TOXICOLOGY. 388 TOXICOLOGi. symptoms in acute poisoning are vomiting of matters luminous in the dark, a smell of phos- phorus in tlie breath, inflammation of the stom- ach and intestines, jaundice, convulsions, and coma. Treatment consists in washing out the stomach and the administration of old oil of turpentine, or potassium permanganate. Poisonous Foods. There is a rather large group of foods which, owing either to their in- herent properties (mushrooms and other fungi) or to the development of putrefactive bodies with- in them (ptomaines), produce symptoms of se- vere poisoning when eaten. The symptoms are very diverse, but intense gastrointestinal irri- tation is common to all of them, and they may therefore be appropriately classed as irritants. Mushroom poisoning arises through mistaking various fungi, such as mushrooms, toadstools, and truffles, for edible varieties. The toxic sub- stance in many of these is muscarine, a deadly alkaloidal poison, producing violent vomiting, colic, thirst, dyspnoea, paralysis, and death. Ptomaine poisoninf/ is due to the products of putrefactive decomposition in animal or vege- table matter. The ptomaines are alkaloids and resemble chemically many of the vegetable alka- loids, thus leading to confusion or error in toxi- eological investigations. Not all ptomaines are poisonous and not all food poisons are ptomaines. The foods which sometimes produce s_vmptoms of poisoning, wliether ptomaine or other, are corned beef, sausage, pickled or decaying fish, putrid game, cheese, milk, shellfish, particularly mus- sels, and certain poisonous fish ( such as cray- fish, land crab, gray snapper, dolphin, etc.). The treatment of food poisoning, from whatever cause, is prompt evacuation of the stomach, preferably by the stomach tul)e, using plenty of water, and administration of tannic or gallic acid or strong tea. See Ptomaines; Mush- room. Neurotic Poisons. These act principally through the nervous system, and as a rule pro- duce little or no tissue change. Alcohol may act as an acute or chronic poison. Its effects are fully considered under Intoxica- tion. Opium and its chief alkaloid morphine, lauda- num. Majendie's solution (of morphine), and paregoric are often used for suicidal or homici- dal purposes. Paregoric particularly is responsible for many cases of opium ])oisoning in children, being a common ingredient of soothing sj'rups. Acute opium poisoning is characterized by a short preliminary stage of pleasurable excitement followed by drowsiness, sleep, and complete un- C(msciousness. In a moderately advanced case, the pupils are contracted to a pin-point, the respirations are slow, the pulse full, the skin moist. The breathing grows slower and slower until death supervenes from respiratory paraly- sis. The stomach must be promptly emptied, and tannic acid or potassium permanganate given as antidote. Stupor is combated by the ad- ministration of strong coffee, atropine, or strych- nine, and by cold douches, flecking with wet towels, electrical stimulation, and later by forced artificial respiration. Chronic opium poisoning is seen in those habituated to the drug, both in Eastern and Western countries. See Opium. Cocaine (q.v. ) is extensively used as a local antesthetic. and alarming symptoms have followed its absorption by the nmcous membrane, or its hypodermic injection. Death occurs very rapid- ly (forty seconds to four minutes), with great depression and respiratory or cardiac failure. If the patient can-be kept alive for half an hour, recovery is almost certain. If the ])oison has been taken by the mouth, evacuate the stomach, and in any case fresh air, artificial respiration, and stimulants are called for. Chloral is quite often injudiciously used by the public to induce sleep and quiet the nerves; it is also taken with suicidal intent and given by criminals (knock-out drops) to induce pro- longed stupor, often with fatal results. The patient simply passes into a deep sleep without previous excitement, and death occurs from heart failure. Treatment is like that of opium and cocaine. See Chloral. Belladonna and its alkaloid atropine produce, when taken in poisonous amounts, dilatation of the pupil, flushing of the skin, dryness of the mouth, delirium, and sometimes convulsions. Re- covery is the rule, but when death occurs it is from paral.vsis of the heart. Treatment consists in washing out the stomach and opium is the physiological antidote. Similar in their effects and treatment to belladonna are homatropine, hyoscyamus (henbane), h.voscyamine, hyoscine, stramonium, and dulcamara. Strychnine and mix vomica. Strychnine is contained in certain vermin-killers, and is used both for suicide and murder. In poisonous doses it acts principally on the spinal cord, producing cramps and convulsions like those of tetanus (q.v.). Death or recovery is usually speedy. The patient is to be put in a quiet dark room, and tannic acid or charcoal is given, followed by stomach-washing. This must be done before spasms set in. Chloroform and ether control the convulsions, and the bromides and opium act in the same way, but more slowly. Fnissic acid and the various c.vanogen com- pounds, contained in cyanide of potash, cherry- laurel water, bitter almonds, cherry, peach, and plum pits, are exceedingly rapid and fatal poisons. Vhen smaller doses have oeen taken sulphate of iron may be given as an antidote and affusions and douches of cold water, and a resort to arti- ficial respiration are the most useful measures. See Hydrocyanic Acid. Among other substances in the class which are occasionally taken in poisonous doses are aconite, cannabis indica. curare (arrow poison), digitalis, hemlock, and the various coal-tar products, such as acetanilid. phenacetine. and sulphonal (qq.v.). Anoesihetics (ether, chloroform, and nitrous oxide) act as narcotic poisons when taken in overdose. The symptoms may be divided into two stages, one of excitement with rapid pulse and respiration, struggling and flushed face; and one of depression, in which the muscles are relaxed, the patient is insensible, passes into coma and dies from cardiac or respiratory fail- ure. When dangerous symptoms come on during the administration of an antesthetic this is to be stopped, the tongue drawn forward, the patient ex])nsed to a current nf fresh air or oxygen, and if breathing stops subjected to artificial respira- tion. Hypodermic injections of atropine or strychnine are also given. The inlialation or drinking of ether and chloroform is indulged in
