\10HMDA POISONS rANNi V: Ji8t«^.ia-«f • UniVERSITY OF CAUFORNIA LIFORNIA COLLEGE OF MEDICir: AUG 3 ic- IRVINE, CAUFORNIA 92664 £ C(^i: MEMORANDA ON poiso:n's. WORKS BY THE SAME AUTHOR. Tanner s Practice of Medicine. Fifth American from the Sixth London Edition. Greatly Enlarged and Improved. Price, bound in cloth, $? 00 ; in leather, $7 00. Tanner s Practical Treatise on The Diseases of Infancy and Childhood. Third American Edition, Revised and Enlarged, \>y Alfred Meadows, M.D. OctaTO. Cloth, $3 50. Tanner s Index of Diseases and their Treat- ment. "With upwards of 500 Formulae for Medicines, Baths, Mineral Waters, Climates for Invalids, etc., et c. Octavo. Price, $3 00. MEMORANDA POISONS BY THE LATE THOMAS HAWKES TANNER, M.D., F.L.S. THIRD AND COMPLETELY REVISED EDITIOX. PHILADELPHIA: LINDSAY & BLAKISTON. 1872. ASHMEAD, PRIXTEK. EDITOR'S PREFACE. The present edition of Dr. Tanner's ■• Memoranda on Poisons" is in some respects almost a new book. It was, as will be seen bv the Antlior"s Preface to the last Edition, Dr. Tanner's object to furnish the practitioner with a useful guide to his duties in cases of poisoning. Experience has, however, shown that the book is more useful to the student than to the practitioner ; and. with a view to ren- der it still more valuable to the former, it has in great measure been remodelled. Whilst, there- fore, due attention has been paid to what might be called the clinical aspects of poisoning, its chemical bearings have been more closely attend- ed to ; and the more important and reliable tests have in each instance been given, as have also the more important processes for separating l)oisons from organic admixture. Sick of the old and clumsy classification of poisons into Irritants, Narcotics, and Narcotico-Irritants. the editor has endeavored to form some more rational groups of toxic agents. These groups are, it is true, quite l)rovisional : and they are somewhat simihir to VI EDITORS PREFACE. those adopted bv Dr. Guv in his admirable text- book on Forensic Medicine. Ther have, however, been worked out independently, whether thej be worth anything or no. Briefly they are these : — Corrosives. — Simple Irritants, Mineral, Vege- table, and Animal. — Irritant Gases. — Specific Irri- tants. Mineral, Vegetable, and Animal. — Neuro- tics : subdivided into Narcotics. Ana?sthetics, Inebriants, Delirants, Convulsives, Hyposthenis- ants. Depressants, Asphyxiants, — and Abortives. Such a grouping is far from perfect ; but it would be impossible to have anything worse than that still in general use. I^is with the hope of rendering this little volume more generally useful these changes have been made : a reason at all times all-powerful with its lamented Author. A. S. AUTHOR'S PREFACE TO THE SECOND EDITION. These Memoranda are intended to refresh the memory of the practitioner on a subject which is not brought under his notice so frequently as many other departments of medicine. They are especially adapted to show at a glance the treat- ment to be adopted in each particular instance of poisoning to which a medical man is liable to be summoned. There seems reason to fear that the crime of slow poisoning is more extensively practised in the present day than is generally believed. The study of the following pages vrill, it is hoped, put the physician on his guard ; and prevent his attributing to natui-al disease symptoms due to the villainous administration of deadly drugs. Henrietta Street, Cavendish S^c.are. CONTENTS. CHAPTER I. PAGE Definition and Mode of Action of Poisons 13 CHAPTER II. Diagnosis of Poisoning — Duties of the Practitioner ... 19 CHAPTER III. Duties of the Practitioner— Treatment of Poisoning ... 24 CHAPTER IV. Detection of Poisons 28 CHAPTER V. Classification of Poisons 32 CHAPTER YI. The Concentrated Mineral Acids 36 CHAPTER YII. The Corrosive Vegetable Acids 43 X CONTENTS. CHAPTER VIII. PAGE The Caustic Alkalies aud their Carbonates : Potash, Soda, Ammonia 48 CHAPTER IX. Si^lts of the Alkalies and Alkaline Earths 52 CHAPTER X. Salts of the Metals : Zinc— Silver— Tin— Bismuth — Chrome — Iron 54 CHAPTER XI. Simple Vegetable and Animal Irritants 57 CHAPTER XII. Irritant Gases 59 CHAPTER XIII. Iodine and Iodide of Potassium 61 CHAPTER XIY. Phosphorus 63 CHAPTER XV. Arsenic and its Compounds 66 CHAPTER XVI. Antimonial Compounds 78 CONTENTS. XI CHAPTER XVII. PAGE Mcrctiry and its Compounds 81 CHAPTER XYIII. • Prepai-ations of Lead 85 CHAPTER XIX. Salts of Copper 89 CHAPTER XX. Specific Tegetable Irritants 92 CHAPTER XXI. Specific Animal Irritants. — Cantbarides 92 CHAPTER XXII. Narcotics. — Neurotics, acting on the Brain and producing Sleep : Opium 95 CHAPTER XXIII. Ana?sthetics. — Neurotics acting on the Brain and producing Insensibility: Chloroform — Chloral — Bichloride of Me- thylene— Ether — Amylene — Nitrous Oxide 102 CHAPTER XXIY. Inebriants. — Neurotics acting on the Brain and producing Intoxication : Alcohol — Nitro-Benzole — Cocculus Indicus —Fungi, &c 108 xii CONTENTS. CHAPTER XXY. PAGE Deliraiits. — Neurotics acting on the Brain and producing Delirium : Hyoscj'amus— Belladonna — Stramonium— Da- tura alba— Nightshade 112 CHAPTER XXYI. Convulsires. — Neurotics producing Convulsions : Nux Vo- mica— Brucia— Strychnia 116 CHAPTER XXYII. Ilyposthenisants. — Neurotics producing Death by Syncope : Aconite — Prussic Acid 122 CHAPTER XXYIII. Depressants. — Neurotics producing marked depression of the Heart's Action: Digitalis — Calabar Beans— Tobacco —Hemlock 129 CHAPTER XXIX. Asphyxiants. — Noxious Gases, producing Neurotic Symp- toms 134 CHAPTER XXX. Abortives. — Substances producing Abortion 137 Appendix ' 139 Index 151 TOXICOLOGICAL MEMORANDA, INTRODUCTION. CHAPTER I. DEFINITION AND MODE OF ACTION OF POISONS. Toxicology (to^okov poison, and Xoyog discourse,) is that branch of medical science which treats of the nature, properties, and effects of poisons. It appears scarcely possible to give any defini- tion of a poison which will bear a critical examina- tion ; insomuch that some have preferred to deal with the evil effects of any substance, that is poisoning^ rather than with the substance itself, the so-called ^oi«o/i. Most medicines are poisonous in improper doses; and even common salt (chloride of sodium) has caused death.* Dr. Guy defines a poison to be any substance which, when applied to the body externally, or in any way introduced into the system, without acting mechanically, but bj its own inherent qualities, is capable of destroy- ing life. A cherrystone may cause death by be- coming arrested in the vermiform appendix, and * In the year 1839, a young lady residing in the north of England took about half a pound of salt to rid herself of worms. Very soon afterwards she began to suffer from all the efifects of an irritant poison, with general paralysis ; and in spite of the use of the stomach pump and of antidotes, she died in a few hours. Dr. Christison has recorded two somewhat similar cases. 2 14 INTRODUCTION. thus producing peritonitis ; boiling water may- cause death also ; but neither are poisons : the one acting mechanically, the other by its heat merely. Any substance which can injure the health or destroy life is regarded as a poison, if given with the intent to do mischief. The words of the statute (1 Yict. c. 85, sec. 2) are — " Whoever shall admin- ister, or cause to be taken by any person, any poison, or other destructive thing, with intent to commit murder, shall be guilty of felony, and being con- victed thereof shall suffer death." Sometimes poisons are administered, not for the purpose of destroying life, but of causing some slight injury or annoyance. An Act passed in March, 1860 (23 Vict, c. 8), provides for the punishment of a guilty person under these circumstances. If life be endangered, or '• grievous bodily harm"' result, the administrator may be found guilty of felony, and sentenced to penal servitude for a term not exceding ten years. If the intent be only to " injure, aggrieve, or an- noy," the crime is reduced to a misdemeanor, punishable with an imprisonment for not more than three years. In accordance with the Pharmacy Act certain substances have been defined as poisons within the meaning of the Act, so as to put some restriction on their sale to the public. Poisons may be introduced into the body in vari- ous ways and in various forms. Thus they may be administered by the mouth or by the rectum, and they may be given in the form of solids, liquids, or gases, uncombined, or mixed with various mat- ters. Some agents are more readily absorbed than others ; whilst some textures permit of absorption taking place more quickly through them than other tissues. Thus, the most diffusible poisons prove most rapidly fatal, especially when introduced DEFINITION AND MODE OF ACTION OF POISONS. 15 directly into the circulation by a wound in a vein, or when they are injected into the subcutaneous connective tissue. Their action is also speedy when applied either in a gaseous state to the pul- monary air-cells, or as a fluid to that of the stomach or intestines. The serous membranes, too, possess an activity of absorption almost superior to that of the mucous membranes ; while absorption through the skin is slow, on account of the cuticle. Poisons taken into the stomach when that viscus is empty, necessarily act much more speedily than when it is full. It is remarkable that the agents which most affect the nervous system do not appear to act at all when applied directly to the brain or trunks of nerves. There are also some poisons, as that of the viper, which, although most deadly when introduced into the blood through a wound, are harmless when swallowed. The effects of poisons may be considered as local and remote. The local effects are mainly of three kinds, viz., corrosion, or chemical decomposition, as is seen in the effects of the strong mineral acids and alkalies ; irritation or inflammation, varying from simple red- ness, in its mildest, to ulceration and gangrene, in its most severe degree, such as may result from the use of corrosive sublimate ; and a local specific effect, produced on the sentient extremities of the nerves, as is felt on the local application of prussic acid, aconite, &c. The remote effects are those influencing organs remote from the part to which the poison has been applied. These may be either common or specific ; common, such as the constitutional indications of inflammatory fever," however produced ; specific, like the constitutional effects of opium over and above its local influences in relieving pain, &c. Various 16 IXTRODUCTION. narcotic poisons produce but little local change, though their remote effects are very remarkable. For example, belladonna, in whatever way it may be introduced into the system, paralyzes the ciliary nerves and so causes dilatation of the pupil. Many substances have both a local and remote action, as is well seen in the influence of cantharides upon the part to which they are applied, and their re- mote effects upon the urinary organs. These remote effects must be induced by one of two modes, or, as some contend, by both: by absorption, that is, by the passage of the poisonous particles into the blood ; or by sympathy, that is, by an impression transmitted through the nerves. In the present day every one allows that poisons may become absorbed, and that, provided they pro- duce poisonous effects at all, they are absorbed, in whatever way they may have been applied to the body. But it is sometimes asked, Is this absorp- tion necessar\- for their action ? The following evidence may be briefly noticed as in some degree affording an affirmative answer to this question. Magendie divided all the parts of one of the pos- terior extremities of a dog, the artery and vein being reconnected by quills, so as to preclude the possibility of the effects being conveyed by the nervous filaments supplying the coats of the ves- sels ; on applying a portion of upas tieute to a wound in the foot, the symptons of poisoning occurred, and death took place in ten minutes. If the veins leading from a poisoned part be tied, the arterial and nervous communication being com- plete, the symptons of poisoning do not occur. Mr, Blake introduced some prussic acid into the stomach of a dog, through an opening in its pari- etes, after he had ligatured the vessel entering the liver (the vena portae, which, directly or indi- DEFINITION AND MODE OF ACTION OF POISONS. 