Aconite(Aconitum Napellus,Monkshood,Wolfsbane,Blue Rocket).—This beautiful plant is found in most parts of Europe.
Aconitia, the alkaloidal base of the plant, is the most deadly poison known; the fiftieth part of a grain having nearly caused death.
The chiefsymptomsof poisoning by aconite are numbness and tingling in the mouth and throat, giddiness, abolition of muscular power, pain in the abdomen, with vomiting and purging. Sometimes delirium and slight stupor have been noticed. The pupils are usually dilated, the skin is cold, the pulse exceedingly feeble, the breathing oppressed, and there is a dread of approaching dissolution. Frequently the sufferer is perfectly conscious, though paralyzed, till death suddenly occurs after two or three hurried gasps. According to Dr. Fleming, death may be due to a sedative impression on the nervous system, or to asphyxia from paralysis of the respiratory muscles, or to syncope.
A fatal mistake is not very uncommonly made in eating the root of aconite for that of horseradish. The sense of tingling and numbness produced by the former is so different from the pungent taste of the latter that with due care no mistake should occur, except the plants be allowed to grow together, which should never be done.
A case occurred in Ireland where a woman poisoned one man and nearly killed another by sprinkling powdered aconite root over a dish of greens.
Of the root one drachm, of the tincture one drachm, and of the alcoholic extract four grains, have caused death. Death follows a considerable dose in less than an hour, but sometimes a longer period elapses.
The Bikh poison, formerly much used in India, and still not unfrequently employed, has as its basis the Aconitum ferox, a still more dangerous drug than our indigenous plant.
Treatment.—No time must be lost in the use of remedies. In addition to emetics, castor oil, and animal charcoal, benefit may be derived from administering strong coffee. Brandy or ammonia should also be given, while the limbs and back are well rubbed with hot towels. Artificial respiration might prove useful.
There is no good test for aconitia.
Hydrocyanic Acid(Prussia Acid), on account of its energetic and rapid action, is one of the most formidable poisons with which we are acquainted. In its concentrated state it is a limpid colorless liquid; possessing a somewhat acrid taste, and having an odor, when diffused through the air, resembling that of oil of bitter almonds. When diluted with water, it forms the acid kept by the druggist. The properties of this variety are similar to those of the pure form; except that, if kept in the dark, it is not so readily decomposed. It is in this condition that it is used as a poison. The diluted acid of the British Pharmacopœia contains about 2 per cent., and that known as Scheele’s from 4 to 5 per cent., of the strong acid; but all vary greatly with keeping.
One of the salts of hydrocyanic acid, thecyanide of potassium, claims a short notice, since it is largely employed by photographers, workers in electrotype, &c. It has been taken as a poison. This salt is sold in the form of deliquescent white crystals, or in crystalline masses, which are very soluble in water, and possess the odor of prussic acid. From three to five grains will destroy life almost as rapidly as prussic acid itself, and in the same manner: a dose of five grains has proved fatal.
Several vegetable substances yield prussic acid, such as the kernels of the peach, apricot, nectarine, cherry, &c., the leaves of the cherry laurel, and the pips of apples and pears. Cases of alarming illness have occurred from eatingbitter almondstoo freely; while the essential oil obtained by distilling the pulp of these almonds with water is a powerful poison. Thisessenceoroil of bitter almondscontains about ten per cent. of anhydrous prussic acid; and it is probable that from ten to thirty drops would prove fatal to an adult. The prussic acid may, however, be separated from it, and leave the oil harmless.
A distilled water obtained from the leaves of the cherry laurel, which was formerly employed in medicine, proved dangerous from its very variable strength; it has been used as a poison. In the well-known case of Sir Theodosius Boughton, poisoned by Captain Donellan in 1781,laurel waterproduced death within half an hour after two ounces had been swallowed.
The smallest quantity of prussic acid which has been known to destroy life is nine-tenths of a grain of the anhydrous acid, equal to forty-five minims of the diluted preparation of the British Pharmacopœia; and it is probable that this would,in most instances, prove fatal. In the case referred to death occurred in twenty minutes; but from a larger dose it has ensued much earlier. The period may be said to vary from two to five and forty minutes. Insensibility may, however, come on in a few seconds. In the case of seven epileptics accidentally poisoned at the Bicêtre, death occurred in the first within twenty minutes, in the last after three-quarters of an hour, though the dose of the acid was the same in each instance.
Symptoms.—These will vary with the dose and the mode of exhibition. Inhalation of the vapor of anhydrous prussic acid would immediately cause death. The vapor of the diluted acid has given rise to serious symptoms with great rapidity. Scheele is said to have been suddenly killed by respiring the vapor of the dilute acid while making his experiments.
