Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/573

 the poison with the stomach-pump; and this in urgent cases should be the first remedy employed. The treatment by the stomach-pump has now become so generally known, that it is unnecessary to describe it particularly. It was recommended in this country by the late Dr. Monro in his lectures; but does not appear to have been tried by him. In 1803 it was first published by Renault in his treatise on the counter-poisons of arsenic; and he had tried it on animals. But the first person who used it in an actual case of poisoning with opium was Dr. Physick of Philadelphia. He saved the life of a child with it in 1812; and not long afterwards his countryman, Dr. Dorsey, cured two other individuals. More lately it was again proposed in London by Mr. Jukes, who does not appear to have been acquainted with these prior trials and experiments. Although he cannot be considered in the light of a discoverer, the profession is much indebted to him for having recalled their attention to this treatment, and for having by his success and activity fairly established its reputation. An account will be seen of his apparatus and of several cases in the Medical and Physical Journal for September and November, 1822. In using the stomach-pump care must be taken not to injure the stomach by too forcible suction.—When it is not at hand, Mr. Bryce of this city recommended the substitution of a long tube with a bladder attached. After the stomach has been filled with warm water from the bladder, the tube is to be turned down so as to act upon the contents of the stomach as a syphon. Dr. Alison cured a patient in this way.

Another method of removing opium from the stomach, which has been practised successfully where the patient could not be made to submit to the common treatment, is the injection of tartar-emetic into the rectum. A case is related by Dr. Roe of New York where this treatment proved successful. Fifteen grains in half a gallon of water excited free vomiting, and ten grains more renewed it. Care was taken to insure the discharge of the whole tartar-emetic by a subsequent purgative injection.

The last method for removing opium from the stomach is a desperate one, which can only be recommended when emetics by the mouth have utterly failed, and when a stomach-pump or Mr. Bryce's substitute, cannot be procured. It is the injection of an emetic into the veins. Tartar-emetic answers best for this purpose, and its effect is almost certain. A grain is the dose. While injecting it, care must be taken by the operator not to introduce air into the vein.

The next object in conducting the treatment of poisoning with opium is to keep the patient constantly roused. This alone is sufficient when the dose is not large, and the poison has been discharged by vomiting; and in every case it forms, next to the evacuation of the stomach, the most important of the treatment.

The best method of keeping the patient roused is to drag him up