Part 54

«Aconite—Monkshood, Wolfsbane.»—Symptoms: Numbness and tingling in the mouth and throat, and afterwards in other portions of the body, with sore throat, pain over the stomach, and vomiting; dimness of vision, dizziness, great prostration, loss of sensibility, and delirium. Treatment: An emetic and then brandy in tablespoonful doses, in ice water, every half hour; spirits of ammonia in half-teaspoonful doses in like manner; the cold douche over the head and chest, warmth to the extremities, etc.

«Alkalis and Their Salts—Concentrated Lye, Wood-ash Lye, Caustic Potash, Ammonia, Hartshorn.»—Symptoms: Caustic, acrid taste, excessive heat in the throat, stomach, and intestines; vomiting of bloody matter, cold sweats, hiccough, purging of bloody stools. Treatment: The common vegetable acids. Common vinegar, being always at hand, is most frequently used. The fixed oils, as castor, flaxseed, almond, and olive oils form soaps with the alkalis and thus also destroy their caustic effect. They should be given in large quantity.

«Antimony and Its Preparations—Tartar Emetic, Antimonial Wine, Kerme’s Mineral.»—Symptoms: Faintness and nausea, soon followed by painful and continued vomiting, severe diarrhea, constriction and burning sensation in the throat, cramps, or spasmodic twitchings, with symptoms of nervous derangement, and great prostration of strength, often terminating in death. Treatment: If vomiting has not been produced, it should be effected by tickling the fauces, and administering copious draughts of warm water. Astringent infusions, such as of gall, oak bark, Peruvian bark, act as antidotes, and should be given promptly. Powdered yellow bark may be used until the infusion is prepared, or very strong green tea should be given. To stop the vomiting, should it continue, blister over the stomach by applying a cloth wet with strong spirits of hartshorn, and then sprinkle on one-eighth to one-fourth of a grain of morphia.

«Arsenic and Its Preparations—Ratsbane, Fowler’s Solution, Etc.»—Symptoms: Generally within an hour pain and heat are felt in the stomach, soon followed by vomiting, with a burning dryness of the throat and great thirst; the matters vomited are generally colored either green yellow, or brown, and are sometimes bloody. Diarrhea or dysentery ensues, while the pulse becomes small and rapid, yet irregular. Breathing much oppressed; difficulty in vomiting may occur, while cramps, convulsions, or even paralysis often precede death, which sometimes takes place within five or six hours after arsenic has been taken. Treatment: Give a prompt emetic, and then hydrate of peroxide of iron (recently prepared) in tablespoonful doses every 10 or 15 minutes until the urgent symptoms are relieved. In the absence of this, or while it is being prepared, give large draughts of new milk and raw eggs, limewater and oil, melted butter, magnesia in a large quantity of water, or even if nothing else is at hand, flour and water, always, however, giving an emetic the first thing, or causing vomiting by tickling the throat with a feather, etc. The inflammation of the stomach which follows must be treated by blisters, hot fomentations, mucilaginous drinks, and the like.

«Belladonna, or Deadly Nightshade.»—Symptoms: Dryness of the mouth and throat, great thirst, difficulty of swallowing, nausea, dimness, confusion or loss of vision, great enlargement of the pupils, dizziness, delirium, and coma. Treatment: There is no known antidote. Give a prompt emetic and then reliance must be placed on continual stimulation with brandy, whisky, etc., and to necessary artificial respiration. Opium and its preparations, as morphia, laudanum, etc., are thought by some to {94} counteract the effect of belladonna, and may be given in small and repeated doses, as also strong black coffee and green tea.

Blue Vitriol, or Blue Stone.—See Copper.

«Cantharides (Spanish or Blistering Fly) and Modern Potato Bug.»—Symptoms: Sickening odor of the breath, sour taste, with burning heat in the throat, stomach, and bowels; frequent vomiting, often bloody; copious bloody stools, great pain in the stomach, with burning sensation in the bladder and difficulty to urinate followed with terrible convulsions, delirium, and death. Treatment: Excite vomiting by drinking plentifully of sweet oil or other wholesome oils, sugar and water, milk, or slippery-elm tea; give injections of castor oil and starch, or warm milk. The inflammatory symptoms which generally follow must be treated by a physician. Camphorated oil or camphorated spirits should be rubbed over the bowels, stomach, and thighs.

Caustic Potash.—See Alkalis under this title.

