Treatise on Poisons: In relation to medical jurisprudence, physiology, and the practice of physicChristison, Robert, Sir
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Treatise on Poisons: In relation to medical jurisprudence, physiology, and the practice of physic
Christison, Robert, Sir
Medical jurisprudence; Toxicology
The state of the other organs of the body has not been taken notice of
in published cases. In several instances, as in Mr. Taylor’s case, the
blood in the veins of the stomach is described as having been black and
as it were charred; probably by the chemical action of the acid after
death.
SECTION IV.—_Of the Treatment of Poisoning with Oxalic Acid._
The chief part of the treatment of this kind of poisoning is obvious. On
account of its dreadful rapidity, remedies cannot be of material use
unless they are resorted to immediately after the acid has been
swallowed. Emetics may be given, if vomiting is not already free; but
time should never be lost in administering them if an antidote is at
hand. In particular it is necessary to avoid giving warm water with a
view to accelerate vomiting, unless it is given very largely; for
moderate dilution will promote the entrance of the poison into the
blood, if it has not the effect of immediately expelling it.
The principal object of the practitioner should be to administer as
speedily as possible large doses of magnesia or chalk suspended in
water. Chalk has been given with great advantage in several cases,[420]
and magnesia has also been of service.[421] As no time should be lost,
the plaster of the apartment may be resorted to, when chalk or magnesia
is not at hand. These substances not only neutralize the acid so as to
take away its corrosive power, but likewise render it insoluble, so as
to prevent it from entering the blood. There appears no particular
reason for using the stomach-pump when antidotes are at hand. But
fashion seems to have authorised the employment of this instrument for
every kind of poison.[422] Alkalis are inadmissible. As might be
inferred from the general statements formerly made on the effect of
chemical changes on poisons [p. 28], the alkalis, as they form only
soluble salts, will not deprive oxalic acid of its remote or indirect
action; and instances are not wanting of their inutility in actual
practice.
Oxalic acid is one of the poisons alluded to under the head of General
Poisoning,—of whose operation distinct evidence may sometimes (though
certainly not always) be found in the symptoms. If a person, immediately
after swallowing a solution of a crystalline salt, which tasted purely
and strongly acid, is attacked with burning in the throat, then with
burning in the stomach, vomiting particularly of bloody matter,
imperceptible pulse and excessive languor, and dies in half an hour, or
still more in twenty, fifteen, or ten minutes, I do not know any fallacy
which can interfere with the conclusion, that oxalic acid was the cause
of death. No parallel disease begins so abruptly and terminates so soon;
and no other crystalline poison has the same effects.
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