AFebJrrrVP?903m-}        Detecting  Cases  of  Poisoning.  53 
chemical  tests  are  not  so  important  as  a  means  of  diagnosis, 
although,  of  course,  they  are  the  main  points  in  the  formal  investi- 
gation, but  when  these  characteristic  actions  or  odors  are  wanting, 
chemical  tests  will  often  help.  It  is  true  that  such  tests  are  rarely 
prompt  enough  for  immediate  diagnosis,  but  they  are  useful  for  sug- 
gesting a  line  of  action  after  the  acute  conditions  have  passed.  Let 
us  take,  for  example,  the  common  irritant  poisonings  to  which  allu- 
sion has  just  been  made.  The  symptoms  developed  by  a  stale  cream- 
puff  on  an  August  afternoon  may  be  so  violent  as  to  seem  to 
threaten  life  and  to  suggest  a  very  active  drug.  We  know,  indeed, 
now,  that  the  effect  is  probably  due  to  one  or  more  organic  bodies, 
products  of  the  breaking  down  of  proteid  matters  of  microbes.  The 
treatment  will,  as  a  rule,  be  addressed  to  the  symptoms,  and  no 
attempt  be  made  at  direct  antidotal  remedies.  In  truth,  I  have  for 
some  years  thought  that  the  formal  table  of  antidotes  that  is  ap- 
pended to  quiz  compends,  physicians'  visiting  lists  and  pocket  for- 
mularies, has  more  of  a  literary  than  a  practical  value.  A  physician 
called  to  a  case  of  violent  vomiting  and  purging,  of  sudden  onset, 
will  rely  on  sedative  or  supportive  remedies  and  will  not  consider 
whether  freshly  precipitated  ferric  hydroxid,  old  oil  of  turpentine, 
albumin  or  tannin  should  be  given.  When  the  symptoms  are  under 
control,  and  opportunity  is  obtained  for  some  history  of  the  case, 
the  question  of  possible  poisoning  will  come  up.  Now,  the  detec- 
tion of  the  so-called  ptomains,  or  of  the  microbes  that  produce 
them,  cannot  be  done  by  the  druggist.  It  is  a  problem  of  the  high- 
est difficulty  and,  if  solved  at  all,  it  is  only  by  the  most  expert  and 
best-equipped  specialists.  Chemical  tests  come  in  here  as  methods 
of  exclusion.  In  ordinary  cases  of  acute  poisoning,  attended  by 
marked  irritation  of  the  stomach,  whether  with  or  without  severe 
burning  pain,  if  you  should  be  asked,  by  a  doctor  to  test  any  sus- 
pected food  or  vomited  matters,  apply  first  Reinsch's  test.  The 
material  usually  requires  no  preparation.  A  slip  of  thin  copper-foil 
about  half  a  square  inch  in  area  is  boiled  in  a  test-tube  or  porcelain 
basin  for  about  half  a  minute  with,  say,  10  c.c.  of  water  and  1  c.c.  of 
hydrochloric  acid.  The  slip  should  remain  bright,  and  will  remain 
so  if  the  chemicals  are  reasonably  pure.  After  this  preliminary  test 
has  been  made  satisfactory,  some  of  the  suspected  material  should 
be  added  and  the  boiling  continued  for  half  a  minute  or  so.  If  the 
copper  acquires  a  dark  stain  the  presence  of  some  foreign  body  is 
