NEUROTIC POISONS. These act principally through the nervous system, and as a rule pro duce little or no tissue change.
Alcohol may act as an acute o• chronic poison. Its effects are fully considered under INTOXICA TION.
Opium and its chief alkaloid morphine, lauda num. iMajendie's solution (of morphine), and paregoric are often used for suicidal or homici dal purposes. Paregoric particularly is responsible for many cases of opium poisoning in children, being a common ingredient of soothing syrups. Acute opium poisoning is characterized by a short preliminary stage of pleasurable excitement followed by drowsiness, sleep, and complete un consciousness. In a moderately advanced case, the pupils are contracted to a pin-point, the respirations are slow, the pulse full, the skin moist. The breathing grows slower and slower until death supervenes from respiratory paraly sis. The stomach must be promptly emptied. and tannic acid or potassium permanganate given as antidote. Stupor is combated by the ad ministration of strong coffee, atropine, o• strych nine, and by cold douches, flecking with wet towels, electrical stinnilation, and later by forced artificial respiration. Chronic opium poisoning is seen in those habituated to the drug, both in Eastern and Western countries. See OPIUM.
Cocaine (q.v.) is extensively used as a local antesthetic. and alarming symptoms have followed its absorption by the mucous membrane, or its hypodermic injection. Death occurs very rapid ly (forty seconds to forn• minutes). with great depression and respiratory or cardiac failure. If the patient can he kept alive for half all hour, recovery is almost certain. If the poison has been taken by the mouth, evacuate the stomach, and in any case fresh air, artificial respiration, and stimulants are called for.
Chloral is quite often injudiciously used by the public to induce sleep and quiet the nerves; it is also taken with suicidal intent and given by criminals (knock-out drops) to induce pro longed stupor, often with fatal results. The patient simply passes into a deep sleep without previous excitement, and death occurs from heart failure. Treatment is like that of opium and cocaine. See CHLORAL.
Belladonna and its alkaloid atropine produce, when taken in poisonous amounts, dilatation of the pupil, flushing of the skin, dryness of the mouth, delirium, and sometimes convulsions. Re
covery is the rule, but when death occurs it is from paralysis of the heart. Treatment consists in washing out the stomach and opium is the physiological antidote. Similar in their effects and treatment to belladonna are homatropine, hyoscyamus (henbane), byoscyamine, hyoscine, stramonium, and dulcamara.
Strychnine and nux romica. Strychnine is contained in certain vermin-killers. and is used both for suicide and murder. In poisonous doses it acts principally on the spinal cord, producing cramps and convulsions like those of tetanus (q.v.). Death or recovery is usually speedy. The patient is to be put in a quiet dark room, and tannic acid or charcoal is given, followed by stomach-washing. This must lie done before spasms set in. Chloroform and ether control the convulsions, and the bromides and opium act in the same way, but more slowly.
Prussic acid and the various cyanogen com pounds, contained in cyanide of potash, cherry laurel water, bitter almonds, cherry, peach, and 1)h1111 pits, are exceedingly rapid and fatal poisons. When smaller doses have well taken sulphate of iron may be given as an antidote and afrusions and douches of cold water, and a resort to arti ficial respiration are the most useful measures. See HYDROCYANIC ACID.
Among other substances in the class which are occasionally taken in poisonous doses are aconite, cannabis indica, curare (arrow poison). digitalis, hemlock, and the various Mill-tar products, such as acetanilid. phenacetine, and sulphonal (qq.v.).
Amrsthetics (ether, chloroform, and nitrous oxide) act as narcotic poisons when taken in overdose. The symptoms may be divided into two stages, one of excitement with rapid pulse and respiration, struggling and flushed face; and one of depression. in which the muscles are relaxed. the patient is insensible, passes into coma and dies from cardiac or respiratory fail ure. When dangerous symptoms come on during the administration of an this is to he stopped, the tongue drawn forward. time patient exposed to a current of fresh air or oxygen, and if breathing stops subjected to artificial respira tion. Hypodermic injections of atropine or strychnine are also given. The inhalation or drinking of ether and chloroform is indulged in as a haoit by a few individuals. See AD/XS THETic.