count I have seen of the morbid appearances under such circumstances is in the cases related by Pyl, by Wildberg, and by Wibmer. In Pyl's case the whole skin was yellow. The intestines, particularly the lesser intestines, were of an unusual green colour, inflamed, and here and there gangrenous. The stomach was also green; its inner coat was excessively inflamed; and near the pylorus there was a spot as big as a crown, where the villous coat was thick, hard, and covered with firmly adhering verdigris. The lungs are likewise said to have been inflamed. The blood was firmly coagulated. In the cases related by Wildberg, which are very like each other, the skin on various parts, and particularly on the face, was yellow; but on the depending parts it was livid. The outer coat of the stomach and intestines was here and there inflamed; and the inner coat of the former was very much inflamed, and even gangrenous near the pylorus and cardia. The duodenum and jejunum, and likewise the gullet, were in a similar state. The blood in the heart and great vessels was black and fluid. * In the case of the girl referred to by Wibmer, the skin was ochre-yellow, the stomach green, much inflamed, especially near the pylorus, the gullet and intestines also inflamed, the diaphragm red, the brain healthy, the lungs and heart "gorged with thick blood." The intestines have been found perforated by ulceration, and their contents thrown out into the sac of the peritonæum. Portal has related one case where the small intestines were perforated, and several where the perforation was in the rectum, which portion of the intestines, as well as the duodenum, jejunum, and ileum, was also extensively ulcerated +. The existence of verdigris in the form of powder lining the inside of the stomach after incessant vomiting for three days, is of course an important circumstance in the inspection of the body. But too much reliance ought not to be placed on mere bluish or greenish colouring of the membranes. For Orfila ‡ Gangrene could not have taken place in thirteen hours. The appearance must have been black extravasation, which has often been mistaken for gangrene. See page 314. + Portal sur les effets des vapeurs méphitiques, 436, 439. Orfila, Tox. Gén. i. 530. and Guersent✶ have both observed, that the inside of the stomach as well as its contents may acquire these tints in a very remarkable degree in consequence of natural disease. SECTION IV. Of the Treatment of Poisoning with Copper. The treatment of poisoning with the salts of copper has been examined in relation to the antidotes by M. Drouard, M. Marcelin-Duval, Professor Orfila, and M. Postel. The Alkaline Sulphurets were at one time thought to be antidotes for the poisons of copper, but without any reason. Drouard found that fifteen grains of verdigris killed a dog in thirty hours, notwithstanding the free use of the liver of sulphur †. More recently M. Marcelin-Duval was led from his experiments to infer that sugar was an antidote ‡, and in the first editions of his Toxicology Professor Orfila agreed with him, and related some experiments of his own, which, along with those of Duval, seemed to place the fact beyond all doubt. Later and more careful experiments however satisfied Orfila, as he announced in the last edition of his Toxicology, that it only acts as an emollient after the poison has been removed from the stomach, and that it has no effect at all if the poison is retained by a ligature on the gullet §. Sugar being thus rejected as well as the sulphurets, he was led to try the effects of albumen; and his experiments have induced him to recommend that substance as an antidote in preference to every thing else. He found that the white of six eggs completely neutralized the activity of between 25 and 36 grains of verdigris; so that even when the mixture was retained in the stomach by a ligature on the gullet no effect ensued which could be ascribed to the poiHe infers that white of egg is the best antidote for poisoning with copper |. He likewise found the ferrocyanate of potass not inferior ¶. son. Since the publication of these inquiries the subject has been again examined by M. Postel, who reverts to the original proposition of Duval, that sugar is really a good antidote; and he founds this conclusion partly on direct comparative experiments, showing that it is at least equally effectual with white of egg, Dict. des Sciences Médicales, vii. 564. t Orfila, Toxic. Gén. i. 534. Ibidem, i. 535. § Ibidem. 