Memoranda on Poisons Part 5

This gas, which is a waste product in the manufacture of was.h.i.+ng soda, is the chief cause of the barrenness which surrounds soda works where it is allowed to escape, it being extremely destructive to vegetable life.

_Ammonia._-It has been already noticed (p. 48) that the vapor of ammonia is poisonous, exciting inflammation of the larynx, bronchitis, and pneumonia. Serious symptoms have sometimes arisen from its indiscriminate application in cases of syncope, &c.

III.-SPECIFIC IRRITANT POISONS.

By Specific Irritant Poisons we mean those which, taken internally, produce local inflammation or irritation, these being of course indicated by certain const.i.tutional symptoms; but over and above these, which may be the result of ordinary inflammation, there are certain specific signs of the action of a poison, in most instances peculiar, and frequently pointing directly to the poison employed. This group is one of the utmost importance in Toxicology, and includes substances acting in many different ways, all, however, giving rise to the common symptoms of gastric irritation.

CHAPTER XIII.

SPECIFIC MINERAL IRRITANTS.

IODINE AND IODIDE OF POTa.s.sIUM.

IODINE is obtained from kelp (the ash of marine plants) and is a bluish black scaly substance. It strikes an intense blue color with starch, and when heated gives off an irritating purple vapor. It likewise imparts a yellowish-brown stain to the skin (which may be removed by liquor pota.s.sae) and mucous membranes, and slowly corrodes these tissues.

Iodine is an active poison, although its effects are variable. Some const.i.tutions are violently affected by two or three grains, whereas others are uninjured by ten or twenty. Iodine is commonly employed in medicine in combination with pota.s.sium (iodide of pota.s.sium). Of this substance very large doses may be given (thirty grains or more, three times a day) in tertiary syphilis, with none but good effect.

The _symptoms_ of poisoning by iodine consist of an acrid taste, tightness about the throat, epigastric pain, vomiting, and purging, especially if much has been taken. In a case which came under observation, a man took an ounce of the compound tincture of iodine, in mistake for a purgative draught. He was immediately seized with an intense burning pain in the throat and epigastrium, and vomiting, followed by great thirst, headache, and syncope. The vomiting was encouraged, large quant.i.ties of arrowroot given, starch enemata administered, and in twelve hours all the symptoms had disappeared, leaving him in a state of exhaustion, from which he recovered in a few days.

In chronic poisoning (iodism) there are signs of irritation of the alimentary ca.n.a.l, often a measly eruption, ptyalism, running from the nose and eyes, mental and bodily depression, and loss of flesh. Nothing leads to the belief that it causes absorption of the t.e.s.t.i.c.l.es or mammae, as is often a.s.serted.

The _post-mortem appearances_ would be those due to an irritant poison, namely, inflammation and softening of the stomach; the mucous membrane being detached in different parts, and stained of a yellow color.

The _treatment_ should consist in the encouragement of vomiting, and the free administration of amylaceous fluids, as gruel, arrowroot, boiled starch, &c. This should be continued until the matters vomited are of their natural color; for as long as any iodine remains they will be rendered blue, iodide of starch being formed.

The crystals _of iodide of pota.s.sium_ are white cubes, very soluble in water, and permanent in the air; though when impure they have a yellowish tinge, and are deliquescent. In a few instances this valuable medicine appears to have given rise to troublesome symptoms, even when administered in small doses. Mr. Erichsen has reported a remarkable case, in which five grains produced coryza, conjunctivitis, difficulty of breathing, and other serious effects, promptly ceasing with the discontinuance of the medicine. The _treatment_ must consist in emptying the stomach by emetics or the stomach-pump, and administering starchy diluents.

_Tests._ 1. Iodine may be readily detected by the blue color it gives to starch.

Iodide of pota.s.sium gives the same when the iodine is set free by an acid, such as sulphuric acid.

2. It also forms a scarlet precipitate with perchloride of mercury; and

3. It gives a yellow precipitate with acetate of lead.

CHAPTER XIV.

PHOSPHORUS.

This substance is sold in a pure state in small wax-like cylinders, which must be preserved under water. It is soluble in oil, alcohol, ether, and chloroform, and still more so in carbon disulphide; it is luminous in the dark, and it ignites at a very low temperature, giving off a dense white smoke. Phosphorus is much more frequently used as a poison abroad than in England; but since restrictions have been put on the sale of poisons, and rat poisons containing it have been more common, cases of poisoning have more frequently occurred, and are likely to do so even oftener in future. The cases which have occurred show that it is a very powerful irritant, and capable of causing death when taken, even in small doses. One grain has caused death; the shortest period in which it has followed the administration of the poison being four hours.

The phosphorous paste sold consists of flour, sugar, and fat, with phosphorous, ordinarily colored with Prussian blue. Coloring matter is also generally present in lucifer-match tops, which contain phosphorus and chlorate of potash, or nitre; hence, the vomited matters after either of these has been swallowed may be variously colored. In the so-called "safety matches" the phosphorus is on the box and not on the match. Phosphorus does not readily lend itself to the purposes of the criminal, its luminosity, its taste, and its garlic odor rendering it difficult of concealment.

