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
Oxide of arsenic being sparingly soluble, its operation is often much
influenced by the condition of the stomach as to food at the time it is
swallowed. If the stomach be empty, it adheres with tenacity to the
villous coat and acts with energy. If the stomach be full at the time,
the first portions that come in contact with the inner membrane may
cause vomiting before it can be diffused, so that the whole or greater
part is discharged. One remarkable case of this nature has been quoted
in page 29. In another, where severe symptoms did supervene, and
recovery was ascribed to the use of magnesia as an antidote, the
favourable result seems to have been really owing to the circumstance,
that the patient had supped heartily not long before taking the
arsenic.[600] An extraordinary case related by Mr. Kerr, in which nearly
three-quarters of an ounce were retained for two hours without causing
any serious mischief, probably comes under the same category; for the
arsenic was taken immediately after a meal, and the stomach was cleared
out by emetics.[601]
In the following detail of the symptoms caused by arsenic in man, its
effects when swallowed will be first noticed; and then some remarks will
be added on the phenomena observed when it is introduced through other
channels.
The symptoms of poisoning with arsenic may be advantageously considered
under three heads. In one set of cases there are signs of violent
irritation of the alimentary canal and sometimes of the other mucous
membranes also, accompanied with excessive general depression, but not
with distinct disorder of the nervous system. When such cases prove
fatal, which they generally do, they terminate for the most part in from
twenty-four hours to three days. In a second and very singular set of
cases there is little sign of irritation in any part of the alimentary
canal; perhaps trivial vomiting or slight pain in the stomach, but
sometimes neither; the patient is chiefly or solely affected with
excessive prostration of strength and frequent fainting; and death is
seldom delayed beyond the fifth or sixth hour. In a third set of cases
life is commonly prolonged at least six days, sometimes much longer, or
recovery may even take place after a tedious illness; and the signs of
inflammation in the alimentary canal are succeeded or become
accompanied, about the second or fourth day or later, by symptoms of
irritation in the other mucous passages, and more particularly by
symptoms indicating a derangement of the nervous system, such as palsy
or epilepsy. The distinctions now laid down will be found in practice to
be well defined, and useful for estimating in criminal cases the weight
of the evidence from symptoms.
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