Emetic

“ That tartar emetic is a stimulant of very high power, is evident from the small quantity of it which produces the state of indirect debility that occasions vomiting. It should be given in such a manner as to increase and to support the excitement. ”

“ Black vomit often comes soon after the administration of an ill-judged emetic. The principle indication are these—the tongue humid, saburral, charged with whitish mucous deposits, nausea, disposition to vomit, bad taste in the mouth, the temperament bilious, constitution lymphatic, atmosphere damp, etc. Administered under these circumstances in the first period of the invasion, the emetic is a heroic remedy. I prescribe thirty grains of ipecac, dissolved in six ounces of distilled water, taken in one draught. ”

“ Let the experimenter or operator place different metallic substances in their hands, taking care that these substances are carefully covered with tissue paper or other light substance, which will help to hide their character, and at the same time not prevent their influence being imparted, or try them with medical substances. In those sufficiently sensitive, an emetic will produce a feeling of nausea. ”

“ If you put your finger down your throat, you produce retching; many people have only to think of anything disgusting to produce the effect of an emetic, just as the thought of something nice makes the mouth water just as much as tasting the most dainty morsel. ”

“ Emetics have two main uses: that of emptying the stomach, especially in cases of poisoning, and that of expelling the contents of the air passages, more especially in children before they have learnt or have the strength to expectorate. Where a physician is in attendance, the first of these uses is nearly always replaced by lavage of the stomach, whereby any subsequent depression is avoided. Emetics still have their place, however, in the treatment of bronchitis, laryngitis and diphtheria in children, as they aid in the expulsion of the morbid products. ”

“ But it appears to be an excellent way to insure the operation of emetics. If the emetic is about to fail in its effect, cold water dashed over the head restores the patient for a few moments to sensibility, during the continuance of which the emetic operates. Dashing cold water over the head may perhaps be dangerous in the advanced stage, when the body is cold and the breathing imperceptible; but the most desperate remedies may be then tried, as the patient is generally in almost a hopeless state. ”

“ Emetics also frequently become more powerful by repetition; Cullen informs us that he knew a person so accustomed to excite vomiting in himself that the one twentieth part of a grain of tartarized antimony was sufficient to excite a convulsive action of the stomach; in some cases such an effect may perhaps be referred to the operation of the mind; for after the frequent use of an emetic, the mere sight of it, or even conversation relative to it, has been found sufficient to excite nausea. ”

“ Where, as is not infrequently the case, a cur takes to eating eggs, a single dose of tartar emetic concealed in an egg which is placed where he can readily find it, is apt to effect an immediate and complete reform. This ready learning from experience is almost the gist of our human quality—at least on the intellectual side of it. ”

“ From this we can understand, how after the operation of an emetic the stomach becomes more irritable and sensible to the stimulus, and the pleasure of food; since as the sensorial power becomes accumulated during the nausea and vomiting, the digestive power is afterwards exerted more forceably for a time. ”

“ In inflammatory fevers with great arterial action, as the stomach is not always affected with torpor, and as there is a direct sympathy between the stomach and heart, some people have believed, that nauseating doses of some emetic drug, as of antimonium tartarizatum, have been administered with advantage, abating by direct sympathy the actions of the heart. ”

“ For Corrosive Sublimate.—Administer an emetic and large doses of white of eggs, milk, mucilage, barley water, or flour and water. Force the patient to swallow large quantities. Use the stomach pump.
For Belladonna.—Give emetics and stimulants. Apply warmth to extremities and mustard plasters to the feet. Use artificial respiration if necessary. ”

“ Was the cgovernment to prescribe to us our medicine and diet, our bodies would be in such keeping as our souls are now. Thus in France the emetic was once forbidden as a medicine, and the potatoe as an article of food. ”

“ An emetic is said to stop a pulmonary hæmorrhage, which it may effect, as sickness decreases the circulation, as is very evident in the great sickness sometimes produced by too large a dose of digitalis purpurea. ”

