Oxalic Acid(Acid of Sugar).—This is one of the most important poisons with which we have to deal. From its cheapness and well-known properties it is frequently made use of in cases of suicide, while from its resemblance to Epsom salts it has on several occasions been taken in mistake for that medicine. The smallest dose which is known to have proved fatal is one drachm, which killed a boy æt. sixteen in eight hours. Taylor relates the case of a woman, aged twenty-eight, who was found dead one hour after swallowing three drachms of the crystallized acid. Christison mentions an instance in which one ounce destroyed life in ten minutes, and another case where the same quantity killed a girl in thirty minutes. One example has been recorded where a fatal result ensued probably within three minutes of the acid being swallowed.
The poisonous properties of theBinoxalate of Potash(Salt of Sorrel, Essential Salt of Lemons) are due to the oxalic acid it contains. This salt, which exists in the leaves of the wood sorrel (Oxalis acetosella), is sold to bleach straw, remove ink-stains, &c. It is very cheap; is almost as powerful as oxalic acid itself, and gives rise to the same kind of symptoms; it has been taken for the purpose of suicide, as well as in mistake for the bitartrate of potash, or cream of tartar.
Oxalate of lime exists in considerable quantity in the leaves and stalks of the common edible rhubarb (Rheum Rhaponticum). It can hardly be considered poisonous.
Symptoms.—The effects of poisoning by oxalic acid are peculiar. When the dose is large (half an ounce or more) and the solution concentrated, it proves very rapidly fatal. It produces a hot burning sensation in the fauces and œsophagus in the act of swallowing, severe burning pain in the stomach, and in most instances immediate vomiting. The vomited matters are strongly acid, of a dirty green or black color, and consist of the contents of the stomach with altered mucus and blood. The remaining symptoms are a sense of constriction or suffocation, lividity of the countenance, great prostration of strength, feeble pulse, cold clammy perspirations, and convulsions, which speedily terminate in death. When a smaller quantity has been taken, much diluted, its corrosive properties are weakened or destroyed, but the nervous symptoms, as cramps and numbness, may be well marked.
In cases of recovery the mouth may remain sore for some time, the tongue swollen, the abdomen tender, the stomach very irritable, and there may be troublesome diarrhœa. In two instances there has been loss of voice for several days, owing to the action of the poison on the nervous system. Twitching of the muscles of the face and extremities has also been observed.
Post-mortem Appearances.—The mucous membrane of the fauces, œsophagus, and stomach is generally white and brittle, but often colored with the brown mucous matter discharged. The stomach often contains a black fluid, like coffee-grounds, consisting principally of altered blood; and its sub-mucous coats are vascular and dark colored. The stomach though seldom perforated, may yet be so softened as to be with difficulty removed entire, and sometimes this is not possible. This softening may be due to the post-mortem action of the poison; but its effects during life in softening and bleaching the mucous membrane are sufficiently marked. Occasionally the stomach is black and gangrenous looking. If death has occurred quickly, the small intestines are seldom much affected; but where the symptoms have been protracted there are usually signs of congestion and inflammation.
Treatment.—Chalk, whiting, or magnesia, suspended in water, or in some demulcent fluid, must be administered immediately; and if necessary, vomiting should be excited by tickling the fauces, or administering emetics of sulphate of zinc and ipecacuan, followed by large quantities of emollient drinks. The antidote, to be effective, must be given as soon as possible, the plaster of the apartment, or any form of mortar being used in the absence of the remedies just mentioned. Alkalies (soda, potash, or their carbonates) are not only useless, but they form salts with oxalic acid, which are as injurious as the acid itself. When there are symptoms of collapse, stimulants are to be freely employed.
From the tendency to softening, the stomach-pump should not be used.
Tests.—Crystals of oxalic acid are met with as four-sided prisms, colorless, without odor permanent in the air, and very acid; this last character distinguishing them from crystals of sulphate of magnesia and sulphate of zinc. The crystals, when heated, melt, and are dissipated without combustion, and leaving no residue. This character is important as a means of distinguishing oxalic acid from other similar crystals. They are soluble in from eight to twelve parts of cold water. This acid may be thus recognised in solution:
1.Nitrate of silverthrows down, with oxalic acid,an abundant white precipitate (oxalate of silver), which is soluble in nitric acid. The oxalate of silver, when dried and heated on platinum foil, detonates, and is dissipated in a white vapor.
2.Sulphate of calciumcauses a white precipitate with oxalic acid (oxalate of calcium) which is soluble in nitric or hydrochloric, but not in any vegetable acid.
The solution containing the acid should be concentrated before testing, if it be not present in considerable quantity.
Lime water and all soluble lime salts throw down precipitates with oxalic acid; but as these are liable to be mistaken for a precipitate with sulphuric acid, it is better to use sulphate of calcium which is slightly soluble, as the test agent. A good deal of the test solution must be used, and the precipitate takes time to settle.
