Chapter XLIII (2)

2637. _Distinctions between Apoplexy and Epilepsy_.--1. Apoplexy mostly happens in people over _thirty_, whereas epilepsy generally occurs under that ago; at any rate for the first time. A person who has epileptic fits over thirty, has generally suffered from them for some years. 2. Again, _in apoplexy_, the body is paralyzed; and, therefore, has not _the convulsions which take place in epilepsy_. 3. The peculiar _snoring_ will also distinguish apoplexy from epilepsy.

2638. _Distinctions between Apoplexy and Drunkeness_.--1. The known habits of the person. 2. The fact of a person who was perfectly sober and sensible a little time before, being found in a state of insensibility. 3. The absence, in apoplexy, of the _smell of drink_ on applying the nose to the mouth. 4. A person in a fit of apoplexy cannot be roused at all; in drunkenness he mostly can, to a certain extent.

2639. _Distinction between Apoplexy and Hysteria_.--Hysterics mostly happen in young, nervous, unmarried women; and are attended with convulsions, sobbing, laughter, throwing about of the body, &c. &c.

2640. _Distinction between Apoplexy and Poisoning by Opium_.--It is exceedingly difficult to distinguish between these two cases. In poisoning by opium, however, we find the particular smell of the drug in the patient's breath. We should also, in forming our opinion, take into consideration the person's previous conduct--whether he has been low and desponding for some time before, or has ever talked about committing suicide.

2641. EPILEPSY.--_Falling Sickness_.--Those fits mostly happen, at any rate for the first time, to young people, and are more common in boys than girls. They are produced by numerous causes.--_Symptoms_. The fit may be preceded by pains in the head, palpitations, &c. &c.; but it mostly happens that the person falls down insensible suddenly, and without any warning whatever. The eyes are distorted, so that only their whites can be seen; there is mostly foaming from the mouth; the fingers are clinched; and the body, especially on one side, is much agitated; the tongue is often thrust out of the mouth. When the fit goes off, the patient feels drowsy and faint, and often sleeps soundly for some time.--_Treatment_. During the fit, keep the patient flat on his back, with his head slightly raised, and prevent him from doing any harm to himself; dash cold water into his face, and apply smelling-salts to his nose; loosen his shirt collar, &c.; hold a piece of wood about as thick as a finger--the handle of a tooth-brush or knife will do as well--between the two rows of teeth, at the back part of the mouth. This will prevent the tongue from being injured. A teaspoonful of common salt thrust into the patient's mouth, during the fit, is of much service. The after-treatment of these fits is various, and depends entirely upon their causes. A good general rule, however, is always to keep the bowels well open, and the patient quiet, and free from fatigue, worry, and excess of all kinds.

2642. _Fainting Fits_ are sometimes very dangerous, and at others perfectly harmless; the question of danger depending altogether upon the causes which have produced them, and which are exceedingly various. For instance, fainting produced by disease of the heart is a very serious symptom indeed; whereas, that arising from some slight cause, such as the sight of blood, &c., need cause no alarm whatever. The symptoms of simple fainting are so well known that it would be quite superfluous to enumerate them here. The _treatment_ consists in laying the patient at full length upon his back, with his head upon a level with the rest of his body, loosening everything about the neck, dashing cold water into the face, and sprinkling vinegar and water about the mouth; applying smelling-salts to the nose; and, when the patient is able to swallow, in giving a little warm brandy-and-water, or about 20 drops of sal-volatile in water.

2643. _Hysterics_.--These fits take place, for the most part, in young, nervous, unmarried women. They happen much less often in married women; and even (in some rare cases indeed) in men. Young women, who are subject to these fits, are apt to think that they are suffering from "all the ills that flesh is heir to;" and the false symptoms of disease which they show are so like the true ones, that it is often exceedingly difficult to detect the difference. The fits themselves are mostly preceded by great depression of spirits, shedding of tears, sickness, palpitation of the heart, &c. A pain, as if a nail were being driven in, is also often felt at one particular part of the head. In almost all cases, when a fit is coming on, pain is felt on the left side. This pain rises gradually until it reaches the throat, and then gives the patient a sensation as if she had a pellet there, which prevents her from breathing properly, and, in fact, seems to threaten actual suffocation. The patient now generally becomes insensible, and faints; the body is thrown about in all directions, froth issues from the mouth, incoherent expressions are uttered, and fits of laughter, crying, or screaming, take place. When the fit is going off, the patient mostly cries bitterly, sometimes knowing all, and at others nothing, of what has taken place, and feeling general soreness all over the body. _Treatment during the fit_. Place the body in the same position as for simple fainting, and treat, in other respects, as directed in the article on Epilepsy. _Always well loosen the patient's stays_; and, when she is recovering, and able to swallow, give 20 drops of sal volatile in a little water. The _after-treatment_ of these cases is very various. If the patient is of a strong constitution, she should live on plain diet, take plenty of exercise, and take occasional doses of castor oil, or an aperient mixture, such as that described as "No. 1," in previous numbers. If, as is mostly the case, the patient is weak and delicate, she will require a different mode of treatment altogether. Good nourishing diet, gentle exercise, cold baths, occasionally a dose of No. 3 myrrh and aloes pills at night, and a dose of compound iron pills twice a day. [As to the myrrh and aloes pills (No. 3), 10 grains made into two pills are a dose for a full-grown person. Of the compound iron pills (No. 4), the dose for a full grown person is also 10 grains, made into two pills.] In every case, amusing the mind, and avoiding all causes of over-excitement, are of great service in bringing about a permanent cure.

