ACCIDENTS——EMEEOENCIES—POISONS. 107 possible ; and, as in the case of all highly irritating poisons, this should be followed by free drinking of Milk, Flaxseed Tea, -White of Egg and Water, Sugar and Wafer, Gum-Arabic Water, and similar things. Camphor. When taken in large doses, camphor acts as a narcotic poison. The contents of the stomach, in such cases, should be evacuated by an Emetic (page 91), followed by draughts of warm water, Flax- seed Tea, Gum-Arabic Water, Milk, and similar substances. The strong odor of Camphor in the breath and perspiration, in case of poisoning, with narcotic symptoms, would naturally point out the peculiar agent employed. Draughts of strong Coffee, it would seem, might be as useful in tlie case of narcotic poisoning from Camphor as in the case of nar- cotic poisoning by Opium and other substances of this class. (See "Opium,"page 109.) t'oniiini (" Hemlock"). This well-known plant is an active poison, when taken internally in sufficient quantity. It is supposed to be the narcotic used by the Greeks, and other nations, to destroy the life of condemned criminals. Socrates and Phocion, it will be remembered, were compelled by the Athenians to drink a decoction of it. Its action is that of a narcotic, and the treatment consists in get- ting out of tlie stomach, as soon as possible, by an Emetic (page 91), all the vegetable there, and then counteracting the effects of tlia't which has been absorbed into the blood, and tends to over- power the brain and nervous system. See remarks on "Alcohol" (page 104), and "Opium," (page 109). Digitalis ("Foxglove"). This beautiful plant of the garden, cultivated in this country for its flower, and used, in proper quantities, as a valuable medi- cine, is a poison of the narcotic class, with a disposition to over- 108 ACCIDENTS——EMERGENCIES——POISONS. come the portion of the nervous system controlling the action of the lieart. The same treatment should be pursued, when Digitalis has been taken in poisonous quantities, as recommended for other narcotics. The peculiar tendency to stop the action of the heart should be specially combated by giving twenty or thirty drops of Aromatic Spirits of Ammonia every three or four minutes in a table-spoonful of water, or some other stimulant. Dnicamara ("Bitter Sweet," "Woody Sightshade"); This well-known plant belongs to the narcotic class of poisons, with symptoms like tliosc of Belladonna and Stramonium. The treatment is about the same as heretofore spoken of since we began our remarks upon the Vegetable Poisons. See "Bella- donna," (page 100). Hyoscvanuis ("Henbane"), This vegetable, made use of in medicine, if taken internally in improper quantities, acts as a narcotic poison, like others of the same natural order (Solanacic), as Belladonna, Dulcamara, and Stramonium. As the treatment of a poison depends upon tlie action of the agent, we would naturally treat poisoning by Hyoscyamus as by other articles acting the same way. See " Belladonna," page 106 ; " Stramonium," page 115. Lobelia ("Indian Tobacco"); This vegetable is not now much used as a medicine by physi- cians, as the comparative recent discoveries in chemistry have added substitutes to the list of drugs, without the peculiar disad- vantages of this substance. In poisonous quantities, Lobelia belongs to the class of aero- narcotics spoken of under the head of "Aconite" (page 105). Fortunately one of the symptoms following its use is vomiting. This should be encouraged by drinks of tepid water, Gum-Arabic ACCIDBNTS—BMBBGENCIES— POISONS. 109 Water, etc.; and, if kept up until all the poison is rejected by the stomach, a favorable issue may be expected. Should vomit- ing not occur at once, as a symptom, enough of the poison may be absorbed into the blood to exert a fatal narcotic influence upon the brain and nervous system; or, perhaps, to speak more pre- cisely, through these organs upon the movements of respiration and circulation of the blood. Opium. This substance, or the numerous preparations of it used in medi- cine, is one of the most frequent causes of poison a physician is called in to sec. A fruitful source of mistake is that of confound- ing together of Laudanum and Paregoric. When the latter is supposed to have been given by the nurse, the mistake is not found out until it is often too late to be of material service in avertin"- a fatal end. Morphia, the active principle of Opium, is often kept as a solution, in private houses, for domestic use. Any of tlicse preparations of Opium, in improper doses, are fol- lowed by symptoms of narcotic poisoning. Not only these, but many popular nostrums, as "Infant Cordials" and "Soothing- Syrups" of various kinds, depend for their utility upon some pre- paration of Opium, and are hence often followed by symptoms of narcotic poisoning. None of these things