Tartar emetic, applied to the skin, is a strong counter-irritant, and excites an eruption closely resembling that of smallpox, viz., small papules, becoming vesicular and finally pustular. It is now but little used in this way. Internally it is irritant, and, as an emetic, its action is partly direct - that is, acting immediately on the walls of the stomach, and partly indirect, or acting on the nerve-centre in the medulla which controls vomiting. Tartar emetic causes nausea and depression both before and after the act of vomiting, and is therefore not well suited to cases where rapid action with as little depression as possible is required, as in poisoning.
In small continued doses the local action of tartar emetic is apt to produce loss of appetite, nausea, diarrhoea, and pain. In the tissues antimony has an alterative action, the special results being an increase of the waste products of the body, with a lessening of oxygenation, and fatty degeneration of the organs.
Tartar emetic depresses the circulation even in small doses, the first effect visible after a therapeutic dose being a diminution of the pulse and increase of perspiration.
With a continuance of the medicine the pulse becomes weakened, soft, and compressible, infrequent and irregular, and fainting may occur. Respiration is weakened, inspiration being shortened, and expiration lengthened.
The nervous system is depressed, a feeling of languor, sleepiness, and lassitude being produced by a moderate dose. It affects the muscular system so powerfully that before chloroform came into use tartar emetic was employed to produce muscular relaxation in the reduction of dislocations, etc., and the depressed state so brought about lasted for six or eight days in spite of heart stimulants.
Emetic doses cause great muscular weakness, tremors, and aching of the muscles, loss of power to stand, with free perspiration and an increase of saliva.
Antimony is excreted by all the mucous surfaces, the liver, kidneys, and skin.
Its excretion by the bile shows it to be a hepatic Stimulant; in passing through the kidneys it acts as a diuretic, and through the skin as a diaphoretic.
The characteristic pustular eruption is sometimes caused by its internal use.
The symptoms of poisoning are very like those of the collapse of cholera, viz.: shrunken features, cold surface and breath; great epigastric pain, vomiting, and purging; small, rapid, soft, and irregular pulse; cyanosis; syncope; cramps of the lower extremities; insensibility to stimulants; intense prostration; delirium; tetanic spasms in some cases, or aphonia.
The quantity of tartar emetic which will destroy life is not definitely known. The smallest fatal dose recorded is 3/4 of a grain in the case of a child; gr. ii. has caused death in an adult, while doses have been recovered from, ranging from gr. xx. to ℥ i. It is probable that, under ordinary circumstances favoring the action of the poison, gr. x. or xv. would destroy life, if taken at once, or a smaller quantity, if divided. The symptoms come on rapidly, and death may occur in a few hours, or days, or may be delayed for several weeks.
Average dose of tartar emetic, gr. 1/12-0.005 Gm., diluted.
Contains of tartar emetic gr. ii. to ℥ i. This preparation decomposes on being kept, and a fungoid growth takes place in it which unfits it for use. It is not considered useful.
Contains squill, senega, sugar, and water, with tartat emetic, about gr. 3/4 to ℥ i. Syrup of squill is sometimes used as a domestic remedy for children, without a physician's order, and as tartar emetic is not a safe medicine for children, its unauthorized use has sometimes had fatal effects, and should always be strongly discouraged.