Chapter LII: Appendix (1)

Treatment by Antidotes or otherwise of Cases of Poisoning.

§ 912. All medical men in practice are liable to be summoned hastily to cases of poisoning. In such emergencies not a moment is to be lost, for valuable lives have ere this been sacrificed simply from the delay caused by searching for medicines and instruments, and visiting the patient unprovided with suitable remedies. Hence it is far the safest plan for every medical man to provide himself with an “_antidote bag_,” which, to be complete, should be furnished with the following requisites:--

I. INSTRUMENTS:--

(1.) A =stomach-pump= or =tube=,[990] with proper mouth gags.

[990] The stomach-tube is simply a tube of india-rubber, from 6 to 8 feet in length, one end of which should be a little stiff, and have a solid rounded extremity pierced with two lateral oval holes--catheter-like; but, on an emergency, any india-rubber tube of a suitable length will do. It is used by passing the proper end gently down the throat into the stomach; if the patient is insensible, or, as in some determined suicides, obstinate, the jaws must be forcibly opened by the handle of a spoon, and some solid substance placed between the teeth so as to give sufficient room for the entry of the tube. If the tube is now passed in the median line well into the grasp of the pharynx, it is actually drawn down into the stomach by the pharyngeal muscles, so that the operator has, as it were, only to “pay out” a sufficient quantity of the tubing. Holding the tube in a perpendicular position, it may then be filled with water by means of a small funnel. When full, the end must be pinched and brought down to the ground to deliver in a basin; it will then act as a syphon and the contents of the stomach will be syphoned off. The tube is elevated again above the body, and the stomach filled with water; this syphoned off, and the process repeated. Coffee, also, or antidotes may be conveniently introduced. If the recumbent position is necessary, the patient must, of course, be placed on a bed or table, in order that there should be sufficient fall for the syphon.

(2.) A =hypodermic syringe=.

(3.) An ordinary bleeding =lancet=.

(4.) A =glass-syringe= with suitable canula, which may, in case of necessity, be used for transfusion.

(5.) =Bistoury=, =forceps= and =tubes= suitable for performing =tracheotomy=.

A small =battery= (interrupted current).

II. EMETICS:--

(1.) _Sulphate of zinc._

(2.) _Apomorphine._

(3.) _Mustard._

(4.) _Ipecacuanha._

The _sulphate of zinc_ may either be carried in 30-grain powders or in the ordinary solid crystalline state, together with a little measure made out of a small pill-box which, when exactly full, is found to contain from 25 to 30 grains.

A still more convenient form is that of the compressed tablets, sold as a speciality by one or more firms. The same remarks apply to _ipecacuanha._

The _apomorphine hydrochlorate_ should be in solution, a suitable strength is 2 per cent.; a few drops of this substance, injected hypodermically, will cause vomiting in a few minutes.

Besides the above list, the bag should be furnished with a selection of the so-called antidotes.

III. ANTIDOTES:--

(_a._) _Chemicals neutralising the poison._

=Acetic acid= and =calcined magnesia=.

(_b._) _Precipitants of alkaloids._

=Tannin=--A solution of =iodine in potassic iodide=.

(_c._) _Narcotics, or anæsthetics,_ for the treatment of the tetanic class.

=Chloral=--chloroform.

(_d._) _Substances which act physiologically._

=French oil of turpentine.=--A solution of =atropine sulphate= for hypodermic use (strength ·8 per cent.); hypodermic dose from 5 to 6 drops.

Solution of =nitrate of pilocarpine= (strength 5 per cent.); dose, 10 drops or more.

=Muscarine=--a solution in water (strength 5 per cent.); dose, 10 drops.

=Morphine meconate= in solution (strength 10 per cent.); dose, from 5 drops.

A solution of =nitrate of strychnine= (strength 2 per cent.); hypodermic dose, from 2 to 3 drops.

=Potassium Permanganate= in crystals.

To these may be added a bottle of =Wyeth’s dialysed iron= for use in arsenic poisoning, a flask of =brandy=, some =chloric ether=, =aromatic spirits of ammonia=, and some really good =extract of coffee=.

TREATMENT.

§ 913. ACID CARBOLIC.

Use the =stomach-tube= or =pump=, unless there is great destruction of the mucous membrane. In the latter case, excite vomiting by injecting subcutaneously from 5 to 6 drops of the =apomorphine= solution; or give an emetic of =zinc sulphate=, =ipecacuanha=, or =mustard=.

The stomach may, by the aid of the tube, be washed out with a weak alkaline solution of =soda=; =albumen= may also be given, and such stimulants as =brandy= and =water=, =chloric ether=, and =aromatic spirits of ammonia=.

It is important to apply warmth to the extremities.

Inject subcutaneously from 2 to 3 drops of the =atropine hypodermic= solution.

=Nitrite of amyl= by inhalation is said to have been useful.

In desperate cases =bleeding=, followed by =transfusion=, is to be considered.

ACIDS--MINERAL, including SULPHURIC, NITRIC, HYDROCHLORIC, GLACIAL ACETIC ACIDS.

=Stomach-tube= or =pump=, inadmissible.

Neutralise by calcined =magnesia=, =lime=, =chalk=, or =soda,= but not with potash, if there is choice.

If no neutralising agent can be immediately procured, then dilute with plenty of water.

Other remedies are--=oil=, =milk=, =white of eggs=, =gruel=.

It is often recommended in such cases to administer hypodermically a little =morphine=.

ACONITE--ACONITINE.

Use at once the =stomach-tube= or =pump=, or give emetics of =sulphate of zinc=, or hypodermic solution of =apomorphine=.

Keep the patient in the recumbent posture.

After the stomach has been emptied, give =atropine=, either by hypodermic injection or by the mouth, say 4 drops of the P.B. solution; failing atropine, 20 drops of the tincture of =belladonna=. The dose may be repeated more or less frequently according to the condition of the patient.

If there is great tendency to heart-syncope, tincture of =digitalis= in ½-drachm doses by the mouth, or in hypodermic doses of from 10 drops upwards.

Apply a mustard poultice to the pericardium; aid vomiting and elimination of the poison by plenty of water, to which may be added brandy or any form of alcohol.

Inhalations of =nitrite of amyl= are said to have been useful. If the breathing stops, try =artificial respiration=.

ALCOHOL.

Empty the stomach by the =tube= or =pump=, and then wash it out with warm coffee; if the stomach-tube is not at hand, then empty the stomach by hypodermic injection of 5 drops of =apomorphine=, or by a =mustard= emetic, or =sulphate of zinc=. Keep the body very warm, but the cold =douche= may be applied to the head.

Endeavours should be made to rouse the patient, if insensible, by shaking, shouting at him, &c.

Inhalations of =amyl nitrite= are said to be useful.

ALKALIES--AMMONIA--POTASH--SODA.--=Stomach-pump= or =tube= not to be used.

Vomiting nearly always present, or may be produced by administering plenty of lukewarm water; after which give =dilute vinegar=, or the juice of =lemons= or =oranges=; =olive oil=, the =white of eggs=, =barley water=, =arrowroot=,= and always plenty of =water= may be administered.

There may be œdema of the glottis, especially if ammonia has been taken. In such a case, and death threatening from suffocation, perform =tracheotomy=. In poisoning by ammonia, with croupous respiration, keep the room warm, and fill it with steam by means of a bronchitis kettle.

Relieve pain by small doses of =morphine= injected subcutaneously.

AMMONIA.--See ALKALIES.

ANTIARIN.--See DIGITALIS.

ANTIMONY--TARTAR-EMETIC--ANTIMONIAL WINE, &C.

The stomach will generally have been emptied by vomiting. In those rare cases in which this does not take place, use the =stomach-pump= or =tube=, or give hypodermic injection of =apomorphine=.

Follow this with doses of =strong tea=, or give half-a-drachm of =tannin= or =gallic acid= in warm water.

Give also demulcent drinks, and stimulants in small doses, frequently repeated.