When the diluted acid is taken in a large dose the symptoms may commence during swallowing, death following so quickly that scarcely any effects can be observed. The chief symptoms, perhaps, are insensibility, slow gasping, or convulsive respiration, a clammy cold skin, fixed and glistening eyes, dilated pupils, spasmodic closure of the jaws, an almost imperceptible pulse, and sometimes convulsions of the limbs and trunk. The rapidity with which consciousness is lost is well exemplified in an instance recorded by Hufeland, where a man about to be apprehended as a thief took an ounce of the acid, staggered a few steps and fell apparently lifeless. In a few moments a single violent respiration was made, and within five minutes of taking the poison he was dead.
Insensibility is not, however, in all instances, immediately produced; many an authenticatedcase having occurred in which the symptoms were protracted for some minutes, the individual performing several acts indicating consciousness, such as replacing the cork in the bottle, adjusting the bed-clothes, or even running some distance to summon help.
The utterance of a shriek has been said to be characteristic of poisoning by this acid; but toxicologists know that such has not been observed in the human subject, and that there is merely a gasping for breath, or perhaps a call for help.
A small dose produces faintness, insensibility, difficulty of breathing, involuntary evacuations, loss of muscular power, convulsions, and temporary paralysis. If the proper treatment be employed, recovery may often be effected.
Post-mortem Appearances.—The body is generally livid, the countenance pallid, or sometimes livid and bloated, the jaws firmly closed, and the hands clenched. There is frequently blood or froth about the mouth, and the eyes are sometimes described as prominent and glistening. There is often an odor of prussic acid about the body, which is more perceptible on opening the stomach. The venous system is usually gorged with blood; and the brain, lungs, heart, liver, spleen, and kidneys have been found congested with dark-colored fluid blood.
Treatment.—There is no chemical antidote to this poison which can be relied upon. Chlorine and the mixed oxides of iron have been recommended; but even if one of these agents happened to be at hand, it is doubtful if its employment could be timely enough to be advantageous. Attempts must be made to restore animation by cold affusion, stimulating frictions to the chest and abdomen, warmth to the surface, and theapplication of ammonia to the nostrils. Cold affusion over the head and neck has proved most efficacious when promptly resorted to, and repeated at short intervals so as to cause a shock. The direct injection of liquor ammoniæ into the veins, as proposed by Professor Halford, for snake bite, might be tried if the means were at hand. As soon as possible ammonia should be given internally and the stomach emptied.
If recovery ensue from the immediate effects, vomiting should be produced by emetics or otherwise, after which strong coffee, with brandy, ought to be administered.
Tests.—The best are the following:
When hydrocyanic acid has to be separated from organic substances, such as the contents of the stomach, it is usual to take advantage of its ready volatility. If the acid be not in combination it may be given off so readily as to be detected by a watch glass moistened with nitrate of silver held over the vessel containing the acid; but in order to make sure of its presence or absence the following process should be adopted. The suspected material should be acidulated with pure sulphuric acid so as to insure the prussic acid being in a free state. The substances thus acidulated are to be placed in a retort, distilled over a water bath, and the distillate collected in a cool receiver containing some caustic potass. About one-sixth of the fluid substance should in this way be distilled over, when the liquid in the receiver may be tested by the silver or iron tests, or the vapor as it passes over may be tried with the sulphur test.
1. The peculiarodorof prussic acid is well known, and is a very delicate test, taken in conjunction with others, of its presence.
2.The Silver Test.—Nitrate of silver yields, withhydrocyanic acid or cyanide of potassium, a white clotted precipitate, (cyanide of silver,) insoluble in cold but soluble in boiling nitric acid. If this precipitate be well dried and heated, cyanogen gas will be given off, which may be known by its burning with a purplish flame. This test is very delicate.
3.The Iron Test.—Of the liquid collected in the receiver above-mentioned, or the suspected acid liquid, saturated with a few drops of caustic potass, a portion is to be taken, and to this is to be added a small quantity of a solution of sulphate of iron. A dirty brownish or greenish precipitate will fall, consisting of a mixture of the oxide of iron and prussian blue. On adding a few drops of diluted sulphuric or hydrochloric acid, and thus dissolving the oxides, the prussian blue will immediately be made clear if hydrocyanic acid be present.
4.The Copper Test.—Sulphate of copper added to prussic acid rendered slightly alkaline by potass, gives a greenish-white precipitate, which becomes white by the addition of a few drops of hydrochloric acid to dissolve the blue precipitated oxide of copper.
5.The Sulphur Test.—One of the most useful tests for prussic acid, whether in the fluid or volatile state, is the so-called sulphur or Liebig’s test. It is best adapted for detecting the acid in a state of vapor, and to this end a drop of yellow sulphide of ammonium in a watch-glass is held over the suspected liquid, which may be warmed by the hand to facilitate the evolution of the acid. In this position the watch-glass should be allowed to remain for some little time, after which a drop of solution of perchloride of iron is to be added, which will give rise to a blood-red color not discharged by corrosive sublimate.
If the acid is in the liquid form a drop of the prussic acid and the yellow sulphide may be mixed and heated until they thoroughly combine. A drop of sulphate of iron is then added as before, but all the sulphide must be decomposed or a black sulphide of iron will be produced, even though prussic acid be present, instead of the ordinary blood-red color.
