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the matter appeared to be entirely settled until some new views of M. Bussy have made very important additions to this subject.
M. Bussy has shown that magnesia, by forming an insoluble compound with arsenious acid, may be very advantageously employed in cases of poisoning by it;-M. H. Lepage has sent him a communication which goes to prove the efficacy of this new antidote. Although this may be the case, until the magnesia be well tested I should be unwilling to give up the hydrated sesquioxide of iron which M. Landras and I have thoroughly tested in various cases by experiments on animals.
If I were called 10-day to render my assistance to a person poisoned by arsenious acid, this is the way in which I should act.
!n the first place I should bring on emesis, according to the rules given above; then I should give the hydrated sesquioxide of iron diffused in two litres (four pints) of sweetened water. It is necessary to give this antidote in great excess, for, as M. Orfila has proved, if we give only what is actually necessary to form the arsenite of the peroxide of iron [properly, the subarseniate of the proloxide of iron] the power of the poison is not wholly destroyed.
If there is no hydrated sesquioxide of iron at hand, we must not hesitate to give thirly grammes (six drams) of the subcarbonate of iron, diffused in a litre of water while the former is being prepared. Experience has proved to us the great value of this course of treatment.
Our experiments on dogs have shown likewise that the persulphuset of iron in jelly is an antidote to the arsenious acid.*
I think it much better, however, at the same time, that we give the hydrated sesquioxide of iron, to administer twenty grammes (half an ounce) of magnesia. This must be a very valuable agent, not only because it forins an insoluble compound with the arsenious acid, but also because it purges and in that way follows up any arsenic that may have got into the intestines, and by increasing the number of evacuations it is likely to carry it off. To repeat then, I would give the hydrated sesquioxide of iron and magnesia both together; and as
* M. Mialhe has lately again strongly recommended the employment of the protosulphuret of iron in poisoning from arsenic, but in the experiments we have made, this article is much less efficacious than the hydrated sesquioxide of iron.
The persulphuret of iron is a very good antidote for several metallic substances; it acts like the protosulphuret to which M. Mialhe drew attention at the same time that M. Sandras and I were engaged in the experiments published in our article on the counter-poisons of arsenic, lead, mercury and copper, (Annuaire Thérapeutique, 1814.) We cannot admit with M. Mialhe the non-existence of the hydrated persulphuret of iron described by Berzelius: this compound is always formed when the alkaline persulphuret is in excess; but this is not the case when there is an excess of the persulphate of iron. We insist on this with M. Berzelius, and we have said that it was indispensable that the persulphuret of iron should be poured into the persulphuret of potassium.
We must observe also that the persulphuret of iron changes very rapidly when exposed to the air, sulphur being set free. This is the reason why we recommend it to be prepared with saccharine matter, and to be kept in well-stopped bottles.
this latter substance only acts when prepared in the manner given by M. Bussy, I shall give iis preparation.
After administering the antidote, if the pulse is feeble and the skin cold, we must favor reaction by sinapisms, warm coverings, frictions, sinall bleedings, stimulating drinks, &c. When the cold stage is past and is followed by reaction, at the same time that we keep the bowels in an open state, we should give diuretic, niirous drinks, as recommended by M. Orfila. In this way we will hasten the removal of the poison from the system, both by the bowels and by the kidneys. Preparation of the Magnesia employed as an Antidote for Arsenious
Acid.-(Bussy.) Magnesia of the proper kind may easily be obtained in the following way: Fill a crucible half full of the carbonate of magnesia of the shops, then heat it until the bottom becomes of a dull red, and during ihe calcination the magnesia is to be constantly stirred with an iron spatula. When it is completely calcined the ebullition caused by the escape of the water and carbonic acid ceases, then a portion should be tested with muriatic acid, and if the calcination is complete there will be no escape of carbonic acid ; but it is better not to perfectly calcine it than to expose it to too great a heat.
When the magnesia has been properly prepared it forms a hydrate without any difficulty ; it makes with water at the ordinary temperature a consistent jelly, like alumina; two grammes of magnesia are sufficient to do this, with fifty grammes or more of water.
This quantity of magnesia difl'used in a decilitre (three ounces) of water, is capable of combining, as we have said, with one decigramme (one and a half grains) of arsenious acid dissolved in a decilitre of water, so that after agitating them together for a moment and filtering, there will be no precipitate formed with sulphuretted hydrogen.
