§ 10. I beg leave on this particular topic to submit the facts and opinions contained in communications from two gentlemen who have paid close and comprehensive attention to the subject.
Dr. Southwood Smith, who, as physician to the London Fever Hospital, and from having been engaged in several investigations as to the effects of putrid emanations on the public health, must have had extensive means of observation, states as follows:—
1. That the introduction of dead animal matter under certain conditions into the living body is capable of producing disease, and even death, is universally known and admitted. This morbific animal matter may be the product either of secretion during life or of decomposition after death. Familiar instances of morbific animal matter, the result of secretion during life, are the poisons of small-pox and cow-pox, and the vitiated fluids formed in certain acute diseases, such as acute inflammations, and particularly of the membranes that line the chest and abdomen. On the examination of the body a short time after death from such inflammations, the fluids are found so extremely acrid, that even when the skin is entirely sound, they make the hands of the examiner smart; and if there should happen to be the slightest scratch on the finger, or the minutest point not covered by cuticle, violent inflammation is often produced, ending, sometimes within forty-eight hours, in death. It is remarkable, and it is a proof that in these cases the poison absorbed is not putrid matter, that the most dangerous period for the examination of the bodies of persons who die of such diseases is from four to five hours after the fatal event, and while the body is yet warm.
That the direct introduction into the system of decomposing and putrescent animal matter is capable of producing fevers and inflammations, the intensity and malignity of which may be varied at will, according to the putrescency of the matter and the quantity of it that is introduced, is proved by numerous experiments on animals; while the instances in which human beings are seized with severe and fatal affections from the application of the fluids of a dead animal body to a wounded, punctured, or abraded surface, sometimes when the aperture is so minute as to be invisible without the aid of a lens, are of daily occurrence. Though this fact is now well known, and is among the few that are disputed by no one, it may be worth while to cite a few examples of it, as specimens of the manner in which the poison of animal matter, when absorbed in this way, acts; a volume might be filled with similar instances.
The following case is recorded by Sir Astley Cooper:—Mr. Elcock, student of anatomy, slightly punctured his finger in opening the body of a hospital patient about twelve o’clock at noon, and in the evening of the same day, finding the wound painful, showed it to Sir Astley Cooper after his surgical lecture. During the night the pain increased to extremity, and symptoms of high constitutional irritation presented themselves on the ensuing morning. No trace of inflammation was apparent beyond a slight redness of the spot at which the wound had been inflicted, which was a mere puncture. In the evening he was visited by Dr. Babington, in conjunction with Dr. Haighton and Sir Astley Cooper; still no local change was to be discovered, but the nervous system was agitated in a most violent and alarming degree, the symptoms nearly resembling the universal excitation of hydrophobia, and in this state he expired within the period of forty-eight hours from the injury.
The late Dr. Pett, of Hackney, being present at the examination of the body of a lady who had died of peritoneal inflammation after her confinement, handled the diseased parts. In the evening of the same day, while at a party, he felt some pain in one of his fingers, on which there was a slight blush, but no wound was visible at that time. The pain increasing, the finger was examined in a stronger light, when, by the aid of a lens, a minute opening in the cuticle was observed. During the night the pain increased to agony, and in the morning his appearance was extremely altered; his countenance was suffused with redness, his eyes were hollow and ferrety; there was a peculiarity in his breathing, which never left him during his illness; his manner, usually gay and playful, was now torpid, like that of a person who had taken an excessive dose of opium, he described himself as having suffered intensely, and said that he was completely knocked down and had not the strength of a child, and he sunk exhausted on the fifth day from the examination of the body.
George Higinbottom, an undertaker, was employed to remove in a shell the corpse of a woman who had died of typhus fever in the London Fever Hospital. In conveying the body from the shell into the coffin, he observed that his left hand was besmeared with a moisture which had oozed from it. He had a recent scratch on his thumb. The following morning this scratch was inflamed; in the evening of the same day he was attacked with a cold shivering and pain in his head and limbs, followed the next by other symptoms of severe fever; on the fourth day there was soreness in the top of the shoulder and fulness in the axilla; on the fifth the breast became swollen and efflorescent; on the seventh delirium supervened, succeeded by extreme prostration and coma, and death took place on the tenth day.
A lady in the country received a basket of fish from London which had become putrid on the road. In opening the basket she pricked her finger, and she slightly handled the fish. On the evening of this day inflammation came on in the finger, followed by such severe constitutional symptoms as to endanger life, and it was six months before the effects of this wound subsided and her health was restored.
Among many other cases, Mr. Travers gives the following, as displaying well the minor degrees of irritation, local and constitutional, to which cooks and others, in handling putrid animal matter with chapped and scratched fingers, are exposed:—A cook-maid practised herself on a stale hare, for the purpose of learning the mode of boning them, in spite of being strongly cautioned against it. A few days afterwards two slight scratches, which she remembered to have received at the time, began to inflame; one was situated on the fore-finger and the other on the ring-finger. This inflammation was accompanied with a dull pain and feeling of numbness, and an occasional darting pain along the inside of the fore-arm. The next day she was attacked with excruciating pain at the point of the fore-finger, which throbbed so violently as to give her the sensation of its being about to burst at every pulsation. The following morning constitutional symptoms came on; her tongue was white and dry; she had no appetite; there was great dejection of spirits and languor, and a weak and unsteady pulse. After suffering greatly from severe pain in the finger, hand, and arm, and great constitutional derangement and debility, the local inflammation disappeared in about three weeks, and she then began to recover her appetite and strength.
2. It is proved by indubitable evidence that this morbific matter is as capable of entering the system when minute particles of it are diffused in the atmosphere as when it is directly introduced into the blood-vessels by a wound. When diffused in the air, these noxious particles are conveyed into the system through the thin and delicate walls of the air vesicles of the lungs in the act of respiration. The mode in which the air vesicles are formed and disposed is such as to give to the human lungs an almost incredible extent of absorbing surface, while at every point of this surface there is a vascular tube ready to receive any substance imbibed by it and to carry it at once into the current of the circulation. Hence the instantaneousness and the dreadful energy with which certain poisons act upon the system when brought into contact with the pulmonary surface. A single inspiration of the concentrated prussic acid, for example, is capable of killing with the rapidity of a stroke of lightning. So rapidly does this poison affect the system, and so deadly is its nature, that more than one physiologist has lost his life by incautiously inhaling it while using it for the purpose of experiment. If the nose of an animal be slowly passed over a bottle containing this poison, and the animal happen to inspire during the moment of the passage, it drops down dead instantaneously, just as when the poison is applied in the form of a liquid to the tongue or the stomach. On the other hand, the vapour of chlorine possesses the property of arresting the poisonous effects of prussic acid; and hence when an animal is all but dead from the effects of this acid, it is sometimes suddenly restored to life by holding its mouth over the vapour of chlorine.