THE word poison has come now by general consent and usage to designate any substance which, through the blood, has a deadly or noxious action upon living beings. Some poisons act in minute, others in comparatively large, doses. The former are termed deadly, being often rapidly fatal in small doses.
The primitive use of poisons was for the purpose of anointing arrows: hence the Greek word for poison (—-) derives its origin from (—–), which signifies a bow. This custom dates from the earliest antiquity, when men earned their means of subsistence by the bow, and is prevalent among savage tribes at the present time.
Poisons have been arranged by toxicologists into three groups, according to their action upon the animal economy, as follows:-
I. IRRITANT POISONS, or those which produce irritation or inflammation, as the mineral acids, oxalic acid, arsenic, mercury, copper, antimony, zinc, lead, baryta, and cantharides.
II. NARCOTIC POISONS, or those which produce stupor, delirium, and other affections of the brain and nervous system; as, opium, hydrocyanic acid, and poisonous gases.
III. NARCOTIC-IRRITANT POISONS, or those which produce sometimes irritation, sometimes narcotism, sometimes both together; these are chiefly derived from the vegetable kingdom, as, strychnia, monkshood, and poisonous fungi.
But it is to be remembered that the chief irritant poisons, like the narcotics, have a specific remote poisonous effects upon the blood, nervous system, and body generally, besides their local irritant operation upon the part to which they are immediately applied.
In cases of suspected poisoning symptoms should be carefully watched and noted; the evacuations should be inspected; the vomit and urine submitted to chemical examination; and, if death occur, a post-mortem examination should be made.
In our observations on the most common poisons, our aim has been to embody such practical points as are most necessary to be remembered. The following is the list included in this chapter.
White Arsenic, or Arsenious Acid, is an intensely irritant poison, two grains having been known to destroy life. When criminally employed, it is more commonly used for murder than of suicide; is generally given in some article of food, and, in small quantities, has no appreciable taste. Hence, also, it has often led to accidental poisoning. Hence, also, it has often led to accidental poisoning. It has been sold for “Salts” or “Magnesia,” and used instead of the plaster-of-Paris in the adulteration of sweets. In farming districts, second hand stone jars have repeatedly proved dangerous. Mr. Freeman reports reports two cases in which stone jars were used for the storage of wine or jam, which had previously been used for the solution containing Arsenic employed in sheep-dipping, and in each instance serious-illness resulted, proving fatal to one man. Some years ago there was a serious epidemic of arsenical poisoning traced to the use of beer which had come to contain small quantities of Arsenic, owing to the use of artificially prepared glucose in its manufacture. It is sparingly soluble in cold water, two-and-a-half parts only being taken up by 1,000 parts of water.
SYMPTOMS.- These come on, if the dose has been moderately large, in about an hour after the poison is taken; but the time and also the severity of the symptoms vary according to the state of fulness of the stomach at the time, and the digestibility of the vehicle in which it is swallowed. There are faintness, nausea, great pain and burning heat in the stomach, an incessant desire for cold drinks, and violent vomiting of brown matter streaked with blood. By vomiting, much of the poison may be ejected, together with the common contents of the stomach, and a great deal of mucus, which is probably secreted as a defence. The skin is generally cold and clammy, but has sometimes been found very hot. In fatal cases the countenance becomes pale, sunken, and expressive of great torture and anxiety; the pulse grows small, feeble, rapid, and soon imperceptible. The pain spreads over the abdomen, which becomes tense and tender, sometimes swollen, sometimes drawn in at the navel; diarrhoea comes on with severe tenesmus, and sometimes bloody evacuations; there is also strangury, priapism, and congestion of the testicles. Finally, difficulty of breathing supervenes, the conjunctivae become dry, red, swollen and injected, and delirium, stupor, or convulsions precede death, which usually occurs on the third day, unless a large quantity has been taken, when the patient suffers much less, and sinks in about twenty-four hours.
