Section IV.—Of the Treatment of Poisoning with Antimony.
The treatment of poisoning with tartar-emetic is simple. If the poison be not already discharged, large draughts of warm water should be given and the throat tickled, to bring on vomiting. At the same time some vegetable decoction should be prepared, which possesses the power of decomposing the poison; and none is better or more likely to be at hand than a decoction of cinchona-bark, particularly yellow-bark. The tincture is also a good form for giving this antidote. The administration of bark has been found useful even after vomiting had continued for some length of time, probably because a part of the poison nevertheless remained undischarged. Before the decoction is ready, it is useful to administer the bark in powder. It is alleged, however, by M. Toulmouche that decoction of cinchona is not nearly so serviceable as infusion of galls, and that powder of galls is better still.[[1161]] When there is reason to believe that the patient has vomited enough, and that a sufficient quantity of the antidote has been taken, opium is evidently indicated and has been found useful; but venesection may be previously necessary if the signs of inflammation in the stomach are obstinate.
The following case related by M. Serres was probably cured by cinchona. At all events, the effect of the antidote was striking. A man purchased half a drachm in divided doses at different shops, and swallowed the whole in a cup of coffee. Very soon afterwards he was attacked with burning pain in the stomach, convulsive tremors, and impaired sensibility,—afterwards with cold clamminess of the skin, hiccup, and some swelling of the epigastrium, but not with vomiting. Decoction of cinchona was given freely. From the first moment almost of its administration he felt relief, and began to sweat and purge. Next morning, however, he vomited, and for some days there were evident signs of slight inflammation in the stomach; nay, for a month afterwards he had occasional pricking pains in that region; but he eventually recovered.[[1162]] Another and more pointed case has been related by Dr. Sauveton of Lyons. A lady swallowed by mistake for whey a solution of sixty grains of tartar emetic. In ten minutes she was seen by her physician, and at this time vomiting had not commenced. Tincture of bark was immediately given in large doses. No unpleasant symptom occurred except nausea and slight colic.[[1163]]
Orfila considers that the diuretic plan of treatment recommended by him for arsenic [p. [288]] is equally applicable in the case of antimony. Having ascertained that a grain and a half of tartar-emetic applied to a wound constantly killed dogs in a period varying from seventeen to thirty-six hours, if no treatment was employed,—he administered to them in this way a dose varying from a grain and a half to three grains, and by then giving diuretics effected a cure in four out of five instances.[[1164]]
Chloride of Antimony.
The chloride of antimony [sesquichloride, muriate, or butter of antimony] being now put to little use and seldom seen except as an intermediate product obtained in the preparation of other compounds of antimony, it is rarely met with as the cause of poisoning, and therefore scarcely deserves notice here, were it not that its effects differ widely from those of tartar-emetic and other antimonials.
It is easily known by the characters mentioned above. It has not yet been made the subject of investigation by experiments on the lower animals. Mr. Taylor has collected three cases of poisoning with it, which show that it is a powerful corrosive and irritant, and that its effects, as hitherto witnessed, seem to depend entirely on this action. In one instance, that of a boy, twelve years old, who swallowed four or five drachms of the solution by mistake for ginger-beer, the symptoms were vomiting in half an hour, then faintness and extreme feebleness, and next day heat in the mouth and throat, difficulty in swallowing, slight abrasions of the lining membrane of the mouth, and general fever; but he got quite well in eight days. In the case of another boy, ten years old, who got about the same quantity by mistake for antimonial wine, there was an immediate sense of choking and inability to speak, then vomiting and pain in the throat, next a general state of collapse, with dilated pupils and a tendency to stupor, and on the subsequent day bright scarlet patches on the throat, with difficulty of swallowing. This patient also recovered completely in a few days. The third was the case of a surgeon who took intentionally between two and three fluid ounces, and was found in an hour by his medical attendant in a state of great prostration, and affected with severe efforts to vomit, violent griping, and urgent tenesmus. Reaction soon ensued, the pain abated, and the pulse rose to 120; a strong tendency to doze succeeded; and in ten hours and a half he expired. The whole inside of the alimentary canal, from the mouth to the jejunum, was black as if charred; the mucous membrane seemed to have been removed along the whole of this extent of the canal; and the submucous and peritoneal coats were so soft as to be easily torn with the finger.[[1165]]
CHAPTER XVII.
OF POISONING WITH TIN, SILVER, GOLD, BISMUTH, CHROME, ZINC, AND IRON.
Several other metallic compounds produce effects analogous to those of the preparations of arsenic, copper, mercury, and antimony. But they may be passed over shortly; because they are little known as poisons, and it is therefore only necessary that their leading properties be mentioned. They are the compounds of tin, silver, gold, bismuth, chrome, zinc, and iron.