Cl. V. NARCOTICO-ACRID POISONS.
We have already stated our objections to this division, and our apology for adopting it. See page [205].
Deadly Nightshade. Atropa Belladonna.
(Pentandria Monogynia. Nat. Ord. Luridæ Linn. Solanaceæ. Juss.)
This plant is an indigenous perennial, found in many parts of Great Britain, particularly in shady places where the soil is calcareous, in large ditches, and on the edge of hilly woods; flowering in June, and ripening its berries in September. Every part of the plant is poisonous; and numerous instances have occurred where children, and the ignorant, or those suffering from hunger, allured by the beautiful and tempting appearance of the berries, have fallen victims to their deadly power. The root of this plant partakes also of the same qualities as the leaves and berries, but is perhaps less virulent.
“Or have we eaten of the insane root,
That takes the reasoner prisoner.”—Macbeth.
The inspissated juice (Extractum Belladonnæ Pharm. Lond.) is also extremely poisonous, when properly prepared; but, as usually met with in commerce, it is of very variable strength; when prepared according to the improved process of Mr. Barry, its activity is so considerable that a dose of two grains is followed by unpleasant effects. (See an account of its effects in the Pharmacologia, vol. 2, p. 199.) M. Brandes has lately ascertained that the active principle of this plant is a peculiar alkaline body, to which he has assigned the name of atropia.
Symptoms of poisoning by Belladonna.
Shortly after the ingestion of the berries, leaves, or root, of this plant, the patient complains of extreme dryness of the lips, tongue, palate, and throat; the deglutition becomes difficult, and the pupil of the eye immoveably dilated; nausea, rarely followed by vomiting; symptoms of intoxication succeed, accompanied with fits of laughter, dreadful ravings, violent gestures of the body, and continual motion of the hands and fingers; sometimes the patient sinks into a state of fatuity, but rarely of stupor; redness and tumefaction of the face, a low and feeble pulse, paralysis of the intestines, livid spots on different parts of the body, profuse sweats, convulsions, and death. In the cases where recovery has taken place, there has been an insensible restoration to health and reason, without any recollection of the preceding state.
Physiological action of Belladonna.
The results of the experiments of Orfila authorise us to arrange the nightshade under the second division of our classification; for it is evidently absorbed, carried into the circulation, and is thus enabled to act upon the nervous system, and particularly on the brain. At the same time it exerts a local action upon the stomach, although less violent than that occasioned by the acrid poisons. It, moreover, appears on some occasions to act directly through the medium of the nerves, like those substances which constitute our first class; or else how shall we explain the fact of the pupil of the eye becoming permanently dilated, by the contact of the belladonna with the tunica conjunctiva? It would, therefore, appear that this plant unites within itself all the three great modes of action, upon which we have attempted to found our physiological arrangement of poisons, as expressed by the tabular classification at page [207].
Organic lesions discovered on dissection.
The bodies of those who have perished by belladonna, are extremely prone to decomposition; they soon putrefy, swell remarkably, and are covered with livid spots; blood flows from the mouth, nose, and eyes, and the stench is insufferable. The stomach and intestines will sometimes display extensive marks of inflammation, extending in some cases to the mesentery and liver; and several cases are recorded in which the stomach appeared ulcerated. The lungs are usually found livid, gorged with venous blood, and studded with black spots; the heart has been also observed to be livid.
Modes of detecting the presence of Belladonna.
Where the berries of this plant have been swallowed, we shall generally detect them in the matter vomited; or, in the event of death, in the stomach, on dissection, for they would appear to be very indigestible; in a case of poisoning by this plant, recorded in the history of the French Academy for the year 1706,[[443]] the stomach was found to contain some berries of the belladonna crushed, and some seeds. Where the quantity of the plant is sufficient, we may proceed to identify it, by obtaining atrophia[[444]] from it. For this purpose, the leaves, or the crushed berries, or any other part of the suspected plant, must be boiled in distilled water; the decoction must then be pressed out, and filtered; after the albumen has been thrown down by a little sulphuric acid, potass must be added as long as any precipitate is produced; when the precipitate is to be washed in pure water, re-dissolved in muriatic acid, and re-precipitated by ammonia. This last result will be atropia. It is white, and collects in acicular crystals, insipid, little soluble in cold water, or even in alcohol, but very soluble in this latter fluid at a boiling temperature, from which, however, it is deposited on cooling.
Stramonium. Thorn-Apple. James-town Weed.
Datura Stramonium (Pentandria Monogynia. Nat. Ord. Solanaceæ, Linn. Solaneæ, Juss.)
The thorn apple is an annual plant, a native of America, which gradually diffused itself, from the south to the north, and is now naturalized to this country, and is to be found very commonly about London growing on dunghills, and by road sides. It flowers in July and August. Every part of this plant is a strong narcotic poison, producing vertigo, and most of those symptoms which we have described as the effects of belladonna, although the former plant appears to excite the brain more violently. Dr. Barton mentions the case of two British soldiers, who ate it by mistake, for the chenopodium album; one became furious, and ran about like a madman; and the other died, with the symptoms of genuine tetanus. In the fifth volume of the Edinburgh Medical and Philosophical Commentaries, two cases are related by Dr. Fowler; and others are to be found in the writings of Haller, Krause, Sproegel, Gmelin, and Orfila, illustrative of the effects of this plant upon the human species. There is reason to believe that this plant has been long known, and that it has been very generally used by uncivilized nations, on account of the narcotic effects which it occasions.
Tobacco. Nicotiana Tabacum.
(Pentandria Monogynia. Nat. Ord. Luridæ, Lin. Solaneæ, Juss.)
Tobacco is an annual plant, a native of America, from whence it was imported into Europe. We learn from Humboldt that it has been cultivated from time immemorial by the native people of the Oroonoko; and was smoked all over America at the time of the Spanish conquest. Hermandez de Toledo sent it into Spain and Portugal in 1559, when Jean Nicot[[445]] was Ambassador at the court of Lisbon, from Francis II, and he transmitted, or carried either the seed, or the plant to Catherine de Medicis, as one of the wonders of the new world, and which, it was supposed, possessed virtues of a very extraordinary nature. This seems to be the first authentic record of the introduction of this plant into Europe. In 1589 the Cardinal Santa Croce, returning from his nunciature in Spain and Portugal to Italy, carried thither with him tobacco; and we may form some notion of the enthusiasm with which its introduction was hailed, from a perusal of the poetry which the subject inspired. It is said that the smoking tobacco was first introduced by Sir Walter Raleigh on his return from America; and the avidity with which the custom was immediately adopted is shewn by the philippic written against it by King James, entitled the “Counterblaste to Tobacco.”
As an object of Medical Jurisprudence, its claims to our attention are numerous and important; not only as having occasionally been the means of destroying human life, but as furnishing, in its most romantic history, a striking illustration of the triumph of popular opinion over a series of legislative enactments[[446]] which had no other origin than that of ignorance and prejudice.
Tobacco was at one period of our history raised to a considerable extent in Yorkshire; but the cultivation of it for the purposes of trade have been long prohibited; and this country, as well as the greater part of Europe, is chiefly supplied from Virginia, where the plant is cultivated in the greatest abundance. The recent leaves do not possess any considerable odour, nor have they much flavour; when dried, however, their odour becomes strong, narcotic, and somewhat fœtid; their taste bitter, and extremely acrid. We have stated, upon another occasion,[[447]] that tobacco would appear to contain two independent elements of activity, an essential oil, and a proximate principle, of an acrid nature, to which Vauquelin has bestowed the name of Nicotin. The essential oil is an extremely virulent poison. Mr. Barrow, speaking of the use which the Hottentots make of it for destroying snakes, says, “A Hottentot applied some of it from the short end of his wooden tobacco-pipe to the mouth of a snake, while darting out his tongue. The effect was as instantaneous as an electric shock; with a convulsive motion that was momentary, the snake half untwisted itself, and never stirred more; and the muscles were so contracted, that the whole animal felt hard and rigid, as if dried in the sun.” The author has ventured a conjecture in his Pharmacologia,[[448]] with respect to this virulent oil, which he takes this opportunity of repeating, that “the juice of cursed hebenon,” by which, according to Shakspeare, the King of Denmark was poisoned, was no other than the essential oil of tobacco.
----“Sleeping within mine orchard,
My custom always of the afternoon,
Upon my secure hour thy uncle stole,
With juice of cursed hebenon in a vial,
And in the porches of mine ears, did pour
The leperous distilment.”
In the first place, the learned commentator Dr. Gray observes, that the word here used (hebenon) was more probably designated by a metathesis, either of the poet or transcriber, for henebon, i. e. henbane. Now it appears from Gerarde that tabaco was commonly called “henbane of Peru” (Hyoscyamus Peruvianus); and when we consider how high the prejudice of the court ran against this herb, as so strikingly evinced by the ‘Counterblaste’ of King James, it seems very likely that Shakspeare, who was fond of playing the courtier, should have selected it, as an agent of extraordinary malignity, upon such an occasion. No preparation of the hyoscyamus with which we are acquainted, would produce death by an application to the ear; whereas the essential oil of tobacco might, without doubt, occasion a fatal result. The term distilment has also called forth a remark from Steevens, which is calculated to add a little farther weight[[449]] to our conjecture; “surely” says he, “this expression signifies, that the preparation was the result of a distillation.”
