No. 718.

LONDON, SATURDAY, JUNE 3, 1837. [1836-37.

LECTURES

ON

MEDICAL JURISPRUDENCE,NOW IN COURSE OF DELIVERY,

AT THE

UNIVERSITY OF LONDON.

BY PROFESSOR A. T. THOMSON.

LECTURE XXXV.POISONING (continued) :-Distinction of poi-

soning from the symptoms of other diseases..Diseases which simulate poisoning. Post-2itoi-tem evidences of poisoning; ; facts andcautions to be observed in the inquiry. The

purity and preparation of chemicall’e-agentsfor tests. List of tests.’ General remarkson the evidence of poisoning. Feigned poison-ing. . The various classifications of poisonsadopted by toxicologists. Objections tothem. Tlte lecturer’s ar)wtzgentent:-I.General acrid poisons; their effects on dif-ferent parts of the system. Diseases ivhich

produce symptoms si7nilar· to those of acridpoisons. Action of the gastris juice on thedeadstO1nach. Particular acrid poisons; in-O1’ganic and organic. Case in illustration;suspicion of poisoning by s7alphuric acid;diagnosis ; evidences after death.GENTLEMEN :-It is of the utmost import-

ance to distinguish between poisoning, in ageneral sense, and diseases; and this is themore necessary, as the evidences of generalpoisoning must frequently be taken from thesymptoms; and hence fallacies may arise,from the similarity of some of these to thesymptoms of diseases. The general symp-toms of poisoning are, local and general un-easiness, nausea, vomiting, convulsions, asense of suffocation, vertigo, delirium, anddrowsiness. Poisoning appears suddenly,when the persons are in health ; this mayhold good as a general rule, in this country,where no art of secret poisoning is practis-ed ; but, as I have already stated, somepoisons might be made to operate slowly,

nam ely,fox glove, belladonna, or hydrocyanicacid. Many diseases, however, are sudden intheir invasion. Plague is fully formed inan hour; and typhus fever nearly as soon :

apoplexy and cholera are, from the sudden-ness of their attack, the diseases very likelyto be confounded with poisoning. Inflam-mation of the stomach and the bowels inchildren also displays symptoms resemblingthose of poisoning, and at that age a diseaseoccurs, in which perforation of the gut takesplace.You will find a case of ulceration of the

stomach in the 11 Medical Repository" forMarch, 1823. The girl was seized sud-denly, after breakfast, with excruciatingpain of the stomach,-she expired at mid-night. A circular aperture through theviscera, near the cardiac orifice of the sto-mach, was discovered. She had for sometime before been complaining of pains of thestomach on any unusual exertion.

Poisons, administered in the doses usu-ally productive of mischief, display moreregularity in the increase of symptoms thandiseases. This, however, is not a decisiverule, as some produce their effects in pa-roxysms, for example, strychnia, and vera-tria ; some admit of exacerbations and re-missions, namely, arsenious acid, which, in-deed, sometimes exhibits even intermis-sions.* Cholera displays the same regularincrease of symptoms as poisons.In general, the symptoms of poisoning

display themselves soon after a meal, orafter food, or something else has been taken,-it may be medicine.Some diseases begin soon after meals ;

such is the case in apoplexy ; in cholera,from unripe fruits ; and in morbid disten-sion of the stomach, from too large a meal.Fallacies may thus arise, but these are di-minished if many persons are affected in thesame manner, at nearly the same time. Theonly use of attending to symptoms, inde-pendently of the history of a case, is to an-thorize further investigation and chemicalanalysis.The effects of poisoning by some poisons,

such as the mineral acids and arsenious acid,

* Dr. Rog’et’s case, Med. Chirg. Trans., vol. ii.,p. t55.

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occasionally subside, yet the persons diefrom the influence of the poison. Dr. CHRIS-TISON mentions a case in which a child waspoisoned by arsenious acid, and lived thirty-six hours in a state of alternate calm andexcitement.

Post-mortem examinations strengthen theevidence of poisoning. These are often,however, very fallacious, except in cases ofthe strong mineral acids, shewn on thegullet. In examining the body, the parts tobe successively examined, the mouth, thelarynx, the trachea, the stomach, liver,spleen, pancreas, and the intestinal canal.Ligatures are to be applied on the oesoplia-gus and rectum, and the intermediate part isto be removed. The fluids are to be collect-ed in clean vessels, and the internal surfaceof every cavity washed with clean distilledwater. Lesions, or gangrenous portions,are to be removed; perforations cut out;and all solid parts preserved in alcohol,until they can be examined. Every portionof fluid is to be soaked up with sponges,and also preserved. No examination shouldbe conducted alone; everything should be ,,noted down in writing. The examinationshould take place as soon after death as pos-sible.The following are the instruments requir-

ed for post-mortem examinations:-scalpels;levers; saws, strait and circular; scissors,of various sizes; bone-nippers; blow-pipes;clean basins; sponges, of various sizes ;several clean, wide mouth-stopped phials;alcohol ; litmus paper; and distilled water.

