EFFECTS OF POISONS ON THE STOMACH. 527 



ground for suspecting the action of a corrosive substance or some 

 other poison on the gastric mucous membrane. If concentrated 

 acids or strong alkalies have been taken, there are almost always 

 characteristic sloughs about the mouth ; the oral mucous membrane 

 is destroyed in some places ; there are severe pains in the mouth 

 and throat ; swallowing is very difficult, or impossible. After tak- 

 ing the metallic salts or arsenic in a diluted form, the signs of cor- 

 rosion of the mouth and throat do not appear, and the symptoms of 

 gastritis do not occur for some time. The symptoms observed in 

 the different organs, but particularly the examination of the evac- 

 uations, show what kind of poison has been taken. In the most 

 severe cases there is nausea, but the paralyzed stomach cannot evac- 

 uate its contents ; an icy coldness spreads over the body, the paral- 

 ysis becomes total, and the patient may die in a few hours. In 

 milder cases death does not occur till later, and, when a quantity of 

 the poison has been vomited, the symptoms of paralysis may 

 gradually disappear, and the circulation may be reestablished ; 

 but convalescence is usually very slow, and the patient often suf- 

 fers for life from strictures in the oesophagus or stomach, or else 

 because the poison taken has undermined the constitution in some 

 other way. 



TREATMENT. The antidotes given in books on toxicology (lime 

 or soap-suds in poisoning by acids, vinegar and water in poisoning 

 by alkalies, and plenty of milk or water for corrosive poisons) can 

 only be used in recent cases, that is, within a few hours after acids, 

 caustic alkalies, or metallic salts have been taken. If these sub- 

 stances have already been vomited, or have united with the ele- 

 ments of the gastric mucous membrane, antidotes can do no possible 

 good, and may prove injurious by exciting new irritation. It js 

 different with arsenic and the acrid vegetable and animal poisons, 

 whose action continues longer. If there be no vomiting, or if this 

 do not suffice to rid the stomach of the poison, we may give an 

 emetic of ipecacuanha. Besides these rules for fulfilling the causal 

 indication, the indications from the disease itself are to use cold, as 

 blood-letting does little or no good. We may cover the abdomen 

 with cold compresses, to be frequently changed, and give small 

 quantities of ice-water, or, if the patient can swallow, small pieces 

 of ice. For further treatment, we refer to works on toxicology. 