Symptoms of poisoning by Tobacco.
The leaves of tobacco, whether whole, or reduced to powder, as they are daily met with in commerce, or in the form of infusion in water or wine, or in the state of smoke, are endued with poisonous properties of extreme energy. Their administration is shortly followed by vertigo; severe nausea; vomiting; a general tremor of the body, which is rarely the result of any other poison; cold sweats; syncope; and death. The author remembers witnessing a lamentable exemplification of the action of tobacco upon a person labouring under a strangulated hernia. The patient had been under the care of a medical practitioner in the vicinity of London, who after repeated and fruitless efforts to return the intestine, injected an infusion of tobacco into the rectum, and sent him in a carriage to the Westminster hospital, for the purpose of undergoing the operation; but the unfortunate man expired very shortly after his arrival, in consequence of the effects of the tobacco clyster. The external application of tobacco, in the form of cataplasm, or infusion, will occasion all the effects above related. A woman applied to the heads of three children afflicted with tinea capitis, a liniment consisting of powdered tobacco and butter, soon after which they experienced vertigo, violent vomiting, and fainting.[[450]]
It was formerly a practice to inject the smoke of tobacco into the anus, by means of a bellows of a peculiar construction, in cases of suspended animation, with a view to stimulate the rectum, and thereby to revive the vital powers; we have already commented upon this most dangerous and mistaken notion, (see page [88].)
In the process of smoking tobacco, the oil is separated, and being rendered empyreumatic by heat, it is thus applied to the fauces in its most active form; whence vertigo, nausea, and all its characteristic symptoms speedily arise upon that occasion; although the system becomes easily habituated to the action of this narcotic, and we continually see a large portion of the community using it daily, in various ways, and in great quantities, as a luxury, without experiencing any other bad effect than that which arises from their inability to relinquish the habit.
The well known errhine, snuff, is prepared from the dried leaves of tobacco, and possesses all the powers of the plant. The celebrated Santeuil experienced vomiting and horrible pains, amidst which he expired, in consequence of having drank a glass of wine, into which some Spanish snuff had been introduced.[[451]]
Physiological action of Tobacco.
The deleterious effects of this plant appear to depend on an especial action upon the nervous system; but farther experiments are required to establish through what medium its powers are conveyed to the sensorium. Orfila concludes that the active part of the plant is absorbed, and carried into the circulation. Mr. Brodie’s experiments, however, would lead to the conclusion that it operates through the medium of the nerves; and, what is extremely singular, they shew that the essential oil operates very differently from the infusion of tobacco; for that while the former appears to act exclusively on the brain, leaving the power of the circulation unimpaired, the latter acts on the heart at once, suspending its action even before the animal ceases to respire, and kills by producing syncope. This apparent anomaly at first led Mr. Brodie, as he has since informed the author, to suspect the accuracy of his experiments; but their careful repetition rendered this impossible. We suggested to him, whether a probable explanation might not be found in the late chemical results respecting the composition of tobacco, which seemed to shew that this plant possesses two active elements.[[452]]
Hemlock. Cicuta.[[453]]
Conium[[454]] Maculatum (Pentandria Digynia. Nat. Ord. Umbellatæ.)
Hemlock is a biennial, umbelliferous, indigenous plant, growing very commonly about the sides of fields, under hedges, and in moist shady places. It is at once distinguished from other umbelliferous plants, with which it may be confounded, by its large and spotted stem, the dark and shining colour of its lower leaves, and their disagreeable smell; which, when fresh and bruised is said to bear a strong resemblance to that of the urine of a cat. Many[[455]] cases of persons who have been poisoned by this plant are to be found in the writings of different toxicologists. The extract, if properly prepared, is a very energetic substance, and gives rise, in large doses, to all the symptoms which we have so often described as the result of narcotic poisons. In those fatal cases, where the bodies have been examined, post mortem, inflammation of the stomach, and sanguineous congestion in the brain, have been the most prominent phenomena. It would appear that the active element of this plant is absorbed and carried into the circulation, through which medium it exerts its action on the nervous system, and more particularly on the brain. At the same time it seems to excite a local irritation, capable of producing an inflammation more or less violent. The best antidote is vinegar, after the stomach has been evacuated, and the cerebral excitement reduced by bleeding and purging.
The Cicuta Virosa, or water hemlock, with which the conium maculatum has been often confounded, is still more virulent; it is however to be distinguished from the latter, by having its hollow roots always immersed in water, while those of the conium never are. M. Orfila has related several cases of poisoning by the water hemlock.
