Antidotes.
From the experiments ofOrfila, it appears that vinegar, diluted with water, is the remedy which can be administered with the greatest success, where any preparation of this alkali has been swallowed in a poisonous dose.
In consequence of the peculiar action of this alkali upon animal matter, we shall generally find the stomach perforated, and its coats extensively dissolved. We shall moreover discover the usual indications of violent inflammation in this viscus, as well as in the intestines.
We have already stated by what chemical reagents this alkali may be distinguished frompotass; it only remains for us to observe that its physiological action, the symptoms arising from its ingestion, and the organic lesions discovered on dissection, are strictly analogous to those we have described as the effects of potass.
Ammonia, in its uncombined state, exists in the state of gas, and is incapable of application; its affinity, however, for water, enables it to combine with that fluid, and to form liquid ammonia, (Liquor Ammoniæ) in which state it is useful in medicine, and in the arts. This solution is colourless; its taste extremely caustic; and its odour strong, pungent, and peculiar. Exposed to the action of heat, the ammoniacal gasis driven off, and may be recognised by its characteristic odour, as well as by its effects upon moistenedturmericpaper. When brought into contact with muriatic acid, it will form dense white vapours, consisting ofmuriate of ammonia. A most elegant and sensible test for ammoniacal gas is afforded by a mixed solution, consisting of arsenious acid and nitrate of silver; these substances when mixed in solution do not occasion the least disturbance in each other, for reasons already explained, (see page240) but upon spreading a portion of the liquid upon glass or paper, and bringing ammoniacal gas into contact, a beautiful yellow cloud immediately diffuses itself over the surface of the solution.
Sub-carbonate of ammoniaoccurs in solid, white, semi-transparent masses, of a highly pungent and ammoniacal odour. Its chemical composition has been found to vary materially according to the circumstances under which it has been prepared;Mr. R. Phillips, who has made some highly interesting experiments upon this subject, considers thesub-carbonateto be asesqui-carbonate, composed of 3 atoms of carbonic acid, 2 atoms of ammonia, and 2 of water. By long exposure to the air, its pungency is lost, and it is converted into an inodorous carbonate.
Cases wherein death has been produced in a few minutes, from the ingestion of liquid ammonia, stand recorded on the authority ofMartinet,Huxham,Haller, and other physiologists. In such cases the lips, tongue, and fauces are described as being burnt by the causticity of the fluid; while hemorrhage of the intestines marks the organic lesions which it occasions.The nervous system would appear also to suffer greatly, at the same time that the abdominal organs are affected with violent inflammation.
Under this division, we have to consider the two earths,LimeandBaryta; both of which are highly corrosive, although they essentially differ from each other in their physiological action. In this respect they may be compared tocorrosive sublimateandarsenic, and offer an additional illustration of the imperfection of the present classification; for whilelimeacts as a local caustic upon the parts with which it comes in contact,barytawill require, for its action, to be absorbed and carried into the current of the circulation.
This earth is of a white colour, and of a hot caustic taste; with acids it forms peculiar salts; a fact which we shall shew affords the most decisive means of identifying its presence. It changes vegetable blues to a green, and reddensturmeric; it is capable of fusion; so great is its affinity for water, that it will absorb and solidify one third of its weight of that fluid, and yet remain perfectly dry. The heat, therefore, that is evolved in the process of slacking lime, evidently proceeds from the water, which yields its caloric, as it passes from the liquid to the solid state.
It is perhaps the least energetic of the corrosive poisons; and yet, when taken in any quantity, it willproduce nausea, vomiting, colics, frequent stools, and all the symptoms which characterise, or are complicated with, inflammation of the stomach and intestines.[332]Lime in combination with carbonic acid is not considered as poisonous.
In examining the body of an animal that has been killed by caustic lime, we shall find the mucous membrane of the stomach reddened, and evincing marks of inflammation in those parts which have been in contact with it.
We may proceed, if the substance be free from mixture, to obtain a solution of the earth in distilled water, and to assay it by the following reagents.
(a)Carbonic acid, and the soluble alkaline sub-carbonatesproduce a copious white precipitate, which is soluble in an excess of carbonic acid. Thecarbonate of lime, of which this precipitate consists, is also decomposed by muriatic acid, with effervescence, a soluble muriate remaining.
(b)Oxalic acid, and oxalate of ammonia.They precipitate lime-water of a white colour, and the resultingoxalateis not soluble in an excess of acid.
(c)Sulphuric acid.This acid does not precipitate lime water, since thesulphate of limeformed does not require more than 300 parts of water to dissolve it. Whereas, saysM. Orfila, the smallest quantity of an exceedingly diluted solution ofbarytabecomes instantly turbid on the addition of that acid, becausethesulphate of barytais insoluble in several thousand times its weight of water. By this test, therefore, we are at once enabled to distinguish lime-water, from barytic water.
Baryta, like lime, is a solid, heavy, alkaline earth, having an acrid and peculiar taste; and turning the syrup of violetsgreen, and the juice of turmericred. When perfectly calcined, it absorbs water very rapidly, disengaging at the same time a quantity of caloric; the phenomenon is similar to that ofslacking lime, and admits of the same explanation. It dissolves in about 20 parts of water, at the temperature of 60°; but boiling water will dissolve half its weight of this earth, part of which will crystallize on cooling.
Muriate of Baryta.This salt crystallises in square plates, or four-sided prisms; its taste is acrid and pungent. It dissolves in 2½ parts of distilled water at 60°Fah.The solution is limpid and colourless, and has been employed in medicine, as a remedy in scrofula, cancer, some forms of syphilis, and in hectic fever connected with ulceration.Dr. Johnstonesays that he has seen a delicate female take as much as thirty drops of a saturated solution of this salt,repeatedly, without nausea; whence he concludes that it would require at least 2 or 3 drachms to do mischief.[333]
All the soluble compounds of this earth are poisonous, especially themuriate; which, whether injectedinto the veins, introduced into the stomach, or externally applied to an abraded surface, will occasion death in a very short period. We are not aware that any case stands recorded of poisoning by baryta.Orfila[334]andBrodie[335]have, however, investigated the symptoms which this poison produces on animals, and they appear to be analogous to those occasioned by the ingestion of arsenic. The muriate, on account of its greater solubility, would appear to be much more active than the pure earth, or its carbonate.
