OF POISONING WITH NIGHTSHADE, THORN-APPLE, AND TOBACCO.
The first group of the narcotico-acrids comprehends these whose
principal symptom in the early stage of their effects is delirium. All
the plants of the group belong to the natural order _Solanaceæ_, and
Linnæus’s class Pentandria Monogynia. Those which have been particularly
examined are deadly nightshade, thorn-apple, and tobacco.
_Of Poisoning with Deadly Nightshade._
The deadly nightshade, or _Atropa belladonna_, is allied in
physiological and botanical characters to the _hyoscyamus_ and _solanum_
formerly mentioned; and by the older writers, indeed, was confounded
with the latter. It is a native of Britain, growing in shady places,
particularly on the edge of woods. The berries, which ripen in
September, have a jet-black colour. Their beauty has frequently tempted
both children and adults to eat them, although they have a mawkish
taste; and many have suffered severely. It is not the berry alone which
is poisonous; the whole plant is so; and the root is probably the most
active part.[2127] From one to four grains of the dried powder of the
root will occasion dryness in the throat, giddiness, staggering, flushed
face, dilated pupils, and sometimes even delirium.[2128] The juice of
the leaves is very energetic, two grains of its extract being, when well
prepared, a large enough dose to cause disagreeable symptoms in man. It
is a very uncertain preparation, unless when procured by evaporation _in
vacuo_; for some samples from the Parisian shops have been found by
Orfila to be quite inert.
It contains a peculiar alkaloid, named _atropia_. In the belladonna
Brandes obtained a volatile, oily-like, alkaloidal fluid, of a
penetrating narcotic smell, and bitterish, acrid taste, which he
supposed to be the active principle of the plant.[2129] The ulterior
researches of Geiger and Hesse, however, as well as the simultaneous
analysis of Mein, have proved that this fluid is not the pure alkaloid
of belladonna, and that the real atropia is a solid substance, forming
colourless, silky crystals, soluble in ether and alcohol, sparingly so
in water, slightly bitter, liable to decomposition under contact with
air and moisture, volatilizable, but with some decomposition, a little
above 212°, and capable of forming definite crystallizable salts with
acids.[2130] The aqueous solutions of its salts exhale during
evaporation a narcotic vapour, which dilates the pupil, and causes
sickness, giddiness, and headache.[2131]
The ordinary extract of belladonna in the dose of half an ounce will
kill a dog in thirty hours when introduced into the stomach. Half that
quantity applied to a wound will kill it in twenty-four hours. And
forty grains injected into the jugular vein prove even more quickly
fatal. Convulsions are rarely produced, but only a state like
intoxication.[2132]
The oleaginous atropia of Brandes in a dose of two or three drops kill
small birds instantaneously like concentrated hydrocyanic acid; in less
doses it occasions staggering, gasping, and in a few minutes death
amidst convulsions; and the dead body presents throughout the internal
organs great venous turgescence and even extravasation of blood, but
more especially excessive congestion within the head.[2133] The pure
crystalline atropia of Mein, when dissolved in water and greatly
diluted, causes extreme and protracted dilatation of the pupils.
_Symptoms in Man._—On man the effects of belladonna are much more
remarkable. In small doses, whatever be the kind or surface to which it
is applied,—such as the skin round the eye, or the surface of a wound,
or the inner membrane of the stomach,—it causes dilatation of the pupil.
This effect may be excited without any constitutional derangement. When
the extract is rubbed on the skin round the eye, or a solution of it
dropped upon the eyeball, vision is not impaired; but when it is taken
internally so as to affect the pupils, the sight is commonly much
obscured. The effects of large or poisonous doses have been frequently
witnessed in consequence of children and adults being tempted to eat the
berries by their fine colour and bright lustre. From the cases that have
been published the leading symptoms appear in the first instance to be
dryness in the throat, then delirium with dilated pupils, and afterwards
coma. Convulsions are rare, and, when present, slight.
The dryness of the throat is not a constant symptom. It is often,
however, very distinct. It occurred, for example, in 150 soldiers who
were poisoned near Dresden, as related by M. Gaultier de Claubry,[2134]
and in six soldiers whose cases have been described by Mr.
Brumwell.[2135] The former had not only dryness of the throat, but
likewise difficulty in swallowing.
