fungi, and thus many fungi have evolved to become decisively inedible, in this case as a direct defense. chronic polluted groundwater, in this case depicting acid mine drainage, can cause chronic poisoning. chronic poisoning is long-term repeated or continuous exposure to a poison where symptoms do not occur immediately or after each exposure. the person gradually becomes ill, or becomes ill after a long latent period. chronic poisoning most commonly occurs following exposure to poisons that bioaccumulate, or are biomagnified, such as mercury, gadolinium, and lead. management initial management for all poisonings includes ensuring adequate cardiopulmonary function and providing treatment for any symptoms such as seizures, shock, and pain. injected poisons (e.g., from the sting of animals) can be treated by binding the affected body part with a pressure bandage and placing the affected body part in hot water (with a temperature of 50 °c). the pressure bandage prevents the poison being pumped throughout the body, and the hot water breaks it down. this treatment, however, only works with poisons composed of protein-molecules. in the majority of poisonings the mainstay of management is providing supportive care for the patient, i.e., treating the symptoms rather than the poison. decontamination treatment of a recently ingested poison may involve gastric decontamination to decrease absorption. gastric decontamination can involve activated charcoal, gastric lavage, whole bowel irrigation, or nasogastric aspiration. routine use of emetics (syrup of ipecac), cathartics or laxatives are no longer recommended. activated charcoal is the treatment of choice to prevent poison absorption. it is usually administered when the patient is in the emergency room or by a trained emergency healthcare provider such as a paramedic or emt. however, charcoal is ineffective against metals such as sodium, potassium, and lithium, and alcohols and glycols; it is also not recommended for ingestion of corrosive chemicals such as acids and alkalis. cathartics were postulated to decrease absorption by increasing the expulsion of the poison from the gastrointestinal tract. there are two types of cathartics used in poisoned patients; saline cathartics (sodium sulfate, magnesium citrate, magnesium sulfate) and saccharide cathartics (sorbitol). they do not appear to improve patient outcome and are no longer recommended. emesis (i.e. induced by ipecac) is no longer recommended in poisoning situations, because vomiting is ineffective at removing poisons. gastric lavage, commonly known as a stomach pump, is the insertion of a tube into the stomach, followed by administration of water or saline down the tube. the liquid is then removed along with the contents of the stomach. lavage has been used for many years as a common treatment for poisoned patients. however, a recent review of the procedure in poisonings suggests no benefit. it is still sometimes used if it can be performed within 1 hour of ingestion and the exposure is potentially life-threatening. nasogastric aspiration involves the placement of a tube via the nose down into the stomach, the stomach contents are then removed by suction. this procedure is mainly used for liquid ingestions where activated charcoal is ineffective, e.g. ethylene glycol poisoning. whole bowel irrigation cleanses the bowel. this is achieved by giving the patient large amounts of a polyethylene glycol solution. the osmotically balanced polyethylene glycol solution is not absorbed into the body, having the effect of flushing out the entire gastrointestinal tract. its major uses are to treat ingestion of sustained release drugs, toxins not absorbed by activated charcoal (e.g., lithium, iron), and for removal of ingested drug packets (body packing/smuggling). enhanced excretion in some situations elimination of the poison can be enhanced using diuresis, hemodialysis, hemoperfusion, hyperbaric medicine, peritoneal dialysis, exchange transfusion or chelation. however, this may actually worsen the poisoning in some cases, so it should always be verified based on what substances are involved. epidemiology in 2010, poisoning resulted in about 180,000 deaths down from 200,000 in 1990. there were approximately 727,500 emergency department visits in the united states involving poisonings—3.3% of all injury-related encounters. applications poisonous compounds may be useful either for their toxicity, or, more often, because of another chemical property, such as specific chemical reactivity. poisons are widely used in industry and agriculture, as chemical reagents, solvents or complexing reagents, e.g. carbon monoxide, methanol and sodium cyanide, respectively. they are less common in household use, with occasional exceptions such as ammonia and methanol. for instance, phosgene is a highly reactive nucleophile acceptor, which makes it an excellent reagent for polymerizing diols and diamines to produce polycarbonate and polyurethane plastics. for this use, millions of tons are produced annually. however, the same reactivity makes it also highly reactive towards proteins in human tissue and thus highly toxic. in fact, phosgene has been used as a chemical weapon. it can be contrasted with mustard gas, which has only been produced for chemical weapons uses, as it has no particular industrial use. biocides need not be poisonous to humans, because they can target metabolic pathways absent in humans, leaving only incidental toxicity. for instance, the herbicide 2,4-dichlorophenoxyacetic acid is a mimic of a plant growth hormone, which causes uncontrollable growth leading to the death of the plant. humans and animals, lacking this hormone and its receptor, are unaffected by this, and need to ingest relatively large doses before any toxicity appears. human toxicity is, however, hard to avoid with pesticides targeting mammals, such as rodenticides. the risk from toxicity is also distinct from toxicity itself. for instance, the preservative thiomersal used in vaccines is toxic, but the quantity administered in a single shot is negligible. deaths from poisonings per million persons in 2012 0-2 3-5 6-7 8-10 11-12 13-19 20-27 28-41 42-55 56-336 disability-adjusted life year for poisonings per 100,000 inhabitants in 2004. history main article: history of poison poisoning of queen bona by jan matejko. throughout human history, intentional application of poison has been used as a method of murder, pest-control, suicide, and execution. as a method of execution, poison has been ingested, as the ancient athenians did (see socrates), inhaled, as with carbon monoxide or hydrogen cyanide (see gas chamber), injected (see lethal injection), or even as an enema. poison's lethal effect can be combined with its allegedly magical powers; an example is the chinese gu poison. poison was also employed in gunpowder warfare. for example, the 14th-century chinese text of the huolongjing written by jiao yu outlined the use of a poisonous gunpowder mixture to fill cast iron grenade bombs. while arsenic is a naturally occurring environmental poison, its artificial concentrate was once nicknamed inheritance powder. in medieval europe, it was common for monarchs to employ personal food tasters to thwart royal assassination, in the dawning age of the apothecary. figurative use the term poison is also used in a figurative sense. the slang sense of alcoholic drink is first attested 1805, american english (e.g., a bartender might ask a customer "what's your poison?" or "pick your poison"). figurative use of the term dates from the late 15th century. figuratively referring to persons as poison dates from 1910. the figurative term poison-pen letter became well known in 1913 by a notorious criminal case in pennsylvania, u.s.; the phrase dates to 1898.