17 rectly, receives the gastric veins ) ; no effect ensued until the removal of the ligature, within one min- ute of which proceeding the poison began to act. And lastly, not only has prussic acid been discov- ered in the blood of an animal which perished in thirty-five seconds, but in some experiments made by Mr. Erichsen, in a case of extroversion of the bladder, prussiate of potass was found in the urine within one minute of its being swallowed on an empty stomach. The chief argument in favor of a sympathetic or direct nerve action, is the almost instantaneous manner in which some poisons act ; fatal effects oc- curring, it is said, before sufficient time has elaps- ed to allow of absorption. It has, however, been proved that the round of the circulation may be accomplished much more speedily than has been imagined. Thus, the ferrocyanide of potassium injected into the jugular vein of a horse was dis- covered throughout the entire venous system in twenty-seconds ; and Mr. Blake has inferred from his experiments that a poison may be diffused through the body in nine seconds. It may there- fore be concluded that in most instances poisons act by being absorbed and conveyed with the blood to the different organs which they impair, or the nerve centres which rule the functions of these ; some paralyzing the heart when they reach it, some affecting the brain or the spinal cord, some stopping the play of the lungs and others acting upon the different glands. Nevertheless, in view of the extreme rapidity with which death is brought about in a few instances, the possibility of a direct shock to the nervous system causing death must not be overlooked. The action of a poison may be variously modified, and the modifying circumstances must be carefully 18 INTRODUCTION. taken into consideration in the formation of a prog- nosis and in suggesting a line of treatment. Tlie quantifi/ or dose is the most important of these ; many substances which are deadly in large doses being exceedingly useful as remedies in small quantities ; such are prussic acid, opium, digitalis, arsenic, &c. Then again, the mechanical and chemi- cal state of aggregation are all-important; a solid being usually much less active than a fluid or a gas, and a pure substance much more active than one mixed with insoluble materials. Even more impor- tant is the chemical constitution of the poisonous agent; as already pointed out. poisonous effects re- sult from absorption of the poisoning body and ab- sorption implies solution; the more soluble, there- fore, the compound is, the more speed}- are its effects, whilst compounds insoluble in water or any of the juices of the body are inert. It is not, however, enough that the substance be insoluble in water ; it must be so also in the gastric juice, or it may give rise to characteristic symptoms. Thus, calomel is insoluble in water, yet it is a powerful medicine ; orpiment is insoluble in water, yet when swallowed, it may give rise to symptoms of arsenical poison- ing, and so on. As already pointed out, the mode in which the poison is introduced into the body is of great consequence in estimating its effects. Then again the mental and bodily condition of the recipi- ent must be taken into account. Thus, in excited maniacs doses of medicines may be given without producing any effect which in ordinary individuals might give rise to serious consequences. The bodily condition, especially as influenced by habit, is still more important. It may be broadly stated, that by gradually increasing the dose of a substance ordi- narily poisonous, in course of time enormous quan- tities may be borne without producing immediate DIAGNOSIS OF POISONING. 19 ill effects. This is especially seen in the practice of opium eating and smoking, and in a less degree in ar- senic eating, as practised in Styria. The latter in- stance is, however, contrary to the usual rule; for whereas with vegetable substances, such as opium the dose requires to be constantly increased to keep up the effects, with minerals, the contrary seems to be the case, especially with antimony and mercury, which cannot be long given without danger to the recipient. CHAPTER II. DIAGNOSIS OF POISONING DUTIES OP THE PRAC- TITIONER. The chief characteristics of poisoning mentioned by authors of repute are, that the symptoms com- mence suddenly after taking any substance or fluid into the stomach, the individual being in a state of health ; that they increase steadily, and are uniform in their nature throughout their course ; and that they prove rapidly fatal. There are many exceptions to these rules. Thus if the stomach be loaded the appearance of the symptoms will often be delayed some few hours. Sleep, ac- cording to Dr. Christison, may retard the action of some agents ; so that if a person fall asleep soon after swallowing arsenic or strychnia, for example, no effect may ensue for four or five hours. In- toxication will mask the effect of narcotics. Again, the individual poisoned may possibly be suffering from disease, and an agent may be given which will only aggravate existing symptoms. The fact 20 INTRODUCTION. must not be forgetten that sometimes r poisonons draught is substituted for a harmless medicine. And lastly, after a poison has manifested its effects the symptoms often remit for a time. When poison is administered with a criminal in- tent it is g-enerally in such a dose as to take im- mediate effect, although this is by no means necessary, as there are numerous substances which accumulate in the system, and when given in small and repeated quantities, ultimately prove fatal. It must also be remembered that there are many diseases, as malignant cholera, internal hemor- rhage, &c., which commence suddenly, and rapidly run to a fatal termination. In inflammation of the stomach or intestines the symptoms often set in suddenly, and might be mistaken for poisoning; such is also the case in intestinal obstruction, and especially in ulceration and perforation of the bowels. So also in organic diseases of the heart, where the symptoms may have remained latent for some time, death often occurs suddenly from syncope. The diagnosis of the effects of irritant poisons is not so difficult as it is in the case of nar- cotics or other neurotics, where the symptoms are very similar to those produced by apoplexy, epi- lepsy, tetanus, convulsions, or disease of the brain. Generally speaking, a person may be supposed to be suffering under the effects of a poison, if soon after taking food or drink, he be seized with violent pain, vomiting, disorder of the alimentary canal, and convulsive movements : or if he be at- tacked under the same circumstances with vertigo, delirium, or great drowsiness. It must not be for- gotten, however, that poisons may be introduced into the body, not only by the mouth, but also by means of suppositories and enemata, or in females DIAGNOSIS OF POISONING. 21 by vaginal injections, or by inhalation, or by sub- cutaneous injection, or through the true skin after the removal of the cuticle. Should death ensue, the presumption of unfair play will of course be strengthened by the discovery of post-mortem ap- pearances similar to those known to be produced by the poison from which the person apparently suffered. The post-mortem appearances, however, except in a few instances, are not very characteristic ; nevertheless they may be of great negative value in proving that a certain poison has not been admin- istered, or that the patient died from the effects of disease. Two symptoms, excessive lividity of the body and early putrefaction, formerly supposed to indicate death by poison, are now known to fre- quently follow other modes of death. It may nevertheless be remarked, that the appearances after death which may be produced by poisons are, in one great class, the signs of inflammation of the alimentary canal ; in another, the signs of conges- tion of the nervous sysem ; and in a third, a com- bination of the two. The detection of poison in some of the food which has been left untaken or in the matters vom- ited would seem to be conclusive evidence of the administration of poison ; but it is to be recollect- ed that designing persons have mixed noxious materials with food or rejected matters, in order to feign poisoning, or to cast unjust imputations upon others. When called to a case of supposed poisoning during life the practitioner's duty is two-fold. His first aim must of course be to preserve life (see next chapter) ; his second, to forward the interests of justice. But if he reaches the spot too late to save life his duties are undivided, for he has but 22 INTRODUCTION. to see that justice is done, and in order that there be no failure it is important that all his obserrations be committed as speedily as possible to writing. He should inquire the time at which any substance was last taken, the nature of the symptoms, the hour at which they commenced, and the precise time at which death occurred. He must take pos- session of :\ny food, medicine, vomited matters, urine, or fieces which may be in the room ; and if possible he is to seal them up, in new and clean vessels, duly labelled, for examination. Then the position and temperature of the body are to be observed, the appearance of the countenance, the presence orabsence of rigor mortis, with the nature and warmth of the apartment, the situation of any marks of violence, and the condition of the inside of the mouth and gullet. In addition to the ordi- nary rules to be observed in conducting post-mor- tem examinations in cases of suspected poisoning, something more must be done with a view to pre- serving portions of the body for subsequent ex- amination. The alimentary canal is the most im- portant organ to be thus secured, and it should be removed in separate portions. A double ligature should be passed round the oesophagus in the chest, and the duodenum a few inches below the pylorus should be secured in like manner ; by cuttingacross the gullet and gut between these ligatures, the stomach may be removed without any danger of spilling its contents. It is best to open the stomach after it has been introduced into the receptacle prepared for it, so that its pathological condition may be noted as early as possible. Another lig- ature should be tied low down in the rectum, and the intestines removed and introduced into a separate vessel prepared for them and then ex- amined like the stomach. Sometimes it may be DIAGNOSIS OF POISONING. 