Barytic poisons require to be absorbed before they act on the system; they may therefore destroy by external application, although it would appear that, unlike arsenic, they act sooner when internally administered.Mr. Brodiethinks that themuriate of barytaoccasions death by acting upon the brain and the heart; at the same time it exerts a local action, and corrodes the viscus with which it comes into contact.
It has been shewn by the experiments ofOrfila, that the soluble sulphates, asGlauberorEpsom salts, by converting thebarytainto an insolublesulphate, will act as antidotes to its virulence. In the first instance, therefore, it will be prudent to produce this chemical decomposition in the poison, and then to expel it, as quickly as possible, by emetics.
Chemical tests for the detection of Baryta.
Where the pure earth,baryta, or its solution in water, is presented for our investigation, it may be identified by the following reagents.
(a)Sulphuric acid, and the soluble sulphates.These bodies precipitate from the barytic solution, a whitesulphateof the earth, insoluble in water, and nitric acid.
(b)Carbonic acid gas, and the alkaline sub-carbonates, produce in it a whitecarbonate of baryta.
(c)Muriatic acidcombines with baryta, and furnishes a salt which is capable of being identified by numerous reagents.M. Orfilahas furnished us with the following satisfactory compendium of its habitudes. “A salt which does not redden the tincture of tournesol, which does not turn the syrup of violets green, which is not precipitated by the alkaline hydro-sulphurets,[336]nor by ammonia; but which, on the contrary, is precipitated by the sub-carbonate of ammonia, soda, or potass; which is not soluble in concentrated alcohol; which furnishes, with the sulphate of potass, or the sulphuric acid, a white precipitate insoluble in water and in the nitric acid, and which gives with the nitrate of silver a curdled precipitate of muriate of silver, likewise insoluble in the nitric acid,can be no other than the muriate of baryta.”
But it may happen, that the above salt is so mixed with alimentary matter, as to defy the action of the tests; in this case we must endeavour to obtain from it the pure earth, by precipitating the suspected fluidsby the sub-carbonate of ammonia; when acarbonate of barytawill fall down, which must be dried on a filter, and calcined with charcoal.
Cantharides are imported into this country in their entire state, and are so kept in the shops; their form and general appearance are too well known to require description, and they will rarely become the objects of inquiry; in powder, however, they may be presented to us for investigation, and it is therefore essential that the forensic physician should be acquainted with the appearances which they assume in the state of disintegration. This powder has a greenish colour, tinged with grey, and abounding with shining points of a very beautiful green colour, and which may be recognised in whatever state of division the powder may exist, even after it has passed through a silken sieve. Its odour is acrid and nauseous; when thrown on burning coals it emits that peculiar smell, which generally attends the destruction of animal matter by heat. The chemical history ofcantharidesis still involved in some obscurity; according toRobiquet, who has furnished us with the most satisfactory analysis, they contain various fatty principles; the phosphates of lime, and magnesia; and the acetic and uric acids; together with a peculiar crystalline principle, in which the vesicatory properties wholly reside, and to which the name ofcantharidinhas been given byDr. Thomson.[338]It may be obtained in plates, having a micaceous lustre; when perfectly pure it is insoluble in water, but it is rendered soluble in that fluid, by the presence of a yellow matter which exists in native combination with it; it is very soluble in oils.
As this substance forms an article of the materia medica it may become an accidental source of poisoning; whilst a general belief in its aphrodisiac powers may induce a trial of its efficacy, to goad the exertions of exhausted nature, or to incense the passion of females, whose seduction is meditated. In the annals of crime in this country, we are acquainted with but few instances in which cantharides have been given with the view of destroying life; we have already referred[339]to the case ofVaux, who was executed for poisoning with cantharides; there is also that ofSir Thomas Overbury, who, on the confession of the person who gave it to him, is said to have taken it, mixed with his sauces. Cantharides may be administered in the form of powder, infusion, or tincture. The following may be considered the more prominent symptoms which will follow the ingestion of a large dose. Violent retching; copious alvine evacuations, frequently bloody; very severe colics; active inflammation of the stomach and intestines; sometimes universal convulsions, attended with a horror of liquids, resembling that which occurs in hydrophobia; furiousdelirium, &c. But the affections of the urinary passages, and organs of generation, may be regarded, κατεξοχην, as the peculiar symptoms of poisoning by cantharides; such as heat in the bladder, bloody micturition; horrible strangury; painful and obstinate priapism;satyriasis, &c. If the dose has not been sufficient to occasion speedy death, it may produce marasmus.
Where the poison has been administered internally, we shall find the stomach and intestines presenting an appearance of inflammation, very similar to that which we have described as the general result of corrosive poisons. Marks of inflammatory action, and sometimes ulceration, will be also discovered in the urinary and genital organs; especially in those cases where the person dies shortly after the ingestion of the poison.
Where the poison has been administered in substance, we shall generally discover some of its particles mixed with the ejected matter; or, after death, adhering to the coats of the stomach, or to the folds of the intestines, and which may be easily identified by their peculiar green and brilliant hue. If the poison should have been administered in the form of infusion, or tincture, our chemical resources will fail us, and we must rely alone upon the evidence furnished by the symptoms, and organic lesions.
Phosphorus.
This singular substance was accidentally discovered byBrandt, a chemist of Hamburgh, in the year 1669,[340]as he was attempting to extract from human urine a liquid capable of converting silver into gold. It was also subsequently discovered byKunkeland byBoyle, without these latter chemists having, in any way, participated in the researches of each other.