“ AS for what concerns the next Means of Remedy, an Emetick may be given in the Infancy of the Disease, where the Stomach is loaded either by over-eating, or by a Crowd of bad Humours, or when there is a Loathing, or a Bitterness in the Mouth; so that any particular Conformation of the Breast and Neck doth not contra-indicate; and amongst these Remedies they are preferrable which plentifully excite Vomiting, without working also downwards. ”

“ Specific emetics cause nausea, even without vomiting, depressing the action of the heart by their influence over the Vagus nerve. Irritant emetics scarcely cause nausea, producing only a feeling of discomfort, arising from the inverted action of the stomach. ”

“ Emetic.—Dose, 1 for a child, and 4 for an adult. They are generally tinged of a pink colour with carmine.
2. From impure or coloured emetine, 32 gr. (or pure emetine, 8 gr.) ; sugar, 4 oz.; mucilage, q. s.; divide into 256 lozenges. Pectoral. One every hour, or oftener, for an adult. The last are intended to take the place of ipecacuanha lozenges, but are rather stronger.
Lozenges, Escharot′ic. Syn. Trochisci escharotici, L. Prep. (P. Cod.) Corrosive sublimate, 2 dr.; starch, 4 dr.; mucilage of tragacanth, q. s.; mix, and divide into 3-gr. oat-shaped granules. ”

“ He forbids the use of strong emetics. His second method of evacuation is by purging, which he recommends to be done by pills containing aloes, hermodactylus, cinnamon, and scammony. He then proceeds to the cure when an attack has come on. In this case, he recommends us to begin with letting blood, unless the stomach be loaded with impurities, when an emetic must be premised, lest the emptiness of the veins produced by venesection should cause these crude humours to be conveyed over the body. ”

“ Such emetics are chiefly used when we wish to unload the stomach of any irritating or poisonous matters; but not when our object is to cause nausea, depression of the heart's action, or relaxation of the muscles. The violent action which they produce may possibly act on remote parts on the principle of counter-irritation. ”

“ when I gave him an emetic, and he heaved it up in small tacks, d’ye see. No possible way for him to digest that jack-knife, and fully incorporate it into his general bodily system. ”

“ As with the Emetics, one kind seem to act by topical irritation, exciting an outpouring of the intestinal secretions, and causing an expulsion of the contents by exciting peristaltic contraction. But Specific Emetics, which act from the blood, seem to produce their effect by influencing the nerve of the stomach; so that they are Neurotic medicines. Specific Cathartics act differently. They are truly Eliminatives. They exert no influence over nerves, but they operate by passing out of the blood through the intestinal glands. Like Specific Emetics, they must be first absorbed. ”

“ Medicine is sometimes necessary to assist the natural powers of the system to remove disease; but it is only an assistant. While emetics are occasionally useful in removing food and other articles from the stomach that would cause disease if suffered to remain, and cathartics are valuable, in some instances, to relieve the alimentary canal of irritating residuum, yet the frequent administration of either will cause serious disease. ”

“ Others, which may be termed systemic emetics, produce their effects through the nervous system, and, therefore, must be absorbed into the circulation before they can produce vomiting. In cases of poisoning, it is desirable to empty the stomach as quickly as possible, hence irritant emetics should be employed, for they act more speedily. Draughts of warm water favor the action of emetics. ”

“ Some nauseating substances, such as emetics, have the power of inverting the order of the muscular contractions, and directing the contents upwards instead of downwards—whence vomiting ultimately arises. Other substances, again, have the property of exciting the natural action to a higher degree, and consequently propelling the contents faster downwards—in other words, of purging. ”

“ It is unnecessary here to treat of the emetics which act most quickly, or which are most proper in different cases, nor of antidotes for various poisons. Many stomach-pumps have been contrived, and their merits have caused much rivalry ”

“ Where the tartarized antimony, given with this intention, operated as [Pg 330] a purgative, it generally produced beneficial effects.
Ten years have elapsed since the former edition of this work appeared; but this length of time, and subsequent observation, have not enabled me to place any greater confidence in the operation of emetics, as a cure for insanity.
An author [36] who has lately published a work, entitled “Practical Observations on Insanity,” is however a determined fautor of emetics in maniacal cases. In his skilful hands they have worked marvellous cures ”