2644. LIVER COMPLAINT AND SPASMS.--A very obliging correspondent recommends the following, from personal experience:--Take 4 oz. of dried dandelion root, 1 oz. of the best ginger, 1/4 oz. of Columba root; braise and boil all together in 3 pints of water till it is reduced to a quart: strain, and take a wine-glassful every four hours. Our correspondent says it is a "safe and simple medicine for both liver complaint and spasms."

2645. LUMBAGO.--A "new and successful mode" of treating lumbago, advocated by Dr. Day, is a form of counter-irritation, said to have been introduced into this country by the late Sir Anthony Carlisle, and which consists in the instantaneous application of a flat iron button, gently heated in a spirit-lamp, to the skin. Dr. Corrigan published, about three years ago, an account of some cases very successfully treated by nearly similar means. Dr. Corrigan's plan was, however, to touch the surface of the part affected, at intervals of half an inch, as lightly and rapidly as possible. Dr. Day has found greater advantages to result from drawing the flat surface of the heated button lightly over the affected part, so as to act on a greater extent of surface. The doctor speaks so enthusiastically of the benefit to be derived from this practice, that it is evidently highly deserving attention.

2646. PALPITATION OF THE HEART.--Where palpitation occurs as symptomatic of indigestion, the treatment must be directed to remedy that disorder; when it is consequent on a plethoric state, purgatives will be effectual. In this case the patient should abstain from every kind of diet likely to produce a plethoric condition of body. Animal food and fermented liquor must be particularly avoided. Too much indulgence in sleep will also prove injurious. When the attacks arise from nervous irritability, the excitement must be allayed by change of air and a tonic diet. Should the palpitation originate from organic derangement, it must be, of course, beyond domestic management. Luxurious living, indolence, and tight-lacing often produce this affection: such cases are to be conquered with a little resolution.

2647. Poisons shall be the next subject for remark; and we anticipate more detailed instructions for the treatment of persons poisoned, by giving a simple LIST OF THE PRINCIPAL POISONS, with their ANTIDOTES OR REMEDIES.

Oil of Vitriol ...............\
Aquafortis ................... Magnesia, Chalk, Soap-and-Water.
Spirit of Salt .............../

Emetic Tartar................. Oily Drinks, Solution of Oak-bark.

Salt of Lemons, or............ Chalk, Whiting, Lime or Magnesia and
Acid of Sugar................. Water. Sometimes an Emetic
Draught.

Pump on back, Smelling-Salts to nose,
Prussic Acid................... Artificial Breathing,
Chloride of Lime to nose.

Pearlash ......................\
Soap-Lees...................... \
Smelling-Salts................. \
Nitre.......................... Lemon-Juice and Vinegar-and-Water
Hartshorn...................... /
Sal-Volatile.................../

Arsenic........................\
Fly-Powder, or................. Emetics, Lime-Water, Soap-and-Water,
White Arsenic.................. Sugar and Water, Oily Drinks.
Kings Yellow, or............... /
Yellow Arsenic................./

Mercury........................\
Corrosive Sublimate............ Whites of Eggs, Soap-and-Water.
Calomel......................../

Opium.......................... Emetic Draught, Vinegar-and-Water,
Laudanum....................... dashing Cold Water on
chest and
face, walking up and down two or
three hours.

Lead...........................\
White Lead..................... Epsom Salts, Castor Oil, Emetics.
Sugar of Lead................../
Goulard's Extract............./

Copper
Blue-stone .................... Whites of Eggs, Sugar-and-Water,
Verdigris...................... Castor Oil, Gruel.

Zinc .......................... Lime-Water, Chalk-and-Water,
Soap-and-Water.

Iron .......................... Magnesia, Warm Water.

Henbane........................\
Hemlock........................ Emetics and Castor Oil;
Nightshade..................... Brandy-and-Water, if necessary.
Foxglove......................./

Poisonous Food................. Emetics and Castor Oil.

2648. The symptoms of poisoning may be known for the most part from those of some diseases, which they are very like, from the fact of their coming on _immediately_ after eating or drinking something; whereas those of disease come on, in most cases at least, by degrees, and with warnings. In most cases where poison is known, or suspected, to have been taken, the first thing to be done is to empty the stomach, well and immediately, by means of mustard mixed in warm water, or plain warm salt-and-water, or, better, this draught, which we call No. 1:--Twenty grains of sulphate of zinc in an ounce and a half of water. This draught to be repeated in a quarter of an hour if vomiting does not ensue. The back part of the throat should be well tickled with a feather, or two of the fingers thrust down it, to induce vomiting. The cases where vomiting must not be used are those where the skin has been taken off, and the parts touched irritated and inflamed by the poison taken, and where the action of vomiting would increase the evil. Full instructions are given in the article on each particular poison as to where emetics are or are not to be given. The best and safest way of emptying the stomach is by means of the stomach-pump, as in certain cases the action of vomiting is likely to increase the danger arising from the swollen and congested condition of the blood-vessels of the head, which often takes place. In the hands, however, of any one else than a surgeon, it would be not only useless, but harmful, as a great deal of dexterity, caution, and experience are required to use it properly. After having made these brief introductory remarks, we shall now proceed to particulars.

