It is impossible to particularize all the articles of the kind now alluded to. But in illustration, I may refer in a few words to six common substances, pepper, Epsom salt, alum, cream of tartar, sulphate of potash, and common salt.
Pepper, which is daily used by all ranks with impunity, will nevertheless cause even dangerous symptoms when taken in large quantity. In Rust’s Journal is noticed the case of a man affected with a tertian ague, who after taking between an ounce and a half and two ounces of pepper in brandy, was attacked with convulsions, burning in the throat and stomach, great thirst, and vomiting of every thing he swallowed. His case was treated as one of simple gastritis, and he recovered.[[1612]]
A very striking instance, which may be arranged under the present head, has also been related to me, of apparent poisoning with Epsom salt. A boy ten years old took two ounces of this laxative partly dissolved, partly mixed in a tea-cupful of water; and had hardly swallowed it before he was observed to stagger and become unwell. When the surgeon saw him half an hour after, the pulse was imperceptible, the breathing slow and difficult, the whole frame in a state of extreme debility, and in ten minutes more the child died without any other symptom of note, and in particular without any vomiting. The circumstances having been investigated judicially, it appeared that the substance taken was pure Epsom salt; that the father, who was doatingly fond of the child, gave the laxative on account of a trifling illness which he supposed might arise from worms; and that on the most careful inspection of the body, no morbid appearance whatever could be found in any part of it. For the particulars of this singular case, I am indebted to Dr. Dewar of Dunfermline, the medical inspector under the sheriff’s warrant. It shows that in certain circumstances even the laxative neutral salts may be irritating enough to cause speedy death.
Of the same nature probably are the cases which have lately led some to ascribe poisonous properties to sulphate of potash, a purgative salt at one time in common use. About three years ago several instances of apparent poisoning with this substance occurred in Paris; and one of them proved fatal. This was the case of a woman, recently delivered, who got 100 grains every fifteen minutes till she had taken six doses. Immediately after the first dose she was seized with severe pain in the stomach, nausea, vomiting, numbness, and cramps in the arms and legs, then with dyspnœa and severe purging, and in two hours she expired. The stomach and intestines were emphysematous, but otherwise healthy; and the stomach contained sulphate of potash, but not a trace of any of the common poisons. The stock of this salt in the shop where it had been purchased was found to be perfectly pure.[[1613]]—A remarkable case of the same kind lately led to a criminal trial in London. A man Haynes was charged with attempting to procure abortion by giving his wife sulphate of potash. It was proved that on two successive evenings he gave her a dose of two ounces of the salt; that she was seized after the first dose with excessive and alarming sickness, from which, however, she soon recovered without apparent harm; but that after the second dose she had violent vomiting and profuse purging, of which she died in five hours, without any alteration in the symptoms, except that she became insensible for five minutes before death. The whole gastro-intestinal mucous membrane was bright red, the vessels of the brain were much congested, and between two and three ounces of blood had escaped from the neighbourhood of the occipital sinus. The salt had been swallowed in a single tumbler of water, so that part of it was undissolved. Mr. Brande, who analyzed the sample which had been used, found it free of all the ordinary irritant poisons. Mr. Coward of Hoxton, to whom I owe the particulars of this singular case, was of opinion, along with other medical gentlemen concerned in it, that death arose from apoplexy brought on by the violent and unceasing vomiting.
Another cathartic, undoubtedly in general very mild in its action, the bitartrate of potash, has also proved fatal, when taken in immoderate quantity. Thus, a man, endeavouring to quench his thirst and cool his stomach the morning after he had been drunk, ate a quarter of a pound of this salt in lumps at once, and a good deal more throughout the day afterwards. He was in consequence attacked with incessant vomiting, frequent purging, and other signs of irritation in the alimentary canal. He died on the third day; and the stomach and bowels were found much inflamed.[[1614]]
Even common salt has been known to act as a poison when taken in large quantity. A striking instance of the kind occurred in London in September, 1828. A man, who had been in the custom of exhibiting various feats of gluttony, proposed to some of his comrades one afternoon to sup a pound of common salt in a pint of ale, and actually finished his nauseous dish, but not without being warned of his imprudence by an attack of vomiting in the middle of it. He was soon after seized with all the symptoms of irritant poisoning, and died within twenty-four hours. The stomach and intestines were found after death excessively inflamed.[[1615]] This remarkable case is not without its parallel. In 1839, a girl in the North of England died in consequence of taking upwards of half a pound of salt as a vermifuge.[[1616]] Not long ago I met with an instance of somewhat similar, but less violent effects. A student having taken upwards of two ounces of salt as an emetic, dissolved in a small quantity of water, was seized with acute burning pain in the stomach, tenderness in the epigastrium and great anxiety, without any vomiting until he drank a large quantity of warm water as a remedy. Before I saw him he had vomited freely, but still suffered severe, intermitting pain, which was removed by a large dose of muriate of morphia.