The _symptoms_ of poisoning by phosphorus are very varied, often insidious. At first there may be merely the ordinary signs of irritant poisoning. The vomited matters are luminous in the dark, sometimes bilious, sometimes b.l.o.o.d.y. There is very great prostration, and there may be diarrha with b.l.o.o.d.y stools. These symptoms sometimes abate, and everything seems going on well, when suddenly a new train of symptoms, still more serious, develop themselves. These are such as would occur in the worst forms of blood poisoning: harsh, dry, yellow skin, with discharges of blood from the various pa.s.sages, and the formation of extravasations below the skin. The urine is ordinarily retained or suppressed, what little there is being alb.u.minous or bile-stained. Finally, acute delirium with convulsions sets in; the patient dies comatose a few hours after taking the poison, or it may be as many months.

The _post-mortem appearances_ after death by phosphorus are very peculiar. If the case has proved rapidly fatal there will be the ordinary signs of irritant poisoning, with, in addition, softening of the stomach, b.l.o.o.d.y or gangrenous patches, blood in the intestines and bladder, and b.l.o.o.d.y serum in the peritoneal cavity. In many respects the lesions resemble those of the worst forms of sea scurvy; but the most marked changes are the remarkable fatty degeneration of the liver, kidneys, heart and other muscles, especially of the first, which is often greatly atrophied.

The diagnosis will depend on the peculiar odor of garlic exhaled by the patient and the luminosity of the vomited matters, in addition to the other signs referred to.

_Treatment._-There is no regular antidote for phosphorus; early evacuation by the stomach-pump and the free promotion of vomiting are the main points. Magnesia or its carbonate should be given freely in mucilaginous fluids. Oils had better be avoided, except for the purpose of removing all traces of the poison by the stomach-pump. Prompt treatment is all in all.

_Detection._-There is but one really satisfactory plan for detecting phosphorus in organic mixtures, that invented by Mitscherlich. The suspected material is introduced into a retort, and acidulated with sulphuric acid. The stem of the retort is conducted into a gla.s.s vessel kept cool by a stream of water on the outside. The retort is heated, and distillation allowed to go on in the dark. If phosphorus be present it pa.s.ses over as vapor, and is condensed in the cool vessel beyond. At each condensation a flash of light is perceived, which is the test relied on.

CHRONIC POISONING by phosphorus used to be exceedingly common among match manufacturers, but is now, comparatively speaking, rare, allotropic or amorphous phosphorus being much more generally employed than it used to be, and the ventilation of the workshops being better.

Its subjects used to be attacked with caries of the gums, gradually extending and implicating the jaw, and giving rise to great deformity.

CHAPTER XV.

a.r.s.eNIC.

a.r.s.eNIC is by far the most important of metallic poisons, whether we consider the deadliness of its effects or the fatal frequency with which they are made manifest. a.r.s.enic exists as an impurity in several metallic ores, notably in iron pyrites, which being commonly employed as a material for the manufacture of sulphuric acid, renders a.r.s.enic one of the most frequent impurities of commercial oil of vitriol. This should never be forgotten in testing any substance for the poison. To the common medicinal preparation of a.r.s.enic, consisting of _a.r.s.enious acid_, or _a.r.s.enites_, and the so-called _chloride of a.r.s.enic_, must be added the _a.r.s.eniates of potash and soda_; the sulphides of a.r.s.enic-as, the _red sulphide_, or _realgar_, and the _yellow sulphide_, or _orpiment_; the _a.r.s.enite of copper_, or _Scheele's green_, and others.

They all produce similar symptoms, and poisoning by either of them requires nearly the same treatment.

According to Von Tschudi, some of the peasants in parts of Styria and Hungary eat a.r.s.enic, taking from two to five grains daily; the men doing so in order that they may gain strength, and be able to endure fatigue, the women that they may improve their complexions. These statements are so contrary to all that we know of the power of this poison, that they have been regarded as unworthy of credit. Evidence has, however, been brought forward by Dr. Craig Maclagan, of Edinburgh, which shows clearly that a.r.s.enic-eating is something more than a mere fiction. This gentleman gave, and saw a Styrian eat, a piece of a.r.s.enious acid, weighing over four grains, and afterwards determined the presence of a.r.s.enic in urine pa.s.sed in his presence by the said peasant. Advantage was taken of these reports in the trial of Miss Madeline Smith (Edinburgh, July, 1857), when the court was asked to believe that a.r.s.enic found in the possession of the prisoner was used by her as a cosmetic.