It is necessary to be careful not to use magnesia which has been 100 highly beated, or its effect will be almost entirely destroyed. Such magnesia is easily recognised in this way. Its density and its cohesion are greater than they should be, and instead of uniting with the water it falls to the bollom and forms a pulverulent deposit which may rest several months in contact with the water without becoming hydrated.
Hydrate of magnesia may also be prepared by precipitation, and this is very efficacious in cases of poisoning. 100 grammes of sulphate of magnesia in crystals contain 51.22 of water, 16.26 of mag. nesia, and 32.52 of sulphuric acid. ll requires theoretically 38.21 of pure potassa, or 45.52 of the hydrate to decompose completely a sojution of 100 grammes of the epsom salt and precipitate from it the magnesia in a hydrated form. But if instead of the pure poiassa we take the ordinary caustic potassa, which always contains some chloride, sulphate, and carbonate, and an excess of water, it is best to take fifty for every hundred parts of salt to be decomposed. If the solutions are well diluted; if ihe sulphate of magnesia, for instance, is
dissolved in twenty-five times its weight of water, and the potassa in twenty times ils weight, it will not be necessary to wash the precipitate, but simply to express the excess of liquid between the folds of linen; the small quantity of sulphate of poiassa and of sulphate of magnesia contained in it can have no injurious effect. For administration it is best to diffuse the precipitate in a large quantity of water. Ten grammes of sulphate of magnesia dissolved in 250 grammes of water, decomposed, as above directed, by five grammes of caustic potassa dissolved in 100 grammes of water, will still leave a liquid containing an excess of sulphate of magnesia, which might still be precipitated with potassa. The precipitate prepared according 10 the above proportions, when dried between the folds of linen without being washed, and then diffused in water, will combine immediately with one decigramme of arsenious acid dissolved in a decilitre of water. I may observe that this proportion of arsenious acid is not at all the maximum quantity the magnesia is capable of neutralizing. The calcined magnesia when properly prepared appears to me just as good, and is more readily made than the precipitated hydrate.
Poisoning frorn Corrosive Sublimate and other Salts of Mercury.
M. Orfila has discovered that albumen is an excellent antidote for corrosive sublimale; its efficacy has indeed been proved in a grea: many cases; it is a substance very frequently employed, and is in the hands of every one, while at the same time it is very safe.
The moment any sympioms indicating poisoning by mercury show themselves, the patient should take some yellows and whites of eggs mixed with water. Too much albumen must not be taken, for if it did not vomit it might redissolve the precipitate.
It will be well at the same time to make the patient swallow im. mediately, or as soon as it can be procured, 50 grammes of hydrated persulphuret of iron, or 10 grammes of Raciborski's.iron, the efficacy of which has been proved by M. Sandras and myself in cases of poisoning by the salts of mercury.
It is indispensably necessary to favour emesis and purging by the free use of fluid, mucilaginous drinks. Cullerier saved two hundred patients who had taken over doses of corrosive sublimate, by making them each drink in the course of twenty-four hours seven or eight litres of milk, flaxseed tea and warm water.
Poisoning from the Salts of Copper. The best counter-poison for the salts of copper, the certainty of which I together with M. Sandras have proved by experiments on animals, is the metallic iron reduced by hydrogen; it must be administered in a quantity at least as great as that of the poison which has been taken.
If the hydrate of the persulphuret of iron can be had, it may also be prescribed with a great deal of benefit. 100 grammes of the hy. draie diffused in 200 grammes of sugar and water may be given.
If neither Raciborski’s iron nor the hydrate of the persulphuret is to be had, albumen and water must be given, (six whites of egg mixed with a litre of water.) The albumen forms insoluble coin. pounds with the salts of copper, as has been proved by Orfila in re. peated experiments.
There has been a great deal of discussion on the utility of sugar in cases of poisoning from the salts of copper. The advocates of this substance maintain that the poison is decomposed by it.
