As the husks and seeds of the berries are very indigestible, some of them will almost certainly be found in the stomach, as happened in the instance last quoted. It should likewise be remembered that the best possible evidence of the cause of the symptoms may be derived during life from the presence of the seeds, husks, or even entire berries, in the discharges. If vomiting has not been brought on at an early period, we may expect to find these remains both in the vomited matter and in the alvine evacuations. Mr. Wilmer mentions an instance in which the black husks appeared in the stools brought away by laxatives at least thirty hours after the poison was swallowed.[[2163]] One of Mr. Brumwell’s patients vomited the seeds towards the close of the third day.[[2164]] Several patients of M. Boucher vomited fragments of the fruit on the second day, and passed more by stool and injections on the third, although they had been treated with activity from the commencement.[[2165]]
While most of the cases of poisoning with belladonna have originated in accident, at the same time they have not been all of this description. Gmelin has quoted an instance of intentional and fatal poisoning by the juice of the berries being mixed with wine; and another singular case of poisoning with the decoction of the buds, given by an old woman for the purpose of committing theft during the stupor of the individual.[[2166]]
Other species of atropa are probably similar to belladonna in properties. Wibmer quotes a single instance of frantic delirium occurring among several shepherds, as well as their cattle, from eating the herb of the A. mandragora.[[2167]] This is well known to have been used anciently as a medicinal narcotic.
Of Poisoning with Thorn-Apple.
The thorn-apple, or Datura stramonium, is another plant of the same natural order, which it is proper to notice, because people have often been poisoned with it, and it has become a common ornament of our gardens. The cases of poisoning which have occurred in recent times in this country have been all accidental. But not long ago the thorn-apple appears to have been extensively used in Germany to cause loss of consciousness and lethargy, preparatory to the commission of various crimes.[[2168]] It was also proved to have been used lately in France for this purpose. Some thieves made a man insensible with wine in which stramonium seeds had been steeped, and robbed him of five hundred francs while in this state. For twenty-four hours the victim knew nothing of what became of him; he was met wandering in a wood, affected with delirium, unconsciousness, staring of the eyes, and oppression of the breathing; and for some time he was taken for a madman.[[2169]] In the Eastern Archipelago, according to Mr. Crawford, this is a common mode of committing theft and robbery.[[2170]]
It is chiefly the fruit and seeds that have hitherto been examined; but the whole plant is probably poisonous. Brandes discovered in it a volatile, oleaginous, alkaline substance, which he supposed to be its active principle.[[2171]] But, though his observations were confirmed by Bley,[[2172]] it now appears that the real principle is a colourless, crystalline alkaloidal substance, of an acrid taste like tobacco, which was discovered more lately by Geiger and Hesse; this is named daturine, or daturia.[[2173]]
The physiological effects of the extract have been determined by Orfila. He found that half an ounce killed a dog within twenty-four hours after being swallowed, that a quarter of an ounce applied to a wound killed another in six hours, and that thirty grains killed another when injected into the jugular vein. The symptoms were purely nervous, and not very prominent. Hence this poison, like the former, acts through the blood-vessels, and probably on the brain.[[2174]] Bley’s daturia proves quickly fatal to small animals in the dose of a few drops. The crystalline daturia of Geiger and Hesse kills a sparrow in the dose of an eighth of a grain, and occasions great and persistent dilatation of the pupil when applied to the eye.
Symptoms in Man.—The symptoms produced by a poisonous dose in man are variable. The leading features are great delirium, dilatation of the pupils, and stupor; but sometimes spasms occur, and occasionally palsy.
Dr. Fowler has related the case of a little girl who took a drachm and a half of the seeds. In less than two hours she was attacked with maniacal delirium, accompanied with spectral illusions; and she remained in this state most of the following night, but had some intervals of lethargic sleep. Next morning, after the operation of a laxative, she fell fast asleep, and after some hours she awoke quite well.[[2175]] In a case somewhat like this, related in Henke’s Journal, the child had general redness of the skin, swelling of the belly, locked jaw, tremors of the extremities, and an attitude and expression as if about to tumble into a pit. Recovery took place after the action of an emetic.[[2176]]
In two instances, one related by Vicat in his treatise on the poisonous plants of Switzerland,[[2177]] the other by Dr. Swaine[[2178]] in the Edin. Phys. and Lit. Essays, the leading symptoms were furious delirium and palsy of the whole extremities. In the instances of three children related by Alibert there were delirium, restlessness, constant incoherent talking, dancing and singing, with fever and flushed face.[[2179]] In another recorded by Dr. Young, there were some convulsions, and livid suffusion of the countenance.[[2180]] In an instance communicated to me by my colleague Dr. Traill, where eighteen or twenty grains of extract of stramonium were taken by mistake for sarsaparilla, the symptoms were dryness of the throat immediately afterwards, then giddiness, dilated pupils, flushed face, glancing of the eyes, and incoherence, so that he seemed to his friends to be intoxicated: and subsequently there was incessant unconnected talking, like that of demency. Emetics were given without effect, and little amendment was obtained from blood-letting, leeches on the temples, cold to the head, or purgatives. But after a glass of strong lemonade vomiting took place, the symptoms began to recede, in ten hours he recognized those around him, and next day he was pretty well. Kaauw Boerhaave has related with great minuteness the case of a girl who very nearly lost her life in consequence of a man having given her the powder in coffee with the view of seducing her. The symptoms were redness of the features, delirium, nymphomania, loss of speech; then fixing of the eyes, tremors, convulsions, and coma; afterwards tetanic spasm and slow respiration with the coma. She was with much difficulty roused for a time by the operation of emetics, and eventually got well after her lethargy had lasted nearly a day.[[2181]] In another related in Rust’s Magazin, and caused by a decoction of the fruit, which was mistaken for thistle-heads, the leading symptoms were spasmodic closing of the eyelids and jaws, spasms also of the back, complete coma, and excessive dilatation and insensibility of the pupil.[[2182]] This case, which seems to have been a very dangerous one, was rapidly cured by free blood-letting. Blood-letting, indeed, seems peculiarly called for in poisoning with thorn-apple, on account of the strong signs of determination of blood to the head.—Gmelin has quoted several fatal cases, one of which endured for six hours only;[[2183]] and Dr. Young says, that a child has been killed by a single apple.[[2184]] The most complete account yet published of the phenomena of poisoning with stramonium when fatal is given by Mr. Duffin of London. A child of his own, two years old, swallowed about 100 seeds without chewing them. Soon after she became fretful and like a person intoxicated; in the course of an hour efforts to vomit ensued, together with flushed face, dilated pupils, incoherent talking, and afterwards wild spectral illusions and furious delirium. In two hours and a half she lost her voice and the power of swallowing, evidently owing to spasms of the throat. Then croupy breathing and complete coma set in, with violent spasmodic agitation of the limbs, occasional tetanic convulsions, warm perspiration, and yet an imperceptible pulse. Subsequently the pulse became extremely rapid, the belly tympanitic, and the bladder paralyzed, but with frequent involuntary stools, probably owing to the administration of cathartics; and death took place in twenty-four hours. At an early period twenty seeds were discharged by an emetic: the stools contained eighty; and none were found in the alimentary canal after death. There was never any marked sign of congestion of blood in the head, except flushed face at the beginning.[[2185]] Dr. Droste of Osnaburg has related a fatal case occasioned by a decoction of 125 seeds given to remove colic. In fifteen minutes the patient became delirious, but soon fell apparently fast asleep, and died in seven hours without again awaking.[[2186]]