Keep the patient very warm by hot blankets and wraps.

The interrupted galvanic current to the heart may be useful.

APOCYNIN.--See DIGITALIS.

ARSENIC.

Use the =stomach-pump= or =tube=, or empty stomach by emetics, such as hypodermic solution of =apomorphine=, or give =mustard= or =sulphate of zinc=. The stomach should then be washed out by large quantities of water, most conveniently administered by the pump or tube.

If the tube or pump is not at hand, then administer at once either =dialysed iron=, or the freshly-precipitated =hydrated oxide of iron=, obtained by precipitating the ordinary perchloride by means of carbonate of soda or ammonia, avoiding excess of the latter. If the operator has sufficient chemical knowledge to precipitate the iron with fair exactness, so that there is no great excess of ammonia, or of sodic carbonate, then filtration is unnecessary. In other cases, filter through a handkerchief.

=Oil=, =mucilaginous drinks=, the =white of eggs=, and, if faintness exists, small doses of =stimulants= may all be given.

If the skin is cold, warmth must be applied to the body by means of hot blankets, &c.

Pain may be relieved by =morphine=.

ATROPINE--BELLADONNA--TINCTURE OF BELLADONNA.

Empty the stomach by means of the =stomach-pump= or =tube=.

Give an enema of =coffee=.

Administer half a grain of =pilocarpine nitrate=; or, if that is not at hand, =morphine= or =opium= in suitable doses will act to a certain extent antagonistic to the poison.

A subcutaneous dose of =muscarine= may be administered instead of pilocarpine, but is not quite so good.

Hot water to the feet, alternate =douches= of cold and hot water are found useful.

If the respiration seems likely to stop, =artificial respiration= must be practised.

BELLADONNA.--See ATROPINE.

BENZENE.

If swallowed, then empty the stomach by =pump= or =tube=, or by the hypodermic injection of =apomorphine=; or give emetics, such as =zinc sulphate=, =mustard=, or =ipecacuanha=.

If the vapour has been _inhaled_, this is unnecessary.

Plenty of =fresh air=.

A subcutaneous dose of =atropine=, say 1-60th of a grain, or from 30 to 40 drops of =belladonna= tincture.

Alternate =douches= of hot and cold water to the chest, =artificial respiration=, if necessary. The heart to be maintained by mild interrupted shocks of the =battery= over the region of the heart.

BICHROMATE OF POTASH.--See CHROMIUM.

BRUCINE.--See STRYCHNINE.

CALABAR BEAN--PHYSOSTIGMINE.

Use =stomach-pump= or =tube=, or emetics, such as =sulphate of zinc=, =mustard=, or =ipecacuanha=; or, better still, hypodermic solution of =apomorphine=.

Give hypodermic doses of 1-60th grain =atropine= until the pupils dilate. This treatment seeming to fail, =chloral= in 10-grain doses, every quarter of an hour, has been recommended.

In certain cases =strychnine= has been used in hypodermic doses of 1-12th of a grain.

=Stimulants= and =artificial respiration= will probably be necessary in some cases.

CAMPHOR.

Use =stomach-pump= or =tube=, or empty the stomach by emetics.

Hypodermic injections of =brandy=, inhalations of =ether=, the alternate hot and cold =douche=, warmth to the extremities by hot blankets, &c., seem to be the best methods of treatment.

CANTHARIDES--CANTHARIDINE.

Use =stomach-pump= or =tube=, if the mucous membrane of the throat is not inflamed; or, administer hypodermic dose of =apomorphine=, or give emetics--=sulphate of zinc, mustard,= or =ipecacuanha=.

Allay pain with =morphine=. Give plenty of water and =demulcent drinks=.

CHLORAL.

Use =stomach-pump= or =tube=, and, when the stomach is emptied, introduce by the same means =warm coffee=, or give a hypodermic injection of =apomorphine=, or administer emetics of =sulphate of zinc=, or =mustard=, or =ipecacuanha.=

An =enema of coffee= will be useful.

Keep the limbs warm.

Administer hypodermically 2 or 3 drops of the solution of =strychnine= at intervals of from fifteen to twenty minutes.

Rouse the patient by various means, such as shouting, shaking, flapping the skin with a wet towel, &c.

Inhalations of =amyl nitrite= are recommended.

=Artificial respiration= may be necessary.

CHLORATE OF POTASH.

Use the same treatment as for =nitrate of potash= (_which see_, p. 696).

CHLORIDE OF ZINC.--See ZINC.

CHLOROFORM--(_Inhaled_).

Give plenty of =fresh air=, pull the tongue forward, and commence at once =artificial respiration=. If the heart has stopped, strike the chest two or three times very hard, over the region of the heart; this has been found occasionally to restore its beat. Apply the =battery=, but with a weak current only; one pole may be placed on the larynx, the other at the pit of the stomach.

Inhalations of =nitrite of amyl= are useful. The hot and cold =douche= may also be used.

CHLOROFORM--(_Swallowed_).

Empty the stomach by =pump= or =tube=, or by emetics, such as 5 drops of the hypodermic solution of =apomorphine=, or =sulphate of zinc=, or =mustard=.

Give an enema of =hot coffee=.

Administer large draughts of =water=, which may advantageously contain a little =sodic carbonate= in solution.

Attempt to rouse the patient. =Nitrite of amyl= inhalations, and, if necessary, =artificial respiration= may be used.

CHROMATE OF POTASH.--See CHROMIUM.

CHROMIC ACID.--See CHROMIUM.

CHROMIUM--BICHROMATE OF POTASH--CHROMATE OF POTASH--CHROMIC ACID.

Empty the stomach by =pump= or =tube=; administer a subcutaneous injection of =apomorphine=, or give =sulphate of zinc=, =mustard=, or =ipecacuanha= as emetics. Follow up by administering, suspended in water, calcined magnesia, or carbonate of magnesia, or chalk.

=Demulcent drinks=, such as =barley-water=, &c.

COCCULUS INDICUS.--See PICROTOXIN.

COLCHICUM--MEADOW SAFFRON--COLCHICUM WINE, TINCTURE, &C.

Use =stomach-pump= or =tube=, or empty the stomach by emetics, such as =sulphate of zinc=, or =mustard=, or =ipecacuanha=; or, better than all, give a hypodermic injection of 4 or 5 drops of the solution of =apomorphine=.

Give =tannin= or =gallic acid= in ½-drachm doses, or strong tea or coffee.

Allay the pain in the bowels and purging by small doses of =opium= or =morphine=.

Keep the extremities warm, apply hot fomentations to the abdomen; =stimulants= may be used, give plenty of =water= and =demulcent drinks=.

COLOCYNTH.

Treatment on the same lines as that for COLCHICUM.

CONIUM--HEMLOCK.

Empty the =stomach= by the =pump= or =tube=, or give a hypodermic injection of 4 or 5 drops of the solution of =apomorphine=, or emetics of =sulphate of zinc=, or =mustard=.

Keep up the temperature of the body by hot wraps.

Administer, as a drink, strong =tea=, =tannin=, =gallic acids=, or any harmless vegetable decoction containing tannin.

=Stimulants= may be administered.

If necessary, use =artificial respiration=.

COPPER--SALTS OF.

Empty stomach by =pump= or =tube=, and either inject by the same means or administer =white of egg= in solution in water; if no white of eggs can be had, substitute milk; give plenty of =water= and =emollient drinks=.

Pain may be allayed by =opium= or =morphine=.

CORROSIVE SUBLIMATE--PERCHLORIDE OF MERCURY--NITRATE OF MERCURY.

Empty the stomach by the =tube= or =pump=, and wash the organ out with plenty of white of egg, dissolved in water or milk. If the stomach-pump is not at hand, then give emetics, such as the solution of =apomorphine=, hypodermically, in from 4 to 5-drop doses, or a =zinc sulphate= emetic, or =mustard=, or =ipecacuanha=. Probably violent vomiting is already present, then stomach-tube or emetics are unnecessary: but, in any case, give plenty of albuminous fluids, such as =white of egg= in water or =milk=. If neither of these is at hand, chop any =fresh meat= up as finely as can be done in a short space of time, diffuse in water, and administer. Follow up with =demulcent drinks=, such as =barley-water=, =flour= and =water=, &c.