If the patient survive the third day, or has had small doses frequently repeated, he will suffer from Gastritis and Enteritis. Even if he finally recover, he will long experience pain in the abdomen, imperfect digestion, sickness, emaciation, falling off of the hair, and other symptoms of chronic arsenical poisoning.
TREATMENT.- Evacuate the contents of the stomach by an emetic (3j zinci sulph. :- tartar emetic should be avoided), or by tickling the finger of a feather; this is better than the stomach-pump, because Arsenic is heavy and somewhat insoluble, and would not probably be washed up. If, however, vomiting be already severe, fluids (cold, never warm) are only necessary to assist in clearing the stomach; the best being milk, which is bland, and may, as it curdles, partly envelope the poison., Taylor recommends equal parts of oil and lime-water. These may be given both before and after the vomiting has begun. A dos of castor oil, to clear away any of the poison that has left the stomach and entered the bowel may be of service. Linseed tea and other farinaceous decoctions are also useful; thy may be thickened with Magnesia, with which Arsenic forms an insoluble compound. A chief source of danger in arsenical poisoning is the want of any effectual antidote; the Hydrated Peroxide of Iron, which may be produced in a moment by addition of Liq. Ammoniae of Tincture of Iron, has the most repute, but is so little to be depended on that it should be postponed until after the stomach has been cleared as far as possible by vomiting. M. Carl affirms that Hydrated Magnesia, or a mixture of Magnesia and sugar may e relied on is arsenical poisoning. Poultices and fomentations should be applied over the abdomen.
TESTS FOR ARSENIC.- Place a piece of bright copper foil in a test-tube, cover with pure Hydrochloric Acid, and apply heat. If the foil remain bright, we have evidence that the acid and copper do not contain Arsenic. Add an equal quantity of the suspected fluid, and apply heat again. If arsenic be present in the fluid, the copper will now turn white or grey. On evaporating the moisture from the surface of the copper foil, and slowly heating it in a test-tube, a ring of Arsenic will be deposited to the cooler part of the tube.
If ammonio-nitrate of silver be added to the solution a rich arsenic of silver will be precipitated, changing to greenish brown.
The addition of ammonia-sulphate of copper to the solution will precipitate the rich green known as Scheele’s green, or arsenite of copper.
ARSENICAL WALL-PAPERS.- This subject has occupied much public attention; and unquestionably a very large number of affection shave been clearly traced by the profession to the use of such papers, while Dr. Stenhouse and others have, on analysis, discovered in them quantities of arsenic, varying from a trace to 14 grains to the square foot. Flannels and other fabrics are also said to be coloured by means of Arsenic. And where papers and articles of clothing are not coloured by Arsenic, the bright aniline dyes are sometimes fixed by an arsenical mordant. The prominent symptoms induced are very similar to those of Hay Asthma, and may be thus summarized; Eyes-bloodshot, sore, smarting, dim; photophobia; Nose-red, swollen, mucous membrane itching, smarting, with constant flow and sudden violent fits of sneezing, loss of smell, inability to breathe through the nose; Mouth-soreness, ulcers, loss of state; Tongue-dry, white; Voice- nasal; Face and Teeth-neuralgic pains; Forehead-sense of weight in frontal sinuses; Throat-soreness, dryness, nauseating greasy impression at the back; Lungs-bronchial affections; Stomach and Bowels-indigestion, thirst; retching, vomiting, diarrhoea, dysentery; Skin-irritation, eruptions, boils; Muscles and Bones- sufferings simulating Rheumatism; Brain and Nervous System- irritation occasioning great irritability of temper; depression of spirits; Neuralgia, and symptoms of peripheral Neuritis; Urine-scanty and highly-coloured; all ailments intensified at night; general prostration, and now slow emaciation. The Turkish- bath, in suitable cases, is said to be a valuable agent in eliminating the poison, and a course of Sulphur waters is very often of service.
