The Book of Household Management Part 270

2638. _Distinctions between Apoplexy and Drunkeness_.--1. The known habits of the person. 2. The fact of a person who was perfectly sober and sensible a little time before, being found in a state of insensibility. 3. The absence, in apoplexy, of the _smell of drink_ on applying the nose to the mouth. 4. A person in a fit of apoplexy cannot be roused at all; in drunkenness he mostly can, to a certain extent.

2639. _Distinction between Apoplexy and Hysteria_.--Hysterics mostly happen in young, nervous, unmarried women; and are attended with convulsions, sobbing, laughter, throwing about of the body, &c. &c.

2640. _Distinction between Apoplexy and Poisoning by Opium_.--It is exceedingly difficult to distinguish between these two cases. In poisoning by opium, however, we find the particular smell of the drug in the patient's breath. We should also, in forming our opinion, take into consideration the person's previous conduct--whether he has been low and desponding for some time before, or has ever talked about committing suicide.

2641. EPILEPSY.--_Falling Sickness_.--Those fits mostly happen, at any rate for the first time, to young people, and are more common in boys than girls. They are produced by numerous causes.--_Symptoms_. The fit may be preceded by pains in the head, palpitations, &c. &c.; but it mostly happens that the person falls down insensible suddenly, and without any warning whatever. The eyes are distorted, so that only their whites can be seen; there is mostly foaming from the mouth; the fingers are clinched; and the body, especially on one side, is much agitated; the tongue is often thrust out of the mouth. When the fit goes off, the patient feels drowsy and faint, and often sleeps soundly for some time.--_Treatment_. During the fit, keep the patient flat on his back, with his head slightly raised, and prevent him from doing any harm to himself; dash cold water into his face, and apply smelling-salts to his nose; loosen his s.h.i.+rt collar, &c.; hold a piece of wood about as thick as a finger--the handle of a tooth-brush or knife will do as well--between the two rows of teeth, at the back part of the mouth. This will prevent the tongue from being injured. A teaspoonful of common salt thrust into the patient's mouth, during the fit, is of much service. The after-treatment of these fits is various, and depends entirely upon their causes. A good general rule, however, is always to keep the bowels well open, and the patient quiet, and free from fatigue, worry, and excess of all kinds.

2642. _Fainting Fits_ are sometimes very dangerous, and at others perfectly harmless; the question of danger depending altogether upon the causes which have produced them, and which are exceedingly various. For instance, fainting produced by disease of the heart is a very serious symptom indeed; whereas, that arising from some slight cause, such as the sight of blood, &c., need cause no alarm whatever. The symptoms of simple fainting are so well known that it would be quite superfluous to enumerate them here. The _treatment_ consists in laying the patient at full length upon his back, with his head upon a level with the rest of his body, loosening everything about the neck, das.h.i.+ng cold water into the face, and sprinkling vinegar and water about the mouth; applying smelling-salts to the nose; and, when the patient is able to swallow, in giving a little warm brandy-and-water, or about 20 drops of sal-volatile in water.

2643. _Hysterics_.--These fits take place, for the most part, in young, nervous, unmarried women. They happen much less often in married women; and even (in some rare cases indeed) in men. Young women, who are subject to these fits, are apt to think that they are suffering from "all the ills that flesh is heir to;" and the false symptoms of disease which they show are so like the true ones, that it is often exceedingly difficult to detect the difference. The fits themselves are mostly preceded by great depression of spirits, shedding of tears, sickness, palpitation of the heart, &c. A pain, as if a nail were being driven in, is also often felt at one particular part of the head. In almost all cases, when a fit is coming on, pain is felt on the left side. This pain rises gradually until it reaches the throat, and then gives the patient a sensation as if she had a pellet there, which prevents her from breathing properly, and, in fact, seems to threaten actual suffocation.