3.Sulphate of coppergives a faint bluish precipitate with oxalic acid (oxalate of copper), which is not redissolved by a few drops of hydrochloric acid.
These tests will not act if the solution contain nitric acid in excess, in which case the liquid must be evaporated to crystallization, and the crystals washed and redissolved in water.
These tests for oxalic acid should never be applied without previously separating it from all organic matter. This is best done by first of all acidulating the suspected fluid with acetic acid, and then adding acetate of lead, which combines with the oxalic acid to form a white insoluble salt, which may ordinarily be removed by filtration or subsidence. This filtrate, after being well washed, is to be diffused in water, and into this a current of sulphuretted hydrogen gas is to be passed for some considerable time. This will throw down the leadas sulphide, leaving the oxalic acid in the fluid; any organic matter will also be carried down. Filtration will separate the solids from the liquid containing the acid, which may now be evaporated until crystals are formed, which may be tested in the usual way.
Acetic Acid.—Although this acid, in its concentrated state, is highly corrosive, yet it is very seldom brought under the notice of the toxicologist.
In the case of a young woman reported by Orfila, death quickly occurred after several attacks of convulsions. At the subsequent post-mortem examination, the integuments of the dependent parts of the body were found very livid; the tongue and œsophagus were of a dirty brown color, the latter being intersected by a fine net-work of capillary vessels; and the interior of the stomach was interspersed with black elevations caused by the presence of coagulated blood in the sub-mucous areolar tissue. The mucous membrane was entire.
As regards thetreatment, it is only necessary to administer draughts containing magnesia or its carbonate, followed by mucilaginous or demulcent drinks.
Tartaric Acid, though not a corrosive, may be here placed along with the other vegetable acids. Strange as it may seem, tartaric acid has destroyed life in at least one instance in this country; an ounce having been given in mistake for an aperient salt. The deceased swallowed the whole at once, and immediately called out that he had been poisoned. He complained of intense pain in the throat and stomach, as if he had swallowed oil of vitriol, or was on fire. Soda and magnesia were administered without avail; and after death, atthe end of nine days’ suffering, the stomach and intestines were found much inflamed.
The second division of the class of Corrosives has now to be considered. It contains the Caustic Alkalies, and some of their Salts. Poisoning by any of these agents is rare.
Potash.—This substance, in its caustic state, as found in commerce, is in the form of grey-colored cakes. It has an acrid taste, is soapy to the touch, and very deliquescent. Moulded in cylinders, it is often employed as a caustic (Potassa fusa). In solution (Liquor potassæ) it is strongly alkaline, and imparts a brown stain to black cloth.
Potassium carbonateorCarbonate of Potash(Pearlash) is extensively used by laundresses and in the dressing of woollen cloth. It is generally sold in a granular condition, white, inodorous, and strongly alkaline; it is soluble in water, but not in alcohol.
Caustic Soda.—This agent resembles potash in its general properties. TheSodium CarbonateorCarbonate of Soda(Soap-lees) bears a similar resemblance to the carbonate of potash, except that it crystallizes easily, and effloresces on exposure to the air.
Ammonia.—When pure, ammonia is a colorless, pungent gas; but it is commonly met with dissolved in water, as the liquor ammoniæ. Itsvapor is poisonous, and may prove fatal by producing inflammation of the larynx and trachea, and even of the lungs. A case is recorded of a French boy, æt. six, who killed his younger sister by making her swallow several teaspoonfuls of a solution of ammonia. Other instances have also occurred where the liquor ammoniæ has either been taken in mistake for the aromatic spirit of ammoniæ, or purposely, to destroy life. An instance is recorded by Dr. Taylor, as occurring in the practice of Mr. Hilton, where liquor ammoniæ, given by mistake, caused corrosion of the throat and gullet and obstruction of the bronchial tubes by false membrane. The œsophagus was completely dissolved at its junction with the stomach, and there was an aperture in the anterior wall of that organ such as might have been caused by oil of vitriol.
TheAmmonium CarbonateorCarbonate of Ammonia(Hartshorn, Smelling Salts) has been used as a poison. It may be distinguished from other salts by its being alkaline, by its entire volatility, and by its pungent odor. A young woman in a state of unconsciousness, was made to swallow a quantity of hartshorn. In an hour there was great pain, sickness, and vomiting of blood. The hæmatemesis continued for some days, and then feebleness and emaciation set in, death occurring in three months. On examination the pylorus was found contracted to the size of a crow-quill, while there was a large cicatrix on the posterior wall of the stomach.
