6. Vinegar, Diluted Mineral Acids

Vinegar, Diluted Mineral Acids. To neutralize alkalies and alkaline salts; Magnesium Oxide, Sodium Bicarbonate, Calcium Carbonate, Sodium and Magnesium Sulphates - for various acids and acid salts; Charcoal, animal and vegetable - for arsenic, corrosive sublimate, etc.; Hydrated Chloral, Chloroform, Ether, Potassium Bromide - as narcotics or anaesthetics in tetanic poisoning.

7. Emetics: (1) Zinc Sulphate, gr. 5-15 (.3-1 Gm.), repeated twice if necessary, at 15-minute intervals, or until emesis is produced; (2) Mustard, 3j-4 (4-15 Gm.), stirred to a cream with water; (3) Ipecac, gr. 15 (1 Gm.), repeated if necessary in 15 minutes; Apomorphine Hydrochloride, 2 p. c. solution, eiij-5 (.2-3 Ml. (Cc.) hypodermically); Stomach-pump, or Rubber Tubing (5-8 feet of \ inch); Tartar Emetic, gr. 1/2 (.03 Gm.) in sweetened water, for children.

8. Hypodermic Solutions: (1) Atrophine Sulphate, 1 p. c, eij-6 (.13-.4) - as physiological antidote for aconite, benzene, gelsemium, morphine, muscarine, opium, physostigmine, pilocarpine, etc.; (2) Pilocarpine Nitrate, 5 p. c, ex-15 (.6-1 Ml. (Cc.)) - as physiological antidote for atropine, scopolamine, daturine, duboisine, hyoscyamine, etc.; (3) Morphine Sulphate, 10 p. c, ev-8 (.3-5 Ml. (Cc.)) - for similar use as pilocarpine nitrate; (4) Strychnine Sulphate or Nitrate, 2 p. c, eij-3 (.13-.2 Ml. (Cc.)) - as physiological antidote for most depressants; acetanilid, aconite, hydrated chloral, chloroform, conium, physos-tigma. All of these should be used in an aseptic hypodermic syringe.

In cases of specific poisoning the following treatments are recommended:

Acetanilid, Antifebrin, Antipyrine, Phenacetin: Empty stomach, place in recumbent position, supply abundant fresh air or oxygen (for cyanosis, loosen clothing around neck, chest, and waist), stimulants (brandy, whisky, ammonia), external heat, atropine or belladonna (to maintain blood-pressure), strychnine to aid respiration.

Acids: If these have been taken in concentrated form, it is unwise to give emetics or use the pump, as either might tend to lacerate the softened oesophagus.

1. Chromic, Potassium Chromate and Dichromate: Emetics, then magnesium oxide or carbonate, sodium bicarbonate or borate, chalk in water to a paste, demulcent drinks (flaxseed, elm, etc.), stimulant enemas.

2. Hydrocyanic - Cyanides, Oil of Bitter Almond, Cherry Laurel Water: Recumbent position, abundant fresh air, oxygen, smell chlorine water or diluted chlorine gas, vomit, hypodermic atropine for heart, brandy, ether, ammonia inhalations; if breathing ceases, use artificial respiration, mild faradic current to the heart, alternate cold and warm affusions to head, chest, and spine; ferrous and ferric sulphates followed by potassium carbonate solution yield insoluble Prussian blue (antidote), ferrous sulphate alone or with magnesium oxide renders acid insoluble, but the action of the acid is so quick that, as a rule, antidotes avail little; exv (1 Ml. (Cc.)) of official acid, or gr. 1 (.06 Gm.) of anhydrous acid, usually is fatal in 15 minutes.

3. Mineral - Hydrochloric, Nitric, Nitrohydrochloric, Sulphuric, Phosphoric, Glacial Acetic: Neutralize with an alkaline solution - sodium, potassium, magnesium carbonate or bicarbonate, magnesium oxide, lime, chalk or wall-plaster (H2SO4), dissolved or mixed with water, soapsuds, water freely, except with sulphuric, then demulcent, drinks gruel, egg-white, almond or olive-oil, warmth and friction to extremities (feet, hands), emollient fomentations, brandy and whisky for collapse, morphine for pain.

4. Oxalic - Oxalates, Salt of Lemon {Potassium Oxalate): Unless the poison has occasioned vomiting, empty stomach at once, then neutralize with chalk, whiting or wall-plaster in creamy paste with water, lime water, now vomit to get rid of insoluble calcium oxalate, give demulcent drinks, oils, opium for pain, hot fomentations to abdomen, friction to extremities (feet, hands), enema, much water to hasten elimination by kidneys; avoid potassium and sodium (alkaline) carbonates, as they form soluble oxalates; ℥ss-1 (15-30 Gm.) usually proves fatal.

Aconite, Aconitine, Pulsatilla: Evacuate and wash out well the stomach, unless symptoms severe, when vomiting should be avoided, if possible, and then in a towel without raising head; place in recumbent position, with absolute quietness, feet elevated (to confine circulation to vital centres at base of brain), dry warmth to body, especially extremities (feet, hands), cardiac (diffusible) stimulants (brandy, whisky, alcohol, ether, ammonia) by mouth or skin, digitalis for heart syncope (tincture exxx; 2 Ml. (Cc.)), hypodermic atropine (eiv; .26 Ml. (Cc.)) or strychnine (gr. 1/20 - 1/10; .003-.006 Gm.) for cardiac and respiratory stimulation, tannin, amyl nitrite, oxygen, artificial respiration. Tine-, ture of aconite exxx-60 (2-4 Ml. (Cc.)), and aconitine gr. 1/20 (.003 Gm.), have each proved fatal.

Alcohol, Alcoholism, Delirium Tremens: Drunkenness resembles somewhat opium-poisoning and brain concussion. Empty stomach, washing it out well with strong warm coffee, apply warmth to body and extremities (feet, hands), cold douche to head, plenty fresh air, interrupted current to respiratory muscles, inhale ammonia, amyl nitrite, artificial respiration, keep awake mechanically.

Alkalies, Potassium and Sodium Hydroxide, Ammonia, Spirit of Hartshorn, Ammonia Smelling-salts, Carbonates: Neutralize with vinegar, lemon-juice, diluted acetic acid, then give demulcent drinks, fatty oils, opium to relieve pain. For ammonia gas inhale warm acetic acid vapor, and lessen chest-pain by a few chloroform inhalations.

Alkaloids: Empty stomach at once, follow with tannin solution or strong coffee, tea to form insoluble tannates.

Alum: This usually vomits per se, otherwise give emetic, then ammonium or potassium carbonate, demulcents.