The patient now generally becomes insensible, and faints; the body is thrown about in all directions, froth issues from the mouth, incoherent expressions are uttered, and fits of laughter, crying, or screaming, take place. When the fit is going off, the patient mostly cries bitterly, sometimes knowing all, and at others nothing, of what has taken place, and feeling general soreness all over the body. _Treatment during the fit_. Place the body in the same position as for simple fainting, and treat, in other respects, as directed in the article on Epilepsy. _Always well loosen the patient's stays_; and, when she is recovering, and able to swallow, give 20 drops of sal volatile in a little water. The _after-treatment_ of these cases is very various. If the patient is of a strong const.i.tution, she should live on plain diet, take plenty of exercise, and take occasional doses of castor oil, or an aperient mixture, such as that described as "No. 1," in previous numbers. If, as is mostly the case, the patient is weak and delicate, she will require a different mode of treatment altogether. Good nouris.h.i.+ng diet, gentle exercise, cold baths, occasionally a dose of No.

3 myrrh and aloes pills at night, and a dose of compound iron pills twice a day. [As to the myrrh and aloes pills (No. 3), 10 grains made into two pills are a dose for a full-grown person. Of the compound iron pills (No. 4), the dose for a full grown person is also 10 grains, made into two pills.] In every case, amusing the mind, and avoiding all causes of over-excitement, are of great service in bringing about a permanent cure.

2644. LIVER COMPLAINT AND SPASMS.--A very obliging correspondent recommends the following, from personal experience:--Take 4 oz. of dried dandelion root, 1 oz. of the best ginger, 1/4 oz. of Columba root; braise and boil all together in 3 pints of water till it is reduced to a quart: strain, and take a wine-gla.s.sful every four hours. Our correspondent says it is a "safe and simple medicine for both liver complaint and spasms."

2645. LUMBAGO.--A "new and successful mode" of treating lumbago, advocated by Dr. Day, is a form of counter-irritation, said to have been introduced into this country by the late Sir Anthony Carlisle, and which consists in the instantaneous application of a flat iron b.u.t.ton, gently heated in a spirit-lamp, to the skin. Dr. Corrigan published, about three years ago, an account of some cases very successfully treated by nearly similar means. Dr. Corrigan's plan was, however, to touch the surface of the part affected, at intervals of half an inch, as lightly and rapidly as possible. Dr. Day has found greater advantages to result from drawing the flat surface of the heated b.u.t.ton lightly over the affected part, so as to act on a greater extent of surface. The doctor speaks so enthusiastically of the benefit to be derived from this practice, that it is evidently highly deserving attention.

2646. PALPITATION OF THE HEART.--Where palpitation occurs as symptomatic of indigestion, the treatment must be directed to remedy that disorder; when it is consequent on a plethoric state, purgatives will be effectual. In this case the patient should abstain from every kind of diet likely to produce a plethoric condition of body. Animal food and fermented liquor must be particularly avoided. Too much indulgence in sleep will also prove injurious. When the attacks arise from nervous irritability, the excitement must be allayed by change of air and a tonic diet. Should the palpitation originate from organic derangement, it must be, of course, beyond domestic management. Luxurious living, indolence, and tight-lacing often produce this affection: such cases are to be conquered with a little resolution.

2647. Poisons shall be the next subject for remark; and we antic.i.p.ate more detailed instructions for the treatment of persons poisoned, by giving a simple LIST OF THE PRINc.i.p.aL POISONS, with their ANTIDOTES OR REMEDIES.

Oil of Vitriol ............... Aquafortis ................... Magnesia, Chalk, Soap-and-Water.

Spirit of Salt .............../

Emetic Tartar................. Oily Drinks, Solution of Oak-bark.

Salt of Lemons, or............ Chalk, Whiting, Lime or Magnesia and Acid of Sugar................. Water. Sometimes an Emetic Draught.

Pump on back, Smelling-Salts to nose, Prussic Acid................... Artificial Breathing, Chloride of Lime to nose.

Pearlash ...................... Soap-Lees...................... Smelling-Salts................. Nitre.......................... Lemon-Juice and Vinegar-and-Water Hartshorn...................... / Sal-Volatile.................../

a.r.s.enic........................ Fly-Powder, or................. Emetics, Lime-Water, Soap-and-Water, White a.r.s.enic.................. Sugar and Water, Oily Drinks.

Kings Yellow, or............... / Yellow a.r.s.enic................./

Mercury........................ Corrosive Sublimate............ Whites of Eggs, Soap-and-Water.

Calomel......................../

Opium.......................... Emetic Draught, Vinegar-and-Water, Laudanum....................... das.h.i.+ng Cold Water on chest and face, walking up and down two or three hours.

Lead........................... White Lead..................... Epsom Salts, Castor Oil, Emetics.

