Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
Suitable emetics are sulphate of zinc in thirty-grain doses dissolved
in warm water, a dessert-spoonful of mustard in half a pint of warm
water, ipecacuanha wine in tablespoonful doses, copious draughts of hot
water. Tartar emetic and sulphate of copper should be avoided, except
in cases of phosphorus poisoning, when the latter may be used. The
hypodermic injection of ⅒ grain of apomorphine is a very useful emetic,
especially in cases of narcotic poisoning. Irritation of the fauces
with the finger or a feather promotes vomiting, and may be useful in
the absence of an emetic.
The stomach tube or pump is most useful in that it is under the
control of the operator and enables him to thoroughly wash out the
stomach. After passing the tube, previously lubricated with vaseline
or glycerine, through the œsophagus down to the stomach, a pint of warm
water should be first injected before withdrawing any of the contents.
By alternate injection of water and its withdrawal, the stomach may
be efficiently cleansed, and at the same time solutions of suitable
antidotes may be passed into it. It must be remembered that neither
the stomach pump, syphon tube, nor emetics, are to be used in cases of
poisoning with corrosives, with the exception of carbolic acid. The
tube should be used with great caution in cases of irritant poisoning.
Antidotes are remedies which counteract the effects of poisons. They
act mechanically, _e.g._ flour and water, chalk mixture; chemically,
as magnesia and chalk in mineral acid poisoning, alkaline sulphates in
lead and barium poisoning; and physiologically, as antagonists, such
as morphine and atropine, atropine and physostigmine, strychnine and
chloral hydrate.
To counteract the effects of the portion of the poison absorbed,
special treatment is necessary: purges and diuretics may be called for;
artificial respiration may be necessary; cardiac depressants require
cardiac stimulants; the cold douche as a restorative and external
warmth are desirable in certain cases. Sedatives may be administered
to alleviate convulsive seizures. Tracheotomy may be required in cases
with laryngeal complications; and pain, exhaustion, excessive vomiting
or purging are to be treated by appropriate remedies.
EXAMINATION OF THE CONTENTS OF THE STOMACH, VISCERA, ETC., FOR POISON
The number and condition of the vessels received should be noted and
copies made of any affixed labels.
The appearance, smell, colour, and reaction to test paper of the
contents should be noted, and their weights and volumes determined.
All jars, wrappers, labels, and seals should be preserved for future
reference.
The stomach contents should be carefully examined in reference to their
nature, colour, and smell, and the presence or absence of any abnormal
constituents. The mucous membrane of the stomach should be examined
with the naked eye and by the aid of a lens, the surface washed with
distilled water, and the washings added to the contents.
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