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 min ms. 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.