Phosphorus, when pure, is semi-transparent and of a yellowish colour; but when kept some time in water, it becomes opaque externally, and then has a great resemblance to white wax. Its consistence is nearly that of wax; it may be cut with a knife. Its mean specific gravity is 1·770. It generally occurs in sticks. When exposed to the air, provided the temperature be not lower than 43°, it emits a white smoke, which has the smell of garlic, and is luminous in the dark. This smoke is more abundant, the higher the temperature is, and is occasioned by the gradual combustion of the phosphorus. When heated to 148° it takes fire, and burns with a very bright flame, and gives out a great quantity of white smoke, which is phosphoric acid. Oils dissolve phosphorus, provided the temperature be a little raised. Water has no effect upon it, unless it be aerated, when it renders the surface of the phosphorus opaque and white, which in a short time becomes red. This change depends upon oxidation.
This substance, whether introduced into the stomach in its pure form, or dissolved in oil, will occasionthe most violent symptoms, from its escharotic action,[341]It has been employed in medicine,[342]in a state of minute division, in the dose of one-fourth of a grain, and is said byLeroito be very efficacious in restoring and establishing the force[343]of young persons exhausted by sensual indulgence, and of even prolonging the life of the aged.[344]It has also been given as a stimulant in local fevers. We are, however, greatly inclined to question the safety of such a practice, notwithstanding the diminutiveness of the dose. The reader will find some interesting cases of poisoning by phosphorus, translated from the German work ofWeickard, inHooper’sMedical Dictionary, under the consideration of that article. Should such a case present itself for the investigation of the forensic physician, he will not find any difficulty in identifying the substance; its external character, its smell, and, above all, its peculiar property of yielding luminous vapour, are too palpable and distinctive, to admit the possibility of error.
We have already examined the pretensions of these bodies to the rank of corrosive poisons, (page145) and we should have not reverted to the subject, but from a wish to introduce the account of “a case ofSchirrus in the intestines, arising from hairs remaining in the canal,” as related in theEdinburgh Medical Journal,[345]byDr. Burrell, and which had, on the former occasion, escaped our notice. The subject of this history,Laurence Harding, æt. 35, being a private soldier, was admitted into the regimental hospital, for an unrelenting constipation of the bowels; but it appears also that he had been affected with dyspeptic symptoms, and pain in his abdomen, for several years; which pain was aggravated by the ingestion of solid food. He received but little benefit from the remedies that were administered, his strength gradually declined, and, about a month after his admission, he expired.
“On laying open the abdomen, the stomach was found much thickened throughout its whole substance, and the pylorus very much contracted, which contraction continued down the duodenum. Through all the intestines this thickening and gristly appearance was observed. The colon was prodigiously enlarged in its calibre, until where it forms its sigmoid flexure; at which point there were three distinct holes ulcerated through the coats of the intestine, and forming a communication with the abdominal cavity. Beyond the sigmoid flexure the intestine was contracted in its diameter, so as hardly to admit the little finger to pass downwards. On cutting open the pylorus and small intestines, the internal coats were found to be covered with a soft substance, which resembled size. The internal coats of the colon were of a dark colour, and in general were completely ulcerated, and hanging in shreds. The colour of the colon was of a dark lurid red. At the sigmoid flexurethere was much contraction, and the thickening was so great on one side, and the valve found so considerable, as hardly to admit a common bougie through it. The portion forming the sigmoid flexure was cut out; and on laying it open, and removing some hardened fæces,five or six hog’s brittles were seen distinctly crossing each other in different directions; they were partially invested in the villous coat, which had grown over them, and which had retained them in the different positions in which they were placed; and so firmly were they kept down by those partial coverings, that it required some force to draw them out. The mesenteric glands were of a cartilaginous appearance; the liver was suffused with blood, and the gall-bladder full of bile. The spleen was very small, and compressed into an oblong shape, probably arising from the pressure of the colon when distended with feculent matter.
This man had formerly been a shoemaker. There was no evidence as to the period at which he swallowed these hairs; but, from the derangement which always existed in the bowels, and the pain referred to the sigmoid flexure, little doubt can be entertained but that these hairs were the cause of all his complaints, and ultimately of his death.”
This metal appears to have been known in the earliest ages; and is mentioned several times byMoses.[346]It has a bluish-white colour; is very brilliant when first cut with a knife, but soon tarnishes byexposure to air; when rubbed violently, it emits a peculiar smell; it is malleable and ductile, but possesses very little tenacity. It is scarcely sonorous; being the softest of all the metals, it yields readily to the hammer. Its specific gravity is 11·35; it melts at 612°. According to the experiments ofDr. Thomson,[347]it is susceptible of four degrees of oxidation, presenting us with four distinct, and well defined oxides, viz.
Lead, in its metallic state, does not exert any action on the living system; but, when oxidized, or in the state of salt, its virulence is very considerable, producing a train of symptoms, so peculiar to itself, as to justify our placing its preparations in a separate class, under the title ofastringentpoisons, as explained at page202.
Metallic lead, althoughper seinert, may occasion deleterious effects when introduced into the stomach, in consequence of its meeting with acids in theprimæ viæ; from the same cause, liquids which are liable to become in any degree acidulous, if kept in leaden vessels, may be productive of much danger to those who drink them. Pure water, provided the air be excluded, does not appear to exert any sensible action upon this metal; but the combined influence of these agents converts the lead into a carbonate: a fact which is at once exemplified by the white line which is so constantly visible at the surface of the water preservedin leaden vessels. So well acquainted were the ancients with this fact, that we find frequent allusions in their works to the dangerous property of leaden utensils.Vitruvius[348]published a very strong remonstrance against leaden pipes, when used for the purpose of conveying water; andGalencautions us continually, not to employ water that has flowed through pipes of this metal; since he had observed that thesedimentof such water, (υποσταθμη του τουιουτου υδατος) rendered such as swallowed it, δυσεντερικους, subject to disorders in the intestines.
