[747] Tome i. Obs. v.
The usual changes produced by arsenious acid may be studied in the museums of the London hospitals. In Guy’s Hospital Museum there are three preparations. In preparation 179832 is seen a large stomach with the mucous membrane at certain points abraded, and at the great curvature the whole coats are thinned; it is also somewhat congested. In preparation 179864 is a portion of coagulated lymph, from the stomach of a lad, aged 14, who had taken accidentally a piece of cheese charged with arsenious acid, prepared for the purpose of destroying rats. He lived twenty-eight hours, and presented the ordinary symptoms. The lymph has a membranous appearance, and the rugæ of the stomach are impressed upon it. It is said when recent to have presented numerous bright bloody spots, although there was no visible breach of substance on the surface of the stomach. The mucous membrane of the stomach is stated to have been injected, and there was also diffuse injection of the duodenum. Preparation 179880 is the stomach of a person who survived thirteen hours after taking a fatal dose of arsenious acid; and in the same museum there is a wax model of the appearances which the fresh preparation exhibited, showing a large oval patch coated with mucus and the poison. The stomach was intensely inflamed, the cæcum injected. The rest of the intestine was healthy.
In the museum of University College there are two preparations, one[748] exhibiting intense swelling and congestion of the gastric mucous membrane, which is of a perfectly vermilion colour. Another preparation (No. 2868) shows the effect of a small dose of arsenic on the stomach; there are spots of arborescent extravasation, and slight congestion of the summits of the rugæ, but in other respects it is normal. There is also a cast of Peyer’s patches from the same case, showing great prominence of the glands, with some injection of the intestinal mucous membrane.
[748] This preparation at the time of my visit had no number.
In St. Thomas’ Hospital there is an interesting preparation (No. 8) showing the gastric mucous membrane dotted all over with minute ulcers, none of which have an inflammatory zone.[749] I have not, however, seen in any museum a preparation of the curious emphysematous condition of the mucous membrane, which has more than once been met with. For example, in a case related by Tardieu,[750] Schwann, a labourer, died from the effects of arsenic in thirty-six hours. The autopsy showed that the mucous membrane of the stomach and small intestine was covered with a pasty coating, and was elevated in nearly its whole extent by bullæ filled with gas, forming true emphysematous swellings which encroached upon the diameter of the intestine. There was neither redness nor ulceration, but the mucous membrane was softened.