Symptoms.—The chief symptoms occasioned by the foregoing poisons are, an acrid, burning taste, with a sensation of excoriation and burning extending along the mouth and throat, to the stomach. There soon ensue exquisite pain in the epigastrium, and tenderness on pressure. Frequently there is cough, hoarseness, dyspnœa, as well as vomiting of altered mucus mixed with blood and detached portions of the mucous membrane. The tongue, mouth, and fauces become swollen, soft, and flabby, and deglutition is difficult. The surface of the body gets cold and moist, the pulse small and feeble, and there is great pain over the abdomen, with diarrhœa. Death took place, in the case of a boy, in three hours from the time of swallowing a strong solution of carbonate of potash. Ammonia, by its effect on the air passages, has proved fatal in four minutes. When recovery from the immediate effects of the poison has taken place, death has subsequently ensued from stricture of the œsophagus, producing starvation. By the proper use of bougies, &c., life may occasionally be prolonged for many months, or even for years. In some instances, however, it is almost impossible to effect dilatation, owing to the whole of the gullet becoming thickened and contracted, so that the opening into the stomach will hardly admit a crow-quill. The pylorus may also be contracted in like manner.
Post-mortem Appearances.—The mucous membrane of the mouth and gullet is softened and inflamed, and portions of it detached. The coats of the stomach and intestines are inflamed, stained of a dark color, and sometimes ulcerated. When death has resulted from ammonia, signs of inflammation are usually found in the larynx and bronchial tubes. The other caustic alkalies may also destroy life by producing inflammation of the glottis, which consequently may be found thus occluded after death.
Treatment.—The object must be to neutralize the poison, which may be effected by a weak acid. Vinegar and water is perhaps the best antidote,and that most readily procurable; its administration may be followed up by freely allowing acidulated demulcent drinks, orange juice, &c. The use of oil has been recommended, on the principle that it converts the alkali into a soap. But that its efficacy is doubtful has been in some measure shown by the death of two young children from swallowing a mixture of ammonia and oil. In one of these cases nearly two ounces of linimentum ammoniæ (made of one part of liquor ammonia to two of olive oil) were poured down an infant’s throat by a child five years old. Were, however, the oil given in much greater abundance, the result would probably be different. At all events, its administration should not be neglected.
Tests.—The specific character of these substances is their strongly marked alkalinity, ammonia possessing, over and above, that of volatility. Potash is known from soda by being precipitated of a creamy yellow by platinum perchloride, soda remaining unaffected by that reagent.
Potassium NitrateorNitrate of Potash(Nitre,Saltpetre,Salprunelle) is a more dangerous poison than is commonly supposed, provided the dose be large. It has ordinarily been given in mistake for other salts as a purgative, and in one instance, caused death in about two hours, in another such instance, referred to by Orfila, an ounce proved fatal in three hours. It produces symptoms of irritation in the alimentary canal, vomiting, and diarrhœa. There is generally also severe pain at the pit of the stomach, trembling of the limbs, scanty urine, and collapse. Marks of violent inflammation are found after death in the stomach and along the intestinal canal.
Potassium SulphateorSulphate of Potash(Sal Polychrest,Sal de Duobus, &c.) has proved fatal when taken in a large dose. It has caused death in two or three cases when purposely administered to procure abortion. Taylor quotes an instance of a lady, a week after delivery, being directed by her medical attendant to take ten drachms of this salt, in divided doses as a laxative. After the first dose she was seized with severe pain in the stomach, with vomiting, &c., the symptoms increasing after each dose, and proving fatalin two hours. At the post-mortem examination the mucous membrane of the stomach and intestines was seen to be soft and pale, and the stomach contained a quantity of reddish-colored liquid. This, on being analyzed, was found to contain no other irritant but this salt.
Bitartrate of PotassorHydrogen Potassium Tartrate(Cream of Tartar,Argol.)—This salt has caused death in one case at least, in which about an ounce and a half was taken. The symptoms were those of an irritant poison, with paralysis of the lower extremities. Death occurred within forty-eight hours.
Sulphuret of Potassium(Liver of Sulphur) has also caused death as an irritant poison.
Treatment.—As no antidotes are known to these salts the treatment must consist in producing vomiting as speedily as possible by means of emetics; or the stomach-pump may be used. Demulcent drinks should be freely given subsequently, with soothing applications to the bowels. Ice may be given in any quantity.
Limeacts as an irritant poison, though a feeble one, when taken into the stomach or applied to a vital part. One fatal instance is reported, where a boy swallowed some lime in an apple-pie. He died in nine days, after suffering from a burning pain in the abdomen, great thirst, and obstinate constipation. Unslaked or imperfectly slaked lime may also prove fatal by being inhaled, and so giving rise to inflammation of the glottis.
Barium Salts.—Two preparations of barium have caused death, viz., the chloride and the carbonate. These may also give rise to specific nervous symptoms, as cramps and convulsions.
Chloride of Bariumis found crystallized in irregular plates or tables, which are permanent in theair, soluble in water, and of a disagreeable bitter taste. Half an ounce has proved fatal in two hours, after causing symptoms of irritation, with vertigo, paralysis and convulsions.