Sugar of Lead................../ Goulard's Extract............./

Copper Blue-stone .................... Whites of Eggs, Sugar-and-Water, Verdigris...................... Castor Oil, Gruel.

Zinc .......................... Lime-Water, Chalk-and-Water, Soap-and-Water.

Iron .......................... Magnesia, Warm Water.

Henbane........................ Hemlock........................ Emetics and Castor Oil; Nightshade..................... Brandy-and-Water, if necessary.

Foxglove......................./

Poisonous Food................. Emetics and Castor Oil.

2648. The symptoms of poisoning may be known for the most part from those of some diseases, which they are very like, from the fact of their coming on _immediately_ after eating or drinking something; whereas those of disease come on, in most cases at least, by degrees, and with warnings. In most cases where poison is known, or suspected, to have been taken, the first thing to be done is to empty the stomach, well and immediately, by means of mustard mixed in warm water, or plain warm salt-and-water, or, better, this draught, which we call No. 1:--Twenty grains of sulphate of zinc in an ounce and a half of water. This draught to be repeated in a quarter of an hour if vomiting does not ensue. The back part of the throat should be well tickled with a feather, or two of the fingers thrust down it, to induce vomiting. The cases where vomiting must not be used are those where the skin has been taken off, and the parts touched irritated and inflamed by the poison taken, and where the action of vomiting would increase the evil. Full instructions are given in the article on each particular poison as to where emetics are or are not to be given. The best and safest way of emptying the stomach is by means of the stomach-pump, as in certain cases the action of vomiting is likely to increase the danger arising from the swollen and congested condition of the blood-vessels of the head, which often takes place. In the hands, however, of any one else than a surgeon, it would be not only useless, but harmful, as a great deal of dexterity, caution, and experience are required to use it properly. After having made these brief introductory remarks, we shall now proceed to particulars.

2649. _Sulphuric Acid, or Oil of Vitriol_ (a clear, colourless liquid, of an oily appearance).--_Symptoms in those who have swallowed it_. When much is taken, these come on immediately. There is great burning pain, extending from the mouth to the stomach; vomiting of a liquid of a dark coffee-colour, often mixed with shreds of flesh and streaks of blood; the skin inside the mouth is taken off; and the exposed surface is at first white, and after a time becomes brownish. There are sometimes spots of a brown colour round the lips and on the neck, caused by drops of the acid falling on these parts. There is great difficulty of breathing, owing to the swelling at the back part of the mouth. After a time there is much depression of strength, with a quick, weak pulse, and cold, clammy skin. The face is pale, and has a very anxious look. When the acid swallowed has been greatly diluted in water, the same kind of symptoms occur, only in a milder degree.--_Treatment_. Give a mixture of magnesia in milk-and-water, or, if this cannot be obtained, of finely powdered chalk, or whiting, or even of the plaster torn down from the walls or ceiling, in milk-and-water. The mixture should be nearly as thick as cream, and plenty of it given. As well as this, simple gruel, milk, or thick flour-and-water, are very useful, and should be given in large quant.i.ties. Violent inflammation of the parts touched by the acid is most likely to take place in the coa.r.s.e of a little time, and can only be properly attended to by a surgeon; but if one cannot be obtained, leeches, the fever-mixtures (the recipe for which appears repeatedly in previous paragraphs), thick drinks, such as barley-water, gruel, arrowroot, &c., must be had recourse to, according to the symptoms of each particular case and the means at hand. The inflamed condition of the back part of the mouth requires particular attention.

When the breathing is very laboured and difficult in consequence, from fifteen to twenty leeches are to be immediately applied to the outside of the throat, and when they drop off, warm poppy fomentations constantly kept to the part. When the pain over the stomach is very great, the same local treatment is necessary; but if it is only slight, a good mustard poultice will be sufficient without the leeches. In all these cases, two tablespoonfuls of the fever-mixture should be given every four hours, and only gruel or arrowroot allowed to be eaten for some days.

2650. _Nitric Acid_, commonly known as _Aqua Fortis_, or _Red Spirit of Nitre_ (a straw-coloured fluid, of the consistence of water, and which gives off dense white fumes on exposure to the air).--_Symptoms produced in those who have swallowed it._ Much the same as in the case of sulphuric acid. In this case, however, the surface touched by the acid becomes _yellowish_. The tongue is mostly much swollen.--_Treatment_.

