It is not difficult to draw the distinction between these perforations and the effects of poison. The throat and gullet may be partially disorganized or corroded by the strong corrosives; but they are very rarely penetrated, since the greater part of the poison must pass into the stomach or be rejected by vomiting. Destruction of the mucous coat is a common consequence, and stricture occasionally follows; but I have hitherto met with only one instance among the innumerable published cases of poisoning with the mineral acids, alkalis, and other corrosives, where the gullet was perforated. In that case the perforation was the result of slow ulceration from poisoning with sulphuric acid, where life was prolonged for two months.[[223]] Perforation from simple corrosion never occurs. The intestines are never perforated by chemical corrosion from within, for either the poison is in a great measure expelled from the stomach by vomiting, or the pylorus contracts and prevents the passage of every poison that is sufficiently concentrated to corrode. Both the small and great intestines might be corroded from without, in consequence of the poison escaping through a hole in the stomach. I am not acquainted, however, with any case of the kind where, intestinal perforation has occurred.
When the intestines are pierced by true ulceration, it is impossible to tell whether it arose from natural disease or an irritant poison.
The mode of forming a diagnosis between the symptoms and appearances of irritant poisoning and those of natural disease being thus explained, the different species of poisons which have been arranged in the class of irritants will now be considered in their order.
The irritant class of poisons may be divided into five orders: the acids and their bases; the alkalies and their salts; the metallic compounds; the vegetable and animal irritants; the mechanical irritants. In a short appendix some substances will be mentioned which are not usually considered poisonous, but are capable of causing violent symptoms when taken in large doses.
The greater number of poisons included in the first order have a very powerful local action. Most of them possess true corrosive properties when they are sufficiently concentrated. Most of them likewise act remotely. One of them, oxalic acid, is evidently not so much an irritant as a narcotico-acrid; but since its most frequent action as seen in man is irritation, it seems inexpedient to break the natural arrangement for the sake of logical accuracy. This is far from being the only instance where the toxicologist is compelled to violate the principles of philosophical classification.
In the present Order are included four of the mineral acids, the sulphuric, nitric, muriatic and phosphoric, with their bases, phosphorus, sulphur, and chlorine: To these may be added iodine and bromine, with their compounds, and also oxalic and acetic acid, two of the vegetable acids.
CHAPTER III.
OF POISONING WITH THE MINERAL ACIDS.
Of the mineral acids, the most important, because the most common, are sulphuric, hydrochloric, and nitric acids. They are remarkably similar in their effects on the animal economy. Phosphoric acid is of much less consequence, and will be noticed cursorily.
Sulphuric acid (vitriolic acid, vitriol—oil of vitriol), hydrochloric acid (muriatic acid,—spirit of salt) and nitric acid (aqua-fortis), have been long known to be possessed of very energetic properties; and consequently cases of poisoning with them have often been observed. The instances of the kind hitherto published have been chiefly the result of suicide; a considerable number have originated in accident; and, however extraordinary it may appear, a few have been cases of murder. Tartra, in an excellent memoir on the subject of poisoning with nitric acid, quotes an instance of a woman having been poisoned while in a state of intoxication by that acid being mixed with wine and poured down her throat.[[224]] Valentini has related the case of a woman who was killed by frequent doses of sulphuric acid given under the pretence of administering medicines.[[225]] In 1829 an hospital servant was condemned at Strasbourg for trying to murder his wife in like manner, by first making her ill with tartar-emetic and then giving her sulphuric acid in syrup, under the pretence of curing her.[[226]] At the Aberdeen autumn circuit in 1830 a woman Humphrey was convicted of murdering her husband by pouring the same acid down his throat while he lay asleep with his mouth open.[[227]] On the whole, considering the powerful taste and excessively acrid properties of these poisons, it is probable that they will seldom be resorted to for the purpose of making away with another person, who is an adult, and in a state of consciousness. Of late, however, there have been several instances in our country of murder committed on infants in this barbarous manner. A woman Malcolm was executed here in 1808 for murdering her own child, an infant of eighteen months, by pouring sulphuric acid down its throat;[[228]] another woman Clark was tried for the same crime at Exeter in 1822; a man was executed lately at Manchester for murdering in the same way his son, a child four years and a half old;[[229]] and the particulars of an interesting trial will be presently noticed, that of Overfield, who was executed at Shrewsbury in 1824, for poisoning his child in the like manner.[[230]]
In a medico-legal point of view, the mineral acids are interesting on another account. Of late a new crime has arisen in Britain, the disfiguring of the countenance by squirting oil of vitriol on it. It originated in Glasgow, during the quarrels in 1820, between masters and workmen regarding the rate of wages,[[231]] and became at last so frequent, that the Lord Advocate, in applying for an act of Parliament to extend the English Stabbing and Maiming act to Scotland, added a clause which renders the offence now alluded to capital. In 1828 a woman Macmillan was tried here and condemned under that act.[[232]] The crime afterwards became common in England. Three cases were noticed in the newspapers as having occurred in London, in November, 1828; and two others near Manchester in the spring of 1829. It is now much less frequent.