Pain may be allayed with a little =opium= or =morphine=.

=Stimulants= are admissible, if necessary.

CROTON OIL.

Empty stomach by means of =tube= or =pump=, or give emetics of =mustard= or =sulphate of zinc=, or administer hypodermic injection of apomorphine.

Give 10 drops of =laudanum= every twenty minutes or half hour, until the pain and purging are somewhat abated, or else inject subcutaneously small doses of =morphine= at intervals.

Give plenty of =demulcent drinks=.

Two or three drops of =essence of camphor= in milk are useful.

Stimulants, such as =brandy=, =ammonia=, or =chloric ether=, are admissible.

CYTISINE.--See LABURNUM.

CURARINE--WOORARI--URARI.

The poison is of course introduced by a wound; if any is likely to be still in the wound apply a =ligature=, =suck the wound=, and then wash it with a slightly alkaline solution of =potassic permanganate=.

Keep up the =respiration artificially=, give plenty of =water= and a dose of spirits of nitre, apply warmth to the loins. By these means the poison will be rapidly separated by the urine; and, if the patient can only be kept alive by artificial respiration for a little time, he may recover, for elimination is very rapid.

CYANIDE OF POTASSIUM.--See PRUSSIC ACID.

DIGITALIS GROUP OF HEART POISONS, _including_, besides the DIGITALINS, ANTIARIN, APOCYNIN, NERIIN, OLEANDRIN, EVONYMIN, THEVETIN, SCILLAIN, STROPHANTIN, and ERYTHROPHLEIN.

Empty the stomach by the =tube= or =pump=, or administer a subcutaneous dose (4 drops) of =apomorphine=, or give a tablespoonful of =mustard= in water, or =sulphate of zinc=.

Follow up with strong =tea=, or half a drachm of =tannin=, or =gallic acid= in aqueous solution.

A very small dose of =aconitine nitrate= in solution (say 1-200th of a grain) may be injected subcutaneously and the effect watched; if in a little time it seems to do good, repeat the dose. On no account let the patient rise from the recumbent posture, or he may faint to death.

=Stimulants= in small doses may be given frequently by the mouth, or, if there is vomiting, by the bowel.

ERGOT.

Use =stomach-pump= or =tube=, or empty the stomach by a =mustard= or =sulphate of zinc emetic=, or give a subcutaneous injection of =apomorphine=.

Give a purgative, such as a drop of =croton oil=, and assist its action by plenty of warm drinks.

=Tannin= and =gallic acid= have also been recommended, but are probably of but little use.

After the bowels have well acted, and the stomach has been emptied, give small doses of =opium= at intervals.

Dr. Murrell recommends 1-50th of a grain of =nitro-glycerin= every fifteen minutes.

The recumbent position is necessary, and the circulation should be maintained by warmth, and, if necessary, by friction.

ERYTHROPHLEIN.--See DIGITALIS.

ETHER.--The same treatment as with CHLOROFORM.

EVONYMIN.--See DIGITALIS.

FUNGI.--See MUSHROOMS.

GELSEMININE.

If seen soon after taking the dose, use the =stomach-pump= or =tube=, or give a tablespoonful of =mustard=.

Administer a small dose of =atropine= subcutaneously, or give by the mouth tincture of belladonna in 20-drop doses.

=Stimulants= are admissible.

If necessary, use =artificial respiration=.

Rouse the patient by hot and cold =douches=.

HEMLOCK.--See CONIINE--CONIUM.

HENBANE--HYOSCYAMINE.--The same treatment as for ATROPINE.

HYDROCHLORIC ACID.--See ACIDS, MINERAL.

HYDROCYANIC ACID.--See PRUSSIC ACID.

HYOSCYAMINE.--The same treatment as for ATROPINE.

IODINE.

Empty the stomach by =pump= or =tube=, or administer emetics, such as the hypodermic solution of =apomorphine=, or give by the mouth =mustard= or =sulphate of zinc=.

Give plenty of =starch= diffused in warm water, or in the form of a dilute paste; or give any =farinaceous substance= whatever, such as =arrowroot=, =boiled rice=, or =flour=, or thin =gruel=.

Inhalations of =amyl nitrite= have been recommended.

Pain may be relieved by =morphine= or =opium=.

JABORANDI.--Treatment the same as PILOCARPINE.

LABURNUM SEEDS--CYTISINE.

Empty stomach by =tube= or =pump=, and wash it out with =tea= or =coffee=, or give (as an emetic) a hypodermic dose of =apomorphine=, or (by the mouth) =mustard= or =zinc sulphate=; follow up this treatment by an enema, or a brisk =purgative=.

=Stimulants= may be administered, the patient may be roused by the hot or cold =douche=.

LAUDANUM.--See MORPHINE.

LAUREL WATER.--See PRUSSIC ACID.

LEAD--SALTS OF.

Empty stomach by =pump= or =tube=, or administer subcutaneously a dose of =apomorphine=, 4 to 5 drops; or give by the mouth a =sulphate of zinc= or =mustard= emetic. Follow up with half a drachm of =dilute sulphuric acid=, or half an ounce of =magnesic= or =sodic sulphate=.

=Milk= and =albuminous fluids= may be given.

Allay pain with =opium= or =morphine=. Treat colic with hot fomentations.

MEADOW SAFFRON.--See COLCHICUM.

MERCURY, SALTS OF.--See CORROSIVE SUBLIMATE.

MONKSHOOD.--See ACONITE.

MORPHINE--OPIUM--_Laudanum and preparations in which the OPIUM ALKALOIDS predominate._

If taken by the mouth, give at once a solution of potassium permanganate and then empty the stomach, but, if taken by hypodermic injection, both these would be useless. The stomach in opium-poisoning is best relieved by the =pump= or =tube,= and should then be well washed out with hot =coffee=, leaving in the organ a pint or more. If the stomach-pump or tube is not at hand, a large subcutaneous dose of =apomorphine= (say 10 minims) may be given, or =mustard= or =zinc sulphate=, but there may be difficulty in obtaining vomiting from any emetic.

Attempt to rouse the patient by the =battery=, if at hand; by flips with a towel, and by shaking. In all books will be found the usual direction that you are to keep walking the patient about; but this treatment is questionable, and likely to favour the toxic action of morphine on the heart.

=Ammonia= may be applied to the nostrils.

Hot =coffee= may also be introduced into the bowels by an =enema= apparatus, or by a simple tube.

The alternate =cold and hot douche= to the head is good, but the body should be kept warm with hot wraps.

Small subcutaneous doses of =atropine= (say 1-20th of a grain) may be administered, repeating the close every twenty minutes, and watching the effect.

If necessary, apply =artificial respiration=.

Inhalations of =nitrite of amyl= have been used.

MUSCARINE.--See MUSHROOMS.

MUSHROOMS--MUSCARINE--POISONOUS FUNGI GENERALLY.

Empty stomach by =stomach-pump= or =tube=, or give a subcutaneous dose of =apomorphine=, or administer by the mouth either =mustard= or =zinc sulphate=.

Inject as soon as possible a subcutaneous dose of 2 to 4 drops of the solution of atropine; or, after the stomach has been emptied, give =tincture of belladonna= every half hour, in from 20 to 30-min. doses.

It is equally important to remove the remains of the fungi from the intestines, and for this purpose it is well to give a dose of =castor oil=, and to use an enema.

=Stimulants= may be given. The body should be kept warm.

NERIIN.--See DIGITALIS.

NICOTINE--TOBACCO.

Unless the stomach has been already emptied by vomiting, use =stomach-pump= or =tube=, or give an emetic of =mustard= and plenty of water.