TEST FOR WALL-PAPER.- Place a drop of Liquor Ammoniae on the suspected paper, and if it change the colour to blue, the probability is that copper and Arsenic are present. But a more satisfactory test is applied as follows :- Place a small piece of the material in a test tube, pour in about a drachm of dilute Hydro-chloric Acid, and boil it over a spirit lamp. The Acid dissolves the Arsenite of Copper and assumes a green colour. Pour off the liquid into another test-tube, and add a few drops of solution of Hydrosulphate of Ammonia, or pass Sulphuretted Hydrogen gas through the liquid. A copious brown precipitate forms; this is mainly composed of Copper Sulphide, with which the Arsenic Sulphide is mixed. Now add an excess of Liquor Ammoniae; this dissolves the Arsenic Sulphide. but not the Copper Sulphide. The ammoniacal solution of the Arsenic Sulphide is separated by filtration, and now the neutralization of the Ammonia by Hydrochloric Acid throw down the yellow Sulphide of Arsenic.
The most common mercurial poison is the bichloride-Corrosive Sublimate. In its action it differs from arsenious acid by being a chemical corrosive, combing with the albumen of the tissues; but it has also, like with the albumen of the tissues; but it has also, like Arsenic, a remote specific poisonous effect.
SYMPTOMS.- A horribly nauseous metallic taste, detected at the time of swallowing, and great constriction of the fauces and oesophagus, rendering even the swallowing of the antidote most difficult; the epithelium of the mouth ad throat becomes white, as if from nitrate of silver, shrivelled, and detached; vomiting of white, stringy mucus; copious diarrhoea. The pain in the stomach, and vomiting, come on earlier than from Arsenic, and blood is more likely to be brought up; the countenance becomes sometimes turgid and congested, at others pale and anxious, whereas from Arsenic it is always pale, contracted, and ghastly. Strangury, too, is a more marked symptom, because the Corrosive Sublimate, being more soluble, enters the circulation freely, and reaches the kidneys; whereas Arsenic remaining in the alimentary canal, causes its chief sufferings there; and, passing down to the rectum, renders tenesmus a more prominent symptom. if recovery take place from mercurial poisoning, salivation first occurs. There is but little difference in the fatality of Corrosive Sublimate and Arsenic-three grains of either may destroy life.
TESTS FOR CORROSIVE SUBLIMATE.- Powder.- If a small quantity be dropped into a white saucer containing a solution of Iodide at Potassium, it becomes scarlet; of Hydro-Sulphuret of Ammonia, it becomes black; of Potash, it becomes yellow. Solution.- A small quantity should be gently evaporated, then allowed to crystallize. Opaque silky prisms will thus be formed, intersecting each other. If Iodide of Potassium be dropped on them, they become scarlet.
TREATMENT.- This differs radically from that of Arsenic. as we have an effectual antidote, which should, therefore, be administered immediately; this is the whites and yolks of eggs, beaten up together. They convert the bichloride of Mercury into a double chloride of Mercury and albumen. If eggs cannot be had, a thin paste of flour and water may be substituted-the gluten acting in the same manner as albumen. Milk may also be given as substitute. Afterwards, bland fluids, emetics, the use of the stomach-pump, and other treatment according to the requirements of the case.
For the Salivation which follows, we have several remedies; Ac.- Nit. (two drops of the dilute acid in a little water, two or three times daily; also gargles of lukewarm water acidulated with the acid); Ac.- Sulph. (also internally and as a gargle); Alum in solution (3ij) of the power to z3iv of water, sweetened with a little honey) for a gargle. The patient should be warmly covered, and have all the nourishment he can take in the way of bread and milk, broths and soups. K. Chlorum is also recommended for its beneficial influence in salivation and is used both internally and as a gargle. Hepar sulph. is an efficient remedy for chronic mercurial eruptions and ulcers; and for the latter, Hydras.; Nux V. for mercurial tremor and Paralysis; Arsenicum-Iodium, etc., for the affections of the bowels; Aurum for mercurial cachexia, bone disease, etc.
The latter symptoms are those of chronic mercurial poisoning, such as are experienced by looking-glass markers, or by others who are constantly exposed to mercurial vapours.