Other substances give a similar reaction with iron; but their color is discharged by corrosive sublimate.
Digitalis Purpurea(Purple Foxglove).—The seeds, leaves, and root of this indigenous hedge-plant are poisonous.Digitalinis the principle which these parts contain. The officinal infusion of digitalis, made from the dried leaves, is used in doses of ʒij, ℥ss, or more; of the tincture m. v to m. xl are usually given. On the recommendation of the late Mr. Jones, of Jersey, half an ounce of the tincture is sometimes administered in cases of delirium tremens; this dose being repeated a second or even a third time, in the course of six or eight hours.
Digitalis is very uncertain in its action. When given medicinally its effects should be watched,as in some cases it probably accumulates in the system, but in others, especially in heart disease, it may be given for months or years without hurt, and even with advantage. A poisonous dose seems to produce vomiting, purging, colic, headache, slowness and extreme irregularity of pulse, dimness of vision, dilated pupils, lethargy, prostration, convulsions, and coma. In two instances death occurred within twenty-two hours. The appearances found afterwards have been chiefly congestion of the cerebral vessels and slight inflammation of the stomach.
Digitalinhas acquired a certain importance from the trial and execution of De La Pommerais for poisoning the widow Pauw by its means. The facts were altogether inconsistent with his innocence, and though digitalin was not separated from the woman’s body, yet extracts of the vomited matters killed dogs with the symptoms of poisoning by digitalis. The extracts obtained from the stomach and bowels did not prove fatal. Tardieu and Roussin, who were engaged on the case, came to the conclusion that the woman had been poisoned by some vegetable poison, probably digitalin. The woman’s symptoms, which were not, however, carefully noted, were violent vomiting and extreme depression.
In addition to the administration of emetics and castor oil, some infusion containing tannin, as strong tea, &c., should be given as an antidote in poisoning by digitalis. Substances containing tannin render the digitalin inert. Strong tea or coffee, with brandy, will likewise be needed, to lessen the depression and exhaustion.
Calabar Bean(Physostigma venenosum).—This bean, which grows on the West Coast of Africa, is generally used as an ordeal. According to thesuperstition of the natives the innocent vomit and are safe, the guilty die. Its most characteristic effect is contraction of the pupil. It seems to act by paralyzing the motor muscles, leaving the senses intact. There is great interference with the heart’s action, it beating tumultuously, but death seems to follow paralysis of the muscles of respiration. In some cases, one fatal, occurring in Liverpool, there was much vomiting.
Tobacco(Nicotiana tabacum).—All parts of this plant are very poisonous. An infusion of the leaves, exhibited as an enema, has, on several occasions, speedily proved fatal. Persons in attempting to acquire the habit of smoking often suffer from severe nausea, vomiting, great prostration, and insensibility; while in some instances, more severe effects have ensued. Symptoms very much resembling those of apoplexy have also been produced by the excessive use of snuff. A celebrated French poet died in fourteen hours, from swallowing the contents of his snuff-box, which had been mixed with his wine, as a joke. Snuff or tobacco is also sometimes used for drugging persons with a view to nefarious purposes, as robbery and such like.
Nicotin, the alkaloid of tobacco, is as deadly a poison as prussic acid. It is an acrid, volatile, oily liquid, of a pale amber color. In 1858 a chemist of rising reputation committed suicide with this substance. He was seen by one of the attendants at the Museum in Jermyn Street, in the act of falling forwards out of a water-closet in which he had concealed himself. The attendant raised him up, and with the aid of another man endeavored to carry him to a table, but he heaved a deep sigh and died in their arms. The appearances afterwards found were great congestion ofthe membranes of the brain and a dark fluid state of the blood.
The only other case of importance on record was the occasion of thecause célèbreBocarmé. This man, a Belgian count, studied chemistry, apparently, with a view to the preparation of this substance, made it in quantity, and with the help of his wife poisoned her brother. The count was condemned and executed. M. Stas was engaged to search for the poison, and thus was introduced his process, so often referred to.
Conium(Conium maculatum,Common or Spotted Hemlock).—This indigenous plant, which grows abundantly in hedges and wild places, belongs to the order Umbelliferæ. The following common umbelliferous plants are likewise poisonous: viz., theCicuta virosaor water-hemlock, the roots of which have been eaten in mistake for parsnips; theŒnanthe crocata, or the water-dropwort, one of the most virulent of English vegetables; theÆthusa cynapium, or fool’s parsley, sometimes gathered in mistake for parsley; and thePhellandrium aquaticum, or fine-leaved water-hemlock, popularly known as water-parsnip. They have all given rise to accidents.
The seeds, leaves, and root of theConium maculatumare all poisonous. The effects are rather variable, sometimes consisting chiefly of delirium, stupor, coma, and convulsions; on other occasions, the action, being chiefly exerted on the spinal cord, gives rise to gradually extending paralysis, the lower limbs being first affected, afterwards the arms and chest, thus producing death by apnœa from paralysis of the muscles of respiration. Probably, however, could artificial respiration be kept up, the heart would continue to beat much longer.