should be used. If a child cries, it is usually because it feels pain; and, instead of making it so stupid with narcotics that it can not feel the pain, it is better to go to work and find out the cause of the pain, and re- move it. There is some reason for the suspicion that, in many instances, where a modicum of the popular remedies of this class arc not furnished by the mother to the nursery, the enterprise of the nurse, "rather than see tlie child suffer," secures it for the char'-e committed to her care, from a neighboring apothecary- shop. Opium, its preparations, and the active principle of the drug, Morphia, all act in the same way, by absorption into the blood, 110 ACCIDENTS-—EMERGENCIES—POISONS. and distribution by it to the brain and nervous system. Through these organs, the movements of the chest and heart become more or less interfered with. In this respect, its action is essentially like tliat of Carbonic Acid Gas, Aicoho], and most of the vegetable poisons herein described, without, however, any acrid or irritating complication. Treatment.—It is safe to say that at present there is no known Antidote to any of the narcotic poisons, using the word Antidote as understood by physicians. What is in the stomach must be taken out, to prevent further absorption, and wliat is in the blood must be worked but, under proper guidance, by the processes of nature constantly engaged with such products. If the breathing and circulation tend to cease, because of the inability of the brain and nervous system to temporarily discharge these duties, these essential movements must be taken charge of by a friend. An active Emetic, like Ground Mustard, must be given at once, remembering that trouble may be found in getting it to act, owing to the diminished sensibility to its presence, from tlie local stupe. tying action of the Opium to the mucous membrane of tlie stomach. The action of the Mustard should be assisted by tickling the inside of tlie throat with the fingers or a feather. Sulphate of Zinc, Salt and Water, Pulverized Ipecacuanha (page 92) may be given ; in fact, any thing, to empty the stomach as soon as possible. The narcotic effects upon the brain at the same time, as far as possible, must be attended to. If the respiration is yielding to the poison, that is, falling much below the standard or about twenty to the minute, it must be sustained by assistance. As directed under the head of "Asphyxia from Carbonic Acid Gas" (page 14), the exposed body of the patient sliould be daslied with cold water, not neglecting the head, face, and chest. After the cold . water has been sufficiently used in this way, the body should be dried, removed to a dry spot, and liot applications made to the ex- tremities and other parts. This is necessary, owing to the heat- ACCIDENTS——EMERGENCIES——POISONS. Ill producing power of the body being impaired by the suspended or diminished respiration. If the respiration is not suspended, but is going on at a dimin- ished rate. say six or eight to the minute, artificial respiration is not required, unless the number of respiratory movements of the chest falls below that; but tlie other measures may be used. In addition to these, a strong stimulant, in the sliape of twenty or thirty drops of Aromatic Spirits of Ammonia in a table-spoonful of water, may be given three or four times, at intervals of a couple or more minutes. It is better than brandy, or any tiling alcoholic, because the mode of the action of brandy is much the same upon the brain as Opium, and it might be rather adding to instead of taking from the poison that is at work. The often referred to Aromatic Spirits of Ammonia will give the advantage without the suggested disadvantage. A few table-spoonfuls of very strong, freshly made Coffee is a useful thing to give in such cases. Among measures to keep in activity the circulation and respira- tion, as well as to promote the elimination (casting out) from the blood of the poison acting as a narcotic, there are few things more useful than muscular exercise. If the circumstances permit it, this is often effected by a person getting on each side of the individual under the influence of the narcotic, supporting him under the arms, and walking up and down the floor with him. The writer saw a case wliero the person under the influence of this narcotic (Opium) was wholly unconscious, and with breathing not over six to the minute. A relay of persons walked him up and down a long room for three hours, a person -walking behind to "hold the head of the patient in a natural position over his shoulder. Occasionally he was stopped at a suitable place, the blanket around him removed for a moment, and lie was-dashed with cold water. The body was then rapidly dried, and the blanket in tlie mean while having been heated, was reapplied. Once the respira- tion