If the examination be made after ex-

humation, care must be taken to registerthe nature of the weather and the winds atthe time.

With respect to the appearances of parts,vascularity of a stomach is no certain indica-tion of poisoning, for although idiopathicinflammation of the stomach be scarcelyknown, yet, independently of disease, manyother states display this appearance; thus,persons who have been hanged have oftena vascular state of the stomach. Dr. YEL-LOLY observed this in five instances; the

vascularity is chiefly found at the cardiac andpyloric portions. This appearance, how-ever, is modified according to the distance oftime after death at which dissection is per-formed. The distinction between ordinaryinflammation and that arising from acridpoisons, arsenious acid, for example, ischiefly in intensity ; portions of the innercoat are destroyed. Spontaneous perfora-tions during life are easily distinguishedwhen resulting from long standing disease,by the previous history of the case; but itis difficult to distinguish when no previoussymptoms can be traced. Digestion of thestomach after death is more easily deter.mined : the part perforated generally ap-pears vascular, but the healthy part is not so

when death is the result of violent causes,as, for instance, fracture of the skull, orhanging. It generally happens at the greatend, from the gastric juice resting there,when the death has been sudden, but notalways.* Perforations from poisoning aremost frequent at the great end. This sub-ject will be frequently brought under noticein treating of individual poisons.

Chemical evidences.-When poison isfound in the contents of the stomach, or theintestines, sufficient evidence is readily ob-tained. But poison may be discharged byvomiting or by purging; in this case nonemay be detected in the stomach. Some-times none can be found even in the vomit-ed matter, but this should not prevent itbeing looked for in the stomach. A womanpoisoned herself with arsenious acid; afterviolent vomiting, which continued for ninehours, I found two drachms of the solid acidin the stomach. Poisons have been found inthe stomach after two days’ incessant vo-miting.Some poisons occasionally disappear alto.

gether from the stomach, as, for instance,preparations of opium, hydrocyanic acid,and narcotics. The moral evidence in suchcases is of great importance.Some poisons undergo changes; thus, bi.

chloride of mercury is reduced to the oxideand the chloride. Nitrate of silver, also, isreduced to the oxide. The decomposition ofthe body after burial prevents many, but notall, poisons from being detected; arseniousacid has been detected months and yearsafter the interment of the poisoned person.Evidence must also be obtained from theeffects of the suspected food, or drink, onthe lower animals, but the evidence obtainedis uncertain: if any animal be employed, thedog is the best.Arsenious acid, salts of copper and of

mercury, mineral acids, opium, strychnia,veratria, hydrocyanic acid, affect cats anddogs in the same manner as they do men.If the animals display symptoms similar tothose observed in the poisoned person, the

presumptive evidence is thereby strength-ened. MARY BATEMAN poisoned a family,by administering poison in a pudding; aportion of it caused vomiting in a cat, andkilled three fowls, and a dog, in four days.

If the animals reject the suspected mattera ligature should be tied on the gullet. Asthe effect of the wound is not felt for twodays, it does not interfere with our decision,for if poison be present its effects are dis-played in less than forty-eight hours. Noeffects may be produced on these animalsby vomited matter, and yet poisoning mayhave been effected. Even when they die,this proof may be fallacious. MORGAGNI men-tions the effects of bile from the stomach of

’ See a paper by Mr. Burns, of Glasgow, vol. vi.of Edinb. Mod. and Surg. Journ.

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a person who died in convulsions; some ofit was given to a cock, and applied to awound in two pigeons: in all it proved fatal.

Tests.

In every instance of poisoning, wheredeath has taken place, and in which it is

requisite to examine the contents of the sto-mach, or any remains of the poison, the che-mical re-agents which we employ should beof the purest kind. It is, therefore, a mat-ter of great importance to he able to ascer-tain their purity : and, in the greater numberof instances, they should be prepared byyourselves. I will now endeavour to makeyou acquainted both with the method ofmaking these tests, which you can prepareyourselves, and demonstrate to you themode of testing them, to determine theirpurity, as laid dowp by DUVERGIE.