23 necessary to remove the gullet in like fashion. As much blood as possible should be saved for the chemist, and a portion of the liver, if not the whole organ, should also be secured. When everything has been tied up, the jars should be sealed, num- bered, labelled, and initialled, to prevent subse- quent confusion and to facilitate identification. In vromen the vagina, uterus and ovaries must be in- spected, the brain, spinal cord and thoracic viscera ought likewise to be examined, and portions of the spleen, kidneys, and muscles should be reserved for analysis. No antiseptic or preservative fluid is to be used. \Yhen possible it will be best to make the autopsy within twenty-four hours after death ; taking care to make the examination patiently, thoroughly, and with a mind free from any bias. Poison may be found in a body, and yet a question may arise as to its having been the cause of death. Hence in these investigations every organ of the body is to be examined, in order to learn whether any disease has existed sufficient to account for the fatal result. Any suspicious conduct on the part of those surrounding the poisoned individual should be carefully noted. Acts of this kind arrange them- selves in three heads, as occurring before, or during the fatal illness, or after death. With the first category the practitioner has ordinarily nothing to do, but his attention to those coming under the second and third is often of essential service to the ends of justice. The kind of acts will suggest themselves to every one, and need not be further referred to here. 24 INTRODUCTION'. CHAPTER III. DUTIES OF THE PRACTITIONER — TREATMENT OP POISONING, When the practitioner is called in to a case of poisoning while yet there is life, he must set him- self to preserve it in whatever way he best can : in this of course he must be guided by circumstances, but several broad rules may be laid down. All have one end. but the order may be varied. That is best which is readiest, the grand rule being to lose no time. Most of the modes of treatment come under one or other of the three following heads: — 1. Get rid of the poison. 2. Stop its ACTION. 3. Remedy the mischief it has done. 1. To get rid of the poison is ordinarily the first thing to be done, but not always. To do so when the poison has been swallowed two means may be employed: vomiting or the stomach-pump. The latter is one of the most certain means we possess of emptying the stomach ; and by means of it this viscus may be Avashed out, and the an- tidote, if any be known, administered. In speak- ing hereafter, however, of the treatment to be adopted in each particular instance it will be seen that there are some cases, as poisoning by corro- sives, in which this instrument cannot be used ; as it might not only cause laceration of the tissues, but even perforation of the oesophagus or stomach. It is hardly necessary to mention that in all cases a certain tact is required in its employment ; the tube having, on more than one occasion, been introduced into the trachea, and the lungs injected with water, &c. It is a good rule also to with- draw less fluid than is pumped into the stomach. TREATMENT OF POISONING. 25 Supposing, however, that this instrument is not at hand, or that it is an improper occasion for its employment, recourse must be had to vomiting, natural or artificial. Vomiting is, in manj in- stances, one of the first and most important signs of poisoning, especially by irritant substances. When such is the case, it is only necessary to fos- ter the tendency by copious draughts of lukewarm water ; but if there be no vomiting and the stomach pump be not at hand an emetic must be given. Of these remedies perhaps there is not one which can be generally used with so much advan- tage as the sulphate of zinc in scruple doses ; for not only is it more rapid in its action, but its effects are less depressing than those of any others. This last recommendation will appear the more desirable when we remember that the absorption of poisons is promoted by all lowering measures; and consequently, bleeding, the exhibition of tar- tarised antimony, and the administration of drastic purgatives, ought to be avoided. In poisoning by opium and other narcotics, the sulphate of copper in eight or ten grain doses will often excite the stomach to act when other emetics have failed. Ipecacuan wine (six or eight drachms) is a useful agent in many cases ; or if a warm stimulating draught be needed a scruple of powdered ipecacu- anha, with the same quantity of the sesquicar- bonate of ammonia, may be administered in a wineglassful of water. In the absence of these, mustard proves an excellent substitute ; a tea- spoonful or two being given in warm water, and frequently repeated. Even common salt may be used with good effect. Vomiting may also be ex- cited by tickling the fauces, as well as by the free administration of warm water or of hot greasy water. 26 INTRODUCTION'. When the poison has been appliedlocally. to prevent its absorption, a ligature must be applied between the trunk and the wounded part, as near the latter as possible ; while the deleterious substance is to be removed by free incisions and plentiful wash- ings. Sucking bv the mouth or by cupping- glasses may also be employed. 2. To stop the action of the poison if it cannot be readily and immediately removed. — The means where- by this is effected is ordinarily the administration of an antidote. As no universal antidote is known, the treatment will of course vary with the sub- stance taken. This will be fully explained when speaking of each particular poison. An antidote, according to Orfila, should possess the following properties: — It should be capable of being taken in a large dose without danger ; it should act upon the poison, whether liquid or solid, at a temperature equal to or below that of the body ; its action should be quick ; it should be ca- pable of combining with the poison, though shielded by the gastric juice, mucus, bile, or other sub- stances contained in the stomach : and lastly, it should deprive the poison of its deleterious prop- erties. Antidotes mostly operate by forming harmless chemical combinations, or by producing insoluble compounds, and thus preventing or delaying ab- sorption. In most cases they have no effect upon the constitution ; but some may be looked upon as a kind of counter-poison. Thus, the antagonistic action of opium and belladonna seems fairly made out, and we might perhaps include under this head chloroform, as in some degree, an antidote to strychnia. Dr. Garrod has described a series of experiments in which he employed purified animal charcoal as TREATMENT OF POISOXING. 27 an antidote. Dogs, rabbits, and guinea-pigs were the animals experimented on ; while the poisons consisted of large doses of opium, belladonna, aconite, nux Yomica, arsenic, and other drugs. They were given without mischief when sufficient animal charcoal was administered simultaneously, or, in some instances, before the peculiar effects of the destructive drug were developed. This sub- stance seems to act in a great measure mechani- cally, but it has also a power of absorbing alkaloids which may render it useful. Such substances as magnesia and gruel are sometimes given witti the view of protecting the walls of the stomach, with doubtful benefit. 3. To remedy the mischief done, and obviate the ten- dency to death. — Unfortunately, in a great number of instances, too long an interval has elapsed be- tween the exhibition of the poison and the time when the first-mentioned indications can be fully carried into effect ; for, as before implied, if absorption has taken place, direct antidotes will be of little avail. Our object must then be to palliate the symptoms as they arise, as well as to neutralize the effects of the poison on the constitution, by remedies of an opposite character. Thus in poisoning by de- pressing agents and narcotics, or such as destroy the nervous force, all lowering measures must be avoided, and agents used which will exert a con- trary eflTect, as stimulants, cold effusion, galvanism &c. The shock to the nervous system must also be taken account, and appropriate remedies em- ployed to aid it in rallying. Thus direct injection of liquid ammonia into the veins has been found successful in the treatment of snake bite in Australia, by Professor Halford and others. 28 INTRODUCTION. Claude Bernard has shown the importance of particularly attending to the way in which the poi- son destroys life. For example, curare paralyzes the motor nerves, puts a stop to all motion, suspends respiration, and so brings on suftbcation ; yet by keeping up artificial respiration for a sufficient length of time, life may be preserved till the poison is eliminated and the danger over. Strychnia at- tacks the sensitive portion of the nervous system; but if the external excitement, which perpetually provokes reflex action and thereby brings on fatal convtilsions. be guarded against, recovery may ensue. A frog, poisoned by strychnia, rapidly dies if frequently excited ; whereas left perfectly quiet under a bell-glass, it will, c^eteris paribus, recover. Lastly, we must endeavor to promote the elimina- tion of the poison from the body, by exciting the excreting functions ; for which purpose, in poison- ing by arsenic, after the stomach has been well emptied, Orfila has proposed the employment of diuretics, because it has been found that this poison, like most others, is carried off in large quantities by the urine. CHAPTER IV. DETECTION OF POISONS. The detection of a poison is, in many instances, no easy matter ; it should not therefore be rashly undertaken, except by one well skilled in the minutice of the processes to be adopted ; but on the other hand, there are so many points of prac- DETECTION OF POISONS. 29 tical importance which may be noted by the practitioner in charge, that his attention should be specially directed to these. The exact deter- mination of the cause of death will depend partly on the symptoms noted during life and on the appearances found after death. These come with- in the province of the ordinary practitioner ; on the other hand, the special physical, chemical and physiological portion of the inquiry should be re- ferred to the expert. In a book of this scope it is impossible to give full details with regard to these last, but a brief sketch nay be useful. The physical examination, say of the contents of the stomach and intestines, should commence with noting the smell, color, and general appear- ance of the matters submitted for examination. The odor, for instance, maybe useful in indicating the presence of prussic acid, of alcohol, of opium, or of phosphorus. The color may indicate the presence of salts of copper, of fragments ofcantha- rides, &c. The general appearance may give some clue to the mode of introducing the poison, the kind of food or drink used to conceal it, &c. Seeds of poisonous plants may be found : this is especially the case in India, where the seeds of datura are frequently used for criminal purposes ; or the poi- sonous substance may have been administered in such quantity that a portion of it may at once be secured for analysis. This not unfrequently hap- pens in poisoning by arsenic. It is not enough to employ the naked eye in examining these suspected matters 5 a hand lens of some power should be used ] in this way characteristic crystalline forms, botanical peculiarities, and such like, may be made out. Still these are merely introductory to the most important part of the research, which ought to be 3 30 INTRODUCTIOJT. undertaken systematically, especially if the qnan- tity of material to be operated on is small. Most frequently the matters to be examined are mixed, some soluble, some insoluble ; but there may also be submitted for analysis portions of the pure substance. The object of the analyst is to obtain the substances which he has to examine chemically in as pure a condition as possible, so that there may be no doubt about the results of his testing ; also, of course, to separate active substances from those that are inert, all being mixed together in the stomach and alimentar\- canal. Again, in dealing with such fluids as the blood, or the tis- sues of the body, their natural constituents must be got rid of before the foreign and poisonous body can be reached. There is this difficulty fur- ther to contend with : that some of the most poison- ous of substances are of unstable composition and readily altered by chemical reagents ; to this group belong many vegetable and most animal poisons. These, therefore, must be treated diflferently from the more stable inorganic compounds. "With an inorganic poison we may destroy all organic materials mixed with it, trusting to find ii, still re- cognizable after the process ; not so with an organic substance : that must be separated by other than destructive means. When the mixture submitted for examination consists of bodies perfectly soluble and perfectly insoluble, simple filtration may sufiice to secure their separation : but this is rarely the case, some colloidal material being ordinarily mixed with the crystalloid, and the plan of separating them by diali/sis, as proposed by Graham, not being alto- gether successful. When the substances looked for are volatile, distillation may be employed to se- cure them in a state of purity ; in this way prussic DETECTION OF POISONS. 