The alkaloid of hemlock is a pale yellow, volatile, acrid oily-looking liquid, known asconia,coneinorconicina. It is a potent poison, occasioning general paralysis without loss of sensibility. This alkaloid, which is found in all parts of the plant, may be readily recognized by rubbing with caustic potass. This sets free the alkaloid from its combination, and being readily volatile its mouse-like odor becomes at once apparent. Chemically it is allied to ammonia, and gives many of the reactions of that substance.
In many respectscurare(referred to underNux vomica) acts similarly toconia.
Lobelia Inflata(Indian Tobacco).—This plant is a native of North America; and its powdered leaves and seeds have been much used as a remedy for asthma. In one instance, in which a quack prescribed a drachm of the leaves, pain, vomiting, unconsciousness, feebleness of pulse, and contraction of the pupils supervened, and death occurred in thirty-six hours. Ignorant imposters, calling themselves “medical botanists” (more appropriately known as “Coffinites”), have poisoned several simple individuals, both in England and America, by physicing them with this mischievous and powerful drug.
Colchicum(Colchicum autumnale,Meadow Saffron).—This plant grows in most damp meadows. Its noxious properties are due to the active principleColchicia, which in its effects is allied to that contained in white hellebore,Veratria. In two instances less than half a grain of colchicia proved fatal to adults.
White Hellebore(Veratum album) is a poisonous plant which, when taken internally, has caused violent sickness, purging, dilatation of the pupils, great prostration, and lowering of the heart’saction, cold sweats, convulsions, and death. At the same time it is powerful in relieving pain. Its properties are due toveratria, an alkaloid, which may also be prepared from the seeds of the Asagræa officinalis, or Cevadilla seeds, and from Veratrum viride.
Gentle emetics, purgatives, and stimulants are the means employed to prevent death in poisoning by any of these vegetable substances. They all produce extreme depression, hence stimulants must be freely used.
The most important of these asphyxiant noxious gases are carbonic oxide, carbonic acid, sulphuretted hydrogen, and carburetted hydrogen.
Carbonic Oxideis a much more dangerous poison than is carbonic acid, but poisoning with it in a pure state is rare. It constitutes an ingredient in most vapors produced by burning coke or carbon, especially if the combustion is imperfect. It forms with the coloring matter of the blood a remarkably stable compound of a light red color; in point of fact it is the impossibility of exchanging carbonic acid for oxygen in the lungs which causes death. After death the blood is bright red in hue.
Carbonic Acid Gas.—This heavy inodorous gas is the cause of numerous accidents, owing to thevariety of sources from which it is produced. It is formed from burning fuel, from the calcination of limestone or chalk, and it is a product of respiration. It is diffused through wells, coal-mines, and caverns. During fermentation it is largely given off, and accumulates in beer vats. The vapor of charcoal partly owes its poisonous properties to carbonic acid gas, as does that arising from lime and brick-kilns.
In this country suicides rarely resort to carbonic acid gas to accomplish their ends; in France they very frequently do so.
Symptoms.—In its pure state this gas causes death by asphyxia, the glottis becoming spasmodically closed the moment the vapor comes in contact with it. When sufficiently diluted to be inspired it acts by absorption, giving rise to giddiness, headache, vomiting, a tendency to sleep, and loss of muscular power. The heat of the body continues, and the limbs are usually flexible. The countenance gets livid, the respiration becomes hurried and stertorous, and complete insensibility ensues; while the heart’s action, which was at first rapid, soon ceases.
Post-mortem Appearances.—The body is generally swollen and livid, especially about the face. The countenance is not always bloated, sometimes being calm and pale. The limbs are often rigid, the skin is marked with livid patches, and the abdomen is distended with gas. The right cavities of the heart, the lungs, and large veins, are found gorged with venous blood; while the brain and its membranes are usually very vascular, and occasionally there is serious effusion.
Treatment.—Prompt removal to the pure air, cold affusion, and stimulating applications to the chest and extremities, are the best means for resuscitation. If the countenance is bloated, venesection may be performed. Artificial respiration, galvanism, and the inhalation of oxygen gas, have been found useful.
Sulphuretted Hydrogen.—This gas is a very active poison, but from its offensive odor (resembling that of rotten eggs) it is not so liable to be accidentally inhaled as is carbonic acid. It is usually met with combined with other gases, resulting from the putrefaction of animal matter. When breathed in a diluted state, it speedily produces insensibility and death. Workmen long engaged in drains and sewers, or in any atmosphere contaminated with sulphuretted hydrogen gas, suffer from giddiness, nausea, and weakness; these symptoms ending at length in a kind of fever, which is often fatal.
In acute cases there will be little hope of recovery, unless the individual can be quickly removed into the open air, and stimulants, &c., applied. Chlorine gas, well diluted with common air, might be employed, as it breaks up the gas.
Carburetted Hydrogen(Coal Gas).—The symptoms produced by this gas, when mixed with air and inhaled, are those of asphyxia. If the person breathing it should be roused before a fatal quantity has been inhaled, the chief effects may be intense headache, labored and oppressed respiration, quickened action of the heart, sickness, and great loss of power.