2649. _Sulphuric Acid, or Oil of Vitriol_ (a clear, colourless liquid, of an oily appearance).--_Symptoms in those who have swallowed it_. When much is taken, these come on immediately. There is great burning pain, extending from the mouth to the stomach; vomiting of a liquid of a dark coffee-colour, often mixed with shreds of flesh and streaks of blood; the skin inside the mouth is taken off; and the exposed surface is at first white, and after a time becomes brownish. There are sometimes spots of a brown colour round the lips and on the neck, caused by drops of the acid falling on these parts. There is great difficulty of breathing, owing to the swelling at the back part of the mouth. After a time there is much depression of strength, with a quick, weak pulse, and cold, clammy skin. The face is pale, and has a very anxious look. When the acid swallowed has been greatly diluted in water, the same kind of symptoms occur, only in a milder degree.--_Treatment_. Give a mixture of magnesia in milk-and-water, or, if this cannot be obtained, of finely powdered chalk, or whiting, or even of the plaster torn down from the walls or ceiling, in milk-and-water. The mixture should be nearly as thick as cream, and plenty of it given. As well as this, simple gruel, milk, or thick flour-and-water, are very useful, and should be given in large quantities. Violent inflammation of the parts touched by the acid is most likely to take place in the coarse of a little time, and can only be properly attended to by a surgeon; but if one cannot be obtained, leeches, the fever-mixtures (the recipe for which appears repeatedly in previous paragraphs), thick drinks, such as barley-water, gruel, arrowroot, &c., must be had recourse to, according to the symptoms of each particular case and the means at hand. The inflamed condition of the back part of the mouth requires particular attention. When the breathing is very laboured and difficult in consequence, from fifteen to twenty leeches are to be immediately applied to the outside of the throat, and when they drop off, warm poppy fomentations constantly kept to the part. When the pain over the stomach is very great, the same local treatment is necessary; but if it is only slight, a good mustard poultice will be sufficient without the leeches. In all these cases, two tablespoonfuls of the fever-mixture should be given every four hours, and only gruel or arrowroot allowed to be eaten for some days.

2650. _Nitric Acid_, commonly known as _Aqua Fortis_, or _Red Spirit of Nitre_ (a straw-coloured fluid, of the consistence of water, and which gives off dense white fumes on exposure to the air).--_Symptoms produced in those who have swallowed it._ Much the same as in the case of sulphuric acid. In this case, however, the surface touched by the acid becomes _yellowish_. The tongue is mostly much swollen.--_Treatment_. The same as for sulphuric acid.

2651. _Muriatic Acid, Spirit of Salt_ (a thin yellow fluid, emitting dense white fumes on exposure to the air).--This is not often taken as a poison. The _symptoms_ and _treatment_ are much the same as those of _nitric acid_.

N.B.--_In no case of poisoning by these three acids should emetics ever be given_.

2652. _Oxalic Acid_, commonly called _Salt of Lemons_.--This poison may be taken by mistake for Epsom salts, which it is a good deal like. It may be distinguished from them by its very acid taste and its shape, which is that of needle-formed crystals, each of which, if put into a drop of ink, will turn it to a reddish brown, whereas Epsom salts will not change its colour at all. When a large dose of this poison has been taken, death takes place very quickly indeed.--_Symptoms produced in those who have swallowed it_. A hot, burning, acid taste is felt in the act of swallowing, and vomiting of a _greenish-brown_ fluid is produced, sooner or later, according to the quantity and strength of the poison taken. There is great tenderness felt over the stomach, followed by clammy perspirations and convulsions; the legs are often drawn up, and there is generally stupor, from which the patient, however, can easily be roused, and always great prostration of strength. The pulse is small and weak, and the breathing faint.--_Treatment_. Chalk or magnesia, made into a cream with water, should be given in large quantities, and afterwards the emetic draught above prescribed, or some mustard-and-water, if the draught cannot be got. The back part of the throat to be tickled with a feather, to induce vomiting. Arrowroot, gruel, and the like drinks, are to be taken. When the prostration of strength is very great and the body cold, warmth is to be applied to it, and a little brandy-and-water, or sal-volatile and water, given.

2653. _Prussic Acid_ (a thin, transparent, and colourless liquid, with a peculiar smell, which greatly resembles that of bitter almonds).--_Symptoms produced in those who have swallowed it_. These come on _immediately_ after the poison has been taken, and may be produced by merely _smelling_ it. The patient becomes perfectly insensible, and falls down in convulsions--his eyes are fixed and staring, the pupils being bigger than natural, the skin is cold and clammy, the pulse scarcely perceptible, and the breathing slow and gasping.--_Treatment_. Very little can be done in these cases, as death takes place so quickly after the poison has been swallowed, when it takes place at all. The best treatment--which should always be adopted in all cases, even though the patient appears quite dead-is to dash quantities of cold water on the back, from the top of the neck downwards. Placing the patient under a pump, and pumping on him, is the best way of doing this. Smelling-salts are also to be applied to the nose, and the chest well rubbed with a camphor liniment.

2654. ALKALIS: _Potash, Soda_, and _Ammonia_, or common _Smelling-Salts_, with their principal preparations--_Pearlash, Soap Lees, Liquor Potassae, Nitre, Sal Prunella, Hartshorn_, and _Sal--Volatile._--Alkalis are seldom taken or given with the view of destroying life. They may, however, be swallowed by mistake.--_Symptoms produced in those who have swallowed them_. There is at first a burning, acrid taste in, and a sensation of tightness round, the throat, like that of strangling; the skin touched is destroyed; retching mostly followed by actual vomiting, then sets in; the vomited matters often containing blood of a dark brown colour, with little shreds of flesh here and there, and always changing vegetable blue colours green. There is now great tenderness over the whole of the belly. After a little while, great weakness, with cold, clammy sweats, a quick weak pulse, and purging of bloody matters, takes place. The brain, too, mostly becomes affected.--_Treatment_. Give two tablespoonfuls of vinegar or lemon-juice in a glassful of water every few minutes until the burning sensation is relieved. Any kind of oil or milk may also be given, and will form soap when mixed with the poison in the stomach. Barley-water, gruel, arrowroot, linseed-tea, &c., are also very useful, and should be taken constantly, and in large quantities. If inflammation should take place, it is to be treated by applying leeches and warm poppy fomentations to the part where the pain is most felt, and giving two tablespoonfuls of the fever mixture every four hours. The diet in all these cases should only consist of arrowroot or gruel for the first few days, and then of weak broth or beef-tea for some time after.

2655. When very strong fumes of smelling-salts have in any way been inhaled, there is great difficulty of breathing, and alarming pain in the mouth and nostrils. In this case let the patient inhale the steam of warm vinegar, and treat the feverish symptoms as before.

2656. _Arsenic_.--Mostly seen under the form of white arsenic, or fly-powder, and yellow arsenic, or king's yellow.--_Symptoms produced in those who have swallowed it_. These vary very much, according to the form and dose in which the poison has been taken. There is faintness, depression, and sickness, with an intense burning pain in the region of the stomach, which gets worse and worse, and is increased by pressure. There is also vomiting of dark brown matter, sometimes mixed with blood; and mostly great thirst, with a feeling of tightness round, and of burning in, the throat. Purging also takes place, the matters brought away being mixed with blood. The pulse is small and irregular, and the skin sometimes cold and clammy, and at others hot. The breathing is painful. Convulsions and spasms often occur.--_Treatment_. Give a couple of teaspoonfuls of mustard in a glass of water, to bring on or assist vomiting, and also use the other means elsewhere recommended for the purpose. A solution, half of lime-water and half of linseed-oil, well mixed, may be given, as well as plenty of arrowroot, gruel, or linseed-tea. Simple milk is also useful. A little castor-oil should be given, to cleanse the intestines of all the poison, and the after-symptoms treated on general principles.

2657. _Corrosive Sublimate_.--Mostly seen in the form of little heavy crystalline masses, which melt in water, and have a metallic taste. It is sometimes seen in powder. This is a most powerful poison.--_Symptoms_. These mostly come on immediately after the poison has been taken. There is a coppery taste experienced in the act of swallowing, with a burning heat, extending from the top of the throat down to the stomach; and also a feeling of great tightness round the throat. In a few minutes great pain is felt over the region of the stomach, and frequent vomiting of long, stringy white masses, mixed with blood, takes place. There is also mostly great purging. The countenance is generally pale and anxious; the pulse always small and frequent; the skin cold and clammy, and the breathing difficult. Convulsions and insensibility often occur, and are very bad symptoms indeed. The inside of the mouth is more or less swollen.--_Treatment_. Mix the whites of a dozen eggs in two pints of cold water, and give a glassful of the mixture every three or four minutes, until the stomach can contain no more. If vomiting does not now come on naturally, and supposing the mouth is not very sore or much swollen, an emetic draught, No. 1, may be given, and vomiting induced. (The No. 1 draught, we remind our readers, is thus made:--Twenty grains of sulphate of zinc in an ounce and a half of water; the draught to be repeated if vomiting does not take place in a quarter of an hour.) After the stomach has been well cleaned out, milk, flour-and-water, linseed-tea, or barley-water, should be taken in large quantities. If eggs cannot be obtained, milk, or flour-and-water, should be given as a substitute for them at once. When the depression of strength is very great indeed, a little warm brandy-and-water must be given. In the course of an hour or two the patient should take two tablespoonfuls of castor-oil, and if inflammation comes on, it is to be treated as directed in the article on acids and alkalis. The diet should also be the same. If the patient recovers, great soreness of the gums is almost certain to take place. The simplest, and at the same time one of the best modes of treatment, is to wash them well three or four times a day with brandy-and-water.

2658. _Calomel_.--A heavy white powder, without taste, and insoluble in water. It has been occasionally known to destroy life.--_Symptoms_. Much the same as in the case of corrosive sublimate.--_Treatment_. The same as for corrosive sublimate. If the gums are sore, wash them, as recommended in the case of corrosive sublimate, with brandy-and-water three or four times a day, and keep the patient on _fluids_, such as arrowroot, gruel, broth, or beef-tea, according to the other symptoms. Eating hard substances would make the gums more sore and tender.