31 acid is separated : but in the case of the poisonous alkaloids other means must be adopted. I. In the separation of such an alkaloid as strychnia, for example, the suspected material is first of all acidulated by one of the weaker min- eral or stronger vegetable acids (hydrochloric acid is best), and the whole carefully heated over a water bath. After a time this mixture is to be filtered, and the filtrate well washed with boiling distilled water, and the filtered fluid subjected to evaporation. When dry the substance is to be rubbed up with distilled water, and again filtered ; this process to be repeated until a tolerably pure product be obtained. This is next to be neutral- ized by hydrogen sodium carbonate, or bicarbonate of soda, and the freed alkaloid taken up by rub- bing or shaking it with chloroform or ether, and the whole set aside in a well-corked tall test tube. Finally, the ether or chloroform containing the al- kaloid is to be removed by a pipette and allowed to evaporate spontaneously, when the alkaloid will probably be left behind in a state fit for testing. This process is a modification of that invented by Stas, in following out the case of the Count Bocarme. II. For the destruction of organic matter in the search for an inorganic poison, such as arsenic, a process introduced by Fresenius and Von Babo is commonly employed. Its essentials are as follows : The organic matter is to be reduced to as fine shreds as possible, and mixed with about one- eighth of its bulk of pure hydrochloric acid. Thisis to be heated, and, as it boils, from time to time crys- tals of potassic chlorate are added, until the solids are reduced to a straw-yellow fluid. This is next treated with hydrogen sodium sulphite, or bisul- 32 INTRODUCTION. phate of soda, until a distinct smell of sulphur- ous acid is given off, after which sulphretted hydrogen is to be passed through the fluid, con- centrated if necessary, for some hours, thus throw- ing down most metallic poisons in the form of sulphide. This precipitate is to be collected and further tested. When exceedingly small quantities are dealt with the microscope is of use, and the plan of subliming alkaloids and examining their crystals under the microscope, introduced by Guy and Helwig, will be found very useful. The shape of crystalline poisons is a valuable means of determining their iudentity ; arsenic and antimony may thus be read- ily distinguished, as may other well known sub- stances. The spectrum has not yet been applied to tox- icological research, although it has been employed to determine the existence of a blood stain. CHAPTER V. CLASSIFICATION OF POISONS. There is nothing more difficult in toxicology than to give a satisfactory classification of poi- sons, insomuch that some have fallen back on the no-classification, or natural history system, and grouped poisons as mineral, vegetable, and ani- mal, according to their source. In despair of CLASSIFICATION OF POISONS. 33 achieving anything better, a modification of the old and well-known system is here followed, poi- sons being classed as Corrosives, Irritants (Simple and Specific), and Neurotics ; the latter group is, however, further subdivided, somethinginthe same way as that adopted by Dr. Guy. The group of corrosives should comprehend all which by contact destroy the bodily textures, and so occasion death. These same substances, when diluted, may be inca- pable of destroying the tissues directly, but may do so by setting up inflammation ; these with certain others having like effects, would form the group of simple irritants. They kill by virtue of their secondary effects on the constitution. But some substances, like arsenic, are not only capable of inducing local inflammations, with their secondary effects, but are also possessed of certain specific and well marked properties differing in each case. These are specific irritants. Neurotics comprehend all poisons whose effects are mostly referable to the nervous system, neces- sarily a most diverse group, which we are not yet in a position to minutely analyze. Some, however, act mainly on the brain, some on the spinal cord, some on certain nerves only, or on the basomotor system of nerves ; some act it is hardly possible to tell how. There was an old group of s^/j^/c poisons; to this might still be referred certain noxious gases, such as sulphuretted hydrogen; or were it made to in- clude all poisons acting directly on the blood, it would include the still more dangerous gas, car- bonic oxide. The following table exhibits these subdivisions, and some of the poisons contained in each: 34 INTRODUCTION. Stronsr Mineral Acids Vegetable A.cid Alkalies . . Simple Ibbitants Specific Ieritants Neubotics C Sulphuric. ■< Nitric. (Hydrochloric. Oxalic. ;i Strong Alkalies. Alkaline Carbonates, &c. The above diluted. Lime. Zinc. Silver, &c. Arsenic. Mercury. Antimony. Phosphorus. Iodine, &c. Opium. Prussic Acid. Chloroform. Belladonna. Aconite. Strychina. Conium. Tobacco, &c. Irritant poisons give rise to pain in the stomach and bowels, faintness and sickness, and purofing with tenesmus. The evacuations are often tinged with blood, the pulse is feeble and in-egular, and the skin cold. Many of the substances of this class from irritating the tissues with which they come in contact, produce a severe burning sensation in the mouth and oesophagus, as well as in the stomach. The degree of local destructive action produced will of course vary in proportion to the amount of the vehicle with which the noxious agent may be diluted. Irritants cause death by inducing col- lapse or convulsions, or by exciting severe in- flammation; or. after a variable interval, by lead- ing to stricture of the oesophagus. The diseases which most resemble the action of irritants are, malignant cholera, severe diarrhoea, colic, gastritis, enteritis, rupture of the stomach or intestines, and CLASSIFICATION OF POISONS. 35 obstruction of the bowels, mechanical or other- wise. The symptoms of apoplexy, epilepsy, and uraemia bear a resemblance to those caused by some of the poisons of the neurotic class. Others give rise to delirum with spectral illusions or convulsions. Sometimes there is tetanus, sometimes coma or syncope. Diseases of the brain and spinal cord, likely to be confounded with these, are often very insidious in their progress, and hence may sud- denly give rise to suspicious symptoms. The his- tory, mode of attack, &c., will generally negative any suspicion of poisoning- I.-CORROSIVES. CHAPTER VI. THE CONCENTRATED MINERAL ACIDS. The first division of the Corrosive consists of the Strong Mineral Acids. In this chapter we have to review the effects. &c., of the acids com- monly encountered, which are Sulphuric Acid, Nitric Acid, Hydrochloric Acid, or a mixture of two or more of them. Sulphuric Acid [Oil of Vitriol). — This heavy, oily looking liquid is met with in two states, con- centrated and diluted ; and being extensively em- ployed in commerce and manufactures is much more frequently used as a poison than the other mineral acids. Many infants and young children have been poisoned by it ; occasionally also men, under the influence of drink. The acid is not un- frequently thrown over the person, either to dis- figure the features or to destroy the clothes. The parts of the body with which it is brought into contact are stained at first of a white, and after- wards of a dark brown or black color. The smallest fatal dose of concentrated acid recorded, in the adult, is one drachm ; but recovery has taken place after as much as two ounces. But it must be understood that the acid proves fatal mainly by its power of corrosion, so that a small dose of the con- centrated acid is more dangerous than is a much larger dose of it in the dilute form. The average THH CONCENTRATED MINERAL ACIDS. 37 period at which death occurs fs from sixteen to twenty-four hours ; but on the other hand, death may not occur for months, and may only follow the organic changes induced by cicatrization fol- lowing the swallowing of the acid, or the malnu- trition following its destructive action on the coats of the stomach. Tests. — It is not within the province of these Memoranda to treat of the various processes by which poisons are to be detected ; for to make a trustworthy analysis requires the skill of a pro- fessed chemist, whose assistance should be allowed in these medico-legal investigations. Where the character of a dead man or the life of a supposed criminal is at stake there must be no chance of error. The ordinary tests will, however, be briefly described, if only to help the physician to treat the case more satisfactorily than he could do by merely guessing that an irritant or narcotic had been employed : Concentrated sulphuric acid is usually a brown- ish colored liquid, which chars or corrodes wood or other organic matter brought into contact with it, and when mixed with water gives out heat. When diluted, its presence may be thus de- tected : 1. The liquid is known to be acid by its action on litmus paper. 2. Add to a portion of the suspected liquid a few drops of nitric acid, and then a solution of nitrate of barium; a white precipitate (sulphate of barium) will fall if sulphuric acid be present. This test is extremely delicate ; for although other acids yield a precipitate on the addition of nitrate of barium, yet as such deposits are all soluble in nitric acid the previous addition of this acid will prevent their formatiou. 38 CORROSIVES. 