1. The neutral acetate of lead is generally ’,obtained tolerably pure; but to purify itcompletely it should be dissolved in water,and a stream of carbonic acid passed throughit so long as any precipitate is thrown down.A partial decomposition only takes place ;and by driving off any excess of carbonicacid, by boiling, on filtering when the fluidis cold, we procure a solution of a perfectlypure neutral acetate.

This solution ought not to redden litmus,nor green syrup of violets. Solution of car-bonic acid should not precipitate it; ferrocy-anide of potassium should form onlya whiteprecipitate, soluble in an excess of nitricacid, after standing a few minutes. Whenthe acetate contains a salt of silver, hydro-chloric acid forms a clotted precipitate, in-soluble in water and in nitric acid.When the hydrocyanide forms a bluish

precipitate the acetate contains iron.2. Diacetate Qf lead.-The solution should

green the syrup of violets; it should be pre-cipitated abundantly by an aqueous solutionof carbonic acid, and in clots by solution ofgum ; neither ferrocyanide of potassium, norliq. ammonias, should form a blue with it.

3. Solution carbonic acid should be madeat the time from white marble.

4. Hydrochloric acid should be colourless,not precipitated by the hydrocyanide of

potassium, or if any precipitate be formed,it should be white, and soluble in water,forming a limpid solution. It should notbe precipitated white by the chloride of

barium ; or, if precipitated, the precipitateshould be soluble in water.

5. Solution of sulphuretted hydrogen shouldcolour, but not precipitate, the solution ofarsenious acid, nor that of nitrate of baryta.

6. Iodic acid should be kept in its crys-talline state.

7. Nitric acid may be purified by addingto It nit. of silver as long as any precipitatefalls ; then decanting off the supernatantfluid, and distilling. The first part of theproduct should be rejected, and the distilla-

tion stopped when the residue is reducedto one-eighth of the original volume of thefluid put in the retort. The pure acid thusobtained should be clear and colourless ;it should not precipitate diluted solution ofnitrate of silver. The white precipitateafforded with a concentrated solution ofany barytic salt, should be soluble in dis-tilled water. Ferrocyanide of potassiumshould not give it a blue colour, but the yel-low colour of the ferrocyanide should bemerely deepened.

8. Oxalic acid, in solution, ought not tobe coloured by sulphuretted hydrogen, forwhen it is so coloured a salt of lead is present.If heated on a plate of platinum it should allvolatilize, and leave the metal clean, andshould not give oil’ any nitrous acid fumes.

9. Sitll)hui-ic acid, when saturated withpure ammonia, and treated with sulphuret-ted hydrogen, should not be precipitatednor coloured. The salts of lead which theacid of commerce always contains, is throwndown when the strong acid is diluted withwater, after which, by distilling off thewater, the acid is obtained pure.

10. Liq. ammoniae should not precipitatethe cyaaaide of potassium, nor the chloride ofbarium; nor should it be coloured by saal-phuretted hyd1’ogen. It should not be preci-pitated by nitrate of silver after saturating itwith nitric acid.

11. Carbonate of ammonia, in solution,should not be precipitated by oxala te of am-monia, nor fe1’1’ocyanide of potassium. Theprecipitate with nitrate of silver should besoluble in nitric acid; when it is not solublein that acid it contains sal ammoniac.

11. Bicarbonate of potassa, in solution,should not precipitate sulphate of magnesia,at the temperature of 60°.

12. Carbonate of potassa should precipi-tate the sulphate of magnesia in the cold : itshould not precipitate ferrocyanide of pot-assium, nor oxalate of ammonia.

13. Animal charcoal ; when boiled withwater, and the fluid decanted should not pre-cipitate nitrate of silver, nor, when treatedwith muriatic acid, either oxalate of ummo-nia, or laydro-cyaraide of potassium.

14. Pure lime should not effervesce withacids. Lime-water ought not to give a pre-cipitate with nitrate of baryta insoluble innitric acid.

15. Gaseous chlorine should be washed bypassing it through water to wash; its solu-tion should not precipitate oxalate of amano-nia, nor barytic salts.

16. Bichlo7-ide of mercury should be com-pletely soluble in water; it should not becoloured blue by the ferrocyanide of pot-a&MMMt.

17. Pure ziuc should be in cylinders, orgranulated.

18. Pure tin in cylinders, or in grains.19. Pure copper, in turnings.20. Hydrochlorute of gold should be crys-

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tallized, to remove any excess of acid, be-fore being dissolved in water.