2659. _Copper_.--The preparations of this metal which are most likely to be the ones producing poisonous symptoms, are _blue-stone_ and _verdigris_. People are often taken ill after eating food that has been cooked in copper saucepans. When anything has been cooked in one of these vessels, _it should never be allowed to cool in it_.--_Symptoms_. Headache, pain in the stomach, and purging; vomiting of green or blue matters, convulsions, and spasms.--_Treatment_. Give whites of eggs, sugar-and-water, castor-oil, and drinks, such as arrowroot and gruel.

2660. _Emetic Tartar_.--Seen in the form of a white powder, or crystals, with a slightly metallic taste. It has not often been known to destroy life.--_Symptoms_. A strong metallic taste in the act of swallowing, followed by a burning pain in the region of the stomach, vomiting, and great purging. The pulse is small and rapid, the skin cold and clammy, the breathing difficult and painful, and the limbs often much cramped. There is also great prostration of strength.--_Treatment_. Promote the vomiting by giving plenty of warm water, or warm arrowroot and water. Strong tea, in large quantities, should be drunk; or, if it can be obtained, a decoction of oak bark. The after-treatment is the same as that for acids and alkalis; the principal object in all these cases being to keep down the inflammation of the parts touched by the poison by means of leeches, warm poppy fomentations, fever-mixtures, and very low diet.

2661. _Lead_, and its preparations, _Sugar of Lead, Goulard's Extract, White Lead._--Lead is by no means an active poison, although it is popularly considered to be so. It mostly affects people by being taken into the system slowly, as in the case of painters and glaziers. A newly-painted house, too, often affects those living in it.--_Symptoms produced when taken in a large dose_. There is at first a burning, pricking sensation in the throat, to which thirst, giddiness, and vomiting follow. The belly is tight, swollen, and painful; _the pain being relieved by pressure_. The bowels are mostly bound. There is great depression of strength, and a cold skin.--Treatment. Give an emetic draught (No. 1, see above) at once, and shortly afterwards a solution of Epsom salts in large quantities. A little brandy-and-water must be taken if the depression of strength is very great indeed. Milk, whites of eggs, and arrowroot are also useful. After two or three hours, cleanse the stomach and intestines well out with two tablespoonfuls of castor-oil, and treat the symptoms which follow according to the rules laid down in other parts of these articles.--_Symptoms when it is taken into the body slowly_. Headache, pain about the navel, loss of appetite and flesh, offensive breath, a blueness of the edges of the gums; the belly is tight, hard, and knotty, and the pulse slow and languid. There is also sometimes a difficulty in swallowing.--_Treatment_. Give five grains of calomel and half a grain of opium directly, in the form of a pill, and half an ounce of Epsom salts in two hours, and repeat this treatment until the bowels are well opened. Put the patient into a warm bath, and throw up a clyster of warmish water when he is in it. Fomentations of warm oil of turpentine, if they can be obtained, should be put over the whole of the belly. The great object is to open the bowels as freely and as quickly as possible. When this has been done, a grain of pure opium may be given. Arrowroot or gruel should be taken in good large quantities. The after-treatment must depend altogether upon the symptoms of each particular case.

2662. _Opium_, and its preparations, _Laudanum, &c_.--Solid opium is mostly seen in the form of rich brown flattish cakes, with little pieces of leaves sticking on them here and there, and a bitter and slightly warm taste. The most common form in which it is taken as a poison, is that of laudanum.--_Symptoms_. These consist at first in giddiness and stupor, followed by insensibility, the patient, however, being roused to consciousness by a great noise, so as to be able to answer a question, but becoming insensible again almost immediately. The pulse is now quick and small, the breathing hurried, and the skin warm and covered with perspiration. After a little time, these symptoms change; the person becomes _perfectly insensible_, the breathing slow and _snoring_, as in apoplexy, the skin cold, and the pulse slow and full. The pupil of the eye is mostly smaller than natural. On applying his nose to the patient's mouth, a person may smell the poison very distinctly.--_Treatment_. Give an emetic draught (No. 1, see above) directly, with large quantities of warm mustard-and-water, warm salt-and-water, or simple warm water. Tickle the top of the throat with a feather, or put two fingers down it to bring on vomiting, which rarely takes place of itself. Dash cold water on the head, chest, and spine, and flap these parts well with the ends of wet towels. Give strong coffee or tea. Walk the patient up and down in the open air for two or three hours; the great thing being to keep him from sleeping. Electricity is of much service. When the patient is recovering, mustard poultices should be applied to the soles of the feet and the insides of the thighs and legs. The head should be kept cool and raised.

2663. The following preparations, which are constantly given to children by their nurses and mothers, for the purpose of making them sleep, often prove fatal:--_Syrup of Poppies_, and _Godfrey's Cordial_. The author would most earnestly urge all people caring for their children's lives, never to allow any of these preparations to be given, unless ordered by a surgeon.

2664. The treatment in the case of poisoning by _Henbane_, _Hemlock_, _Nightshade_, and _Foxglove_, is much the same as that for opium. Vomiting should be brought on in all of them.

