SPECIFICS FOR THE ALIMENTARY TRACT 



2. A tablespoonful of mustard in a cup of warm water may act a 

 little more vigorously than the preceding but is slow and unreliable 

 but may be used in cases of emergency. 



3. Alkalies. Any neutral salt in concentrated solution may act 

 as an emetic by irritating the stomach. They are slow and uncer- 

 tain of action, and with the exception of the ammonium salts which 

 have a stimulating action, thus counteracting the depression which 

 attends nausea, have no advantage. These ammonium salts should be 

 used whenever further depression is dangerous. Ammonium carbon- 

 ate is too slow for poisoning but is indicated in catarrhal conditions 

 since it has additional value in dissolving the mucus. Ten to 20 

 grains may be given in solution frequently repeated until vomition 

 takes place. 



4. Metallic Salts. Most important and effective are: antimony 

 and potassium tartrate, zinc and copper sulphate and alum. 



Tartar emetic is quite slow, may be somewhat absorbed and is then 

 very depressing. Copper and zinc sulphate are identical in action 

 although the copper salt is to be preferred. They both irritate the 

 stomach in some specific manner and reflexly start vomiting before 

 the gastric wall has undergone any perceptible change. They are 

 not absorbed so long as the mucosa of the stomach is intact and are 

 consequently quite safe. They produce quick action and are accom- 

 panied by but little depression or nausea. They usually cause some 

 irritation to the mucosa and on this account should be used to re- 

 move toxic material which is not irritating to the stomach. They 

 should be strictly avoided when there is reason to believe the mucosa 

 is injured since they would then be rapidly absorbed and cause poison- 

 ing. Their only advantages over apomorphine are: 1. that they 

 are always available, 2. produce but little depression and nausea. 

 In poisoning by phosphorus copper sulphate is especially indicated 

 if any phosphorus remains in the stomach since metallic copper is 

 precipitated, over the globules of phosphorus, quickly changing to 

 the insoluble phosphide of copper. Used in 1 per cent, solution 

 (about 5 grains) repeated at intervals. 



5. Vegetable Irritants. Ipecac, veratrine, etc. These are slow 

 and have side actions which limit their use more or less to the produc- 

 tion of nausea. Ipecac is sometimes used as an emetic, 1 dram of 

 the wine or syrup every 15 minutes or as a powder 15 grs. in luke 

 warm water. 



Veratrine, liypodermically, gr. % — %; (0.02. — 0.03) in alcohol 

 is the best emetic for swine according to Frohner or veratrum may be 

 administered per os or per rectum, dose for swine grs. vij — ^xxx; 

 0.5—2. 



6. Apomorphine is the only alkaloid not a local irritant that is 

 used as an emetic. It is indicated wherever a prompt action is de- 

 sired and unless further depression is dangerous, it is administered 



