SECT. XXVIII.—THE GENERAL TREATMENT OF THOSE WHO HAVE TAKEN ANY SORT OF DELETERIOUS SUBSTANCE.
If any persons have already taken some deadly poison with the intention of despatching themselves, such as often happens in life, or from the wicked design of others, if it be obvious to us what substance has been taken, we can straightway apply the suitable remedy, as will be described in the account of them. But if the medicine is unknown to us, we must have recourse immediately to such things as are generally applicable to those who have taken any poison whatever; for to wait until the consequent symptoms have come on, is to render the case hopeless, since owing to the remedies being too long of being applied such symptoms can hardly be removed: wherefore, without delay, we must give warm oil by itself or with water, and force them to vomit, or if oil is not at hand, butter with hot water may be given, or a decoction of mallows, or of linseed, or of spelt, or of fenugreek, or of nettle seed. For these things will not only evacuate by vomiting, but will loosen the belly and counteract the bad effects of the poisons, by blunting their acrimony; and more especially oil will do this, as you may ascertain clearly from the following consideration. For if you wish to produce ulceration of the skin by means of cantharides, quicklime, or some such acrid substance, and the body has been previously rubbed with oil, no ulcers will take place, and neither also can you astringe the body if previously rubbed with oil. Besides, vomiting is not only useful by evacuating the offending matter, but by showing the poison which had been taken from its smell, particles, or colour. For by its smell and bitterness poppy-juice is known; by their colour, ceruse and gypsum; by their coagula, milk and fresh blood; by their heavy smell and quality, the sea-hare and toad: so that by these means we are enabled to have recourse to the remedies which are suitable to each. With the oil may be mixed the decoction of mallows, or the grease of geese, or broth prepared from fat flesh or fowls, or the cinders of wood. Natron also triturated with hydromel, much old wine, and those things which are prepared from fat or butter are efficacious. Having evacuated the contents of the stomach by emetics, we must bring away whatever had passed into the intestines by a stimulant clyster. After these things, we are to give milk to drink, for whatever is noxious and deleterious will be readily changed by it. We must also give those medicines which are generally applicable to all such cases, among which are the Lemnian vermilion, southernwood, agaric, hedge-mustard, the root of eryngo, the seed of parsnip or of calamint, the Celtic nard, castor, the inner part of green fennel-giant, the flowers of nerium (called also rhododendron and rhododaphon), the juice of leeks, laserwort or the juice thereof, sagapene, opoponax, the juice and root of hog’s fennel, the long birthwort, the seed of wild rue, the leaves of that species of cestrum, called betony; of each of these a drachm may be taken in wine. The decoction of poley and liquid pitch in a linctus is also efficacious, and the aforesaid antidotes are excellent remedies, especially the theriac from vipers. But they have not the same power when taken after as before the poisonous substances, for a dose which would have been sufficient, if administered beforehand, to prevent any bad consequences, must be given in a fourfold or fivefold quantity, in order to prove effectual when administered afterwards, and that too not once, but twice a day. For such is the opinion of the celebrated Galen.
Commentary. Except the last two sentences the whole of this section is copied from Dioscorides. Celsus’ directions, so far as they go, are excellent: “Commodissimum est tamen, ubi primum sensit aliquis, protinus oleo multo epoto vomere: deinde, ubi præcordia exhausit, bibere antidotum; si id non est, vel merum vinum.” The directions given by Aëtius are to the same purpose as our author’s, but somewhat fuller. He is particularly to be commended for the precision with which he lays down the rules of treatment, when any organ happens to be affected in an especial manner. Thus, if the poison attack the bladder, he directs us to put the patient into a hip-bath of oil or water, in which fenugreek, linseed, mallows, or some such emollient herbs have been, boiled and to give him to drink the decoction of some vegetable diuretic, such as parsley, fennel, or spikenard. If the bladder be corroded he directs us to give the seed of cucumber in diluted sweet wine. In the same manner when the intestines are corroded the same seed is to be given, and all heating articles are to be abstained from. When the poison is determined to the skin, he recommends the hip-bath of oil or water, friction with warm oil, and the like, evidently with the intention of evacuating it from the pores of the skin. Food of easy digestion, soups with honey, tender fishes, and the like are to be given. When the head is particularly affected he directs us to evacuate the bowels with a clyster of linseed, marshmallows, and a decoction of the root of the wild cucumber, after which sternutatories and odoriferous things are to be applied to the nose. Like our author, he strongly commends Lemnian earth with wine as an excellent and speedy emetic. This remedy is also mentioned by Avicenna. Galen assures us that he found it an excellent emetic in various cases of poisoning. (Simpl. ix.) It consists principally of silica, alumina, and oxyde of iron.
Avicenna directs us to give immediately as an emetic, oil of sesame or olive oil, impregnated if possible with the virtues of dill, and afterwards to use demulcents, such as the decoction of linseed, melted butter and milk. These emetics are to be followed by clysters, provided the mischief has spread downwards. If the disorder continue, another emetic is to be given, and draughts of milk repeated. When, after the emetic, inflammation supervenes, he directs us to give snow-water, or oil of roses, and to promote vomiting with them. When the poison is ascertained to be of an inflammatory nature the parts affected are to be cooled with camphor, rose-water, or that of coriander; or these things are to be congealed in snow and applied over the vital organs. If the poison is ascertained to be of a sharp penetrating nature, medicines are to be given to blunt its acrimony, such as milk, almond oil, melted butter, &c. Bloodletting, if indicated, is to be performed. When the poison is known to be of a stupefying nature, garlic is to be given, or the theriac and assafœtida in undiluted wine. When it is particularly deleterious, the cure is to be effected by means of the mithridate, theriac, musk, and other aromatics. He inculcates the necessity of preventing sleep and of rousing by every possible means. The patient is to be covered with aromatic cloths, the pit of his stomach is to be rubbed, his face is to be fanned, his hair pulled, and in short, everything is to be done to prevent him from sinking into a state of stupor.
Haly Abbas recommends the same plan of treatment. When the poison is discharged he recommends citrons, plums, and the like, as restoratives. Rhases gives the following directions: First, he says, produce vomiting with oil and water; then give food of a nauseating nature to continue this operation; if the bowels are inflamed give snow-water and rose-oil, and afterwards provoke vomiting once more: administer the theriac, rub the hands and feet, and when the poison appears to have descended to the intestines give clysters. (Contin. l. c.) Rhases and other of the Arabian authorities recommend the bezoar stone as an antidote for poisons.