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
1. The first characteristic is the _suddenness of their appearance and
the rapidity of their progress_ towards a fatal termination. Some of
them act instantaneously, and the effects of most of them are in general
fully developed within an hour or little more. But this character is by
no means uniform. The most violent may be made to act, so as to bring on
their peculiar symptoms slowly, or even by imperceptible degrees. Thus
arsenic, which usually causes violent symptoms from the very beginning,
may be so administered as to occasion at first nothing more than slight
nausea and general feebleness; and afterwards in slow succession its
more customary effects. In like manner corrosive sublimate may be given
in such a way as to cause at first mild salivation, and finally gangrene
of the mouth. Even many vegetable poisons might be administered in the
same way. The well-known consequences of digitalis in medicinal doses
will serve as a familiar instance. A still better illustration is
supplied by the medicinal effects of the alkaloid of nux-vomica, whose
action in other circumstances is most rapid and violent: Strychnia in a
moderate dose will cause death by violent tetanus in two or three
minutes; but when given in frequent small doses as a remedy in palsy, it
has been known to bring on first starting of the limbs, then stiffness
of the jaw, afterwards pain and rigidity of the neck; and these effects
might be increased so gradually, that the patient would seem to die
under ordinary tetanus. Nevertheless, the foregoing considerations being
kept always in mind, it still remains true, that the effects of poisons
for the most part begin suddenly, when the dose is large. This is an
important circumstance in regard to certain active poisons, such as the
mineral acids, oxalic acid, arsenic, strychnia, &c. For when it is
considered that in criminal cases they are given for the most part in
unnecessarily large doses, it follows that if the effect ascribed to
these poisons in such doses have not begun suddenly, the suspicion is
probably incorrect.
The same remarks may be applied to the sudden termination of the
symptoms. Poison is for the most part given criminally in doses so large
that it proves rapidly fatal. Yet this is not always the case; the
diseased state occasioned by poisons has often been prolonged, as will
be seen hereafter, for several weeks, sometimes for several months; nay,
a person may be carried off by a malady, the seeds of which have been
sown by the operation of poison years before.
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