Dangerous effects may result from the application of the thorn-apple to the skin when deprived of the cuticle. An instance has been lately published of alarming narcotism from the application of the leaves to an extensive burn.[[2187]]
Morbid Appearances.—As to the morbid appearances, Droste found in his case redness of the cardiac end of the stomach, which contained two table-spoonfuls of a pulpy matter mixed with black and white grains, the remains of the teguments of the seeds; and there was also lividity of the back, lividity of the lungs, emptiness of the cavities of the heart, and gorging of the vessels of the brain. Haller says he once found general congestion of the brain and sinuses,[[2188]]—an appearance which may naturally be expected, considering the signs of strong determination of blood towards the head, which often prevail during life. In Mr. Duffin’s case, however, the brain was healthy, not congested; the stomach and intestines presented no morbid appearance; and the only unusual appearances observed were a slight blush over the pharynx, larynx, and upper third of the gullet, thickening and swelling of the rima glottidis, and a semi-coagulated state of the blood.
Of Poisoning with Tobacco.
A plant of the same natural order with the two former, tobacco, the Nicotiana tabacum of botanists, is familiarly known to be in certain circumstances a virulent poison. Every part of the plant possesses active properties. It has been used as a poison in this country for criminal purposes.
Vauquelin analyzed it some time ago, and procured an acrid volatile principle which he called nicotine.[[2189]] This substance, which was afterwards obtained in a purer state as a crystalline body by Hermbstädt, has been more recently ascertained by MM. Posselt and Reimarus to be nothing else than essential oil of tobacco, which is sold at ordinary temperatures; and they succeeded in procuring another principle which they consider the true nicotina. This is fluid at 29° F., volatile, extremely acrid, alkaline, and capable of forming crystallizable salts with some of the acids.[[2190]] Tobacco then appears to contain an acrid alkaline principle, and an essential oil to which the alkaloid adheres with great obstinacy. The relation of the empyreumatic oil of tobacco to these principles has not been accurately ascertained, though it probably contains one or other of them. It is well known to be an active poison, which produces convulsions, coma and death. Mr. Morries-Stirling found that its active part is removed from the oil by washing with weak acetic acid, as he also observed in the instance of similar oils obtained from various narcotic vegetables.[[2191]]
Process for detecting Tobacco in Organic mixtures.—In a medico-legal case which happened at Aberdeen in 1834, and of which some notice is taken at page [651], Dr. Ogston of that city successfully employed the following process for detecting tobacco in the contents of the stomach. The contents, consisting of a pulpy fluid, were acidulated with acetic acid, digested, and filtered; the liquid was treated with diacetate of lead, filtered again, freed of lead by hydrosulphuric acid, filtered a third time, treated with caustic potash, and then allowed to settle. The supernatant liquid, which had the taste of tobacco-juice, was separated and distilled to half its volume. The distilled liquor had a strong tobacco odour and taste, and some acridity, and gave a precipitate with infusion of galls. The residuum in the retort presented oily particles on its surface, and when heated in an open basin filled the apartment with a vapour which had a strong odour of tobacco smoke, and caused in several persons present a sense of acridity of the throat, watering of the eyes, and tendency to sneeze. Various additional experiments confirmatory of these results were also performed; and a simultaneous examination of tobacco-powder gave precisely the same indications. I am indebted to Dr. Ogston for these particulars and a detailed narrative of his investigation; which appears to supply a convenient and conclusive process for the detection of tobacco.—Perhaps the ordinary process for obtaining nicotina may also be employed with advantage. This consists in distilling the suspected substance with caustic potash, neutralizing the distilled liquor with sulphuric acid, concentrating the product to a thin syrup, exhausting this with etherized alcohol, evaporating off the solvent, and distilling the extract with strong solution of potash. Nicotina passes over, and may be recognized by its sensible and chemical qualities.
