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Poisoning by Medicines and Chemicals.Symptoms. - If one of the strong acids be taken into the mouth, the patient becomes instantly aware of the mistake by the intense pain. If the liquid be swallowed, the pain is felt along the throat and gullet into the stomach. Upon examining such a patient, we find the lining membrane of the mouth dry and hard, and sometimes presenting a yellowish or blackish appearance as if charred. The patient vomits violently, the matter ejected being sometimes red from admixture with blood, and sometimes of a black and tarry appearance ; this latter substance is really blood, which has been acted upon by the acid. If much of the liquid have been swallowed, the patient becomes prostrate; the hands and feet are cold and clammy, the pulse small and feeble and very rapid. In the course of a few hours there sometimes occur bloody or tarry evacuations from the bowels. Treatment.-The first object of treatment is to neutralize the acid ; that is, to cause it to combine chemically with other substances, so as to deprive it of its corrosive power. For this purpose, we may give any alkaline substance, such as soda or potash. It is, of course, improper to give the strong alkalies, since these are themselves corrosive. A teaspoonful of washing soda stirred up in water,, or if this cannot be promptly procured, as much soap in water should be given at once ; or a little plaster may be knocked off the wall, broken into small pieces and administered in water. After a sufficient quantity of this has been given to neutralise the acid - the exact amount must, of course, depend upon the quantity of acid which has been taken - the patient should take three or four eggs beaten up together, or, if these be not at hand, a glass or two of milk. After a short time he may have some bland tea or barley water. It is not advisable to give emetics or to use the stomach pump; the acid will be neutralized at once by the alkaline substances, and will exert no further corrosive action. It is necessary to keep the stomach as quiet as possible, since it is already damaged by the acid, and if it be made to contract violently by the act of vomiting further injury may occur. The patient's mouth and throat are extremely sore ; the surface usually mortifies in patches, and pieces of the flesh come away, leaving raw surfaces. Nothing can be done to prevent this ; we can simply take care that the parts are kept as quiet as possible, and are not irritated by food. If the injury be not extensive, the patient may take liquid food-milk, broths, and the like,- in small quantities at short intervals. If, on the other hand, a large quantity of acid has been taken, or much time has elapsed before the administration of the antidote, the nourishment should be administered by injections into the rectum. Poison by Alkalies.-The alkalies which are most frequently taken into the mouth are potash, soda and hartshorn. Symptoms.-The symptoms are very similar to those caused by the mineral acids. They are manifested more especially in the throat, however, causing the patient to choke and gag. Hartshorn has not only a local influence upon the lining membrane of the mouth and throat, but also affects the system generally, frequently giving rise to convulsions. Treatment.-The alkalies are neutralized by acid substances, and are converted into soap by oils. Hence, the treatment consists in the administration of acids and fat. The patient should take a glassful of weak vinegar, or vinegar and water in equal parts. This should be followed in ten minutes by a tablespoonful of sweet oil. If neither of these remedies is at hand, an abundance of warm water should be administered, followed in a short time by a glass of milk. Poisoning by Oxalic Acid.-Oxalic acid is a solid substance, and is usually taken by mistake for some of the other white crystalline substances (such as Epsom salts). This acid does not cause any serious injury to the lining membrane of the mouth or throat. Its injurious effects result from its absorption into the system, since when in the blood, it acts as a deadly poison. Treatment.-Any alkaline substance, chalk, magnesia, washing soda or lime, should be given at once in quantities dependent upon the amount of oxalic acid which has been swallowed. Immediately after this the patient should take two or three eggs or a glass of milk. After five minutes, vomiting should be provoked, either by giving a teaspoonful of mustard in a glass of warm water or by tickling the throat with the finger or with a feather. Poisoning by Carbolic Acid.-Carbolic acid is sometimes taken by mistake, and occasionally used for purposes of suicide. Symptoms.-The symptoms are in many respects those caused by mineral acids. The surface of the mouth and throat is turned white by the acid. The patient soon becomes prostrated, a condition which is due to the constitutional effects rather than to the local injury. The urine contains blood, and in a few hours acquires a dense black color so that it resembles ink. Treatment.