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
of poisons. I have seen cases of hysteria, more particularly those
assuming the form of tetanus, where very large doses of opium were
required to produce a calmative effect and sleep; and in hydrophobia it
is well shown that the narcotic action of opium is not produced even by
large doses often repeated.—The same state occurs in excessive
hemorrhage.
In the operation of this class of modifying agents it is a general law,
to which there are probably few exceptions, that they chiefly affect
poisons of the organic kingdoms, and the narcotics above all. At least
in the instance of most mineral poisons their influence is very
inferior. Their operation may be accounted for in various ways.
Sometimes, as in dysentery and cholera, the poison is carried with
unusual rapidity through the alimentary canal. Sometimes again it
remains comparatively inert, because on account of the impaired activity
of absorption, it is not taken up with the usual quickness by the
absorbent vessels. And sometimes, as in the instance of tetanus, mania,
and rabies, the nervous system is in a state of peculiar excitement, by
which the customary action of the poison is in a great measure, if not
entirely, counteracted.
In a few diseased states of the system there is an increased
susceptibility of the action of poisons: and it is important that the
medical jurist should attend to this circumstance. When a poison has a
tendency to bring on a peculiar pathological state of the system, or of
a particular organ, which state is also produced by a disease existing
at the time or impending, violent and even fatal consequences may ensue
from doses of poisons which in ordinary circumstances are innocuous or
beneficial. Thus in persons affected with apoplexy an ordinary dose of
opium may accelerate death; and in people even with a mere tendency to
apoplexy, if it is strongly marked, or appears from what are called
warning symptoms to be on the point of developing itself, a common dose
of such narcotics as occasion determination to the brain may excite the
apoplectic attack. Thus, too, in cases of inflammatory disorders of the
alimentary canal, irritating substances, in doses not otherwise
injurious, may produce dangerous impressions on the tender membrane with
which they come in contact. But in respect to this last example, it must
be remarked, that the improvements or the caprice of medical practice
have gone directly in face of the rule, by suggesting that some internal
inflammations of the alimentary canal may be successfully treated with
irritating remedies.
I might here perhaps have added among the causes which modify the action
of poisons, sleep, and the administration of other poisons. The latter
subject, however, will be better considered at the end of the Individual
Poisons, under the title of Compound Poisoning. The former agent is of
doubtful effect. Some observations on its influence will be found in the
chapter on the Evidence of General Poisoning, p. 41.
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