The most common form of Lead poisoning is the chronic, as seen in house-painters, glaziers, and others who use lead in their trades, or work in lead mines, or who habitually drink water, cider, or other liquids contaminated with it. In the case of painters, that variety of paint which gives a dead or non- glistening surface is the most poisonous, from the large admixture of turpentine, which passing off by evaporation, carries with it a portion of the lead; this is inhaled, or mixed with the saliva, and received into the stomach, or settles on the skin and is absorbed. In such cases the source of the lead may be little suspected.
SYMPTOMS.- Vomiting, thirst, habitual constipation, and occasional severe colic; Paralysis of the extensor muscles of the forearm, so that the hands hand down by their won weight (wrist- drop), the patient having no power to raise them; general chilliness, pallor, and emaciation; contracted blood-vessels, and blood deficient in red corpuscles. The Palsy is at first local, but if the cause be not avoided, the patients fall into a state a general cachexia, become miserable cripples, and eventually sink under disease of some vital organ. A striking diagnostic sign of lead-poisoning is the existence of a dark-blue line round the edges of the gums, most marked in the lower jaw. This line is probably caused by a deposit of sulphide of lead in the gum tissue, the sulphide being produced by the sulphur, which is evolved from decomposing fragments of food in the clefts of the teeth, and which combines with the salts of lead in the blood; the breath is offensive and the gums red and sore.
TREATMENT.- For recent cases, Sulphur water and the Sulphates of Sodium and Magnesium. Iodide of Potassium (* “In Lead- poisoning,” the late Dr. Newton wrote us: “I greatly prefer the following treatment to the Iodide of Potassium : Mercurius-S. I. gr. ij. morning and night, and Nux vomica I, trit gr.ij twice daily. By this method we avoid the depression of spirits and loss of appetite which the Iodide brings on.”) is useful to remove the lead from the system in the form of the iodide tin the urine; for although iodide of Lead is insoluble in water it is soluble in urine and other fluids of the body. The Bromide has even greater solvent power than the Iodide, and it is preferable when there is sleeplessness. Another method of cure is to give frequent doses of Magn.-Sulph. (Epsom Salts), with excess of Ac.-Sulph. For lead-colic-Opi., Alumina, Platina, Belladonna, or Ac.-Sulph., with the warm bath, is the best treatment.
PREVENTIVE MEASURES are, chiefly, great cleanliness, using soap and water at frequent intervals, especially for the face, hand, s and nails; and avoidance of taking food in the workrooms or mines, or food which has been allowed to remain therein. The habitual use of a drink resembling lemonade, but acidulated with dilute Sulphuric Acid, as provided for the artizans in some lead works, is probably the best means of correcting the morbid influence on the stomach, while the entrance of the poison into the air-passages should be guarded against by working with the mouth closed, or by wearing a fine respirator.
The same antidote may also be used against Sugar-of-lead-a salt not infrequently use for poisoning-the Magn.-Sulph. in this instance forming an insoluble and probably inert Sulphate of Lead. ( Plus It is important to remember tat all substances which are insoluble are not also inert; for although insoluble in water, they may be dissolved in the fluids of the mouth, stomach, or other parts of the body. Of this, Calomel maybe cited as an illustration.
Owing to the facility with which soft water absorbs lead, pipes of this metal should not be employed for conveying water to houses. Much colic and lead poisoning at one time prevailed in Glasgow and Edinburgh from this source. Pipes made of block-tin, or lead lined with tin, should be substituted for leaden ones, particularly where the water is soft.
Poisoning from this metal usually occurs from food cooked in imperfectly cleaned copper or brass vessels; the metal becomes oxidized, and them, not only the vegetable acids, such as vinegar and pickles, but also oils and fats of greasy foods, as hashes and stews, from the fatty acids they contain, dissolve the metal, and from acrid, irritant, poisonous compounds, such as Verdigris (the acetate of copper), Blue Vitriol (sulphate of copper), etc.
These are the most common salts of copper; but though slightly poisonous, they seldom prove fatal, owing to their emetic properties.