-The whites of eggs should be beaten up and administered in abundance. After this, vomiting should be caused by administering mustard and warm water. After the stomach is emptied of its contents, sweet oil, with or without magnesia, must be administered. Poisoning by Prussic Acid and its Compounds.-Prussic acid is often taken with suicidal intent. The cyanide of potassium is one of its compounds, which is almost as deadly as the acid itself. Bitter almonds also contain a considerable quantity of prussic acid. The oil of bitter almonds, as well as cherry-laurel water, are sometimes taken by mistake. If the prussic acid be strong, or if much of the cyanide of potassium be taken, no measures offer much promise of recovery ; for these drugs cause a rapid arrest of the heart's beating, as well as a cessation of the breathing. Treatment.-Vomiting should be promoted as soon as possible by tickling the throat or by a teaspoonful of mustard in warm water. Meanwhile ammonia should be held near the nostrils, and cold water should be dashed upon the face and chest. So soon as the patient seems capable of breathing, he should be stimulated by strong coffee containing a little whisky or brandy. In many cases there is a numbness and a loss of feeling in the limbs ; the skin should be vigorously rubbed with a flesh brush or a coarse towel, and the patient frequently spoken to in order to prevent him from lapsing into unconsciousness. While these measures are being executed the following solution may be prepared : Ten or fifteen grains of green vitriol should be dissolved in two ounces of water ; to this half a teaspoonful of subsulphate of iron solution is added, and enough caustic soda to make the liquid somewhat alkaline in reaction. Half of this may be given at once. Poisoning by Arsenic.-This is indicated by an acrid taste in the mouth and a sense of tightness in the throat ; in a short time a burning pain is felt in the pit of the stomach, soon extending into the abdomen ; nausea and vomiting occur; there is extreme thirst. If the quantity taken be large, convulsions may occur, and the patient soon becomes prostrated. Treatment.- Vomiting should be excited at once ; give a teaspoonful of mustard in warm water or tickle the throat with the finger. Then administer dialysed iron in teaspoonful doses, and follow this with milk, whites of eggs and barley water. Poisoning by Copper and its Compounds.- The most common sources of this poison are blue vitriol and verdigris. The symptoms are very similar to those of poisoning by arsenic. Treatment.- Whites of eggs are to be administered freely, after which vomiting should be excited with warm water and mustard or by irritating the throat with the finger. After the contents of the stomach have been evacuated eggs and milk should be given. Poisoning by Quicksilver Compounds.- The most frequently met with of these is corrosive sublimate ; the red precipitate and white precipitate and vermilion are other compounds which are sometimes taken into the stomach. Treatment.- Whites of eggs and milk are to be freely given, afterwards vomiting should be excited. After the stomach has been emptied, milk or linseed tea should be given. Poisoning by Zinc Compounds.- The only one of these which is apt to be used as a poison is white vitriol. The treatment is the same as that for poisoning by compounds of copper or mercury. Poisoning by Compounds of Lead.- These are sugar of lead, white lead, goulard water and red lead. Treatment.- Epsom salts should be given freely, one or two ounces being dissolved in water. After this vomiting should be excited by a teaspoonful of mustard stirred in a glass of warm water, and by tickling the throat. Poisoning by Lunar Caustic.- A teaspoonful of common salt dissolved in a cupful of water should be swallowed at once, and followed by the whites of a dozen eggs. If vomiting do not occur at once it should be excited by tickling the throat, or by the usual emetics. Poisoning by Opium.- A large percentage of the cases of poisoning which the physician is called upon to treat result from the use of opium, laudanum or morphine. It is important that this condition be recognized, since certain principles of treatment must be carried out in order to overcome the effects of the drug upon the system. Symptoms.-The symptoms caused by the use of opium vary extremely according to the quantity of the drug which has been taken. If a comparatively small quantity has been swallowed the patient becomes gradually drowsy, the pupils of the eyes are contracted, the breathing becomes slower, the pulse is less rapid and full. If a large quantity be taken these symptoms ensue in a very short time, and are rapidly followed by complete unconsciousness ; stupor has been known to ensue within three minutes after a hypodermic injection of morphine. The patient does not die, however, during this stage. So long as he can be roused by shouting or shaking there is still a possibility of complete recovery. If the individual be so comatose that he cannot be roused in any way, a condition of extreme prostration ensues. The pupils of the eyes are contracted to the size of pins' points ; the breathing becomes so slow that every respiration seems to be the last. The acts of breathing may be diminished from sixteen or eighteen in a minute, which is the usual number, to eight, six, or even four per minute. The pulse is very slow and very full; the face is pale and livid ; the skin is cool and clammy. Even when these symptoms have ensued it is possible for the patient to recover, though death is usually the result. In some persons who are especially susceptible to the action of opium, many of these symptoms may be brought on by a dose of the drug which is perfectly safe for most persons. Treatment.