POISONS What a poison is, is not easily defined since one and the same substance, ac cording to the amount in which it is absorbed, and according to the con dition in which it is taken into the organism, and also according to the condition of the body into which it enters, may have more or less toxic action. Poisoning is not then an absolute, but a relative, condition. Every substance which acts upon the constituents of the child's body may become toxic under certain conditions. The essential condition for the production of such toxic action is that the poison must be in solution or must become soluble.
We must distinguish ectogenotts intoxications and endogenous in toxications (autointoxications). In the endogenous intoxications the sub stanc which acts as a poison is manufactured in the child's body. In ectogenous intoxication the poison is introduced into the body as such or in combination, from which it is freed and made soluble by the secre tions of the body. The ectogenous poisons are those with which we have mainly to do.
Poisoning is not very rare in childhood. It is true that, certain factors which play an important role in adult life seldom play a part in childhood, namely, suicide and the absorption of poisonous substances incidental to some trades. On the other hand the unreasonable habit of putting everything to the mouth, and the circumstance that even small amounts of poison can produce very severe effects in children are of great consequence in the causation of some poisonings. In pro phylaxis we must especially consider these two last-mentioned factors.
Every sulmtance which can act as a poison or as a corrosive must be kept away from the child's environment and well out of reach to avoid accidents. In deciding on the dose of medicine we must always consider the age of the patient for whom the medicine is intended and regulate the amount of the various constituents. accordingly the bottle should have the exact prescription (do not write: " according to the physician's directions "; instead, vvdite " a teaspoonful every three hours", " 6 drops 5 times a (lay," etc.). When prescribing dangerous remedies I always oblige the mother or nurse to repeat my directions and I am careful in giving opium, santonin, etc., to emphasize the injury whieh may result from over-doses. Even in prescribing medicines to be used externally care is necessary when these are poisonous. In prescribing baths of corrosive sublimate, for instance, I impress the mother strongly with the necessity of keeping the mercurial lozenges locked up that the other children may not be tempted by the sight of the red pills and put them into their mouths. One must also take pains that the patient in the tub does not swallow the solution and that none of it reaches the mouth, nose or ears. In prescribing poisons one should limit oneself to the minimum dose necessary. Unfortunately unused drugs are frequently kept and may subsequently fall into careless hands.