«Cobalt, or Fly Powder.»—Symptoms: Heat and pain in the throat and stomach, violent retching and vomiting, cold and clammy skin, small and feeble pulse, hurried and difficult breathing, diarrhea, etc. Treatment: An emetic, followed by the free administration of milk, eggs, wheat flour and water, and mucilaginous drinks.

«Copper—Blue Vitriol, Verdigris or Pickles or Food Cooked in Copper Vessels.»—Symptoms: General inflammation of the alimentary canal, suppression of urine; hiccough, a disagreeable metallic taste, vomiting, violent colic, excessive thirst, sense of tightness of the throat, anxiety; faintness, giddiness, and cramps and convulsions generally precede death. Treatment: Large doses of simple syrup as warm as can be swallowed, until the stomach rejects the amount it contains. The whites of eggs and large quantities of milk. Hydrated peroxide of iron.

«Creosote—Carbolic Acid.»—Symptoms: Burning pain, acrid, pungent taste, thirst, vomiting, purging, etc. Treatment: An emetic and the free administration of albumen, as the whites of eggs, or, in the absence of these, milk, or flour and water.

Corrosive Sublimate.—See Mercury under this title.

«Deadly Nightshade.»—See Belladonna under this title.

«Foxglove, or Digitalis.»—Symptoms: Loss of strength, feeble, fluttering pulse, faintness, nausea and vomiting and stupor; cold perspiration, dilated pupils, sighing, irregular breathing, and sometimes convulsions. Treatment: After vomiting, give brandy and ammonia in frequently repeated doses, apply warmth to the extremities, and if necessary resort to artificial respiration.

«Gases—Carbonic Acid, Chlorine, Cyanogen, Hydrosulphuric Acid, Etc.»—Symptoms: Great drowsiness, difficult respiration, features swollen, face blue as in strangulation. Treatment: Artificial respiration, cold douche, friction with stimulating substances to the surface of the body. Inhalation of steam containing preparations of ammonia. Cupping from nape of neck. Internal use of chloroform.

«Hellebore, or Indian Poke.»—Symptoms: Violent vomiting and purging, bloody stools, great anxiety, tremors, vertigo, fainting, sinking of the pulse, cold sweats, and convulsions. Treatment: Excite speedy vomiting by large draughts of warm water, molasses and water, tickling the throat with the finger or a feather, and emetics; give oily and mucilaginous drinks, oily purgatives, and clysters, acids, strong coffee, camphor, and opium.

«Hemlock (Conium).»—Symptoms: Dryness of the throat, tremors, dizziness, difficulty of swallowing, prostration, and faintness, limbs powerless or paralyzed, pupils dilated, pulse rapid and feeble; insensibility and convulsions sometimes precede death. Treatment: Empty the stomach and give brandy in tablespoonful doses, with half teaspoonful of spirits of ammonia, frequently repeated, and if much pain and vomiting, give bromide of ammonium in 5-grain doses every half hour. Artificial respiration may be required.

«Henbane, or Hyoscyamus.»—Symptoms: Muscular twitching, inability to articulate plainly, dimness of vision and stupor; later, vomiting and purging, small intermittent pulse, convulsive movement of the extremities, and coma. Treatment: Similar to opium poisoning, which see.

«Iodine.»—Symptoms: Burning pain in throat, lacerating pain in the stomach, fruitless effort to vomit, excessive tenderness of the epigastrium. Treatment: {95} Free emesis, prompt administration of starch, wheat flour, or arrowroot, beaten up in water.

«Lead—Acetate of Lead, Sugar of Lead, Dry White Lead, Red Lead, Litharge, or Pickles, Wine, or Vinegar Sweetened by Lead.»—Symptoms: When taken in large doses, a sweet but astringent metallic taste exists, with constriction in the throat, pain in the region of the stomach, painful, obstinate, and frequently bloody vomitings, hiccough, convulsions or spasms, and death. When taken in small but long-continued doses it produces colic, called painters’ colic; great pain, obstinate constipation, and in extreme cases paralytic symptoms, especially wrist-drop, with a blue line along the edge of the gums. Treatment: To counteract the poison give alum in water 1 1⁠/⁠2 ounce to a quart; or, better still, Epsom salts or Glauber’s salts, an ounce of either in a quart of water; or dilute sulphuric acid, a teaspoonful to a quart of water. If a large quantity of sugar of lead has been recently taken, empty the stomach by an emetic of sulphate of zinc (1 drachm in a quart of water), giving one-fourth to commence, and repeating smaller doses until free vomiting is produced; castor oil should be given to clear the bowels and injections of oil and starch freely administered. If the body is cold use the warm bath.