3. The precipitate should next be collected, dried; and reduced with charcoal bv the blow-pipe flame to the condition of barium sulphide. This, when treated with a drop of hydrochloric acid, gives off sulphuretted hydrogen, known by black- ening paper dipped in acetate of lead solution. To examine a piece of cloth stained with this poison it is only necessary to boil it in distilled water and then apply to the liquid the barium test as before. XiTRic Acid {Aqua fortis. Red Spirit of Xitre). — This substance has been employed as a poison for upwards of four centuries. Like the oil of vitriol it is found in commerce in a concentrated and in a diluted state. Cases of poisoning by it are rare. It produces a yellow stain on the skin. Two drachms is the smallest quantity which has de- stroyed life ; but less than this would probably prove fatal, if it produced much corrosion about the wind-pipe. Death has occurred from it, in one hour and three quarters ; the average would be within twenty-four hours. Several cases ending fatally have followed the inhalation of the fumes of this acid, probably by- inducing very extensive inflammation of the lung. Tests. — The concentrated acid may be known by its orange-colored irritating fumes, and by its action on copper, tin, or mercury. 1. When poured on copper-filings, effervescence takes place, a red acid vapor is given off. and a green liquid remains (solution of nitrate of copper). 2. In a diluted state it is detected by its acid reaction ; by no precipitate being obtained by nitrate of barium or by nitrate of silver, proving the absence of sulphuric and hydrochloric acids; further, by neutralizing the liquid with potass, evaporating it, and then procuring crystals of THE CONCENTRATED MINERAL ACIDS. 39 nitrate of potassium, in the form of lengthened fluted prisms, which are permanent in the air. These crystals may be powdered and moistened with strong sulphuric acid, when a colorless acid vapor (nitric acid) will be evolved. Or the pow- dered crystals may be mixed with an equal bulk of fine copper filings, moistened with water, and treated with a few drops of sulphuric acid; when ruddy acid fumes will be given off. 3. Other tests for nitric acid are, (a.) its action on morphia, which it turns red : (i>.) its action on green iron sulphate, which it blackens : (f,) a trace of it along with sulphuric acid gives with narcotine a blood red color; and finally. {(/,) along with hydrochloric acid it dissolves gold. Hydrochloric Acid {Muriatic Acid, Spirit of Salt). — Not more than half a dozen cases of poisoning by this acid have occurred in the last fifteen or twenty years in this country. In May, 1859, a' woman sixt^'-three years old was admitted into King's College Hospital within three-quarters of an hour of swallowing half an ounce of the strong acid. She had burning pain in the throat and stomach, vomiting of brown shreddy matters, and great prostration. Death occurred in eighteen hours, from the corrosive action of the poison. This is the smallest dose which has been known to prove fatal. Tests. — The concentrated hydrochloric acid of commerce is of a yellowish color, it fumes in the air when strong, and produces dense white fumes with the vapor of ammonia. 1. It may be identified by boiling with black oxide of manganese ; chlorine being given off, which is known by its odor, color, and bleaching properties. 2. When diluted, its presence is ascertained by 40 CORROSIVES. nitrate of silver causing a dense white precipitate (chloride of silver). The chloride is distinguished from other salts of silver by (or,) its insolubility in nitric acid, and in caustic potass ; (b,) by its being soluble in ammonia ; (c,) by its melting and form- ing a horny mass when dried and heated. Mixed Acids. — These acids being used for com- mercial purposes when mixed — the nitro -muriatic (aqua regia) to dissolve gold, and the nitro-sul- phuric (aqua reginae) to dissolve silver — might oc- casion their being employed as poisons. Sulphate of indigo, which consists of a solution of indigo in strong sulphuric acid, has proved fatal in cases where it has been accidentally taken. Symptoms, Treatment, ^c. — The symptoms pro- duced by the mineral acids are much the same in all cases. There is violent, burning pain in the mouth, oesophagus, and stomach, commencing m- mediately. The burning is followed by retching and vomiting of a dark colored liquid with shreds of mucus, and portions of the mucous membrane of the oesophagus or stomach. The inside of the mouth is shrivelled and more or less corroded un- less the agent has been given in a spoon or other- wise passed over the tongue to the back of the fauces. The outside of the lips and mouth will probably present the stains characteristic of the acid used. There is great thirst, difficulty of swal- lowing, and impeded respiration. The bowels are confined ; the urine scanty or suppressed. Next succeeds great exhaustion, the pulse becomes quick and feeble, and the skin gets cold and clammy. The countenance is anxious and expressive of great suffering ; death speedily occurs, the intellectual faculties remaining clear to the last. These acids may prove fatal without entering the stomach by causing asphyxia, the chink of the THE CONCENTRATED MINERAL ACIDS. 41 glottis becoming closed by swelling of the fauces, &c. They have sometimes been administered by the vagina, rectum, &c., and been poured into the ear during sleep. Where recovery takes place from their immediate effects there is always fear of death resulting at the end of one or two years from stricture of the oesophagus, and even at an earlier period, unless proper treatment is adopted. Occasionally one of the secondary effects of sulphuric acid has been profuse salivation. The post-mortem appearances are the following : The body may have a healthy appearance. Usually there are stains about the mouth, fingers, and wherever the cuticle has been reached by the acid. The inner surface of the mouth, fauces, and oesophagus, is usually white and corroded, or dark brown and shrivelled, the mucous coat being easily detached. The epiglottis and glottis are usually swollen. The gullet resembles the mouth in most respects. The outer surface of the stom- ach and intestines is very vascular, that of the former being sometimes corroded and occasionally perforated. The stomach is sometimes contracted, sometimes distended with gas, and contains a thick, dark brown fluid ; its inner surface has a charred, blackened appearance, the mucous mem- brane between the rugte being of a scarlet hue. The pylorus is mostly contracted ; while the inner coat of the duodenum and small intestines presents a similar appearance, in a less degree, to that of the stomach. When perforation occurs it usually takes place posteriorly, and the edges of the rent are softened. The escaped matters may have acted on the adjacent viscera. According to Casper, after poisoning by sul- phuric acid the bodies resist putrefaction for 42 CORROSIVES. some time, owing perhaps to the acid neutralizing the ammonia of decomposition. It may be the same with the other mineral acids. Treatment. — Bicarbonate of soda, or calcined magnesia, or the carbonate of magnesia, should be immediately given, mixed in milk or any mucilagin- ous fluid; the doses being continued at short in- tervals, until it may be inferred that the acid is neutralized. In the absence of these remedies substitutes may be found in chalk, whiting, soap and water, or the plaster of the apartment beaten up with water. Oleaginous and mucilaginous fluids, as olive oil, linseed tea, barley water, milk gruel. &c., may be freely given, either alone, or as the vehicles of the antidote. The success of this treatment will depend upon the promptitude with which it is adopted. The stomach pump should not be employed; the disorganized and softened state of the gullet and stomach, rendering them excessively liable to perforation. Should the larynx be affected and the breathing impeded, tracheotomy must be at once had re- course to. After a sufficiency of the antidote has been given the use of mucilaginous diluents must be continued for some time, and the subsequent treatment will be that for gastro-enteritis. Great benefit will be derived from the use of oily euemata. The external parts which have been injured by the acid should be well bathed with soap and water, and treated like burns. VEGETABLE ACIDS. 43 CHAPTER VII. THE CORROSIVE VEGETABLE ACIDS. Oxalic Acid [Acid of Sugar). — This is one of the most important poisons with which we have to deal. From its cheapness and well-known proper- ties it is frequently made use of in cases of suicide, while from its resemblance to Epsom salts it has on several occasions been taken in mistake for that medicine. The smallest dose which is known to have proved fatal is one drachm, which killed a boy set. sixteen in eight hours. Taylor relates the case of a woman, aged twenty-eight, who was found dead one hour after swallowing three drachms of the crystallized acid. Christison mentions an in- stance in which one ounce destroyed life in ten minutes, and another case where the same quantity killed a girl in thirty minutes. One example has been recorded where a fatal result ensued pro- bably within three minutes of the acid being swallowed. The poisonous properties of the Binozalate of Potash (Salt of Sorrel, Essential Salt of Lemons) are due to the oxalic acid it contains. This salt, which exists in the leaves of the wood sorrel (Oxalis acetosella), is sold to bleach straw, remove ink-stains, &c. It is very cheap ; is almost as powerful as oxalic acid itself, and gives rise to the same kind of symptoms; it has been taken for the purpose of suicide, as well as in mistake for the bitartrate of potash, or cream of tartar. Oxalate of lime exists in considerable quantity in the leaves and stalks of the common edible rhubarb (Rheum Rhaponticum.) It can hardly be considered poisonous. 44 CORROSIVES, Stimptoms. — The effects of poisoning by oxalic acid are peculiar. When the dose is large (half an ounce or more) and the solution concentrated, it proves very rapidly fatal. It produces a hot burn- ing sensation in the fauces and cesophagus in the act of swallowing, severe burning pain in the stomach, and in most instances immediate vomit- ing. The vomited matters are strongly acid, of a dirty green or black color, and consist of the contents of the stomach with altered mucus and blood. The remaining symptoms are a sense of constriction or suffoc-ation, lividity of the counte- nance, great prostration of strength, feeble pulse, cold clammy perspirations, and convulsions, which speedily terminate in death. AVhen a smaller quantity has been taken, much diluted, its corro- sive properties are weakened or destroyed, but the nervous, symptoms, as cramps and numbness, may be well marked. In cases of recovery the mouth may remain sore for some time, the tongue swollen, the abdomen tender, the stomach very irritable, and there may be troublesome diarrhoea. In two instances there has been loss of voice for several days, owing to the action of the poison on the nervous system. Twitching of the muscles of the face and extremi- ties has also been observed. Post-mortem Appearances. — The mucous mem- brane of the fauces, oesophagus, and stomach is generally white and brittle, but often colored with the brown mucous matter discharged. The stomach often contains a black fluid, like coffee-grounds, consisting principally of altered blood ; and its sub- mucous coats are vascular and dark colored. The stomach though seldom perforated, may yet be so softened as to be with difhculty removed entire, and sometimes this is not possible. This soften- VEGETABLE ACIDS. 