The affections induced by poisoning with digitalis are often much more lasting than the effects of most other vegetable narcotics. Dr. Blackall’s case is one instance in point, and another no less remarkable in its details is described in Corvisart’s Journal. The usual local and constitutional symptoms were produced by a drachm of the powder being taken by mistake; and the slowness of the pulse did not begin to go off for seven days, the affection of the sight not for five days more.[[2316]]
The preparations of foxglove are very uncertain in strength. From what I have observed in the course of their medicinal employment, I conceive few powders retain the active properties of the leaves, and even not many tinctures. Two ounces of the tincture of the London College have been taken in two doses with a short interval between them, yet without causing any inconvenience.[[2317]] This assuredly could not happen with a sound preparation.
Of Poisoning with Rue.
The Ruta graveolens, or rue, although its wild variety is expressly declared by Dioscorides to be mortal when taken too largely, has attracted little attention as a poison in recent times, and is indeed scarcely considered deleterious. Orfila seems to have found it by no means active; for the juice of two pounds of leaves, secured in the stomach of a dog by tying the gullet, did not prove fatal till the second day, the symptoms were not well marked, and the only appearances in the dead body were the signs of slight inflammation in the stomach. Even when the distilled water was injected into a vein, the only effects were a temporary nervous disorder similar to intoxication.[[2318]]
According to the late experimental inquiry, however, by M. Hélie,[[2319]] rue is possessed of peculiar and energetic properties. All parts of its organization, especially the roots and leaves, produce the effects of the narcotico-acrid poisons; and although he never met with any instance of a fatal result, its activity is such as to render this event not improbable, even when the dose is by no means very large. His attention was drawn to the subject in consequence of finding, that it was often employed in his neighbourhood for producing abortion,—a property ascribed to it immemorially by the country people of France; and all the instances he has seen of its poisonous action were cases in which it had been given with this object. Sometimes the juice of the leaves is given, sometimes an infusion of them, sometimes a decoction of the root; and in one instance a woman took a decoction of two roots, each about as thick as the finger. The effects were, severe pain in the stomach, followed by violent and obstinate vomiting, drowsiness, giddiness, confusion, dimness of sight, difficult articulation, staggering, contracted pupils, convulsive movements of the head and arms, like those of chorea, retention of urine, slowness of the pulse, and great prostration. There was never any purging. In the course of two days or a little more miscarriage took place, preceded by the usual precursors, and followed by abatement of the symptoms of poisoning. At the period of the milk-fever, however, these symptoms again increased, and the patient was also attacked with swelling and pain in the tongue and copious salivation. In about ten days the pulse began to increase in frequency; and a mild typhoid fever commonly succeeded, from which recovery took place slowly. In another case the symptoms throughout their whole course were so mild, that, although miscarriage occurred, the subject of it was not confined to bed, and in fifteen days recovered her health completely. M. Hélie adds, that with full knowledge of the doubts entertained by eminent authorities, whether any substance whatever possesses a peculiar property of inducing miscarriage, he is strongly persuaded that rue is really a substance of the kind, and that it will take effect even when there is no natural tendency to miscarriage, or any particular weakness of constitution.
Notwithstanding these statements, it may be suspected that M. Hélie has overrated both its poisonous properties and its virtues as a drug capable of inducing miscarriage.
Of Poisoning with Ipecacuan.
Ipecacuan is well known as an emetic. It is procured from a plant of the natural family Rubiaceæ, the Cephaëlis ipecacuanha. It contains a peculiar principle, not yet crystallized, which is white, permanent in the air, sparingly soluble in water, easily soluble in alcohol and ether, fusible about 122° F., capable of forming crystallizable salts with acids, and possessing an alkaline reaction on litmus. It was discovered by M. Pelletier.[[2320]]
Ipecacuan itself is not known to be a poison; because in consequence of its emetic properties it is quickly discharged from the stomach. But in doses of considerable magnitude it would probably be dangerous. In some constitutions the odoriferous effluvia from the powder induce difficult breathing, anxiety, and imperfect convulsions. I have met with several instances of this singular idiosyncrasy, and one in particular where the subject of it, a surgeon’s apprentice, suffered so often and so severely as to be induced to abandon the medical profession. A German physician, Dr. Prieger, has published a remarkable case of a druggist’s servant, who, in consequence of incautiously inhaling the dust of ipecacuan powder, was attacked with a sense of tightness in the chest, vomiting, and soon after an alarming sense of suffocation from tightness of the throat. When these symptoms had continued several hours the uneasiness in the throat was removed after the use of a decoction of uva-ursi and rhatany-root; but the dyspnœa remained several days.[[2321]]
Its active principle, emeta, is a powerful poison. Two grains of the pure alkaloid will kill a dog; and the symptoms are frequent vomiting, followed by sopor and coma, and death in fifteen or twenty-four hours. In the dead body the lungs and stomach are found inflamed. The same effects result from injecting it into a vein, or applying it to a wound.[[2322]] It appears, then, to be a narcotico-acrid. But its irritant properties are so prominent that it might be properly arranged with the vegetable acrids.