Nux Vomica.
This is the seed of the Strychnus Nux Vomica (Pentandria Monogynia, Nat. Ord. Apocyneæ, Juss.)
The tree[[456]] which produces these seeds grows in Ceylon, upon the coast of Coromandel, and in Malabar. The nux vomica is round and flat, about an inch broad, and nearly a quarter of an inch thick, with a prominence in the middle on both sides, of a grey colour, covered with a kind of woolly matter, but internally hard and tough. The kernel discovers to the taste a considerable bitterness, but makes little or no impression on the organs of smell. There is a popular belief that this substance is poisonous to all animals, except man. Instances, however, are not wanting to illustrate its deleterious effects upon the human species. It proves fatal to dogs in a very short period; it has also poisoned hares, foxes, wolves, cats, rabbits, and even some birds. Loureiro relates that a horse died in four hours after taking a drachm of the seed in an half roasted state. Its effects, however, on different animals, and even on those of the same species, are somewhat uncertain, and not always in the proportion to the quantity given. With some animals it produces its effects almost instantaneously: with others, not until after the lapse of several hours, when laborious respiration, followed by torpor, tremblings, coma, and convulsions usually precede the fatal spasms, or Tetanus, which so especially distinguishes the operation of this poison. Hoffman reports the case of a young girl of ten years of age, who, labouring under an obstinate quartan fever, took, at two doses, fifteen grains of nux vomica, and died very shortly afterwards. MM. Pelletier and Caventou have discovered in these seeds, a peculiar proximate principle, to which their virulence is owing; it was originally named Vauqueline, in honour of the celebrated French philosopher, but in deference to the opinion of the French Academy of Sciences, the discoverers have substituted the name Strychnia,[[457]] because “a name dearly loved, ought not to be applied to a noxious principle!”
Strychnia is highly alkaline, and crystallizes in very small four-sided prisms, terminated by four-sided pyramids; its taste is insupportably bitter, leaving a slight metallic flavour, and is so powerful as even to be perceptible when a grain is dissolved in eighty pounds of water;[[458]] it has no smell. So extreme is its activity upon the animal system, that in doses of half a grain it occasions serious effects, and in larger ones, convulsions and death. It is, perhaps, the most powerful, and, next to hydro-cyanic acid, the most rapid of poisons. M. Majendie has killed a dog with one-eighth of a grain; and the editor of the Edinburgh Medical and Surgical Journal has seen one die in two minutes after the injection of one-sixth of a grain into the cavity of the pleura.
Nux vomica is supposed by Orfila to exert a specific action on the spinal marrow, thereby producing tetanus, immobility of the thorax, and consequently asphyxia, of which the animal dies. That this effect is produced by the absorption of the poison, and its passage into the circulation, is clearly established by the interesting and important experiments of M. Majendie.[[459]]
Cocculus Indicus.
This is the fruit of a shrub (Menispermum Cocculus) which grows naturally in the sand, in the midst of the rocks, on the coast of Malabar, in the island of Ceylon, and in other parts of the East Indies. The berries are imported into this country in a dry and shrivelled state. In India they are employed for killing fish, which they intoxicate and poison, when thrown into fish ponds. M. Goupil, a physician of Nemours, communicated to the Society of Medicine some interesting facts on the subject of this poison;[[460]] and he has shewn that it is not only destructive to fishes, but also to different carnivorous quadrupeds, and, very probably, to man. He also states that the poisonous principle of this substance is not sensibly changed by the gastric juices, and the vital action of the organs of digestion; but, on the contrary, that it passes into the absorbent system with all its properties unimpaired; and that the flesh of those fishes which have eaten it, irritates the stomach and bowels of the animals to which it is given, nearly in the same manner as the Cocculus Indicus itself. All the fishes who eat it do not die in an equal space of time. Roach, pollard, breme, perch, tench, and barbel, are affected in an order corresponding with that in which they are here arranged; the roach is killed the easiest of all; the barbel is the last to die, and is moreover said to be, of all fish, the one whose flesh the most frequently occasions accidents in those animals who eat it; probably, says M. Goupil, because these fish, taking a longer time to die, the poison is longer subjected to the action of the digestive juices, and a considerable quantity of it is consequently absorbed.[[461]]
Late experiments[[462]] have shewn that the active principle of the cocculus Indicus is an alkaline body, crystallizable, bitter, and extremely poisonous; to this principle, M. Boullay has given the name of picrotoxine, and the experiments of M. Orfila have confirmed the idea of its constituting the only active element of the seeds.
Poisonous Mushrooms.
