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84 DENTAL MEDICINE.
there is experienced a feeling of distress, relaxation and faintness^
with a cool, moist skin and small, feeble and irregular pulse, such
symptoms increasing until emesis occurs ; during which the face
becomes flushed, the pulse full and frequent, with an increase in
the temperature of the body. When the action of vomiting is
over, the skin again becomes moist, the pulse soft and feeble,
and a languid and drowsy feeling is experienced. Whatever
may be the apparent necessity for evacuating the stomach, all the
circumstances of the case must be considered, and, especially if
there be much arterial excitement, with determination to the
head, blood-letting should sometimes be premised.
When the full dose of an emetic is requisite, as in cases of
poisoning, the object is to evacuate the contents of the stomach
as speedily as possible ; but in other cases it is better to adminis-
ter the emetic substance in divided doses, frequently repeated,
until the desired effect is produced.
In cases of torpor or congestion, it is sometimes necessary to
arouse the system by retching or vomiting, which may be done
by administering the emetic with only a small quantity of fluid
;
but when the object is to empty the stomach, and duodenum
merely, free draughts of tepid water or weak chamomile tea may
be given as sopn as nausea occurs. When the excitability of the
stomach is greatly diminished by a narcotic, as in cases of poison-
ing, it is necessary to assist the emetic by the addition of some
excitant. Vinegar, mustard or ammonia answer as excitants,
when such an effect is caused by opium ; but the stomach-tube
is the best resource.
There are some few cases where emetics cannot be employed
with safety, as in congestion of the brain, a great determination
of blood to the head dependent upon constitutional causes, preg-
nancy, hernia, active hemorrhage from the lungs and uterus,
acute gastritis, etc., etc. ; and if emetics are allowable in such
diseases or conditions, it is in nauseating doses only. When
they are used merely to excite nausea, they are termed nauseants.
Emetics, by frequent use, are prone to cause an increased sus-
ceptibility of the stomach to their action ; hence, persons of deli-
cate habits should use them cautiously.