1. _Slow Poisons._ According to the popular acceptation of the term,
they may be defined, _Substances which can be administered
imperceptibly; and a single dose of which will operate so gradually, as
to shorten life like a lingering disease; their force, at the same time,
admitting of so nice an adjustment as to enable the artist to occasion
death at any required period._ We have now to inquire how far such
alleged powers are consistent with the known laws of physiology. It
cannot be denied that certain substances have been introduced into the
alimentary canal, where they have remained for an indefinite period,
without occasioning the slightest inconvenience, and at length excited a
disease that has terminated fatally; in the _London Medical and Physical
Journal_ for February 1816, a case is related in which death was
occasioned by a chocolate-nut having lodged in the entrance of the
_Appendix Vermiformis_; and in the _Edinburgh Medical and Surgical
Journal_ for July 1816, we have an analogous case, communicated by Dr.
_Briggs_ of Liverpool, where the _Appendix cæci_ sphacelated, owing to
the irritation of a human tooth which was found sticking in its cavity.
Mr. _Children_ has lately communicated to the Royal Society a case where
a concretion in the colon produced death; upon examination it was found
to contain a plum-stone, as a nucleus, and to consist of a fine fibrous
vegetable substance, from the inner coat enveloping the farina of the
oat, and which was derived from the oatmeal upon which the deceased had
fed. (_Phil. Trans._ 1822.) However disposed we may feel, by a forced
construction of the term, to consider such agents as _slow_ poisons, it
is very evident that they can rarely have been made subservient to the
purposes of secret poisoning; although a case occurred in the practice
of the author,[136] in which a girl swallowed six copper pence for the
avowed purpose of destroying herself; the coin produced a disease which
remained chronic for a very considerable period, when, after a lapse of
five years, they were voided, and the young woman recovered. A similar
attempt was also made by _Theodore Gardelle_, after his conviction for
the murder of Mrs. _King_ (_vide ante_), he swallowed a number of
halfpence, for the purpose of destroying himself, but without any ill
effect. Dr. _Baillie_, in his ‘_Morbid Anatomy_,’ relates an instance
where five halfpence had been lodged in a pouch in the stomach for a
considerable time, without occasioning any irritation; and Mr. _A.
Thomson_ has also furnished us with two analogous cases in children, in
one of which the copper coin remained six months in the intestines, and
in the other, two months. These facts furnish sufficient data to enable
the practitioner to appreciate the degree of danger attendant upon such
agents, and to determine how far they can ever become successful
instruments in the hands of the assassin.[137]
But it has been supposed that certain bodies, as glass, enamel,
diamonds,[138] agates, smalt, &c. when administered in the form of
powder, so lacerate the membranes of the stomach, by the sharpness of
their particles, as slowly to destroy life; and upon the same principle,
it has been asserted, that human hair, chopped fine,[139] constitutes
the active ingredient of a slow poison frequently employed in Turkey,
and that it induces, by irritation, a chronic disease resembling cancer.
With respect to the danger arising from the ingestion of diamond dust,
enamel powder, powdered glass, and the like, there still may be said to
exist some difference of opinion. _Caldani_, _Mandruzzato_,[140] and M.
_Le Sauvage_, have reported experiments made upon men and inferior
animals, in which no bad consequences followed the administration of
such bodies; whereas _Schurigius_[141] and _Cardanus_[142] cite
instances where persons have died of ulcerations of the stomach from
such causes; and this opinion receives the support of _Plouquet_,[143]
_Stoll_,[144] _Gmelin_,[145] _Foderé_,[146] _Mahon_,[147] _Franck_,[148]
and many others. The modern pathologist will not find much difficulty in
reconciling such conflicting testimony. The experimentalist may
administer mechanical substances a thousand times without producing any
ill effects, while, under certain circumstances, the most trivial body
may lodge in the intestines and produce death; but surely the occasional
occurrence of such accidents ought not to confer the general title of
_poison_ upon the substances which may happen to produce them.
Having thus disposed of a considerable number of bodies, which have been
classed as _slow_ poisons, we may proceed to observe that most of the
other substances which have found a place in the same division, appear
to us to deserve consideration under a very different head, and that we
shall get rid of much obscurity by adopting the following arrangement.
2. _Consecutive Poisoning._ Where the patient, having recovered from the
acute effects occasioned by the ingestion of a single dose of poison,
_subsequently suffers a series of symptoms from the injured structure to
which it had given origin_. By referring to our definition of _slow_
poisoning, we shall at once perceive the striking and important
distinction between that and _Consecutive poisoning_. The following
case, related by M. _Orfila_, may serve as an illustration. _Maria
Ladan_ drank by mistake a spoonful of _Aqua fortis_, the most violent
symptoms supervened, but which by judicious treatment gradually
subsided, when at length she passed by stool a long membranous
substance, rolled up, and which represented the form of the æsophagus
and stomach, and which, in fact, was found to be the interior membrane
of these organs; from that moment the sensibility of the digestive
organs became excessive, and two months after the accident she
experienced a sudden shock and died. M. _Tartra_, in observing upon
cases of this kind, asserts that the symptoms produced at first by the
nitric acid decrease insensibly; and that at the end of a certain
period, the internal membrane of the digestive canal is struck with
death, and thrown off, and the person dies of a _Marasmus_.
_Fordyce_[149] relates the case of a woman who was subject to cholics
for the space of thirty years, in consequence of having _once_ taken an
infusion of the pulp of Colocynth prepared with beer. This was
undoubtedly an extraordinary instance of idiosyncrasy, but it is
probable that some organic lesion was occasioned by its operation, to
which the subsequent suffering is to be referred. We have hitherto only
considered the effects that may arise from the ingestion of a _single_
dose of poison, but there are numerous and very interesting cases in
which fatal results have been produced by the repetition of small doses
at various intervals. We therefore propose a third, and new subdivision
of our subject, viz.