The common mushroom, or champignon, (Agaricus Campestris) has been long esteemed an article of epicurean delicacy; and is eaten in its fresh state either stewed or boiled; and as a preserve, in the form of pickle or powder. Its juice, moreover, furnishes the sauce so well known by the name of ketchup,[[463]] or catsup. Mr. Miller informs us that the true eatable mushroom may be easily distinguished from the poisonous and unpleasant species by the following characters. “When young, it appears of a roundish form, smooth, like a button; which together with its stalk, is white, especially the fleshy part of the button; the gills within, when broken, are livid. As it grows larger, it expands its head by degrees into a flat form; the gills underneath are at first of a pale flesh-colour, but become blackish on standing.” There are besides a vast number of species which may be eaten with perfect impunity; the Agaricus Procerus, or tall mushroom, is sometimes exposed for sale in Covent Garden market, and is quite harmless; although, when preserved in pickle, it is very apt to run into the vinous fermentation. With equal safety the Agaricus Pratensis, or Scotch bonnet, as it has been called, may be eaten; it occurs in those patches which are well known by the popular name of fairy rings. The Agaricus deliciosus is considered by Withering to have been the mushroom which formed the vehicle of poison to Claudius Cæsar, as related at page [134] of this volume, and which has been celebrated by the satiric pen of Juvenal, and the epigrammatic muse of Martial; a species of mushroom, observes Withering which is still highly esteemed in modern Italy, as it was in ancient Rome. Schæfer and Clusius, however, consider the plant in question to have been the Agaricus Xerampelinus, a species which although esculent, has a strong, and by no means an agreeable flavour. The common champignon has never, as far as we can learn, produced any mischief, although a popular opinion prevails that soil, shade, and other local circumstances, may render it virulent. If any unpleasant symptoms were to follow its ingestion, we should be inclined to regard them as the result of the peculiar idiosyncrasy of the individual, rather than as the consequence of an absolute poison; indeed a question has been raised how far such an explanation may not apply to all the cases of poisoning from this tribe of plants; for it has been observed that in many parts of Europe several of those species of mushroom are eaten with impunity, that are regarded by us as most virulent poisons; of this number we may reckon the Agaricus Piperatus, or Pepper Agaric, which is eaten in great quantity by the Russians, who fill large vessels with them in the autumn, seasoning or pickling them with salt, and then eating them in the ensuing lent.[[464]] There is, however, too much direct evidence in favour of the existence of an acrid poison in certain Agarics, to allow the supposition of their being relative[[465]] in their operation, as exemplified in the history of the Agaricus Muscarius, or Bugagaric, which is so called from its power in destroying these insects; and for which purpose the inhabitants of the north of Europe infuse it in milk, and set it in their windows. It constitutes the Mouchomore of the Russians, Kamtschadales, and Koriars, who use it for the sake of intoxication; upon some occasions they eat it dry, but generally it is steeped in a liquor made with the Epilobium Angustifolium; upon drinking which, they are seized with convulsions in all their limbs, followed by raving delirium: an effect which renders it a desirable potation[[466]] to those who intend to accomplish any desperate act, or premeditated assassination. It is also stated that those who drink the urine of persons intoxicated by this agaric, experience the effects of the mushroom. Withering,[[467]] who has been very assiduous in the display of this species, acknowledges ten varieties, all of which are natives of Britain. The Agaricus Semi-globalus of this botanist, and which is identical with the A. Glutinosus of Curtis, is extremely poisonous, and has proved fatal in several instances in this country. There are a great many other species equally destructive, but notwithstanding the labour that has been bestowed upon this branch of natural knowledge, much remains to be explained. The ancients appear to have taken considerable pains in discriminating between esculent and poisonous fungi; among the moderns, Clusius has furnished a mass of information. Withering has described with great botanical minuteness and accuracy the different species and varieties of this extensive genus of the cryptogamia; but he has failed in pointing out the poisonous, from the esculent and harmless species. Orfila, in his late lessons on Poisons,[[468]] has bestowed considerable labour with a view to establish a practical distinction, and has enriched his work with highly illustrative engravings. Upon the present occasion, it is scarcely necessary to observe, that it would be foreign to the plan of this work to enter into such botanical details as the full elucidation of this subject would require; the research would, in itself, occupy a quarto volume; we must therefore rest satisfied with general observations. The following indications should excite a suspicion of mushrooms. A marshy and shady locality; an ugly or lurid physiognomy; a glairy or moist surface; a change of colour when cut, and a soft, porous, and moist texture; a virulent smell; a bright colour, or a combination of distinct colours. We ought also to reject as dangerous all those which have bulbous and soft stems, or which have fragments of skin glued to their surface.
