POISONING BY ARSENIC

626

POISONING BY ARSENIC.

THE FATAL RESULT PROTRACTED FOR SIX DAYS.

To tlte Editor of THE LANCET.SIP. :-I submit the following case to your

notice, as illustrating a peculiar morbid ap-pearance observed in poisoning by arsenic,one which I have never found noticed byany author who has written upon that sub-ject. If you think the facts of value in amedico-legal point of view, you will obligeme by inserting the case in your valuableJournal. I am, Sir, your very obliged ser-vant, FREDERICK PAGE, Surgeon.

Beccles, Suffolk, July 12, 1837.W. S., a fine healthy boy, aged 3! years,

swallowed a small piece of bread which wascovered with butter, sugar, and arseniousacid (about 8 grains), which his mother hadjust prepared to poison vermin; it appears,she had turned her back towards him for amoment, during which time the child ate it.I was immediately summoned to attend, andexhibited an emetic of sulphate of zinc,which produced powerful vomiting; and inabout twenty minutes from the time at whichthe poison was taken, the stomach appearedto be quite free from the drug. During thethree following days the child appeared tobe as well as usual, but on the morning ofthe fourth he was attacked with slight diffi-culty of breathing, quick pulse, hot skin,loss of appetite, and anxious expression ofcountenance, without sickness, purging, orany indications of pain; in the evening hewas evidently sinking, and died on the fol-lowing morning, at about five o’clock, con-tinuing perfectly sensible up to the time oflliq death

S.C.—On viewing the body, ten hours afterdeath, some few dark spots were visible onthe surface ; nothing particular offered itselfto notice, on examining the stomach and theorgans of digestion, with the exception ofone or two slight traces of inflammation inthe former viscus ; the liver enlarged, har-dened, and of a pale yellow colour; blad-der full, distended. The lungs and cavitiesof the pleura healthy. The pericardiumfilled with a pale straw-coloured transparentfluid. On dividing the venæ cavae, close to ithe auricle, a considerable lump of semi-transparent, perfectly organized, coagulablelymph, fell from this cavity, in which wasdiscovered much more. Ou opening theventricles, large strings of the same sub-stance were found to occupy their cavities,interwoven with the carnese columns, andextending from the left into the aorta, nearlyfilling up the ventriculo-aortic opening. Thewalls of the heart were pale, flabby, andsoft.Dr. Christison, in his valuable work on

poisons, speaking of arsenic, describes its

deleterious action, under three distinctheads.

1st." Producing death in from twenty-fourhours to three days, with signs of violentirritation of the mucous membrane, unac-

companied by distinct disorder of the nervoussystem."

2ndly. "With little irritation in any partof the alimentary canal, the patient beingaffected with extreme prostration of strength,frequent fainting, and death, seldom delayedbeyond the fifth or sixth hour."

3rdly. " Life commonly prolonged to thesixth day, sometimes much longer; the signsof inflammation in the alimentary canal be.ing succeeded, or accompanied, about thesecond or fourth day, or later, by symptomsof irritation in the other mucous passages,and more particularly by symptoms indi.cating derangements of the nervous system,such as palsy, or epilepsy."

I should suppose that the case relatedabove would be placed under the last head ;at least, it bears resemblance to that form,so far as time is concerned ; but in thatrespect only, as there seemed no irritationof mucous membranes, no affection of thenervous system, characterised by coma,tetanus, palsy, hysteria, or mania. The onlyfunctional derangements observed, were

those of respiration and circulation, which,, consider, are to be fully accounted for bythe mechanical obstruction of the passageof the blood through the heart, caused by

the presence of coagulable lymph in its

cavities, and by the obstructed vital ener-gies of the organ itself.

POWDER OF THE ERGOT OF RYE.To the Editor of THE LANCET.

SiR:—I have observed in some of thelate numbers of your able Journal, variousopinions on the efficacy and action of theergot of rye, and I have watched withanxiety their character ; but as none have

approached so nearly to my own as thoseoffered last week by " OBSTETRICUS," I aminduced more particularly to request thepublication of my humble testimony, in sup-port of the remarks made by him. Aftertwenty years of general practice, it may notbe considered arrogant, or intrusive, in me,perhaps, to do so, as ample opportunitieshave occurred in that time, by which a

tolerably accurate judgment may be formed;and I can safely state, that the superiorefficacy and power of this medicine, existonly itt the powder. I have tried every otherform, but not with such decided and spe-cifiesuccess. I think I may truly add, thatit has never disappointed me : within thelast few years, many cases of flooding, andinaction, have come under my care, requir.