Strychnine poisoning is comparatively rare, except when this substance is given with suicidal or murderous intent. Water should be given, immediately followed by an emetic. A mass of crystals of permanganate of potash as big as a pea may be administered in a glass of water, if this substance be at hand. After the poison has been absorbed nothing is usually of any avail if the amount was originally sufficient to produce death.
One of the commonest forms of poisoning is from opium in the form of morphine, paregoric or laudanum. When this happens the stomach should be washed out by water frequently, even where the drug was administered hypodermatically. This is best accomplished by causing vomiting by warm water to which a small amount of mustard has been added. The patient should be given strong coffee or tea at frequent intervals, and artificial respiration should be practiced. Where it is possible to obtain it, permanganate of potash in a watery solution should be given, enough of the chemical being used to make the water a deep purple color; this may be frequently repeated, as the substance is not poisonous in ordinary doses, and destroys morphine and other alkaloids of opium very rapidly.
It should never be forgotten that infants and children are poisoned by comparatively very small doses of opium, and consequently nothing containing any derivative of this substance should be given them except on the advice of a competent doctor.
Many soothing syrups advertised for the relief of the minor ailments of children contain opium, and there can be no doubt that many deaths have occurred as a consequence of taking such nostrums.
Mushroom poisoning in this country is relatively rare, but there are quite a number of popular notions on this subject that are totally incorrect, chief among which is the idea that there is a difference between mushrooms and toad-stools, the former being generally regarded as edible, and the latter poisonous. As a matter of fact, those conversant with this subject make no distinction between the two, using the terms toad-stool and mushroom as interchangeable. It is likewise a common error to suppose that we possess any tests by which the poisonous toad-stools can be told from those that are wholesome. Although a skilled student of the subject can almost at a glance determine which are poisonous and which are not, it is hazardous in the extreme to consume those selected by one who is inexperienced. As a matter of fact, for all practicable purposes, there is only one species that is generally eaten,—the Agaricus campestris, or meadow mushroom. This grows for the most part in open fields, and in many parts of the world may be gathered in great number throughout the warmer seasons immediately following rains. This mushroom has also the great advantage that it is the only one of the edible species that can be cultivated.
Just as we have only one common mushroom that is ordinarily eaten, there is only one common species of these plants that is highly dangerous,—the Amanita phalloides, which contains one of the most deadly poisons known—and one for which we possess no adequate antidote. This mushroom is very common, being frequently seen along the roadside, and at the edges of fields; it also grows in forests, and is occasionally encountered in treeless areas.
It presents a rather attractive appearance, being rather large, and having a glistening white cap with a long stem, around which there may always be seen a distinct collar; on carefully removing the soil from around its roots, it will be seen that its stem is surrounded just below the surface of the earth by a sheath-like structure, the so-called “death-cup,” which, together with the peculiarities already mentioned, clearly stamp this mushroom as being one of the most deadly of all known natural objects. In addition to the rather inviting appearance of this toad-stool, its flavor is agreeable, thus in every way insidiously inviting, it would seem, the unwary to their doom. Less common than the species just considered is another closely related fungus known as the Amanita muscarius, or fly-agaric; this handsome mushroom presents the same peculiarities of structure exhibited by the Amanita phalloides, but differs from it in the fact that the tip of its cap is scaly, and is of a reddish-yellow color. The fly-agaric is quite as poisonous as its more common relative, and is equally to be shunned. The reader should be warned that even handling either of the fungi just considered may result in poisonous symptoms—probably as a consequence of multitudes of the tiny spores of the plants being carried into the nose and mouth by the air.
Some hours after eating the Amanitas, the patient is taken with vomiting, diarrhœa, cramps, and extreme prostration; in children, convulsions may occur. Most unfortunately evidences of this poisoning do not usually develop until some hours after eating it. As a consequence, a considerable amount of the poison has usually been absorbed into the body before the victim is aware that anything is wrong, and it, therefore, becomes impossible, as a rule, to greatly help matters by attempting to remove the offending material from the stomach by emetics. Notwithstanding this it would be proper to administer warm water, into which a small amount of mustard had been stirred, in order to assist nature by washing out of the stomach whatever portions of the fungus might remain. When exhaustion begins to appear, it should be combated with doses of aromatic spirits of ammonia, and by the external application of heat. As it is believed that atropine possesses some antidotal powers to the poison of the Amanitas, this substance should be injected hypodermatically in the usual dose as quickly as possible, and an experienced physician should be called at once.
Ivy Poisoning from Touch.—One of the two species of Rhus, is exceedingly common in all portions of the United States, producing a severe inflammation of the skin when handled, or even in some persons by merely being near the plants or in the smoke of a fire where they are burning. There are two varieties of the Rhus toxicodendron, one being the shrub commonly called poison oak, and the other a climbing vine generally known by the name of poison ivy. The Rhus venenata grows in swampy localities all over the United States, and is known as poison-sumac, swamp dog-wood, poison-elder, and poison dog-wood. About twenty-four to forty-eight hours after the exposure, the skin begins to itch, and this is shortly followed by an inflammation accompanied by the formation of numerous small blisters, and still later by scaling. It should not be forgotten that the berries and other portions of these plants are poisonous when taken internally, giving rise under such circumstances to vertigo, faintness, dilation of the pupils, trembling, confusion of the senses, and, in some instances, convulsions. Should it be discovered that anyone has been exposed to poisoning by these plants, the skin should be washed as quickly as is possible with alcohol, or some substance like whisky that contains it; where this cannot be obtained, hot water and soap should be liberally applied—the object, in either case, being the removal of as much of the poison as is possible. After the irritation of the skin has begun, the parts may be bathed in a one per cent. solution of carbolic acid, to be repeated every few hours, as the necessities of the case may demand. Lead-water is also frequently used with benefit, lime-water also appears to be of use, but the various powders and salves sold in stores rarely help the patient much. The best thing after all is soap and water as hot as it can be borne; and ordinarily the itching and inflammation will disappear in four or five days, followed by scaling.