In 1841 a family in Strasburg were poisoned by being in an atmosphere contaminated with coal gas, for forty hours. Of the six members, four were found dead, while the father died in twenty-four hours; but the mother recovered. The gas escaped from a pipe which passed under the cellar of the house where this family resided; so that it probably poisoned the air gradually, and gave rise to no suffering to warn the unfortunates.
This group, though far from a natural one, is nevertheless convenient. It comprehends a great variety of substances, first among which comes.
Ergot of Rye(Spurred Rye,Secale cornatum).—The grain of wheat, barley, oats, and rye is apt to be attacked by a parasitic fungus which imparts to it specific properties. This substance has the power of inducing contraction of unstriped muscular fibre, especially in the smaller arteries and uterus. Ergotised grain, in full doses, gives rise to lassitude, headache, nausea, and diarrhœa. From small quantities, frequently repeated, gangrene of the extremities has resulted. The peculiar influence of ergot on the muscular coat of the uterus renders this agent a valuable medicine when we wish to induce powerful contractions, but in the hands of the ill-intentioned it is frequently used to procure abortion; but its action in this way is far from certain, and at all times dangerous.
Savin and its oil are irritant poisons, only indirectly affecting the uterus; nevertheless, they not unfrequently are used to induce miscarriage.
Oil of Tansy has also been employed in America as an abortive agent, and in three instances, at least, has caused death.
The Yew (Taxus baccata), which has acquired in certain districts a reputation as an abortive, acts as do some others, by producing irritation of the bowels, and so communicating a kind ofstimulus to the uterus. The leaves and berries of the yew have both proved fatal, commonly with irritant symptoms; but those of coma have also been observed.
In America extract of Cotton-wood has a reputation as an abortive.
I.Bites of Venomous Reptiles.—The poisonous reptiles provided with fangs are the Ophidia, or Serpents.
Accidents from serpents’ bites rarely, of course, happen in this country, but are of frequent occurrence in India, Australia, and America.
On the morning of the 20th October, 1852, one of the keepers at the Zoological Gardens in the Regent’s Park, was wounded by a cobra, which he had removed from its cage and was playing with. For twenty minutes after the animal bit him at the root of the nose no peculiar symptoms were manifested, and the part was merely bathed with water. Forty minutes afterwards the man was admitted into University College Hospital, his face then being livid, respiration impeded, and the power of locomotion imperfect. He pointed to his throat as the seat of pain, but could not speak, and was unable to swallow. Artificial respiration was employed for fifty minutes, and subsequently galvanism; but stupor rapidly succeeded to faintness, and the patient died comatose fifty-five minutes after admission. The chief appearances found on dissection were an unnatural fluidity and blackness of the blood, with great congestion of the lungs and spleen.
The only poisonous reptile indigenous to this country is thecommon viperoradder. It is found on the heaths and in the dry woods of all parts of England, Scotland, and Wales, and is much fearedon account of its venom. Very few cases are known in which the bite of this animal has proved fatal. In May, 1862, a little boy, at Burgess Hill, near Brighton, clambered up a bank, to examine a bird’s nest. Groping with his hand among the moss, he felt, as he thought, a sharp prick from a thorn. It turned out to be a bite from an adder. As the real cause of the wound was not suspected, the swelling of the hand and arm was not properly attended to until too late, and the poor child died on the second day.
The poison apparatus of the viper consists of a gland placed by the side of the head, a duct, and a fang or pointed curved tooth, moulded in the form of a tube on either side. On being bitten, the person has pain in the wounded part, which quickly becomes severe and extends up the adjoining tissues. The limb swells greatly, becomes red and livid; while faintness soon sets in, and the pulse gets rapid and small. Bilious vomitings, dyspnœa, profuse cold sweats, jaundice, delirium, and convulsions, have also been noticed. In a few days the symptoms usually amend; but in weak sickly individuals gangrene of the limb may follow, or death may occur in the course of two or three days.
Thetreatmentof the bites of venomous reptiles must be local and constitutional. Immediately the wound is inflicted it should be sucked freely and perseveringly. If the patient is too faint to do this for himself, a bystander may fearlessly help him; for it is well known that these poisons may be smeared upon the lips and tongue, or even swallowed, with impunity. At the same time a ligature is to be placed around the limb, above the wound; or if this be impossible, from its situation, the textures around are to be compressed. Then,the bitten part may be excised; or it may be destroyed by the actual cautery, nitric acid, the strong liquor ammoniæ, or nitrate of silver.
