On certain peculiarities of action of aconite and opium : with some general observations on the treatment of narcotic poisoning : (illustrated by the history of two cases) / by John Ellis Blake.

  • Blake, John Ellis.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On certain peculiarities of action of aconite and opium : with some general observations on the treatment of narcotic poisoning : (illustrated by the history of two cases) / by John Ellis Blake. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of that which may have been absorbed. It has been recom- mended, and by high authority, in cases of aconite-poisoning, to give a large dose of animal charcoal, which, it is said, will entangle and neutralize it; and it is even advised that this should precede the administration of an emetic. Unless the charcoal were at hand this might prove dangerous advice. In no case of aconite or opium poisoning would I ever wait for the operation of an emetic. I would give one, of course, and if it took effect before the tube of the stomach-pump could be introduced, well and good, but I consider any delay as dan- gerous, for this reason: that, in a certain proportion of cases, the nervous connections upon which the reflex action of vom- iting depends are very early paralyzed by these poisons, and perhaps by all their class, although they may all sometimes act as emetics. There is also reason for the belief that the process of ab- sorption goes on for a long time after the stomach has ceased to respond to the action of emetics. In this connection the Case No. II., herewith appended, is interesting, since it shows that a stomach, which was naturally most irritable, could in no way be affected by emetics, after taking a large dose of opium. Dr. D. D. Hanson, in the American Journal of Medical Sciences, January, 1862, page 285, reports a case of aconite- poisoning, the subject being a colored boy five years of age. Dr. Hanson reports the case as illustrative of the antagonistic action of strychnia upon the effects of aconite. The emetics given (ipecac, and antimony) failed, as well as irritation of the fauces, to excite vomiting. At the end of half an hour the report says : u The respiration grew more difficult and the pulse became imperceptible at the wrist. He was sinking evi- dently, and emetics were aiding the poison, instead of the patient, as the muscular fibres of the stomach were rendered insensible to expulsive stimuli by the depressing influence of the poison.” In this case the stomach was roused to action, and the pa- tient eventually saved, by giving repeated doses of the tinc- ture of nux-vomica. It will be noticed that, in Case No. I., ulso (appended), no impression could be made upon the stom-