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
8. The last modifying cause to be mentioned comprehends certain
_diseased states of the body_. The effect of disease, like that of
habit, is in general to impair the activity of poisons. But it is only
in the instance of a few diseases that this diminution is so strongly
marked as to be important in relation to medical jurisprudence.—In the
continued fever of this country there is a diminished susceptibility of
the constitutional action of mercury; and this peculiarity is very
strongly marked in the yellow fever, as well as in the bilious fevers
generally of tropical climates. In some varieties of typhoid fever there
is obviously a diminished sensibility to the action of wine and other
spirituous liquors; but this diminution in a great majority of cases is
much inferior to what some physicians have represented.—In severe
dysentery the susceptibility of the narcotic action of opium is so much
impaired, that a person unaccustomed to the use of that drug, may
continue to take daily, for several days together, a quantity which
might prove fatal to him in a state of health. In the severe form which
dysentery occasionally puts on in this country I have known a patient
take from twenty-four to thirty grains of opium daily, and retain it
all, without experiencing more than a mild narcotic action.—In epidemic
cholera the same insensibility has been remarked to the operation of
opium.—It also occurs in the instance of excessive hemorrhagy.—According
to the doctrines and practice of the present dominant school in Italy,
there is an unusual insensibility during inflammatory dropsy to the
irritant action of gamboge, so that sixty or eighty grains may be taken
without harm.—There is no disease, however, in which the power of
mitigating the action of poisons is more remarkably exhibited, than in
tetanus: It is often scarcely possible to bring on the narcotic action
of opium by any doses which can be administered; calomel, too, acts with
much less energy than usual; and even common purgatives must be
administered in doses considerably larger than those required in most
other disorders.—Mania is similarly circumstanced: almost all remedies
must be given in increased doses, narcotic remedies in particular. But
there is good reason for believing that the impaired susceptibility of
the action of poisons remarked in this disorder is far from being always
so great as some have alleged.—Another disease allied to the last, where
the diminution of susceptibility is often great, is delirium tremens. It
has in particular been often found, that to produce sleep in this
disease opium must be given in frequent large doses,—so large indeed,
that they would undoubtedly prove fatal to a person in health. At the
same time it is worthy of remark, that in some cases of delirium
tremens, even violent in degree, the peculiarity now specified, as I
have myself several times witnessed, is far from being strongly
marked.—Hydrophobia always, and hysteria sometimes, impair the activity
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