Treatise on Poisons: In relation to medical jurisprudence, physiology, and the practice of physicChristison, Robert, Sir
Science
Treatise on Poisons: In relation to medical jurisprudence, physiology, and the practice of physic
Christison, Robert, Sir
Medical jurisprudence; Toxicology
Medico-Chirurgical Society of this city, none of the members present
could remember to have seen such a case;[164] and of the witnesses who
were brought to swear to this point on a well-known trial, all of them
physicians of extensive practice, not one could depose that such a case
had ever come within his personal observation.[165] It has been stated
however in a controversial publication written by the late Dr.
Mackintosh of this place, that the author had seen many cases fatal
within the period now mentioned.[166] This is incomprehensible. For my
own part, I cannot help repeating, as the result of the whole inquiry,
that simple cholera rarely causes death in this country, in the period
within which irritant poisoning commonly proves fatal,—that,
consequently, every case of the kind will naturally be apt to lead, in
peculiar circumstances, to suspicion of poisoning,—and that in charges
of poisoning, rapid death under symptoms of violent irritation in the
alimentary canal, like those of cholera, must always be considered an
important article of a chain of circumstantial or presumptive evidence.
7. _Of Malignant Cholera._—The history of this disease affords a fair
promise that, in so far as British practitioners are concerned, it may
ere long be excluded from the list of those which imitate irritant
poisoning. Meanwhile, however, malignant cholera must be allowed to
bear, in its essential symptoms and their course, a marked resemblance
to poisoning with the irritants. So much indeed is this the case that
some authors have actually compared its phenomena to the effects of
arsenic, tartar-emetic, and other powerful acrids. In many cases the two
affections are undoubtedly not so distinguishable by symptoms as to
warrant a physician to rely on the diagnosis in a medico-legal inquiry.
But in many other instances the distinction may be drawn satisfactorily.
Thus the uneasiness in the throat which sometimes attends cholera never
precedes the vomiting. The vomiting in cholera is never bloody. The
colour and expression of the countenance and whole body are peculiar. In
frequent instances the early signs which resemble poisoning are followed
by a secondary stage, sometimes of simple coma, sometimes of typhoid
fever, which a practised person may easily distinguish from the
secondary phenomena produced by some irritants. Lastly, no mistake can
arise where the patient, before presenting the symptoms common to both
affections, experiences violent burning pain or certain tastes, during
or immediately after the swallowing of food, drink, or some other
article.
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