With regard to the use of Antidotes, it has been already stated how little they are to be depended upon; in certain cases, however, we are bound to acknowledge their power, but they should be very rarely trusted, unless subsequent to, or in conjunction with, the operation of an emetic; in many cases the effects of this latter remedy may be promoted by the ingestion of liquids holding the particular antidote in solution, a practice which offers the double advantage of accelerating the elimination of the poison, and at the same time of decomposing any which may remain. Orfila has fully established the fact of Albumen being a counter-poison to Corrosive Sublimate; vomiting may therefore be very judiciously promoted in cases of such poisoning by water holding the white of egg in solution; with equal effect, where Verdegris has been swallowed, sugared water may be used as a diluent to encourage emesis; and Muriate of Soda in solution will be found the most efficient antidote to Nitrate of Silver; and Sulphate of Magnesia to Acetate of Lead. Where an emetic salt, like Tartarized Antimony, has been taken, copious dilution with common water will in general so provoke vomiting, as to render it its own antidote; but it may be useful to remember, that the Infusion of Galls, and according to Berthollet, the Decoctions of Bark, at the temperature of from 30° to 40° Fah. have the power of decomposing it; while Orfila considers milk the most efficient counter-poison to the Sulphate of Zinc.
Having ejected from the stomach all the poisonous matter we can by vomiting, and attempted to decompose what remains, we are to pursue such measures as may be calculated to prevent the absorption of the poison into the circulation; it has been already observed that on this account nauseating emetics should be avoided; the reader is now requested to refer to our exposé of the celebrated doctrine of Majendie, (page 86, note) and he will see that Venesection proves one of the most powerful means of exciting the function of absorption; hence in poisoning by arsenic, such an expedient should never be recommended,[[231]] while a particle of that substance remains in the body; where Corrosive Sublimate has been swallowed, the same precaution is unnecessary. The last indication which remains to be fulfilled is—
3. To anticipate the occurrence of the Consecutive Phœnomena, and to combat them by appropriate treatment.
This is to be conducted on the general principles of Therapeutics; the treatment must necessarily vary in each particular case. Where the exhaustion of nervous energy is to be feared, as after poisoning by Prussic Acid, ammonia, and other diffusible stimulants, together with external warmth, will furnish the best resource; for the same reason Venesection should be performed with great caution and judgment after a narcotic poison. Where, on the other hand, inflammatory action is to be anticipated, it is unnecessary to detail the plan of treatment which may be adopted with the greatest chance of success. In cases where the nervous system is stupified, the symptoms may be combated by vegetable acids, infusion of coffee, &c. but where it is in a state of præternatural excitement, recourse must be had to opiates.
ESCHAROTICS:[[232]]
Substances whose application to the animal solids, erodes, or decomposes them.
The operation of these bodies may, in general, be considered chemical; for having destroyed the life of the part to which they are applied, they cause, as if by a species of resulting affinity, the elements of the animal matter to enter into a new state of combination; this is well exemplified in the action of caustic potass, where the nascent elements thus disengaged by the decomposition of the animal substance, reunite in proportions to generate an oily matter, which may be observed to form a film over the ulcerated surface, while the excess of nitrogen and hydrogen constitute ammonia, which is disengaged during the action of the caustic; and may be rendered sensible by inverting over the surface, a small jar moistened with muriatic acid, when the fumes of Muriate of Ammonia become visible.[[233]]
Their surgical value consists in their power to remove excrescencies, to establish an ulcer, or to convert an ulcerated surface into a simple sore.
IV. OF MECHANICAL REMEDIES.
This subdivision includes those classes of remedies, whose operation depends entirely upon mechanical principles; and we must agree with Dr. Murray in considering them as the least important of all the articles which we have enumerated, and which cannot therefore constitute objects of elaborate inquiry.