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
One would expect to find the acid always in the stomach when it is
perforated. Nevertheless it is sometimes almost all discharged. In
Mertzdorff’s case, that of an infant who was killed in twelve hours, a
hole was found in the stomach ¾ths of an inch in diameter, and the
contents of the stomach were effused into the belly: yet by a careful
analysis the whole acid he could procure from the contents and tissues
together was only 4½ grains. Sometimes of course the disappearance of
the acid may be owing, as in Dr. Craigie’s case, to the effectual
administration of antacids during life.
The inner coat of the duodenum often presents appearances closely
resembling those of the stomach. Sometimes, however, as in the case just
related from Mertzdorff, and in the infant I examined, the inner coat of
the small intestines is not affected at all, probably because in such
rapid cases the pylorus retains a state of spasmodic contraction till
death or even after it.
The urinary bladder is commonly empty. The thoracic surface of the
diaphragm is sometimes lined with lymph, indicating inflammation of the
chest. In the case which was fatal in two hours [p. 131], Professor
Remer found the surface of the lungs, as well as that of the liver and
spleen, brown and of a leathern consistence, and the tissue beneath
scarlet;—appearances which he thinks arose from the acid penetrating in
vapour and acting chemically. I have not found this appearance mentioned
by any other writer; but I have seen it in animals poisoned with oxalic
acid. The blood in the heart and great vessels has been several times
seen forming a firm black clot. Kerkring[292] relates an instance of the
kind; in Dr. Latta’s case the appearance was very distinct; and it is
dwelt on strongly in a recent paper by M. Bouchardat.[293] Bouchardat
thinks this state of the blood is simply the effect of the absorbed
acid; but coagulation of the blood in the heart and great vessels,—a
striking appearance in contradiction to what is observed after death
from most other poisons,—is more probably the healthy state of the
blood, and not the effect of the particular poison.
The general appearance of the body of those who have died of the second
or chronic variety of poisoning with the acids, is that of extreme
emaciation. The stomach and intestines are excessively contracted: The
former has been found so small as to measure only two inches and a half
from the cardia to the pylorus, and two inches from the lesser to the
greater curvature.[294] Tartra says the intestines are sometimes no
thicker than a writing quill. They are in other respects sound
outwardly, except that they sometimes adhere together.
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