Inject subcutaneously a small dose of =strychnine= (say 1-25th of a grain of the nitrate), or give half a drachm of tincture of =nux vomica=.

=Stimulants=, such as =brandy=, =chloric ether=, &c., may be given.

Keep the body warm, but the =cold douche= may be applied to the head.

=Tannin= and vegetable infusions containing =tannin= may also be given, but it is questionable if they are of much use, unless any remnants remain in the stomach.

Keep the patient lying down for fear of fatal syncope.

NITRE--NITRATE OF POTASH.

Empty the stomach immediately by the =pump= or =tube=, or give a subcutaneous dose of =apomorphine= (from 2 to 3 drops), or administer by the mouth a tablespoonful of =mustard=, or a scruple of =sulphate of zinc=.

Dilute the poison, and attempt to wash it out of the system by giving plenty of =water= or =mucilaginous drinks=.

Apply hot fomentations to the loins, and keep the patient as warm as possible.

Stimulants that are likely to increase the kidney congestion are to be avoided.

Inhalations of =nitrite of amyl= have been recommended.

NITRIC ACID.--See ACIDS, MINERAL.

NITRO-BENZENE.

Empty the stomach at once by the= stomach-pump= or =tube=, and wash the organ out with plenty of warm water, to which advantageously a little spirit may be added; or give emetics, such as =zinc sulphate= or =mustard=.

Administer stimulants, either by the stomach-tube, as an enema, or by subcutaneous injection.

Keep up the respiration artificially, if necessary, and maintain the heart’s action by application of weak, interrupted shocks to the chest-wall, by means of the =battery=.

Rouse the patient by the =douche=.

=Atropine= subcutaneously has been recommended.

NITROUS OXIDE GAS.

The treatment is the same essentially as for chloroform (_which see_).

Inhalations of =oxygen= may do good, but oxygen is very rarely at hand.

NUX VOMICA.--See STRYCHNINE.

OLEANDRIN.--See DIGITALIS.

OPIUM.--See MORPHINE.

OXALIC ACID--BINOXALATE OF POTASH--SODIC OXALATE.

Unless the patient has already vomited freely, empty the stomach at once by emetics of =zinc sulphate= or =mustard=; or the =stomach-pump= or =tube= may, in most cases, be used. If the acid has been taken, neutralise by =chalk=, =lime water=, or, better, by =saccharated lime water=; but on =no= account neutralise by carbonate of soda or any alkali, for the alkaline oxalates are extremely poisonous.

Assist elimination by the kidneys by giving plenty of water; apply hot fomentations to the loins.

An enema may be given, if necessary, to empty the bowels well.

PHOSPHORUS.

Empty the stomach by =tube= or =pump=, and, at the same time, wash the organ out with water to which has been added a drachm of =French turpentine=, or give emetics. The best emetic for phosphorus is said to be =sulphate of copper=, 4 or 5 grains dissolved in water, and given every ten minutes until vomiting is produced.

In default of sulphate of copper, then =sulphate of zinc= or =mustard=.

Give ½-drachm doses of =turpentine=, floating on water or on mucilage, every half hour. Inhalations of turpentine vapour, much diluted, are also of service. The American and German turpentines are said to be of no avail. Probably the turpentine will freely purge the patient; but, if not, the bowels should be opened by a suitable purgative, such, for instance, as =magnesic sulphate=.

PHYSOSTIGMINE.--See CALABAR BEAN.

PICROTOXIN--COCCULUS INDICUS.

Use =stomach-pump= or =tube=, or empty stomach by usual emetics, _e.g._, =mustard=, =zinc sulphate=, or =apomorphine=, subcutaneously.

=Chloral=, in doses of from 10 to 20 grains, may be given every half hour to allay or prevent tetanus, the effects being, of course, watched. For the same purpose =bromide of potassium= has been recommended. In severe cases, it may be combined with choral, 1 drachm of the bromide with 20 grains of chloral.

PILOCARPINE.

The best treatment is a subcutaneous dose of =atropine= (say 1-60th of a grain) or tincture of =belladonna= by the mouth in 20-minim doses, to be repeated every twenty minutes until the pupils dilate.

POTASH.--See ALKALIES

PRUSSIC ACID.[991]

[991] J. Kossa, considering that potassium permanganate ought, theoretically, to act as a chemical antidote to potassium cyanide, by checking the paralysis of the respiratory centres, has performed some experiments. Rabbits were shown to be fatally affected in a few minutes by 0·01 grm. of the poison, but if, at the time of administration, 0·5 grm. of permanganate dissolved in 50 c.c. of water was also introduced into the stomach, doses of cyanide up to 0·1 grm. failed to cause death. Larger quantities (0·2 grm.) proved fatal under similar conditions, but the action of the poison was much delayed. Successful experiments were also performed with aqueous solutions of hydrocyanic acid containing 0·1 per cent. It is suggested, therefore, that, in cases of cyanide poisoning, ½ to ⅓ litre of a 3 to 5 per cent. solution of permanganate should be administered immediately (_Vratch_, through _Nouv. rem._, ix. 567).

Use =stomach-pump= or =tube=, or, if not at hand, an emetic of =mustard= or =sulphate of zinc=.

If the breathing has stopped, try =artificial respiration= and weak shocks to the heart.

1-60th of a grain of =atropine= subcutaneously is recommended to assist the heart’s action.

A =brandy enema= may be given, or brandy injected under the skin.

The body must be kept warm, but the cold =douche= may be advantageously applied to the head.

SALTS OF SORREL.--See OXALIC ACID.

SAVIN.

If the patient has not already emptied the stomach by repeated vomiting, and the throat is not inflamed, use the =stomach-pump= or =tube=, and wash the organ out with water, or give any one of the usual emetics--such as =mustard=, =sulphate of zinc=, or =ipecacuanha=.

If the bowels have not acted well, give a dose of =castor oil=; allay pain with small doses of morphine.

SCILLAIN.--See DIGITALIS.

SNAKES, BITE OF.

Suck the wound, and apply an alkaline solution of =permanganate of potash=.

In severe cases of cobra poisoning and other extremely venomous snakes, death threatening, the only likely means of saving life would be bleeding at one arm and =transfusing= blood by the other.

=Ammonia= may be given by the mouth, and also smelt.

In cobra poisoning and venoms which kill mainly through the respiration, the breathing must be kept up artificially; and, should there be signs of the heart failing, weak, interrupted =galvanic= shocks may be applied to the walls of the chest.

Lacerda’s plan of injecting permanganate of potash under the skin is not alone useless but mischievous, for it takes up time which might be more valuably employed.

SODA CAUSTIC.--See ALKALIES.

SOLANINE--SOLANUM DULCAMARA--BITTER SWEET--WOODY NIGHTSHADE.--The same treatment as for ATROPINE (_which see_).

STRAMONIUM.--The same treatment as for ATROPINE.

STROPHANTIN.--See DIGITALIS.

STRYCHNINE--BRUCINE--NUX VOMICA.

Empty the stomach as quickly as possible by an emetic of =mustard=, or =zinc sulphate=, or by a hypodermic solution of =apomorphine= (4 drops).

The =stomach-pump= or =tube= inadmissible; for, if tetanus is present, it cannot be applied; or, if absent, it is likely to excite a spasm.

Place patient at once under =chloroform= or =ether=, and keep up a gentle narcosis for several hours, if necessary.

Darken the room, stifle all noise; if in a town, and opportunity permit, have straw or peat placed at once before the house to deaden noise.

If the spasms threaten the respiration, =artificial respiration= is absolutely necessary; and, to facilitate this, it would be justifiable, in a dangerous case, to perform =tracheotomy=, of course under chloroform.

=Chloral= may be given in place of chloroform, but the latter is best; the dose of =chloral= should be, at least, half a drachm, and if no effect is produced in half an hour, then doses of 20 grains should be given at intervals of a quarter of an hour.