Carbonate of BarytaorBarium Carbonate, in its native state, occurs in massive radiated crystals, very heavy, and nearly colorless. Artificially prepared, as sold in the shops, it is a fine, tasteless, odorless powder, almost insoluble in hot or cold water. One drachm is said to have destroyed life, but recovery has taken place after a much larger dose.
Treatment.—The sulphate of soda or sulphate of magnesia, or some earthy sulphate, should be speedily administered, by which the poison will be converted into an inert insoluble sulphate of baryta. Emetics should also be given, or the stomach-pump used.
Two preparations ofZINCmust be noticed:
Sulphate of Zinc(White Vitriol,White Copperas.)—This is a very mild irritant, resembling in its appearance Epsom salts and oxalic acid. It is very useful as an emetic in scruple or half-drachm doses, dissolved in any thin fluid.
In one case an ounce was accidentally taken. Great pain in the stomach, vomiting, and prostration, soon set in. Subsequently there wasgastritis, and recovery only occurred after a prolonged convalescence.
Treatment.—Vomiting is to be encouraged by milk or albuminous fluids; after which remedies containing tannin (strong tea, decoction of oak bark, or tincture of Peruvian bark) are to be given.
Chloride of Zinc.—A solution of chloride of zinc forms a valuable disinfectant, but is also a dangerous irritant, or, if sufficiently strong, a corrosive poison. Sir William Burnett’s Fluid consists of gr. xxv of this salt to the drachm of water. It has been taken in mistake for fluid magnesia, pale ale, &c., and has caused death.
Symptoms.—A burning sensation in the mouth and throat is immediately produced. This is followed by nausea, vomiting, and signs of collapse. Death has occurred in less than four hours.
Post-mortem Appearances.—The mucous membrane of the throat and stomach has been found corrugated, hard, and leathery. In the case of a sailor who died from about half a pint of Burnett’s solution, the body was livid, the neck swollen, the cerebral vessels were engorged, and the lungs were congested. The mucous coat of the stomach was of a purple red, and partially corroded, while the pyloric orifice looked as if caustic had been applied to it. There were patches of congestion in different parts of the small intestines.
Treatment.—Albuminous drinks, followed by some preparation of tannin, will be needed.
Tests.—Zinc is distinguished from all other substances by giving a white precipitate with sulphuretted hydrogen. The solution containing it must not be too acid or no precipitate will be formed. Zinc also gives white precipitates with ferrocyanide of potassium and ammonia.
Nitrate of Silver(Lunar Caustic).—This is a powerful irritant, and has proved fatal in at least two instances. The antidote is common salt, which must be given immediately, followed by emetics.
Tin.—The chlorides of tin being employed in dyeing, color-making, &c., may lead to their being used as poisons, or being taken accidentally. Death from their use is rare. They are decomposed by magnesia, which should therefore be freely administered, followed by albuminous and mucilaginous drinks.
Bismuth.—The nitrate or magistery of bismuth has caused death in nine days, after a dose of two drachms. The symptoms were those of a strong irritant, but in all probability were caused by some impurity in the substance. Arsenic is frequently present in this way. As no antidote is known, vomiting must be promoted and emollient drinks freely given.
Chrome.—The bichromate of potassium is found in the form of orange-red crystals, which yield a yellow acid solution. It is used as a dye, and has caused death in more than one instance. Emetics and magnesia or chalk, must be the remedies employed.
It is well to know that this substance is apt to produce troublesome sores on the hands of those engaged in its manufacture. Some slight abrasion begins the lesion, which does not heal, but forms on its surface a tough slough, which separating, leaves a foul ulcer with hard edges, and most untractable, behind it.
Sulphate of Iron(Green Vitriol,Copperas).—Although not a powerful irritant, sulphate of iron has proved fatal when taken in a large dose. It is sometimes given to procure abortion. Theperchloride of ironhas also produced alarming symptoms, after being taken for the same purpose. Dr. Christison relates the case of a man who died in five weeks from an ounce and a half of the tincture. Magnesia and diluents, freely administered, must constitute the treatment.
This division of the class of simple irritants is an important one, on account of the substances composing it consisting in considerable part of ordinary remedies or drugs, which given in over doses, may produce symptoms of poisoning. They chiefly give rise to vomiting and purging.
The most important arealoes,colocynth,jalap,gamboge,scammony,elaterium,croton oil,castor oil seeds, various species ofarum,euphorbium,bryony,mesereon,physic nut, and others less commonly known. Dr. Taylor says that aloes and colocynth are the basis ofMorrison’s pills, which in many instances have induced fatal purging. InHolloway’s pills, aloes is the chief ingredient. A favorite remedy with nurses for promoting the catamenia ishierapicra, a brown powder consisting of four parts of aloes to one of canella bark. This may give rise to dangerous symptoms.
Thesymptomsinduced by these substances are those of irritation of the intestinal canal, severe pain, vomiting, diarrhœa, tenesmus, &c.; followedby collapse, cold sweats, and occasionally convulsions. These effects may also be produced by diseased and decayed vegetables.
