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
Passing now to the differences between these gelatinized perforations,
and the perforations caused by corrosive poisons, it may in the first
instance be observed, that the margin of a corroded aperture is
sometimes of a peculiar colour,—for example, yellow with nitric acid,
brown with sulphuric acid or the alkalis, orange with iodine. But a much
better, perhaps indeed an infallible criterion, and one of universal
application, is the following. Either the person dies very soon after
the poison is introduced, in which case vital action may not be excited
in the stomach: or he lives long enough for the ordinary consequences of
violent irritation to ensue. In the former case, as a large quantity of
poison must have been taken, and much vomiting cannot have occurred,
part of the poison will be found in the stomach: In the latter case, the
poison may have been all ejected; but in consequence of the longer
duration of life, deep vascularity, or black extravasation must be
produced round the hole, and sometimes too in other parts of the
stomach; changes which will at once distinguish the appearance from a
gelatinized aperture. There is no doubt that the stomach may be
perforated by the strong corrosives, and yet hardly any of the poison be
found in the stomach after death. Thus in a case related by Mertzdorff
of poisoning with sulphuric acid, where life was prolonged for twelve
hours, he could detect by minute analysis only 4½ grains of the acid in
the contents and tissue of the stomach. But then the hole was surrounded
by signs of vital reaction, and so was the spleen upon which the
aperture opened.[216] Judging from what I have often seen in animals
killed with oxalic acid, which is the most rapidly fatal of all
corrosives, so that little time is allowed for vital action, and also
several times in persons who had died quickly from the action of
sulphuric acid, I believe no poison can dissolve the stomach, without
such unequivocal signs of violent irritation of the undissolved parts of
the villous coat, as will secure an attentive observer from the mistake
of confounding with these appearances the effects of spontaneous
erosion. Spontaneous erosion is very generally united with unusual
whiteness of the stomach, and there is never any material vascularity.
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