If neither chloroform nor chloral is at hand, the juice from a recently-smoked pipe may be diffused in a little water and a few drops injected subcutaneously, and the effect watched. If there is a marked improvement the treatment may be persevered in.

=Bromide of potassium= in combination with chloral has been recommended.

=Nitrite of amyl= inhalations are said to be of use.

=Curarine= in a subcutaneous dose of one-third of a grain is antagonistic so far that it paralyses the voluntary muscles.

SULPHURIC ACID.--See ACIDS, MINERAL.

TARTAR EMETIC.--See ANTIMONY.

TARTARIC ACID.--The same treatment as for OXALIC ACID (_which see_).

THEVETIN.--See DIGITALIS.

TOBACCO.--See NICOTINE.

TURPENTINE.

Empty stomach by =tube= or =pump=, or administer the usual emetics, such as =mustard=, or =sulphate of zinc=, or =ipecacuanha=, or give hypodermically 3 or 4 drops of the solution of apomorphine.

If purging is not already present, empty the bowel by enema; give plenty of water and demulcent drinks to aid elimination by kidneys.

Apply hot fomentations to the loins.

Allay pain with =opium= or =morphine.=

VERATRINE.

Empty the stomach by the =tube= or =pump=, or give any one of the usual emetics--such as =mustard=, or =zinc sulphate=, or =ipecacuanha=.

Keep the patient lying down.

=Stimulants= may be administered.

An enema of =hot coffee= has been recommended.

Keep the body warm with wraps, hot blankets, &c.

WHITE PRECIPITATE.--The same treatment as for CORROSIVE SUBLIMATE.

WASPS, BEES, HORNETS--STING OF.

An =onion= immediately applied to the part stung is a favourite popular remedy; but =ammonia= is better.

=Extract the sting=, if it remains in the wound.

Give =stimulants=, if necessary.

ZINC.

The only salt likely to cause poisonous symptoms is the chloride, which is used in the arts, and is the active principle of Burnett’s disinfecting fluid.

=Stomach-pump= or =tube= inadmissible. Give plenty of =water=, in which =carbonate of soda= is dissolved; or, if that is not at hand, =carbonate of potash=.

=Eggs= and =milk= should also be given.

Solutions of =tannin=, strong =tea=, and the like, also, to some extent, neutralise the poison.

The pain in the abdomen is to be allayed in the usual way--by hot fomentations and small frequent doses of =morphine= or =opium=.

DOMESTIC READY REMEDIES FOR POISONING.

§ 914. Large households, more especially those in which no one possesses any special medical knowledge, would do well to furnish an ANTIDOTE CUPBOARD, for use in cases of emergency. This cupboard may contain:--

(1.) _The Multiple Antidote_, which consists of saturated solution of sulphate of iron 100 parts, water 800, magnesia 88, animal charcoal 44 parts. It is best to have the animal charcoal and magnesia mixed together in the dry state and kept in a well-corked bottle; when required for use, the saturated solution of sulphate of iron is mixed with eight times its bulk of water, and the mixture of charcoal and magnesia added with constant stirring. The multiple antidote may be given in wine-glassful doses, frequently repeated, in poisoning by arsenic, zinc, opium, digitalis, mercury, or strychnine; it is of no use in phosphorus poisoning, or in poisoning by the caustic alkalies or antimony.

(2.) _Calcined Magnesia_, for use in poisoning by acids.

(3.) _French Turpentine_, for poisoning by phosphorus.

(4.) Powdered ipecacuanha in a well-corked bottle; the bottle containing a small pill-box which is cut down, so that when full it contains 30 grains--the proper dose as an emetic. A similar small supply of sulphate of zinc may also be provided.

(5.) A tin of mustard.

(6.) A bottle of vinegar.

If, then, provided with such a supply, any member is known to have taken poison, and yet the precise poison is not known, give a =sulphate of zinc= or =ipecacuanha emetic=, and follow it up by the =multiple antidote=, which is in itself not poisonous.

If PHOSPHORUS has been taken, then give the =French turpentine= as directed under Phosphorus (p. 697).

If ACIDS, neutralise by the =calcined magnesia= (see Acids, mineral, p. 687).

If ALKALIES, neutralise with =vinegar= (see Alkalies, p. 688).

INDEX.