The delirium is generally extravagant, and also most commonly of the
pleasing kind, sometimes accompanied with immoderate uncontrollable
laughter, sometimes with constant talking, but occasionally with
complete loss of voice, as in the cases of the 150 soldiers. At other
times the state of mind resembles somnambulism, as in the instance of a
tailor who was poisoned with a belladonna injection, and who for fifteen
hours, though speechless and insensible to external objects, went
through all the customary operations of his trade with great vivacity,
and moved his lips as if in conversation.[2136] Sometimes frantic
delirium is almost the only symptom of consequence throughout the whole
duration of the poisoning. Thus a gentleman at Perigueux in France, who
took by mistake a mixture containing a drachm and a half of extract, was
attacked in half an hour with delirium, which soon became furious, and
continued till next day, when it gradually left him.[2137] In others the
delirium is attended with a singular and total loss of consciousness,
but without coma, as in the following case which occurred not long ago
at St. Omer. A young man having taken by mistake an infusion of two
drachms of dried leaves, was seized in an hour with great dryness of the
mouth and throat, afterwards slight delirium, loss of consciousness, and
dilatation of the pupil, next with retention of urine, convulsive
twitches of the face and extremities, and incessant tendency to walk up
and down. In three hours, after the action of an emetic and a clyster,
he lay down, but still in a state of total unconsciousness and muttering
delirium. Blood-letting being at last resorted to as a remedy, he
speedily recovered his senses, and eventually got well, after suffering
for some time from headache, fatigue, and much debility.[2138]
The pupil is not only dilated in all cases, but likewise for the most
part insensible;[2139] and, as in the soldiers at Dresden, the eyeball
is sometimes red and prominent. The vision also, as in these soldiers,
is generally obscure; sometimes it is lost for a time;[2140] and so
completely that even the brightest light cannot be distinguished.[2141]
The sopor or lethargy, which follows the delirium, occasionally does not
supervene for a considerable interval. In a case related by Munnik it
did not begin till twelve hours after the poison was taken.[2142]
Sometimes, as in the same case, the delirium returns when the stupor
goes off. A patient of my colleague Dr. Simpson, after using a
belladonna suppository consisting of two grains of extract, was attacked
with dryness of the throat and delirium, followed soon by drowsiness and
stupor; and in five or six hours more, as the stupor wore off, the
delirium returned, prompting to constant movements as if she was busy
with her toilette and various other ordinary occupations. Sometimes the
relation of the delirium to the coma is reversed, as in a case related
by Mr. Clayton, where sopor came on first, and delirium ensued in six
hours. The dose in this instance was forty grains of the extract.[2143]
Frequently the stupor is not distinct at any stage.—Even the delirium is
not always formed rapidly. A man whose case is described by Sir John
Hill did not become giddy for two hours after eating the berries, and
the delirium did not appear till five hours later.[2144] In Mr.
Brumwell’s cases, the delirium was not particularly noticed till the
morning after the berries were taken.
Convulsions, it has been already stated, are rare. In the case from the
24th volume of Sedillot’s Journal, the muscles of the face were somewhat
convulsed: there is also at times more or less locked-jaw,[2145] or
subsultus tendinum;[2146] and occasionally much abrupt agitation of the
extremities.[2147] But well-marked convulsions do not appear to be ever
present.
The effects now detailed are by no means so quickly dissipated as those
of opium. Almost every person who has taken a considerable dose has been
ill for a day at least. The case from Sedillot’s Journal lasted three
days, delirium having continued twelve hours, the succeeding stupor for
nearly two days, and the departure of the stupor being attended with a
return of delirium for some hours longer. One of Mr. Brumwell’s
patients, too, was delirious for three days; and Plenck has noticed
several instances where the delirium was equally tedious.[2148] Sage has
related a case in which the individual was comatose for thirty
hours.[2149] Blindness is also a very obstinate symptom, which sometimes
remains after the affection of the mind has disappeared. This happened
in Plenck’s cases. In two children whose cases have been described in a
late French journal, the eyes were insensible to the brightest light for
three days.[2150] In general, the dilated state of the pupils continues
long after the other symptoms have departed. It further appears from an
official narrative in Rust’s Journal, that dilated pupil is not the only
symptom which may thus continue, but that various nervous affections,
such as giddiness, disordered vision, and tremors, may prevail even for
three or four weeks.[2151]
Hitherto little or no mention has been made of symptoms of irritation
from this poison. They are in fact uncommon, and seldom violent. In the
cases related by Gaultier de Claubry and by Mr. Brumwell, dryness and
soreness of the throat and difficult deglutition were remarked, and
appear not unusual. These symptoms were especially noticed by Buchner,
who by way of curiosity took half a drachm of seeds digested in beer.
The sense of dryness and constriction of the throat were such as to
prevent him swallowing even the saliva.[2152] Sage’s patient passed
blood by stool; and after the symptoms of narcotic poisoning ceased, he
had aphthous inflammation in the throat, and swallowing was so difficult
as for some time to excite convulsive struggles. Aphthæ in the throat
and swelling of the belly also succeeded the delirium in Munnik’s case.