Dr. Lambe, to whom we are indebted for an important work[349]upon this subject, states, that there is a great diversity in the corrosive powers of different waters; in some places the use of leaden pumps has been in part discontinued, from the expense entailed upon the proprietors by the perpetual want of repair;[350]and if any acidity be communicated to the water, from the accidental intrusion of decayed leaves or other vegetable matter, its power of dissolving this metal will be increased to a very dangerous extent. The noted colic of Amsterdam is said byTronchin, who has written a history of the epidemic, to have been occasioned by leaves falling and putrefying inleaden cisterns, filled with rain water.Van Swieten[351]has also related an instance of a whole family who were afflicted with colic from a similar cause; andDr. Lambe[352]entertains no doubt but that the very striking case recorded in the Medical Commentaries,[353]proceeded more from some foulness in the cistern than from the solvent power of the water; in this instance, the officers of a packet vessel used water out of a leaden cistern; the men also drank the same water, except that the latter had been kept in wood; the consequence was, that all the officers were seized with colic, while the men remained healthy.Sir George Bakerhas furnished the following striking illustration of the subject. “The most remarkable case that now occurs to my memory, is that ofLord Ashburnham’sfamily, in Sussex; to which, spring water was supplied from a considerable distance in leaden pipes. In consequence, his lordship’s servants were every year tormented with colic, and some of them died. An eminent physician of Battle, who corresponded with me on the subject, sent up some gallons of that water, which were analysed byDr. Higgins, who reported that the water had contained more than the common quantity of carbonic acid; and that he found in it lead in solution, which he attributed to the carbonic acid. In consequence of this representation,Lord Ashburnhamsubstituted wooden for leaden pipes; and from that time his family have experienced no particular complaints in their bowels.”
But the most extensive and dangerous source of poisoning by lead, is the presence of this metal in various wines, and acescent drinks, and meats, andwhich may arise either from accident or design. A knowledge of the different avenues, through which this poison may gain admittance into the human body, is therefore of great importance to the forensic physician, and we shall accordingly proceed to the investigation of the subject.
That certain wines were occasionally liable to produce endemic colics, is a fact which has been long known; although the disease was universally ascribed to a mistaken origin, until the publication of the elaborate researches[354]ofSir George Baker, into the cause of the Devonshire colic; which, like the same disease observed in other countries, was attributed to the acidity of the liquor so abundantly drunk[355]in these districts. This celebrated physician, however, was early led to entertain doubts with respect to the truth of this doctrine: “when I consider,” says he, “that this colic of Devonshire is precisely the same disease as that which is the specific effect of all saturnine preparations, and that there is not the least analogy between the juice of apples and the poison of lead, it seems to me very improbable that two causes, bearing so little relation to one another, should make such similar impressions on the human body.” The investigation of the subject completelyestablished the justness of these views; and no doubt remains, but that the endemic colic, which harrassed the cyder drinkers in Devonshire for some years, was the effect of saturnine impregnation, derived from the lead used in the construction of the apple mills and cyder presses; and in some cases, from the pernicious practice of introducing a leaden weight into the cask, or even racking the cyder into leaden cisterns, where the liquor fretted too much, and was thereby in danger of becoming acetous.Sir G. Bakeralso states that the custom of boiling themustin vessels capped with lead, affords another source of saturnine impregnation; and he informs us that, a few years ago, this very practice produced theDevonshire colicin the county of Kent. Some cyder, which had been made in a gentleman’s family, being thought too sour, was boiled with honey in a brewing vessel, capped with lead. All, who drank this liquor, were seized with this disease; some more, others less violently; one of the servants died very soon in convulsions: several others were cruelly tortured a long time. The master of the family, notwithstanding all the assistance which art could give him, never recovered his health; but died miserably, after having for nearly three years languished under a tedious and incurable malady.Dr. Lambeobserves, that the saturnine colic is not endemial in Devonshire, or the other cyder countries, during the whole year, but is confined to those months when the liquor is still new, crude, and the fermentation incomplete. When the liquor becomes fine, the noxious matter in a great measure separates, and is carried to the bottom of the vessel, as the feculencies subside. Tartar is generated during the vinous fermentation, the acid of which, uniting with the lead, forms a salt, scarcely, ifat all, soluble in water; and hence the purification which the liquor receives. But although this new salt is insoluble in water, it is otherwise in regard to vinegar; for this acid dissolves a small quantity, and forms a triple compound, anaceto-tartrate of lead;[356]and since no cyder, or perhaps wine, is wholly destitute of vinegar, it necessarily follows that if the liquor has been once contaminated during the first stages of fermentation, it is impossible for it ever to become entirely pure, except by processes which would render it unfit for drinking.[357]It has very lately been discovered, thatGallic acidandtanninare capable of combining with lead in solution, and of forming a perfectly insoluble substance, which falls to the bottom of the cask; hence all liquors which have been kept in oak casks, for a certain time, must be freed from lead. This explains a fact with respect to the effect of new rum in the West Indies, of some importance. This spirit, when newly distilled, is found to contain traces of lead, derived from the leaden rims of the coppers, and the leaden worm, used for its condensation; but, by keeping about twelve months in oaken casks, it loses its deleterious properties, and no longer exhibits any traces of this metal.[358]
Another source, from which acescent liquids may contract saturnine impregnation, is afforded by the metallic glazing of earthenware[359]; that for instanceof the commoncream colouredware is composed of an oxide of lead,[360]and is accordingly easily acted upon by vinegar, and saline compounds; jars and pots of this description ought therefore never to be used for preserving pickles, jellies of fruits, marmalade, and similar conserves. For the same reason,Sir George Bakerprotests against the custom of baking fruit tarts in such ware.[361]Stone wareis glazed with muriate of soda, and is therefore not liable to such an objection.[362]
The custom which prevails in some parts of England of keeping milk in leaden vessels, is extremely improper;Dr. Darwin[363]has illustrated this subject by the following case; “A delicate young girl, the daughter of a dairy farmer, who kept his milk in leaden cisterns, used to wipe off the cream from the edges of the lead, and frequently, as she was fond of cream, licked it from her finger. She was seized with the saturnine colic, and semi-paralytic wrists, and sunk from general debility.” We are informed byMr. Parkes,[364]that in Lancashire the dairies are furnished with milk-pans made of lead; and that when he expostulated with some individuals on the danger of this practice, he was told thatleadenmilk pans throw up the cream much better than vessels of any other kind.
