BLOOD.-Urine containing blood has a peculiar smoky color, and always contains a trace of albumen. Under the microscope, the blood-corpuscles are usually colorless, have lost their biconcave form, and are globular from imbibition of water. Pus. If there be a thickish yellow deposit at the bottom of the vessel, of a stringy consistence, it usually consists of mucus containing pus. The supernatant fluid being poured off, an equal bulk of caustic potash is added to the deposit, which at once gelatinizes, becom ing so thick and tough that it cannot be poured from the test-tube. When pus is present in small quantity, puscorpuscles can readily be detected by the microscope. TUBE CASTS.-These are either: 1. Fibrinous casts, often containing blood-disks. 2. Desquamative casts, containing epithelial casts. 3. Granular or fatty casts, containing numerous oil-globules, free, or in the epithelial cells. 4. Hyaline or waxy casts, solid and transparent, or containing epithelial cells, granules, and free nuclei. These bodies may be detected by allowing any sediment to fall to the bottom of a conical glass, removing a small portion of it with a fine pipette, placing a drop on a slide, covering it with a thin glass, and examining it with a power of 250 diam. linear. SPERMATOZOIDS, TORULE, SARCINE, BACTERIA, VIBRIONES, ETC., Occasionally found in urine, may be readily detected by their characteristic microscopical appearance. 15 POISONS, THEIR NATURE AND TREATMENT. A condensed table of poisons, presenting, at a glance, the prominent symptoms and the most available remedies or antidotes, is sure to prove, sooner or later, of practical and immediate utility. After all, the general principles of treatment only can be indicated in such an outline portrait of the effects of toxical agents; the details must be left to the intelligence, aptness, and presence of mind of the practitioner. Whenever it may be possible to apply a direct chemical antidote, no time should be lost in its speedy employment. Of late years the antagonizing physiological action of various powerful remedies has also been invoked in cases of poisoning, and in a number of medical journals favorable results have been reported, where reliance had been successfully placed in this class of physiological opposites. Thus atropia, which dilates the pupil, has in a toxical overdose been combated by morphia, which contracts it; and a small dose of atropia administered hypodermically, say ' to 3 of a grain, until its characteristic effects are induced, is a physiological antidote to physostigmia, the active principle of Calabar bean. Watchful care must be taken, however, so far as quantity is concerned, lest in substituting one. intensely potent agent for another the character of the poison may alone be changed, and the patient be left in equal peril. In cases in which no such chemical or physiological antidotal power is available, general principles of treatment must guide the practitioner in the employment of emetics, counter-irritants, etc. The following classification, modified from that of Taylor,' is based on the modus operandi of poisons on the human system in its normal or healthy state: By way of illustration, the following explanation may be made: Irritants exert their action on the mucous membrane of the alimentary canal. They cause great pain in the abdomen, acrid and burning taste on swallowing, nausea, vomiting, purging, cramps, and sometimes bloody evacuations. Some irritants are corrosive, and act immediately. Death may ensue from collapse, from convulsions, from intense inflammation, or stricture of the oesophagus. The symptoms of irritant poisoning are not unlike those attendant on some of the diseases of the gastro-intestinal apparatus, as colic, gastritis, enteritis, cholera, etc. Neurotics act specially on the cerebro-spinal system, producing drowsiness, headache, giddiness, coma, delirium, and occasionally convulsions, and at times an irritant action on the alimentary canal. The subdivision into spinal, cerebral, and cerebro-spinal neurotics indicates 1 Manual of Toxicology, by Dr. John J. Reese; Phila., 1874. 2 As opium and alcohol. 3 As ether, chloroform, and alcohol. As nux vomica, strychnia, brucia, etc. 6 As belladonna, stramonium, hyoscyamus, solanum. 6 As conium, tobacco, lobelia, aconite, Calabar bean. 7 As hydrocyanic acid, oil of bitter almonds, digitalis, cocculus indi cus, etc. the mode of action of each. Self-evident also is the method of subdivision of the latter into deliriants, d-pressants, and asthenics, the latter producing death by shock. The symptoms may resemble those of apoplexy, epilepsy, and uræmic poisoning, or insidious cerebro-spinal diseases, which at times burst unexpectedly and with full force on the patient. The Treatment of Poisoning. The treatment of poisoning is briefly and concisely detailed in the following statement, prepared for the ready reference of the practitioner. The list of articles is arranged alphabetically for convenience, the class to which each belongs being mentioned. He should, in the absence of any information as to specific chemical or physiological antidote or remedy, treat the case on general principles; in other words, evacuate the stomach by emetics or the stomach pump; resort to the use of cathartics, if they seem to be indicated, stimulants, diluents, oleaginous substances, external friction, artificial respiration, etc., according to the urgency of the symptoms. A General Antidote for Poisons has been suggested by Jeannel for use in poisoning by various powerful agents, as arsenic, zinc, digitaline, etc., the preparations of which. are rendered completely insoluble by it: Solution of sulphate of iron (sp. gr. 1.45), 21 oz. Calcined magnesia, 2 oz. Washed animal charcoal, 1 oz. The ingredients are kept separate, the solution of the sulphate in one vessel, the magnesia and charcoal in another, with some water. When needed for use, the solution of the sulphate is poured into the other vessel, and violently agitated. The mixture should be administered in doses of from one and a half ounces to three ounces. Poison. Class. Treatment. Acetic acid. Irritant. Aconite (and CerebroAconitia). spinal neurotic. Alcohol. Free vomiting, followed by exhibition of alka- antidote. Cerebral Stomach-pump; cold affusion; inhalation of neurotic. vapor of ammonia; use of electro-magnetic apparatus. Irritant. Mild vegetable acids, as dilute vinegar or lemon-juice; olive oil; milk may be given copiously; stomach-pump should not be used. Inhalation of vapor of acetic acid. Cerebral Same treatment as for chloroform poisoning. Arsenic, pre- Irritant. parations of. Arsenious Irritant. acid. Atropia. Cerebro- Barium, salts Irritant. of. Belladonna (and Atropia). Cerebro- Free vomiting with warm mucilaginous drinks, In the absence of vomiting prompt emesis by Sulphate of soda or of magnesia; emetics or stomach-pump. Prompt emetic or stomach-pump. No reliable chemical antidote: tannin and animal charneurotic. coal have been employed. Physiological antidote, morphia, which may be administered subcutaneously. Jaborandi has also been suggested. |