Chapter 18

PRUSSIC OR HYDROCYANIC ACID--LAUREL WATER, CYANIDE OF POTASSIUM, BITTER ALMOND OIL, ETC.--Symptoms: In large doses almost invariably instantaneously fatal, when not immediately fatal, sudden loss of sense and control of the voluntary muscles; the odor of the poison generally susceptible on the breath. Treatment: Chlorine, in the form of chlorine water, in doses of from one to four fluid drachms, diluted. Weak solution of chloride lime of soda; water of ammonia (spirits of hartshorn) largely diluted may be given, and the vapor of it cautiously inhaled. Cold affusion, and chloroform in half to teaspoonful doses in glycerine or mucilage, repeated every few minutes, until the symptoms are ameliorated. Artificial respiration.

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.

ALKALIES AND THEIR SALTS--CONCENTRATED LYE, WOODASH LYE, CAUSTIC POTASH, AMMONIA, HARTSHORN.--Symptoms: Caustic, acrid taste, excessive heat in the throat, stomach and [Transcriber's Note: The original text reads 'intenstines'] 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 alkalies and thus also destroy their caustic effect. They should be given in large quantity.

ALCOHOL, BRANDY, AND OTHER SPIRITUOUS LIQUORS.--Symptoms: Confusion of thought, inability to walk or stand, dizziness, stupor, highly flushed or pale face, noisy breathing.--Treatment: After emptying the stomach, pour cold water on the head and back of the neck, rub or slap the wrists and palms, and the ankles and soles of the feet, and give strong, hot coffee, or aromatic spirits of hartshorn, in teaspoonful doses in water. The warmth of the body must be sustained.

ANTIMONY, AND ITS PREPARATIONS. TARTAR EMETIC, ANTIMONIAL WINE, KERME'S MINERAL.--Symptoms: Faintness and nausea, soon followed by painful and continued vomiting, severe diarrhoea, 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. Astringment 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 the 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 brownish, and sometimes bloody. Diarrhoea 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 ten or fifteen 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, etc., etc.

BELLADONNA OR DEADLY NIGHT SHADE.--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 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 Copperas.

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 medical man. Camphorated oil or camphorated spirits should be rubbed over the bowels, stomach and thighs.

CAUSTIC POTASH.--See Alkalies.

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, diarrhoea, 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 SOUL 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.

COPPERAS.--See 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.

DEADLY NIGHT-SHADE.--See Belladonna.

FOX-GLOVE, 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 respirations, cold douche, frictions 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.

GREEN VITRIOL.--See Iron.

HELLEBORE, OR INDIAN POKE.--Symptoms: Violent vomiting and purging, bloody stools, great anxiety, tremors, vertigo, fainting, sinking of the pulse, cold sweets 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 five-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: Free emesis, prompt administration of starch, wheat flour, or arrowroot, beat 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 painter's 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, one and a half ounce to a quart; or, better still, Epsom salts or Glauber salts, an ounce of either in a quart of water; or dilute sulphuric acid, a teaspoonful in 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 (one 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.

LUNAR CAUSTIC.--See Silver.

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 VERMILLION.--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 diarrhoea, 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--albumen 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.

MONKSHOOD.--See Arnica.

MORPHINE.--See Opium.

NITRATE OF SILVER (LUNAR CAUSTIC.)--Symptoms: Intense pain and vomiting and purging of blood; mucus and shreds of mucus 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 flax-seed or elm bark tea, and after a while a dose of castor oil.

NUX VOMICA.--See Strychnine.

OPIUM AND ALL ITS PREPARATIONS--MORPHINE, LAUDANUM, PAREGORIC, ETC.--Symptoms: Giddiness, drowsiness, increasing to stupor, and insensibility; pulse usually, at first, quirk 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 wrist and ankles; use the cold douche to the head and chest, 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 two grains of the extract, every twenty 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, and if necessary a bunch of switches may be freely used. Finally, as a last resort, use artificial respiration, and a persistance in it will sometimes be rewarded with success in apparently hopeless cases. Galvanism should also be tried. OXALIC ACID.--See Acids.

PHOSPHORUS--FOUND IN LUCIFER MATCHES AND SOME RAT POISONS.--Symptoms: Symptoms of irritant poisoning; pain in the stomach and bowels; vomiting; diarrhoea; tenderness and tension of the abdomen. Treatment: An emetic is to be promptly given; copious draughts containing magnesia in suspension: mucilaginous drinks. General treatment for inflammatory symptoms.