Thetreatmentmust be directed to the removal of the injurious substance by emetics, &c., unless spontaneous vomiting has freely taken place, when it need merely be encouraged by the use of diluents. If the irritant has passed out of the stomach into the intestines it must be carried off by purgatives, especially castor oil. The inflammatory symptoms should be cautiously combated, on account of the great prostration usually caused by these poisons. Opiates, emollient enemata, and fomentations to the abdomen will subsequently be found useful.
The substances which require consideration under this head, though few, are important.
Poisonous Fish.—Several kinds of fish are constantly poisonous, while some only act injuriously on particular constitutions. The chief effects are sickness and vomiting, irritation of the eyes, depression, and severe urticaria or nettle-rash. In this country the different varieties of shell-fish are those most frequently injurious, especially cockles, mussels, crabs and such-like.
Poisonous Meat.—The flesh of animals which have died of disease has produced serious symptoms when eaten, and has even destroyed life. Several substances, as sausages, cheese, bacon, &c., also become poisonous from putrefaction.
Thetreatmentin these instances should consist in the use of emetics, purgatives, and diluents. The vital power must be supported by stimulants, tonics, nutritious diet,&c.
The chief are chlorine, sulphurous-acid gas, nitrous-acid gas, and hydrochloric-acid gas. When diluted, they admit of being inhaled; not so when pure.
Chlorine.—This gas has a greenish-yellow color, and a powerful suffocating odor. It is used to fumigate buildings, being a valuable disinfectant. Chlorine is employed by the calico-printer and paper-maker for its bleaching properties. The men who work in an atmosphere slightly impregnated with it suffer from dyspepsia, but are long-lived, and it has been supposed to be actually beneficial to consumptives. Any attempt to inspire chlorine in its concentrated state would at once prove fatal by closing the glottis and causing asphyxia. When diluted it excites excessive irritation of the air-passages, cough, difficulty of breathing, and inflammation.
In poisoning by chlorine, the inhalation of a small quantity of sulphuretted hydrogen appeared to afford relief in a case reported by Christison, but with that, or any other of the irritant gases, our treatment must chiefly consist in the instant removal of the sufferer to pure air. Then the cautious inhalation of ammonia, sulphuric ether, or the vapor of warm water, will be useful.
Sulphurous Acid Gasis one of the products formed by the combustion of ordinary coal. It possesses bleaching and antiseptic properties; and is very irritating when inspired.
Nitrous Acid Gasis a very violent poison when inhaled, producing inflammation of the lungs,&c. It has proved fatal in several instances, when given off by nitric acid.
Hydrochloric Acid Gasis irrespirable in its concentrated state, and when diluted produces great irritation of the lungs and air-passages. This gas, which is a waste product in the manufacture of washing 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.
By Specific Irritant Poisons we mean those which, taken internally, produce local inflammation or irritation, these being of course indicated by certain constitutional 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.
Iodineis 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 potassæ) and mucous membranes, and slowly corrodes these tissues.
Iodine is an active poison, although its effects are variable. Some constitutions 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 potassium (iodide of potassium). 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.
Thesymptomsof 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 quantities 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 canal, 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 testicles or mammæ, as is often asserted.
Thepost-mortem appearanceswould 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.
Thetreatmentshould 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 crystalsof iodide of potassiumare 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. Thetreatmentmust 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 potassium 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.
This substance is sold in a pure state in small wax-like cylinders, which must be preserved underwater. 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.
Thesymptomsof 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 bloody. There is very great prostration, and there may be diarrhœa with bloody stools. These symptoms sometimes abate, and everything seems going on well, when suddenly a new train of symptoms, still moreserious, 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 passages, and the formation of extravasations below the skin. The urine is ordinarily retained or suppressed, what little there is being albuminous 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.
Thepost-mortem appearancesafter 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, bloody or gangrenous patches, blood in the intestines and bladder, and bloody 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 suspectedmaterial is introduced into a retort, and acidulated with sulphuric acid. The stem of the retort is conducted into a glass 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 passes 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 Poisoningby 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.
Arsenicis 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. Arsenic 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 arsenic 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 arsenic,consisting ofarsenious acid, orarsenites, and the so-calledchloride of arsenic, must be added thearseniates of potash and soda; the sulphides of arsenic—as, thered sulphide, orrealgar, and theyellow sulphide, ororpiment; thearsenite of copper, orScheele’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 arsenic, 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 arsenic-eating is something more than a mere fiction. This gentleman gave, and saw a Styrian eat, a piece of arsenious acid, weighing over four grains, and afterwards determined the presence of arsenic in urine passed 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 arsenic found in the possession of the prisoner was used by her as a cosmetic.