Abel and Field’s test for bismuth, 627.
Abrin, 462.
Abrus, 462.
Absynthin, 244.
Acetaldehyde, 154.
Acetanilide, 40.
Aceta-trimethyl-colchicin-amide, 409.
Acetic acid, 110.
„ Deaths from, 29.
Acetum digitalis, 422.
Acetyl phenyl hydrazine, 40.
Acid, carbolic. See _Carbolic acid_.
Acid hæmatin, Spectrum of, 58.
Acids, mineral. See _Hydrochloric_, _Nitric_, _Sulphuric acid_, &c.
Acolyctin, 252.
Aconine, 351, 354.
Aconite alkaloids, 351.
Aconite, Bibliography of papers relating to physiological action of,
360, 361.
„ Deaths from, 30.
„ extract, 351.
„ liniment, 351.
„ ointment, 351.
„ treatment of poisoning by (App.), 687.
„ Old knowledge of, 3.
„ Pharmaceutical preparations of, 351.
„ poisoning, Statistics of, 361.
„ _Post-mortem_ appearances after poisoning by, 366.
„ root, Poisoning by, 361.
„ seeds, 350.
„ tincture, 351.
Aconitine, 243, 252, 253, 351.
„ acetate, 245 (footnote).
„ action on fish, 359.
„ „ frogs, 359.
„ „ insects, 358.
„ „ mammals, 359, 360.
„ Carbon and nitrogen percentage in, 262.
„ Colour reactions of, 240.
„ Commercial, 355.
„ gold salt, 264, 352.
„ Phospho-molybdate of, 238.
„ Physiological action of, 366.
„ Poisoning by, 362.
„ Properties of, 351, 352.
„ Separation of, from tissues, &c., 367.
„ Sublimation of, 259.
„ Tests for, 352, 353.
„ Value of Mayer’s precipitate of, 263.
Acquetta di Perugia, 11.
Acqua Toffana, 10, 11.
Adder, Thuringian, 484.
Adonidin, 434.
Aërated waters, Detection of lead in, 609.
Æsculin, 345 (footnote).
Æthusa cynapium, 457.
Agaricus pantherinus, 418.
„ phalloides, Poisoning by, 417.
„ ruber, 418.
Agrostemma sapotoxin, 436.
Ague drops, 532.
Alchid Becher, 5.
Alcohol, Deaths from, 29.
„ Detection of, in chloroform, 144.
„ Excretion of, 139.
„ Fatal dose of, 137.
„ _Post-mortem_ appearances after poisoning by, 138.
„ Separation of, 51.
„ Statistics of poisoning by, 136.
„ Symptoms of poisoning by, 137.
„ Toxicological detection of, 140.
„ Treatment of poisoning by (App.), 688.
Alcoholic poisoning, criminal or accidental, 137.
Aldehyde, 154.
„ groups, 39.
„ in chloroform, 145.
Alexander VI., Death of, by poisoning, 7.
Ali Ahmed’s treasures of the desert, 593.
Alkalies, Fixed caustic, 116-122.
„ Chronic poisoning by, 120.
„ Effects on animal and vegetable life, 118.
„ Estimation of, 121.
„ Local effects of, 119.
„ _Post-mortem_ appearances of poisoning by, 119.
„ Statistics of poisoning by, 118.
„ Symptoms of poisoning by, 119.
„ Toxicological detection of, 127.
„ Treatment of poisoning by (App.), 688.
Alkaloids, Discovery of, 15.
„ General properties of, 236.
„ of the veratrums, 390.
„ Quantitative estimation of, 262.
Alkyls replacing hydrogen, 36.
Allantoin, 39.
Alloxantin, 39.
Almonds, bitter, Case of poisoning by, 209.
Aloetin, 244.
Alum, 676, 677.
„ Action of, 676, 677.
„ _Post-mortem_ appearances after poisoning by, 678.
Aluminium, 676-679.
Aluminic and sodic lactate, 677.
„ „ tartrate, 677.
Alumina, Detection of, 678, 679.
„ Test for, 678, 679.
Amanita muscaria, 413.
Amanitine, Carbon and nitrogen percentage in, 262.
„ gold salt, 264.
Amarin, 40.
Amines, 488-490.
Ammonia, 111-116.
„ action on animal life, 113.
„ action on plants, 113.
„ -alum, 676.
Ammoniac and mercury plaster, 635.
Ammonia, Deaths from, 29.
„ Effects of, 113.
„ Estimation of, 116.
„ liniment, 111.
„ and hypochlorite test for carbolic acid, 177.
„ _Post-mortem_ appearances after poisoning by, 115.
„ Properties of, 111.
„ salts, Detection of, 128.
„ Separation of, 115.
„ Statistics of poisoning by, 112.
„ Solution of, 111.
„ Symptoms of poisoning by, 112.
„ Tests for, 116.
„ Uses of, 111.
„ vapours, Poisoning by, 112.
Ammoniated mercury, Effects of, 648.
„ ointment, 637.
Ammonic cyanide, 210.
Amygdalin, 194.
Amyl nitrite poisoning, 141.
Amylic alcohol, 141.
Anderseck’s case of corrosive sublimate poisoning, 647.
Androctonus bicolor, 468.
„ occitanus, 468.
Angelic acid, 392.
Aniline, 250.
„ Characters of phospho-molybdate precipitate, 237.
„ Detection of, 281.
„ Fatal dose of, 281.
„ Production of, from nitro-benzene, 133, 188.
„ Properties of, 280.
„ Separation of, 51.
„ Spectrum of colour reaction, 55.
„ Symptoms of poisoning by, 280.
Animal bases, 3.
Antiarin, 432.
Antidote bag, 685.
Antimonial compounds used in pyrotechny, 581.
„ powder, 579.
Antimonious sulphide, 577.
Antimony, black, 580.
„ chloride, 580.
„ Deaths from, 29.
„ Detection of, 587.
„ Effects of, 582.
„ Elimination of, 586.
„ Flowers of, 581.
„ Glass of, 581.
„ in alloys, 582.
„ metal, 577.
„ Mirror of, 537.
„ oxide, 579.
„ „ vapour, 585.
„ pentasulphide, 578.
„ Pharmaceutical preparations of, 79, 80.
„ pills, 580.
„ _Post-mortem_ appearances from poisoning by, 585, 586.
„ poisoning (chronic), 585.
„ Quantitative estimation of, 589.
„ salts, Doses of, 582.
„ Separation of, 50.
„ sulphide, Separation of, 52.
„ sulphurated, 580.
„ tartarated, Antidotes for, 586.
„ „ Effects of, 583.
„ „ Estimation of, 578.
„ treatment of poisoning by (App.), 688.
Antimony wine, 579.
„ yellow, 582.
Antipater, Trial of, 2.
Antipyrine, Deaths from, 30.
Antiseptic action of hydric cyanide, 203 (footnote).
Ants, Poisonous properties of, 471.
Aplysia, 3.
Apocynin, 434.
Apollodorus, 3.
Apomorphine, 317.
„ Separation of, 51.
Aqua Orientalis, 630.
Aromatic spirits of ammonia, 112.
Aromatic sulphuric acid, 76.
Arsen-dimethyl chloride, 38.
Arseniate of iron, 530.
„ of soda, 530.
Arsenic chloride, 529, 575, 576.
Arsenic, Deaths from, 29.
„ Detection of, 555.
„ „ in antimony sulphide, 578.
„ Doses of, 535.
„ eaters, 538.
„ Effects of, on animals, 536, 537.
„ „ man, 538.
„ „ plants, 535.
„ Elimination of, 553.
„ Estimation of, 566-568.
„ „ as trisulphide, 571.
„ Imbibition of, after death, 563.
„ in the arts, 529.
„ in glycerin, 560.
„ in organic matters, 560.
„ Introduction of, 539.
„ Hydrochloric acid solution of, 530.
„ (arsenious anhydride), Properties of, 524, 525.
„ Law relating to, 535.
„ Localisation of, in the body, 561, 562.
„ Metallic properties of, 524.
„ Mirrors of, 557.
„ Pharmaceutical preparations of, 530.
„ Physiological action of, 552.
„ poisoning, Absence of symptoms in, 545.
„ „ Antidotes for, 553, 554.
„ „ Microscopical appearances of liver in, 552.
„ „ Museum preparations illustrative of, 550, 551.
„ „ _Post-mortem_ appearances of, 548-552.
„ Separation of, 49, 50.
„ „ by Chittenden’s method, 568, 569.
„ Slow poisoning by, 546.
„ Solubility of, 525.
„ Statistics of poisoning by, 534.
„ sulphide, 52, 528, 529, 573, 575.
„ treatment of poisoning by (App.), 689.
Arsenious acid. See _Arsenic_.
Arsenites and Arseniates, Tests for, 555.
Arsen-methyl-chloride, 38.
Arseniuretted hydrogen. See _Arsine_.
Arsine, Development of, in Fleitmann’s process, 571.
„ effects on man, 527.
„ uses in the arts, 527.
„ Properties of, 525, 526.
Arum maculatum, 465.
„ seeds, Death from, 30.
Aselline, 506.
Asiatic knowledge of poisons, 4.
Asparagin, Percentage of carbon and nitrogen in, 262.
Aspidospermine, 344.
Atkinson’s infant preserver, 288.
Atropine, 251, 368, 369.
„ Action of, on animals, 377.
„ „ infusoria, 42.
„ „ man, 377, 378.
„ and strychnine, Tests for, 374.
„ antagonistic to muscarine, 416.
„ Accidental and criminal poisoning by, 375, 376.
„ Carbon and nitrogen content of, 262.
„ Chronic poisoning by, 379.
„ Colour reactions of, 240.
„ Deaths from, 30.
„ effects on the iris, 374.
„ effects on the heart in digitalis poisoning, 429.
„ Fatal dose of, 376, 377.
„ Gold salt of, 264.
„ Melting point of, 259.
„ Pharmaceutical preparations of, 371.
„ Physiological action of, 380.
„ Phospho-molybdate of, 238.
„ poisoning, Diagnosis of, 380.
„ „ _Post-mortem_ signs after poisoning by, 380.
„ „ Statistics of, 375.
„ „ Treatment of, 380.
„ Properties of, 371, 372.
„ Separation of, from organic matters, 381.
„ Separation of, from the urine, 381.
„ Tests for, 372, 373.
„ Treatment of poisoning by (App.), 689.
„ Value of Mayer’s precipitate, 263.
Attalus Phylometer, 2.
Autenrieth’s general process of analysis for poisons, 50-54.