Mr. Wibmer alludes to the case of a man who, besides difficult
deglutition at the beginning, had violent strangury towards the
close.[2153] An instance of violent strangury with suppression of urine
and bloody micturition is also related by M. Jolly. In the early stage,
the patient had redness of the throat and burning along the whole
alimentary canal, combined with the customary delirium and loss of
consciousness. The symptoms were caused by forty-six grains of the
extract given by mistake instead of jalap.[2154] Nausea and efforts to
vomit are not infrequent at the commencement.
If the accident be taken in time, poisoning with belladonna is rarely
fatal; for, as the state first induced is delirium, not sopor, suspicion
is soon excited, and emetics may be made to act before a sufficient
quantity of the poison has been absorbed to prove fatal. Hence few fatal
instances have occurred in recent times. Mr. Wilmer, however, has
mentioned two fatal cases occurring in children, and terminating within
twenty-four hours.[2155] M. Boucher, a writer in the old French Journal
of Medicine, has referred to several cases of the same nature;[2156]
Gmelin has described the particulars of a good example;[2157] and many
others have been succinctly quoted by Wibmer, chiefly from the older
authors.[2158]
Cases of poisoning with this plant have occurred in man through other
channels besides the stomach. Allusion has already been made to the
instance of a tailor who was poisoned by an injection. A small quantity
will sometimes suffice when administered in that way. A woman, whose
case is mentioned in Rust’s Journal, was attacked with wild delirium,
flushed face and glistening eyes, in consequence of receiving, during
labour, a clyster, that contained six grains of the common
extract;[2159] and Dr. Simpson’s patient, who was severely affected, had
only two grains.
Perhaps the berry is in some circumstances not very active. A French
physician, M. Gigault of Pontcroix, says he has frequently had occasion
to treat cases of poisoning with it, as accidents of the kind are
extremely common in his neighbourhood; that he never knew it prove
fatal; and that in one instance a young man took a pound of the berries
before going to bed, and was not subjected to treatment till next
morning, when he was found in a state of delirium, but speedily
recovered after the free operation of emetics.[2160]
_Morbid Appearances._—I have hitherto seen but one good account of the
appearances after death from poisoning with belladonna. It is described
by Gmelin. The subject was a shepherd who died comatose twelve hours
after eating the berries. When the body was examined twelve hours after
death, putrefaction had begun, so that the belly was swelled, the
scrotum and penis distended with fetid serum, the skin covered with dark
vesicles, and the brain soft. The blood-vessels of the head were gorged,
and the blood every where fluid, and flowing profusely from the mouth,
nose, and eyes.[2161] In the only other fatal case I have read, where
the body was inspected, there appears to have been no unusual appearance
at all.[2162]
As the husks and seeds of the berries are very indigestible, some of
them will almost certainly be found in the stomach, as happened in the
instance last quoted. It should likewise be remembered that the best
possible evidence of the cause of the symptoms may be derived during
life from the presence of the seeds, husks, or even entire berries, in
the discharges. If vomiting has not been brought on at an early
period, we may expect to find these remains both in the vomited matter
and in the alvine evacuations. Mr. Wilmer mentions an instance in
which the black husks appeared in the stools brought away by laxatives
at least thirty hours after the poison was swallowed.[2163] One of Mr.
Brumwell’s patients vomited the seeds towards the close of the third
day.[2164] Several patients of M. Boucher vomited fragments of the
fruit on the second day, and passed more by stool and injections on
the third, although they had been treated with activity from the
commencement.[2165]
While most of the cases of poisoning with belladonna have originated in
accident, at the same time they have not been all of this description.
Gmelin has quoted an instance of intentional and fatal poisoning by the
juice of the berries being mixed with wine; and another singular case of
poisoning with the decoction of the buds, given by an old woman for the
purpose of committing theft during the stupor of the individual.[2166]
Other species of atropa are probably similar to belladonna in
properties. Wibmer quotes a single instance of frantic delirium
occurring among several shepherds, as well as their cattle, from eating
the herb of the _A. mandragora_.[2167] This is well known to have been
used anciently as a medicinal narcotic.
_Of Poisoning with Thorn-Apple._
The thorn-apple, or _Datura stramonium_, is another plant of the same
natural order, which it is proper to notice, because people have often
been poisoned with it, and it has become a common ornament of our
gardens. The cases of poisoning which have occurred in recent times in
this country have been all accidental. But not long ago the thorn-apple
appears to have been extensively used in Germany to cause loss of
consciousness and lethargy, preparatory to the commission of various
crimes.[2168] It was also proved to have been used lately in France for
this purpose. Some thieves made a man insensible with wine in which
stramonium seeds had been steeped, and robbed him of five hundred francs
while in this state. For twenty-four hours the victim knew nothing of
what became of him; he was met wandering in a wood, affected with
delirium, unconsciousness, staring of the eyes, and oppression of the
breathing; and for some time he was taken for a madman.[2169] In the
Eastern Archipelago, according to Mr. Crawford, this is a common mode of
committing theft and robbery.[2170]
It is chiefly the fruit and seeds that have hitherto been examined; but
the whole plant is probably poisonous. Brandes discovered in it a
volatile, oleaginous, alkaline substance, which he supposed to be its
active principle.[2171] But, though his observations were confirmed by
Bley,[2172] it now appears that the real principle is a colourless,
crystalline alkaloidal substance, of an acrid taste like tobacco, which
was discovered more lately by Geiger and Hesse; this is named daturine,
or daturia.[2173]
The physiological effects of the extract have been determined by Orfila.