POISONOUS FISH.--Symptoms: In an hour or two--often in much shorter time--after the fish has been eaten, a weight at the stomach comes on, with slight vertigo and headache; sense of heat about the head and eyes; considerable thirst, and often an eruption of the skin. Treatment: After full vomiting, an active purgative should be given to remove any of the noxious matter from the intestines. Vinegar and water may be drunk after the above remedies have operated, and the body may be sponged with the same. Water made very sweet with sugar, with aromatic spirits of ammonia added, may be drunk freely as a corrective. A solution of cholorate of potash, or of alkali, the latter weak, may be given to obviate the effect of the poison. If spasms ensue after evacuation, laudanum in considerable doses it necessary. If inflammation should occur, combat in the usual way.

POISONOUS MUSHROOMS.--- Symptoms: Nausea, heat and pains in the stomach and bowels; vomiting and purging, thirst, convulsions and faintings, pulse small and frequent, dilated pupil and stupor, cold sweats and death.

Treatment: The stomach and bowels are to be cleared by an emetic of ground mustard or sulphate of zinc, followed by frequent doses of Glauber of Epsom salts, and large stimulating clysters. After the poison is evacuated, either may be given with small quantities of brandy and water. But if inflammatory symptoms manifest themselves, such stimuli should be avoided, and these symptoms appropriately treated.

POTASH.--See Alkali.

PRUSSIC ACID, HYDROCYANIC.--See Acids.

POISON IVY.--Symptoms. Contact with, and with many persons the near approach to the vine, gives rise to violent erysipelatous inflammation, especially of the face and hands, attended with itching, redness, burning and swelling, with watery blisters.

Treatment: Give saline laxatives, and apply weak lead and laudanum, or limewater and sweet oil, or bathe the parts freely with spirits of nitre. Anointing with oil will prevent poisoning from it.

SALTPETRE, NITRATE OF POTASH.--Symptoms. Only poisonous in large quantities, and then causes nausea, painful vomiting, purging, convulsions, faintness, feeble pulse, cold feet and hands, with tearing pains in stomach and bowels.

Treatment: Treat just as is directed for arsenic, for there is no antidote known, and emptying the stomach and bowels with mild drinks must be relied on.

SAVINE.--Symptoms: Sharp pains in the bowels, hot skin, rapid pulse, violent vomiting and sometimes purging, with great prostration. Treatment: Mustard and hot fomentations over the stomach and bowels, and ice only allowed in the stomach until the inflammation ceases. If prostration comes on, food and stimulants must be given by injection.

STRAMONIUM, THORN-APPLE OR JAMESTOWN WEED.--Symptoms: Vertigo, headache, perversion of vision, slight delirium, sense of suffocation, disposition to sleep, bowels relaxed and all secretions augmented. Treatment: Same as Belladonna.

STRYCHNINE AND NUX VOMICA.--Symptoms: Muscular twitching, constriction of the throat, difficult breathing and oppression of the chest; violent muscular spasms then occur, continuous in character like lock-jaw, with the body bent backwards, sometimes like a bow. Treatment: Give, if obtainable, one ounce or more of bone charcoal mixed with water, and follow with an active emetic; then give chloroform in teaspoonful doses, in flour and water or glycerine, every few minutes while the spasms last, and afterwards brandy and stimulants, and warmth of the extremities if necessary. Recoveries have followed the free and prompt administration of oils or melted butter or lard. In all cases empty the stomach if possible.

SULPHATE OF ZINC, WHITE VITRIOL.--See Zinc.

TIN--CHLORIDE OF TIN, SOLUTION OF TIN (USED BY DYERS), OXIDE OF TIN OR PUTTY POWDER.--Symptoms: Vomiting, pains in the stomach, anxiety, restlessness, frequent pulse, delirium, etc. Treatment: Empty the stomach, and give whites of eggs in water, milk in large quantities, or flour beaten, up in water, with magnesia or chalk.

TARTAR EMETIC.--See Antimony.

TOBACCO.--Symptoms: Vertigo, stupor, fainting, nausea, vomiting, sudden nervous debility, cold sweat, tremors, and at times fatal prostration. Treatment: After the stomach is empty apply mustard to the abdomen and to the extremities, and give strong coffee, with brandy and other stimulants, with warmth to the extremities.

