§ 760. Elimination of Antimony.—Antimony is mainly eliminated by the urine. In 1840, Orfila showed to the Académie de Médecine metallic antimony, which he had extracted from a patient who had taken ·12 grm. of tartar emetic in twenty-four hours. He also obtained antimony from an old woman, aged 80, who twelve hours before had taken ·6 grm. (91⁄4 grains)—a large dose, which had neither produced vomiting nor purging. In Dr. Kevin’s experiments on rabbits, antimony was discovered in the urine after the twelfth dose, and even in the urine of an animal twenty-one days after the administration of the poison had been suspended.
§ 761. Antidotes for Tartar Emetic.—Any infusion containing tannin or allied astringent principles, such as decoctions of tea, oak-bark, &c., may be given with advantage in cases of recent poisoning by tartar emetic, for any of the salt which has been expelled by vomiting may in this way be decomposed and rendered harmless. The treatment of acute poisoning which has proved most successful, has been the encouraging of vomiting by tickling the fauces, giving strong green tea and stimulants. (See [Appendix].)
§ 762. Effects of Chloride or Butter of Antimony.—Only a few cases of poisoning by butter of antimony are on record: its action, generally speaking, on the tissues is like that of an acid, but there has been considerable variety in the symptoms. Five cases are recorded by Taylor; three of the number recovered after taking respectively doses of 7·7 grms. (2 drachms) and 15·5 grms. (4 drachms), and two died after taking from 56·6 to 113 grms. (2 to 4 ounces). In one of these cases the symptoms were more like those of a narcotic poison, in the other fatal case there was abundant vomiting with purging. The autopsy in the first case showed a black appearance from the mouth to the jejunum, as if the parts had been charred, and extensive destruction of the mucous membrane. In the other case there were similar changes in the stomach and the upper part of the intestines, but neither the lips nor the lower end of the gullet were eroded. In a case recorded by Mr. Barrington Cooke,[812] a farmer’s wife, aged 40, of unsound mind, managed to elude the watchfulness of her friends, and swallowed an unknown quantity of antimony chloride about 1.30 P.M. Shortly afterwards she vomited several times, and had diarrhœa; at 2.30 a medical man found her lying on her back insensible, and very livid in the face and neck. She was retching, and emitting from her mouth a frothy mucous fluid, mixed with ejected matter of a grumous colour; the breathing was laboured and spasmodic; the pulse could not be felt, and the body was cold and clammy. She expired at 3.30, about one hour and a half from the commencement of symptoms, and probably within two hours from the taking of the poison. The autopsy showed no corrugation of the tongue or inner surface of the lining membrane of the mouth, and no appearance of the action of a corrosive upon the lips, fauces, or mucous membrane of the œsophagus. The whole of the mucous membrane of the stomach was intensely congested, of a dark and almost black colour, the rest of the viscera were healthy. Chemical analysis separated antimony equivalent to nearly a grm. (15 grains) of the chloride, with a small quantity of arsenic, from the contents of the stomach.
[812] Lancet, May 19, 1883.
§ 763. Detection of Antimony in Organic Matters.—In acute poisoning by tartar emetic it is not impossible to find a mere trace only in the stomach, the greater part having been expelled by vomiting, which nearly always occurs early, so that the most certain method is, where possible, to analyse the ejected matters. If it should be suspected that a living person is being slowly poisoned by antimony, it must be remembered that the poison is mainly excreted by the kidneys, and the urine should afford some indication. The readiest way to test is to collect a considerable quantity of the urine (if necessary, two or three days’ excretion), concentrate by evaporation, acidify, and then transfer the liquid to a platinum dish, in which is placed a slip of zinc. The whole of the antimony is in time deposited on the platinum dish, and being thus concentrated, may be subsequently identified in any way thought fit.
Organic liquids are boiled with hydrochloric acid; organic solids are extracted with the same acid in the manner described ([p. 51]); or, if the distillation process given at [p. 576] be employed, the antimony may be found partly in the distillate, and partly in the retort. In any case, antimony in solution may be readily detected in a variety of ways—one of the most convenient being to concentrate on tin or platinum, to dissolve out the antimonial film by sulphide of ammonium, and thus produce the very characteristic orange sulphide.