3. _Accumulative Poisoning._—By the repeated administration of a
substance, in doses, of which no single one could occasion harm; but
which, by gradually accumulating in the system, ultimately occasions
disease, and death.
The familiar operation of mercury will at once suggest itself to the
Physician, as a striking illustration of that species of poisoning which
we have ventured to name _Accumulative_, and to the forensic student the
effects of this metal, in reference to such a quality, will form a more
than ordinary object of interest, as involving questions which have
frequently embarrassed judicial inquiry; as, for instance, _Whether it
can lie dormant any considerable time without betraying its effects upon
the constitution_, and, having displayed its powers, and the symptoms
having subsided, viz. salivation, &c. _Whether they can be renewed
without a fresh application of the substance?_ See Corrosive sublimate.
To how many substances this power of accumulation extends is at present
not well understood. It may occur in those that act by absorption, and
in those whose action is wholly local. Arsenic, digitalis, and several
of the narcotic plants, as hemlock, may undoubtedly occasion serious
mischief in this manner, as the author has more fully explained in
another work,[150] and we have lately heard of several fatal cases
arising from accumulated masses of magnesia in the _primæ viæ_, from the
habitual use of small doses of that earth.
The history of many of the arts, especially those of metallurgy, would
furnish also abundant examples of this kind of poisoning.
These few facts are we trust sufficient to authorise the foregoing
arrangement, and we apprehend that the adoption of the distinctions,
upon which it is founded, will be of great service in establishing fixed
and definite notions with regard to the _chronic_ operation of poisons.
It may perhaps be useful to present the reader with a synoptical
recapitulation of the subject.
_A Slow Poison._ A single dose is sufficient; which produces upon its
administration no sensible effect, but gradually undermines the
health.
_A Consecutive Poison._ A single dose is sufficient; producing the
most violent symptoms, very shortly after its ingestion, but which
gradually subside, and the patient is supposed cured; when, at some
future period, death takes place from the organic lesions that had
been occasioned.
_An Accumulative Poison._ Many doses are required; the effects being
produced by the repetition of doses which would, _individually_, be
harmless.
There still remains another point of view in which it is essential to
regard the operation of a poison, in order to establish a distinction
between those substances which, in a given dose, will destroy life under
every circumstance of constitution, and those which occasion death in
consequence of some constitutional peculiarity in the individual to whom
they may have been administered, and which are innocuous to the general
mass of mankind; the gradations by which food, medicine, and poison, are
thus enabled to branch into each other cannot be defined, because the
circumstances with which they are related, defy generalization. The
distinction, however, must be acknowledged and preserved, and we know no
terms better adapted for expressing it than those of _Absolute_ and
_Relative_ poisons; and our readers are accordingly requested to receive
them in conformity with this explanation, whenever they occur in the
following pages. Every work professing to treat the subject of Poisons,
abounds with instances, in which articles that, by universal consent,
are considered innocuous, have occasioned the most direful effects.
_Morgagni_ relates a case of a person who died from eating bread made
with the farina of the chesnut. Dr. _Winterbottom_[151] says that he is
subject to severe nettle-rash after eating sweet almonds. _Schenkius_
relates a case in which the general law of astringents and cathartics
was always reversed. _Donatus_ tells us of a boy whose jaws swelled,
whose face broke out in spots, and whose lips frothed, whenever he eat
an egg: we might add many more examples, but it is needless to encumber
a subject with illustrations which is already so obvious and
indisputable. Nor do the anomalies of constitutional idiosyncrasies end
here, for they not only convert food into poison, but they change poison
into food, or at least, into a harmless repast. The most extraordinary
exemplification of this on record is contained in the history of the old
man at Constantinople, as related by M. _Pouqueville_, physician to the
French army in Egypt, and who was a prisoner at Constantinople in the
year 1798[152]. “This man,” says he, “was well known all over
Constantinople, by the name of _Suleyman Yeyen_, or _Suleyman, the taker
of corrosive sublimate_. At the epoch when I was there he was supposed
to be nearly a hundred years old, having lived under the Sultans
_Achmet_ III, _Abdul Hamet_, and _Selim_ III. He had in early life
habituated himself to taking opium; but, notwithstanding that he
constantly increased the dose, he ceased to feel from it the desired
effect, and then tried sublimate, the effects of which he had heard
highly spoken of; for thirty years this old man never ceased to take it
daily, and the quantity he could now bear exceeded a drachm. It is said,
at this epoch he came into the shop of a Jewish apothecary, and asked
for a drachm of sublimate, which he swallowed immediately, having first
mixed it in a glass of water. The apothecary, terrified, and fearing
that he should be accused of poisoning a Turk, immediately shut up his
shop, reproaching himself bitterly with what he had done; but his
surprise was very great, when, the next day, the Turk came again, and
asked for a like dose of sublimate.”
Morbid states of the body may also exist which are capable of resisting,
to a certain extent, or of modifying, the violent operation of
particular poisons. In the history of the Royal Academy of Sciences for
1703, a case is related of a woman, who being tired out by a protracted
dropsy, under which her husband had suffered, _charitably_ administered
to him fifteen or twenty grains of opium with the intention of
despatching him; but the dose immediately produced such copious
evacuations by sweat and urine, that it restored him to health. This
relation will immediately recal to the recollection of the classical
reader the story, recorded by _Plutarch_, in his life of _Crassus_, of
_Hyrodes_ king of the Parthians, who having fallen into a dropsical
complaint had poison (_Aconite_) administered to him by his second son,
_Phraates_, but which, instead of destroying the king, as intended,
cured his disease. The son, however, having thus failed in his attempt,
shortly afterwards smothered his father with his pillow.