The different types of poisoning are many. They cannot all be given in the space here available, but the symptoms and general treat ment of a few of the more common types of poisoning will be mentioned. Poisoning by the mineral acids, nitric, sulphuric, hydrochloric, is not uncommon. In these there is a marked caustic action, with intense burning pain when taken by the mouth. The lips are stained yel low, black or white respectively, according to the acid taken. There is nausea, vomiting and diarrhoea, with all the symptoms of an intense gastro-enteritis, with collapse, pale face, cold sweating extremities, small, feeble pulse, rapid respiration; and the patient dies in intense agony. Treatment is by prompt washing out of the stomach with an alkaline solution, soap, washing soda or other mild alkali being useful. Then comes the use of heat, of mucilaginous drinks, such as white of egg, gum arabic, slip pery elm, olive oil, milk, etc. The technical details require prompt medical attendance as soon as the washing out with the alkaline solu tion is commenced.
Oxalic acid is frequently swallowed by mis take. Here the staining is usually absent; the gastro-enteritis is marked as in poisoning with the mineral acids; there is great muscular weak ness and twitching of the muscles, particularly about the face; sometimes there are convulsions and further symptoms of collapse are present. In treatment wash out stomach by tube, or by .
drinking large quantities of water with — teaspoonful of lime to quart of water—and stimulants. Following oxalic poisoning large quantities of water should be taken for a week or so to flush the surplus oxalates from the kidneys.
Poisoning by alkalis is infrequent. Occa sionally sodium hydrate, or potassium hydrate, is swallowed. Lime is also taken by accident; so (rarely) is ammonia. The symptoms are much like those of poisoning by the mineral acids. There are no marked discolorations, as noted, but otherwise the symptoms are sim ilar. Treatment is by rapid washing of stom ach with weak acids, vinegar being the most convenient, and by demulcents, as in acid poisoning.
The halogen compounds are very markedly poisonous as gases, notably chlorine, bromine, fluorine; and the iodides and bromides cause forms of chronic poisoning known as iodism and bromism (q.v.).
The heavy metals as such are not poisonous, but their soluble compounds are all poisonous. They vary widely, however, in strength. In order, from the strongest to the weakest, they are caustic or astringent; severe caustic metal lic being, in order, mecury, tin, silver, antimony, copper, zinc, iron and aluminium.
But in poisoning the acid part of the salt is of importance. From strongest to weakest these acids run: hydrocnloric, nitric, sulphuric, phos phoric, acetic, citric, tartaric. If a caustic metal is combined with a caustic acid the re sulting salt, if soluble, is a very powerful poison, mercuric chloride, or corrosive sub limate, being an illustration. If a weak metal like iron is combined with a strong acid the result is an intermediate poison like chloride of iron ; when a weak metal, as lead, is combined with a weak acid, as acetic, lead acetate, sugar of lead, a weak poison, is formed. Thus the strength of a metallic salt may be calculated from the comparative positions of the metallic and acid ions. In all these metallic poisons albumen compounds are formed. The coagu lum varies in all and according to its solubility or insolubility the burning of the poison is more or less deep. In all the symptoms are analogous; there is severe gastro-enteritis, with symptoms of collapse. The treatment is similar in all: washing of the stomach, white of eggs, milk, demulcents, artificial heat, respi ration and afterward careful feeding.
Arsenic and phosphorus are poisons that give very similar symptoms: acute gastro-en teritis, with nausea, vomiting, purging; then some grade of apiiarent recovery, to be fol lowed after a few days with a recrudescence of the gastro-enteritis and the development of secondary blood-vessel changes, which may cause minute hemorrhages in any part of the body. Then follow fatty degeneration and death. The commonest form of salt causing arsenic-poisoning is Paris green; while rat poison and matches are responsible for most cases of phosphorus poisoning. Treatment of arsenic poisoning calls for prompt washing of the stomach, Small doses of magnesia and water every 15 minutes for several hours and stimulant supportives. Phosphorus can usu ally be detected by the odor. There should be prompt washing, and avoidance of oils, although castor-oil may help in getting phosphorus out of the intestinal canal. Authorities, however, prefer the saline cathartics. A prompt oxidiz ing agent, permanganate of potash or hydrogen peroxide, should be used, or small doses (1 to 2 grains), diluted, of copper sulphate.
For the effects of poisoning by the alcohols, see ALCOHOLISM. Practically all of the anms thetics (ether, chlorotorm, ethyl chloride, etc.) and hypnotics (chloral, paraldehyde, trional, sulphonal, veronal, etc.) belong to the alcohol group (see At.coxot.), and the symptoms are closely allied.