Bain de Tessier, 533.
Baking-powder, 677.
Bamberger’s views as to hydrogenised bases, 36.
Barium, 679.
„ carbonate, 680.
„ Characters of, 680.
„ chloride, Deaths from, 29.
„ Koningh’s method of detection, 675.
Barium salts, Effect of, on man, 681, 682.
„ „ Fatal dose of, 682.
„ „ Localisation of, 683.
„ „ Separation and detection of, 684.
„ „ Symptoms of poisoning by, 682.
„ sulphate, 680.
„ „ Identification of, 684.
„ sulphide, 680.
Barley, Content of copper in, 612.
Battle’s vermin-killer, 328.
Bécoeur’s soap, 533.
Belladonna, Alkaloids of, 369.
„ Deaths from, 30.
„ Pharmaceutical preparations of, 370, 371.
Benzene, 131-133.
„ Purification of, 132.
„ Treatment of poisoning by (App.), 689.
Benzoic acid, Tests for, 354.
Benzoline, 129.
Benzoyl-aconine, 351-353.
Benzoyl chloride method of isolating diamines, 487.
Berberine, 245.
„ Carbon and nitrogen content of, 262.
„ Gold salt of, 264.
„ Phospho-molybdate of, 238.
Bergeron and L’Hôte’s researches on copper, 613.
Bernatzic’s views on copper poisoning, 617.
Bernhardt’s case of poisoning by carbon disulphide, 164.
Berzelius’ test for arsenic, 554.
Besnou on specific gravity of alcohol and chloroform, 145.
Betaine, 501, 502.
„ Carbon and nitrogen percentage of, 262.
Bibliography of chief works on toxicology, 16.
Bicarbonate of soda lozenges, 118.
Bichromate of potash. See _Chromium_.
Bichromate disease, 671, 672.
Binoxalate of potash, 572.
Binz’s theory of the action of arsenic, 553.
Bishop Stortford cases of food poisoning, 507.
Bismuth citrate solution, 625.
„ Extraction and detection of, 626.
„ Estimation of, 627, 628.
„ in the arts, 625.
„ lozenges, 624.
„ Medicinal doses of, 625.
„ nitrate, 625.
„ oxide, 625.
„ oleate, 625.
„ peroxide, 624.
„ potassium iodide, 237.
„ Properties of, 624.
„ Separation of, 50.
„ subgallate, 625.
„ subiodide, 625.
„ sulphide, 624.
„ Tests for, 626, 627.
„ Toxic effects of, 625.
Bitter aloes, Deaths from poisoning by, 30.
Black drop, 287.
„ bryony, 465.
Blair’s gout pills, 412.
Bleaching-powder, 71.
Blondlot’s apparatus for production of phosphine, 231.
„ modification of Marsh’s test, 56.
Blood, Action of ammonia on, 114.
„ Characters of, in arsine poisoning, 527.
„ „ carbon oxide poisoning, 59, 66.
„ „ dinitrobenzol poisoning, 191.
„ „ hydric sulphide poisoning, 58.
„ „ nitrobenzol poisoning, 187, 191.
„ „ phosphine poisoning, 224.
„ „ phosphorus poisoning, 222.
„ „ sulphuric acid poisoning, 90.
„ Examination of, 56-63.
„ Guaiacum test for, 61.
„ corpuscles of man and animals, 62.
„ Spectroscopic examination of, 57.
„ spots, Treatment of, 60, 61.
Blowfly, Action of digitalins on, 429.
„ Action of poisons on, 43.
Blue pill, 634.
Bluestone, 616.
Bocarmé, Count, 274.
Bocklisch’s flask, 486.
Böhm’s experiments on barium, 681.
Boletus satanas, 418.
Bottcher’s depilatory, 680.
Bottger’s observations on copper, 611.
Boyle, Hon. Robert, 13.
Braun’s method of estimating HCl, 101.
Bread, Content of copper in, 612.
Brieger’s process for ptomaines, 485.
Brighton Green, 616.
Brinvilliers, Mad. de, 11.
Britannia metal, 582.
Britannicus, Death of, by poison, 6.
Bromine as a test for carbolic acid, 178.
Bromo-picrotoxin, 452.
Brown’s lozenges, 639.
Brucine, 248, 251, 340.
„ Colour reactions of, 240.
„ Melting-point of, 260.
„ picrate, 340.
„ Phospho-molybdate of, 238.
„ Physiological action of, 341.
„ Platinum salt of, 264.
„ Separation of, from organic matters, 343.
„ Separation of, from strychnine 323.
„ Spectrum of colour reactions, 55.
„ sulphate, 341.
„ Tests for, 342, 343.
„ Value of Mayer’s reagent, 263.
Brugnatelli’s method of detecting mercury, 653.
Brunswick green, 616.
Buchner on solubility of arsenic, 525.
Burnett’s fluid, 657.
„ Symptoms of poisoning by, 660.
Busscher’s case of aconitine poisoning, 363.
Butter of antimony, 587.
Butylamine, 506.
Bynssen’s observations on the elimination of mercury, 650.