Professor Halford, of the University of Melbourne, in a paper published at the commencement of 1869, recommended the injection of liquor ammoniæ into the veins for snake bite. Of twenty cases of snake bite since treated in this manner, by different practitioners, recovery occurred in seventeen. The snakes were all venomous, and included the tiger snake, the brown and black snake of Australia, &c. These, according to Professor Halford, are as deadly as the cobra and rattlesnakes of India. The plan of proceeding is to expose the vein, and then to pierce its coats with the sharp point of a hypodermic syringe containing the officinal liquor ammoniæ—sp. grav. 0·959. At least thirty minims are to be employed; the dose being repeated as the power of the preceding injection is expended. Professor Halford formerly thought that in consequence of the entrance of the snake poison into the blood a rapid growth of new cells occurred, which took up and exhausted the fibrin and oxygen of the blood, and rendered them incapable of ministering to the wants of the system. He now thinks that the new corpuscles are only the white corpuscles of the blood altered and enlarged, the change in them being caused by an alteration in the liquor sanguinis; this alteration being, in fact, a disappearance of the fibrin under the action of the poison. The ammonia is believed to counteract this power, and in favor of this view many Australian physicians have spoken strongly. Dr. Fayrer, however, has found the proceeding a failure in India. This gentleman is of opinion that the activity of the poison in some Indian snakes isso great that it is impossible to counteract it by any method.
The constitutional remedies are derived chiefly from the class of diffusible stimulants. No agent is more generally recommended than ammonia; and therefore the officinal compound tincture of ammonia (formerly known as eau de luce) should be given in half-drachm doses, well diluted; or the aromatic spirits of ammonia may be administered in the proportion of two drachms to an ounce and a half of water. Supposing that no ammonia is at hand, brandy will prove an excellent substitute. Transfusion of blood has been likewise recommended; but I do not know of any instance in which it has been resorted to.
II.Bites of Rabid Animals.—As the subject of Hydrophobia is fully treated of in Dr. Tanner’s work on “The Practice of Medicine,” remarks are here confined to the treatment to be adopted directly a person is bitten by a rabid animal. This is briefly as follows:—The tissues round the seat of injury are to be compressed by a ligature or otherwise, to prevent absorption. Then the wounded part is to be excised as soon as possible; taking care to remove every portion touched by the animal’s teeth, and to obtain a clean raw surface. The wound should then be thoroughly washed by a stream of water, long poured over it, and lunar caustic afterwards applied. Mr. Youatt prefers the nitrate of silver, freely used, to every other caustic; and he also recommends that after its application the wound should be quickly healed, though many authorities advise that it be kept open by irritating ointments. As these operations are very painful, there is no objection to the patient being placed under the influence of chloroform. He should afterwards be assured that everything has been done to prevent any subsequent mischief; and to give him greater confidence and to banish all fear from his mind, it may be as well to administer ammonia and bark for some days after the accident.
III.Stings of Bees, etc.—The poison apparatus of the common bee consists of glands, and a sting placed at the extremity of the body. The effect of the bite is usually slight, and the pain quickly passes off. In some few instances, however, there have resulted swelling and erysipelas, or suppuration and gangrene, or even death.
In the month of August, 1819, John Trevalli, of Pennsylvania, was stung by a bee in the middle finger of his right hand. He immediately became faint and insensible to surrounding objects; his complexion was livid, his breathing slow, and the perspiration saturated his clothes. At the end of an hour and a half he was bled, and recovered. On the 21st July, 1820, he was stung in the temple by a bumble bee. His wife was present and gave him some water, but in ten minutes he was dead.—(American Journal of Medical Sciences, Vol. 19, p. 265. Philadelphia, 1836.) Two other rapidly fatal cases are noticed in the same journal, as well as two examples of death from the sting of a wasp and one from the bite of a spider.
Mr. C. Hanbury has recorded a case of death from the sting of a bee (Medical Times and Gazette, p. 232. 10th March, 1860); and has also given short abstracts of several examples collected by Dr. Crisp, where severe symptoms have resulted from the same injury. Sir Benjamin Brodie (Lectures on Pathology and Surgery, p. 286. London, 1846) says he has seen a case in which sloughing of the cellular tissue followed from a leech bite,and another in which similar mischief followed the sting of a bee. Both the patients died.
And again, in a communication from Montbard (La Patrie, 19th September, 1858) it is stated that a youth sixteen years of age was drinking from a bottle, when a wasp, which he had not seen, got into his throat and wounded him. He died suffocated by the swelling, before any assistance could be procured.
According to Messrs. Kirby and Spence (Introduction to Entomology, Seventh Edition, p. 76, London, 1856), serious effects are sometimes produced on peculiar constitutions by eating freely of honey or from partaking of mead—a drink made by fermenting honey and water. These authors state that they knew a lady upon whom such things acted like poison, and they had heard of instances in which death was the consequence. Sometimes, when the bees have extracted their sweets from poisonous plants, these injurious results have not been confined to individuals of a particular habit. Thus, according to Dr. Barton (American Philosophical Transactions, vol. 5), there were numerous deaths in the autumn and winter of 1790 from eating honey collected in the neighborhood of Philadelphia, which, on inquiry, was found to be due to this substance having been extracted from the beautiful but poisonous flowers of the Kalmia latifolia.
The following Table from Dr. Garrod’s “Materia Medica” shows the proportions in which some of the more important drugs of the “Pharmacopœia” are contained in the Officinal Preparations.
