Poisons.—In all cases of poisoning, at once note the position and surroundings of the patient, and whether bottles likely to have contained poison are at hand. Send for the nearest doctor, and proceed immediately to get the poison out of the stomach by encouraging vomiting. Vomiting is often one of the first and most important signs of poisoning, and then only requires fostering by large draughts of warm water. If vomiting is not present, at once administer an emetic, such as sulphate of zinc in 20-30 gr. doses, 2 tablespoonfuls ipecacuanha wine mixed with warm water. In the absence of these, resort to mustard and water, a teaspoonful or two in warm water frequently repeated, or common salt and water may be used; vomiting may also be excited by tickling the back of the throat, and by freely drinking hot greasy water. A stomach pump must only be used by a surgeon; but a safe substitute, if the patient is conscious, is a piece of rubber tubing, about 3 yd. long and ½ in. diameter. Let the patient swallow about 2 ft. of this, then hold the free end of the tube above his head (Fig. 125) and pour down through a funnel 1-2 pints warm water, which will go direct into the stomach. By lowering the free end (Fig. 126) the stomach empties itself readily. By frequent repetition the cavity of the stomach is completely washed out.
125. 126. Stomach-tube.
Try to ascertain what the poison is, and proceed to administer antidotes. Most poisons may be grouped under two classes—narcotic and irritant; the former being mainly organic (vegetable) substances, and the latter chiefly minerals. In narcotic poisoning, vomiting must be induced or the stomach emptied in some other way, and means must be taken to prevent sleep ensuing, by walking the patient about, slapping with wet towels, dashing cold water in the face, &c.; give strong black coffee to drink (or with an enema); put icy cold compresses on the head, and mustard plaisters on the stomach and calves of the legs. In irritant poisoning, the poison itself is pretty sure to cause vomiting, which then need not be encouraged. To protect the stomach and gullet from the corrosive action of irritant poisons, bland and oily fluids, such as salad oil, egg-white, milk, flour and water, should be freely administered.
The following summary of poisons and antidotes will be found useful:—
Narcotic Poisons.
Irritant Poisons.
| Acid—carbolic, creosote. | emetics; lime-water; salad oil; coffee. |
| Acid—oxalic, potassium oxalate, salt of sorrel, salt of lemon. | water containing chalk or whiting, but not ammonia, potash, or soda. |
| Acids—acetic, hydrochloric, nitric, sulphuric; spirit of salt. | abundance of water containing chalk, magnesia, sal-volatile, washing soda, or whiting; egg-white, milk, thick gruel. |
| Alkalies—ammonia, potash, soda. | water containing lemon-juice or vinegar; salad oil, milk, egg-white, gruel. |
| Antimony, tartar emetic | emetic if needed; plenty of strong coffee; egg-white, milk. |
| Arsenic, emerald green, fly paper | emetics; magnesia; warmth and friction; strong coffee; best antidote is moist peroxide of iron, which can be made by dissolving ½ oz. iron sulphate and ½ oz. potash carbonate (or ¾ oz. soda carbonate) separately in warm water and mixing, adding ¼ oz. magnesia— calcined if handy—dilute with ½ pint hot water, and drink very hot. |
| Bichromate of potash | emetics; magnesia, chalk, or whiting. |
| Blistering fluid | emetics; egg-white, barley water, gruel; not oil. |
| Bluestone | emetic if needed; milk, eggs, barley water, gruel. |
| Caustic, nitrate of silver | abundance of salt in water or milk, egg-white, barley water. |
| Chloride of mercury, corrosive sublimate | emetic if needed; raw egg beaten up in milk, gruel, arrowroot; strong coffee. |
| Iodine | emetics; plenty of gruel, arrowroot or starch. |
| Phosphorus, matches, rat poison | emetics; 10 drops oil of turpentine, every ¼ hour in gruel or milk with a little magnesia; egg-white, barley water. |
| Pyrogallol | emetics. |
| Sugar of lead, paint | emetics, zinc sulphate best; ½ oz. Epsom salts in water; egg-white, milk, barley water. |
| Turpentine, furniture polish | emetics; milk, egg-white, barley water. |
| White precipitate | emetics; coffee; egg-white beaten up in water, barley water, arrowroot. |
Sprains.—A sprain is a sudden forcible stretching of the tendons or ligaments, or both combined, of a joint, and is always accompanied by most acute pain, and generally followed by rapid swelling. It is always tedious and troublesome, and hence often leads to more serious results; in all but very slight cases, a surgeon should be seen. Meantime give the injured part perfect rest, keep it in an elevated position, and apply cold water continuously, or immerse in water as hot as can be possibly borne, and after keeping it there for ¼ hour, frequently apply hot bran (or oatmeal and vinegar) poultices. As an embrocation, put ¼ lb. camphor in ½ lb. methylated spirits of wine; when dissolved, add 1 oz. oil of origanum, and rub the place night and morning, or use Elliman’s embrocation. In many cases of supposed severe sprain, some of the bones forming the injured joint are broken, therefore it is wise to treat these cases by the rules for broken bones before removing the patient.