First Aid Rule 1.—Rid patient of poison. Cause repeated vomiting by giving three or four glasses of warm water, each containing half a level teaspoonful of mustard. Put finger down throat to assist. Empty bowels by giving warm injection of soapsuds and water by fountain syringe.
Rule 2.—Support heart and rally nerve force. Give teaspoonful of whisky in tablespoonful of hot water every half hour, as needed. Put hot-water bottles at feet and about body.
Conditions, Etc.—Bacterial poisons, constituting irritants of the stomach and bowels, are found in certain mussels, oysters from artificial beds, eels out of stagnant ditches—as well as the uncooked blood of the common river eel—certain fish at all times, certain fish when spawning, putrefied fish, fermented canned fish, sausages of which the ingredients have putrefied, putrefied meat, imperfectly cured bacon, putrefied cheese, milk improperly handled and not cooled before being transported, ice cream which fermented before freezing, or ice cream containing putrid gelatin, and mouldy corn meal and the bread made from it.
These poisons are called toxins, or toxalbumins, or bacterial proteids. They are no longer called ptomaines, because many ptomaines are not poisonous. They are formed within the cells of the bacteria, and result from the combination of certain constituents of the food material that nourishes the bacteria, in some way not quite understood. Some decomposition must have taken place in the food before it can furnish to the bacteria the nourishment it needs. If this has happened, the bacteria multiply rapidly, and the toxins that are formed are taken up by the lymphatics and carried away from the tissues as fast as possible. But so great is their virulence that they act on several vital organs before they can be antagonized by the natural elements of the blood.
Symptoms.—The symptoms are much the same in all the cases of bacterial poisoning mentioned. Sudden and violent vomiting and diarrhea appear a few hours after eating the spoiled food, or may be delayed. There may be headache, colic, and cramps in the muscles. Marked prostration and weak pulse with cold hands and feet are characteristic. The appearance of skin eruptions is not uncommon. The occurrence of such symptoms in several persons, some hours after partaking of the same food, is sufficient to warrant one in pronouncing the trouble food poisoning.
Treatment.—The objects of treatment are to rid the patient of the poison, and to stimulate the heart and general circulation, and draw on the reserve nerve force. It is best to procure medical aid to wash out the stomach, but when this is impossible, the patient should be encouraged to swallow plenty of tepid water and then vomit it. If there is no natural inclination to do so, vomiting may be brought about by putting the finger in the back of the throat. The same process should be repeated a number of times, and the result will be almost as good as though a physician had used a stomach tube. A teaspoonful of salt or tablespoonful of mustard in the water will hasten its rejection. Then the bowels should likewise be emptied. If vomiting continues this will not be possible by means of drugs given by the mouth, although calomel may be retained given in half-grain tablets hourly to an adult, until the bowels begin to move, or till eight to ten tablets are taken. When vomiting is excessive, emptying of the bowels may be brought about quickly by giving warm injections of soapsuds into the bowel with a fountain syringe. Brandy or whisky in teaspoonful doses given in a tablespoonful of hot water at half-hour intervals should follow the emptying of the stomach and bowels, and the patient must be kept quiet. He must also be kept warm by means of hot-water bags and blankets.
INFECTED FOOD.—A frequent source of illness is infection by disease germs transmitted in food. The meat of animals slaughtered when sick with abscess, pneumonia, kidney disease, diarrhea, or anthrax (malignant pustule) carries disease germs and causes serious illness; so does the meat of animals killed after recent birth of their young, and probably having fever. Oysters may be contaminated with excrement from typhoid patients, and may then transmit the disease to those who eat them.
Milk from diseased animals, or contaminated with germs of typhoid fever, scarlet fever, tuberculosis, diphtheria, etc., is apt to cause the same disease in the human being who drinks it.
If such infected food is eaten raw, the diseases with which it is contaminated may be transmitted. If subjected to cooking at a temperature of at least the boiling point, comparative safety is secured; but the toxins accompanying the disease germs in the infected food are not as a rule rendered harmless. Treatment must be directed to each disease thus transmitted.
Poisoning resulting from eating canned meats has sometimes been attributed to supposed traces of tin, zinc, or solder, which have become dissolved in the fluids of the meat, but in the vast majority of cases such poisoning is due to toxins accompanying the germs of putrefaction, the meats having been unfit for canning at the outset. In such cases the symptoms are the same as in other food poisoning, and the treatment must be such as is elsewhere directed (see pp. [147] and [149]).