Page:The New International Encyclopædia 1st ed. v. 19.djvu/445

* TOXICOLOGY. character before absorption ami thereby prevent its toxic action upon the organism. Mechanical antidotes include the use of the stomacli tube or pump, the employment of emetics, cathartics, stimulants, injections, ligations, etc. The true or chemical antidotes include albumen, milk, charcoal, soap, starch, oils, tannin, turpentine, acids, alkalies, potassium, permanganate, sodium, chloride, iodine, iron. etc. When a poison lias been taken by the mouth the stomach should be emptied immediately by means of the stomach tube or emetics, except where there is severe corrosion and perforation of the stomach is feared. A prompt and certain emetic is apomorphine, which has the advantage of acting when given hypodermically. Domestic resources are usually limited to giving large draughts of mustard and warm water, warm milk in large quantities, oils, butter, and lard, common salt solution, soapsuds, and these often act with great promptness. Ipecac in the form of the syrup is found in most liouseholds and may be given in doses of one or two tablespoon- fuls to adults or as many teaspoonfuls to chil- dren. It is a safe and unirritating emetic, but is too slow for emergencies. Other useful emetics are copper sulpliate, zinc sulphate, turpeth min- eral, and alimi. In poisoning it is better to use almost any emetic at once than to lose valuable time getting just the right one. When poisoning is due to irritants after evacuation of the stomach, bland and viscid fluids shoiild be given to protect the walls of the alimentary tract and allay in- flammation. These agents are called demulcents, and include flaxseed tea, white of egg, milk, barley water, and the like. Where the poison has gained entrance by inoculation, as in the case of dog-bites or the stings of reptiles, the part should be washed, sucked, and a ligature applied about the extremity above the wound, i.e. between it and the heart. The wound should then be thoroughly cauterized. The stomach having been emptied, the next step is to administer the proper antidote or physiological antagonist. ( See Antidote.?. ) In general it is to be remembered that alkalies coun- teract acids and vice versa, since they tend to form harmless salts. Poisoning by the irritant metallic salts is best treated with albumen, in the form of white of egg, an inert, insoluble albuminate being formed. The antidote for the vegetable alkaloids is tannin, most conveniently given in the form of strong green tea. Chemical antidotes act only on such portions of the poison as have not been absorbed by the stomach and must be given promptly to be of any use. Physiological antidotes or antagonists follow the poison into the circulation and combat its efTects as long as it remains in the body. CoBROSiVE Poisons include acetic, carbolic, chromic, lactic, oxalic, and salicylic acids: con- centrated mineral acids (sulphuric, nitric, etc.) ; creosote : corrosive sublimate : the caustic alka- lies (potassium and sodium dioxide, usually in the form of lye, ammonia, etc.) : quicklime: potassimn chlorate; and potassium nitrate. These act either on the siirface of the body, causing deep and painful destruction of tissue, or in- ternally, by proilucing intense gastroenteritis and collapse. The symptoms common to the group are nausea, vomiting, pain, and purging, the vomited and dejected matters being mucous, 387 TOXICOLOGY. serous, or bloody. The mouth and lips, hands and face, are frequently burned and corroded. Treatment consists in neutralizing the poison and the giving of demulcents. In the case of weak acids, magnesia, chalk, soap, and dilute ammonia may be given as antidotes; in the event of alkaline poisoning weak acids, such as dilute vinegar or lemon juice, may be given. When the poison is concentrated the .stomach tube should not be used. Carbolic acid is probably the most frequently used of the corrosives, and is best antidoted with alcohol diluted and given up to four ounces. The sulpliate of magnesia is also a perfect antidote. True Irritants include, besides certain of the corrosive poisons already mentioned, bromine, cantharides, croton oil, chlorine, antimon}', ar- senic, copper chromium, lead, tin, zinc, phospho- rus, and iodine. In concentrated form most of them cause irritation to the gastro-intestinal tract, but besides this show a specific action on various organs after their absorption by the blood. Arsenic is the most commonly em- ployed of this group, accidentally or with homicidal or suicidal intent. The substance is widely used in the arts and is a con- stituent of some vermin exterminators. Poison- ing may be acute or chronic. In acute cases the symptoms are those common to irri- tant poisons. The chemical antidote is known as 'arsenic antidote.' and may be prepared by adding ammonia water to tincture of iron. It must be freshly prepared. Arsenic poisoning is generally fatal, a small dose (I to 3 grains) being sufficient to kill. Chronic poisoning by arsenic is also common as a result of inhalation or contact with the various arsenical greens used in coloring wall papers, carpets, etc., grind- ing arsenic in mills, and from vapors in smelting copper. The symptoms are gastric irritation, cough, sneezing, throat troubles, gradually fail- ing health, and paralysis. See Arsenic. Lead poisoning may also be acute or chronic, the latter being the most usual form. Acute eases are due to the ingestion of the acetate (sugar of lead), carbonate, oxide, or ehromate of lead and mainly painters suffer. The prom- inent symptoms are gastro-intestinal irritation, cramps in the legs .and abdomen, followed by paralysis of the extremities, convulsions, and coma. The sulphate of magnesia (Epsom salt) is the antidote, forming an insoluble sulphate of lead, and acting in addition as a purge. Chronic poisoning arises from handling paints, drinking water conducted in lead pipes, the use of cos- metics containing lead, and eating canned foods contaminated by solder. The symptoms come on insidiously and consist of a peculiar griping colic (lead colic), obstinate constipation, muscu- lar cramps, paralysis of the extensor muscles of the forearms (wrist-drop), and a blue line at the junction of the gums and teetli. Chronic poisoning is treated by removing its source, and by the administration of Epsoni salt and potas- sium iodide to eliminate the lead already ab- sorbed. See Lead. PJwsphorus poisoning is due to yellow phos- phorus, commonly derived from matches or rat poisons. Workers in match factories are most usually attacked, although rat poison is some- times taken with suicidal intent. The poison is very active and recover)' is rare. The prominent