2665. _Poisonous Food_.--It sometimes happens that things which are in daily use, and mostly perfectly harmless, give rise, under certain unknown circumstances, and in certain individuals, to the symptoms of poisoning. The most common articles of food of this description are _Mussels_, _Salmon_, and certain kinds of _Cheese_ and _Bacon_. The general symptoms are thirst, weight about the stomach, difficulty of breathing, vomiting, purging, spasms, prostration of strength, and, in the case of mussels more particularly, an eruption on the body, like that of nettle-rash.--_Treatment_. Empty the stomach well with No. 1 draught and warm water, and give two tablespoonfuls of castor-oil immediately after. Let the patient take plenty of arrowroot, gruel, and the like drinks, and if there is much depression of strength, give a little warm brandy-and-water. Should symptoms of fever or inflammation follow, they must be treated as directed in the articles on other kinds of poisoning.

2666. _Mushrooms_, and similar kinds of vegetables, often produce poisonous effects. The symptoms are various, sometimes giddiness and stupor, and at others pain in and swelling of the belly, with vomiting and purging, being the leading ones. When the symptoms come on quickly after taking the poison, it is generally the head that is affected.--The treatment consists in bringing on vomiting in the usual manner, as quickly and as freely as possible. The other symptoms are to be treated on general principles; if they are those of depression, by brandy-and-water or sal-volatile; if those of inflammation, by leeches, fomentations, fever-mixtures, &c. &c.

2667. FOR CURE OF RINGWORM.--Take of subcarbonate of soda 1 drachm, which dissolve in 1/2 pint of vinegar. Wash the head every morning with soft soap, and apply the lotion night and morning. One teaspoonful of sulphur and treacle should also be given occasionally night and morning. The hair should be cut close, and round the spot it should be shaved off, and the part, night and morning, bathed with a lotion made by dissolving a drachm of white vitriol in 8 oz. of water. A small piece of either of the two subjoined ointments rubbed into the part when the lotion has dried in. No, 1.--Take of citron ointment 1 drachm; sulphur and tar ointment, of each 1/2 oz.: mix thoroughly, and apply twice a day. No. 2.--Take of simple cerate 1 oz.; creosote 1 drachm; calomel 30 grains: mix and use in the same manner as the first. Concurrent with these external remedies, the child should take an alterative powder every morning, or, if they act too much on the bowels, only every second day. The following will be found to answer all the intentions desired.

2668. Alterative Powders for Ringworm.--Take of

Sulphuret of antimony, precipitated . 24 grains.
Grey powder . . . . . 12 grains.
Calomel . . . . . . 6 grains.
Jalap powder . . . . . 36 grains.

Mix carefully, and divide into 12 powders for a child from 1 to 2 years old; into 9 powders for a child from 2 to 4 years; and into 6 powders for a child from 4 to 6 years. Where the patient is older, the strength may be increased by enlarging the quantities of the drugs ordered, or by giving one and a half or two powders for one dose. The ointment is to be well washed off every morning with soap-and-water, and the part bathed with the lotion before re-applying the ointment. An imperative fact must be remembered by mother or nurse,--never to use the same comb employed for the child with ringworm, for the healthy children, or let the affected little one sleep with those free from the disease; and, for fear of any contact by hands or otherwise, to keep the child's head enveloped in a nightcap, till this eruption is completely cured.

2669. SCRATCHES.--Trifling as scratches often seem, they ought never to be neglected, but should be covered and protected, and kept clean and dry until they have completely healed. If there is the least appearance of inflammation, no time should be lost in applying a large bread-and-water poultice, or hot flannels repeatedly applied, or even leeches in good numbers may be put on at some distance from each other.

2670. FOR SHORTNESS OF BREATH, OR DIFFICULT BREATHING.--Vitriolated spirits of ether 1 oz., camphor 12 grains: make a solution, of which take a teaspoonful during the paroxysm. This is found to afford instantaneous relief in difficulty of breathing, depending on internal diseases and other causes, where the patient, from a very quick and laborious breathing, is obliged to be in an erect posture.

2671. SPRAINS.--A sprain is a stretching of the leaders or ligaments of a part through some violence, such as slipping, falling on the hands, pulling a limb, &c. &c. The most common are those of the ankle and wrist. These accidents are more serious than people generally suppose, and often more difficult to cure than a broken log or arm. The first thing to be done is to place the sprained part in the straight position, and to raise it a little as well. Some recommend the application of cold lotions at first. The editress, however, is quite convinced that warm applications are, in most cases, the best for for the first three or four days. These fomentations are to be applied in the following manner:--Dip a good-sized piece of flannel into a pail or basin full of hot water or hot poppy fomentation,--six poppy heads boiled in one quart of water for about a quarter of an hour; wring it almost dry, and apply it, as hot as the patient can bear, right round the sprained part. Then place another piece of flannel, quite dry, over it, in order that the steam and warmth may not escape. This process should be repeated as often as the patient feels that the flannel next to his skin is getting cold--the oftener the better. The bowels should be opened with a black draught, and the patient kept on low diet. If he has been a great drinker, he may be allowed to take a little beer; but it is better not to do so. A little of the cream of tartar drink, ordered in the case of burns, may be taken occasionally if there is much thirst. When the swelling and tenderness about the joint are very great, from eight to twelve leeches may be applied. When the knee is the joint affected, the greatest pain is felt at the inside, and therefore the greater quantity of the leeches should be applied to that part. When the shoulder is sprained, the arm should be kept close to the body by means of a linen roller, which is to be taken four or five times round the whole of the chest. It should also be brought two or three times underneath the elbow, in order to raise the shoulder. This is the best treatment for these accidents during the first three or four days. After that time, supposing that no unfavourable symptoms have taken place, a cold lotion, composed of a tablespoonful of sal-ammoniac to a quart of water, or vinegar-and-water, should be constantly applied. This lotion will strengthen the part, and also help in taking away any thickening that may have formed about the joint. In the course of two or three weeks, according to circumstances, the joint is to be rubbed twice a day with flannel dipped in opodeldoc, a flannel bandage rolled tightly round the joint, the pressure being greatest at the lowest part, and the patient allowed to walk about with the assistance of a crutch or stick. He should also occasionally, when sitting or lying down, quietly bend the joint backwards and forwards, to cause its natural motion to return, and to prevent stiffness from taking place. When the swelling is very great immediately after the accident has occurred, from the breaking of the blood-vessels, it is best to apply cold applications at first. If it can be procured, oil-silk may be put over the warm-fomentation flannel, instead of the dry piece of flannel. Old flannel is better than new.

