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
1. As to the _suddenness of their invasion and rapidity of their
progress_, it is almost needless to observe, that many natural diseases
commence with a suddenness and prove fatal with a rapidity, which few or
no poisons can surpass. The plague may prove instantaneously fatal; and
even the continued fever of this country may be fully formed in an hour,
and may terminate fatally, as I have once witnessed, at the beginning of
the second day. Inflammation of the stomach also begins suddenly and
terminates soon. Cholera likewise answers this description: I have known
the characters of ordinary cholera fully developed within an hour after
the first warning symptom, and frequently in hot climates, nay, in some
rare instances even in Britain, it proves fatal in a few hours.
Malignant cholera frequently proves fatal in a few hours. Inflammation
of the intestines, too, may begin, or at least seem to begin, suddenly
and end fatally in a day: One variety of it, now well known to affect
the mucous membrane, may remain quite latent till the gut is perforated
by ulceration, and then the patient is attacked with acute pain,
vomiting, and mortal faintness, and frequently perishes within
twenty-four hours.[74] But in particular many organic diseases of the
heart prove suddenly fatal, without any previous warning; and this is
also true to a certain extent even of apoplexy; for, as will afterwards
be seen, it is an error to suppose that apoplexy is always, or even
generally, preceded by warning symptoms. The first characteristic,
therefore, as applied to the symptoms of poisoning generally, contrasted
with those of general disease, must appear by no means distinctive. But
opportunities will occur afterwards for showing, that it is sometimes a
good diagnostic in the case of particular poisons.[75]
2. As to the uniformity or _uninterrupted increase of the symptoms_, it
is equally the attribute of many common diseases. I am not aware, that
in speedily fatal cases of the internal _phlegmasiæ_ a considerable
remission is often observed. Apoplexy, too, very frequently continues
its course without interruption; and the same may be said of cholera,
and indeed of most acute diseases, when they prove rapidly fatal.
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