Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
Besides the above, there are also certain conditions connected with
the action of poisons: (1) The poison is absorbed and distributed by
the blood. (2) A portion is eliminated by the fluid secretions and
excretions. (3) Another portion is for a time deposited in the tissues
and organs of the body. These processes are of necessity simultaneous.
The channels of entrance and exit are as follows: Of entrance we
have--(1) _The blood-vessels as a result of wounds_--more important
in a physiological than a medico-legal question. (2) _The skin and
cellular membrane._--Absorption by the skin is modified by the
condition of the part, and also by the form in which the drug is
applied. Thus the skin of the arm-pits and groins is more absorbent
than the palms of the hands. Watery solutions are not so effective
as oily preparations, and the application of the drug in fine powder
is more effectual than a watery solution of it. This is explained
by the presence of a natural oily, unctuous substance on the skin,
which prevents the direct contact of the watery solution, but if the
solution be allowed to evaporate on the part, the substance thus left
in minute division is then readily absorbed. The danger of allowing
strong solutions of corrosive sublimate to evaporate on the head in the
treatment of certain skin eruptions is thus explained. (3) _The lungs
and air-passages._--Absorption by these organs is most active, hence
the intense rapidity in the action of aerial poisons. (4) _The stomach
and intestines._--Poisons introduced into the stomach or intestines
take longer to arrive at the special organs on which they act than by
the other channels of entrance. They are absorbed by the capillaries
into the mesenteric veins, and before passing to the heart, by which
they enter the general circulation, they pass through the liver, where
they are in part excreted in the bile or deposited in the gland. The
absorbing power of the stomach is modified by its fulness or emptiness,
and poisons not soluble in water may be rendered so by the gastric
secretion.
The avenue of entrance may materially modify the action, and some
poisons which act rapidly when entering by a wound, are inert when
taken into the stomach. Snake poisons when given by the mouth are
entirely harmless. Hydrogen sulphide is more toxic when inhaled
than when taken in solution. This, though true in some cases, does
not always occur; and the inertness of these poisons, it has been
suggested, may be due to the elimination of them being as rapid
as their absorption, so that a poisonous dose never enters the
circulation. The intestines absorb more rapidly than the stomach, and
this must be borne in mind when administering powerful drugs _per anum_.
Of the channels of exit we have: (1) _The kidneys._ (2) _The lungs._
(3) _The bile._ (4) _The milk._ (5) _The saliva._ (6) _Mucous
membrane._ (7) _The skin._
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