I. From Liquors.—Generally speaking, there is no remedy for drunkenness equal to vomiting. The sooner the stomach is emptied of its contents the better, and this may, in most cases, be accomplished by drinking freely of tepid water, and tickling the fauces. On more obstinate occasions, powerful emetics will be necessary. The best for this purpose, are ten grains of sulphate of copper, half a drachm of sulphate of zinc, or five grains of tartar emetic. Either of these should be dissolved in a small quantity of tepid water, and instantly swallowed. Should this treatment fail in effecting vomiting, and dangerous symptoms supervene, the stomach pump should be employed. Cold applications to the head are likewise useful. In all cases, the head ought to be well elevated, and the neck-cloth removed, that there may be no impediment to the circulation. Where there is total insensibility, where the pulse is slow and full, the pupils dilated, the face flushed, and the breathing stertorous, it becomes a question whether blooding might be useful. Darwin[26] and Trotter speak discouragingly of the practice. As a general rule I think it is bad; and that many persons who would have recovered, if left to themselves, have lost their lives by being prematurely bled. In all cases it should be done cautiously, and not for a considerable time. Vomiting and other means should invariably be first had recourse to, and if they fail, and nature is unable of her own power to overcome the stupor, blooding may be tried. In this respect, liquors differ from opium, the insensibility from which is benefited by abstraction of blood.

There is one variety of drunkenness in which both blooding and cold are inadmissible. This is when a person is struck down, as it were, by drinking suddenly a great quantity of ardent spirits. Here he is overcome by an instantaneous stupor: his countenance is ghastly and pale, his pulse feeble, and his body cold. While these symptoms continue, there is no remedy but vomiting. When, however, they wear off, and are succeeded, as they usually are, by flushing, heat, and general excitement, the case is changed, and must be treated as any other where such symptoms exist.

The acetate of ammonia is said to possess singular properties in restoring from intoxication. This fact was ascertained by M. Masurer, a French chemist. According to him, from twenty to thirty drops in a glass of water, will, in most cases, relieve the patient from the sense of giddiness and oppression of the brain; or, if that quantity should be insufficient, half the same may be again given in eight or ten minutes after. In some cases the remedy will occasion nausea or vomiting, which, however, will be salutary to the patient, as the state of the brain is much aggravated by the load on the stomach, and subsequent indigestion. It is also farther stated that the value of this medicine is greatly enhanced from its not occasioning that heat of the stomach and subsequent inflammation which are apt to be produced by pure ammonia. Whether it possesses all the virtues attributed to it, I cannot say from personal observation, having never had occasion to use it in any case which came under my management; but I think it at least promises to be useful, and is, at all events, worthy of a trial. I must mention, however, that the acetate of ammonia is seldom to be procured in the highly concentrated state in which it is used by M. Masurer. Owing to the great difficulty of chrystallizing it, it is rarely seen except in the fluid state, in which condition it is recommended by the French chemist. The form in which it is almost always used in this country, is that of the Aq. Acet. Ammon. or Spirit of Mindererus, in doses of half an ounce or an ounce, but whether in this shape it would be equally effectual in obviating the effects of drunkenness, remains to be seen.

Mr. Broomley of Deptford recommends a draught composed of two drachms of Aq. Ammon. Aromat. in two ounces of water, as an effectual remedy in drunkenness.

The carbonate of ammonia might be used with a good effect. M. Dupuy, director to the Veterinary School at Toulouse, tried a curious experiment with this medicine upon a horse. Having previously intoxicated the animal by injecting a demiletre of alcohol into the jugular vein, he injected five grains of the carbonate of ammonia, dissolved in an ounce of water, into the same vein, when the effects of the alcohol immediately ceased.

We have already mentioned that the excitement of drunkenness is succeeded by universal languor. In the first stage, the drunkard is full of energy, and capable of withstanding vigorously all external influences. In the second, there is general torpor and exhaustion, and he is more than usually subject to every impression, whether of cold or contagion. Persons are often picked up half dead in this second stage. The stimulus of intoxication had enabled them to endure the chill of the atmosphere, but the succeeding weakness left them more susceptible than before of its severity. In this state the body will not sustain any farther abstraction of stimuli; and blooding and cold would be highly injurious. Vomiting is here equally necessary, as in all other instances; but the person must be kept in a warm temperature, and cherished with light and nourishing food with soups, if such can be procured, and even with negus, should the prostration of strength be very great.

A paroxysm of periodical drunkenness may be sometimes shortened by putting such small quantities of tartar emetic into the liquor which the person indulges in, as to bring on nausea. This, however, must be done with secrecy and caution.

It may here be mentioned, though not with a view of recommending the practice, that the vegetable acids have a strong effect both in counteracting and removing drunkenness. To illustrate this fact, the following circumstance may be mentioned:—About twenty years ago, an English regiment was stationed in Glasgow, the men of which, as is common in all regiments, became enamoured of whisky. This liquor, to which they gave the whimsical denomination of white ale, was new to them—being nearly unknown in England: and they soon indulged in it to such an extent, as to attract the censure of their officers. Being obliged to be at quarters by a certain hour, they found out the plan of sobering themselves by drinking large quantities of vinegar, perhaps a gill or two at a draught. This, except in very bad cases, had the desired effect, and enabled them to enter the barrack-court, or appear on parade, in a state of tolerable sobriety. The power of the vegetable acids in resisting intoxication, is well shown in the case of cold punch—a larger portion of which can be withstood than of either grog or toddy, even when the quantity of spirit is precisely the same.

