1. M. Chomel of Paris has related a case of poisoning with the gas diluted with air, in the person of a labourer, who was suddenly immersed in it at the bottom of a well, and remained there three-quarters of an hour. He was first affected with violent and irregular convulsions of the whole body and perfect insensibility, afterwards with fits of spasm like tetanus; and during the second day, when these symptoms had gone off, he continued to be affected with dumbness.[[2057]]—It is worthy of particular remark that, contrary to general belief, these effects may be produced in situations where the air is not sufficiently impure to extinguish lights. Thus M. Collard de Martigny relates the case of a servant, who, on entering a cellar where grape-juice was fermenting, became suddenly giddy, and, under a vague impression of terror, fled from the place, dropping her candle on the floor and shutting the door behind her. She fell down insensible outside the door, and those who went to her assistance found on opening the door that the light continued to burn.[[2058]]—Mr. Taylor indeed has since ascertained that a candle will burn in air, which contains ten, or even twelve per cent. of carbonic acid,[[2059]]—a proportion more than sufficient to cause poisoning in no long time. It is also important to observe, that, contrary to what would be expected from the statements of Sir H. Davy and other experimentalists on the effects of the pure gas, it will often happen that no odour or taste is perceived. M. Bonami, in an account of an accident which happened at Nantes to two workmen who descended an old well, says that the first while descending uttered a piercing cry and fell down; and that as soon as his comrade, who tried to rescue him, was lowered ten or twelve feet, he felt as if he was about to be suffocated for want of breath, but perceived no strong or disagreeable smell.[[2060]] It should be remembered therefore by workmen, that there may be danger in descending pits where none is indicated by the sense of smell, or by the extinguishing of a light.
2. The fumes of burning charcoal have been long known to be deleterious. The early symptoms caused by them have been little noticed; for, as this variety of poisoning generally occurs during sleep, the patient is seldom seen till the symptoms are fully formed. In an attempt at self-destruction described in a French journal, the first effects were slight oppression, then violent palpitation, next confusion of ideas, and at last insensibility.[[2061]] Tightness in the temples, and an undefinable sense of alarm have also been remarked;[[2062]] and others have, on the contrary, experienced a pleasing sensation that seduced them to remain on the fatal spot.[[2063]] The best account of the incipient symptoms has been given by Mr. Coathupe of Wraxhall, in an account of an experiment he made with Joyce’s stove,—a preposterous invention, the fuel of which was supposed by the inventor to burn without contaminating the air, although it was neither more nor less than prepared charcoal. Having closed every aperture in a room of the capacity of eighty cubic yards, Mr. Coathupe kindled the stove and watched the results. In four hours he had slight giddiness, in five hours and a half intense giddiness, the desire to vomit without the power, excessive prostration and incapability of muscular effort, a frequent full throbbing pulse, a sense of distention of the cerebral arteries, agonizing headache, chiefly in the hindhead, but no sense of suffocation. At this time he experienced great difficulty in opening the window and removing the stove; and in seven hours, when his wife entered the room, he was unable to tell what was the matter, although quite conscious of all that was passing. He then slowly recovered.[[2064]] A similar account has also been given by Mr. Chapman of Tooting of the effects of this notorious stove. A young gentleman, after being only one hour in a chamber heated by it, felt first slight giddiness and headache, and afterwards violent pain in the head and tightness round the forehead and temples; the pupils became excessively dilated and nearly insensible; there was constant ringing in the ears, a feeble frequent pulse, paleness of the features and lividity of the lips and hands, coldness of the extremities, laborious irregular breathing, and extreme prostration. A temporary relief, obtained by stimulants, was succeeded by violence; which, however, was subdued by blood-letting; and he recovered.[[2065]] A set of cases, 70 in number, similar to the last two, but milder, occurred in January, 1836, in the church of Downham in Norfolk, which was heated by two of these stoves.[[2066]]
