“On laying open the abdomen, the stomach was found much thickened throughout its whole substance, and the pylorus very much contracted, which contraction continued down the duodenum. Through all the intestines this thickening and gristly appearance was observed. The colon was prodigiously enlarged in its calibre, until where it forms its sigmoid flexure; at which point there were three distinct holes ulcerated through the coats of the intestine, and forming a communication with the abdominal cavity. Beyond the sigmoid flexure the intestine was contracted in its diameter, so as hardly to admit the little finger to pass downwards. On cutting open the pylorus and small intestines, the internal coats were found to be covered with a soft substance, which resembled size. The internal coats of the colon were of a dark colour, and in general were completely ulcerated, and hanging in shreds. The colour of the colon was of a dark lurid red. At the sigmoid flexure there was much contraction, and the thickening was so great on one side, and the valve found so considerable, as hardly to admit a common bougie through it. The portion forming the sigmoid flexure was cut out; and on laying it open, and removing some hardened fæces, five or six hog’s brittles were seen distinctly crossing each other in different directions; they were partially invested in the villous coat, which had grown over them, and which had retained them in the different positions in which they were placed; and so firmly were they kept down by those partial coverings, that it required some force to draw them out. The mesenteric glands were of a cartilaginous appearance; the liver was suffused with blood, and the gall-bladder full of bile. The spleen was very small, and compressed into an oblong shape, probably arising from the pressure of the colon when distended with feculent matter.
This man had formerly been a shoemaker. There was no evidence as to the period at which he swallowed these hairs; but, from the derangement which always existed in the bowels, and the pain referred to the sigmoid flexure, little doubt can be entertained but that these hairs were the cause of all his complaints, and ultimately of his death.”
CL. II. ASTRINGENT POISONS.
Lead.
This metal appears to have been known in the earliest ages; and is mentioned several times by Moses.[[346]] It has a bluish-white colour; is very brilliant when first cut with a knife, but soon tarnishes by exposure to air; when rubbed violently, it emits a peculiar smell; it is malleable and ductile, but possesses very little tenacity. It is scarcely sonorous; being the softest of all the metals, it yields readily to the hammer. Its specific gravity is 11·35; it melts at 612°. According to the experiments of Dr. Thomson,[[347]] it is susceptible of four degrees of oxidation, presenting us with four distinct, and well defined oxides, viz.
| Yellow | (protoxide) | contains of lead | 91·5 | oxygen | 8·5 |
| Yellow | (deutoxide) | contains of lead | 90·5 | oxygen | 9·5 |
| Red | (tritoxide) | contains of lead | 88· | oxygen | 12· |
| Brown | (peroxide) | contains of lead | 80· | oxygen | 20· |
Lead, in its metallic state, does not exert any action on the living system; but, when oxidized, or in the state of salt, its virulence is very considerable, producing a train of symptoms, so peculiar to itself, as to justify our placing its preparations in a separate class, under the title of astringent poisons, as explained at page [202].
Metallic lead, although per se inert, may occasion deleterious effects when introduced into the stomach, in consequence of its meeting with acids in the primæ viæ; from the same cause, liquids which are liable to become in any degree acidulous, if kept in leaden vessels, may be productive of much danger to those who drink them. Pure water, provided the air be excluded, does not appear to exert any sensible action upon this metal; but the combined influence of these agents converts the lead into a carbonate: a fact which is at once exemplified by the white line which is so constantly visible at the surface of the water preserved in leaden vessels. So well acquainted were the ancients with this fact, that we find frequent allusions in their works to the dangerous property of leaden utensils. Vitruvius[[348]] published a very strong remonstrance against leaden pipes, when used for the purpose of conveying water; and Galen cautions us continually, not to employ water that has flowed through pipes of this metal; since he had observed that the sediment of such water, (υποσταθμη του τουιουτου υδατος) rendered such as swallowed it, δυσεντερικους, subject to disorders in the intestines.
Dr. Lambe, to whom we are indebted for an important work[[349]] upon this subject, states, that there is a great diversity in the corrosive powers of different waters; in some places the use of leaden pumps has been in part discontinued, from the expense entailed upon the proprietors by the perpetual want of repair;[[350]] and if any acidity be communicated to the water, from the accidental intrusion of decayed leaves or other vegetable matter, its power of dissolving this metal will be increased to a very dangerous extent. The noted colic of Amsterdam is said by Tronchin, who has written a history of the epidemic, to have been occasioned by leaves falling and putrefying in leaden cisterns, filled with rain water. Van Swieten[[351]] has also related an instance of a whole family who were afflicted with colic from a similar cause; and Dr. Lambe[[352]] entertains no doubt but that the very striking case recorded in the Medical Commentaries,[[353]] proceeded more from some foulness in the cistern than from the solvent power of the water; in this instance, the officers of a packet vessel used water out of a leaden cistern; the men also drank the same water, except that the latter had been kept in wood; the consequence was, that all the officers were seized with colic, while the men remained healthy. Sir George Baker has furnished the following striking illustration of the subject. “The most remarkable case that now occurs to my memory, is that of Lord Ashburnham’s family, in Sussex; to which, spring water was supplied from a considerable distance in leaden pipes. In consequence, his lordship’s servants were every year tormented with colic, and some of them died. An eminent physician of Battle, who corresponded with me on the subject, sent up some gallons of that water, which were analysed by Dr. Higgins, who reported that the water had contained more than the common quantity of carbonic acid; and that he found in it lead in solution, which he attributed to the carbonic acid. In consequence of this representation, Lord Ashburnham substituted wooden for leaden pipes; and from that time his family have experienced no particular complaints in their bowels.”
But the most extensive and dangerous source of poisoning by lead, is the presence of this metal in various wines, and acescent drinks, and meats, and which may arise either from accident or design. A knowledge of the different avenues, through which this poison may gain admittance into the human body, is therefore of great importance to the forensic physician, and we shall accordingly proceed to the investigation of the subject.