There is nothing which has so strong a tendency to dispel the effects of a debauch as hard exercise, especially if the air be cold. Aperients and diaphoretics are also extremely useful for the same purpose.

For some days after drinking too much, the food should be light and unirritating, consisting principally of vegetables. Animal food is apt to heat the body, and dispose it to inflammatory complaints.[27]

II. From Opium.—When a dangerous quantity of opium has been taken, the treatment, in the first instance, is the same as with regard to spirits, or any other intoxicating fluid. Immediate vomiting, by the administration of similar emetics, is to be attempted, and when it has taken place, it should be encouraged by warm drinks, till there is reason to believe that the stomach has been freed of the poison. These drinks, however, should not be given before vomiting is produced, for, in the event of their failing to excite it, they remain upon the stomach, and thus dissolve the opium and promote its absorption. But when vomiting occurs from the action of the emetics, it will in all probability be encouraged by warm drinks, and the stomach thus more effectually cleared of the poison. Large quantities of a strong infusion of coffee ought then to be given, or the vegetable acids, such as vinegar or lemon-juice, mixed with water. These serve to mitigate the bad consequences which often follow, even after the opium has been brought completely up. If the person show signs of apoplexy, more especially if he be of a plethoric habit, the jugular vein, or temporal artery should be opened, and a considerable quantity of blood taken away. Indeed, it may be laid down as a general rule, that as soon as the poison is rejected, the patient ought to be bled, and the operation should be repeated according to circumstances. Every means must be used to arouse him from stupor. He must be moved about, if possible, from room to room, hartshorn applied to his nostrils, and all plans adopted to prevent him from sinking into lethargy. For this purpose, camphor, asafœtida, or musk, might be administered with advantage. It is also a good practice to sponge the body well with cold water; and the affusion of cold water on the head and over the body, is still more effectual. In cases where vomiting cannot be brought about by the ordinary means, M. Orfila suggests that one or two grains of tartar emetic, dissolved in an ounce or two of water, might be injected into the veins. In desperate cases, the stomach pump must be had recourse to. Purgatives are latterly necessary.

Many practitioners consider vinegar and the other vegetable acids antidotes to opium. This opinion M. Orfila has most satisfactorily shown to be erroneous. In a series of well-conducted and conclusive experiments made by him, it appears that the vegetable acids aggravate the symptoms of poisoning by opium, whenever they are not vomited. They hurry them on more rapidly, render them more violent, produce death at an earlier period, and give rise to inflammation of the stomach—an event which hardly ever occurs when they are not employed. These effects, it would appear, are partly produced by their power of dissolving opium, which they do better than the mere unassisted fluids of the stomach; consequently the absorption is more energetic. The only time when acids can be of use, is after the person has brought up the poison by vomiting. They then mitigate the subsequent symptoms, and promote recovery; but if they be swallowed before vomiting takes place, and if this act cannot by any means be brought about, they aggravate the disorder, and death ensues more rapidly than if they had not been taken.

Coffee has likewise a good effect when taken after the opium is got off the stomach; but it differs from the acids in this, that it does not, under any circumstances, increase the danger. While the opium is still unremoved, the coffee may be considered merely inert; and it is, therefore, a matter of indifference whether at this time it be taken or not. Afterwards, however, it produces the same beneficial effects as lemonade, tartaric acid, or vinegar. According to Orfila, the infusion is more powerful as an antidote than the decoction.

Drunkenness or poisoning from the other narcotics, such as hemlock, belladonna, aconite, hyoscyamus, &c., is treated in precisely the same manner as that from opium.

III. From Tobacco.—If a person feel giddy or languid from the use of this luxury, he should lay himself down on his back, exposed to a current of cool air. Should this fail of reviving him, let him either swallow twenty or thirty drops of hartshorn, mixed with a glass of cold water, or an ounce of vinegar moderately diluted. When tobacco has been received into the stomach, so as to produce dangerous symptoms, a powerful emetic must immediately be given, and vomiting encouraged by copious drinks, till the poison is brought up. After this, vinegar ought to be freely exhibited, and lethargy prevented by the external and internal use of stimuli. If apoplectic symptoms appear, blooding must be had recourse to. The same rule applies here, with regard to acids, as in the case of opium. They should never be given till the stomach is thoroughly liberated of its contents by previous vomiting.

Accidents happen oftener with tobacco than is commonly supposed. Severe languor, retching, and convulsive attacks sometimes ensue from the application of ointment, made with this plant, for the cure of the ring-worm; and Santeuil, the celebrated French poet, lost his life in consequence of having unknowingly drunk a glass of wine, into which had been put some Spanish snuff.

IV. From Nitrous Oxide.—Though the inhalation of this gas is seldom attended with any risk, yet, in very plethoric habits, there might be a determination of blood to the head, sufficient to produce apoplexy. If a person, therefore, becomes, after the experiment, convulsed, stupified, and livid in the countenance, and if these symptoms do not soon wear away, some means must be adopted for their removal. In general, a free exposure to fresh air, and dashing cold water over the face, will be quite sufficient; but if the affection is so obstinate as to resist this plan, it will then be necessary to draw some blood from the arm, or, what is still better, from the jugular vein. When, in delicate subjects, hysteria and other nervous symptoms are produced, blooding is not necessary; all that is requisite to be done being the application of cold water to the brow or temples, and of hartshorn to the nostrils. In obstinate cases, twenty or thirty drops of the latter in a glass of water, may be administered with advantage.