Emetics

Emetics (from Gr. ἐμετικός, causing vomit), the term given to substances which are administered for the purpose of producing vomiting. It is customary to divide emetics into two classes, those which produce their effect by acting on the vomiting centre in the medulla, and those which act directly on the stomach itself. There is considerable confusion in the nomenclature of these two divisions, but all are agreed in calling the former class central emetics, and the latter gastric. The gastric emetics in common use are alum, ammonium carbonate, zinc sulphate, sodium chloride (common salt), mustard and warm water. Copper sulphate has been purposely omitted from this list, since unless it produces vomiting very shortly after administration, being itself a violent gastro-intestinal irritant, some other emetic must promptly be administered. The central emetics are apomorphine, tartar emetic, ipecacuanha, senega and squill. Of these tartar emetic and ipecacuanha come under both heads: when taken by the mouth they act as gastric emetics before absorption into the blood, and later produce a further and more vigorous effect by stimulation of the medullary centre. It must be remembered, however, that, valuable though these drugs are, their action is accompanied by so much depression, they should never be administered except under medical advice.

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. Occasionally also they are administered when a foreign body has got into the larynx. Their use is contra-indicated in the case of anyone suffering from aneurism, hernia or arterio-sclerosis, or where there is any tendency to haemorrhage.

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