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Articles from Aids To Forensic Medicine And Toxicology

Evidence Of Poisoning

Presumption Of Death; Survivorship

Duration Of Pregnancy

Death By Suffocation

Antipyrine Antifebrin Phenacetin And Aniline

Blackmailing

Crimes

The Mineral Acids

Death From Starvation

Death By Drowning


Treatment Of Poisoning





The modes of treatment may be ranged under three heads: (1) To eliminate
the poison; (2) to antagonize its action; (3) to avert the tendency to
death.

1. The first indication is met by the administration of emetics, to
produce vomiting, or by the application of the stomach-tube. The best
emetic is that which is at hand. If there is a choice, give apomorphine
hypodermically. The dose for an adult is 10 minims. It may be given in
the form of the injection of the Pharmacopoeia, or preferably as a
tablet dissolved in water. Apomorphine is not allied in physiological
action to morphine, and may be given in cases of narcotic poisoning.
Sulphate of zinc, salt-and-water, ipecacuanha, and mustard, are all
useful as emetics. Tickling the fauces with a feather may excite
vomiting.

In using the elastic stomach-tube, some fluid should be introduced into
the stomach before attempting to empty it, or a portion of the mucous
membrane may be sucked into the aperture. The tube should be examined to
see that it is not broken or cracked, as accidents have happened from
neglecting this precaution. The bowels and kidneys must also be
stimulated to activity, to help in the elimination of the poison.

2. The second indication is met by the administration of the appropriate
antidote. Antidotes are usually given hypodermically, or, if by mouth,
in the form of tablets. In the absence of a hypodermic syringe, the
remedy may be given by the rectum. In the selection of the appropriate
antidote, a knowledge of pharmacology is required, especially of the
physiological antagonism of drugs. Antidotes may act (1) chemically, by
forming harmless compounds, as lime in oxalic acid poisoning; (2)
physiologically, the drug which is administered neutralizing more or
less completely the poison which has been absorbed; (3) physically, as
charcoal. Every doctor should provide himself with an antidote case. The
various antidotes will be mentioned under their respective poisons.

3. To avert the tendency to death, we must endeavour to palliate the
symptoms and neutralize the effects of the poison. Pain must be relieved
by the use of morphine; inflamed mucous membrane soothed by such
demulcents as oils, milk, starch; stimulants to overcome collapse;
saline infusions in shock, etc. In the case of narcotics and depressing
agents, stimulants, electricity, and cold affusions, may be found
useful. We should endeavour to promote the elimination of the poison
from the body by stimulating the secretions.





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Previous: Duty Of Practitioner In Supposed Case Of Poisoning



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