on, but the physician must employ whatever agent he can lay his hands upon in the emergency. Sometimes a copious draught of water in which vegetables have been boiled may he within reach, and by adding butter or grease af any kind to this a highly nauseating and effective emetic combination can be prepared in a few seconds.
Jona has demonstrated that if a full dose (, oz.) of Adrenalin Solution, in r,000 in dilution, be promptly administered after a lethal dose of strychnine, the blanching of the gastric mucosa will present a reliable barrier against absorption for a considerable period, and this gains valuable time in the treatment of such swiftly acting poisons as the cyanides and powerful alkaloids. Perhaps an equally efficacious method is to administer promptly a draught of water containing 5 to to grs. Permanganate of Potassium which will rapidly oxidise all alkaloids.
The antidote suitable for each poison will be mentioned in the following paragraphs mainly reprinted from the last edition of the author's work on Materia Medica.
In the case of a poison of unknown nature a general antidote has been recommended consisting of equal quantities of Calcined Magnesia, Pow dered Wood Charcoal and hydrous Peroxide of Iron—i s oz. of this
mixture may be given in a tumbler of water every 3o minutes till three doses be taken.
It is often necessary for the after-investigation of poisoning cases that the stomach contents should be preserved for analysis in a clean vessel which should be sealed up by the physician himself, and this procedure is also necessary in fatal cases after opening the body.
Acetanilid or Antifebrin.
The stomach-tube or an emetic of Carbonate of Ammonia should he use,l, followed by Strychnine, gr. hypodermically, and external warmth. Where – cyanosis is marked, inhalations of Oxygen may be given, and free stimulation with Alcohol.
Acid, Carbolic—see under Carbolic Acid. Acids, Mineral.
The stomach-tube should not be used. Alkalies—Lune, Soap, Chalk, Potash, Soda or Magnesia—moderately diluted with water may be freely given. In the absence of these, plaster off a wall (softened by hot water), oils (Almond or Olive), and small doses of Morphine hypodermically should be administered; all food should be given by the rectum. At a later stage, when the danger of perforation hail passed off, bland mucilaginous foods, like barley water, linseed tea and white of eggs ,may be freely given.
Acid, Oxalic—see under Oxalic Acid. Acid, Prussic (or Hydrocyanic).
The stomach, if possible, should be emptied by the tube or by a rapid emetic (I dr. Sulphate of Zinc) ; hypodermic injections of Atropine gr.) ; nuns. of the r in too Solution of Atropine may be given and repeated in 3o minutes if necessary.. Ammonia or Whiskey, inhalation of Oxygen. Ammonia or Chlorine, cold and hot allusions alternately and artificial respiration are the best agents to resort to.
Freshly precipitated Oxide of Iron, followed by a solution of Carbonate of Potassium, is to some extent a chemical antidote, but free stimulation after the evacuation of the stomach must be alone relied upon.
Kobert's method of treatment consists in the hypodermic injection at various points of a 3 per cent. Peroxide of Hydrogen every few viinutes, and lavage of the stomach with a 15 per cent. solution in order to change the prussic acid into oxamide in the blood and stomach.