21. Chromate of potassa.22. 13arytic-7vate)- should not precipitate

ferrocyanide of potassium, nor succinate ()fammonia.

23. Distilled mater should not precipitateoxalate o/’ ammonia, nor barytic-water, nornitrate of silver, nor diacetate of lead.

24. Protochlorate of tin is to be made withpure grain tin, introduced in small portions,successively, into pure hydrochloric acid,until no more can be dissolved. The solu-tion should spontaneously crystallize, andthe crystals ought to be preserved free fromthe contact of air. When dissolved in

water, hydrochloric acid, in excess, shouldnot blacken the solution ; nor should it becoloured blue by ferrocyanide of potassium.Sulphuretted hydrogen should colour it

brown, not black.25. Hydrochlorate of platinum should be

kept in crystals.26. Ferro-cyanide of potassium should be

twice crystallized, and preserved in crys-tals.

27. Hydro-sulphate of ammonia should notbe changed by barytic-water, and ought notto precipitate sulphate ofmagwesiu.

28. Nitrate of silver, in solution, shouldnot redden litmus paper, nor be colouredblue by ammonia.

29. Proto-nitrate of mercury, in a weak so-lution, should form with sol. of hydriodate ofpotassa, a greenish-yellow precipitate, whichshould not become red.

30. Solution of pernitrate of mercury shouldafrord a red precipitate with hydriodate ofpotassa, and not give a black precipitatewith pure potassa.

31. Solution of phosphate of soda affords awhite precipitate with salts of baryta, whichshould dissolve, without effervescence, innitric acid.

32. Ammoniated sulphate of copper shouldbe of a deep blue colour, and clear.

33. Sulphate of copper.34. Proto-sulphale of iron should not be

very acid.35. Persulphate of it-on, in solution, when

tested with chloride of gold, should not pro-duce the gold in a metallic state.

36. Sulphate of magnesia should not bluethe ferrocyanide of potassium.

37. Tiucture of galls should be transpa-rent.

38. Tincture of litmus should be trans-parent.

11foral evidence.—Medical men may collectmuch of the moral evidence which is re-

quisite in the legal investigation of casesof poisoning; thus, they, may ascertainwhether the food which is suspected, wastaken by more than one person; its gene-ral influence on those who ate of the dish;the behaviour of persons who did not

eat of it ; whether there was any delay inobtaining medical aid, or unnecessary has-tening of the funeral, or objecting to the in-spection of the body ; the withholding anyremains of suspected substances; argu-ments used to persuade persons to takethe poisoned food ; secreting vomited niat-ters. Medical men should always get holdof the suspected article in which it wascontained, if the article itself be thrownaway. If the food be solid, the part cutought to be analyzed. Beef poisoned bygravy could not be detected by Dr. CHRISTI-SON, and Dr. TURNER, because the piece whichthey preserved for analysis had been putupon a clean plate ; not left on that on whichit was served up for dinner. In this casethese gentlemen could not find the poison; itwas tartar emetic, and had been put into thegravy. They were led to suspect the gravy,from the vomiting appearing severe in thosewho had eaten most of the gravy. The salteven should be examined.When symptoms always occur after food

has been given by some individual; moralevidence is strong -against that individual.Miss BLANDY poisoned her father with arse-nious acid, administered in gruel: everytime, after taking the gruel, pains of thestomach, vomiting, and other symptoms ofpoisoning supervened.

If the evidence be strong respecting asuspected substance, the assertion of impos-sibility that it could be that substance,brought forward by the person suspected ofhaving administering it, as, for instance, inmaking up medicine, tells rather againstthan for the truth of the assertion.

For particular purposes, attempts at sui.cide by poisoning may be feigned. A caseof this kind is detailed by Dr. CHRISTISON,m his work on poisons, in treating of im-puted poisoning. We may detect this im-position by comparing the state of the pulse,the aspect of the tongue, the temperature,the succession of symptoms and matters

supposed to be vomited, with those whichoccur in real cases ; and the same mode ofdetection is applicable to imputed poison-ing, with the view of criminating others.Such, Gentlemen, is the outline of the gene-ral remarks which I have to offeron poison-ing. You will do well to peruse with atten-tion the first part of Dr. CHRISTISON’S work,which treats in detail of the points whichwe have briefly gone over, and also the re-marks on the subject, in the second volumeofPARis’s work, and in those of ORFILA andof FODERE.

