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
This most important discovery, pregnant alike with interesting
physiological deductions and valuable medico-legal applications, was
first announced by him to the Parisian Academy of Medicine in January,
1839; when he stated that arsenic is absorbed in such quantity in cases
of poisoning as to admit of being discovered by an improved process of
analysis in various organs and fluids of the body, such as the liver,
spleen, kidneys, muscles, blood, and urine.[569] In November, 1840, he
proved these facts to the satisfaction of a committee of the
academy.[570] And since then they have been confirmed by others, not
merely in express experiments, but likewise in the familiar experience
of medico-legal practice. The situations where arsenic is met with in
largest quantity are the liver, the spleen, and the urine, but above all
the liver. The precise circumstances in which it may be found in one or
another of these quarters have not yet been determined. But in most
cases of acute arsenical poisoning where the search has been made at
all, it has proved successful in the liver. In two late instances I have
readily found arsenic by the process of Marsh or Reinsch in the liver
after four months’ interment.
Since arsenic then is clearly absorbed into the blood, it becomes an
interesting question whether the organization of the blood is thereby
changed. This question cannot be answered with confidence. But in all
probability the blood does undergo some change in its _crasis_; for in
most cases of acute poisoning that fluid is found after death in a
remarkable state of fluidity [see Section on the Morbid Appearances];
and Mr. James observed that if venous or arterial blood be received into
a solution of arsenic, instead of coagulating in the usual way, a
viscous jelly first forms, and lumpy clots separate afterwards.[571]
Our knowledge of the affection induced by the remote action of arsenic
is in some respects vague. Toxicologists have for the most part been
satisfied with calling it a disorder of the general nervous system. When
employed to designate the state of collapse which accompanies or forms
the chief feature of acute cases of poisoning with arsenic, this term is
misapplied. The whole train of symptoms is that not of a general nervous
disorder, but simply of depressed action of the heart. That this is the
chief organ remotely acted on in such cases farther appears probable
from certain physiological experiments, in which it has been remarked,
that immediately after rapid death from arsenic the irritability of the
heart was exhausted or nearly so, while that of the intestines, gullet,
and voluntary muscles continued as usual.[572] As to the singular
symptoms which often arise in the advanced stage of lingering cases, the
term, disorder of the general nervous system, is more appropriately
applied to them. They clearly indicate a deranged state sometimes of the
brain, sometimes of particular nerves.
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