2672. CURE FOR STAMMERING.--Where there is no malformation of the organs of articulation, stammering may be remedied by reading aloud with the teeth closed. This should be practised for two hours a day, for three or four months. The advocate of this simple remedy says, "I can speak with certainty of its utility."

2673. STAMMERING.--At a recent meeting of the Boston Society of Natural History, Dr. Warren stated, "A simple, easy, and effectual cure of stammering." It is, simply, at every syllable pronounced, to tap at the same time with the finger; by so doing, "the most inveterate stammerer will be surprised to find that he can pronounce quite fluently, and, by long and constant practice, he will pronounce perfectly well."

2674. SUFFOCATION, APPARENT.--Suffocation may arise from many different causes. Anything which prevents the air getting into the lungs will produce it. We shall give the principal causes, and the treatment to be followed in each case.

2675. 1. _Carbonic Acid Gas. Choke-Damp of Mines_.--This poisonous gas is met with in rooms where charcoal is burnt, and where there is not sufficient draught to allow it to escape; in coalpits, near limekilns, in breweries, and in rooms and houses where a great many people live huddled together in wretchedness and filth, and where the air in consequence becomes poisoned. This gas gives out no smell, so that we cannot know of its presence. A candle will not burn in a room which contains much of it.--_Effects_. At first there is giddiness, and a great wish to sleep; after a little time, or where there is much of it present, a person feels great weight in the head, and stupid; gets by degrees quite unable to move, and snores as if in a deep sleep. The limbs may or may not be stiff. The heat of the body remains much the same at first.--_Treatment_. Remove the person affected into the open air, and, even though it is cold weather, take off his clothes. Then lay him on his back, with his head slightly raised. Having done this, dash vinegar-and-water over the whole of the body, and rub it hard, especially the face and chest, with towels dipped in the same mixture. The hands and feet also should be rubbed with a hard brush. Apply smelling-salts to the nose, which may be tickled with a feather. Dashing cold water down the middle of the back is of great service. If the person can swallow, give him a little lemon-water, or vinegar-and-water to drink. The principal means, however, to be employed in this, as, in fact, in most cases of apparent suffocation, is what is called _artificial breathing_. This operation should be performed by three persons, and in the following manner:--The first person should put the nozzle of a common pair of bellows into one of the patient's nostrils; the second should push down, and then thrust back, that part of the throat called "Adam's apple;" and the third should first raise and then depress the chest, one hand being placed over each side of the ribs. These three actions should be performed in the following order:--First of all, the throat should be drawn down and thrust back; then the chest should be raised, and the bellows gently blown into the nostril. Directly this is done, the chest should be depressed, so as to imitate common breathing. This process should be repeated about eighteen times a minute. The mouth and the other nostril should be closed while the bellows are being blown. Persevere, if necessary, with this treatment for seven or eight hours--in fact, till absolute signs of death are visible. Many lives are lost by giving it up too quickly. When the patient becomes roused, he is to be put into a warm bed, and a little brandy-and-water, or twenty drops of sal-volatile, given cautiously now and then. This treatment is to be adopted in all cases where people are affected from breathing bad air, smells, &c. &c.