In the treatment of every subject, arrange-ment is of great importance. In the worksof authors on toxicology very various clas-sifications have been proposed. In theoldest the poisons are classed according totheir sources, whether these belong to theanimal, the vegetable, or the mineral kind-

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doms. There are many objections to thisclassification. Thus, the action of irritantsis nearly the same, whether they be of ananimal, or a vegetable, or a mineral origin.This classification, in fact, disjoins sub-stances which act in the same manner.Poisons have also been classed according

to their mode of action, being local or gene-ral. The objections to this arrangement areeven greater than to the former. Some poi-sons act both locally and generally; someact, under some circumstances, as generalpoisons ; for instance, when arsenious acidis deposited under the epidermis, in smallquantities, poisoning takes place, and deathensues, without any alteration in the tissuein contact with the poison: on the otherhand, when the acid is employed in a largequantity, it produces a decided local ac-tion. This is also the case with regard tooxalic acid in the stomach.A third classitication is founded on the

tardy or rapid operation of the poisons; andthey are classed as sloiv or quick -poisons.This arrangement is objectionable, becausemuch depends on the dose of the poison,and on the condition of the system, or whe-ther the poison be taken before or afterfood. Accumulative poisons, which operateslowly, act quickly if they be administeredin large doses.Other arrangements are based on the

pathological effects of the poisons. Thiswas first proposed by FODERE; and his ar-rangement, modified, is adopted by ORFILA :whose classes were at first six, namely,

1. Corrosives.2. Astringents.3. Acrids.4. Narcotics.

5. Narcotico-acrids.6. Septics.ORFILA afterwards reduced these classes

to four, by joining the three first into one,under the title of irritants. Dr. CHRISTISONhas adopted ORFlLA’S classes, leaving outthe class of septics. His classes are three,namely,

I. Irritants.2. Narcotics.3. Narcotico-acrids.In my opinion many objections may be

urged to the term irritants ; instead of whichI employ that of acrids. I divide narcoticsinto sedatives and narcotics, and I shall giveyou ample reasons for retaining septics whenI treat of the poisonous effects of mussels ; ofsea-water when it does not purge ; and of pu-trid animal matters. My arrangement is,-

1. Acrids, or those poisons which exerta local action on the mucous membrane ofthe alimentary canal.

2. Narcotico-acrids, those which act onthe brain, heart, and alimentary canal, boththrough the circulation and locally.

3. Narcotics, those which act on the ner-

voussystem directly, or through the circula-tion, causing excitement, followed by col-lapse.

4. Sedatives, which act directly, or solely,on the nerves.

5. Septics.1. Acrid poisons are both organic and in-

organic substances. Let us first trace theirgeneral symptoms, then point out the diag-nosis which distinguishes them from gene-ral diseases. Their first influence is felt onthe e °

Gullet. It is displayed by a burning sen-sation, and great difficulty of deglutition,when the poison is fluid, but when it is solidthere is no effect on the gullet. The effectson the

Stomach are, burning, lancinating pains,sickness (often vomiting blood); but theseeffects are much modified by the solubilityof the poison ; sometimes an hour elapsesbefore any pain is experienced. In the

Intestines the same burning pain, extend-ing from the stomach, stretches through thegreater part of the canal; it is often ac-companied with tormina, violent purging,tenesmus, sometimes with prolapsus of rec-tum, pain and tension of the whole abdo-men, strangary, and complete eschuria.The pulse is at first hard and quick, it

then becomes small, and, lastly, feeble.In the nervous system, collapse ; the in-

fluence of the poison is displayed byrigors, reduction of temperature to icycoldness, a moist, clammy, state of the skin,hiccoughs, convulsions, and coma.

The following diseases produce symptomsclosely resembling these, and, consequently,an incorrect diagnosis may be formed.

1. Rupture of the inner coat of the stomach.- This may arise from over eating. The

following case by M. CHEVALIER, publishedin the "Medico-Chirurgical Transactions,"°. p. 93., is illustrative of this fact. A lad,14 years of age, who had eaten freely at aChristmas feast, and drunk some gin andwater, was attacked on the following nightwith violent vomiting, which continued allthat night until the following morning. On

attempting to drink, spasms supervened, sosevere as to force him to dash the cup fromhim. Pressure on the region of the stomachcaused great pain, and an immediate recur-rence of the efforts to vomit. Towardsevening he vomited nearly two pints ofblood, after which he became easier, andexpressed a desire for something to eat; heate some toasted bread, which he almostimmediately vomited,and directly afterwards.expired.