There is, saysDr. Darwin, a bad custom in almost all families, and public houses, of washing out their wine bottles by putting a handful of shot corns into them, and by shaking them about forcibly to detach the super-tartrate of potass from their sides; that such a practice may occasionally give origin to serious consequences, will become evident by the relation of the following case.[365]“A gentleman who had never in his life experienced a day’s illness, and who was constantly in the habit of drinking half a bottle of Madeira after his dinner, was taken ill three hours after dinner with a serious pain in the stomach and violent colic, which gradually yielded within twelve hours to the remedies prescribed by his medical attendant. The day following he drank the remainder of the same bottle of wine which was left the precedingday, and within two hours afterwards he was again seized with the most violent pains, head-ache, shiverings, and great pain over the whole body. His apothecary becoming suspicious that the wine he had drunk might be the cause of the disease, ordered the bottle, from which it had been decanted, to be brought to him, with a view that he might examine the dregs, if any were left. The bottle happening to slip out of the hand of the servant, disclosed a row of shot, wedged forcibly into the angular bent-up circumference of it. On examining the beads of shot, they crumbled into dust, the outer crust (defended by a coat of black lead with which the shot is glazed) being alone left unacted on, whilst the remainder of the metal was dissolved. The wine, therefore, had become contaminated withlead, and perhapsarsenic, for in order to form shot the former metal is alloyed with the latter.”[366]
But we have, hitherto, only directed the reader’s attention to the different sources from which wine, and acescent liquors, mayaccidentallyderive saturnine impregnation. We have now to state that such liquors have, in different ages and countries, been fraudulently adulterated with lead. It appears to have been early discovered, that wines which have become morbidly acescent may be corrected by the addition of lead; whence, in those countries where Rhenish, Moselle, and other similar wines are drunk, the saturnine colic has been endemic. The celebrated colic which raged in the province ofPoitou, towards the end of the sixteenth, and in the beginning of the seventeenth century, was evidently the effect of suchadulteration.[367]We find that, in the year 1487, there was aRecessus Imperiipromulgated at Rotenberg; and, in the year 1498, at Friberg; which was enacted, in the year 1500, at Tubingen; and, in the year 1508, at Frankfort; and, in the year 1577, in the same place. By which decrees it was made a capital crime to adulterate wines withlitharge, or to usebismuthin the fumigation of them; it having been, at several periods, represented to the Emperors, that great mischief had accrued from such adulterations; and that they had been the cause of insuperable and mortal diseases. It should seem, that these laws were not carried into strict execution; and, indeed, that in the latter end of the seventeenth century, it was hardly known in Germany that such laws existed. In consequence of which, an epidemic colic arose, which was at length traced to the effects of lead in the wines.[368]A representation of this fact having been made to theDuke of Wirtemberg, it was ordained a capital crime to mix litharge withwine, or even to sell it in the shops, by a decree, bearing date March 10, 1696. But, notwithstanding the severity of this law, we are informed byZeller, that in the year 1705, the same dangerous experiments were repeated in the circle ofZwaabe, with a view to correct the acidity of the weaker wines.Bishop Watson[369]informs us that, in the year 1750, theFarmers generalin France being astonished at the great quantitiesde vin gatéwhich were brought into Paris, in order to be made into vinegar, redoubled their researches to find out the cause of the great increase in that article; for nearly thirty thousand hogsheads had been annually brought in for a few years preceding the year 1750, whereas the quantity annually brought in forty years before, did not exceed 1200 hogsheads. They discovered that several wine merchants, assuming the name of vinegar merchants, bought these sour wines, and afterwards, by means of litharge, rendered them potable, and sold them as genuine wines.[370]Dr. Warren[371]has related the cases of thirty-two persons in theDuke of Newcastle’sfamily, who were residing in Hanover in June, 1752, and were seized with theColica Pictonum, after having used, as their common drink, a small white wine that has been adulterated with lead. Nor has the English vintner been less regardless of the health of his employer. In a popular work on wine making byGraham,[372]which has gone through six editions, and may therefore be supposed to have donesome mischief, we find under the article ofvintner’s secrets, the following receipts.—
“To hinder wine from turning,
“To hinder wine from turning,
“To hinder wine from turning,
“Put a pound of melted lead, in fair water, into a cask, pretty warm, and stop it close.”
“To soften green wine,
“To soften green wine,
“To soften green wine,
“Put in a little vinegar, wherein litharge has been well steeped, and boil some honey to draw out the wax. Strain it through a cloth, and put a quart of it into a tierce: and this will mend it, in summer especially.”
We have already alluded to the presence of lead[373]in thenewrum of the West Indies, as the cause of the disease known in that country by the name of thedry belly-ache; it remains for us to state that the excise officers frequently avail themselves of the peculiar power of thesub-acetate of leadto precipitate colouring matter, in order to remove from seized Holland gin, the colour which it obtains by being long kept in the tubs in which it is smuggled over. A practice which it is said renders the gin liable to gripe.
According to the important experiments ofProust,[374]it appears, that if lead be associated with tin, it will be incapable of furnishing to acids any saturnine impregnation. The following are the interesting conclusions at which this philosopher has arrived, viz.
“That thetinning, which contains even so large a proportion as an equal part of lead, cannot be dangerous; since it is sufficient that the lead should becombined with tin, in order to prevent it from being dissolved, either in lemon juice, or vinegar, the two acids most to be feared. The tin, being more oxidable than the lead, dissolves exclusively in these acids, and prevents the second from being attacked.The lead cannot appropriate to itself an atom of oxygen, but the tin would carry it off in an instant.”
This salt of lead, to whose presence the numerous accidental maladies above enumerated are to be chiefly attributed, occurs in commerce in the form of irregular masses resembling lumps of sugar, being an aggregation of acicular four-sided prisms terminated by dihedral summits; its taste is sweet and astringent. It is soluble in 25 parts of water, hot, or cold; when common spring water, however, is employed for such a purpose, a white precipitate occurs from the presence of a certain proportion ofsulphatesandcarbonates.
