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
In the following set of cases the nervous symptoms exhibited a singular
combination of delirium, convulsions, tetanus, and coma, such as is
frequently met with in paroxysms of hysteria; but the cases are probably
not pure examples of poisoning with arsenic, for liver of sulphur was
administered as a remedy to a considerable amount. Three servant girls
in one of the Hebrides ate a mixture of lard, sugar, and arsenic, which
had been laid for destroying rats. The ordinary signs of irritation in
the stomach ensued, but on the following morning were greatly mitigated.
They were then ordered twelve grains of liver of sulphur every other
hour. Soon afterwards the inflammatory symptoms became more severe, the
root of the tongue swelled and inflamed, and in the afternoon two of
them lost the power of speech and swallowing, and were attacked with
locked-jaw and general convulsions. The third had not locked-jaw, but
was otherwise similarly, affected. On the morning of the third day one
of the two former was found comatose, with continuance of the locked-jaw
and occasional return of convulsions; and on being roused by venesection
and the cold affusion, she complained of headache and heat in the
throat. The sulphuret of potass, which had been discontinued on account
of the locked-jaw, was then resumed. On the evening of the fourth day
the headache increased, and the patient became delirious and
unmanageable. The cold affusion, however, soon restored her again to her
senses, and from that time her recovery was progressive. In the other
patients the symptoms were similar, but less violent. In these instances
the evidence of an injury of the nervous system was decisive; but it may
be doubted whether the symptoms were not, in part at least, owing to the
sulphuret of potass, which has been already described as an active
poison, capable of inducing convulsions and tetanus. Its properties were
not generally known in this country at the time the cases in question
happened.[661]
Sometimes the convulsions caused by arsenic assume the form of pure
tetanus. At least a case of this affection is noticed by Portal.[662] He
has given only a mere announcement of it; and I have not hitherto met
with a parallel instance in authors.
A common nervous affection in the advanced stage of the more tedious
cases of poisoning with arsenic is partial palsy. Palsy in the form of
incomplete paraplegia is a very common symptom even of the early stage
in animals, and has been also sometimes observed during that stage in
man. The paralytic affection, however, is more frequent in the advanced
stage; and in those persons who recover, an incomplete paralysis of one
or more of the extremities, resembling lead palsy, is often the last
symptom which continues.
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