Symptoms: Giddiness, drowsiness, increasing to stupor, and insensibility; pulse usually, at first, quick and irregular, and breathing hurried, and afterwards pulse slow and feeble, and respiration slow and noisy; the pupils are contracted and the eyes and face congested, and later, as death approaches, the extremities become cold, the surface is covered with cold, clammy perspiration, and the sphincters relax. The effects of opium and its preparations, in poisonous doses, appear in from a half to two hours from its administration. Treatment: Empty the stomach immediately with an emetic or with the stomach pump. Then give very strong coffee without milk; put mustard plasters on the wrists and ankles; douche the head and chest with cold water, and if the patient is cold and sinking, give brandy,, or whisky and ammonia. Belladonna is thought by many to counteract the poisonous effects of opium, and may be given in doses of half to a teaspoonful of the tincture, or 2 grains of the extract, every 20 minutes, until some effect is observed in causing the pupils to expand. Use warmth and friction, and if possible prevent sleep for some hours, for which purpose the patient should be walked about between two persons. Finally, as a last resort, use artificial respiration, persistence in which will sometimes be rewarded with success in apparently hopeless cases. Electricity should also be tried.

Cooley advises as follows: Vomiting must be induced as soon as possible, by means of a strong emetic and tickling the fauces. If this does not succeed, the stomach pump should be applied. The emetic may consist of a half drachm of sulphate of zinc dissolved in a half pint of warm water, of which one-third should

be taken at once, and the remainder at the rate of a wineglassful every 6 or 10 minutes, until vomiting commences. When there is much drowsiness or stupor 1 or 2 fluidrachms of tincture of capsicum will be found a useful addition; or one of the formulas for emetic draughts may be taken instead. Infusion of galls, cinchona, or oak bark should be freely administered before the emetic, and water soured with vinegar and lemon juice, after the stomach has been well cleared out. To rouse the system spirit and water or strong coffee may be given. To keep the sufferer awake, rough friction should be applied to the skin, an upright posture preserved, and walking exercise enforced, if necessary. When this is ineffectual cold water may be dashed over the chest, head, and spine, or mild shocks of electricity may be had recourse to. To allow the sufferer to sleep is to abandon him to destruction. Bleeding may be subsequently necessary in plethoric habits, or in threatened congestion. The costiveness that accompanies convalescence may be best met by aromatic aperients; and the general tone of the habit restored by stimulating tonics and the shower bath. The smallest fatal dose of opium in the case of an adult within our recollection was 4.5 grains. Children are much more susceptible to the action of opium than of other medicines, and hence the dose of it for them must be diminished considerably below that indicated by the common method of calculation depending on the age.

Oxalic Acid

See Acids.