When this salt is exposed to the action of heat, it undergoes aqueous fusion, then dries, and at length is decomposed, leaving a globule of metallic lead, mixed with the yellow protoxide, and an acid product of a fetid smell. This decomposition is similar to that which vegetable substances undergo when heated for some time. The quantity of metallic lead, thus obtained, will be more considerable if the salt has been previously mixed with charcoal, and particularly if it be submitted for a long time to the action of a powerful heat. The strong sulphuric acid of commerce, when poured uponsugar of leadin powder, decomposes it with effervescence, and disengages vapours of acetic acid.
This must be considered as an active preparation, and may, when administered in doses of a few drachms, speedily occasion death. At the same time, like other poisons, it may by judicious administration, become a valuable remedy. SeePharmacologia, art.Plumbi Super-acetas.
In consequence of the sweet taste of this salt, children have been induced to swallow it.
This liquor is a saturated solution of thesub-acetate of lead. Spring water, from the salts which it contains, produces with it a very milky and turbid appearance; and even whendistilled, in consequence of the carbonic acid diffused through it, it will occasion precipitation. It is principally used as an external application to diminish inflammation, an effect which it probably produces by paralysing the nerves of the part. Cases have occurred where this lotion has been accidentally swallowed, and the usual symptoms of saturnine poisoning have supervened. How far its external application may be capable of occasioning mischief, will form a subject of inquiry under the consideration of the physiological action of the preparations of lead.
The substance, known in commercial language by the name ofWhite Lead, has received at different times, very various appellations, in consequence of the fluctuating opinions which have prevailed respecting its composition. Thus it has been successively styled asub-acetate, anoxide, and asub-carbonate;of which the last is unquestionably the correct name. In the large way it is prepared by exposing sheets of metallic lead to the fumes of vinegar. The sub-carbonate so produced appears as a white, brittle, and scaly substance, on the surface of the lead; which is scraped off, and afterwards ground in mills fitted for the purpose. Formerly, it was ground dry, and the workmen suffered severely from the operation; it is now ground in water, and the sub-carbonate is afterwards dried in earthen pans placed in stoves, heated by means of flues; still, however, persons employed in grinding white lead, as well as painters[375]who are constantly using it, occasionally suffer severely, from the want of cleanliness in not washing their hands before eating, by which some of the white lead is introduced into the stomach with their food.
This is a yellow protoxide of lead, which has been melted, and left to crystallize by cooling. It is in the form of small reddish, or yellowish scales, which are brilliant and vitrified. Its character is so peculiar that it cannot easily be mistaken. It is employed for various purposes in the arts, and is the saturnine preparation more usually selected for the purpose of removing acidity from wines, as above related.
When treated with a muriatic salt, and submitted to a high temperature, amuriate of leadis produced, of a bright yellow colour, the brilliancy of which may be much heightened by grinding it as usual with oil. In this state it forms the pigment known by the nameofTurner’s yellow, orpatent yellow.[376]It is very poisonous.
This red oxide of lead is easily distinguished by its colour, weight, and the facility with which it yields metallic lead, when heated with carbonaceous matter. Common red wafers, which derive their colour from this oxide, afford a striking illustration of this fact, for if burnt in a candle, globules of metallic lead will be observed to flow from them. It is poisonous; and we have already alluded to a case where Gloucester cheese[377]occasioned deleterious effects, in consequence of its adulteration withred lead. (p.277) It is destructive also to inferior animals, apparently in very small quantities; red wafers prove poisonous to birds who may pick them up; and the same paste is sold for the purpose of destroying beetles, in which it succeeds very effectually. Since it is employed as a pigment, it may on many occasions prove an accidental cause of poisoning; there is indeed one very common and dangerous source, mentioned bySir George Baker,[378]which deserves to be particularized in this place, viz. the practice of painting toys withred lead, and other poisonous substances; children, observes this distinguished physician, are apt to carry every object which gives them delight to their mouths, the painting of toys, therefore, with poisonous colours,is a practice which ought to be abolished, and is the more open to censure, as it is of no real utility.
The effects of this poison will vary considerably according to the quantity swallowed, and the circumstances under which it is taken. We shall, therefore, first consider its operation, in doses sufficiently large to occasion at once violent effects; and then describe its agency as anaccumulativepoison, where it is introduced into the system gradually, and in small quantities, so as to act slowly and imperceptibly, and to lay the foundation of irreparable mischief, before any alarm is occasioned.
1.Symptoms which follow a large dose.Where a salt of lead has been taken in a considerable dose, the patient soon experiences excruciating pains in the abdomen, accompanied with sickness and vomiting; the colic increases to a violent degree, but admits of temporary alleviation by pressure, a circumstance which at once distinguishes it from the effects of corrosive poison. Although it is necessary to observe, that inflammatory symptoms may afterwards occur, where the dose has been very considerable, and the consequences direct and speedy.
The patient describes the pain as if produced by a boring instrument, and the abdominal muscles become knotted, and sometimes painfully retracted with all the contents of the abdomen towards the spine.[379]The sphincter muscles of the bladder and anus arealways affected; sometimes strangury and tenesmus are the consequences; at other times, a total incapacity of making any water at all, and so great a contraction of the sphincter ani that a clyster can hardly be introduced. After suffering these torments for a period of an indefinite duration, delirium and cold sweats may supervene, and the patient die in convulsions. If, however, the treatment has been prompt and judicious, and the quantity of poison has not been excessive, he may recover from its immediate effects, and live to testify the severity of the consecutive phenomena. A most inveterate constipation of the bowels will continue for a considerable period, and there will be an occasional recurrence of colic; at length a peculiar species of palsy will supervene in the upper extremities, especially affecting the muscles of the fore arm, and wrist,[380]Citoishas given us a striking description of this stage of the saturnine disease. “Per vicos, veluti larvæ, aut arte progredientes statuæ, pallidi, squalidi, macilenti conspiciuntur, manibus incurvis et suo pondere pendulis, nec nisi arte ad os et cæteras supernas partes sublatis, ac pedibus non suis, sed crurum muculis, ad ridiculum, ni miserandum, incessum compositis, voce clangosa et strepera.” It does not appear that the train of symptoms above described has ever been excited by any other external cause than the one here assigned. Whenever we meet with colic, attended with paralytic symptoms of the extremities, we may at once conclude that it has arisen from the influence of lead.
