Certain substances are statutory poisons. They are enumerated in the Schedule to the Poison Act. Any preparation which contains a statutory poison must be labeled as “poison.” A medicine prescribed for internal use maybe thus labeled, but this fact need not alarm the patient; care must be taken, however, to adhere to the instructions.
Poisonous substances must be dispensed in containers which are easily distinguishable by color and shape, and on no account should they be transferred to plain containers in the home. All poisons should be kept under lock and key. It is illegal to send poisonous substances by mail, except such as are contained in medicines prescribed by a registered doctor and dispensed by a registered chemist and druggist. Opium, it alkaloids and cocaine are classed as Dangerous Drags, and dealings in them, by prescription or otherwise, are subject to strict regulations.
In few emergencies can sagacious first aid be of such service as in that of poisoning. The need may arise in a variety of circumstances. It may be definitely known that poison has been swallowed or otherwise may have got into the body, and the nature of the poison may even be known. Without this knowledge, however, the probability of poisoning should be recognized when a person becomes ill shortly after taking food, drink or a dose of medicine. If several persons who have taken the same food are affected, the presumption is very strong.
Some poisons destroy tissues with which they come into contact, and are known as corrosives. There is evidence of destruction of the lining of the mouth, and possibly marks on the face and clothing. Such poisons cause an immediate burning pain in the mouth, throat and stomach, also vomiting, and perhaps purging. The vomited matter may contain shreds of stomach lining. From irritation of the entrance to the larynx there may be difficulty in breathing. The patient is more or less collapsed.
Among the corrosive poisons are the strong mineral acids, such as oil of vitriol; the caustic alkalies, such as strong ammonia, corrosive sublimate, formalin, oxalic acid, certain metallic salts, etc. Carbolic acid and creosote also cause a burning pain, but vomiting is uncommon, and there is a sense of giddiness and intoxication, followed by unconsciousness.
Irritant poisons may or may not occasion a hot feeling during swallowing, but they cause nausea, vomiting, abdominal pain, purging, and more or less collapse. Some cause difficulty in breathing, and some cramps in the legs. They include antimony, arsenic, copper, lead, mercury, zinc, croton oil and other strong purgatives, arum, cantharides, etc.
Narcotic poisons may, like opium, cause immediate somnolence, deepening into sleep and coma; or, like belladonna, there may be pronounced delirium for a time and then coma; or, like alcohol and nitro-benzene, they may cause signs of intoxication, followed by coma.
Some poisons, including aconite, diluted oxalic acid, prussic acid, etc., cause great depression of the heart, while others, such as hemlock, calabar bean and curare, cause muscular paralysis. Nux vomica and its alkaloids, strychnine and brucine, cause convulsions, without impairing consciousness or producing signs of irritation of the alimentary tract, but poisons of other descriptions and giving rise to such signs may also cause convulsions. Cantharides, or Spanish fly, turpentine and potassium chlorate cause bloody urine, among other symptoms.
How to render first aid:
In the event of poisoning a doctor should be sent for at once, and should be told what poison has been taken if this fact be known. In the meantime, first aid should be rendered promptly. If the nature of the poison is known, instructions as to its treatment must be found. If the poison is a corrosive, on no account should an emetic be given, as vomiting might cause perforation of the stomach, but in all other cases, if the patient can swallow, an effort should be made to empty the stomach.
To this end, a tablespoonful of mustard, or two tablespoonsful of common salt may be given in a tumbler of warm water. Vomiting may be hastened by tickling the back of the throat with a feather or a and other ways. When it begins the patient should drink large draughts of tepid water in order to wash out the stomach. In the next place, or in the first, when dealing with a corrosive poison, something should be given to neutralize the activities of any drug remaining in the stomach: as there are appropriate things to use for each poison. A strong infusion, or decoction, of tea is usually a good thing to give, as not only does it stimulate, but the tannic acid which it contains is an antidote for alkaloids, the active principle of most vegetable poisons, and for some metals.
Dealing with corrosive poisoning:
The irritation caused by a corrosive or irritant poison may be lessened by giving demulcent drinks, such as milk, thin gruel, thin com flour or arrowroot, olive oil, or white of egg in water. Oil should not be given, however, in poisoning by cantharides or phosphorus, and as little water as possible in poisoning by oxalic acid or Lysol. When poison has been in the stomach for some time some of it may have passed into the bowel, in which case one or two table spoonsful of castor oil or a tablespoonful of Epsom salts in a tumbler of warm water, should be given.
For difficulty of breathing caused by corrosive poisons, hot cloths should be put on the neck, and the air may be moistened with steam by means of a bronchitis kettle, which can be improvised if necessary. Pieces of ice should be given to the patient to suck.
Faintness and collapse are treated by keeping the patient lying down in bed and promoting warmth by blankets and by putting hot-water bottles, covered with flannel, at the feet and by the sides. Stimulants should be given, whisky or brandy, a teaspoonful, according to age, etc., well diluted, or strong tea or coffee. If the patient is unconscious, one or two table-spoonsful of diluted spirits, or, when a narcotic: poison has been taken, a pint of coffee, may be injected into the bowel.
No alcohol should be given in poisoning by aniline, nitrobenzene, or related poisons. Pain or cramps are treated by placing large hot fomentations or, poultices over the affected parts. If breathing ceases, artificial respiration should be started at once. Any bottles found near the patient, or any vomited matter, should always be kept for the doctor’s inspection. See: Shock..
Application and treatment:
See Autointoxication, and nicotine poisoning for applications.