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
_Acute._--The rapidity and virulence of the symptoms are more or less
modified by the form (_e.g._ solution) and the dose taken. From half
an hour to an hour is the usual time which elapses before the symptoms
of poisoning present themselves. In one case, in which the poison was
in solution, the symptoms came on immediately after it was swallowed;
in another, after the lapse of ten hours. The patient first complains
of a feeling of faintness and depression, followed by intense burning
pain in the stomach, increased by the slightest pressure. Nausea and
vomiting, the latter increased by the act of swallowing, now occur. The
vomited matters may be dark brown, black, or bilious; or they may be
greenish from the indigo mixed with the arsenic coming in contact with
the yellow colouring matter of the bile. Blood may also be vomited.
Purging, accompanied with straining at stool, and cramps in the calves
of the legs may occur--the purging, like the vomiting, being incessant,
and affording no relief to the sufferer; the stools may contain blood,
or resemble those of cholera. The thirst is intense, and there may
be a feeling of throat irritation, the pulse feeble and irregular,
and the skin cold and clammy. The urine may or may not be suppressed.
As a rule, the symptoms in this form of poisoning are _continuous_;
but cases occur in which there are distinct _remissions_, and even
_intermissions_. Coma, paralysis, or tetanic convulsions may supervene
before death closes the scene.
_Certain anomalies may occur._--The pain may be absent or but slight.
Vomiting and purging do not occur in all cases, nor is thirst, a
most common and persistent symptom, always present. In some cases
the symptoms resemble those which accompany an attack of cholera. In
others, signs of collapse first make their appearance, from which the
patient may rally, or he may die outright. These variations in the
symptoms do not appear to be due to the _form_ or _quantity_ of the
poison taken. It should also be remembered that arsenic may produce
symptoms closely resembling those the result of _narcotic poisoning_.
_Chronic._--In whatever way the poison be exhibited in small and
repeated doses, there follows a peculiar and characteristic train of
symptoms, associated with (_a_) the general nutrition of the body,
(_b_) the facial appearance, (_c_) irritative disturbance of the
alimentary canal, (_d_) skin eruptions, and (_e_) implication of the
nervous system.
(_a_) The nutrition of the body is altered, there is gradual loss of
flesh with ragged growth of the finger-nails and falling out of the
hair. There may be œdema and jaundice in some cases.
(_b_) The face presents a peculiar appearance, the eyes are inflamed
and watery, the conjunctivæ reddened and congested, there is excessive
secretion from the nose resembling coryza.
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