SYMPTOM.- They resemble those caused by Arsenic and Corrosive Sublimate, with some that are peculiar to the metal itself, especially violent headache, then vomiting of blue and green matters, and cutting pains in the bowels, and afterwards cramps in the legs, pains in the thighs, etc. Jaundice very frequently occurs, and the symptom is the more important from being seldom met with in other cases of poisoning. Death is generally preceded by convulsions and insensibility. A chronic from of poisoning has occurred from the water on shipboard being contaminated by copper, in such cases the perspiration of the affected person has stained the linen of a greenish hue.
TREATMENT.- The best antidote in acute poisoning is albumen-the white and yolks of eggs beaten up-which when administered forms an insoluble compound with the copper salt; it should be followed by milk, arrowroot or mucilaginous drinks. In the absence of eggs, a thin paste of flour and water may be used. Emetics and the stomach-pump are less serviceable than in other irritant poisonings.
Poisoning with Antimony is uncommon, but it does sometimes occur on the employment of Tartar Emetic; or from antimonial wine being accidentally swallowed. In consequence of the largest doses of Antimony being powerful emetics, the poison in this from is generally rejected, and little harm follows; it is the chronic form of poisoning, in which the metal is continually taken in small doses, that is most to be feared; and this insidious plan has sometimes been adopted by slow poisoners, to produce symptoms analogous to those of internal visceral disease, so that, when they finally destroy their victims, less suspicion may arise. Suspicion should therefore be always entertained when a patient is, without evident cause, constantly sick on receiving his food or medicine, through the instrumentality of the particular individual.
SYMPTOMS.- From moderate doses, a strong metallic taste in the mouth; great heat and condition of the throat, violent burning pains in the stomach; followed by violent vomiting, purging, and extreme depression of the circulation. The most marked symptoms from the full action of the poison are.- nausea, sickness, and great depression.
TREATMENT.- Large draughts of water, and tickling the throat to induce vomiting; at the same time a decoction of cinchona, oak- bark, tannin, or even strong tea should be prepared and diligently administered. Magnesia dissolved in milk is a good remedy.
CHLORIDE OF ANTIMONY.- Taylor relates four cases of poisoning by this substance (popularly called Butter of Antimony); there of the persons recovered. In the fatal case the whole of the inside of the inside of the alimentary canal was blackened as if it had been charred; two or three ounces had been taken, and death occurred in ten hours and a half.
TREATMENT.- Magnesia must be given, followed buy the means recommended in poisoning by Tartar Emetic.
6.- Zinc, Chloride of (Brunett’s Disinfecting Fluid).
This popular disinfectant may be taken inadvertently with disastrous results.
SYMPTOMS.- Countenance anxious and depressed; voice feeble; throat sore and inflamed; feeling of faintness; tenderness on pressure and burning pain of the epigastrium and under the left ribs; vomiting; bowels inactive. Mucous membrane of the soft palate covered with a diphtheritic film, or yellow slough; vomit of black fluid, with mucus and shreds of tissue; stool very infrequent, black, pitchy. Occasional tetanic spasm in the right forearm and hand. Gums spongy and bleeding; vomit of brownish fluid with a flocculent sediment, but without bile; urine turbid, with lithates, sp. gr. 1025-1030. Temperature 100.6 slowly falling to 96.4
The patient sinks from corrosive action of the poison and from inanition caused by the secondary effects of the poison on the fauces, oesophagus, and stomach. One ounce, containing 200 grs. of the salt, has been known to cause rapid death; but recovery was taken place after swallowing 600 grains.
TREATMENT.- Mixture of eggs and milk freely administered, and continued so long as it is vomited in a curdled state. Copious and long-continued supplies of albuminous substances. Soapsuds given freely have proved curative. Nothing can be better than the carbonates of potash and soda, if given early. Copious draughts of warm water dilute the fluid and promote vomiting. As a very short contact with the mucous membrane is sufficient to corrode it, and convert it into a substance like leather, prompt measures are essential.