became so feeble that he was placed on his back, and tlie artificial breathing (Silvester's method, page 8) used for some min- ,li2 ACCIDENTS——EMEBQENCIES—POISONS. utes. "While this was being done by one person (a policeman ?T ihis case), under the directions of the physician, another individual caught hold of each ankle, bent the knee, pushed the knee upward until it touched the stomach, and then straightened out the entire leg. This was done several times a minute, and perhaps was as useful as walking the patient up and down the floor, besides not interfering in any way with other measures of relief. Indeed, there is some reason for thinking the action of the lieart would be more favored by such muscular movements, with the patient on his back. than if the person was standing uprio-ht. Whipping the body by a folded towel wrung out in cold water is of the greatest use in cases of narcotic poisoning. In case medical assistance shall not have been secured, and the patient shows signs of improvement, in the shape of more frequent respirations, stronger pulse, and returning consciousness, many of these measures may be omitted as the apparent necessity disap- pears. In a short time, the patient will appear as a person who i? soundly sleeping from the effects of a full dose of Opium or other narcotic ; the quantity beyond that having been parted with bv the blood. He may now be let alone, unless some return to tlie pre- vious condition is noticed, when a dose or two of the strong and easily procured stimulant. Aromatic Spirits of Ammonia, mav again be given him. It must be recollected that a person who has been in such a state as to require all these artificial muscular movements is, practically, in about the condition, as far as strength is concerned, of a man who has run hurriedly several miles without resting. He, of course, has consumed all his available strength, and the sooner it is made up to him by beef-tea, and such things, the sooner he will be where he was before the narcotic was taken. Oxalic Acid. This substance is largely used in the arts, and in private house- holds, for removing stains of iron from textures and surfaces, ACCIDENTS—EMERGENCIES — POISONS. 113 which it does by combining with an otherwise insoluble salt of iron, and converting it into a soluble oxalate of iron/easily re- movable by water. From the strong resemblance Oxalic Acid bears to Epsom Salts, it has often been taken instead of the well- known purgative of that name. To avoid the possibility of such an accident. Oxalic Acid should be kept in another part of the house from which medicines are kept, and no precaution omitted, by label and other marking of the parcel, to make the difference between them as decided as possible. It is well to remember, also, that, wholly unlike Epsom Salts, the taste of Oxalic Acid, ap- plied to the tip of the tongue, is quite sour. When swallowed internally the activity of this poison admits of no delay. It belongs to the class of irritant poisons spoken of BO often, and produces death, it is said, by destructive action on the mucous membrane (lining) of the throat, stomach, and bowels. Time can scarcely be lost to give an Emetic ; but something must be given to rapidly combine with it, and divert its activity from the parts mentioned. It has a strong affinity for Lime. form- ing with it a comparatively insoluble Oxalate of Lime ; and for Magnesia, forming with it an insoluble Oxalate of Magnesia, which can be dislodged with less haste. A tea-spoonful of Lime from a whitewash-bucket or at the bottom of the bottle of Lime-Water, when made as directed in another place (page 132), mixed with a cup of water, might be given every few minutes, or some crushed Chalk (a Carbonate of Lime), or some Magnesia, may be given. All these things can easily be had, and not a moment need be lost in getting the person to swallow them. The common-Whiting,- used for polishing glass, making cheap paint and putty, is essentially the same as prepared Chalk. Scraping the ceiling or wall will not get the antidote if Plaster of Paris has been used instead of common lime, as is often the case The often recommended mantel images of Plaster of Paris are likewise of w little use. Lime in the sulphate (Plaster ol 114 ACCIDENTS—EMERGENCIES——POISOKS. Paris) is too firmly united to the Sulphuric Acid to give it un for Oxalic. After the Oxalic Acid is supposed to have been neutralized, an emetic of ground mustard or pulverized ipecacuanha may be given. Pnlsatilla. The eating of this plant, " Meadow Anemone," or parts of it, has been followed by symptoms of aero-narcotic poisoning. The plant is so active at times that when applied externally, irritation to the parts touched is felt. When poisoning results from swallowing it, the course of treatment recommended under " Aconite" (page 105) may