The disease has been described by authors underthe name of thecolic of Poitou,[381]orcolica Pictonum,[382]from the circumstance of its having raged with such epidemic fury in that province, in consequence of the adulteration of its wines with lead. It is also mentioned as the painter’s colic, since this class of artists is very commonly visited by the disease, in consequence of thewhite leadcontained in their pigments. At the Lead Hills, it is known to the miners, under the provincial name ofmilreek; and in Derbyshire, under that ofbelland.[383]
The effects produced upon various artists by the imperceptible operation of lead, sufficiently shew the power which this metal possesses of accumulating in the human system, and it is probable, saysSir George Baker, that from an observation of such slow, but certain effects of lead, the French and Italians derived the hint of preparing their celebrated poisons, called “Poudres de Succession;”[384]the basis of which has been supposed to have been some preparation of that mineral.Zellermentions a certain chemical operator, near the confines of Bohemia, who, after having diligently applied himself to the composition of poisons, did, by means of lead, combined with some more volatile and corrosive substance, prepare a most slow poison, which given to dogs andother animals, had the power of destroying them, without producing any violent symptoms, after several weeks, or even months.[385]
The following-curious case,[386]communicated byDr. Wall, of Worcester toSir George Baker, will serve to illustrate the present subject, and to shew that lead may gain admittance into the human body, unobserved, and even unsuspected. “A gentleman of Worcester was the father of a numerous offspring, having had one and twenty children, of whom eight died young, and thirteen survived their parents. During their infancy, and indeed until they had quitted the place of their usual residence, they were all remarkably unhealthy; being particularly subject to disorders of the stomach and bowels. The father, during many years, was paralytic; the mother, for as long a time, subject to colics and bilious obstructions. She died at last of an obstinate jaundice. This disease had been several times removed by the use of the Bath water; but it always came on again soon after her return to Worcester; and at last eluded every method and medicine which was tried. After the death of these parents, the family sold the house which they had so long inhabited. The purchaser found it necessary to repair the pump. This was made of lead; and, upon examination, was found to be so corroded, that several perforations were observed in the cylinder, in which the bucket plays; and the cistern in the upper part was reduced to the thinness of common brown paper, and was full of holes like a sieve. The waters of this town are remarkablyhard. It is then more than probable that the water of this pump, thus impregnated with lead, occasioned the unhealthiness of the family who drank it. I have been just informed by the plumber,” addsDr. Wall, “that he had several times repaired the pump in question; and that he had done so not more than three or four years before the gentleman’s death; when he found it nearly in the same state as it has been described; so that the corrosion was effected in a short time; and consequently the water must have been very strongly impregnated with the noxious quality of the metal.”
The reports of the dissection of those who have been destroyed by saturnine poisons are far from being satisfactory. Where the person has died from the primary effects of a large dose of the acetate of lead, the stomach has betrayed a state of inflammation, similar to that which results from the action of a corrosive poison; black points and spots, from venous extravasation, have been also observed in the interior of this viscus;M. Orfilastates that he has seen in the stomach of animals who have taken a large dose of the acetate of lead, and have not vomited, a membraneous lining tolerably thick, of an ash colour, easily detaching in small pieces; the origin of which appeared to be owing to the decomposition of a part of the acetate of lead by the mucous, bilious, and other fluids, contained in this viscus. The mucous membrane lying under this lining, was of a dark grey colour throughout its whole thickness, and appeared to have exercised the same action on the acetate of lead. The case is very different in those who havedied from the slow action of this metal; all anatomists agree in reporting, that in thecolica pictonum, the digestive canal exhibits no vestige of inflammation;[387]but the diameter of the large intestines, especially that of the colon, is generally contracted; thus displaying the effects of that operation, which is supposed to be characteristic of the compounds of lead, and which has bestowed upon them the peculiar designation ofastringentpoisons.Foderéstates that the mesentery and its glands; and the lacteal and lymphatic vessels, are inflamed and obstructed, and the thoracic duct almost obliterated; the liver, spleen, pancreas, and lungs often inflamed, tumefied and purulent, and even the heart shrivelled;[388]and the whole body, in consequence of the constriction of the chyliferous vessels, in a state of complete marasmus. Upon this passageOrfilamakes the following observation. “We are under the necessity of declaring, that almost all these signs are wanting in the majority of the cases of simple colic of lead, terminated by death.”Fourcroy, in a note to his translation ofRamazzini, “De Morbis Artificum,” observes that the intestines have, in these cases, been discovered distended by air, parched, and slightly altered in colour; and that in the larger ones, balls of dry, dark coloured, excrementitious matter, have been found.
