Part 48

Lesions. After large doses there are congestion, ulceration, corrosion and sloughing of the œsophagus, gastric and intestinal mucosa, and more or less yellow discoloration of the parts. The odor is characteristic. With iodine there may be blue iodide of starch in the ingesta.

Treatment. Favor emesis by tickling the fauces and giving tepid water, or apomorphia subcutem. Boiled starch is the best antidote and may be given freely, both by mouth and rectum. Opium is often called for to relieve suffering.

POISONING BY COPPER.

Copper sulphate: Fatal dose, horse, dog. Symptoms: Dullness, colic, blue or green vomit, diarrhœa, straining, weakness, spasms, palsy, albuminuria, icterus, hæmoglobinuria, impaired appetite, emaciation, spasms. Lesions: Redness, softening, ulceration, sloughing of alimentary mucosa, methe-globinæmia, fatty liver, enlarged spleen, ingesta give copper film on polished iron. Treatment: Albumen, milk, mucilage, iron filings, sulphur, magnesia, laxatives, opium. Avoid acids.

The common copper poisons are the sulphate and acetate. Copper alum, oxide or carbonate of copper and paints with a copper base are less frequently taken.

=Sulphate of copper= 1 ounce has proved fatal to the horse. In dilute solution or with mucilaginous liquids it is much less injurious. Ten grains to 2 drachms subcutem have killed the dog. (Tabourin.)

Symptoms. Dullness, colics, emesis of blue or greenish matter in vomiting animals, diarrhœa, tenesmus, weakness, trembling, spasms, trismus, paralysis, small, weak pulse, hurried breathing. In experimental chronic poisoning in the sheep, albuminuria, icterus, hæmaglobinuria, hæmaturia, impaired appetite and rumination, constipation followed by diarrhœa, great emaciation and weakness and finally convulsions. (Ellenberger and Hofmeister).

Lesions. Redness and softening of the alimentary mucosa, ulceration, sloughing, perforation. In the chronic forms methe-globinæmia, free hæmatin as crystals in liver, spleen and kidney, nephritic extravasation, fatty degeneration of the liver, enlarged spleen, and catarrhal changes in the intestinal mucosa. Polished iron placed in the gastric or intestinal contents becomes coated with copper.

Treatment. White of egg, milk, mucilage, iron filings, sulphur, calcined magnesia, laxatives. Opium may be required to calm suffering, but acids must be carefully avoided.

POISONING BY ZINC.

Sulphate and chloride poisonous, less potent oxide and carbonate. Symptoms: colics, emesis, congested alimentary mucosa, diarrhœa, cramps, weakness, paresis, anæmia, emaciation. Lesions: white, leathery, sloughing or ulcerated alimentary mucosa, strictures. Treatment: emesis, demulcents, tannic acid, sodium carbonate.

The =sulphate= and =chloride= are the most likely to be taken in dangerous amount, the former being mistaken for Glauber salts. Three ounces of sulphate intravenously in the horse has proved fatal, or 10 to 50 grains in the dog. In the vicinity of zinc ore furnaces the agent is taken in on the fodder as oxide or carbonate.

Symptoms. There is much abdominal pain, emesis in vomiting animals, quick pulse, congested mucosæ, diarrhœa, cramps, weakness, and paresis, and if the patient survives, anæmia and emaciation.

Lesions. The mucosa of mouth, gullet, stomach and perhaps duodenum is white, opaque, hard, corrugated, leathery, sloughing, or ulcerated. Congestion is well marked. Strictures may appear in chronic cases.

Treatment. Give tepid water and tickle the fauces. Use white of egg or milk freely and mucilaginous agents. Tannic acid, or carbonate of soda are antidotal by tending to precipitate insoluble compounds.

POISONING BY SILVER.

Toxic doses of silver come mostly from materials used in the arts. The photographer uses chiefly the nitrate, iodide, bromide, cyanide and chloride. Taken into the stomach the silver salts are less poisonous because they are largely precipitated as insoluble chloride or albuminate. The chloride and albuminate are, however, soluble in solutions of alkaline chlorides and hence even they may poison.

Symptoms. Colic, emesis in vomiting animals the vomited matters blackening in the light, diarrhœa, great muscular weakness, paresis, weak clonic spasms, and disturbed respiration. The nervous symptoms are very prominent (Rouget and Curci). Chronic poisoning produces emaciation and fatty degeneration of liver, kidneys and muscles (Bogoslowsky).

Lesions. Patches of congestion and of white corrosion on the buccal œsophageal and gastric mucous membrane, the presence of the curdy white chloride of silver adherent to the gastric mucosa. In chronic cases the visible mucosæ and white skin may have a slaty color.

Treatment. Emetics in vomiting animals. White of egg, common salt largely diluted and followed by milk as antidotal, demulcent and nutritive agent.

POISONING BY BARIUM.

Poisonous salts. Symptoms: spasms, peristalsis, defecation, urination, restlessness, prostration, emesis, weak pulse, coma. Lesions: Moderate congestion of gastro-intestinal mucosa. Treatment: alkaline sulphate, anodynes, demulcents.

The salts of barium are irritant with a special action on the nervous system shown by weakened action of the heart and spasms or paresis of the muscles. The chloride is used in staining wool, the nitrate and chlorate in producing green colors in fireworks, the oxide and carbonate in glassmaking, the chromate by painters, and the sulphate for giving weight and body to various white powders. The chloride is now largely used to stimulate intestinal peristalsis in animals.

Symptoms. Barium chloride hypodermically produces tonic and clonic convulsions, increased peristalsis, discharges of urine and fæces, great restlessness, muscular prostration, emesis in vomiting animals, hurried, shallow respiration, weak, thready pulse, asthenia, coma, and death.

Lesions. There is congestion of the gastric and intestinal mucosa, but this is rarely violent, and corrosion and ulceration are almost unknown. The agent indeed seems to act more energetically upon the nervous system than on the mucosa of the alimentary tract.

Treatment. This consists in giving an alkaline sulphate (sulphate of soda, potash, or magnesia), to precipitate the insoluble barium sulphate, with anodynes (opium) and mucilaginous agents.

POISONING BY IRON.

Sulphate and chloride on empty stomach poisonous. Symptoms: Colic, emesis, rumbling, purging. Treatment: Alkaline or earthy carbonates, tannic acid, albumen. Opium.