The effects of tobacco are somewhat different from those of belladonna and thorn-apple; but it is here arranged with them, as it belongs to the same natural family. Orfila remarked that 5½ drachms of common rappee, introduced into the stomach of a dog and secured by a ligature, caused nausea, giddiness, stupor, twitches in the muscles of the neck, and death in nine hours; and that two drachms and a quarter applied to a wound proved fatal in a single hour. Mr. Blake thinks tobacco has no direct action on the heart, even when admitted directly into the blood by the jugular vein;—that it acts primarily on the capillary circulation of the lungs, by obstructing which it prevents the blood from reaching the left cavities of the heart, and thus acts on that organ indirectly. For he observed, that laboured respiration always preceded any sign of depressed action of the heart, that forcible action of the heart often returned after its first cessation, and that its contractility continued after death.[[2192]] An infusion of ten grains caused laborious breathing in ten seconds, and in twenty seconds temporary arrestment of the heart’s action, which then returned, and was attended for a time with increased arterial pressure. Soon afterwards the animal recovered, without any convulsions or loss of sensibility. Two scruples had the same effect. But when three drachms were used, convulsions succeeded similar phenomena, and death ensued in two minutes, the heart continuing to act for some time after respiration had ceased, until at length it was stopped by the usual consequences of asphyxia.[[2193]] On the other hand, Sir B. Brodie found that the effects are very different, according to the form in which the poison is used. Thus four ounces of a strong infusion, when injected into the anus of a dog, killed it in ten minutes by paralyzing the heart; for after death the blood in the aortal cavities was arterial. But the empyreumatic essential oil does not act in that manner: it excites convulsions and coma, without affecting the heart. It may prove fatal in two minutes.[[2194]] Like other violent poisons, tobacco has no effect when applied directly to the brain or nerves.[[2195]] Two drops of the alkaloid, nicotina, injected into the jugular vein of a dog, begin to act in ten seconds, and will prove fatal in a minute and a half.[[2196]]
Symptoms in Man.—The effects observed in man are allied to those produced in dogs by the infusion. In a slight degree they are frequently witnessed in young men, while making their first efforts to acquire the absurd practice of smoking. The first symptoms are acceleration and strengthening of the pulse, with very transient excitement, then sudden giddiness, fainting and great sickness, accompanied with a weak, quivering pulse. These effects are for the most part transient and trifling, but not always. Some degree of somnolency is not uncommon. Dr. Marshall Hall has given an interesting account of a young man who smoked two pipes for his first debauch, and in consequence was seized with nausea, vomiting, and syncope, then stupor, stertorous breathing, general spasms and insensible pupils. Next day the tendency to faint continued, and in the evening the stupor, stertor and spasms returned; but from that time he recovered steadily.[[2197]] Gmelin has quoted two cases of death from excessive smoking,—caused in one by seventeen, in the other by eighteen pipes, smoked at a sitting.[[2198]] It is likewise mentioned by Lanzoni that an individual fell into a state of somnolency and died lethargic on the twelfth day in consequence of taking too much snuff;[[2199]] Dr. Cheyne says, “he is convinced apoplexy is one of the evils in the train of that disgusting practice;”[[2200]] and I have met with an instance where the excessive use of snuff, occasioned twice, at distant intervals, an attack resembling imperfect apoplexy, united with delirium. Such cases, however, must be admitted to be rare; and the practice of taking snuff is in general unattended with injury.
Serious consequences have resulted from the application of tobacco to the abraded skin. In the Ephemerides an account is given of three children who were seized with giddiness, vomiting, and fainting from the application of tobacco-leaves to the head for the cure of ring-worm.[[2201]] Dr. Merriman has also alluded to an instance of death in a child from the incautious employment of a strong decoction of tobacco as a lotion for ring-worm of the scalp.[[2202]] And in Leroux’s Journal there is an account of a man, who, after using a tobacco decoction for the cure of an eruptive disease, was seized with symptoms of poisoning, and died in three hours.[[2203]]
In recent times poisoning with tobacco has been often produced by the employment of too large doses in the way of injection. Richard has mentioned a case, not fatal, which arose from an infusion of five leaves in a choppin of water, used as an injection by a lady for costiveness. She was immediately seized with colic, giddiness, buzzing in the ears, headache, nausea, and then syncope of seven hours’ duration. During this period the breathing was difficult, the pulse very slow, the pupils dilated, the skin cold and moist, the urine suppressed, the efforts to vomit constant, and the belly depressed, contracted, and affected with constant borborygmus. She recovered under the use of emollient injections and fomentations.[[2204]] Dr. Grahl of Hamburg has related minutely a fatal case, which arose from an ounce of rather more, boiled for fifteen minutes in water, and administered by advice of a female quack. The individual, who laboured merely under dyspepsia and obstinate costiveness, was seized in two minutes with vomiting, violent convulsions, and stertorous breathing, and died in three-quarters of an hour.[[2205]] Another accident of the same kind is noticed in the Journal de Chimie Médicale, where the person became as it were intoxicated, and died immediately. Instead of an infusion of two drachms she had used a decoction of two ounces.[[2206]]—M. Tavignot describes the following remarkable case occasioned by a similar dose. An infusion prepared by mistake with two ounces and one drachm, instead of a drachm and a half, was used as an injection for a stout man affected with ascarides. In seven minutes he was seized with stupor, headache, paleness of the skin, pain in the belly, indistinct articulation, and slight convulsive tremors, at first confined to the arms, but afterwards general. Extreme prostration and slow laborious breathing soon ensued, and then coma, which ended fatally in eighteen minutes.[[2207]]—Even two drachms, however, or a drachm and a half, are by no means a safe dose. An anonymous writer in the Medical and Surgical Journal says a patient of his died in convulsions an hour or two after receiving a clyster composed of two drachms infused in eight ounces.[[2208]] Nay, in the Acta Helvetica there is an account by an anonymous writer of the case of a woman, who, after an injection made with one drachm only, was seized with pain in the belly, anxiety and faintings, proving fatal in a few hours.[[2209]] And a case, fatal in thirty-five minutes, which was occasioned by the same dose, occurred not long ago in Guy’s Hospital, London.[[2210]]