In France, though not hitherto, so far as I know, in Britain, several instances have occurred of extensive sickness in particular districts, which have been traced to the accidental adulteration of common salt with certain deleterious articles. In an investigation conducted by M. Guibourt, in consequence of several severe accidents having been produced apparently by salt in Paris and at Meaux, oxide of arsenic was detected;[[1617]] and this discovery was subsequently confirmed by MM. Latour and Lefrançois, who ascertained that the proportion of arsenic was sometimes a quarter of a grain per ounce.[[1618]] Another singular adulteration which appears fully more frequent is with hydriodate of soda. At a meeting of the Parisian Academy of Medicine in December, 1829, a report was read by MM. Boullay and Delens, subsequent to an inquiry by M. Sérullas, into the nature of a sample of salt which appears to have occasioned very extensive ravages. In 1829, various epidemic sicknesses in certain parishes were suspected to have arisen from salt of bad quality. In the month of July no less than 150 persons in two parishes were attacked, some with pain in the stomach, nausea, slimy and even bloody purging, others with tension of the belly, puffiness of the face, inflammation of the eyes and swelling of the legs; and in several parishes in the Department of the Marne a sixth part of the population was similarly affected. The salt being suspected to be the source of the mischief, as it had an unusual smell which some compared to the effluvia of marshy ground, M. Sérullas analyzed it, and after him MM. Boullay and Delens; and both analyses indicated the presence of a hundredth of its weight of hydriodate of soda, besides a little free iodine.[[1619]] Subsequently, in reference to the discovery of arsenic by other chemists in different samples of suspected salt, M. Sérullas repeated his analysis, but could detect none of that poison.[[1620]] Still more lately the whole subject has been investigated with great care by M. Chevallier.[[1621]] M. Barruel states that he observed the occasional adulteration of salt with some hydriodate accidentally in 1824, while preparing experiments for Professor Orfila’s lectures. He found it in two samples from different grocers’ shops in Paris.[[1622]] No satisfactory explanation has yet been given of the source of the adulteration with arsenic; but the presence of hydriodate of soda has been traced to the fraudulent use of impure salt from kelp [see p. [160]].
Some difference of opinion prevails among toxicologists in regard to the alleged deleterious qualities of alum. On the whole it scarcely appears so active as to deserve the name of a poison; yet, like other salts, it may in large doses do serious injury. It merits particular mention among the present description of substances, partly on account of a trial at Paris, where dangerous effects were alleged to have been produced by it, and partly for the physiological inquiries made on that occasion. A druggist supplied a lady by mistake with powder of burnt alum instead of gum-arabic; and the lady, who had long laboured under chronic derangement of the stomach and bowels, took a single dose of a solution containing between ten and twenty grains of the salt. She immediately complained of acute pain in the stomach and gullet, burning in the mouth, and nausea; the symptoms of a severe attack of inflammation in the stomach and bowels ensued; and she was not considered out of danger for several days. The druggist was accordingly prosecuted, and heavy damages claimed. The attending physician ascribed the symptoms to the alum. But Marc and Orfila, who were consulted, declared that this was impossible except on the supposition that the lady had a very unusual sensibility of the stomach to irritating substances;—that it was a common thing to give three, four, and even five times the quantity in the treatment of diseases, without any such consequences resulting;—and that at the very time of the inquiry a physician in Paris was using it to the amount of six or eight drachms in a day. From an experimental inquiry conducted by Professor Orfila it appears, that large doses of calcined alum, such as one or even two ounces, excite in dogs little more than one or two attacks of vomiting, even although retained between ten and thirty minutes,—that one ounce will not excite any marked symptoms though secured in the stomach by a ligature,—but that two ounces given in the same way prove fatal in five hours, under symptoms of excessive exhaustion and insensibility.[[1623]] A similar inquiry was instituted about the same time by M. Devergie, who seems, however, to have remarked more activity in alum than is indicated by Orfila’s experiments. He infers that two ounces may sometimes kill dogs, even though they vomit freely; that half that quantity is fatal if the gullet be tied; that calcined alum is more active than a solution of the salt; that it is a corrosive or irritant; and that probably man is more sensible to its operation than the lower animals.[[1624]] Whatever may be thought of the effects of alum on the animal body when administered in large doses, it is plain from its frequent medicinal use as an internal astringent that it is not poisonous when given in small doses, like that taken by the patient in the trial alluded to. I may add that it appears very doubtful whether any injury accrues from the long-continued use of very small doses. Bakers, it is well known, are in the practice of using it in minute proportion for improving the whiteness of bread; and it has been imagined that chronic disorders of the stomach and bowels may consequently originate, by reason of its constipating tendency. These fears, however, are not borne out by facts. Either the quantity is insufficient to do harm in the way supposed; or the constitution becomes accustomed to the continual operation of the salt, and does not suffer.
CHAPTER XXIV.
CLASS SECOND.
OF NARCOTIC POISONS GENERALLY.
The term narcotism has been used by different writers with different significations, but is now generally understood to denote the effects of such poisons as bring on a state of the system like that caused by apoplexy, epilepsy, tetanus, and other disorders commonly called nervous. Narcotic poisons, therefore, are such as produce chiefly or solely symptoms of a disorder of the nervous system.