The _quantity_ or _dose_ is the most important of these; many substances
which are deadly in large doses being exceedingly useful as remedies in
small quantities; such are prussic acid, opium, digitalis, arsenic, &c.
Then again, the _mechanical_ and _chemical_ state of aggregation are
all-important; a solid being usually much less active than a fluid or a
gas, and a pure substance much more active than one mixed with insoluble
materials. Even more important is the chemical constitution of the
poisonous agent; as already pointed out, poisonous effects result from
absorption of the poisoning body and absorption implies solution; the
more soluble, therefore, the compound is, the more speedy are its
effects, whilst compounds insoluble in water or any of the juices of the
body are inert. It is not, however, enough that the substance be
insoluble in water; it must be so also in the gastric juice, or it may
give rise to characteristic symptoms. Thus, calomel is insoluble in
water, yet it is a powerful medicine; orpiment is insoluble in water,
yet when swallowed, it may give rise to symptoms of arsenical poisoning,
and so on. As already pointed out, the mode in which the poison is
introduced into the body is of great consequence in estimating its
effects. Then again the _mental_ and _bodily condition_ of the recipient
must be taken into account. Thus, in excited maniacs doses of medicines
may be given without producing any effect which in ordinary individuals
might give rise to serious consequences. The bodily condition,
especially as influenced by habit, is still more important. It may be
broadly stated, that by gradually increasing the dose of a substance
ordinarily poisonous, in course of time enormous quantities may be borne
without producing immediate ill effects. This is especially seen in the
practice of opium eating and smoking, and in a less degree in arsenic
eating, as practised in Styria. The latter instance is, however,
contrary to the usual rule; for whereas with vegetable substances, such
as opium the dose requires to be constantly increased to keep up the
effects, with minerals, the contrary seems to be the case, especially
with antimony and mercury, which cannot be long given without danger to
the recipient.
CHAPTER II.
DIAGNOSIS OF POISONING—DUTIES OF THE PRACTITIONER.
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