acid, to give them a ratafia flavour. Cases of this nature may be embarrassing. In general, they may be made out by attending strictly to the symptoms, the quantity of liquor taken, and the contents of the stomach. But, it must be admitted, that if a murderer, who chooses such a method, should season his guest's drink judiciously, and ply him well with it, a medical jurist might be puzzled to determine whether the liquor was to blame in point of quality or quantity.
Of the Treatment.—The treatment of poisoning with alcoholic fluids does not differ essentially from that of poisoning with opium. In the former, as in the latter, the chief objects must be to remove the poison from the stomach, and to rouse the patient from his state of stupor; but in poisoning with alcoholic fluids it is also frequently necessary to treat a secondary stage of reaction by local and even general antiphlogistic measures. As to the primary object, the removal of the poison from the stomach, it appears that in the present form of poisoning emetics are more seldom effectual than in the case of other narcotics, and that the stomach-pump should be promptly resorted to. It is remarkable that the operation of clearing out the stomach is likewise often a sufficient stimulus to dispel stupor immediately and even permanently. I have seen almost complete consciousness permanently restored with the discharge of the alcoholic fluid; and the same remark has been made by others. Where the senses are not thus restored, one of the most effectual stimulants, according to the practice of the police-office of this city, is the injection of water into the ears. Great advantage has been derived, as in poisoning with opium, from the cold affusion applied to the head. Dr. Ogston, who has appended to his paper formerly quoted a very useful summary of the treatment of poisoning with spirits, has found this a safe and effectual remedy where the heat of the head was unnaturally great and that of the body not too low.[1] Cases have been published where it proved successful although the pulse was gone at the wrist, the breathing scarcely perceptible, and the temperature of the whole body greatly reduced.[2] It is doubtless a powerful remedy: but where the general temperature of the surface is much lowered, I conceive it should be restricted to the head and neck, and conjoined with the application of warmth to the body. Dr. Ogston objects to the general use of blood-letting in cases of poisoning with spirits, as being often apt to be followed by sudden sinking. Where other remedies are judiciously used, it is probably seldom called for; and the purpose it is intended to serve, namely, the relief of cerebral congestion and determination, is better fulfilled by the local employment of cold, and local blood-letting. Ammonia and its acetate have been found useful as internal stimulants where the stupor is deep. The treatment of the secondary affections adverted to above does not require specific mention.