Meadow Saffron.—See Belladonna.

Laudanum.—See Opium.

«Lobelia—Indian Poke.»—Symptoms: Excessive vomiting and purging, pains in the bowels, contraction of the pupils, delirium, coma, and convulsions. Treatment: Mustard over the stomach, and brandy and ammonia.

«Mercury—Corrosive Sublimate» (bug poisons frequently contain this poison), Red Precipitate, Chinese or English Vermilion.—Symptoms: Acrid, metallic taste in the mouth, immediate constriction and burning in the throat, with anxiety and tearing pains in both stomach and bowels, sickness, and vomiting of various-colored fluids, and sometimes bloody and profuse diarrhea, with difficulty and pain in urinating; pulse quick, small, and hard; faint sensations, great debility, difficult breathing, cramps, cold sweats, syncope, and convulsions. Treatment: If vomiting does not already exist, emetics must be given immediately—white of eggs in continuous large doses, and infusion of catechu afterwards, sweet milk, mixtures of flour and water in successive cupfuls, and to check excessive salivation put a half ounce of chlorate of potash in a tumbler of water, and use freely as a gargle, and swallow a tablespoonful every hour or two.

Morphine.—See Opium.

«Nitrate of Silver (Lunar Caustic).»—Symptoms: Intense pain and vomiting, and purging of blood, mucus, and shreds of mucous membranes; and if these stand they become dark. Treatment: Give freely of a solution of common salt in water, which decomposes the poison, and afterwards flaxseed or slippery-elm-bark tea, and after a while a dose of castor oil.

«Opium and All Its Compounds—Morphine, Laudanum, Paregoric, Etc.»—Symptoms: Giddiness, drowsiness, increasing to stupor, and insensibility; pulse usually, at first, quick and irregular, and breathing hurried, and afterwards pulse slow and feeble, and respiration slow and noisy; the pupils are contracted and the eyes and face congested, and later, as death approaches, the extremities become cold, the surface is covered with cold, clammy perspiration, and the sphincters relax. The effects of opium and its preparations, in poisonous doses, appear in from a half to two hours from its administration. Treatment: Empty the stomach immediately with an emetic or with the stomach pump. Then give very strong coffee without milk; put mustard plasters on the wrists and ankles; douche the head and chest with cold water, and if the patient is cold and sinking, give brandy, or whisky and ammonia. Belladonna is thought by many to counteract the poisonous effects of opium, and may be given in doses of half to a teaspoonful of the tincture, or 2 grains of the extract, every 20 minutes, until some effect is observed in causing the pupils to expand. Use warmth and friction, and if possible prevent sleep for some hours, for which purpose the patient should be walked about between two persons. Finally, as a last resort, use artificial respiration, persistence in which will sometimes be rewarded with success in apparently hopeless cases. Electricity should also be tried.

Cooley advises as follows: Vomiting must be induced as soon as possible, by means of a strong emetic and tickling the fauces. If this does not succeed, the stomach pump should be applied. The emetic may consist of a half drachm of sulphate of zinc dissolved in a half pint of warm water, of which one-third should {96} be taken at once, and the remainder at the rate of a wineglassful every 5 or 10 minutes, until vomiting commences. When there is much drowsiness or stupor 1 or 2 fluidrachms of tincture of capsicum will be found a useful addition; or one of the formulas for emetic draughts may be taken instead. Infusion of galls, cinchona, or oak bark should be freely administered before the emetic, and water soured with vinegar and lemon juice, after the stomach has been well cleared out. To rouse the system spirit and water or strong coffee may be given. To keep the sufferer awake, rough friction should be applied to the skin, an upright posture preserved, and walking exercise enforced, if necessary. When this is ineffectual cold water may be dashed over the chest, head, and spine, or mild shocks of electricity may be had recourse to. To allow the sufferer to sleep is to abandon him to destruction. Bleeding may be subsequently necessary in plethoric habits, or in threatened congestion. The costiveness that accompanies convalescence may be best met by aromatic aperients; and the general tone of the habit restored by stimulating tonics and the shower bath. The smallest fatal dose of opium in the case of an adult within our recollection was 4 1⁠/⁠2 grains. Children are much more susceptible to the action of opium than of other medicines, and hence the dose of it for them must be diminished considerably below that indicated by the common method of calculation depending on the age.