_a.r.s.enite of Copper_, in one form or another, either as Scheele's green, emerald green, Brunswick green, &c., is unfortunately largely employed in the manufacture of green paper-hangings, artificial flowers, toys, and even some kinds of confectionery. Too many cases of ill-health caused by this practice have been recorded to permit any doubt as to its deleterious effects. These may be manifested by people living in rooms furnished with such paper-hangings. The chief symptoms are, sneezing, lachrymation, frontal headache, nausea, and loss of appet.i.te, with colicky pains, thirst, &c. Among those employed in preparing the paper-hangings more serious symptoms manifest themselves. The irritation of the pigment gives rise to circular patches of ulceration on the alae of the nose, in the folds of the arm, in the groin and s.c.r.o.t.u.m-in short, wherever dirt tends to lodge. These prove very untractable, except the employment be abandoned. In November, 1861, a young woman died in London from the poisonous effects of a.r.s.enite of copper used in dusting wax leaves. The workmen who employ the pigment in its dry state suffer, while those who use it in a moist condition are probably unaffected by it. A simple method for roughly detecting a.r.s.enite of copper in these fabrics was published in the _Chemical News_ (vol. 1, p.

12). A small portion of the suspected material is to be put into a test tube with strong ammonia. If a blue tint be produced, a salt of copper is shown to be present. Withdraw the object, and drop a piece of nitrate of silver into the ammonia; if a.r.s.enic be there, the nitrate of silver will be covered with a yellow coating of a.r.s.eniate of silver, which will disappear on stirring. On igniting a.r.s.enical paper and allowing it to smoulder, the odor of garlic may be detected in the fumes given off.

Another mode in which the noxious effects of a.r.s.enic are produced is by the use of bright green tarlatans as ball dresses. One could hardly conceive a more deadly amus.e.m.e.nt than dancing in an a.r.s.enicated dress, sweeping against an a.r.s.enicated wall-paper. When both are lightly adherent the a.r.s.enic is scattered in showers about the room.

a.r.s.eNIOUS ACID (_White Oxide of a.r.s.enic_, _White a.r.s.enic_, _a.r.s.enic_).-This is the preparation of a.r.s.enic most frequently used as a poison; the facility with which it used to be procured, its cheapness (twopence an ounce), and the ease with which it may be administered, all tended to recommend it to the murderer or suicide. According to a parliamentary report, the number of fatal cases of poisoning in England in the years 1837, 1838, amounted to 543, of which no less than 186 were caused by a.r.s.enic, 185 arising from the use of the a.r.s.enious acid, and 1 from orpiment or yellow a.r.s.enic.

Since the Act of 1851 (14 Vict. cap. xiii.) the deaths from this agent have greatly decreased. This statute chiefly enacts that a.r.s.enic is not to be sold without the seller entering the transaction in a proper book, without a witness, nor without its being mixed with soot or indigo, unless such admixture would render it unfit for the purchaser's business.

a.r.s.enious acid is found in commerce in the form of a white powder or in small opaque cakes. It is very feebly acid, tasteless, or slightly sweet in small doses, though not very soluble, an ounce of cold water dissolving about one grain. The quant.i.ty so held in solution may, however, be increased by dissolving the a.r.s.enic in boiling water and allowing it to cool. The shortest period within which it was believed a.r.s.enic would cause death was two hours; but Dr. Taylor gives a case where death with tetanic symptoms followed the fatal dose in twenty minutes. The smallest quant.i.ty known to have proved fatal is two grains.

Two grains and a half killed a girl nineteen years of age in thirty-six hours. Half a grain will produce alarming symptoms; and yet recovery has ensued after doses of half an ounce or an ounce.

_Symptoms._-These commence within half an hour or an hour of swallowing the poison. There is faintness, nausea, incessant vomiting, and a burning pain in the epigastrium, increased on pressure, and gradually extending over the whole abdomen, followed by headache, diarrha, a sense of constriction and heat in the fauces and throat, great thirst, and catching, painful respiration. The heart's action becomes depressed, the pulse is quick and feeble; there is great restlessness and anxiety; cold, clammy skin, and perhaps coma are present; and death usually occurs within twenty-four hours.

These symptoms are liable to great variety, the pain and vomiting being occasionally absent, and the patient being affected as if by a narcotic poison. In some instances there is troublesome tenesmus, with heat and excoriation about the a.n.u.s. Convulsive movements in the extremities often occur, with cramp in the legs, especially if the diarrha is severe. Death sometimes takes place calmly from collapse, sometimes it follows on convulsions.

The vomited matters may be red or brown from admixture with blood or bile; or they may be blue or black, if the a.r.s.enic has been colored with indigo or soot. Although the vomiting, pain, &c., are generally continuous, yet sometimes all the symptoms remit, and the patient rallies for a time, only to sink more rapidly.

The symptoms of _chronic_ poisoning by a.r.s.enic are loss of appet.i.te, a silvery coating to the tongue, thirst, nausea, colicky pains, diarrha, frontal headache, langor, sleeplessness, cutaneous eruptions, soreness of the edges of the eyelids, emaciation, anaemia, convulsions, and death. In some cases, when small doses have been administered for many days in succession, with the intent to destroy life, the symptoms have been masked by other substances. The most marked results of this practice have been sickness and vomiting, pain in the bowels, nervous irritability, and emaciation. The pract.i.tioner must be careful not to mistake these symptoms for those due to simple gastritis or enteritis.