The thoracic and abdominal viscera wereapparently in a healthy condition; but, onlaying open the stomach and the duodenum,the internal coat of both was discovered to betorn in various places. The lacerations were

larger in the duodenum than in the stomach ;

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they extended, indeed, nearly round the py-loric part of the duodenum. Two extensivelacerations were also found in the middleportion of the gut. Every other part of theintestinal tube was healthy. Rupture hasoccurred from lifting heavy weights. See acase in the"Med. Repository," xvii. p. 109.Sometimes over distension causes death,without rupture. A child died from eatingmackarel ; I opened the body and found norupture, nor any cause, except over disten-sion, to account for the death of the child.

2. Rupture of duodenmra.-A case of thiskind is detailed in the " Bull. des SciencesMedicales," t. x. p. 64, from passion, in aquarrel at a billiard-table, immediately afterdinner. In this case, the mucous coat of theduodenum was inflamed and lacerated forthe extent of two-thirds of the circumference.All the other viscera were healthy.

3. Ices and cold water when the body ishot.-The low state of vitality in hot weather,when ice is freely eaten, may cause suddencollapses. HALLER mentions a case of thiskind in which dissection displayed gangreneat the fundus of the stomach. Many peoplesuffered from this cause in 1825, when thesummer was very hot. In Paris so manydied after eating ice as to produce a legalinvestigation into the cause.

4. Cholera.—In this disease there is greatheat at the scrobiculum cordis, vomiting,purging, spams, and sudden collapse closelyresembling poisoning.

5. Sudden invasions of acute pain of stomach.- -°When these have terminated fatally, per-forations have been found after death. Theinvasion is often sudden, and no symptomsindicate previous disease, although it musthave existed. Dr. KELLY relates a case ofthis kind :-A stoutservant-girl was attackedwith excruciating pain of the stomach, anddied in 18 hours. On examining the body,dissection displayed a perforation of thestomach in the centre of a thickened indura-tion of the villous coat. In a similar case ofa lady, 29 years of age, detailed by Dr. M.CRAMPTON of Dublin,* which terminatedfatally, in twelve hours, the perforation wasnot larger than a pea, and appeared to bethe result of an ulcer in the mucous surface,hollow, circular, and the size of a shilling:"it had the appearance as if it had beenmade with caustic, with the orifice in itscentre." In the case of a child which cameunder my own care, the perforation was inthe centre of a superficial ulcer. Othercases of this description may be perused inDr. ABERCROMIE’S work on diseases of thestomach. In the " Transactions of the Dub-lin College of Physicians," vols. i. ii., andin the essays of the French physiologists,especially CRUVEILHIER and M. Louis.The chief distjnguishing symptoms be-

tween these cases and those of poisoning* Med. Chir. Trans. viii. p. 228

by acrid poisons, are the absence of pain ofthe gullet; the spreading of the pain begin-ning in the stomach and extending even tothe limbs ; rigidity and hardness of the ab-domen, and the pulse remaining natural,until acute peritonitis supervenes.

When the diagnosis is obscure, much mustdepend on the moral evidence, namely, thestate of mind of the person previous to theattack; whether the attack occurred imme-diately after taking food or medicine; whe-ther others who had partaken of the samedish were similarly affected; and if the ap-pearances, on post-mortem examination, tendto prove the suspicion of poisoning, everymeans must be taken to discover the natureof the poisoning agent.

In making the post-mortem examination,we must keep in recollection that the gastricjuice is acid, and is capable of dissolvIDgthe stomach after death ; that the erosionsthus produced occur in the fundus of thestomach, unless local circumstances, suchas enlargement of the spleen, or great disten-sion of the transverse arch of the colon, tendto make the pyloric the most depending partof the viscus, or some other circumstanceproduces the dissolution of the viscus in anuncommon part. The softening varies froma mere lessened consistence of the mucouscoat, to a conversion of all the coats into agelatinous pulp. When the stomach is muchdistended by gas, the action of the gastricacid forms a well-defined perforation, withan abrupt margin, whilst the membrane be-yond it retains its natural colour and con-sistence. These appearances aid greatly ourdiagnosis ; inasmuch as they demonstratethat the action of the physical agent musthave taken place after death. Redness ofthe softened mucous membrane, such as oc-curs from the the action of poisons duringlife, is never observed when the perforationis spontaneous after death.

If, notwithstanding the most careful exa-mination and comparison, doubts still exist,the benefit of these must be given to the sus-pected person.

Particular Acrid Poisons.

These are both inorganic and organic sub-stances.

1. The htoyaycic comprehend acids, al-kalies, salts of these bases, metallic oxides,salts of metallic oxides, chlorides, phos-phorus, iodine, and iodides, and mechanicalirritants.