Arsenite 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 appetite, 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 alæ of the nose, in the folds of the arm, in the groin and scrotum—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 arsenite 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 arsenite of copper in these fabrics was published in theChemical 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 arsenic be there, the nitrate of silver will be covered with a yellow coating of arseniate of silver, which will disappear on stirring. On igniting arsenical 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 arsenic are produced is by the use of bright green tarlatans as ball dresses. One could hardly conceive a more deadly amusement than dancing in an arsenicated dress, sweeping against an arsenicated wall-paper. When both are lightly adherent the arsenic is scattered in showers about the room.
Arsenious Acid(White Oxide of Arsenic,White Arsenic,Arsenic).—This is the preparation of arsenic 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 arsenic, 185 arising from the use of the arsenious acid, and 1 from orpiment or yellow arsenic.
Since the Act of 1851 (14 Vict. cap. xiii.) the deaths from this agent have greatly decreased. This statute chiefly enacts that arsenic 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.
Arsenious 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 quantity so held in solution may, however, be increased by dissolving the arsenic in boiling water and allowing it to cool. The shortest period within which it was believed arsenic 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 quantity 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 alarmingsymptoms; 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, diarrhœa, 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 anus. Convulsive movements in the extremities often occur, with cramp in the legs, especially if the diarrhœa 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 arsenic 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 ofchronicpoisoning by arsenic are loss of appetite, a silvery coating to the tongue, thirst, nausea, colicky pains, diarrhœa, frontal headache, langor, sleeplessness, cutaneous eruptions, soreness of the edges of the eyelids, emaciation, anæmia, 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 practitioner must be careful not to mistake these symptoms for those due to simple gastritis or enteritis.
Arsenic is not a poison that accumulates in the system, but is slowly eliminated from it especially by the kidneys, but partly also by the bile.
The local application of arsenic to the mucous membranes, to wounds, or to surfaces deprived of their cuticle, produces constitutional effects similar to those just described. The only difference is that the symptoms show themselves more slowly. Not a few lives have been sacrificed from the application by ignorant quacks of a mixture of arsenious acid, realgar, and oxide of iron to ulcerating cancers.
Cases of compound poisoning have been met with. When arsenic is taken mixed with opium, the symptoms produced by the former are masked.
Post-mortem Appearances.—Arsenic appears to exercise a specific influence over the alimentary canal, and more especially over the stomach; for in whatever manner it may have been introduced into the system, it is to this organ that we must look for its effects. These effects consist in the signs of acute inflammation commencing in this viscus, and often extending along the duodenum, small intestines, and colon. In acute cases the stomach is the viscus most affected; but in chronic cases the whole alimentary canal is found inflamed and ulcerated, particularly the duodenum andrectum. When death has occurred within five hours of taking the poison, the stomach has been found intensely inflamed in an adult; while the same result was witnessed in a child who died at the end of two hours. The stomach often contains a dark grumous fluid, occasionally tinged with blood. On removing the contents the mucous membrane is seen red and inflamed, the inflammation being most intense around certain spots. On examining these spots, particles of arsenic will probably be found adhering to the walls of the stomach and surrounded by a zone of inflammatory redness. Sometimes also blood is effused into the visceral walls, giving rise to an appearance resembling gangrene. Ulceration of any of the coats of the stomach is rare, and perforation is still more so.
In a few exceptional cases there has been no appearance of inflammation in the stomach or bowels.
Putrefaction of the body is said to be remarkably retarded after death from arsenic.
Treatment.—The first object must be to expel the poison from the stomach, for which purpose the stomach-pump may be advantageously employed, or emetics of sulphate of zinc, mustard, or ipecacuan administered, unless vomiting is already present. The sickness must be promoted by the free use of albuminous or mucilaginous diluents. Raw eggs beaten up in milk are particularly useful, as is likewise a mixture of albumen, milk, and limewater. Taylor advises equal parts of oil and limewater, for the oil invests the poison, and the lime renders it less soluble. A large dose of castor oil (℥j to ℥ij) may be given, to carry off any of the poison which may have passed into the intestines, as soon as sickness has subsided. Animalcharcoal, calcined magnesia, &c., when taken in large quantities, may be of service by enveloping the arsenic, and preventing its contact with the mucous membrane of the stomach; but oil or milk will act more efficiently in this manner. The hydrated peroxide of iron[B]should be administered moist, and in large doses, after the stomach-pump has been used; or indeed, mixed with water, it may be first introduced and then expelled, thus washing out the stomach by means of the stomach-pump. This is the most efficient antidote known.
The subsequent treatment must be conducted on general principles, according to the severity of the symptoms; but the great depression of the nervous and vascular systems must not be overlooked in combating any inflammatory action. Henbane or opium, in many instances combined with stimulants, ice internally, and hot fomentations externally, will frequently be found of great service.
