The use of drugs to produce emesis is not so prevalent as it was years ago, and if it becomes necessary to cause vomiting, the simpler means (such as drinking large draughts of tepid water and putting one's finger down the throat) should be tried whenever possible.

Stomach-Tube

We have at present in the stomach-tube an efficient means of emptying the stomach, and one that is simple, easily accomplished, and does not cause the patient great inconvenience and danger as in the use of zinc or copper sulphate, ipecac or tartar emetic, provided one is acquainted with the use of the stomach-tube. For ordinary stomach washing, etc., the patient should be seated in a chair and a rubber sheet placed around the neck, the end of the sheet resting in a basin between the patient's feet. The tube should be taken from cold water and passed carefully and rapidly down into the stomach, the operator standing behind the patient and grasping the tube firmly with the fingers of the two hands. The patient should be told to hold the head forward and allow the tube to pass down the throat. As soon as a feeling of choking or shortness of breath is experienced a deep breath should be taken. The tube should enter to a distance of about 30 cm. The stomach may then be washed out with warm water, and such drugs as necessary administered, leaving them in the stomach. While operating, the tube should be held firmly just at the patient's teeth that it be not forced out by reflex peristalsis of the oesophagus, or by other means.

Mustard

One teaspoonful of mustard to a teacup-ful of warm water may be given to produce vomiting.

Repeat in ten minutes, if necessary, and keep on repeating until the desired effect is produced. Be sure that the mustard is removed from the patient's stomach before leaving him. Mustard should not be used in any condition of inflammation of the stomach.

Soap-Suds; Salt

Either of these in small amounts with tepid water will prove effective in producing vomiting and is to be used in preference to more drastic remedies.

Ammonium Carbonate

This is a very safe and effective emetic, being at the same time a rapidly diffusible stimulant and expectorant. It may be given in doses of gr. 30, 2 Gm., largely diluted, and in milk.

Ipecacuanha

The action of this drug is similar to that of the above, but it is slower in its action. It is used as an aid to other emetics, or for children to assist expectoration, or in old persons, or those who are very weak. It is safe and not depressing. Dose, 4-6 fl. dr., 15-20 Gm., of the wine of ipecac, given every quarter of an hour until the desired effect is produced. Large draughts of tepid water hasten its action.

Apomorphine

Apomorphine is injected hypoder-mically when rapid action is necessary, when the stomach is inflamed, or if the patient is unable to swallow. It should not be given unless the nervous mechanism is intact. After irritant, corrosive, or narcotic poisons the stomach-tube is better. Dose, gr. 1/10-1/6, 0.006-0.01 Gm. Vomiting usually takes place in from four to ten minutes. Repeat with caution, if necessary.

Sulphate Of Zinc

This is a specific emetic, acting promptly, without absorption, and causes little nausea or depression. Dose, gr. 15-20, 1.0-2.0 Gm., largely diluted with warm water and repeated in fifteen minutes if necessary.

Sulphate Of Copper

This is rarely employed as an emetic, but is rapid in its action when used. It is extremely irritant and should not be repeated if not at first effective.

Tartar Emetic

This old remedy has fallen into disuse on account of its depressing effect and slow results. Any dose large enough to produce emesis also produces depression both before and after the act of vomiting, and the patient is usually left in an exhausted if not critical condition. Dose, gr. 1/12-1, 0.003-0.06 Gm.