2676. 2. _Drowning_.--This is one of the most frequent causes of death by suffocation.--Treatment. Many methods have been adopted, and as some of them are not only useless, but hurtful, we will mention them here, merely in order that they may be avoided. In the first place, then, never hang a person up by his heels, as it is an error to suppose that water gets into the lungs. Hanging a person up by his heels would be quite as bad as hanging him up by his neck. It is also a mistake to suppose that rubbing the body with salt and water is of service.--_Proper Treatment_. Directly a person has been taken out of the water, he should be wiped dry and wrapped in blankets; but if these cannot be obtained, the clothes of the bystanders must be used for the purpose. His head being slightly raised, and any water, weeds, or froth that may happen to be in his mouth, having been removed, he should be carried as quickly as possible to the nearest house. He should now be put into a warm bath, about as hot as the hand can pleasantly bear, and kept there for about ten minutes, artificial breathing being had recourse to while he is in it. Having been taken out of the bath, he should be placed flat on his back, with his head slightly raised, upon a warm bed in a warm room, wiped perfectly dry, and then rubbed constantly all over the body with warm flannels. At the same time, mustard poultices should be put to the soles of the feet, the palms of the hands, and the inner surface of the thighs and legs. Warm bricks, or bottles filled with warm water, should be placed under the armpits. The nose should be tickled with a feather, and smelling-salts applied to it. This treatment should be adopted while the bath is being got ready, as well as when the body has been taken out of it. The bath is not absolutely necessary; constantly rubbing the body with flannels in a warm room having been found sufficient for resuscitation. Sir B. Brodie says that warm air is quite as good as warm water. When symptoms of returning consciousness begin to show themselves, give a little wine, brandy, or twenty drops of sal-volatile and water. In some cases it is necessary, in about twelve or twenty-four hours after the patient has revived, to bleed him, for peculiar head-symptoms which now and then occur. Bleeding, however, even in the hands of professional men themselves, should be very cautiously used--non-professional ones should never think of it. The best thing to do in these cases is to keep the head well raised, and cool with a lotion such as that recommended above for sprains; to administer an aperient draught, and to abstain from giving anything that stimulates, such as wine, brandy, sal-volatile, &c. &c. As a general rule, a person dies in three minutes and a half after he has been under water. It is difficult, however, to tell how long he has actually been _under_ it, although we may know well exactly how long he has been _in_ it. This being the case, always persevere in your attempts at resuscitation until actual signs of death have shown themselves, even for six, eight, or ten hours. Dr. Douglas, of Glasgow, resuscitated a person who had been under water for fourteen minutes, by simply rubbing the whole of his body with warm flannels, in a warm room, for eight hours and a half, at the end of which time the person began to show the _first_ symptoms of returning animation. Should the accident occur at a great distance from any house, this treatment should be adopted as closely as the circumstances will permit of. Breathing through any tube, such as a piece of card or paper rolled into the form of a pipe, will do as a substitute for the bellows. To recapitulate: Rub the body dry; take matters out of mouth; cover with blankets or clothes; slightly raise the head, and place the body in a warm bath, or on a bed in a warm room; apply smelling-salts to nose; employ artificial breathing; rub well with warm flannels; put mustard poultices to feet, hands, and insides of thighs and legs, with warm bricks or bottles to armpits. _Don't bleed_. Give wine, brandy, or sal-volatile when recovering, and _persevere till actual signs of death are seen._

2677. Briefly to conclude what we have to say of suffocation, let us treat of _Lightning_. When a person has been struck by lightning, there is a general paleness of the whole body, with the exception of the part struck, which is often blackened, or even scorched.--_Treatment_. Same as for drowning. It is not, however, of much use; for when death takes place at all, it is generally instantaneous.

2678. CURE FOR THE TOOTHACHE.--Take a piece of sheet zinc, about the size of a sixpence, and a piece of silver, say a shilling; place them together, and hold the defective tooth between them or contiguous to them; in a few minutes the pain will be gone, as if by magic. The zinc and silver, acting as a galvanic battery, will produce on the nerves of the tooth sufficient electricity to establish a current, and consequently to relieve the pain. Or smoke a pipe of tobacco and caraway-seeds. Again--

2679. A small piece of the pellitory root will, by the flow of saliva it causes, afford relief. Creosote, or a few drops of tincture of myrrh, or friar's balsam, on cotton, put on the tooth, will often subdue the pain. A small piece of camphor, however, retained in the mouth, is the most reliable and likely means of conquering the paroxysms of this dreaded enemy.

2680. WARTS.--Eisenberg says, in his "Advice on the Hand," that the hydrochlorate of lime is the most certain means of destroying warts; the process, however, is very slow, and demands perseverance, for, if discontinued before the proper time, no advantage is gained. The following is a simple cure:--On breaking the stalk of the crowfoot plant in two, a drop of milky juice will be observed to hang on the upper part of the stem; if this be allowed to drop on a wart, so that it be well saturated with the juice, in about three or four dressings the warts will die, and may be taken off with the fingers. They may be removed by the above means from the teats of cows, where they are sometimes very troublesome, and prevent them standing quiet to be milked. The wart touched lightly every second day with lunar caustic, or rubbed every night with blue-stone, for a few weeks, will destroy the largest wart, wherever situated.

2681. To CURE A WHITLOW.--As soon as the whitlow has risen distinctly, a pretty large piece should be snipped out, so that the watery matter may readily escape, and continue to flow out as fast as produced. A bread-and-water poultice should be put on for a few days, when the wound should be bound up lightly with some mild ointment, when a cure will be speedily completed. Constant poulticing both before and after the opening of the whitlow, is the only practice needed; but as the matter lies deep, when it is necessary to open the abscess, the incision must be made _deep_ to reach the suppuration.

2682. WOUNDS.--There are several kinds of wounds, which are called by different names, according to their appearance, or the manner in which they are produced. As, however, it would be useless, and even hurtful, to bother the reader's head with too many nice professional distinctions, we shall content ourselves with dividing wounds into three classes.

2683. 1. _Incised wounds or cuts_--those produced by a knife, or some sharp instrument.

2684. 2. _Lacerated, or torn wounds_--those produced by the claws of an animal, the bite of a dog, running quickly against some projecting blunt object, such as a nail, &c.

2685. 3. _Punctured or penetrating wounds_--those produced by anything running deeply into the flesh; such as a sword, a sharp nail, a spike, the point of a bayonet, &c.