Section IV.—Of the Treatment of Poisoning with Antimony.
The treatment of poisoning with tartar-emetic is simple. If the poison be not already discharged, large draughts of warm water should be given and the throat tickled, to bring on vomiting. At the same time some vegetable decoction should be prepared, which possesses the power of decomposing the poison; and none is better or more likely to be at hand than a decoction of cinchona-bark, particularly yellow-bark. The tincture is also a good form for giving this antidote. The administration of bark has been found useful even after vomiting had continued for some length of time, probably because a part of the poison nevertheless remained undischarged. Before the decoction is ready, it is useful to administer the bark in powder. It is alleged, however, by M. Toulmouche that decoction of cinchona is not nearly so serviceable as infusion of galls, and that powder of galls is better still.[1] When there is reason to believe that the patient has vomited enough, and that a sufficient quantity of the antidote has been taken, opium is evidently indicated and has been found useful; but venesection may be previously necessary if the signs of inflammation in the stomach are obstinate.
The following case related by M. Serres was probably cured by cinchona. At all events, the effect of the antidote was striking. A man purchased half a drachm in divided doses at different shops, and swallowed the whole in a cup of coffee. Very soon afterwards he was attacked with burning pain in the stomach, convulsive tremors, and impaired sensibility,—afterwards with cold clamminess of the skin, hiccup, and some swelling of the epigastrium, but not with vomiting. Decoction of cinchona was given freely. From the first moment almost of its administration he felt relief, and began to sweat and purge. Next morning, however, he vomited, and for some days there were evident signs of slight inflammation in the stomach; nay, for a month afterwards he had occasional pricking pains in that region; but he eventually recovered.[2] Another and more pointed case has been related by Dr. Sauveton of Lyons. A lady swallowed by mistake for whey a solution of sixty grains of tartar emetic. In ten minutes she was seen by her physician, and at this time vomiting had not commenced. Tincture of bark was immediately given in large doses. No unpleasant symptom occurred except nausea and slight colic.[3]
Orfila considers that the diuretic plan of treatment recommended by him for arsenic [p. 288] is equally applicable in the case of antimony. Having ascertained that a grain and a half of tartar-emetic applied to a wound constantly killed dogs in a period varying from seventeen to thirty-six hours, if no treatment was employed,—he administered to them in this way a dose varying from a grain and a