2. The Organic comprehend cantharidesand mylabris, in the animal kingdom; eu-phorbium, elaterium, croton oil, colocynth,the ranunculacese, mezereon, and savine, inthe vegetable.Now, let us suppose that we are called to

attend a person who has been suddenlytaken ill after eating or drinking, or takinga medicine, with the following symptoms ;-

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1. Burning sensation of the fauces, ex-tending downwards along the gullet, in-creased by pressure, or by swallowing eithersolids or fluids, or hacking, or coughing;that the lips appear shrivelled, or excoriated,or blistered, and the inside of the mouth ap-pears polished, and coated with a brownishfactitious membrane, and the breath is foetid.

2. Excruciating pain at the epigastrium ;nausea; vomiting of a blackish, liquid mat-ter, which causes effervescence if it fall ona marble hearth, and stains blue and blackcloth red, if sputtered on it, or remains moistfor several days.

3. Pain extending to the abdomen; greattenderness there, increased by slight pres-sure ; purging of either bloody stools, orhalf-dissolved brown shreds.

4. The breathing laborious ; the voice

altered; cough; extreme anxiety ; rigors;great restlessness; agitation; the pulse fre-quent, small, contracted, and irregular; cold-ness of the extremities ; clammy perspira-tion ; and convulsions, preceding death, if ittake place.When such symptoms occur, whether fol-

lowed by recovery or by death, and if, inaddition, we find the chin, cheeks, and

hands spotted with marks, inflamed, as ifscalded, poisioning by sulphuric acid maybe suspected. How are these suspicions tobe verified?

1. By examining whether any bottle or

glass can be found containing the remains ofthe poisoning agent. This is to be testedwith litmus paper, to ascertain that it is an

acid ; next, to determine that it is the sul-

phuric acid, rub it between the fingers; if itfeel saponaceous, it is sulphuric acid; onadding water, by drops, heat is evolved.

2. To some of the suspected fluid add waterand a few drops of nitric acid, thenasolutionof nitrate of baryta ; the appearance of a whiteprecipitate confirms our suspicions. This,which, if sulphuric acid be the poison, mustbe a sulphate of baryta, which should beequally insoluble in acids as it is in water.But phosphates, tartrates, and oxalates, also I

cause white precipitates ; these are, how-

ever, soluble in nitric acid. We must alsorecollect that vinegar is allowed by the ex-cise laws to contain a certain portion ofsulphuric acid. On this account, v. of vinegar should yield gr. It of sulphate of ’,baryta, when tested with nitrate of baryta.Quantity, therefore, as far as regards theprecipitate, may guide us in determiningwhether the sulphate can be formed from ’’,vinegar or from sulphuric acid. ,

3. To prove that the precipitate is sul-! pha.te of baryta, wash Fig. 1.I and dry it, then mix it with charcoal and exposeit to the flame of the spi-rit lamp, after folding itup in platinum foil in atriangular form (fig. 1.),then put the reduced saltinto a tube lined with

paper (fig. 2.) to keep thesides clean, and, afterwithdrawing the paper, add a few Fig. 2.drops of diluted muriatic acid, andhold within the tube a narrow stripeof paper moistened with the solutionof the acetate of lead, or rubbedwith carbonate of lead ; if this paperbe blackened, the poison is sulphu-ric acid.

The theory of this operation is ob-vious. The sulphate of baryta, mix-ed with charcoal, is decomposed, andpartly converted into sulphuret ofbarium ; on adding the hydrochloricacid, this is decomposed, the chlorineunites with the barium, and formsa fixed chloride, whilst the hydrogencombines with the sulphur, and con-stitutes volatile sulphuretted hydro-gen, which converts the salt of leadon the paper into a sulphuret, and

gives it the brown colour indicativeof this change.

4. If only the spotted clothes or the vomitedmatters of the stomach be found, let the for-mer be boiled in distilled water, and filter ;the latter alone ; then add pure carbonate oflead, (i. e. a carbonate wholly soluble innitric acid), and boil to complete neutraliza-tion. This-forms sulphate of lead, whenthe matters examined contain free sulphuricacid, but not when sulphates only are pre-sent. Collect the precipitate on a filter,washit with distilled water and dry it; removeany carbonate by means of nitric acid, andagain wash the residue. This residue is thento be mixed in water, and decomposed witha stream of sulphuretted hydrogen gas,maintained for half an hour, and the mixtureafterwards boiled. If free sulphuric acidhas been present, it will now be demonstratedby testing with nitrate of barj ta, as alreadydescribed.This process is adopted to prevent any

fallacy, were sulphate of soda or of magnesiapresent in the stomach. When there is no rea-son to suspect the presence of these salts, thecontents of the stomach may be simply dis-tilled three or four times, to drive off allmuriatic or acetic acid, and then what re-mains in the retort, diluted, filtered, and’testedfor free sulphuric acid.