Tests.—In itssolid statearsenious acid may be known by the following properties. Heated on platinum foil or on the point of a penknife, it produces a white smoke and is entirely volatilized. If some of the powder be heated in a small test tube, it will be sublimed, and small octahedral crystals, visible to the naked eye or by a lens, obtained. If arsenious acid be mixed with freshly-burnt powdered charcoal, and heated in a small test tube, a ring of shining metallic arsenic of a grey color will be found on the cool portion of the tube, andan odor of garlic is perceptible. If this deposit be driven about from place to place it will gradually become oxidized, and octahedral crystals of arsenious acid formed. Further, if the tube be divided and the part containing the arsenious acid be washed out with distilled water, the liquid tests may be applied to the solution. This is called the Reduction test. It is very delicate, detecting according to Christison, the 300th part of a grain.
In solution, this substance may be detected by what are called the liquid tests. A solution of arsenic in water is colorless, almost tasteless, and has a very slightly acid reaction. If a few drops be evaporated on a glass slide and examined by the microscope, numerous minute and mostly imperfect octahedral crystals, or an amorphous deposit, will be seen, presenting triangular surfaces by reflected light.
1. Theammonio-nitrate of silver(prepared by adding a few drops of liquor ammoniæ to a solution of nitrate of silver, till the brown oxide of silver at first precipitated is nearly redissolved) throws down with arsenious acid a rich yellow deposit of arsenite of silver.
2. Theammonio-sulphate of copper(formed by adding liquor ammoniæ to a solution of sulphate of copper till the bluish-white oxide of copper is almost redissolved) produces a pale green precipitate, arsenite of copper, or Scheele’s green. Care must be taken not to add too much of the test in the first instance, otherwise its blue may overpower the green of the precipitate.
3.Sulphuretted hydrogen waterprecipitates a yellow deposit of sulphide of arsenic. It is better, however, to use pure and well-washed sulphuretted hydrogen generated in the usual manner. Care must be taken that the liquid is not alkaline,or no precipitate will be produced, even though arsenic be present. For this reason yellow sulphide of ammonium will not precipitate arsenic until acidulated with pure hydrochloric or some such acid. The precipitate should be collected, carefully washed, and dried. It should then be mixed with black flux or dry ferrocyanide of potassium and reduced, as already described.
These tests are so delicate, especially the first, that they will detect the 8000th part of a grain of arsenic in solution; they should be employed successively. There are several other processes which require to be noticed, namely, Marsh’s process, the process known as Reinsch’s process, Fresenius’s process, and the Destillation process.
Marsh’s Test or Process.—This process is founded on the decomposition of arsenious acid by nascent hydrogen, and the formation of arsenuretted hydrogen gas, which possesses the following properties: It burns with a bluish-white flame, and white smoke (arsenious acid), possessing a slight garlic odor. If a piece of glass or porcelain be held in the flame a blackish metallic stain will be deposited upon it, consisting of metallic arsenic. This stain might be confounded with one produced by antimony under similar circumstances. But the antimonuretted hydrogen gas does not burn with the odor of the arsenuretted hydrogen; while the antimonial stain is sooty, and has not a metallic lustre. The arsenical stain is further readily dissolved by a solution of chloride of lime (bleaching powder), whilst the antimonial stain is not affected. To the stain may be added a few drops of strong nitric acid; it will dissolve the arsenic; if this be allowed to evaporate, and the acid be neutralized, a few drops of nitrate of silver solutionwill give a brick-red precipitate of arseniate of silver.
Marsh’s test is thus accomplished: a flask furnished with a cork through which pass a funnel and a long bent tube drawn to a point, is prepared so that the funnel reaches almost to its bottom. Several pieces of pure zinc are introduced, and then some sulphuric acid is poured through the funnel. In this way hydrogen gas is produced and escapes by the bent tube. When all the air has been expelled the gas should be ignited as it escapes, and a piece of cool porcelain held over the flame. If there be no deposit it is plain that neither the zinc nor the sulphuric acid, contains arsenic. A portion of the suspected fluid is next introduced into the flask by the funnel, and the issuing gas again tested. Should a stain giving the characters alluded to above be produced, the fluid contains arsenic in some form or other.
Reinsch’s Process.—The suspected liquid is boiled with from one-sixth to one-eighth of its bulk of pure hydrochloric acid, and a bright slip of copper introduced. If arsenic be present the copper will be coated with it in the form of an iron-grey deposit. Next after removing the copper, washing it with distilled water, and drying it between folds of blotting paper, cut it into slips, and introduce it into a reduction-tube and apply heat; arsenious acid will be sublimed and deposited on the sides of the tube, in the form of minute octahedral crystals. These may be dissolved in water and tested in the usual way. Before resorting to this test, the acid must be examined to make sure of its purity. This is easily effected by boiling the copper with a mixture of the hydrochloric acid and distilled water before adding the suspected liquid. In conducting the analysis in the case ofSmethurst (Cent. Crim. Court, Aug. 1859) Taylor and Odling found that all the varieties of copper in common use for Reinsch’s process contained arsenic. A copper of ascertained purity must therefore be used.