This explanation is erroneous; in fact, if the sugar, together with the gastric juice, is able to act at all on the salts of copper, it is at a higher degree of temperature than is ever found in the stomach. I know that persons poisoned by copper have been saved by being crammed with sugar, and by being vomited and purged at the same time, but the action of the sugar is different entirely from what they supposed, M. Sandras and I in our experiments on sugar as a nutriment, sound that when it was given in excess, absorption was very considerably diminished, in accordance with the laws given by M. Dutrochet. It is easy to understand, therefore, how sugar may be useful while the poison is being removed by emetics and cathartics; but it cannot rank with counter-poisons, but with evacuants and substances which lessen absorption.
Poisoning from the Salts of Lead. There are three things to be considered in the treatment of poison. ing by the salts of lead.
1. The treatment of active poisoning by those salts taken in large doses and a small number of times.
2. The treatment of slow poisoning. 3. Prophylactic treatment. I have already spoken of the two last heads in the second edition of my work on Materia Medica, and I have republished it in my “ Annuaire" of 1846. I only give in this number the recipe for the syrup of the hydrate of the sulphuret of iron which M. Sandras and I have adopted, (page 101.)
It only remains for us to speak of the first head, or the active poisoning by lead.
The counter-poison on which the most reliance is 10 be placed, is the hydrate of ihe persulphuret of iron, which must be given to the patient in excess. It is best to administer the hydrate mixed with once or twice its weight of this syrup. If the hydrated sulphuret of iron cannot be had, 50 grammes of sulphate of soda or inagnesia may be prescribed.
In both cases we may bring on vomiting and purging by the assistance of two drops of croton oil. Poisoning by Sulphuretted IIydrogen or by the Efluvia of Pricies.
In these cases of poisoning chlorine must be breathed by the pa. tient, with caution, however. M. Labarraque saved a privy-cleaner who was asphyxied, by placing under his nose at intervals a sponge applied in a solution of chloride of soda. If the chloride of soda is not to be had, and all success depends on prompt action, we may get
at any grocer's the “eau de Javelle,” which is a chloride of potassa, with which a sponge should be wet and carried cautiously under the nose of the patient. The disengagement of chlorine may be increased at pleasure by pouring a few drops of vinegar on the sponge. An. other way, recommended by M. Mialhe, for obtaining a slow and gradual disengagement of chlorine, is to enclose in a compress a handful of the chloride of lime, and to pour on it a few drops of vinegar.
When the patient begins to breathe he must have fresh air, and the circulation must be kept up by brushing the skin with a fleshbrush, and by wrapping him with warm coverings. Venesection should be practised, and then he should take an anti-spasmodic potion with two grammes of ether. Poisoning from the Liver of Sulphur, or its solution, known as the
“radical de Barèges, solution pour bains sulfureux, sulfure de poYasse liquide,” (or by any alkaline sulphuret.)
Vomiting must be obtained immediately in these cases by adminis. tering freely of tepid water, warm mucilaginous drinks, and by tickling ihe fauces; if these means do not cause emesis, the stomachpump must be used. Neither the tartar emetic, nor the sulphate of copper or zinc can be used, because they are decomposed by the alkaline sulphurets. We administer afterwards, so long as the matters ejected have the odour of putrid eggs, the solution of ten grammes of the proto, or what is better, of the persulphate of iron, in one litre of water, with 200 grammes of sugar, in divided doses. Instead of the sulphuret of potassium, which is poisonous, we will have the sulphate of potassa formed, which is purgative, and the sulphuret of iron, which is insoluble. I have lately discovered and proved the efficacy of this antidote, which is very valuable, for the double decomposition is instantaneous, and the two coin pounds which result are innoxious; but as the sulphate of iron is poisonous of itself, we must watch its employment, and stop giving it as soon as the vomited matters contain no alkaline sulphuret.
Poisoning from Hydrocyanic Acid. 1. There is no time for administering an emetic.
2. In poisoning by hydrocyanic acid ihe antidote must be administered immediately; for if death follows at all, it does so quickly.
When the acid is anhydrous, or even diluted with its own volume of water, it acts so quickly that M. Larroque thinks there are no hopes in administering the antidote; but if it is the medicinal acid, and especially if that has been diluted, the absorption is much more gradual, and we may hope for success in administering the antidote of M. Smith, which may be prepared beforehand, as follows, and which, according to M. Larroque, may be kept several months by the following precautions: To the solution of the two sulphates of iron we add a solution of sugar; we then precipitate with the carbonate of soda, and keep it in vessels filled and closely stopped.