An accident of a similar nature, for the particulars of which I am indebted to Dr. Swanwick of Macclesfield, occurred at Stockport in the summer of 1830. A family of five persons took for dinner broth made of beef, which, owing to its black colour, the master of the family had previously said to his wife he thought bad and unfit for use. In the course of some hours two boys were attacked with sickness and vomiting, but appear to have got soon well, probably owing to the early discharge of the poison. Next morning a washerwoman who had dined with the family was seized with violent pain in the bowels, diarrhœa, racking pains and weakness in the limbs; and she did not recover for ten days. On the evening of the second day the master of the house was similarly affected, and was ill for a fortnight. And a day later his wife was also seized with a similar disorder, preceded by soreness of the throat and tongue and difficulty of swallowing, and ending fatally in fourteen days. The last person was previously in delicate health, and subject to disorder in the stomach and bowels. The investigation made by the police authorities into the circumstances of this accident was extremely imperfect: but there seems little reason to doubt that unsound meat was the cause.
I am not sure under what head to arrange the following observations, communicated to me by Dr. M’Divitt of Canterbury, and of which he has since published a detailed account.[[1594]] But they may be mentioned, perhaps not inappropriately, in the present place; and at all events they deserve careful attention, as referring to a description of cases which may be mistaken for other kinds of poisoning.
It is well known that pork in all forms, but especially when fresh, is apt to cause indigestion in many persons who are not accustomed to it. But Dr. M’Divitt has shown by a number of interesting cases, that even in those habituated to its use, it may, from unascertained causes, excite symptoms closely allied to those of irritant poisoning. The effects sometimes begin within three hours, the symptoms being those of an affection of the stomach, such as sudden violent pain in the epigastrium, difficult breathing, irregularity of the pulse, great prostration and alarm, coldness of the extremities and vomiting. If a longer period elapses,—and sometimes no injury accrues for many hours, or even a whole day,—the symptoms indicate an affection of the abdomen, namely, pain in the region of the duodenum, or of the sigmoid flexure of the colon, with the other symptoms just enumerated, but which ere long become attended with more pungent pain, tension and tenderness of the belly, frequency of the pulse, and ineffectual straining to evacuate the bowels. In the less urgent and slower cases of this nature there is little or no vomiting. Sometimes nettle-rash appears. Stimulants, opiates, and blood-letting are of no avail; and the only useful remedies are emetics and cathartics, which speedily put an end to the symptoms by removing their cause. In all the cases related by the author the pork was either fresh or recently salted, fatter than usual, but not ill preserved or otherwise faulty in any appreciable respect. In every instance the individuals had eaten pork often before without injury; and on several occasions others ate without harm the same pork which seemed deleterious.
CHAPTER XXV.
OF POISONING BY MECHANICAL IRRITANTS.
The fifth order of the irritant class of poisons includes mechanical irritants.
These substances have not properly speaking any poisonous quality; but occasion symptoms like those of poisoning, and even sometimes death itself, in consequence of their mechanical qualities only. They have therefore been excluded from every toxicological system proposed in recent times; but in a medico-legal work on poisoning it would be wrong to pass them without notice.
The most important of the mechanical irritants are those which cause injury by reason of their roughness, sharpness, or size.
Many instances have occurred of persons having swallowed fragments of steel, copper, iron, broken glass, or entire prune-stones, cherry-stones, and the like,—who not long afterwards were attacked with signs of inflammation, or some other abdominal disease, and were carried off by it as by the administration of poison. The disorders thus induced are almost always of a chronic or lingering kind, and commonly depend on gradual perforation of the intestines by the foreign body pressing on the coats. In general the illness ends in inflammation of the peritonæum. Sometimes the irritating substance perforates the skin and muscles as well as the intestines, and escapes outwardly; and a few individuals have even recovered under these circumstances. An excellent account of the ordinary course of such accidents is given in the London Medical and Physical Journal. The person swallowed a chocolate bean, and after experiencing many uneasy sensations throughout the belly for several days, was attacked with peritonitis and died.[[1595]] Mr. Howship has related the particulars of the case of a woman, died after two years of constant suffering, in consequence of having swallowed a large quantity of cherry-stones.[[1596]] Dr. Marcet has also described the case of a sailor who died in a similar way after swallowing several large clasp-knives.[[1597]] Thus too, although it is a familiar fact, that needles and pins are in general swallowed with impunity, death nevertheless sometimes arises from this cause. Guersent mentions the case of a child who died in the course of two months of frequent vomiting caused by swallowing a pin, which was found after death pinning the stomach, as it were, to the liver.[[1598]] Dupuytren relates the case of a woman, who, after swallowing an incredible number of needles and pins, became very lean and was confined to bed by the excruciating pain excited on motion by the needles and pins escaping through the skin. There were seldom less than fifty tumours or abscesses on various parts of the body; and Dupuytren, on opening about a hundred of these, invariably found one or more needles or pins in each. She laboured under general debility, irritative fever, and marasmus, and at length died hectic. After death many hundred pins and needles were found among the muscles and viscera.[[1599]] Many other examples might be referred to, but these will suffice for information on the ordinary effects of mechanical irritants of the kind under consideration.
From the case of Dr. Marcet and other similar facts, it appears that large and even angular bodies do not always cause serious mischief, nay, that they have been frequently swallowed without any material injury. Dr. Marcet’s sailor in the course of his life had repeatedly swallowed several clasp-knives in quick succession: and nevertheless recovered perfectly after some days of slight illness. As to prune and cherry-stones, buttons, coins, needles, pins, and the like, they have been very often taken, and even sometimes in large quantities, without any harm. It is indeed extraordinary, and almost incredible, if the facts were not authenticated beyond the possibility of a doubt, how much mechanical irritation the alimentary canal has been subjected to, without sustaining any injury. Mr. Wakefield mentions that a man, who was committed to the House of Correction, swallowed seven half-crowns, to prevent the prison authorities from depriving him of them. He suffered no inconvenience for twenty months; when, after an attack of sickness, slight bowel-complaint, and general tenderness of the belly, he discharged them all at one evacuation.[[1600]] Many singular instances to the same effect have been related in the various medical journals of Europe. At the head of the list, however, may be placed the following, which is related by the late Professor Osiander of Göttingen, in his work on Suicide.
A young German nobleman tried to kill himself in a fit of insanity by swallowing different indigestible substances, but without success. He never suffered any particular inconvenience except a single attack of vomiting daily, though in the course of seven months after being detected he passed the following articles by stool—150 pieces of sharp, angular glass, some of them two inches long—102 brass pins—150 iron nails—three large hair pins, and seven large chair-nails—a pair of shirt-sleeve buttons—a collar-buckle, half of a shoe-buckle, and three bridle-buckles—half a dozen sixpenny pieces—three hooks, and a lump of lead—three large fragments of a currycomb, and fifteen bits of nameless iron articles, many of them two inches in length.[[1601]]