Arsenic in Organic Matters.—The following process, which has been introduced by Dr. Taylor, is a very convenient one. The suspected matters are to be thoroughly dried in a water-bath or otherwise, taking care not to use too great a heat. They are then to be introduced into a flask fitted with a long bent tube; to the dried material is to be added a quantity of strong hydrochloric acid, proved free from arsenic, sufficient to drench it, and the whole allowed to digest for some hours. At the end of that time heat is to be applied to the flask by means of a sand-bath, and a receiver fitted to the bent tube. The receiver should contain a little water, and both it and the bent tube should be kept cool. As distillation goes on the arsenic passes over in the form of chloride of arsenic, and is collected in the receiver beyond. A second portion of hydrochloric acid may be used to remove any last traces of arsenic in the organic material. The arsenic may be recovered from the chloride by boiling with pure polished copper, as in Reinsch’s process.
The process of Fresenius and Von Babo given at page31is especially adapted for the recovery of arsenic from organic admixture.
Several cases of poisoning by arsenuretted hydrogen are on record, some proving fatal.
In its metallic state antimony is not regarded as poisonous. Two of its preparations, however, claim attention; namely, tartar emetic, and chloride of antimony.
Tartar Emetic(TartratedorTartarised Antimony,Potassio-Tartrate of Antimony,Tartar Emetic).—Since the trials of Palmer, Dove, Smethurst, and Pritchard, poisoning by this compound has attracted much attention. In large doses it has been administered without any serious result, a circumstance which may be accounted for by the promptitude with which it excites vomiting and purging. Given in small doses, frequently repeated, the effects of tartar emetic may be made to simulate, in some degree, those due to natural disease.
Three quarters of a grain killed a child; and a dose of two grains has destroyed an adult, under circumstances which favored its action. Dr. Taylor says that from ten to twenty grains taken at once might prove fatal to an adult; while in divided doses a smaller quantity might suffice. It is plain, therefore, that the quantity necessary to cause death must vary with the condition of the patient.
Symptoms.—In acute poisoning by this agent there is a metallic taste, nausea, and violent vomiting, burning heat with pain in the stomach, and purging. Difficulty in swallowing, thirst, cramps, cold perspiration, and great debility soon set in. Should the case terminate fatally, death may be preceded by giddiness, insensibility, difficult respiration, utter prostration, with violent spasms, tonic or clonic; but even when matters appear to be most critical, symptoms of improvement are often manifested, and recovery gradually follows.
The effects ofchronicpoisoning are, constant nausea, frequent attacks of vomiting and purging, a loathing for food, a weak frequent pulse, loss of muscular power, cold clammy sweats and fatal exhaustion. The symptoms are of course aggravated after each administration of the poison, whether given in food or medicine.
Tartar emetic ointment applied to the skin produces a pustular eruption like that of smallpox; while, if much be absorbed, there will be nausea, sickness, &c. Sometimes this same eruption appears in the throat and on the skin after swallowing a large dose.
Post-mortem Appearances.—The most common are inflammation of the throat, stomach, and intestines. Sometimes the mucous membrane of the stomach is softened and infiltrated with blood. The cæcum and large intestine are also inflamed, especially if life has been prolonged after the dose, as in chronic poisoning. The brain and lungs have been found congested.
Treatment.—Vomiting should be encouraged by warm greasy water, milk, &c. Liquids containing tannin, as tea without milk or sugar, decoction of oak bark, &c., must be freely given. Cinchona bark in tincture or powder may be advantageously prescribed. Afterwards opiates may be administered.
Tests.—Tartar emetic is soluble in water but not in alcohol.
In solution tartar emetic may be thus detected:
1. A drop evaporated on a glass slide leavesmicroscopic crystals, either tetrahedra or cubes, with the edges bevelled off.
2. The solution may further be proved to contain antimony by passing through it sulphuretted hydrogen or adding to it sulphide of ammonium, either of which throws down an orange-red precipitate of sulphide of antimony. This precipitate is soluble in strong hydrochloric acid, which being diluted, throws down a white precipitate.
3. The three dilute mineral acids (nitric is best) throw down a white precipitate with tartar emetic, which is soluble in excess of the acid used or in tartaric acid.
The metal may be separated from organic substances by Marsh’s or Reinsch’s process.
Chloride of Antimony(TerchlorideorButter of Antimony) is a powerfully corrosive liquid. It produces violent inflammation and corrosion of the whole intestinal canal; occasionally also drowsiness, as from the use of a narcotic.
Dr. Taylor has collected the histories of four cases of poisoning by butter of antimony, three of which recovered. The fourth, in which a gentleman took from two to three ounces, proved fatal in ten hours and a half, after producing great prostration, nausea, violent griping pain, and tenesmus, followed by a tendency to sleep. On inspection, the whole of the inside of the alimentary canal was blackened, as if it had been charred; there was but little mucous membrane remaining, and the parts were much softened.
Treatment.—Magnesia must be administered in milk, together with the remedies recommended in poisoning by tartar emetic.