ANTIMONY.(Tartar Emetic.)1⁄4gr. of tartarated antimony is contained in 1 fl. drm. of vinum antimoniale.1 gr. of tartarated antimony is contained in 5 gr. of unguentum antimonii tartarati.(Oxide of Antimony.)1 gr. of oxide of antimony is contained in 3 gr. of pulvis antimonialis.ARSENIC.(Arsenious Acid, White Arsenic.)1⁄24gr. of arsenious acid is contained in 5 min. of liquor arsenicalis.1⁄24gr. of arsenious acid is contained in 5 min. of liquor arsenici hydrochloricus.(Arseniate of Soda.)1⁄24gr. of arseniate of soda (dried) is contained in 5 min. of liquor sodæ arseniatis.MERCURY.(Metallic.)1 gr. of mercury is contained in 3 gr. of hydrargyrum cum cretâ.1 gr. of mercury is contained in 3 gr. of pilula hydrargyri.1 gr. of mercury is contained in 2 gr. of unguentum hydrargyri.(Hydrargyri Perchloridum.)1⁄16gr. of perchloride of mercury is contained in 1 fl. drm. of liquor hydrargyri perchloridi.(Hydrargyri Subchloridum, or Calomel.)1 gr. of subchloride of mercury (calomel) is contained in 5 gr. of pilula hydrargyri subchloridi composita.1 gr. of subchloride of mercury (Calomel) is contained in about 61⁄2gr. of unguentum hydrargyri subchloridi.ACONITE.1 gr. of dried aconite root is contained in about 9 min. of tinctura aconiti.ACONITIA.8 gr. of aconitia are contained in one oz. of unguentum aconitiæ.ATROPIA.1 gr. of atropia is contained in 2 fl. drm. of liquor atropiæ.1 gr. of sulphate of atropia in 2 fl. drm. of liquor atropiæ sulphatis.8 gr. of atropia are contained in 1 oz. of unguentum atropiæ.BELLADONNA.1 gr. of dried belladonna is contained in about 22 min. of tinctura belladonnæ.Each fluid part of linimentum belladonæ contains the active portion of a solid part of the dried root.CANNIBIS INDICA.1 gr. of alcoholic extract of Indian hemp is contained in about 22 min. of tinctura cannabis Indicæ.CANTHARIDES.1 gr. of cantharides is contained in about 88 min. of tinctura cantharidis.COLCHICUM.1 gr. of dried corm of colchicum is contained in about 51⁄2min. of vinum colchici.1 gr. of colchicum seeds is contained in about 9 min. of tinctura colchici.DIGITALIS.1 gr. of dried leaves of digitalis is contained in about 9 min. of tinctura digitalis.HEMLOCK.1 gr. of hemlock fruit is contained in about 9 min. of tinctura conii.IPECACUANHA.1 gr. of ipecacuanha root is contained in about 22 min. of vinum ipecacuanhæ.1 gr. ipecacuanha root is contained intwelvemorphia and ipecacuanha lozenges.1 gr. of ipecacuanha root is contained in 4 ipecacuanha lozenges.NUX VOMICA.1 gr. of nux vomica seed is contained in about 11 min. of tinctura nucis vomicæ.(Strychnia.)1 gr. of strychnia is contained in 2 fl. drm. of liquor strychniæ.OPIUM.(Acetate of Morphia.)1⁄4gr. of acetate of morphia is contained in 30 min. of liquor morphiæ acetatis.(Hydrochlorate of Morphia.)1⁄4gr. of hydrochlorate of morphia is contained in 30 min. of liquor morphiæ hydrochloratis.1⁄4gr. of hydrochlorate of morphia is contained inninemorphia lozenges.1⁄4gr. of hydrochlorate of morphia is contained inninemorphia and ipecacuanha lozenges.1⁄2grain of hydrochlorate of morphia is contained ineachmorphia suppository.(Opium dried sufficiently to be powdered.)1 gr. of opium is contained in 141⁄2min. of tinctura opii.1 gr. of opium is contained in 141⁄2min. of vinum opii.1 gr. of opium is contained in1⁄2fl. oz. of tinctura camphoræ composita.1 gr. of opium is contained in 96 min. of tinctura opii ammoniata.1 gr. of opium is contained in 1 fl. oz. of enema opii.1 gr. of opium is contained in 5 gr. of pilula saponis composita.1 gr. of opium is contained in 8 gr. of pilula plumbi cum opio.1 gr. of opium is contained in 10 gr. of pulvis ipecacuanhæ compositus.1 gr. of opium is contained in 20 gr. of pulvis kino compositus.1 gr. of opium is contained in 40 gr. of pulvis cretæ aromaticus cum opio.1 gr. of opium is contained in 10 gr. of pulvis opii compositus.1 gr. of opium is contained in about 131⁄2gr. of unguentum gailæ cum opio.1 gr. of opium is contained intenopium lozenges.1 gr. of opium equals about1⁄2gr. of extractum opii.1 gr. of extract of opium is contained in 22 min. of extractum opii liquidum.