The following abstract of a case by Dr. Babington will convey an accurate idea of the advanced symptoms. The waiter of a tavern and a little boy, on going to bed, left a choffer of charcoal burning beside it; and next morning were found insensible. The boy died immediately after they were discovered. The waiter had stertorous breathing, livid lips, flushing of the face, and a full, strong pulse; for which affections he was bled to ten ounces. When Dr. Babington first saw him, however, the pulse had become feeble, the breathing imperfect, and the limbs cold; the muscles were powerless but twitched with slight convulsions, the sensibility gone, the face pale, the eyelids closed, the eyes prominent and rolling, the tongue swollen and the jaw locked upon it, and there was a great flow of saliva from the mouth. The employment of galvanism at this time caused an evident amendment in every symptom. But it was soon abandoned; because each time it was applied, the excitement was rapidly followed by corresponding depression. Cold water was then dashed upon him, ammonia rubbed on his chest, and oxygen thrown into the lungs; through which means a warm perspiration was brought out, and his state rapidly improved. He was nearly lost, however, during the subsequent night by hemorrhage from the divided vein; but next day he was so well that he could even speak a little. For two days afterwards the left side of the face was paralyzed, and his mental faculties were somewhat disordered.[[2067]]—In such cases as this the stupor is generally very deep. There is a case in a French Journal of a girl, who, after remaining some time in a small close chamber heated by a charcoal choffer, fell down insensible, remained in that state for three hours, and found, on recovering from her lethargy, that the choffer had fallen, and burnt the skin and subjacent fat of the thighs to a cinder.[[2068]]
Occasionally the stage of stupor is followed, as in some other varieties of narcotic poisoning, by a stage of delirium, at times of the furious kind, or by a state resembling somnambulism.[[2069]] It does not follow that recovery is certain because coma has thus given place to delirium,—an alteration, which in most varieties of narcotic poisoning is considered a sure sign of recovery. Collard de Martigny has related a case which eventually proved fatal, notwithstanding this sign of improvement.[[2070]]
The narcotism induced by breathing charcoal fumes often lasts a considerable length of time,—much longer indeed than the effects of other narcotic poisons. This will appear sufficiently from the case described by Dr. Babington. One of the people, mentioned at the commencement of this chapter as having been suffocated at Gerolzhofen, lingered five days in a state of coma before he expired.
Commonly in cases of recovery, there is found to have been no consciousness of any thing going on around, or recollection of what passed subsequently to the first impressions of poisoning. The reverse, however, occurred in Mr. Coathupe’s experiment; and a similar instance has been published, where the individual, though apparently insensible, knew when the room was first entered by strangers, and heard them call him by name and bid him put out his tongue, and stretch forth his arm,—without, however, his having the power to answer, or in any way to express the consciousness of understanding them.[[2071]]
Poisoning with charcoal vapour has become a subject of great importance in French medical jurisprudence, partly on account of the frequency with which it is resorted to for the purpose of committing suicide, and partly because repeated attempts have been made to conceal murder by arranging matters so as to present the appearances of suicide. M. Devergie says, that in the years 1834 and 1835 no fewer than 360 cases of poisoning with charcoal-vapour occurred in Paris, of which nearly four-fifths proved fatal; and he has given the particulars of two attempts to conceal murder under the appearance of death from this cause.[[2072]]
The subject has therefore been carefully examined by various authors, but by none so successfully as by M. Devergie; of whose important researches the following is a brief analysis.
In stating the various sources whence charcoal-vapour may become incidentally the cause of death, he dwells particularly on the risk of its admission from adjoining vents, even in other houses from that where the accidents happen,—because there may be currents in the apartment which occasion back-draught. Three remarkable cases of this kind, very obscure in their origin, have been related by M. d’Arcet.[[2073]]
The very discrepant effects of the poison on different individuals, simultaneously and to appearance alike exposed to it, have usually been explained by reference to the great density of the gas, which consequently accumulates near the floor. Some, however, have doubted the fact that the gas is unequally diffused. Mr. Taylor in particular says he ascertained by analysis, that air collected above and below a choffer of burning charcoal was equally contaminated, that what was collected a foot above its level contained 4·65 per cent., and that another portion taken the same distance below it contained 4·5 of carbonic acid.[[2074]] M. Devergie has discovered the source of these discrepant opinions. He has found,[[2075]] that, notwithstanding the high density of carbonic acid gas, the currents caused by the heat, disengaged when charcoal is burnt in a room, without an issue for the products of combustion, produce an equable mixture of gases at all elevations in the apartment, provided the air be examined while still warm, and not long after the charcoal has burnt out; but that, at a later period, such as twelve hours, the carbonic acid partly separates and sinks, so that, while the air at the top contains only a 78th, that near the floor contains four times as much, or a 19th of carbonic acid gas.