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
Internally the pylorus is contracted. In a case of slow poisoning, fatal
in three months, which has been described by Dr. Braun of Fürth, the
chief appearance besides excessive emaciation was a thickening of the
coats round and behind the pylorus to such a degree that the opening of
the pylorus was formed of an almost cartilaginous ring several lines
broad, and only wide enough to pass a quill.[295] There are spots over
the stomach apparently of regenerated villous tissue, smoother and
redder than the natural membrane. At the points where the stomach
adheres to the neighbouring organs, its coats are sometimes wanting
altogether, so that when its connections are torn away, perforations are
produced. The other parts of the body are natural.
It may in some circumstances be necessary to determine from the
appearances in the dead body whether sulphuric acid has been the
occasion of death or has been introduced into the body after death. This
may always be easily done. If a few drachms of sulphuric acid be
injected into the anus immediately after death, and the parts be
examined in twenty-four hours, it will be found, that wherever the acid
touches the gut, its mucous coat is yellowish and brittle, its muscular
and peritonæal coats white, as if blanched, and the blood in the vessels
charred; the injury is confined strictly to the parts actually touched,
is surrounded by an abrupt line of demarcation, and shows no sign of
inflammatory redness. Nitric acid produces nearly the same effects. The
whole tunics are yellow, and the disorganization is greater. For these
facts we are indebted to Orfila.[296]
In closing this account of the morbid appearances, some observations
will be required on the force of evidence derived from them; because
circumstances may exclude all other branches of medical proof. In many
instances both of acute and of chronic poisoning with the strong acids,
I conceive, contrary to the general statements of most systematic
writers on modern medical jurisprudence, that distinct evidence might be
derived from morbid appearances only. Thus, what fallacy can intervene
to render the following opinion doubtful? In a case several times
alluded to as described by Mertzdorff, there were vesicles and brown
streaks on the lips, neck, and shoulders, similar to the effects of
burning,—almost total separation of the lining membrane of the mouth,
throat, epiglottis, and gullet,—perforation of the stomach, with a
margin half an inch wide, which was extensively charred, and surrounded
by a red areola. From the appearances alone Mertzdorff declared that the
child must have been poisoned with sulphuric acid. Perhaps he should
have said sulphuric or muriatic acid.
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