45 ing may be due to the post-mortem action of the poison ; but its eflfects during; life in softening and bleaching the mucous membrane are suflSciently marked. Occasionally the stomach is black and gangrenous looking. If death has occurred quickly, the small intestines are seldom much affected ; but where the symptoms have been protracted there are usually signs of congestion and inflammation. Treatment. — Chalk, whiting, or magnesia, sus- pended in water, or in some demulcent fluid, must be administered immediately ; and if neces- sary, vomiting should be excited by tickling the fauces, or administering emetics of sulphate of zinc and ipecacuan, followed b\^ large quantities of emol- lient drinks. The antidote, to be effective, must be given as soon as possible, the plaster of the apartment, or any form of mortar being used in the absence of the remedies just mentioned. Alkalies (soda, potash, or their carbonates) are not only useless, but they form salts with oxalic acid, which are as injurious as the acid itself. When there are symptoms of collapse , stimulants are to be freely employed. From the tendency to softening, the stomach- pump should not be used. Tests. — Crystals of oxalic acid are met with as four-sided prisms, colorless, without odor per- manent in the air, and very acid ; this last char- acter distinguishing them from crystals of sulphate of magnesia and sulphate of zinc. The crystals, when heated, melt, and are dissipated without combustion, and leaving no residue. This char- acter is important as a means of distinguishing oxalic acid from other similar crystals. They are soluble in from eight to twelve parts of cold water. This acid may be thus recognised in solution : 1. Nitrate of silver throws down, with oxalic acid, 4 46 CORROSIVES. an abundant white precipitate (oxalate of silver), "which is soluble in nitric acid. The oxalate of silver, when dried and heated on platinum foil, detonates, and is dissipated in a white vapor. 2. Sulphate of calcium causes a white precipitate with oxalic acid (oxalate of calcium) which is soluble in nitric or hydrochloric, but not in any vegetable acid. The solution containing the acid should be con- centrated before testing, if it be not present in considerable quantity. Lime water and all soluble lime salts throw down precipitates with oxalic acid ; but as these are liable to be mistaken for a precipitate with sulphuric acid, it is better to use sulphate of calcium which is slightly soluble, as the test agent. A good deal of the test solution must be used, and the precipitate takes time to settle. 3. Sulphate of copper gives a faint bluish precipi- tate with oxalic acid (oxalate of copper,) which is not redissolved by a few drops of hydrochloric acid. These tests will not act if the solution contain nitric acid in excess, in which case the liquid must be evaporated to crystallization, and the crystals washed and redissolved in water. These tests for oxalic acid should never be ap- plied without previously separating it from all or- ganic matter This is best done by first of all acid- ulating the suspected fluid with acetic acid, and then adding acetate of lead, which combines with the oxalic acid to form a white insoluble salt, which may ordinarily be removed by filtration or subsi- dence. This filtrate, after being well washed, is to be diffused in water, and into this a current of sulphuretted hydrogen gas is to be passed for some considerable time. This will throw down the lead VEGETABLE ACIDS. 47 as sulphide, leaving the oxalic acid in the fluid ; any organic matter will also be carried down. Filtration will separate the solids from the liquid containing the acid, which may now be evaporated until crystals are formed, which may be tested in the usual way. Acetic Acid. — Although this acid, in its con- centrated state, is highly corrosive, yet it is xevy seldom brought under the notice of the toxicolo- gist. In the case of a young woman reported by Orfila, death quickly occurred after several attacks of convulsions. At the subsequent post-mortem ex- amination, the integuments of the dependent parts of the body were found very livid ; the tongue and oesophagus were of a dirty brown color, the latter being intersected by a fine net-work of capillary vessels ; and the interior of the stomach was in- terspersed with black elevations caused by the presence of coagulated blood in the sub-mu- cous areolar tissue. The mucous membrane was entire. As regards the treatment, it is only necessary to administer draughts containing magnesia or its carbonate, followed by mucilaginous or demulcent drinks. Tartaric Acid, though not a corrosive, may be here placed along with the other vegetable acids. Strange as it may seem, tartaric acid has destroyed life in at least one instance in this country ; an ounce having been given in mistake for an aperi- ent salt. The deceased swallowed the whole at once, and immediately called out that he had been poisoned. He complained of intense pain in the throat and stomach, as if he had swallowed oil of vitriol, or was on fire. Soda and magnesia were administered without avail ; and after death, at 48 CORROSIVES. the end of nine days' suffering, the stomach and intestines were found much inflammed. CHAPTER YIII. THE CAUSTIC ALKALIES AND THEIR CARBONATES J POTASH, SODA, AMMONIA. The second division of the class of Corrosives has now to be considered. It contains the Caustic Alkalies, and some of their Salts. Poisoning by any of these agents is rare. Potash. — This substance, in its caustic state, as found in commerce, is int he form of grey-colored cakes. It has an acrid taste, is soapy to the touch, and very deliquescent. Moulded in cylinders, it is often employed as a caustic (Potassa fusa). In solution (Liquor potassa?) it is strongly alkaline, and imparts a brown stain to black cloth. Potassium carbonate or Carbonate of Potash (Pearl- ash) is extensively used by laundresses and in the dressing of woollen cloth. It is generally sold in a granular condition, white, inodorous, and strongly alkaline ; it is soluble in water, but not in alcohol. Caustic Soda. — This agent resembles potash in its general properties. The Sodium Carbonate or Carbonate of Soda (Soap-lees) bears a similar re- semblance to the carbonate of potash, except that it crystallizes easily, and effloresces on exposure to the air. Ammonia. — When pure, ammonia is a colorless, pungent gas ; but it is commonly met with dis- solved in water, as the liquor amraoniie. Its THE CAUSTIC ALKALIES. 49 vapor is poisonous, and may prove fatal by pro- ducing inflammation of the larynx and trachea, and even of the lungs. A case is recorded of a French boy, set. six, who killed his younger sister by making her swallow several teaspoonfuls of a solution of ammonia. Other instances have also oc- curred where the liquor ammonite has either been taken in mistake for the aromatic spirit of ammonia}, or purposely, to destroy life. An instance is record- ed by Dr. Taylor, as occurring in the practice of Mr. Hilton, where liquor ammouiee, given by mistake, caused corrosion of the throat and gullet and ob- struction of the bronchial tubes by false mem- brane. The oesophagus was completely dissolved at it^ junction with the stomach, and there was an aperture in the anterior wall of that organ such as might have been caused by oil of vitriol. The Ammonium Carbonate or Carbonate of Am- monia (Hartshorn, Smelling Salts) has been used as a poison. It may be distinguished from other salts by its being alkaline, by its entire volatility, and by its pungent odor. A young woman in a state of unconsciousness, was made to swallow a quantity of hartshorn. In an hour there was great pain, sickness, and vomiting of blood. The hjema- temesis continued for some days, and then feeble- ness and emaciation set in, death occurring in three months. On examination the pylorus was found contracted to the size of a crow-quill, while there was a large cicatrix on the posterior wall of the stomach. Symptoms. — The chief symptoms occasioned by the foregoing poisons are, an acrid, burning taste, with a sensation of excoriation and burning ex- tending along the mouth and throat, to the sto- mach. There soon ensue exquisite pain in the epigastrium, and tenderness on pressure. Fre- 50 CORROSIVES. quently there is cough, hoarseness, dyspnoea, as ■well as vomiting of altered mucus mixed with blood and detached portions of the mucous mem- brane. The tongue, mouth, and fauces become swollen, soft, and i:\bby. and deglutition is diffi- cult. The surface of the body gets cold and moist, the pulse small and feeble, and there is great pain over the abdomen, with diarrhoea. Death took place, in the case of a boy, in three hours from the time of swallowing a strong solution of car- bonate of potash. Ammonia, by its effect on the air passages, has proved fatal in four minutes. "When recovery from the immediate effects of the poison has taken place, death has subsequently ensued from stricture of the oesophagus, producing starvation. By the proper use of bougies, &c., life may occasionally be prolonged for many months, or even for years. In some instances, however, it is almost impossible to effect dilatation, owing to the whole of the gullet becoming thickened and contracted, so that the opening into the stomach will hardly admit a crow-quill. The pylorus may also be contracted in like manner. Post-mortem Ap})earances. — The mucous mem- brane of the mouth and gullet is softened and in- flamed, and portions of it detached. The coats of the stomach and intestines are inflamed, stained of a dark color, and sometimes ulcerated. When death has resulted from ammonia, signs of inflam- mation are usually found in the larynx and bron- chial tubes. The other caustic alkalies may also destroy life by producing inflammation of the glottis, which consequently may be found thus occluded after death. Treatment. — The object must be to neutralize the poison, which may be effected by a weak acid. Vinegar and water is perhaps the best antidote, THE CAUSTIC ALKALIES. 51 and that most readily procurable ; its administra- tion may be followed up by freely allowing acid- ulated demulcent drinks, orange-juice, &c. The use of oil has been recommended, on the principle that it converts the alkali into a soap. But that its efficacy is doubtful has been in some measure shown by the death of two young children from swallowing a mixture of ammonia and oil. In one of these cases nearly two ounces of linimentum ammoniaj (made of one part of liquor ammonia to two of olive oil) were poured down an infant's throat by a child five years old. Were, however, the oil given in much greater abundance, the re- sult would probably be different, At all events, its administration should not be neglected. Tests. — The specific character of these substances is their strongly marked alkalinity, ammonia pos- sessing, over and above, that of volatility. Pot- ash is known from soda by being precipitated of a creamy yellow by platinum perchloride, soda re- maining unaffected by that reagent. II.-SBIPLE IRRITANTS. CHAPTER IX. SALTS OF THE ALKALIES AND ALKALINE EARTHS. Potassium Nitrate or Xitrate op Potash [Xitre^ Saltpetre, Salprunelle) is a more dangerous poison than is commonly supposed, provided the dose be large. It has ordinarily been given in mistake for other salts as a purgative, and in one instance, caused death in about two hours, in an- other such instance, referred to by Orfila, an ounce proved fatal in three hours. It produces symptoms of irritation in the alimentary canal, vomiting, and diarrhoea. There is generally also severe pain at the ])it of the stomach, trembling of the limbs, scanty urine, and collapse. Marks of violent inflammation are found after death in the stomach and along the intestinal canal. Potassium Sulphate or Sulphate of Potash {Sal Poli/chrest, Sal de Duohus, &c.) has proved fatal when taken in a large dose. It has caused death in tvro or three cases when purposely ad- ministered to procure abortion. Taylor quotes an instance of a lady, a week after delivery, being directed by her medical attendant to take ten drachms of this salt, in divided doses as a laxative. After the first dose she was seized with severe pain in the stomach, with vomiting, &c., the sym- toms increasing after each dose, and proving fatal SALTS OF THE ALKALIES. 