Treatment by Antidotes or otherwise of Cases of Poisoning

Appendix.

§ 912. All medical men in practice are liable to be summoned hastily to cases of poisoning. In such emergencies not a moment is to be lost, for valuable lives have ere this been sacrificed simply from the delay caused by searching for medicines and instruments, and visiting the patient unprovided with suitable remedies. Hence it is far the safest plan for every medical man to provide himself with an “antidote bag,” which, to be complete, should be furnished with the following requisites:—

I. Instruments:—

(1.) A stomach-pump or tube, with proper mouth gags.

(2.) A hypodermic syringe.

(3.) An ordinary bleeding lancet.

(4.) A glass-syringe with suitable canula, which may, in case of necessity, be used for transfusion.

(5.) Bistoury, forceps and tubes suitable for performing tracheotomy.

A small battery (interrupted current).

II. Emetics:—

(1.) Sulphate of zinc.

(2.) Apomorphine.

(3.) Mustard.

(4.) Ipecacuanha.

The sulphate of zinc may either be carried in 30-grain powders or in the ordinary solid crystalline state, together with a little measure made out of a small pill-box which, when exactly full, is found to contain from 25 to 30 grains.

A still more convenient form is that of the compressed tablets, sold as a speciality by one or more firms. The same remarks apply to ipecacuanha.

The apomorphine hydrochlorate should be in solution, a suitable strength is 2 per cent.; a few drops of this substance, injected hypodermically, will cause vomiting in a few minutes.

Besides the above list, the bag should be furnished with a selection of the so-called antidotes.

III. Antidotes:—

(a.) Chemicals neutralising the poison.

Acetic acid and calcined magnesia.

(b.) Precipitants of alkaloids.

Tannin—A solution of iodine in potassic iodide.

(c.) Narcotics, or anæsthetics, for the treatment of the tetanic class.

Chloral—chloroform.

(d.) Substances which act physiologically.

French oil of turpentine.—A solution of atropine sulphate for hypodermic use (strength ·8 per cent.); hypodermic dose from 5 to 6 drops.

Solution of nitrate of pilocarpine (strength 5 per cent.); dose, 10 drops or more.

Muscarine—a solution in water (strength 5 per cent.); dose, 10 drops.

Morphine meconate in solution (strength 10 per cent.); dose, from 5 drops.

A solution of nitrate of strychnine (strength 2 per cent.); hypodermic dose, from 2 to 3 drops.

Potassium Permanganate in crystals.

To these may be added a bottle of Wyeth’s dialysed iron for use in arsenic poisoning, a flask of brandy, some chloric ether, aromatic spirits of ammonia, and some really good extract of coffee.