be followed. Sangmnara ("Blood-Boot"), Taken internally in an overdose, acts as aero-narcotic poison. See " Aconite" (page 105). Savine. This is an active irritating poison, inflaming the stomach and bowels. When thus taken, vomiting, by tickling the throat with the finger or a feather, should be at once induced. The mucous membrane (lining) of the bowels should be protected from the irri- tating action of what has escaped beyond the stomach before it could be emptied by vomiting, by drinking large quantities of water or milk, with good quantities of Gum-Arabic dissolved in it. If the Oil of Savine, which is the usual form of the substance when used with a criminal intent, has been taken, it might be well to take a dose of Castor Oil. Splgelia. The use of this plant, commonly called " Pink Root," as a de- stroyer of worms, was given, it is said, to the whites by the Che- rokee Indians, and has become very general throughout the entire country. It is given with a great deal of confidence and reckless- ness, and is often followed by symptoms of a narcotic character, ACCIDBNTS—EMERGENCIES—POISONS. 115 attended also with convulsive movements. When such poisonous symptoms follow its use, vomiting should be promoted, and kept up by frequent draughts of warm water. As in the case of other narcotics, a drink of strong coffee may be of service. Acidulated drinks, as water and vinegar, -water with lemon-juice, are thought to be useful, and probably are, in favoring the elimination (throw- ing out) of the poison absorbed into the blood, by the action of the skin and kidneys, which they promote. Stramonium, Usually known as "Thorn Apple," or " Jimson "Weed," belongs to the same natural order in botany as Belladonna, Dulcamara, and Hyoscyamus ; and when taken internally, in improper quan- tities, is followed by similar general symptoms. Children often gather the seeds and eat them. A history of the case, the evidence of some of the seeds or capsules, the narcotic symptoms, with the peculiar duskiness of the face and dryncss of the mouth and throat mentioned when speaking of Belladonna, are sufficient to point out the vegetable used. There is a decided disposition to laugh, and pick at imaginary objects, on the part of the person under its effects. Treatment has been given under the head of " Belladonna" (page 106). Strychnia. This is the active principle of the Nux Vomica, or "Dog But- ton," as it is sometimes called, from the use often made of it. The action of this poison is so rapid that, like Prussic Acid, little can be done to delay death. This poison acts in a peculiar manner upon the nervous system, throwing the muscles of the body into strong convulsive movements. The convulsions from Strychnia are attended with one strongly-marked and peculiar feature. It is a disposition, during the convulsion, for the heels and the back of the head to meet (opisthotonos). under the influence of the violent muscular movements. Whenever this is seen, and if seen it 116 ACCIDENTS —EMERGENCIES—POISONS. will surely be remembered, the coincidence between it and the use of Strychnia should be remembered. The stomach should be evacuated with the least possible delay, if it is known the person has just taken the poison. If convul- sions have occurred, and death taken place, it may be well to re- member that death resulted from Asphyxia, the spasmodic action of the muscles attached to the ribs having prevented movements of respiration. Artificial breathing, in such a case, should be tried, with the hope that something might possibly be done to invite back the natural movements. Tobacco. To a person not accustomed to its effects, by beginning with small quantities, and persisting in its use, tobacco is an aero-nar- cotic poison, agreeing in its essential character with Aconite, and others of the same general class. The movements of the heart becomes so much interfered witli that death may take place unless proper assistance is at once given. Fortunately, like Lobelia, it acts as an Emetic, and before enough can be absorbed into the blood from the stomach, the contents of that organ are rejected. Hence, when death has ensued from the direct use of Tobacco, we find that it was used as an injection, a form in which it should never be given. Other Vegetable Poisons. . Besides those enumerated in the foregoing pages are many others, whose names even can not be here given. Most of them belong to the Acro-narcotio class, and may be treated as advised in speaking of those mentioned under that head. See "Aconite" (page 93). SIGNS OP REAL DEATH. Usually it is not a difficult matter to pronounce with confi- dence whether a person is really dead, or whether it is an instance of what is called suspended animation , but sometimes it becomes a question not easily determined, even with professional assistance.