Symptoms of poisoning by Mushrooms.
Exhilaration of spirits, laughter, vertigo, sickness, griping pains, vomiting, and purging, suffusion of the eyes, stupor, cold sweats, syncope, convulsions, death. Numerous records of sickness and death might be adduced in illustration of this subject. The celebrated musician, Schobert, and, with the exception of one child, his whole family, together with a friend and a physician who dined with him, were all fatally poisoned by a dish of mushrooms, which he had himself gathered in the fields of Saint Gervais, a village in the environs of Paris. It is not known to what species the plants belonged. In the Gazette de Santé, for August 1812, we have the following narrative. “M. Dufour, a physician of Montargis, gathered in the neighbouring forest some mushrooms, which were stripped of their skin, and their stem, cut into pieces, and cooked in their juice with butter and fine herbs, under a camp oven. They were served up at table. The servant girl, aged twenty years, who had eaten the greatest quantity, very shortly complained of confusion of the head, giddiness, and a slight heaving of the stomach; her face was red and inflamed, the eyes starting and lively, the pulse full and undulating. The eldest daughter of M. Dufour experienced the same symptoms without any nausea. A little child, eighteen months old, that had only eaten some bread dipped in the gravy, slept quietly for sixteen hours, contrary to his usual custom, and exhibited no other remarkable phenomenon. The other child, aged eleven years, complained of confusion of the head and intoxication; the parents did not experience any ill effects. Upon investigation it was discovered that two mushrooms of the Agaricus Muscarius, having been confounded with the proper one, had entered into the composition of the dish.”
Amongst the cases which have occurred in this country, we may particularize that related by Mr. E. Brande, in the third volume of the London Medical and Physical Journal, p. 41, “J. S. gathered early in the morning of the third of October, in the Green Park, what he supposed to be small mushrooms; these he stewed with the common additions in a tinned iron[[469]] saucepan. The whole did not exceed a tea-saucer full, which he, and four of his children ate the first thing, about eight o’clock in the morning, as they frequently had done without any bad consequence; they afterwards took their usual breakfast of tea, &c., which was finished about nine, when Edward, one of the children (eight years old) who had eaten a large proportion of the fungi, was attacked with fits of immoderate laughter, nor could the threats of his father or mother restrain him. To this succeeded vertigo, or stupor; the pupils of his eyes were, at times, dilated to nearly the circumference of the cornea, and scarcely contracted at the approach of a strong light; his breathing was quick, his pulse very variable, at times imperceptible, at others too frequent and small to be counted, latterly very languid; his feet were cold, livid, and contracted; he sometimes pressed his hands on different parts of his abdomen, as if in pain, but when roused and interrogated respecting it, he answered yes, or no, evidently without any relation to what was asked. About the same time the father, aged forty, was attacked with vertigo, and complained that every thing appeared black, then wholly disappeared; to this succeeded loss of voluntary motion and stupor; in about ten minutes he gradually recovered, but complained of universal numbness and coldness, with great dejection, and a firm persuasion that he was dying; in a few minutes he relapsed, but recovered as before, and had several similar fits during three or four hours, each succeeding one being less violent, and with longer intermission than that preceding. Harriet, twelve years old, who had eaten but a very small quantity, was also attacked at the time with slight vertigo. Charlotte, a delicate little girl, ten years of age, who had eaten a considerable quantity, was suddenly attacked in the presence of Dr. Burges and myself, with vertigo and loss of voluntary motion. Martha, aged eighteen, who had eaten a small proportion, was attacked with similar symptoms.” By judicious treatment they all recovered. Upon investigation Mr. Sowerby determined the mushroom to have been a variety of the A. glutinosus of Curtis (Flora Londinensis) the same with Dr. Withering’s A. semi-globatus; and yet no notice of its deleterious properties is taken by either of these botanists.