-The objects of treatment are: First, to empty the stomach ; second, to keep up the breathing ; third, to stimulate the heart. To empty the stomach an emetic should be given at once. A teaspoonful of mustard in a glass of warm water should be administered, and the throat should be irritated by the finger. These means are, however, often insufficient. In the first place it may be impossible to induce the patient to swallow, and the lining membrane of the throat and stomach are so benumbed by the drug that they may not respond to these irritants. If vomiting do not promptly occur after two or three draughts of mustard and water have been given, a stomach pump should be brought into requisition. This can be extemporized by any one who has a piece of rubber tubing four feet in length and half an inch in diameter. One end of this should be passed into the stomach. To do this it is only necessary to push the tube into the back part of the mouth, well up against the back part of the throat, and then to direct it downward. It is important to keep the tube pressed well against the back part of the throat in order to avoid passing it into the windpipe, which lies a little further in front. After the tube has been passed into the throat for eighteen or twenty inches, the outer end should be elevated ; water is then poured into it from a pitcher, one or two quarts being employed for the purpose. The end of the tube is then lowered so as to make a siphon; the liquid returns from the stomach through the tube into a basin held for the purpose. This process should be repeated once or twice. To keep up respiration, the patient's skin should be briskly whipped with a wet towel; at intervals of five or ten minutes, his head and chest may be dashed with cold water ; the effect will be greater if ice-cold water and warm water (no degrees Fahr.) be employed in quick succession. In the intervals between the douches, the patient may be made to walk the floor, supported on either side by an assistant. This measure is, of course, impossible if the patient be so profoundly unconscious as to be unable to use his limbs. Yet much more can be done in this direction than would be supposed by one who has had no experience. As a last resort, artificial respiration may be performed, a process which is described under the head of drowning. It has sometimes been possible to save a life by keeping up artificial respiration for half or three-quarters of an hour after the patient has ceased to breathe. Strong coffee should be prepared, and may be administered at short intervals by the mouth if the patient can swallow, otherwise by the rectum. If an electric battery can be procured and managed by some one acquainted with it, one pole should be applied to the nape of the neck and the other to the pit of the stomach. The effects of opium can be counteracted in great measure by atropine. This is a powerful drug and should be used by a physician if the services of a medical man can be procured. One-fortieth of a grain of atropine may be injected under the skin if the symptoms of opium poisoning be profound ; this dose may be repeated in fifteen or twenty minutes if the breathing be very slow and show no signs of improvement. Ammonia should be held near the nostrils; if the pulse become weak, a tablespoonful of whisky may be administered by the rectum every half hour until four or five doses have been given. Poisoning by Belladonna, Henbane, Stramonium and Digitalis.-These drugs cause different symptoms, but the differences between them will be recognized only by a medical man. In general there occurs a state of excitement and agitation often culminating in delirium ; there is frequently vomiting, diarrhea and extreme pain in the bowels. Treatment.-If vomiting have not occurred, it should be provoked at once by tickling the throat and giving a teaspoonful of mustard in a glass of warm water. The patient should then take a teaspoonful of powdered charcoal. After this, milk and strong tea may be given. If the pulse be very weak and feeble and the patient appear much prostrated, ammonia (hartshorn) should be held near the nostrils and a teaspoonful of whisky should be given every twenty or thirty minutes until six or eight doses have been taken. Poisoning by Strychnine, Nuoo Vomica, White Hellebore, Oleander and Spigelia. - Finely powdered charcoal, which can be made by pounding in a handkerchief the coal from a wood fire, should be given at once in large quantities. Vomiting is to be excited by tickling the throat and by the administration of mustard in warm water. After this strong coffee should be given. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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