The preparations of lead seem to act upon the nervous system, destroying its energy, and thereby producing paralysis. Whether this is effected throughthe medium of the circulation, or whether they produce their effects without being absorbed, appears to us to be a question which has not hitherto received a satisfactory answer. It must, however, be admitted that they act upon the alimentary canal, by coming into contact with its nerves; and in some cases, where the dose of theacetatehas been large, it may have produced death by the local injury which it inflicted.Dr. Lambeobserves upon this subject, that “certain facts render it probable that lead does not operate entirely through the medium of the circulation, nor by nervous sympathy; but also topically, affecting the part to which it is applied more than the other parts of the body.” This latter position is clearly established by the beneficial effects occasioned by the topical application of lead to inflamed surfaces; nor can any doubt exist as to the fact of such applications having produced local paralysis. There is a paper in the third volume of theMedical TransactionsbyDr. Reynolds, in which the case of a gentleman is detailed, who brought on a temporary paralysis of thesphincter ani, by freely usingGoulard’slotion for the cure of piles. Foreign writers have also maintained that saturnine applications have frequently occasioned impotence; for further information upon this subject the reader may refer toIstitutione di Medicina Forens: di Tortosa,vol.1,p.58; alsoFritze Compend: sopra i Malat. Vener.p.189; andMonteggia Annotat. sopra i Mali Venerei,p.36.Sir George Bakerstates that he has some reason to doubt, whetherlitharge, the common basis of our plasters, when used for the purpose of dressing issues, has not, in certain irritable constitutions, produced some of the ordinary effects of saturnine preparations taken internally. There have been instances of childrenthrown into convulsions, bycerusse, sprinkled on excoriated parts.Zellerquotes, on the authority ofMolingius, a remarkable instance of the pernicious effects oflitharge, externally applied.[389]Sir George Bakermet with a most violent and obstinate colic, which seemed to have been occasioned by some litharge, mixed in a cataplasm, and applied to thevagina, with a view to allay a troublesome itching; and he says that he was informed byDr. PetitthatGoulard’s poulticeapplied for some time to a patient’s knee, in St. George’s hospital, occasioned violent pain in the bowels, which did not cease until the poultice had been removed; nor are authorities deficient to prove, that the fashionable application ofcerusseto the skin has been followed by obstinate colics, pains, and tremors. We have been desirous of laying before our readers the above authorities, in proof of the constitutional effects which may be occasionally produced by the external application of lead, since the fact has been questioned, and is still considered by many as involved in doubt and uncertainty.Dr. Lambeis inclined to believe, that “to the production of the saturnine colic, it is necessary that the metal should be appliedimmediatelyto the stomach and intestines.” If this hypothesis be just, he excludes nervous sympathy, as well as absorption, as a proximate cause of saturnine colic; and, consequently, no dependence can be placed on the accounts given by the above pathologists with regard to the productionof such an effect by lotions and cataplasms of lead.
These will necessarily vary according to the different states of combination in which it may be supposed to exist; we shall, therefore, proceed to consider the modes of establishing its presence, 1, In solution inwater;wine;spirit; andoils. 2. In a state of mixture withvarious solids. 3. Combined withsolid or liquid aliments.
1.The lead exists in some unknown state of combination in solution in water.We are greatly indebted toDr. Lambe[390]for the able directions which he has afforded us for ascertaining the presence of minute portions of lead in water; and we recommend the practitioner, who may be engaged in such an investigation, to peruse his work with attention. The following are the reagents through which our analysis must be conducted.
(a)Sulphuretted hydrogen.A solution of this gas in distilled water is a very delicate test for lead, throwing down a precipitate of a very dark brown colour, approaching to black. The competency, however, of this test to the discovery of very minute quantities of lead, in certain states of combination, has been questioned byDr. Lambe; who was enabled to detect the presence of this metal, by other methods, in water that manifested no indication withsulphuretted hydrogen. He detected it, for instance, in the precipitate occasioned in such water by thecarbonate of potass or soda. In operating on these waters, he noticed the following appearances.
1.The precipitate, produced as above stated, when re-dissolved in nitric acid, formed a dark cloud with sulphuretted hydrogen.
2.Although the sulphuretted hydrogen formed no cloud, the precipitate itself became darkened by it.
3.The precipitate re-dissolved in nitric acid, (as in 1)formed, with sulphuretted hydrogen, a white cloud.
4.Sulphuretted hydrogen neither formed a cloud, nor darkened the precipitate.
5.In the cases 2, 3, 4, if the precipitate be heated to redness, in contact with an alkaline carbonate; and after dissolving out the carbonate, it be redissolved in nitric acid; then sulphuretted hydrogen will form a dark cloud with the solution.In these experiments it is necessary that the acid used to redissolve the precipitate be not in excess; if it should so happen, the excess must be saturated, before the test is applied. It is better to use so little, that some precipitate may remain undissolved. The nitric acid, used in these experiments, should be perfectly pure; and the sulphuretted hydrogen test should be recently prepared by saturating distilled water with the gas.
(b)Sulphate of soda, or potass.This test will produce a white precipitate in water, containing one hundred-thousandth of its weight of lead; and is considered byDr. Thomsonas the most unequivocal reagentof that metal which we possess. “The precipitate is a fine dense powder, which speedily falls to the bottom, and is not re-dissolved by nitric acid; no other precipitate can be confounded with it, exceptsulphate of baryta, and there is no chance of the presence of baryta in solution in water.”[391]
(c)Muriate of soda.One of the methods of analysis proposed byDr. Lambe, consists in precipitating the lead by common salt; but as themuriate of leadis partly soluble in water, this test cannot be applied to small portions of suspected water. The precipitate must, therefore, be collected from two or three gallons, and heated to redness with twice its weight of carbonate of soda. The alkaline carbonate is then to be dissolved out, and nitric acid added, in order to saturate any superfluity; thesulphuretted hydrogentest will then produce its indication.
(d)Reduction of the metal.This is undoubtedly the most satisfactory of all the tests; and, except the trouble of collecting a large quantity of precipitate, is not embarrassed with any difficulty. The precipitate may be mixed with its own weight of alkaline carbonate, and exposed either with, or without, the addition of a small proportion of charcoal, to a heat sufficient to melt the alkali. On breaking the crucible, a small globule of lead will be found reduced at the bottom. The precipitate from about fifty gallons of water yieldedDr. Lambeabout two grains of lead.
2.The lead is dissolved in wine.For the detection of this dangerous fraud, the reagent invented byDr. Hahnemannaffords a ready and convenient test. It consists of water saturated with sulphuretted hydrogengas, and acidulated with muriatic acid;[392]this latter ingredient is added for the purpose of preventing the precipitation of any iron, which the wine might accidentally contain. This liquor will, if added in the proportion of one part to two of wine, produce with the smallest quantity of lead, a dark coloured, or black precipitate; which, if collected, dried, and fused before the blow-pipe on a piece of charcoal, will yield a globule of metallic lead. Or we may modify the experiment by passing a current of sulphuretted hydrogen gas through the wine, having previously acidulated it with muriatic acid, to prevent the precipitation of the iron.