(Tartar Emetic.)
1⁄4gr. of tartarated antimony is contained in 1 fl. drm. of vinum antimoniale.
1 gr. of tartarated antimony is contained in 5 gr. of unguentum antimonii tartarati.
(Oxide of Antimony.)
1 gr. of oxide of antimony is contained in 3 gr. of pulvis antimonialis.
(Arsenious Acid, White Arsenic.)
1⁄24gr. of arsenious acid is contained in 5 min. of liquor arsenicalis.
1⁄24gr. of arsenious acid is contained in 5 min. of liquor arsenici hydrochloricus.
(Arseniate of Soda.)
1⁄24gr. of arseniate of soda (dried) is contained in 5 min. of liquor sodæ arseniatis.
(Metallic.)
1 gr. of mercury is contained in 3 gr. of hydrargyrum cum cretâ.
1 gr. of mercury is contained in 3 gr. of pilula hydrargyri.
1 gr. of mercury is contained in 2 gr. of unguentum hydrargyri.
(Hydrargyri Perchloridum.)
1⁄16gr. of perchloride of mercury is contained in 1 fl. drm. of liquor hydrargyri perchloridi.
(Hydrargyri Subchloridum, or Calomel.)
1 gr. of subchloride of mercury (calomel) is contained in 5 gr. of pilula hydrargyri subchloridi composita.
1 gr. of subchloride of mercury (Calomel) is contained in about 61⁄2gr. of unguentum hydrargyri subchloridi.
1 gr. of dried aconite root is contained in about 9 min. of tinctura aconiti.
8 gr. of aconitia are contained in one oz. of unguentum aconitiæ.
1 gr. of atropia is contained in 2 fl. drm. of liquor atropiæ.
1 gr. of sulphate of atropia in 2 fl. drm. of liquor atropiæ sulphatis.
8 gr. of atropia are contained in 1 oz. of unguentum atropiæ.
1 gr. of dried belladonna is contained in about 22 min. of tinctura belladonnæ.
Each fluid part of linimentum belladonæ contains the active portion of a solid part of the dried root.
1 gr. of alcoholic extract of Indian hemp is contained in about 22 min. of tinctura cannabis Indicæ.
1 gr. of cantharides is contained in about 88 min. of tinctura cantharidis.
1 gr. of dried corm of colchicum is contained in about 51⁄2min. of vinum colchici.
1 gr. of colchicum seeds is contained in about 9 min. of tinctura colchici.
1 gr. of dried leaves of digitalis is contained in about 9 min. of tinctura digitalis.
1 gr. of hemlock fruit is contained in about 9 min. of tinctura conii.
1 gr. of ipecacuanha root is contained in about 22 min. of vinum ipecacuanhæ.
1 gr. ipecacuanha root is contained intwelvemorphia and ipecacuanha lozenges.
1 gr. of ipecacuanha root is contained in 4 ipecacuanha lozenges.
1 gr. of nux vomica seed is contained in about 11 min. of tinctura nucis vomicæ.
(Strychnia.)
1 gr. of strychnia is contained in 2 fl. drm. of liquor strychniæ.
(Acetate of Morphia.)
1⁄4gr. of acetate of morphia is contained in 30 min. of liquor morphiæ acetatis.
(Hydrochlorate of Morphia.)
1⁄4gr. of hydrochlorate of morphia is contained in 30 min. of liquor morphiæ hydrochloratis.
1⁄4gr. of hydrochlorate of morphia is contained inninemorphia lozenges.
1⁄4gr. of hydrochlorate of morphia is contained inninemorphia and ipecacuanha lozenges.
1⁄2grain of hydrochlorate of morphia is contained ineachmorphia suppository.
(Opium dried sufficiently to be powdered.)
1 gr. of opium is contained in 141⁄2min. of tinctura opii.
1 gr. of opium is contained in 141⁄2min. of vinum opii.
1 gr. of opium is contained in1⁄2fl. oz. of tinctura camphoræ composita.
1 gr. of opium is contained in 96 min. of tinctura opii ammoniata.
1 gr. of opium is contained in 1 fl. oz. of enema opii.
1 gr. of opium is contained in 5 gr. of pilula saponis composita.
1 gr. of opium is contained in 8 gr. of pilula plumbi cum opio.
1 gr. of opium is contained in 10 gr. of pulvis ipecacuanhæ compositus.
1 gr. of opium is contained in 20 gr. of pulvis kino compositus.
1 gr. of opium is contained in 40 gr. of pulvis cretæ aromaticus cum opio.
1 gr. of opium is contained in 10 gr. of pulvis opii compositus.
1 gr. of opium is contained in about 131⁄2gr. of unguentum gailæ cum opio.
1 gr. of opium is contained intenopium lozenges.
1 gr. of opium equals about1⁄2gr. of extractum opii.
1 gr. of extract of opium is contained in 22 min. of extractum opii liquidum.
Absorption of poisons,16