ZINC--OXIDE OF ZINC, SULPHATE OF ZINC, WHITE VITRIOL, ACETATE OF ZINC.--Symptoms: Violent vomiting, astringent taste, burning pain in the stomach, pale countenance, cold extremities, dull eyes, fluttering pulse. Death seldom ensues, in consequence of the emetic effect. Treatment: The vomiting may be relieved by copious draughts of warm water. Carbonate of soda, administered in solution, will decompose the sulphate of zinc. Milk and albumen will also act as antidotes. General principles to be observed in the subsequent treatment.

WOORARA.--Symptoms: When taken into the stomach it is inert; when absorbed through a wound it causes sudden stupor and insensibility, frothing at the mouth and speedy death. Treatment: Suck the wound immediately, or cut it out and tie a cord around the limb between the wound and the heart. Apply iodine, or iodide of potassium, and give it internally, and try artificial respiration.

SCALDS.--See Burns and Scalds.

SPRAINS.--The portions most frequently implicated are the wrist and ankle; no matter which portion it may be, however, rest and quietness is a very important part of the treatment, and, when possible, in an elevated position. If the wrist is sprained it should be carried in a sling; if the ankle, it should be supported on a couch or stool. Cold lotions (see Bruises) should be freely applied, and irrigation by pouring water from a pitcher or tea-kettle resorted to several times a day to prevent inflammation. Later, frictions with opodeldoc, or with some stimulating liniment, and supporting the parts by pressure made with a flannel roller, or laced stocking when the ankle is involved, will be useful to restore tone; or strips of adhesive plaster properly applied will be useful for the same purpose. Recovery from severe sprains is always tedious. It is an old saying "that a bad sprain is worse than a broken bone."

STINGS OF BEES AND WASPS.--See Bites and Stings.

SUFFOCATION FROM NOXIOUS GASES, FOUL AIR, FIRE DAMP, ETC.--Remove to fresh air and dash cold water over the head, neck and chest; carefully apply hartshorn, or smelling salts to the nostrils, and when the breathing is feeble or has ceased, resort immediately to artificial respiration (see Asphyxia and Drowning). Keep up the warmth of the body, and as soon as the patient can swallow give stimulants in small quantities.

SUNSTROKE.--This is caused by long exposure in great heat, especially when accompanied with great fatigue and exhaustion. Though generally happening from exposure to the sun's rays, yet precisely similar effects may be and are produced from any undue exposure to great and exhaustive heat, such as workmen are exposed to in foundries, gas factories, bakeries, and other similar employments. Its first symptom is pain in the head and dizziness, quickly followed by loss of consciousness, and resulting in complete prostration: sometimes, however, the attack is sudden, as in apoplexy. The head is generally burning hot, the face, dark and swollen, the breathing labored and snoring, and the feet and hands cold. Remove the patient at once to a cool and shady place, and lay him down with his head a little raised; apply ice or iced water to the head and face; loosen all cloths around the neck or waist; bathe the chest with cold water, apply mustard plasters, or cloths wetted with turpentine, to the calves and soles of the feet, and as soon as the patient can swallow, give weak brandy or whisky and water.

There is no easy road to success--I Thank God for it . . . . A trained man will make his life tall. Without training, you are left on a sea of luck, where thousands go down, while one meets with success. JAMES A. GARFIELD.

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THE FAMILY PHYSICIAN

The following receipts written by DR. J. H. Gunn will be found of great value, especially in emergencies:

ASTHMA.--Take hyssop water and poppy water, of each ten ounces; oxymel of squills, six ounces; syrup of maiden hair, two ounces. Take one spoonful when you find any difficulty in breathing.

AGUE IN THE BREAST.--Take one part of gum camphor, two parts yellow bees-wax, three parts clean lard; let all melt slowly, in any vessel [earthen best], on stove. Use either cold or warm; spread very thinly on cotton or linen cloths, covering those with flannel. No matter if the breast is broken, it will cure if persevered in. Do not, no matter how painful, cease from drawing milk from the breast that is affected.

AGUE, MIXTURE.--Mix twenty grains quinine with one pint diluted gin or port wine, and add ten grains subcarbonate of iron. Dose, a wine-glass each hour until the ague is broken, and then two or three times a day until the whole has been used.

2. Take Peruvian bark, two ounces; wild cherry tree bark, 1 ounce; cinnamon, one drachm; powdered capsicum, one teaspoonful; sulphur, one ounce; port wine, two quarts. Let it stand a day or two. Dose, a wine-glassful every two or three hours until the disease is broken, and then two or three times a day until all is taken.