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 cases of which an abstract has here been given, will, it is
apprehended, be sufficient to correct the erroneous impression of
many,—that arsenic, when it proves fatal, always produces violent and
well-marked symptoms. It will of course be understood that cases of the
present kind pass by insensible shades into those of the first
class,—the following, for example, being intermediate between the two. A
young man had frequent vomiting and diarrhœa, which were supposed to
depend on indigestion merely, as the countenance was calm, without any
appearance of suffering, the appetite tolerable, and the abdomen quite
free of tenderness. The pulse, however, quickly sunk, the voice failed,
and death took place in eleven hours; and on dissection about twenty
grains of arsenic were found in the stomach with strong signs of
inflammation.[658]—In a case communicated to me by a former pupil, Mr.
Adams of Glasgow, that of a woman who died five hours after taking six
drachms of arsenic, there was some vomiting not long after she swallowed
it; but subsequently she presented no prominent symptoms except a
ghastly expression, redness of the eyes, a fluttering pulse and extreme
prostration, until within half an hour before death, when the action of
an emetic and the stomach-pump was followed by severe burning pain.
3. The third variety of poisoning with arsenic places in a clear point
of view its occasional action on the nervous system. This occurs chiefly
in persons who, from having taken but a small quantity, or from having
vomited soon after, are eventually rescued from destruction; but it has
also been met with in some cases where death ensued after a protracted
illness.
In such cases the progress of the poisoning may be divided into two
stages. The first train of symptoms is exactly that of the first or
inflammatory variety, and is commonly developed in a very perfect and
violent form. In the second stage the symptoms are referrible to nervous
irritation.
These generally come on when the former begin to recede; yet sometimes
they make their appearance earlier, while the signs of inflammation in
the alimentary canal continue violent; and more rarely both classes of
symptoms begin about the same period. The nervous affection varies in
different individuals. The most formidable is coma; the slightest, a
peculiar, imperfect palsy of the arms or legs, resembling what is
occasioned by the poison of lead; and between these extremes have been
observed epileptic fits, or tetanus, or an affection resembling
hysteria, or mania. As these affections are of much interest, in respect
to the evidence of poisoning from symptoms, it may be well to relate in
abstract a few characteristic examples of each.
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