I am not aware that the exhumation of abody suspected of having been poisoned withsulphuric acid has taken place for the pur-pose of verifying the suspicion of poisoning

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by that acid, but such a case may occur.The following experiment of ORFILA throwssome light on what we may expect to meetwith in the examination of such a case. He

put a drachm of concentrated sulphuricacid and a portion of the intestinal canal intoa porcelain cup, and inclosed the vessel in awooden box, which was buried two feet anda half beneath the surface of the ground. Thisinterment was effected on the 30th Novem-ber, 1826, and the box was taken up on the10th of April, 1828. The intestine was yel-lowish, and floating in a greyish, slightlyturbid fluid. On examining this fluid, it

reddened litmus, effervesced with marble,gave a white precipitate with the salts ofbaryta insoluble in nitric acid, and when itwas boiled with mercury, evolved sulphur-ous acid gas. It thence appears, that whenthe acid is considerable it retards the putre-factive process, and may be detected longafter interment. When the acid is in small

quantity, it is transformed, by remaining longin the intestinal canal of a dead body, into isulphate of ammonia, and the presence of free acid cannot be detected.

If the person have died, no verdict eitherof suicide or of murder can be pronounceduntil the body be opened and examined. Ifour examination of the contents of the vessel

supposed to have contained the poison, or ofthe clothes, or of the vomited matter, haveafforded satisfactory evidence of the natureof the poison, this is no reason for slightingthe post-mortem examination, for, under

every circumstance, the legal evidence willbe incomplete without it. We must satisfythe jury that the poison which we havefound, was taken by the poisoned person,before they can feel authorized to come to adecision on the question. Now, let us in-quire what appearances the dead body of aperson poisoned by sulphuric acid usuallypresents.

In the mouth we find the mucous mem.brane thickened, white, or greyish, and sepa-rated in parts, or, at least, easily peeled off.If the poison have been taken in a glass, thelips exhibit a semilunar space, in which theepidermis is very separable, like the mucousmembrane. The tongue, the palate, and thethroat, are generally stript of the mucousmembrane, whilst the lining of the oesopha-gus, is marked with longitudinal bands orfurrows of a grey, granular aspect. Theuvula is sometimes ash-coloured.

In the stomach, when the poison has entered it, which does not always happen, the

coat of the viscus exhibits patches of thesame grained layers, and it contains a muddy-looking liquid. There is a puffy appearanceoften of the tissues ; and occasionally thesurface is studded with black or brown spots,as if cauterized. There is generally a verydiminished volume of the organ, owing tothe influence which this acid always exertsin causing contraction of the tissues duringlife. The softening of the tissue extends toall of the coats of the stomach, so that rup-ture readily takes place, and the contents ofthe viscus is often poured into the peritonealcavity.

In reviewing these appearances in the

stomach, we must not forget that the muria-tic, the acetic, and even the nitric acids,producethe same patches of brown as the sul-phuric; they are the result of the disorgani-zation of the tissues, and of their carboniza-tion. Sometimes the duodenum presents thesame appearance. ’

The epiglottis is affected in the same man-ner as the pharynx; and sometimes the

larynx, a little below the rima glottidis, hasbeen observed to be white, and the mem-brane detached; and if the death has notbeen sudden, pus is found in the muscu-lar substance between the larynx and os

hyoides.The influence of sulphuric acid is gene-

rally confined to the first passages. Thenature of the action of the acid on the mouthand the fauces depends much on the mannerin which the dose is swallowed. When thehead is thrown much back, so that the

mouth, the pharynx, and the cesophagusform nearly one line, or vertical cavity, thepoison rapidly enters the stomach, and thoseparts are little affected. But the dangeris augmented by this circumstance. The

empty state of the organ is also a cause of

augmented danger, for when the stomachcontains food, the acid mixes with the foodbefore it acts upon the organ; thence if the

quantity of the acid be not great the stomachdoes not suffer much. The state of the lipsis more important than might at first appearas it goes, sometimes, to aid the proof ofmurder having been committed by this poison.A butcher in Aberdeen who was poisoned byhis wife, who poured the acid down his

throat as he slept with his mouth open, nomarks were observed on the lips, althoughthe mouth and the tongue were white, andthe tia-ttla was black. ,