The fatal result sometimes takes place in a few hours, but generally not under two or three days, and is often much longer protracted. I have myself witnessed two instances of poisoning from this medicine. One occurred in a woman to whom I was called in consultation by an experienced practitioner, under the impression that it was a case of cholera, though no epidemic of that disease was then prevailing. The symptoms very closely resembled those of cholera. She was vomiting and purging a whitish liquid without a tinge of bile; the pulse was extremely feeble, the features shrunk, and the skin cold and of a bluish hue, especially in the hands and feet, of which the fingers and toes were of a dark-livid or purplish colour; the fingers were shrunk like those of a washer-woman; there were cramps of the extremities; and she complained of severe pains in her stomach and bowels. Upon investigating the cause of the symptoms, we learned from her that she had taken, I think on the previous day, to use her own language, "a five-penny-bit's worth of tartar emetic." Under the influence of opium, a sinapism to the epigastrium, and moderately supporting measures, she recovered, though the symptoms were in the highest degree alarming. What was the precise quantity of tartar emetic taken I did not learn. The other instance was in an infant, about a year old. Tartar emetic had been prescribed by the attending physician for an attack of croup, which was relieved; but directions were left with the mother to give small doses of antimonial wine at short intervals, without any warning as to the possible danger, or limitation as to the length of time. When I saw the child, some days had elapsed from the first administration of the medicine. it was in the last stage of exhaustion, pulseless, cold, pale or purplish, and discharging white liquid stools. Death quickly followed.

* Two cases of infants are on record, in which death followed the administration of three-fourths of a grain. They were both recovering from measles. Two other children died from the effects of ten grains, one in eight, the other in thirteen hours after swallowing the poison. [Guy's Hosp. Reports, a.d. 1857, p. 418.) - Note to the second edition.

It will have been noticed that, in both these cases, the evacuations were whitish. They had the appearance of opaque rice-water; but differed in this respect from the stools of cholera, that they did not on standing separate into a clear liquid above, and a white flocculent precipitate. Tartar emetic is peculiarly hazardous in children; and, though I believe it may always be safely administered, with due caution on the part of the physician, it requires great care and watchfulness. As it destroys mainly by its irritant action on the alimentary canal, if the dose be not unwarrantably large in the beginning, and the caution be observed to suspend it on the first signs of excessive action, and especially on the appearance of white stools, there is little reason to apprehend danger. Though I have used it much, I have never seen effects approaching to the character of poisonous, in any case in which I have prescribed it.

The appearances after death from tartar emetic are those of inflammation of the mucous membrane of the stomach, sometimes extending upward through the oesophagus, and downward into the small intestines; and in some instances the rectum appears to have been affected. Evidences of venous congestion are often also presented in the lungs, brain, etc.; and the blood is said to have been found in a fluid state. in chronic poisoning the liver has been observed to be enlarged and softened. But it may happen, when death has resulted from the frequent exhibition of the poison in small doses, that no post - mortem evidence whatever shall be given by the anatomical characters. Thus, in the case of Mrs. Pritch-ard, killed by slow poisoning with tartar emetic, though no doubt whatever existed as to the cause of death, and antimony was detected in various parts of the body, yet the mucous membrane of the stomach and bowels was perfectly normal, except a small patch of punctuated redness near the cardia. (Archives Generates, Sept. 1865, p. 267.) in such cases, the poison has not been in the stomach at any one time in quantities sufficient to induce inflammation. Nor is the detection of the poison in the alimentary canal a positive proof that it was introduced into the system by that avenue; for tartar emetic is eliminated from the circulation not only with the urine, but also with the intestinal secretions, and after the injection of tartar emetic into the veins, the fluids of the alimentary canal have given evidence to chemical tests of the presence of antimony. (Guy's Hasp. Reports, 1860, vi. 397.)

The treatment is very simple, consisting, if the patient has not freely and frequently vomited, of warm water to wash out the stomach; infusion of green tea, yellow cinchona, or galls to neutralize any remaining portion of the poison, by forming with it an insoluble tannate of antimony; opiates by the stomach, or still better by the rectum, to allay irritation; and the application of a large sinapism to the epigastrium to obviate inflammation. The after-treatment must be conducted on general principles. Wine-whey may possibly be required, in order to support the strength in cases of great prostration; with leeches to the epigastrium, followed by emollient cataplasms, and in the end by a blister, should symptoms of gastritis be obvious.

2. Mode Of Operation

There is no doubt that tartar emetic acts locally as an irritant to the part to which it is applied, and may thus prove emetic by a direct influence on the mucous membrane of the stomach; but there is as little doubt that it is often also absorbed, and produces its effects through the circulation. If reliance can be placed on the results obtained by Ma-gendie in his experiments on dogs, it would seem to have a tendency to produce gastric irritation and provoke vomiting and purging, even though not introduced into the stomach; as, for example, when injected into the veins, or into the areolar tissue. It has operated as an emetic when injected into the rectum, and even when applied to the surface of the body. Dr. Brinton, of London, injected a solution of ten grains of the antimonial in four ounces of water, into the femoral vein of a dog; and, after the death of the animal, found considerable quantities in the stomach, showing that, however it may enter the system, it has a peculiar relation to that organ. (Guy's Hosp. Reports, 1857, p. 438.) Death is said to have resulted from its external use in a child two years old. (Lond. Med. Repos., xvi. 357.) I have myself repeatedly found it impossible to continue the external use of tartar emetic, in consequence of the vomiting which it appeared to occasion, and which subsided upon its relinquishment. But such cases are comparatively very rare; and I have known the most violent vomiting to be checked by its application between the shoulders in cases of spinal tenderness. Other proofs of its absorption, besides those above given, are that it has been detected, after administration by the stomach, in the blood, the urine, and several of the viscera, as the liver and kidneys. It is even believed to be secreted with the milk; and a very important practical inference is to be deduced from the fact; namely, that it should be given with great caution to nursing women. A case is on record in which an infant was attacked with vomiting, in several instances, immediately after taking the breast of a nurse under the influence of tartar emetic. (Christison on Poisons, p. 452.) I have been witness of a somewhat similar case, even more suggestive of caution. An infant, whom I was in the habit of attending, had an attack of convulsions whenever antimonial wine was given to it on account of catarrh or other cause, consequent, as I believed, upon irritation of the stomach and bowels by the medicine; so that I found it necessary, in its case, to substitute the wine of ipecacuanha, when there was occasion for an expectorant. I was once called to see it in convulsions, having the same character as those induced on previous occasions by the antimonial. On inquiry, I learned that, though none of the medicine had been given to the patient, the mother had taken antimonial wine for a cold, and had afterwards suckled her child. The convulsions were not peculiarly alarming, and subsided after a change of diet.