539. || Ibidem, 540. Ibidem, 541. and partly on the singular fact ascertained by him, that sugar, which was believed to decompose the salts of copper only at the temperature of 212°, does actually accomplish this decomposition at the temperature of the human body, and throws down the copper in the form of oxide *. According to the experiments of MM. Mylne-Edwards and Dumas, metallic iron is likewise a good antidote: They found that when fifteen, twenty, and even fifty grains of sulphate of copper, acetate of copper, or verdigris, were given to animals, and an ounce of iron filings administered either immediately before, or immediately afterwards, the gullet being tied to prevent the discharge of the poison,- death did not ensue for five, six, or even eight days, and consequently proceeded from the operation on the gullet; and that in one experiment, on the ligature being removed from the gullet, the opening healed and complete recovery took place †. up, Before quitting the subject of the treatment, it is necessary to caution the practitioner particularly against the employment of a substance ignorantly used for this, in common with many other, species of poisoning,-vinegar. On account of its solvent power over the insoluble compounds formed by the salts of copper with animal and vegetable matters, it must be injurious rather than useful. * Journal de Pharmacie, xviii. 570. + London Medico-Chirurgical Review, v. 611, CHAPTER XVI. OF POISONING WITH ANTIMONY. THE Fourth genus of the Metallic Irritants includes the preparations of Antimony. Poisoning with antimonial preparations is not very common. They are employed extensively in medicine, however, and consequently accidents have sometimes occurred with them. One of them is also often foolishly used, in the way of amusement, to cause sickness and purging, and likewise to detect servants who are suspected of making free with their mistress's tea-box or whisky-bottle; and in both of these ways alarming effects have sometimes been produced. In large doses some of the antimonial compounds may cause death; and one of them, the Butter of Antimony, now very little or never put to use in this country, is a violent corrosive. SECTION I. Of the Chemical History and Tests for the Metallic antimony has a bluish-white colour, not liable to tarnish. Its specific gravity is 6.7 It is easily fused, but is not very volatile. In certain circumstances, however, it easily undergoes a spurious sublimation, by being carried along with the gases disengaged while it is in the act of being reduced. This curious phenomenon will be exemplified presently. A great number of preparations of antimony were at one time to be found in the shop of the apothecary; but they are now reduced to a few. Those which require notice here are the prepared sulphuret, the precipitated sulphuret, and tartar emetic. The Prepared Sulphuret is sold in brownish-black cakes or powder; it dissolves in diluted muriatic acid with the aid of heat, sulphuretted-hydrogen being evolved. The best mode of showing the presence of antimony in it is the method of Dr Turner, who proposes to place a little in a horizontal tube, to transmit hydrogen gas through the tube by means of the apparatus represented in Figure 9; and when all the air of the apparatus is expelled, to apply heat to the sulphuret with a spirit-lamp. Sulphuretted-hydrogen is evolved, and metallic antimony is left if the current of hydrogen be gentle, or it is sublimed if the current be rapid*. I have seldom been able to procure metallic globules with a small tube by heating the sulphuret with potass, according to the process recommended by Orfila. His process rarely succeeds on the small scale. The Precipitated Sulphuret is always in the form of a dirty scarlet or reddish-brown powder. It yields metallic antimony by the process of reduction with hydrogen; but not easily on a small scale with potass. Tartar Emetic. In its solid state Tartar emetic forms regular tetraedral crystals of a yellowish white colour, efflorescent, and of an acid and slightly metallic taste. As commonly seen in the shops it is in the form of a white, or pale yellowish white powder. When heated it decrepitates and then chars; and if the heat be increased the oxide of antimony is reduced by the carbonaceous matter, and little globules like those of quicksilver in point of colour are found in the mass. The best way of reducing tartar emetic is to char it in a porcelain vessel or watch-glass, and then to increase the heat till the charred mass takes fire. Or the charred mass may be introduced into a tube and heated strongly with the blowpipe, after which globules of antimony will be found lining the bottom of the glass where the material has been. None of it is ever sublimed. It is not easy to procure distinct globules by heating tartar emetic at once in a small tube. According to Dr Duncan, Tartar Emetic is soluble in three parts of boiling and fifteen of temperate water. The solution presents with reagents various peculiar appearances, which have been examined with great care by Dr Turner *. 1. Caustic potass precipitates it white, but only if the solution is tolerably concentrated. The first portions of the test have no effect, as the tartrate contains an excess of acid which must be neutralized. The precipitate thrown down, which is the oxide of antimony, is redissolved by an excess of potass. 2. Lime-water precipitates the solution white, and with somewhat greater delicacy than caustic potass. It does not act, however, when the solution contains only half a grain to an ounce. On the Detection of Antimony in mixed fluids. Ed. Med. and Surg. Journ. xxviii. 71. |