HYPOSTHENISANTS.
NEUROTICS PRODUCING DEATH BY SYNCOPE.
ACONITE--PRUSSIC ACID.
ACONITE (_Aconitum Napellus_, _Monkshood_, _Wolfsbane_, _Blue
Rocket_).--This beautiful plant is found in most parts of Europe.
_Aconitia_, the alkaloidal base of the plant, is the most deadly poison
known; the fiftieth part of a grain having nearly caused death.
The chief _symptoms_ of poisoning by aconite are numbness and tingling
in the mouth and throat, giddiness, abolition of muscular power, pain in
the abdomen, with vomiting and purging. Sometimes delirium and slight
stupor have been noticed. The pupils are usually dilated, the skin is
cold, the pulse exceedingly feeble, the breathing oppressed, and there
is a dread of approaching dissolution. Frequently the sufferer is
perfectly conscious, though paralyzed, till death suddenly occurs after
two or three hurried gasps. According to Dr. Fleming, death may be due
to a sedative impression on the nervous system, or to asphyxia from
paralysis of the respiratory muscles, or to syncope.
A fatal mistake is not very uncommonly made in eating the root of
aconite for that of horseradish. The sense of tingling and numbness
produced by the former is so different from the pungent taste of the
latter that with due care no mistake should occur, except the plants be
allowed to grow together, which should never be done.
A case occurred in Ireland where a woman poisoned one man and nearly
killed another by sprinkling powdered aconite root over a dish of
greens.
Of the root one drachm, of the tincture one drachm, and of the alcoholic
extract four grains, have caused death. Death follows a considerable
dose in less than an hour, but sometimes a longer period elapses.
The Bikh poison, formerly much used in India, and still not unfrequently
employed, has as its basis the Aconitum ferox, a still more dangerous
drug than our indigenous plant.
_Treatment._--No time must be lost in the use of remedies. In addition
to emetics, castor oil, and animal charcoal, benefit may be derived from
administering strong coffee. Brandy or ammonia should also be given,
while the limbs and back are well rubbed with hot towels. Artificial
respiration might prove useful.
There is no good test for aconitia.
HYDROCYANIC ACID (_Prussia Acid_), on account of its energetic and rapid
action, is one of the most formidable poisons with which we are
acquainted. In its concentrated state it is a limpid colorless liquid;
possessing a somewhat acrid taste, and having an odor, when diffused
through the air, resembling that of oil of bitter almonds. When diluted
with water, it forms the acid kept by the druggist. The properties of
this variety are similar to those of the pure form; except that, if kept
in the dark, it is not so readily decomposed. It is in this condition
that it is used as a poison. The diluted acid of the British
Pharmacopoeia contains about 2 per cent., and that known as Scheele's
from 4 to 5 per cent., of the strong acid; but all vary greatly with
keeping.
One of the salts of hydrocyanic acid, the _cyanide of potassium_, claims
a short notice, since it is largely employed by photographers, workers
in electrotype, &c. It has been taken as a poison. This salt is sold in
the form of deliquescent white crystals, or in crystalline masses, which
are very soluble in water, and possess the odor of prussic acid. From
three to five grains will destroy life almost as rapidly as prussic acid
itself, and in the same manner: a dose of five grains has proved fatal.
Several vegetable substances yield prussic acid, such as the kernels of
the peach, apricot, nectarine, cherry, &c., the leaves of the cherry
laurel, and the pips of apples and pears. Cases of alarming illness have
occurred from eating _bitter almonds_ too freely; while the essential
oil obtained by distilling the pulp of these almonds with water is a
powerful poison. This _essence_ or _oil of bitter almonds_ contains
about ten per cent. of anhydrous prussic acid; and it is probable that
from ten to thirty drops would prove fatal to an adult. The prussic acid
may, however, be separated from it, and leave the oil harmless.
A distilled water obtained from the leaves of the cherry laurel, which
was formerly employed in medicine, proved dangerous from its very
variable strength; it has been used as a poison. In the well-known case
of Sir Theodosius Boughton, poisoned by Captain Donellan in 1781,
_laurel water_ produced death within half an hour after two ounces had
been swallowed.
The smallest quantity of prussic acid which has been known to
destroy life is nine-tenths of a grain of the anhydrous acid, equal
to forty-five minims of the diluted preparation of the British
Pharmacopoeia; and it is probable that this would, in most instances,
prove fatal. In the case referred to death occurred in twenty minutes;
but from a larger dose it has ensued much earlier. The period may be
said to vary from two to five and forty minutes. Insensibility may,
however, come on in a few seconds. In the case of seven epileptics
accidentally poisoned at the Bicetre, death occurred in the first within
twenty minutes, in the last after three-quarters of an hour, though the
dose of the acid was the same in each instance.
_Symptoms._--These will vary with the dose and the mode of exhibition.
Inhalation of the vapor of anhydrous prussic acid would immediately
cause death. The vapor of the diluted acid has given rise to serious
symptoms with great rapidity. Scheele is said to have been suddenly
killed by respiring the vapor of the dilute acid while making his
experiments.