“ The stimulus of so much volition supports insane people under variety of hardships, and contributes to the cure of diseases from debility, as sometimes occurs towards the end of fevers. See Sect. XXXIV. 2. 5. And, on the same account, they bear large doses of medicines to procure any operation on them; as emetics, and cathartics, which, before they produce their effect in inverting the motions of the stomach in vomiting, or of the absorbents of the bowels in purging, must first weaken the natural actions of those organs, as shewn in Sect. ”

“ Prep. Elaterium, 1 gr.; spirit of nitric ether, 2 fl. oz.; tincture of squills, 1⁄2 oz.; oxymel of colchicum, 1⁄2 oz.; syrup of buckthorn, 1 fl. oz.—Dose, 1 dr. 3 times a day in water.
Mixture, Emet′ic. Syn. Mistura emetica, L. Prep. 1. (Copland.) Sulphate of zinc, 40 gr.; ipecacuanha wine and tincture of serpentary, of each 4 fl. dr.; tincture of capsicum, 40 drops; oil of chamomile, 12 drops; peppermint water, 41⁄2 fl. oz. As an excitant emetic; in cases of poisoning by narcotics, &c.
2. (Magendie.) Coloured emetine, 4 gr. (or white emetine, 1 gr.) ; acetic acid, 8 drops ”

“ The diet is to be regulated with a strict abstinence from gross food; if there be plethora, venesection is to be premised; then drastic purgatives and emetics are to be given, and the parts affected are to be rubbed with stimulant and caustic applications, containing hellebore, nitre, sulphur, misy, red arsenic, &c., or even the actual cautery may be applied. In short, all treat the disease in nearly the same manner as our author. (See in particular Serapion and Avicenna.) ”

“ With regard to the treatment, he disapproves, in general, of abstinence and purgative medicines, recommends bleeding, if the strength permit, more especially if the fever be attended with pain; but, if venesection cannot be practised, he directs emetics to be given. At an earlier period than in ordinary fevers the patient is to be put into the bath, and is afterwards to get hot undiluted wine, and everything of a glutinous nature, and flesh of this description. In the case of young persons, he directs these remedies to be administered with great caution. ”

“ But there are also the substances which the living body compounds or modifies for itself. It has been said that the organism is the receptacle and laboratory of poisons; in the state of emotion, the only one with which we are concerned at present, the function of this chemical process is manifested at every instant. We are always speaking of the weakening or the increase of the circulation of the blood; yet the emotional dispositions or modifications are connected, not only with variations of quantity, but also with those of quality in the blood (anæmia, aglobulia, malarial poisoning, etc.) ”

“ Cathartics and Enemas. He who makes a practice of flushing out his intestinal tract with high enemas and internal baths is like a person who eats a good dinner and then proceeds to wash out his stomach. In the mistaken idea that he is making himself clean, he is washing what was never intended to be washed and robbing the body of the nutrition which it needs. And the man who persists in the pill habit is making a worse mistake, adding insult to injury and forcing the mucous membrane to toughen itself against such malicious attacks. ”

“ But when in succeeding ages, the use of medicines became more common, a great number of remedies for this dreadful disease were invented, some of which indeed were too filthy and shocking: such as drinking the warm blood of a gladiator just slain; eating human or horse’s flesh, the testicles and penis of some animals, and other things of the same kind; [132] as if matters so repugnant to nature, could be contrary to such grievous defects of it. For so it often happens, that when a rational medicine is not to be found, any improper and rash one is attempted. ”

“ If his strength be good, we must have recourse either to phlebotomy or purging, having first determined which of these remedies we shall try. If he be weak, we must not bleed, but may purge him moderately. If there be many crude humours in the system, we must neither bleed, nor purge, nor exercise, nor move at all, nor try the bath; but we must keep him in a state of perfect quietude, and give him food, drink, and medicines of attenuating and incisive qualities, without being of a manifestly heating nature. We may give vinegar and honey, and occasionally some ptisan or honied water. ”