The same as for sulphuric acid.

2651. _Muriatic Acid, Spirit of Salt_ (a thin yellow fluid, emitting dense white fumes on exposure to the air).--This is not often taken as a poison. The _symptoms_ and _treatment_ are much the same as those of _nitric acid_.

N.B.--_In no case of poisoning by these three acids should emetics ever be given_.

2652. _Oxalic Acid_, commonly called _Salt of Lemons_.--This poison may be taken by mistake for Epsom salts, which it is a good deal like. It may be distinguished from them by its very acid taste and its shape, which is that of needle-formed crystals, each of which, if put into a drop of ink, will turn it to a reddish brown, whereas Epsom salts will not change its colour at all. When a large dose of this poison has been taken, death takes place very quickly indeed.--_Symptoms produced in those who have swallowed it_. A hot, burning, acid taste is felt in the act of swallowing, and vomiting of a _greenish-brown_ fluid is produced, sooner or later, according to the quant.i.ty and strength of the poison taken. There is great tenderness felt over the stomach, followed by clammy perspirations and convulsions; the legs are often drawn up, and there is generally stupor, from which the patient, however, can easily be roused, and always great prostration of strength. The pulse is small and weak, and the breathing faint.--_Treatment_. Chalk or magnesia, made into a cream with water, should be given in large quant.i.ties, and afterwards the emetic draught above prescribed, or some mustard-and-water, if the draught cannot be got. The back part of the throat to be tickled with a feather, to induce vomiting. Arrowroot, gruel, and the like drinks, are to be taken. When the prostration of strength is very great and the body cold, warmth is to be applied to it, and a little brandy-and-water, or sal-volatile and water, given.

2653. _Prussic Acid_ (a thin, transparent, and colourless liquid, with a peculiar smell, which greatly resembles that of bitter almonds).--_Symptoms produced in those who have swallowed it_. These come on _immediately_ after the poison has been taken, and may be produced by merely _smelling_ it. The patient becomes perfectly insensible, and falls down in convulsions--his eyes are fixed and staring, the pupils being bigger than natural, the skin is cold and clammy, the pulse scarcely perceptible, and the breathing slow and gasping.--_Treatment_. Very little can be done in these cases, as death takes place so quickly after the poison has been swallowed, when it takes place at all. The best treatment--which should always be adopted in all cases, even though the patient appears quite dead-is to dash quant.i.ties of cold water on the back, from the top of the neck downwards. Placing the patient under a pump, and pumping on him, is the best way of doing this. Smelling-salts are also to be applied to the nose, and the chest well rubbed with a camphor liniment.

2654. ALKALIS: _Potash, Soda_, and _Ammonia_, or common _Smelling-Salts_, with their princ.i.p.al preparations--_Pearlash, Soap Lees, Liquor Pota.s.sae, Nitre, Sal Prunella, Hartshorn_, and _Sal--Volatile._--Alkalis are seldom taken or given with the view of destroying life. They may, however, be swallowed by mistake.--_Symptoms produced in those who have swallowed them_. There is at first a burning, acrid taste in, and a sensation of tightness round, the throat, like that of strangling; the skin touched is destroyed; retching mostly followed by actual vomiting, then sets in; the vomited matters often containing blood of a dark brown colour, with little shreds of flesh here and there, and always changing vegetable blue colours green. There is now great tenderness over the whole of the belly. After a little while, great weakness, with cold, clammy sweats, a quick weak pulse, and purging of b.l.o.o.d.y matters, takes place. The brain, too, mostly becomes affected.--_Treatment_. Give two tablespoonfuls of vinegar or lemon-juice in a gla.s.sful of water every few minutes until the burning sensation is relieved. Any kind of oil or milk may also be given, and will form soap when mixed with the poison in the stomach. Barley-water, gruel, arrowroot, linseed-tea, &c., are also very useful, and should be taken constantly, and in large quant.i.ties. If inflammation should take place, it is to be treated by applying leeches and warm poppy fomentations to the part where the pain is most felt, and giving two tablespoonfuls of the fever mixture every four hours. The diet in all these cases should only consist of arrowroot or gruel for the first few days, and then of weak broth or beef-tea for some time after.