A less fortunate case of poisoning by Fungi is related in the twentieth volume of the same journal by Mr. Parrott, surgeon of Mitcham, of which the following is a sketch. The subject of the history was a family of six persons, viz. William Attwood, ætat. 45; Eliza, his wife, 38; and their daughters, Mary, æt. 14; Hannah, 11; Sarah, 7; Eliza, 5. They all ate stewed champignons, at one o’clock, on Monday the 10th of October, which stew was made in an iron vessel, and consisted of the articles already mentioned with the addition of butter and flour, pepper, salt, and water only; and each of the parties (Hannah excepted) was supposed to have eaten more than half a pint. Within ten minutes after they had eaten their meal, they felt their spirits exhilarated, and the eldest daughter said to her mother “how funny you look.” All the parties continued cheerful till about six o’clock, when having taken their tea, they were attacked with stupor, which was soon succeeded, by severe pains in the bowels, accompanied with violent vomiting, and copious purging, which continued till the following afternoon, when the parents became alarmed and sent for the surgeon. The treatment which was pursued appears to have been, in every respect, judicious, and Mary had so far recovered on the following day (Wednesday) that she walked into the village about a quarter of a mile from home; in the evening, however, the symptoms returned; on Thursday evening she became convulsed, and died on Friday morning at two o’clock. Eliza did not complain much of her sufferings, but became convulsed at the same time as her sister, and died half an hour after her. Sarah never complained of pain in the head, but was continually suffering under extreme pain in the bowels, which was aggravated by pressure, but no tension existed; she died on Saturday morning, in the same convulsed state as her sisters. A dog which had partaken of the stew died on the Wednesday night, apparently in great agony. The father recovered, the mother, who was two months advanced in pregnancy, miscarried, but ultimately became convalescent. Mr. Wheeler, of St. Bartholomew’s hospital, a gentleman who has been long known to the profession as an eminent botanist, no sooner heard of the event than he repaired to the spot where the mushrooms had been gathered, when he immediately recognised the Agaricus semi-globatus, which had nearly proved fatal in the instance related by Mr. E. Brande, and which, upon being shewn to the father, he instantly pronounced to be similar to those, of which the family had so unfortunately eaten.
Organic Lesions discovered on Dissection.
In the above case of the family of Attwood, the body of Mary was examined, but no morbid appearance whatever could be discovered. In collecting the different phenomena exhibited in other recorded cases, they may be reduced to the following: “violet coloured spots over the integuments; abdomen extremely bulky; the tunica conjunctiva of the eye as if it were injected; the pupil contracted; stomach and intestines inflamed, and scattered over with gangrenous spots; and, in some cases, they have exhibited very considerable contractions, so much so as almost to obliterate the canal. In no case have any remains of the mushroom been found. The lungs have been observed inflamed, and gorged with black blood.”
There cannot, however, be any doubt but that the different species of poisonous agarics act very differently.
Antidotes.
In all cases, the first object is to evacuate the offensive matter by emetics. After which, stimulants, especially ammonia, will be found highly serviceable.
Alcohol.
In treating of the action of this substance upon the human body, it may be considered as a slow, or quick poison; as one which, according to the circumstances of its administration, may either implant the seeds of disease and death, by an insidious, and scarcely perceptible operation, or extinguish the principle of animation in the space of a few hours.
Its effects as an accumulative[[470]] poison are principally interesting to the physician in their relations to therapeutics, although their history may perhaps suggest some few points of interest to the founders of medical police.
We shall, therefore, observe, with regard to the habitual use of fermented liquors, that the bodily evils which arise from the custom rather depend upon the quality, or, in other words, the state of combination in which the alcohol exists in such liquors, than on the absolute quantity of the libation, or the frequency with which it is repeated. Daily experience convinces us that the same quantity of alcohol applied to the stomach under the form of wine, and in a state of mixture with water, will produce very different effects upon the living body, as well with reference to the immediate symptoms, as to the remote consequences of the potation; it has, for instance, been clearly demonstrated that port, madeira, and sherry, contain from one-fourth to one-fifth their bulk of alcohol;[[471]] so that a person who takes a bottle of either of these wines, will thus take nearly half a pint of pure alcohol, which is equivalent to a pint of brandy! The remote consequences too of alcohol in these different states, are as striking and distinct as their immediate effects. It is well known that diseases of the liver are the most common, and the most formidable of those produced by the use of ardent spirits; it is equally certain that no such disorders follow the intemperate use of wine that is perfectly pure; let it be remembered that the greater proportion of that which is drunk in this country contains uncombined brandy, purposely added to meet the demand of the British market; and Dr. MacCulloch thinks that it is to the unwitting and concealed consumption of this uncombined spirit, that we ought to attribute the prevalence of those hepatic affections which are comparatively little known to our continental neighbours. But although wine, in a state of purity, may be thus fairly excluded from the general obloquy which attaches to spirituous potations, it must not be regarded as entirely free from imputation. “The effects of wine,” says Rush “like those of tyranny in a well formed government, are first felt in the extremities; while spirits, like a bold invader, seize at once upon the vitals of the constitution.” And even with respect to ardent spirits, although they can only be regarded as diluted alcohol, still each species appears to possess a peculiarity of operation; owing, no doubt, to the modifying influence of the other elements of the liquid; thus brandy[[472]] is said to be cordial and stomachic; rum more heating and sudorific; gin and whiskey, diuretic; and arrack, styptic, heating, and narcotic. It seems also that a modified effect is produced by the addition of various other substances, such as sugar and acids; which latter bodies, besides their anti-narcotic powers, appear to act by favouring a more perfect combination and mutual penetration of the particles of spirit and water. The effects also which are produced by the habitual use of fermented liquors differ essentially according to the kind that is drunk; thus ale and porter, in consequence of the nutritive matter, and perhaps the invigorating bitter with which they are charged, and the comparatively small proportion of alcohol which they contain, dispose to plethora, which is sometimes terminated by apoplexy.[[473]]
Symptoms of Poisoning by Alcohol.
