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
the acid, it became palsied in thirty-five minutes, while the other
hind-leg continued perfectly sensible and irritable. Acetate of lead
probably possesses the same property.
These facts are important, because some physiologists have doubted
whether any local impressions of a purely nervous nature, unconnected
with appreciable organic change, may arise from the action of poisons.
Yet the existence of impressions of the kind is essential to the
stability of the doctrine of the sympathetic operation of poisons,—that
is, of the transmission of their influence from organ to organ along the
nerves. Nay, in the instance of many poisons supposed to act in that
manner, we must still farther believe in the existence of primary
nervous impressions, which are not only unconnected with organic change,
but likewise undistinguishable by any local sign whatsoever.
Of the three varieties in the local effects of poisons—corrosion,
irritation, and nervous impressions,—the first two may take place in any
tissue or organ; for example, they have been observed on the skin, on
the mucous membrane of the stomach, intestines, windpipe, air tubes,
bladder, and vagina, in the cellular tissue, in the serous membranes of
the chest and abdomen, in the muscular fibre. We are not so well
acquainted with the nature of local nervous impressions on different
tissues; but it is probable that in some textures of the body they are
very indistinct.
So much for the local effects of poisons.
On tracing the phenomena which follow more remotely, we observe that the
affected part sometimes recovers without any visible change, sometimes
undergoes the usual processes consequent on inflammation, sometimes
perishes at once and is thrown off; and if the organ is one whose
function is necessary to life, death may gradually ensue, in consequence
of that function being irrecoverably injured. The purest example of the
last train of phenomena is to be seen in the occasional effects of the
mineral acids or alkalis: death may take place simply from starvation,
because the inner surface of the stomach and intestines is so much
injured that a sufficient quantity of nutriment cannot be assimilated.
But death and its antecedents can seldom be accounted for in this way.
For symptoms are often witnessed, which bear no direct relation to the
local injury: death is generally too rapid to have arisen from the
function of the part having been annihilated: and the rapidity of the
poisoning is not proportional in different cases to the local injury
produced. Even the mineral acids and alkalis seldom kill by impeding or
annihilating digestion, because they often prove fatal in a few hours;
and among other poisons there are few which ever cause death simply by
disturbing the function of the part primarily acted on. Death and the
symptoms preceding it arise from an injury of some other organ, to which
they are not and cannot be directly applied. We are thus led to consider
their remote action.
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