2655. When very strong fumes of smelling-salts have in any way been inhaled, there is great difficulty of breathing, and alarming pain in the mouth and nostrils. In this case let the patient inhale the steam of warm vinegar, and treat the feverish symptoms as before.

2656. _a.r.s.enic_.--Mostly seen under the form of white a.r.s.enic, or fly-powder, and yellow a.r.s.enic, or king's yellow.--_Symptoms produced in those who have swallowed it_. These vary very much, according to the form and dose in which the poison has been taken. There is faintness, depression, and sickness, with an intense burning pain in the region of the stomach, which gets worse and worse, and is increased by pressure.

There is also vomiting of dark brown matter, sometimes mixed with blood; and mostly great thirst, with a feeling of tightness round, and of burning in, the throat. Purging also takes place, the matters brought away being mixed with blood. The pulse is small and irregular, and the skin sometimes cold and clammy, and at others hot. The breathing is painful. Convulsions and spasms often occur.--_Treatment_. Give a couple of teaspoonfuls of mustard in a gla.s.s of water, to bring on or a.s.sist vomiting, and also use the other means elsewhere recommended for the purpose. A solution, half of lime-water and half of linseed-oil, well mixed, may be given, as well as plenty of arrowroot, gruel, or linseed-tea. Simple milk is also useful. A little castor-oil should be given, to cleanse the intestines of all the poison, and the after-symptoms treated on general principles.

2657. _Corrosive Sublimate_.--Mostly seen in the form of little heavy crystalline ma.s.ses, which melt in water, and have a metallic taste. It is sometimes seen in powder. This is a most powerful poison.--_Symptoms_.

These mostly come on immediately after the poison has been taken. There is a coppery taste experienced in the act of swallowing, with a burning heat, extending from the top of the throat down to the stomach; and also a feeling of great tightness round the throat. In a few minutes great pain is felt over the region of the stomach, and frequent vomiting of long, stringy white ma.s.ses, mixed with blood, takes place. There is also mostly great purging. The countenance is generally pale and anxious; the pulse always small and frequent; the skin cold and clammy, and the breathing difficult. Convulsions and insensibility often occur, and are very bad symptoms indeed. The inside of the mouth is more or less swollen.--_Treatment_. Mix the whites of a dozen eggs in two pints of cold water, and give a gla.s.sful of the mixture every three or four minutes, until the stomach can contain no more. If vomiting does not now come on naturally, and supposing the mouth is not very sore or much swollen, an emetic draught, No. 1, may be given, and vomiting induced.

(The No. 1 draught, we remind our readers, is thus made:--Twenty grains of sulphate of zinc in an ounce and a half of water; the draught to be repeated if vomiting does not take place in a quarter of an hour.) After the stomach has been well cleaned out, milk, flour-and-water, linseed-tea, or barley-water, should be taken in large quant.i.ties. If eggs cannot be obtained, milk, or flour-and-water, should be given as a subst.i.tute for them at once. When the depression of strength is very great indeed, a little warm brandy-and-water must be given. In the course of an hour or two the patient should take two tablespoonfuls of castor-oil, and if inflammation comes on, it is to be treated as directed in the article on acids and alkalis. The diet should also be the same. If the patient recovers, great soreness of the gums is almost certain to take place. The simplest, and at the same time one of the best modes of treatment, is to wash them well three or four times a day with brandy-and-water.

2658. _Calomel_.--A heavy white powder, without taste, and insoluble in water. It has been occasionally known to destroy life.--_Symptoms_. Much the same as in the case of corrosive sublimate.--_Treatment_. The same as for corrosive sublimate. If the gums are sore, wash them, as recommended in the case of corrosive sublimate, with brandy-and-water three or four times a day, and keep the patient on _fluids_, such as arrowroot, gruel, broth, or beef-tea, according to the other symptoms.

Eating hard substances would make the gums more sore and tender.

2659. _Copper_.--The preparations of this metal which are most likely to be the ones producing poisonous symptoms, are _blue-stone_ and _verdigris_. People are often taken ill after eating food that has been cooked in copper saucepans. When anything has been cooked in one of these vessels, _it should never be allowed to cool in it_.--_Symptoms_.