When the diluted acid is taken in a large dose the symptoms may commence
during swallowing, death following so quickly that scarcely any effects
can be observed. The chief symptoms, perhaps, are insensibility, slow
gasping, or convulsive respiration, a clammy cold skin, fixed and
glistening eyes, dilated pupils, spasmodic closure of the jaws, an
almost imperceptible pulse, and sometimes convulsions of the limbs and
trunk. The rapidity with which consciousness is lost is well exemplified
in an instance recorded by Hufeland, where a man about to be apprehended
as a thief took an ounce of the acid, staggered a few steps and fell
apparently lifeless. In a few moments a single violent respiration was
made, and within five minutes of taking the poison he was dead.
Insensibility is not, however, in all instances, immediately produced;
many an authenticated case having occurred in which the symptoms were
protracted for some minutes, the individual performing several acts
indicating consciousness, such as replacing the cork in the bottle,
adjusting the bed-clothes, or even running some distance to summon help.
The utterance of a shriek has been said to be characteristic of
poisoning by this acid; but toxicologists know that such has not been
observed in the human subject, and that there is merely a gasping for
breath, or perhaps a call for help.
A small dose produces faintness, insensibility, difficulty of breathing,
involuntary evacuations, loss of muscular power, convulsions, and
temporary paralysis. If the proper treatment be employed, recovery may
often be effected.
_Post-mortem Appearances._--The body is generally livid, the countenance
pallid, or sometimes livid and bloated, the jaws firmly closed, and the
hands clenched. There is frequently blood or froth about the mouth, and
the eyes are sometimes described as prominent and glistening. There is
often an odor of prussic acid about the body, which is more perceptible
on opening the stomach. The venous system is usually gorged with blood;
and the brain, lungs, heart, liver, spleen, and kidneys have been found
congested with dark-colored fluid blood.
_Treatment._--There is no chemical antidote to this poison which can be
relied upon. Chlorine and the mixed oxides of iron have been
recommended; but even if one of these agents happened to be at hand, it
is doubtful if its employment could be timely enough to be advantageous.
Attempts must be made to restore animation by cold affusion, stimulating
frictions to the chest and abdomen, warmth to the surface, and the
application of ammonia to the nostrils. Cold affusion over the head and
neck has proved most efficacious when promptly resorted to, and repeated
at short intervals so as to cause a shock. The direct injection of
liquor ammoniae into the veins, as proposed by Professor Halford, for
snake bite, might be tried if the means were at hand. As soon as
possible ammonia should be given internally and the stomach emptied.
If recovery ensue from the immediate effects, vomiting should be
produced by emetics or otherwise, after which strong coffee, with
brandy, ought to be administered.
_Tests._--The best are the following:
When hydrocyanic acid has to be separated from organic substances, such
as the contents of the stomach, it is usual to take advantage of its
ready volatility. If the acid be not in combination it may be given off
so readily as to be detected by a watch glass moistened with nitrate of
silver held over the vessel containing the acid; but in order to make
sure of its presence or absence the following process should be adopted.
The suspected material should be acidulated with pure sulphuric acid so
as to insure the prussic acid being in a free state. The substances thus
acidulated are to be placed in a retort, distilled over a water bath,
and the distillate collected in a cool receiver containing some caustic
potass. About one-sixth of the fluid substance should in this way be
distilled over, when the liquid in the receiver may be tested by the
silver or iron tests, or the vapor as it passes over may be tried with
the sulphur test.
1. The peculiar _odor_ of prussic acid is well known, and is a very
delicate test, taken in conjunction with others, of its presence.
2. _The Silver Test._--Nitrate of silver yields, with hydrocyanic acid
or cyanide of potassium, a white clotted precipitate, (cyanide of
silver,) insoluble in cold but soluble in boiling nitric acid. If this
precipitate be well dried and heated, cyanogen gas will be given off,
which may be known by its burning with a purplish flame. This test is
very delicate.
3. _The Iron Test._--Of the liquid collected in the receiver
above-mentioned, or the suspected acid liquid, saturated with a few
drops of caustic potass, a portion is to be taken, and to this is to be
added a small quantity of a solution of sulphate of iron. A dirty
brownish or greenish precipitate will fall, consisting of a mixture of
the oxide of iron and prussian blue. On adding a few drops of diluted
sulphuric or hydrochloric acid, and thus dissolving the oxides, the
prussian blue will immediately be made clear if hydrocyanic acid be
present.
4. _The Copper Test._--Sulphate of copper added to prussic acid rendered
slightly alkaline by potass, gives a greenish-white precipitate, which
becomes white by the addition of a few drops of hydrochloric acid to
dissolve the blue precipitated oxide of copper.
5. _The Sulphur Test._--One of the most useful tests for prussic acid,
whether in the fluid or volatile state, is the so-called sulphur or
Liebig's test. It is best adapted for detecting the acid in a state of
vapor, and to this end a drop of yellow sulphide of ammonium in a
watch-glass is held over the suspected liquid, which may be warmed by
the hand to facilitate the evolution of the acid. In this position the
watch-glass should be allowed to remain for some little time, after
which a drop of solution of perchloride of iron is to be added, which
will give rise to a blood-red color not discharged by corrosive
sublimate.
If the acid is in the liquid form a drop of the prussic acid and the
yellow sulphide may be mixed and heated until they thoroughly combine. A
drop of sulphate of iron is then added as before, but all the sulphide
must be decomposed or a black sulphide of iron will be produced, even
though prussic acid be present, instead of the ordinary blood-red color.
Other substances give a similar reaction with iron; but their color is
discharged by corrosive sublimate.