frequent nor long continued, as the ammonia may cause deleterious effects when too freely inhaled. Pulling the hair and injecting water into the ears are also powerful modes of rousing the patient.
Venesection has been recommended and successfully used by some physicians. If the stomach be emptied, and the patient kept roused, as may almost always be done when means are resorted to in time, venesection will be unnecessary. Sometimes, however, when the pulse is full and strong, it may be prudent to withdraw blood; and it certainly appears that in most cases where this remedy has been employed the sensibility began to return almost immediately after. This is very well shown in a case of poisoning with opium related by Mr. Ross[1] in the Edinburgh Medical Journal, in another described in the same journal by Mr. Richardson,[2] and also in two cases of poisoning with acetate of morphia mentioned in a former page. Sometimes, on the contrary, it has seemed injurious, probably because it was not had recourse to till the patient was moribund. It is a sound general rule that blood-letting ought not to be resorted to until the poison is thoroughly removed from the stomach; for it favours absorption. And yet facts are not wanting to show that this rule, now generally admitted since the researches of Magendie on absorption, is not infallible. Dr. Young of the United States has given the particulars of a case where imperturbable coma was formed, together with puffing stertorous respiration, in consequence of an ounce of laudanum having been swallowed,—and where recovery took place, without the poison having been removed at all, simply under the employment of three blood-lettings to the amount of twenty-eight ounces altogether, of cold to the head, and of sinapisms to the legs.[3]
Galvanism has been sometimes resorted to, but seldom with decided advantage. I saw it tried, with dubious utility, a few years ago in an urgent case which was treated in the Edinburgh Infirmary. Six ounces of laudanum had been swallowed, but most of it was removed in three-quarters of an hour by the stomach-pump. A stage of deep sopor followed, after which sensibility was restored, and maintained for four hours by forced exercise. A state of pure and extreme coma then ensued, during which galvanism was for some time of great service, in rousing the patient. Gradually, however, it ceased to have any effect of the kind. Recovery took place eventually under the use of external and internal stimuli. Mr. Erichsen of the University-College Hospital, London, has related a case, in which electro-magnetism was of undoubted service. The usual symptoms had been occasioned by an ounce of laudanum. The poison had been withdrawn by the stomach-pump, when unavailing attempts were made to restore sensibility by means of various stimulants. At length several electro-magnetic shocks were passed from the forehead to the upper part of the spine, with the effect of speedily eliciting signs of consciousness; in twenty minutes the pa-*
