Colic.—May be confounded with poisoning by the salts of lead. If lead be taken in large doses, it produces the symptoms common to irritant poisons added to those of colic. In chronic lead poisoning, the blue line round the gums, the aspect of the patient, and history of the case, will point to the true cause of the symptoms. Lead colic is also generally accompanied with extreme depression of spirits.
Rupture of Internal Organs.—Rupture of the stomach, duodenum, gall-bladder, and impregnated uterus, is of rare occurrence. The autopsy will show the true cause of death.
Table giving the names of Diseases the Symptoms of which resemble those the result of Narcotic Poisoning, together with such points of difference as may assist in distinguishing the one from the other:
Narcotic Poisoning.—Giddiness, headache, drowsiness, and considerable difficulty in keeping awake. Paralysis of the muscles, convulsions, ending in profound coma and death. The symptoms of narcotic poisoning begin not later than an hour, or at most two hours, after the poison is taken, except in the case of poisonous fungi and spurred rye, when a day or two may elapse. The symptoms of narcotic poisoning advance gradually. The person may, in most cases, be roused from the deepest lethargy. The pupil in opium poisoning is, as a rule, contracted. Recovery seldom occurs after twelve hours; in most cases, death takes place in six or eight hours—the shortest time being three hours.
Apoplexy.—In some cases apoplexy is preceded by warning symptoms—headache and giddiness. As a rule apoplexy is a disease of old age, and of stout, plethoric people. If the symptoms do not come on for some hours after food or drink has been taken, this disease is to be suspected; but it may occur at or immediately after a meal, too soon to be the result of the action of narcotics—ten to thirty minutes always elapsing before these poisons act. Apoplexy generally comes on suddenly, coma at once present. It is seldom possible to rouse the person when the sopor of apoplexy is fully developed. The pupils in apoplexy are usually unequal or dilated; but should the effusion of blood take place into the pons Varolii, the pupils may be contracted, hence closely simulating opium poisoning. Apoplexy may last for days, or death may occur in an hour.
Epilepsy.—Loss of consciousness and presence of convulsions mark this disease; and in these it resembles poisoning by prussic acid. Epilepsy is in most cases a chronic disease. Warnings—aura epileptica—are often present. The fit begins violently and abruptly. The paroxysm generally lasts for some time, and death rarely occurs during the first attack.
Table showing Points of Difference in the Action of
Corrosive and Irritant Poisons
| Corrosives. | Irritants. |
| 1. Destruction of the parts to | 1. Irritation of the parts to |
| which they are applied. No | which they are applied |
| remote action on the system. | producing inflammation. |
| Remote action present in | |
| most of the irritants. | |
| 2. Symptoms supervene immediately | 2. Symptoms may rapidly |
| they are swallowed, and consist | supervene after they are |
| of a burning, scalding pain | taken, or some delay may |
| elt in the mouth, gullet, and | occur, due to the state of |
| stomach. | concentration or dilution |
| of the poison. Pain in | |
| the stomach and bowels, | |
| more or less severe, is | |
| always present with the | |
| other signs of irritation. | |
| 3. Death may result from— | 3. Death may result from— |
| (1) Shock. | (1) Shock. |
| (2) Extensive destruction of | (2) Irritation, causing |
| the parts touched. | |
| (3) Starvation. | (3) Protracted suffering. |
| (4) Suffocation, the result of | (4) Starvation. |
| œdema, or spasms due to | |
| acid in larynx. | |
| 4. Post-mortem appearances: | 4. Post-mortem |
| corrosion and extensive | appearances: irritation |
| destruction of tissue. | and signs of inflammation, |
| ulceration, &c. |
GENERAL TREATMENT OF CASES
OF POISONING
The principal modes of procedure are as follows: