These cases would seem to indicate very considerable activity; yet there can be little doubt that even larger doses have been at times taken with much less effect. Thus, from an account given by Dr. Eickhorn of New Orleans, of its operation on himself, when incautiously swallowed to the amount of two drachms in frequent small doses within three hours, it would appear that the only result was great heat, palpitation, hurried pulse, and pleasant intoxication, then moisture of the skin, next profound sleep for some hours, attended with excessive sweating, and finally no ultimate ill consequence except great debility.[[2376]] I am assured by a correspondent, Dr. Jennison of Cambridge, U. S., that a medical friend of his has given 90 grains of camphor four times a day in phrenitis, with safety and advantage.
Professor Wendt of Breslau has related an instance, which proves the irritant action of camphor on man, and likewise the uncertainty of the dose required to act deleteriously. In the case of Mr. Alexander, two scruples would in all probability have proved fatal, had they not been discharged in time by vomiting. In the case now to be noticed, 160 grains were taken in a state of solution in alcohol, and were not vomited; yet the individual recovered. He was a drunkard, who took four ounces of camphorated spirit, prescribed for him as an embrocation. Soon afterwards he was attacked with fever, burning heat of the skin, anxiety, burning pain in the stomach, giddiness, flushed face, dimness of sight, sparks before the eyes, and some delirium. He soon got well under the use of almond oil and vinegar, but did not vomit.[[2377]]
Morbid Appearances.—The morbid appearances caused by camphor have not, so far as I know, been witnessed in man. In dogs examined immediately after death, the heart is no longer contractile, and its left cavities contain arterial blood of a reddish-brown colour. When the poison has been given in fragments, it leaves marks of inflammation in the stomach and intestines. Orfila found these organs much inflamed in such circumstances.[[2378]] Scudery found the membranes of the brain much injected, and the brain itself sometimes softened; the inner membrane of the stomach either very red, or checkered with black, gangrenous-like spots of the size of millet-seeds; the duodenum in the same state; the ureters, urethra, and spermatic cords inflamed; and every organ in the body, even the brain, impregnated with the odour of camphor.[[2379]]
Of Poisoning with Cocculus Indicus.
The Menispermum cocculus, Cocculus suberosus, or Anamirta cocculus of botanists, is a creeping plant which grows in the island of Ceylon, on the Malabar coast, and in other parts of the East Indies. Its fruit, which is the only part of the plant hitherto particularly examined, is like a large, rough, grayish-black pea, and is known in the shops by the name of Cocculus indicus. It has a rough, ligneous pericarp, enclosing a pale grayish-yellow, brittle kernel, of a very strong lasting bitter taste. The medical jurist should make himself well acquainted with its external characters, because, besides being occasionally used in medicine, it is a familiar poison for destroying fish, and has also been extensively used by brewers as a substitute for hops,—an adulteration which is prohibited in Britain by severe statutes. It has been analyzed by M. Boullay of Paris,[[2380]] who found in it besides other matters, a peculiar principle termed picrotoxin. This principle constitutes, according to Boullay, about a fifth part of the kernel; according to Nees von Esenbeck, only a hundreth part:[[2381]] and my own experiments agree with the results of the latter. It is moderately soluble in water, and crystallizes readily from a hot acidulous watery solution. It is more soluble in hot alcohol, from which it crystallizes in granular masses. Ten grains of it killed a dog in twenty-five minutes in the second paroxysm of tetanus.
The seeds themselves occasion vomiting soon after they are swallowed; so that animals may often swallow them, if not without injury, at all events without danger. But if the gullet be tied, the animal soon begins to stagger; the eye acquires a peculiar haggard expression, which is the sure forerunner of a tetanic paroxysm; and the second, third, or fourth fit commonly proves fatal. Three or four drachms will kill a dog when introduced into the stomach; less will suffice when it is applied to a wound; and still less when it is injected into a vein.[[2382]] Wepfer has related a good experiment, from which he infers that Cocculus indicus acts by exhausting the irritability of the heart. In the intervals of the fits the pulse could not be felt; and on opening the chest immediately after death, he found the heart motionless and all its cavities distended.[[2383]] Orfila also sometimes found the heart motionless, and its left cavities filled with reddish-brown blood.[[2384]]
This poison does not seem to possess distinct acrid properties in regard to animals. M. Goupil indeed found that it produced vomiting and purging,[[2385]] but Orfila could not observe any such effect. According to Goupil it possesses the singular property of communicating to the flesh of animals, more particularly of fish, that have been killed with it, some of the poisonous qualities with which it is itself endowed. The accuracy of this statement may be doubted, the alleged fact being contrary to analogy. Besides, this poison has been used immemorially in the East for taking fish; and it is familiarly used for the same purpose in some parts of France, though prohibited by statute. Chevallier mentions that in a particular parish the inhabitants live half the year on fish caught with this poison; and that a friend of his made trial of fish so caught, without the slightest injury.[[2386]]
Symptoms in Man.—Although it is well known that malt liquors have often been adulterated with Cocculus indicus for the purpose of economizing hops, cases of poisoning in the human subject are rare, because the quantity required to communicate the due degree of bitterness is small. Professor Bernt has shortly noticed a set of cases, which arose in consequence of an idiot having seasoned soup with it by mistake. Nine people were taken ill with sickness, vomiting, pain in the stomach and bowels; and one died in twelve days.[[2387]] The symptoms under which this person died are not stated; but the account of the accident sent to Bernt imputed death to the poison,—which is improbable, considering the length of the interval before death.
In the same group with camphor and Cocculus indicus Orfila has arranged Upas antiar, a Javanese poison. This poison is a very bitter milky juice or extract, which is known in Europe only as an article of curiosity. It has been sometimes confounded with the Upas tieuté. It owes its properties to a neutral principle called antiarin.[[2388]] From the experiments of MM. Magendie and Delille,[[2389]] as well as from those of Sir B. Brodie[[2390]] and of Emmert[[2391]] it appears to act in the same manner, and to produce the same effects, as camphor and Cocculus indicus. In small doses it acts as an irritant; in large doses it causes convulsions and coma.
It is here noticed principally because it is one of the poisons which act violently on the heart. If the body of an animal be examined immediately after death from the Upas antiar, the heart is found to have lost its irritability, and the left ventricle to contain florid blood: Schnell found, that, like many other active poisons, it has no effect when applied to the divided end of a nerve.[[2392]]