53 in two hours. At the post-mortem examination the mucous membrane of the stomach and intes- tines was seen to be soft and pale, and the stomach contained a quantity of reddish-colored liquid. This, on being: analyzed, was found to contain no other irritant but this salt. ElTARTRATE OF PoTASS Or HyDROGEN PoTASSIUM Tartrate [Cream of Tartar^ Argol.) — This salt has caused death in one case at least, in which about an ounce and a half was taken. The symptoms Avere those of an irritant poison, with paralysis of the lower extremities. Death occurred within forty-eight hours. SuLPHURET OF PoTASSiUM [Liver of Sulphur) has also caused death as an irritant poison. Treatment. — As no antidotes are known to these salts the treatment must* consist in producing vomiting as speedily as possible by means of emetics ; or the stomach-pump may be used. De- mulcent drinks should be freely given subsequently, with soothing applications to the bowels. Ice may be given in any quantity. Lime acts as an irritant poison, though a feeble one, when taken into the stomach or applied to a vital part. One fatal instance is reported, where a boy swallowed some lime in an apple-pie. He died in nine days, after suffering from a burning pain in the abdomen, great thirst, and obstinate constipation. Unslaked or imperfectly slaked lime may also prove fatal by being inhaled, and so giving rise to inflammation of the glottis. Barium Salts.- — Two preparations of barium have caused death, viz., the chloride and the car- bonate. These may also give rise to specific nervous symptoms, as cramps and convulsions. Chloride of Barium is found crystallized in irreg- ular plates or tables, which are permanent in the 54 SIMPLE IRRITANTS. air. soluble in water, aud of a disagreeable bitter taste. Half an ounce has proved fatal in two hours, after causing symptoms of irritation, with vertigo, paralysis and convulsions. Carbonate of Baryta or Barium Carbonate, in its native state, occurs in massive radiated crystals, very heavy, and nearly colorless. Artificially prepared, as sold in the shops, it is a fine, taste- less, odorless powder, almost insoluble in hot or cold water. One drachm is said to have destroyed life, but recovery has taken place after a much larger dose. Treatment. — The sulphate of soda or sulphate of magnesia, or some earthy sulphate, should be speedily administered, by which the poison will be converted into an inert insoluble sulphate of baryta. Emetics should also be given, or the stomach-pump used. CHAPTER X. SALTS OF THE METALS : ZIXC SILVEB TIN BISMUTH CHROME IRON. Two preparations of zixc must be noticed : Sulphate of Zixc ( White Vitriol^ White Cop- peras.) — This is a very mild irritant, resembling in its appearance Epsom salts and oxalic acid. It is very useful as an emetic in scruple or half-drachm doses, dissolved in any thin fluid. In one case an ounce was accidentally taken. Great pain in the stomach, vomiting, and pros- tration, soon set in. Subsequently there was SALTS OF THE METALS. 55 gastritis, and recovery only occurred after a pro- longed convalescence. Treatment. — Vomiting is to be encouraged by milk or albuminous fluids ; after which remedies containing tannin (strong tea, decoction of oak bark, or tincture of Peruvian bark) are to be given. Chloride of Zi\c. — A solution of chloride of zinc forms a valuable disinfectant, but is also a dangerous irritant, or, if sufficiently strong, a cor- rosive poison. Sir William Burnett's Fluid con- sists of gr. XXV of this salt to the drachm of water. It has been taken in mistake for fluid magnesia, pale ale, &;c., and has caused death. Symptoms. — A burning sensation in the mouth and throat is immediately produced. This is fol- lowed by nausea, vomiting, and signs of collapse. Death has occurred in less than four hours. Post-mortevi Appearances. — The mucous mem- brane of the throat and stomach has been found corrugated, hard, and leathery. In the case of a sailor who died from about half a pint of Burnett's solution, the body was livid, the neck swollen, the cerebral vessels were engorged, and the lungs were congested. The mucous coat of the stomach was of a purple red, and partially corroded, while the pyloric orifice looked as if caustic had been applied to it. There were patches of congestion in different parts of the small intestines. Treatment. — Albuminous drinks, followed by some preparation of tannin, will be needed. Tests. — Zinc is distinguished from all other sub- stances by giving a white precipitate with sul- phuretted-hj-drogen. The solution containing it must not be too acid or no precipitate will be formed. Zinc also gives white precipitates with ferrocyanide of potassium and ammonia. 56 SIMPLE IRRITANTS. Nitrate of Silver [Lunar Caustic). — This is a powerful irritant, and has proved fatal in at least two instances. The antidote is common salt, which must be given immediately, followed by emetics. Tix. — The chlorides of tin being employed in dyeing, color-making, &c.. may lead to their being used as poisons, or being taken accidentally. Death from their use is rare. They are decom- posed by magnesia, which should therefore be freely administered, followed by albuminous and mucilaginous drinks. Bismuth. — The nitrate or magistery of bismuth has caused death in nine days, after a dose of two drachms. The symptoms were those of a strong irritant, but in all probability were caused by some impurity in the substance. Arsenic is fre- quently present in this way. As no antidote is known, vomiting must be promoted and emollient drinks freely given. Chrome. — The bichromate of potassium is found in the form of orange-red crystals, which yield a yellow acid solution. It is used as a dye, and has caused death in more than one instance. Emetics and magnesia or chalk, must be the remedies em- ployed. It is well to know that this substance is apt to produce troublesome sores on the hands of those engaged in its manufacture. Some slight abrasion begins the lesion, which does not heal, but forms on its surface a tough slough, which separating, leaves a foul ulcer with hard edges, and most untractable, behind it. Sulphate of Irox (Green Vitriol, Cbpperas). — Although not a powerful irritant, sulphate of iron has proved fatal when taken in a large dose. It is sometimes given to procure abortion. The VEGETABLE AND AMMAL IRRITANTS. 57 perchloride of iron has also produced alarming symptoms, after being taken for the same purpose. Dr. Christison relates the case of a man who died in five weeks from an ounce and a half of the tincture. Magnesia and diluents, freely adminis- tered, must constitute the treatment. CHAPTER XL SIMPLE VEGETABLE AND ANIMAL IRRITANTS. This division of the class of simple irritants is an important one, on account of the substances composing it consisting in considerable part of ordinary remedies or drugs, which given in over doses, ma}" produce sj'mptoms of poisoning. They chiefly give rise to vomiting and purging. VEGETABLE IRRITANTS, The most important are aloes^ colocynth^ jalap^ gamboge^ scammoni/, elaterium, croton oilj castor oil seeds, various species of arum, euphorhium, hrxjony^ mesereoii, physic nut, and others less commonly known. Dr. Taylor says that aloes and colocyuth are the basis of 3Iorriso7i^s pills, which in many in- stances have induced fatal purging. In Holloicay's pills, aloes is the chief ingredient. A favorite remedy with nurses for promoting the catamenia is hierapicra, a brown powder consisting of four parts of aloes to one of canelia bark. This may give rise to dangerous symptoms. The symptoms induced by these substances are those of irritation of the intestinal canal, severe pain, vomiting, diarrhoea, tenesmus, &c. ; followed 58 SIMPLE IRRITANTS. by collapse, cold sweats, and occasionally con- vulsions. These effects may also be produced by diseased and decayed vegetables. The treatment must be directed to the removal of the injurious substance by emetics, /77iptoms. — These will vary with the dose and the mode of exhibition. Inhalation of the vapor of anhydrous prussic acid would immediately cause death. The vapor of the diluted acid has given rise to serious symptoms with great rapidity. Seheele is said to have been suddenly killed by respiring the vapor of the dilute acid Avhile making his experiments. When the diluted acid is taken in a large dose the symptoms may commence during swallowing, death following so quickly that scarcely any cfi'ects can be observed. The chief symptoms, perhaps, are insensibility, slow gasping, or con- vulsive respiration, a clammy cold skin, fixed and glistening eyes, dilated pupils, spasmodic closure of the jaws, an almost imperceptible pulse, and sometimes convulsions of the limbs and trunk. The rapidity with which consciousness is lost is well exemplified in an instance recorded by Ilufe- land. where a man about to be apprehended as a thief took an ounce of the acid, staggered a few steps and fell apparently lifeless. In a few mo- ments a single violent respiration was made, and within fire minutes of taking the poison he was dead. Insensibility is not, however, in all instances, immediately produced ; many an authenticated 126 NEUROTIC POISOXS. case having occurred in which the symptoms were protracted for some minutes, the individual per- forming several acts indicating consciousness, such as replacing the cork in the bottle, adjusting the bed-clothes, or even running some distance to summon help. The utterance of a shriek has been said to be characteristic of poisoning by this acid; but toxi- cologists know that such has not been observed in the hnraan subject, and that there is merely a gasping for breath, or perhaps a call for help. A small dose produces faintness, insensibility, difficulty of breathing, involuntary evacuations, loss of muscular power, convulsions, and tempo- rary paralysis. If the proper treatment be em- ployed, recovery may often be effected. Post-mortem Appearances. — The body is gener- ally livid, the countenance pallid, or sometimes livid and bloated, the jaws firmly closed, and the hands clenched. There is frequently blood or froth about the mouth, and the eyes are sometimes described as prominent and glistening. There is often an odor of prussic acid about the body, which is more perceptible on opening the stomach. The venous system is usually gorged with blood ; and the brain, lungs, heart, liver, spleen, and kid- neys have been found congested with dark-colored fluid blood. Treatment. — There is no chemical antidote to this poison which can be relied upon. Chlorine and the mixed oxides of iron have been recom- mended ; but even if one of these agents happened to be at hand, it is doubtful if its employment could be timely enough to be advantageous. Attempts must be made to restore animation by cold affusion, stimulating frictions to the chest and abdomen, warmth to the surface, and the HYDROCYANIC ACID. 127 jipplication of ammonia to the nostrils. Cold aflfusion over the head and neck has proved most efficacious when promptly resorted to, and re- peated at short intervals so as to cause a shock. The direct injection of liquor ammonise into the veins, as proposed by Professor Halford, for snake bite, might be tried if the means were at hand. As soon as possible ammonia should be given internally and the stomach emptied. If recovery ensue from the immediate effects, vomiting should be produced by emetics or other- wise, after which strong coffee, with brandy, ought to be administered. Tests. — The best are the following : When hydrocyanic acid has to be separated from organic substances, such as the contents of the stomach, it is usual to take advantage of its ready volatility. If the acid be not in combination it may be given off so readily as to be detected by a watch glass moistened with nitrate of silver held over the vessel containing the acid ; but in order to make sure of its presence or absence the follow- ing process should be adopted. The suspected material should be acidulated with pure sulphuric acid so as to insure the prussic acid being in a free state. The substances thus acidulated are to be placed in a retort, distilled over a water bath, and the distillate collected in a cool receiver con- taining some caustic potass. About one-sixth of the fluid substance should in this way be distilled over, when the liquid in the receiver may be test- ed by the silver or iron tests, or the vapor as it passes over may be tried with the sulphur test. 1. The peculiar odor of prussic acid is well known, and is a very delicate test, taken in con- junction with others, of its presence. 