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
(_c_) The disturbance of the digestive organs is revealed by the
dryness of the mouth and occasional excoriation of the tongue, which
may be reddened or covered with white fur and silvery in appearance;
salivation may be present instead of dryness of the mouth; there may
also be irritation of the throat; symptoms of gastro-enteritis, _e.g._
nausea and vomiting, anorexia, diarrhœa, or alternating diarrhœa and
constipation.
(_d_) The skin eruptions are of various kinds, and comprise eczema,
herpes, urticaria, erythema, keratosis, marked pigmentation and
exfoliation.
(_e_) The nervous symptoms are those of peripheral neuritis, numbness,
formication, hyperæsthesia, and tenderness, especially of the soles
of the feet, the latter presenting appearances of erythro-melalgia;
there is some amount of paresis, in some cases amounting to absolute
paralysis of the limbs affected. The hands may be anæsthetic, while
the feet are hyperæsthetic and hyperalgesic, and the perspiration much
increased. Mental symptoms are not common, but there may be hebetude,
or delusions.
In the Maybrick case, tried at the Liverpool Assizes in 1889, the
following symptoms arose from repeated administration of arsenic during
a period of probably about fourteen days. On April 27 Mr. Maybrick was
seized with vomiting after taking tea. On the next day the vomiting
continued, with foulness of the tongue, and he complained of stiffness
in the lower limbs. On May 1 he complained of feeling unwell after
taking luncheon, and he was sick on the following three days, and
complained of a tickling sensation in the throat, with retching. On May
7 he was still suffering from vomiting, diarrhœa had commenced, and the
throat was very dry and inflamed. On May 8 the diarrhœa was accompanied
by tenesmus. On May 9 the tenesmus was distressing, and he died on May
11.
Dr. Prosper de Pietra Santa describes a disease to which workers in
manufactories of paper coloured with Schweinfurt-green are liable,
characterised by the appearance of vesicles, pustules, _plaques
muqueuses_, and ulcerations on the exposed parts of the body,
fingers, toes, and scrotum. Arsenical poisoning has been mistaken
for nettle-rash, scarlet fever, and Addison‘s disease. In cases of
slow poisoning the symptoms resemble very much those of gastritis and
ulcer of the stomach, and death due to the action of arsenic has been
referred to “spontaneous inflammation of the bowels.”
It must be remembered that in some cases of acute arsenical poisoning,
when the acute symptoms have passed away, the nervous system exhibits
its effects at a later period; in one case paresis came on on the
fifth day, in another at the end of a week, and in a case recorded by
Seeligmüller four weeks elapsed before the onset of nervous symptoms.
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