Poisoning

Poisoning as an acute emergency may be suicidal, homicidal or accidental. Both suicidal and accidental poisonings are on the increase, the latter especially among children, who have too ready access to modern drugs of dangerous toxicity and prevalent use.
In acute poisoning prompt action is of vital importance. There is not a moment to lose. Time should not be lost from the im- mediate care of the patient by looking for clues or hunting up antidotes. The immediate need is for removal of the poison from the body or its neutralization in the stomach.
The latter course must be pursued if the poison swallowed is corrosive, in which case there will be burns or stains on the lips and in the mouth and, possibly, confirmatory evidence in the shape of stains on the clothing or the floor, or the label on a bottle or other container beside the patient.
Corrosives are strong acids, sulphuric, hydrochloric, nitric, or strong alkalis, caustic soda, caustic potash, ammonia. The neutralizing agent must be given in sips, to prevent vomiting, and in large quantities to help dilute the poison. Up to a pint should be given for adults, less in the case of a child. Too much fluid must not be given for fear of distending and rupturing a stomach wall damaged by the corrosive substance ingested.

To neutralize the above acids use magnesia, four tablespoonfuls to the pint of water, or if this substance is not available one of the following may be used, chalk, whitening, washing soda, or soapsuds.
To neutralize alkalis give vinegar, six tablespoonfuls to the pint of water, or the juice of six lemons in the same quantity.
It should be noted that phenol (carbolic acid) and salts of lemon (oxalic acid) are mild corrosives and if one of these has been swallowed an emetic should be given and the stomach washed out.
Washing soda or bicarbonate of soda must not be used if oxalic acid or oxalates have been taken. Instead use magnesia, chalk, or rely on washing out the stomach.
In every case, except the swallowing of the above mentioned corrosives, the urgent need is to rid the body of the poison as quickly and as thoroughly as possible. The sooner gastric lavage can be carried out the better, and in summoning professional aid the probability of poisoning must be mentioned so that the apparatus for washing out the stomach will be brought and no time wasted.
The fact that the patient has already vomited, if this is the case, is no reason for delay in giving an emetic and, or, in washing or the stomach very thoroughly

As emetic give warm salt and water, one tablespoonful of salt to half a tumbler of warm water. Force the patient to gulp this down quickly so as to encourage vomiting, and keep on till vomiting has occurred not once but many times.
Emetics cannot, of course, be given to an unconscious or comatose patient. In this case lavage must be carried out and in the prone, head-down, position to prevent backflow of fluid into the air passages and choking.
In cases of poisoning by mushrooms salt and water should not be given as this might lead to increased absorption. Mustard, one tablespoonful in half a tumbler of warm water, should be swallowed, and followed by copious draughts of warm water.
In this type of poisoning give AGARICUS 6 or 30 every 15 to 30 minutes till improvement is apparent.
Poisoning associated with severe vomiting and purging and extreme exhaustion with restlessness calls for ARSENICUM ALBUM in similar dosage. With similar symptoms but cold sweat on brow and collapse give VERATRUM ALBUM. In marked collapse with air hunger and desire to be fanned give CARBO -VEGETABILIS. Should there be fiery burnings, burning pain on passing urine, and pallor of face CANTHARIS is indicated. With restless tossing and great fear a dose or two of ACONITUM would be called for.
Poisoning cases often manifest symptoms of shock and this should be dealt with as mentioned above in the section on collapse. Expert aid must always be sought in these cases.

Writer- Dr Ricardo Kidron


Isra Homeo Medic Ltd