§ 842. Effects of the Corrosive Salts of Mercury.—The type of the corrosive salts is mercuric chloride, or corrosive sublimate—a compound which acts violently when administered, either externally or internally, in large doses.[920] If the poison has been swallowed, the symptoms come on almost immediately, and always within the first half hour; the whole duration also is rapid. In 36 cases collected by F. A. Falck, 11 died on the first or second day, and 11 on the fifth day; so that 61 per cent. died in five days—the remainder lived from six to twenty-six days. The shortest fatal case on record is one communicated to Dr. Taylor by Mr. Welch; in this instance the man died from an unknown quantity within half an hour.
[920] The effects on animals are similar to those on man. Richard Mead gave a dog with bread 3·8 grms. (60 grains) of corrosive sublimate:—“Within a quarter of an hour he fell into terrible convulsions, casting up frequently a viscid frothy mucus, every time more and more bloody, till, tired and spent with this hard service, he lay down quietly, as it were, to sleep, but died the next morning.”
In the very act of swallowing, a strong metallic taste and a painful sensation of constriction in the throat are experienced. There is a burning heat in the throat extending downwards to the stomach. All the mucous membranes with which the solution comes in contact are attacked, shrivelled, and whitened; so that, on looking into the mouth, the appearance has been described as similar to that produced by the recent application of silver nitrate. The local changes may be so intense as to cause œdema of the glottis, and death through asphyxia. In a few minutes violent pain is felt in the stomach; so much so, that the sufferer is drawn together, and is in a fainting condition; but there are rare cases in which pain has been absent. There are nausea and vomiting, the ejected matters being often streaked with blood; after the vomiting there is purging; here also the motions are frequently bloody.[921] The temperature of the body sinks, the respiration is difficult, and the pulse small, frequent, and irregular. The urine is generally scanty, and sometimes completely suppressed.[922] Sometimes there is profuse hæmorrhage from the bowel, stomach, or other mucous membrane, and such cases are accompanied by a considerable diminution of temperature. In a case recorded by Lœwy,[923] after a loss of blood by vomiting and diarrhœa, the temperature sank to 33·4°. The patient dies in a state of collapse, or insensibility, and death is often preceded by convulsions.
[921] The mixture of blood with the evacuations is more constantly observed in poisoning by corrosive sublimate than in poisoning by arsenic, copper, or lead.
[922] In a case recorded by Dr. Wegeler (Casper’s Wochenschrift, January 10, 1846, p. 30), a youth, aged 17, swallowed 11·6 grms. (3 drachms) of the poison. No pain was experienced on pressure of the abdomen; he died on the sixth day, and during the last three days of life no urine was secreted.
[923] Vierteljahrsschr. für ger. Med., 1864, vol. i. p. 187.