2. The Silver Test. — Nitrate of silver yields, with 128 NEUROTIC POISONS. hydrocyanic acid or cyanide of potassium, a white clotted precipitate, (cyanide of silver,) insoluble in cold but soluble in boiling nitric acid. If this precipitate be well dried and heated, cyanogen gas will be given off, which may be known by its burning with a purplish flame. This test is very delicate. 3. The Iron Test. — Of the liquid collected in the receiver above-mentioned, or the suspected acid liquid, saturated with a few drops of caustic potass, a portion is to be taken, and to this is to be added a small quantity of a solution of sulphate of iron. A dirty brownish or greenish precipitate will fall, consisting of a mixture of the oxide of iron and Prussian blue. On adding a few drops of diluted sulphuric or hydrochloric acid, and thus dis- solving the oxides, the prussian blue will immedi- ately be made clear if hydrocyanic acid be present. 4. The Copper Test. — Sulphate of copper added to prussic acid rendered slightly alkaline by potass, gives a greenish-white precipitate, which becomes white by the addition of a few drops of hydro- chloric acid to dissolve the blue precipitated oxide of copper. 5. llie Sulphur Test. — One of the most useful tests for prussic acid, whether in the fluid or vola- tile state, is the so-called sulphur or Liebig's test. It is best adapted for detecting the acid in a state of vapor, and to this end a drop of yellow sulphide of ammonium in a watch-glass is held over the suspected liquid, Avhich may be warmed by the hand to facilitate the evolution of the acid. In this })osition the watch-glass should be allowed to remain for some little time, after which a drop of solution of perchloride of iron is to be added, which will give rise to a blood-red color not discharged bv corrosive sublimate. DIGITALIS. 129 If the acid is in the liquid form a drop of the prussic acid and the yellow sulphide may be mixed and heated until they thoroughly combine. A drop of sulphate of iron is then added as before, but all the sulphide must be decomposed or a black sulphide of iron will be produced, even though prussic acid be present, instead of the ordinary blood-red color. Other substances give a similar reaction with iron ; but their color is discharged by corrosive sublimate. CHAPTER XXVIII. DEPRESSAXTS. neurotics producing marked depression of the heart's action. digitalis — calabar bean tobacco hemlock. Digitalis Purpurea [Purple Foxglove). — The seeds, leaves, and root of this indigenous hedge- plant are poisonous. Digitalin is the principle which these parts contain. The officinal infusion of digitalis, made from the dried leaves, is used in doses of ^ij, ^ss, or more ; of the tincture m. v to m. xl are usually given. On the recommendation of the late Mr. Jones, of Jersey, half an ounce of the tincture is sometimes administered in cases of delirium tremens : this dose being repeated a second or even a third time, in the course of six or eight hours. Digitalis is ver}' uncertain in its action. "When given medicinally its effects should be watched, 130 NEUROTIC POISONS. as in some cases it probably accumulates in the system, but in others, especially in heart disease, it may be given for months or years without hurt, and even with advantage. A poisonous dose seems to produce vomiting, purging, colic, head- ache, slowness and extreme irregularity of pulse, dimness of vision, dilated pupils, lethargy, pros- tration, convulsions, and coma. In two instances death occurred within twenty-two hours. The appearances found afterwards have been chiefly congestion of the cerebral vessels and slight in- flammation of the stomach. Diijilalin has acquired a certain importance from the trial and execution of De La Pommerais for poisoning the widow Pauw by its means. The facts were altogether inconsistent with his inno- cence, and though digitaline was not separated from the woman's body, yet extracts of the vom- ited matters killed dogs with the symptoms of poisoning by digitalis. The extracts obtained from the stomach and bowels did not prove fatal. Tardieu and Roussin. who were engaged on the case, came to the conclusion that the Avoman had been poisoned by some vegetable poison, probably digitaline. The womans symptoms, which were not, however, carefully noted, were violent vomit- ing and extreme depression. In addition to the administration of emetics and castor oil, some infusion containing tannin, as strong tea, S Chloride of antimony, 80 arsenic, 77 harium. 53 mercury, 85 zinc, 55 Chlorides of tin, 56 Chlorine, 59 Chloroform, 102 Chrome, 5(5 Chronic antimonial poisoning, 79 arsenical poisoning. 70 copper poisoning, 89 lead poiscming, 88 mercurial poisoning, 82 Cicuta virosa, 132 Cinnahar, 85 Cliussification of poisons, 32 Coal gas, 130 Cocculus Indicus, 110 Cockles, 58 Colchicia, i;i3 Culchicum, 133 Colic, 88 Colocynth, 57 Common hemlock, 132 salt. 13 Confectionery, poisonous. G7 Couia, 13;i Conium, 132 Copper, arsenite of, 67 salts of, 89 Copperas, 56 Corrosive sublimate, 81 Crabs, 58 Cream of tartar, 53 Croton oil seeds, 57 Curare, 116 Cyanide of mercury, 85 pot;u5sium, 124 Cytisus laburnum, 92 Darnel seeds, 110 Deturia, 115 Detura stramonium, 115 Deadly nightshade, 113 Definition of a poison, 13 Diagnosis of poisoning, 19 Digitalin, 129 Digitalis purpurea, 129 Duties of the medical practi- tioner, 19 Eating of arsenic, 67 opium, 96 Effects ol poisons, 15 Elaterium, 57 Ilmetics, 25 Ergot of rye. 137 Essence of bitter almonds, 124 mirbane, 109 Essential salt of lemons, 43 Ether, 106 Eui)horbium, 57 Fisli, poisonous, 58 Fool's parsley, 132 Foxglove, 129 Fungi, 111 Gamboge, 57 Garden-nightshade, 115 Gaseous test for arsenic, 74. Gases, irritant, 59 Goulard's extract, 87 Green vitrol, 56 Hartshorn. 49 Hellebore, black, 92 Hemlock, 132 Hemlock, water-dropwort, 132 Henbane, 112 Hierapicra, 51 Hocussing, 115, Holloway's mils, 57 IlydrochlorOTe of morphia, 97 Hydrochloric acid. 39 Hydrocyanic acid, 123 Hydrogen, carburetted, 136 INDEX. 153 Hydrogen, sulphuretted, 136 Hydrophobia, 142 Hyoscyamiis niger, 112 Indian tobacco, 133 Indigo, sulphate of, 40 Investigation of cases, 19 Iodide of potassium, 63 Iodine, 61 lodisni, 62 Iron, sulphate of, 56 Irritant gases, 59 Ijoisons, 34 Jalap, 57 Ketchup, 111 Laburnum, 92 Laudanum, 95 Laurel water, 124 Lead and its preparations, 85 palsy, 88 Lemons, essential salt of, 43 Levant nut, 110 Lime, 53 Liquid mercury, 81 tests for arsenic, 74 Liquor ammonia?, 48 potassae, 48 Lobelia inflata, 133 Local action of poisons, 15 Lolium temulentum, 110 Lunar caustic, 56 Magistery of bismuth, 56 Marsh's test for arsenic, 75 Meadow saffron, 133 Meats, poisonous, 58 Meconic acid, 101 Medical witness, the duty of, 19 Modico-legal reports, 21 Menispermum cocculus, 110 Mercurial paralysis, 83 Mercury and its compounds, 81 Mesereon, 57 Metallic antimony, 78 Metallic arsenic, 66 lead, 85 Metals, compounds of the, 6G Mineral acids, 36 green, 67 Mirbane, essence of, 109 Mixed acids, 41 Monkshood, 122 Morphia, 97 Morrison's pills, 57 Muriatic acid, 39 Mushrooms, 111 Mussels, 58 Narcotic poisons, 95 Nicotiana tabacum, 131 Nicotina, 131 Nightshade, 115 Nitrate of bismuth, 56 potash, 52 silver, 56 Nitrate of mercury, 85 Nitre, 52 Nitric acid, 38 Nitro-benzol, 109 Nitro-muriatic acid, 40 Nitro-sulphuric acid, 40 Nitrous-oxide gas, 107 Nux-vomica, 117 (Enanthe crocata, 132 (Esophagus, stricture of the, 41 Oil of bitter almonds, 124 vitrol, 36 Opium, 95 Opium-eating, 96 Orpiment, 67 Oxalate of lime, 43 Oxalic acid, 43 Oxalis acetosella, 43 Oxides of lead, 87 Painter's colic, 87 Paralysis from lead, 86 mercury, 83 Pearlash, 48 Phellaudrium aquaticum, 132 Phosphorus, 63 154 INDEX. Picrotoxiu, 110 Poison, definition of a, 13 Poisoning, diagnosis of, 19 treatment of, 27 Poison of vipers. 140 Poisonous confectionery, 67 fungi, 111 Poisons, absorption of, 14 classification of, 32 mode of action of, 14 sympathetic action of, "17 Potash, 48 arsenite of, 67 bichromate of, 56 binoxalate of, 43 bitartrate of, 53 carbonate of, 48 nitrate of, 52 sulphate of, 52 Potassa fusa, 48 Potassio-tartrate of antimonj-, 78 Pota-ssium, iodide of, 63 Prussic acid, 123 Ptyalism, 83 Purple foxglove, 129 Rabid animals, bites of, 142 Realgar, 07 Red arsenic, 67 oxide of mercury, 85 precipitate, 85 spirit of nitre, 38 Reduction test for arsenic, 73 Reinsch's test for arsenic, 70 Remote effects of poisons, 15 Reptiles, bites of, 140 Rhubarb, 43 St. Ignatius' bean, 116 Sal de duobus, 52 Salivation, 83 Sal polychrest, 52 Salprunelle, 52 Salt of sorrel, 43 Saltpetre. 52 Salts of copper, 89 Sausages, 58 Savin, 137 Scammony, 57 Scheele"s green, 67 hydrocyanic acid, 123 Secale cornutum, 137 Serpents, poisonous, 140 Sesquicarbonate of ammonia, 40 Shell-fish, 58 Silver, nitrate of, 56 Smelling-salts, 49 Soap-lees. 48 Soda, carbonate of, 48 Solan ia, 115 Solanum dulcamara, 115 nigrum, 115 Soothing svrups, 95 Sorrel, 43 ' salt of, 43 Spanish flies. 92 Spirit of salt. 39 Spiritous liquors, 108 Spotted hemlock, 132 Spurred rye, 137 Stings of bees, 143 Stomach-pump, 24 Stramonium, 115 Strychnia, 117 Subacetate of copper, 90 lead, 87 Subchloride of mercury, 85 Sugar, acid of, 43 of lead, 80 Sulphate of copper, 90 indigo. 40 iron, 50 potash. 52 zinc. 54 Sulphides of arsenic. 67 Sulphuretted hydrogen, 136 Sulphuric acid. 36 Sulphuric ether, 100 Sulphurous-acid gas. 59 Sympathetic action of poisons, "17 Symptoms of poisoning, 20 Tartar emetic. 78 Tartaric acid, 47 INDEX, 155 Tartarized antimony, 78 Taxus baccata, 137 Tersulphide of arsenic, 67 Thorn-apple, 115 Ticunas, 116 Tin, 56 Toadstools, 111 Tobacco, 131 Treatment of poisoning, 24 Vapor of ammonia, 49 Vegetable acids, 43 irritants, 57 Venomous reptiles, 140 Veratria, 133 Verdigris, 90 Vermilion, 85 Viper, the common, 139 Wasps, stings of, 143 "VVater-hemlock, 132 Water, impregnated with lead, 88 Water-parsnip, 132 White arsenic, 69 hellebore, 133 lead. 87 oxide of arsenic, G9 precipitate, 85 vitriol. 54 Wine containing lead, 88 Wolfsbane, 122 Wood sorrel, 43 Woody nightshade, 115 Woorara, 116 Yellow arsenic, 66 Yew, 137 Zinc, chloride of, 55 sulphate of, 54 THE END. Date Due t**f CAT. NO. 23 233 PRINTED IN U.S. B 000 007 403 9 Tanner, Thomas H Memoranda on poisons QV600 Tl6Tm 18T2 QV600 Tl67m 1872 anner, Thomas H Memoranda on poisons CALIFORNIA COLLEGE OF MEDICINE LIBRARY UNIVERSITY OF CALIFORNIA, IRVINE IRVINE, CALIFORNIA 92664 EHQ