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TREATMENT IN CASES OF POISONING                                   453

Water containing 40 grains of sodium chloride to the pint and sweetened
with glucose should be given frequently by the mouth, if fere is dehydration
owing to intense vomiting or diarrhoea. If water cannot be retained by the
mouth, an enema of two pints of warm normal saline should be adnMstered.
In severe cases it is advisable to administer intravenously normal saline
particularly by the drip method. It also dilutes the poison in the blood and
promotes its elimination from the system, especially by the kidneys.

Respiratory failure should be treated by intravenous or hypodermic
injection of nikethamide (coramine), the hypodermic injection of atropine or
strychnine, by artificial respiration and by the inhalation of oxygen,

Coma should be treated by the hypodermic injection of} grain of
strychnine, by the intravenous or intramuscuk injection of 5 to 15 cc. of a
25 per cent solution of nikethamide (coramine) and by lumbar puncture.
In a case where coma is prolonged, an intravenous injection of normal saline
may be administered continuously by the drip method.

Convulsions should be controlled by chloroform or by a drug belonging
to the barbituric acid group.

Appropriate treatment will be necessary for remote effects of poisons,
such as ulceration or contracting cicatrices after corrosive poisoning and
neuritis after chronic arsenic poisoning.