Headache, pain in the stomach, and purging; vomiting of green or blue matters, convulsions, and spasms.--_Treatment_. Give whites of eggs, sugar-and-water, castor-oil, and drinks, such as arrowroot and gruel.

2660. _Emetic Tartar_.--Seen in the form of a white powder, or crystals, with a slightly metallic taste. It has not often been known to destroy life.--_Symptoms_. A strong metallic taste in the act of swallowing, followed by a burning pain in the region of the stomach, vomiting, and great purging. The pulse is small and rapid, the skin cold and clammy, the breathing difficult and painful, and the limbs often much cramped.

There is also great prostration of strength.--_Treatment_. Promote the vomiting by giving plenty of warm water, or warm arrowroot and water.

Strong tea, in large quant.i.ties, should be drunk; or, if it can be obtained, a decoction of oak bark. The after-treatment is the same as that for acids and alkalis; the princ.i.p.al object in all these cases being to keep down the inflammation of the parts touched by the poison by means of leeches, warm poppy fomentations, fever-mixtures, and very low diet.

2661. _Lead_, and its preparations, _Sugar of Lead, Goulard's Extract, White Lead._--Lead is by no means an active poison, although it is popularly considered to be so. It mostly affects people by being taken into the system slowly, as in the case of painters and glaziers. A newly-painted house, too, often affects those living in it.--_Symptoms produced when taken in a large dose_. There is at first a burning, p.r.i.c.king sensation in the throat, to which thirst, giddiness, and vomiting follow. The belly is tight, swollen, and painful; _the pain being relieved by pressure_. The bowels are mostly bound. There is great depression of strength, and a cold skin.--Treatment. Give an emetic draught (No. 1, see above) at once, and shortly afterwards a solution of Epsom salts in large quant.i.ties. A little brandy-and-water must be taken if the depression of strength is very great indeed. Milk, whites of eggs, and arrowroot are also useful. After two or three hours, cleanse the stomach and intestines well out with two tablespoonfuls of castor-oil, and treat the symptoms which follow according to the rules laid down in other parts of these articles.--_Symptoms when it is taken into the body slowly_. Headache, pain about the navel, loss of appet.i.te and flesh, offensive breath, a blueness of the edges of the gums; the belly is tight, hard, and knotty, and the pulse slow and languid. There is also sometimes a difficulty in swallowing.--_Treatment_. Give five grains of calomel and half a grain of opium directly, in the form of a pill, and half an ounce of Epsom salts in two hours, and repeat this treatment until the bowels are well opened. Put the patient into a warm bath, and throw up a clyster of warmish water when he is in it.

Fomentations of warm oil of turpentine, if they can be obtained, should be put over the whole of the belly. The great object is to open the bowels as freely and as quickly as possible. When this has been done, a grain of pure opium may be given. Arrowroot or gruel should be taken in good large quant.i.ties. The after-treatment must depend altogether upon the symptoms of each particular case.

2662. _Opium_, and its preparations, _Laudanum, &c_.--Solid opium is mostly seen in the form of rich brown flattish cakes, with little pieces of leaves sticking on them here and there, and a bitter and slightly warm taste. The most common form in which it is taken as a poison, is that of laudanum.--_Symptoms_. These consist at first in giddiness and stupor, followed by insensibility, the patient, however, being roused to consciousness by a great noise, so as to be able to answer a question, but becoming insensible again almost immediately. The pulse is now quick and small, the breathing hurried, and the skin warm and covered with perspiration. After a little time, these symptoms change; the person becomes _perfectly insensible_, the breathing slow and _snoring_, as in apoplexy, the skin cold, and the pulse slow and full. The pupil of the eye is mostly smaller than natural. On applying his nose to the patient's mouth, a person may smell the poison very distinctly.--_Treatment_.

Give an emetic draught (No. 1, see above) directly, with large quant.i.ties of warm mustard-and-water, warm salt-and-water, or simple warm water.

Tickle the top of the throat with a feather, or put two fingers down it to bring on vomiting, which rarely takes place of itself. Dash cold water on the head, chest, and spine, and flap these parts well with the ends of wet towels. Give strong coffee or tea. Walk the patient up and down in the open air for two or three hours; the great thing being to keep him from sleeping. Electricity is of much service. When the patient is recovering, mustard poultices should be applied to the soles of the feet and the insides of the thighs and legs. The head should be kept cool and raised.