Toxic Gastritis i)i Solipcds. 165 



ance or analj'sis of the matters rejected, or otherwise of the 

 urine, will often indicate the nature of the poison. 



Lesions. The gastric mucosa is congested and discolored, but 

 the corrosion and even the ulceration are especially characteristic. 

 Patches of necrotic mucous membrane may be more or less de- 

 tached exposing a deep red submucosa. The coloration other- 

 wise varies ; — white or black with sulphuric acid or silver nitrate ; 

 white with muriatic acid, the caustic alkalies, or zinc chloride ; 

 3'ellow with nitric acid ; or green with salts of copper. 



Similar lesions are found on the buccal, oe.sophagean and in- 

 testinal mucosae, and even at times on the respiratory. 



Treatment . In the treatment of this form of gastritis the first 

 consideration is to expel, or use an antidote to, the poison. In 

 the soliped, emetics are useless. The stomach pump or tube may, 

 however, be applied with good effect in nearl}^ all cases, alternatelj- 

 throwing in water and drawing it off. Demulcents and coagu- 

 lants are also universally applicable. Milk, eggs beaten up in 

 milk, blood albumen, flaxseed tea, well boiled gruels, or slippery 

 elm bark, may be used as may be most convenient. Next come 

 the other chemical antidotes the use of which however demands 

 a previous knowledge of the poison present. For the mineral 

 acids one can make use of calcined magnesia, lime water, chalk, 

 or carbonate of soda in weak solution. For alkalies the appro- 

 priate antidote is vinegar. For carbolic acid, vinegar, alcohol, or 

 failing these a weak solution of soda or oil. For tartar emetic, 

 gallic or tannic acid. For bichromate of potash or chromic acid, 

 calcined magnesia, magnesia carbonate, or lime carbonate. For 

 phosphorus, old oil of turpentine and demulcents — -no oil. For 

 ammonia, vinegar followed by almond, olive or sweet oil. In case 

 of oedema glottidis, tracheotomy. For copper salts yellow prus- 

 siate of potash, which precipitates the copper in an insoluble form, 

 and demulcents. For mercuric chloride, demulcent drinks can 

 be resorted to, there is no other reliable antidote. In all cases 

 after tlie evacuation of the .stomach and the use of the antidote, 

 mucilaginous agents must be given freely with morphia or other 

 anodynes. 