The ordinary effects of an excessive dose of any spirituous liquor are too well known to require description; and generally pass off without the necessity of professional interference. In cases, however, where the draught has been very large, the person has suddenly fallen down in a state of complete insensibility, and has exhibited all the phenomena of apoplexy; or, in some instances, he has expired almost immediately. The insensibility of the patient may render it difficult for the practitioner to distinguish the immediate cause of the symptoms; although his history for the last few hours, and the spirituous odour of his breath, will generally announce the true nature of his situation. Mr. Brodie observes that there is a striking analogy between the symptoms arising from the ingestion of spirits, and those produced by injuries of the brain; concussion of the brain, which may be considered the slightest degree of injury, occasions a state of mind resembling intoxication; pressure on the brain, which is a more severe injury than concussion, produces loss of motion, insensibility, dilation of the pupils, laborious and stertorous respiration, and death.
Physiological Action of Alcohol.
We shall not enter into the history of the slow operation of repeated doses of spirit upon the human body; but limit our present inquiry to the modus operandi of this agent, as a quick and destructive poison.
Large draughts of liquids containing alcohol, would appear to destroy, at once, the functions of the brain, without occasioning that previous stage of excitement, which is produced by smaller quantities of spirit—whence coma and insensibility are the immediate consequences; and the nervous energy being no longer conveyed to the muscles of respiration, the breathing becomes laborious, and the patient dies, as he does in apoplexy, for want of those changes in the blood which are produced by the respiratory functions.[[474]] In the greater number, however, of fatal cases of inebriety, life has been destroyed by circumstances purely accidental; such as improvident exposure to cold, as explained at page [59], or suffocation from an imperfect act of vomiting, during which a portion of the contents of the stomach are forced into the trachea, (see page [58],[[475]].) It having then been clearly established that the brain is the organ principally affected by a large dose of alcohol, it remains to be explained in what manner, and through what medium such an effect is produced; upon this question we are inclined to concur with Mr. Brodie, and to consider that alcohol acts sympathetically on the brain by means of the nerves of the stomach; for it has been observed that animals which die under such circumstances, exhibit a decided inflammation of the stomach; and, in the next place, the effects produced by this agent are too instantaneous to admit the possibility of absorption, while repeated instances have shewn that vomiting will often restore the intoxicated individual to his senses. At the same time, we think it very probable that, upon some occasions, the alcohol passes into the current of the circulation, and is thus carried to remote organs. Dr. Cooke[[476]] has related a case, on the authority of Sir A. Carlisle, of a person who was brought dead into the Westminster hospital, in consequence of having drunk a quart of gin for a wager, at a draught; and that upon examination, a considerable quantity of a limpid fluid was found within the lateral ventricles of the brain, distinctly impregnated with gin. We well remember this case, for it occurred during the period that the author of the present work held the situation of physician to that hospital. See Pharmacologia, vol. 1, p. 138.
Treatment of Persons in a State of Inebriety.
In the first instance we should endeavour to evacuate the stomach; for which purpose a brisk emetic of sulphate of zinc, or tartarised antimony may be administered. Blood should also be taken from the jugular vein, or temporal artery; more especially if there appear a considerable determination of blood to the head. The head should be also washed with cold water, or some evaporating lotion.
For reasons which we have already explained, the patient should be carefully preserved in a warm atmosphere; and his body should be placed in an easy reclining posture, and be disencumbered of all tight bandages. These precautions are of the utmost moment, for many of those cases of inebriety which stand recorded in our journals, have terminated fatally, for want of attention to them.
ANIMAL POISONS.
This extensive kingdom of Nature presents us with a variety of objects destructive to human life; their agency, however, is on many occasions involved in impenetrable obscurity, and we are not even able to discover whether their deleterious effects depend upon certain definite principles, or upon the combination of circumstances connected with the individuals upon whom they act; and which thus render many substances relatively poisonous, that are innocuous to the general mass of mankind. With regard to the chemical laws by which animal compounds are governed, and the principles upon which their analysis may be conducted, the same observations will apply as those with which we introduced the consideration of vegetable poisons.