Cadaverine, 494, 495.
Cadmium, 590.
„ Fatal dose of, 590.
„ in the arts, 590, 591.
„ oxide, 590.
„ Separation and detection of, 50, 52, 590.
„ sulphide, 590.
Caffein, 40.
„ Spectrum of murexide test for, 55.
Calabar bean. See _Physostigmine_.
Calomel, 634, 636.
Calvert’s Carbolic acid powder, 167.
Camphor, 135, 243.
„ Compound liniment of, 111.
„ „ tincture of, 285.
„ Deaths from, 30.
„ Effects of, 135.
„ _Post-mortem_ appearances after poisoning by, 136.
„ Separation of, 136.
„ Spirits of, 135.
„ Treatment of poisoning by (App.), 690.
„ water, 135.
Camphorated oil, 30.
Camphoric acid, 135.
Cantharides, 471.
„ Deaths from poisoning by, 30.
„ Effects of, on animals, 472.
„ „ man, 473.
„ Fatal dose of, 472.
„ Pharmaceutical preparations of, 472.
„ _Post-mortem_ appearances after poisoning by, 474.
„ Tincture of, 472.
„ Treatment of poisoning by (App.), 690.
Cantharidin, 244, 260, 471, 472.
„ Tests for, 475.
Capsicin, 243.
Capsicum alkaloids, 248.
„ seeds, as distinguished from Datura, 248.
Carbolic acid, 242.
„ Changes in urine after taking, 174.
„ Colorimetric method of estimating, 183.
„ Deaths from, 29.
„ Effects of, on animals, 169, 170.
„ effects on man, 173.
„ Examination of urine for, 181.
„ Fatal dose of, 169.
„ in organic fluids, 180.
„ Museum preparations illustrative of poisoning by, 176.
„ _Post-mortem_ appearances in cases of poisoning by,
166.
„ powder, 167, 183.
„ „ Assay of, 181, 183.
„ Properties of, 166,
„ Separation of, 51, 176, 180.
„ soap, 167, 183.
„ Statistics relating to poisoning by, 167.
„ Symptoms produced by, 170.
„ Tests for, 177, 178.
„ Uses of, 167.
Carbon bisulphide, 163-165.
„ „ Deaths from, 29.
„ „ Chronic poisoning by, 164.
„ „ Poisoning by, 163.
„ „ Properties of, 165.
Carbon monoxide, 64-71.
„ „ blood, Characters of, 58, 59.
„ „ Detection of, 70.
„ „ Mass poisoning by, 67.
„ „ Properties of, 64.
„ „ Symptoms of poisoning by, 64.
„ „ _Post-mortem_ appearances after poisoning by, 67.
Carbylamine, 490.
Carnelley’s observations on the solubility of copper, 610, 611.
Carlisle, A case of food poisoning, 508.
Cascarillin, 245.
Cassava root, Prussic acid in, 195.
Cassella, Yellow, 582.
Castor seeds, 462.
„ Deaths from, 30.
Cattle poisoning by meadow saffron, 411.
Cayenne pepper, 30.
Cedrenes, 133.
Cephalopods, Action of poisons on, 43.
Cerbera odallam, 434.
Cevadine, 392.
“Chandoo,” 305.
Charles IX. as a poisoner, 8.
Chelidonine, Carbon and nitrogen content of, 262.
„ Spectrum of colour reaction of, 55.
Chenot’s death by carbon monoxide, 65.
Ching’s Worm lozenges, 639.
Chittenden’s method of estimating arsenic, 568.
„ on the local distribution of arsenic, 562.
Chloral, 154.
„ Chronic poisoning by, 160.
„ Deaths from, 30.
„ Detection of poisoning by, 155.
„ Effects of, on animals, 156.
„ „ man, 157.
„ Excretion of, 161.
„ Fatal dose of, 158.
„ Statistics of poisoning by, 155.
„ Treatment of poisoning by, 160, (App.) 690.
„ Properties of, 154.
„ Separation of, 51, 162.
„ Symptoms of poisoning by, 159.
Chlorcodeine, 299.
Chlorine, 72.
„ Detection of, 72.
„ Effects of, 72.
„ _Post-mortem_ appearances in cases of poisoning by, 72.
Chlorodyne, 288.
„ Deaths from, 30.
Chloroform, 143.
„ Chronic poisoning by, 151.
„ Detection and estimation of, 152, 153.
„ Effects of liquid, 148.
„ „ vapours of, 148-152.
„ Fatal dose of liquid, 147.
„ Impurities in, 144.
„ Local action of, 146.
„ Manufacture of, 145, 146.
„ Physiological effects of, 150.
„ Properties of, 144.
„ _Post-mortem_ appearances after poisoning by, 148, 152.
„ Separation of, 51.
„ Statistics of poisoning by, 146, 148.
„ Suicidal and criminal poisoning by, 149.
„ Treatment of poisoning by (App.), 691.
Chloroxalmethyline, 522.
Chodomisky on the solubility of arsenic, 525.
Choline, 41, 415, 500.
Chromate of lead, Poisoning by, 673.
„ potash, 670.
Chrome red, 594, 671.
„ yellow, 594, 671.
Chromic acid, Deaths from, 29.
Chromium, 670-675.
„ compounds, Effects of, 671.
„ Detection of, 674, 675.
„ Separation of, 53.
„ Statistics of poisoning by, 672.
„ Treatment of poisoning by (App.), 691.
Chrysammic acid, 244.
Chrysophyllum glycyphleum, 437.
Cicutoxin, 456, 457.
„ Effects of, on animals, 456.
„ „ man, 456, 457.
„ Separation of, 457.
Cinchonidine colour reaction with potash, 240.
„ Platinum salt of, 264.
Cinchonine, 246, 252, 253.
„ colour reaction with potash, 240.
„ Phospho-molybdate of, 238.
„ Platinum salt of, 264.
„ Value of Mayer’s precipitate of, 263.
Cinnabar, 638.
Cleator Moor case of mass poisoning by hydric sulphide, 74.
Clemen’s solution of arsenic, 530.
Cleopatra’s asp, 484.
Cloth, Action of hydrochloric acid on, 95.
Clupea thrissa, 469.
Coal gas, Content of carbon monoxide in, 64.
„ creasote, 165.
„ tar naphtha, 130-133.
Cobalt nitrate as an antidote to prussic acid, 203 (footnote).
Cobalt. See _Nickel and Cobalt_.
Cobra poison, 478-480.
„ „ Antidotes to, 480.
„ „ Detection of, 482.
„ „ Effects of, on animals and man, 479.
„ „ Fatal dose, 479.
„ „ Treatment of poisoning by (App.), 698, 699.
Cocaine, Action of, on pilocarpine, 403.
„ Carbon and nitrogen percentage of, 262.
„ Chronic poisoning by, 349.
„ Deaths from, 30.
„ Effects of, 349.
„ Fatal dose of, 350.
„ hydrochlorate, 348.
„ Pharmaceutical preparations of, 348.
„ _Post-mortem_ appearances in cases of poisoning by, 349.
„ Properties of, 347, 348.
„ Separation of, and Tests for, 348, 349.
„ Sublimation of, 259.
Cocculus Indicus, Deaths from, 30. See _Picrotoxin_.
Cochineal, Spectrum of, 59.
Codamine, Reactions of, 317.
Codeine, 252.
„ Carbon and nitrogen of, 262.
„ Colour reactions of, 240.
„ Effects of, 311.
„ nitrate, 342.
„ phospho-molybdate, 238.
„ platinum salt, 264.
„ Properties of, 310.
„ Spectrum of colour reaction of, 55.
Colchiceine, 409.
„ Carbon and nitrogen content of, 262.
Colchicine, 244, 408-413.
„ Carbon and nitrogen content of, 262.
„ Colour reactions of, 240.
„ Effects of, on animals and man, 411.
„ Pharmaceutical preparations of, 410.
„ Phospho-molybdate of, 238.
„ _Post-mortem_ appearances in cases of poisoning by, 412.
„ Quack and patent medicines containing, 410.
„ Separation of, 413.
„ Tests for, 409.
Colchicum, Ancient knowledge of, 4.
„ Deaths from, 30.
„ Treatment of poisoning by (App.), 691.
„ seeds, Amount of colchicine in, 408.
Collidine, 39.
Colocynth, Deaths from, 30.
„ Treatment of poisoning by (App.), 692.
Colocynthin, 244.
Colophene hydrocarbons, 133.
Come’s cancer paste, 532.
Conhydrine, 262.
Coniine, 39, 248, 249.
„ Carbon and nitrogen content of, 262.
„ Colour reactions of, 240.
„ Effects of, on animals, 267.
„ „ blowflies, 267.
„ „ cats, 267.
„ „ frogs, 267.
„ „ man, 268.
„ Fatal dose of, 268.
„ Pharmaceutical preparations of, 266, 267.
„ Phospho-molybdate of, 238.
„ Physiological action of, 268.
„ Platinum salt of, 264.
„ _Post-mortem_ appearances in cases of poisoning by, 264.
„ Properties of, 264.
„ Separation of, from organic matters, 269.
„ Statistics of poisoning by, 267.
„ Tests for, 265.
„ Value of Mayer’s precipitate of, 263.
Conium, Botanical characters of, 264.
„ Treatment of poisoning by, 266.
Convallamarin, 246, 254.
Copper, Chronic poisoning by, 621.
„ carbonate, 620.
„ Deaths from, 29.
„ Detection of, 625.
„ Estimation of, 622.
„ leguminate, 617.
„ Medicinal dose of, 616.
„ nitrate, 616.
„ oxide, 610.
„ poisoning, Statistics of, 619.
„ _Post-mortem_ appearances in cases of poisoning by, 620.
„ Properties of metallic, 610.
„ salts, Toxic dose of, 619.
„ Separation of, 52.
„ Solubility of, in various fluids, 610-612.
„ subacetate, 620.
„ subchloride, 620.
„ sulphate, 615, 616.
„ sulphide, 610.
„ tartrate, 617.
„ Treatment of poisoning by, 692.
„ Volumetric processes for estimation of, 624.
Copperas, 668.
Coppering of vegetables, 614.
Cornutin, 445, 450.
Corrosive sublimate, Dose of, 640.
„ „ Effects of, 646.
„ „ Treatment of poisoning by (App.), 692.
Corydaline, 350.
Cotton seeds, 464.
Cream, Neill, Murders by, 325.
Creasote, 179.
„ Deaths from, 30.
Cresol, 166, 178, 179.
„ Examination of urine for, 181.
Cresylic acid. See _Cresol_.
Cresyl-sulphate of potash, 181.
Criminal poisoning, 33.
Croton oil, Deaths from, 30.
„ Treatment of poisoning by (App.), 692.
Crowfoot, Deaths from, 30.
Crum’s method of estimating nitrates, 110.
Cryptopine, Properties of, 315, 316.
Cubebin, 244.
Cuckoo-pint, 465.
Curarine, 254, 405-408.
„ Action of, on cephalopods, 43.
„ Carbon and nitrogen content of, 262.
„ Colour reactions of, 240.
„ Physiological effects of, 407.
„ Platinum salt of, 264.
„ Separation of, 407.
„ Treatment of poisoning by (App.), 693.
Cushman’s method of separating strychnine, 334, 335.
Cuttle fish, 502.
Cyanmethæmoglobin, 203.
Cyanogen chloride, 211.
Cyanuric acid, 211.
Cyclamen, 436.
Cymene, 135.
Cymogene, 129.
Cyon’s experiments on barium, 681.
Cystinuria, Amides in, 494.
Cytisine, 387-390.
„ Carbon and nitrogen content of, 262.
„ Effects of, on animals and man, 389.
„ Properties of, 388.
„ Reactions of, 388.
„ Treatment of poisoning by (App.), 694.