He found that half an ounce killed a dog within twenty-four hours after
being swallowed, that a quarter of an ounce applied to a wound killed
another in six hours, and that thirty grains killed another when
injected into the jugular vein. The symptoms were purely nervous, and
not very prominent. Hence this poison, like the former, acts through the
blood-vessels, and probably on the brain.[2174] Bley’s daturia proves
quickly fatal to small animals in the dose of a few drops. The
crystalline daturia of Geiger and Hesse kills a sparrow in the dose of
an eighth of a grain, and occasions great and persistent dilatation of
the pupil when applied to the eye.
_Symptoms in Man._—The symptoms produced by a poisonous dose in man are
variable. The leading features are great delirium, dilatation of the
pupils, and stupor; but sometimes spasms occur, and occasionally palsy.
Dr. Fowler has related the case of a little girl who took a drachm and a
half of the seeds. In less than two hours she was attacked with maniacal
delirium, accompanied with spectral illusions; and she remained in this
state most of the following night, but had some intervals of lethargic
sleep. Next morning, after the operation of a laxative, she fell fast
asleep, and after some hours she awoke quite well.[2175] In a case
somewhat like this, related in Henke’s Journal, the child had general
redness of the skin, swelling of the belly, locked jaw, tremors of the
extremities, and an attitude and expression as if about to tumble into a
pit. Recovery took place after the action of an emetic.[2176]
In two instances, one related by Vicat in his treatise on the poisonous
plants of Switzerland,[2177] the other by Dr. Swaine[2178] in the Edin.
Phys. and Lit. Essays, the leading symptoms were furious delirium and
palsy of the whole extremities. In the instances of three children
related by Alibert there were delirium, restlessness, constant
incoherent talking, dancing and singing, with fever and flushed
face.[2179] In another recorded by Dr. Young, there were some
convulsions, and livid suffusion of the countenance.[2180] In an
instance communicated to me by my colleague Dr. Traill, where eighteen
or twenty grains of extract of stramonium were taken by mistake for
sarsaparilla, the symptoms were dryness of the throat immediately
afterwards, then giddiness, dilated pupils, flushed face, glancing of
the eyes, and incoherence, so that he seemed to his friends to be
intoxicated: and subsequently there was incessant unconnected talking,
like that of demency. Emetics were given without effect, and little
amendment was obtained from blood-letting, leeches on the temples, cold
to the head, or purgatives. But after a glass of strong lemonade
vomiting took place, the symptoms began to recede, in ten hours he
recognized those around him, and next day he was pretty well. Kaauw
Boerhaave has related with great minuteness the case of a girl who very
nearly lost her life in consequence of a man having given her the powder
in coffee with the view of seducing her. The symptoms were redness of
the features, delirium, nymphomania, loss of speech; then fixing of the
eyes, tremors, convulsions, and coma; afterwards tetanic spasm and slow
respiration with the coma. She was with much difficulty roused for a
time by the operation of emetics, and eventually got well after her
lethargy had lasted nearly a day.[2181] In another related in Rust’s
Magazin, and caused by a decoction of the fruit, which was mistaken for
thistle-heads, the leading symptoms were spasmodic closing of the
eyelids and jaws, spasms also of the back, complete coma, and excessive
dilatation and insensibility of the pupil.[2182] This case, which seems
to have been a very dangerous one, was rapidly cured by free
blood-letting. Blood-letting, indeed, seems peculiarly called for in
poisoning with thorn-apple, on account of the strong signs of
determination of blood to the head.—Gmelin has quoted several fatal
cases, one of which endured for six hours only;[2183] and Dr. Young
says, that a child has been killed by a single apple.[2184] The most
complete account yet published of the phenomena of poisoning with
stramonium when fatal is given by Mr. Duffin of London. A child of his
own, two years old, swallowed about 100 seeds without chewing them. Soon
after she became fretful and like a person intoxicated; in the course of
an hour efforts to vomit ensued, together with flushed face, dilated
pupils, incoherent talking, and afterwards wild spectral illusions and
furious delirium. In two hours and a half she lost her voice and the
power of swallowing, evidently owing to spasms of the throat. Then
croupy breathing and complete coma set in, with violent spasmodic
agitation of the limbs, occasional tetanic convulsions, warm
perspiration, and yet an imperceptible pulse. Subsequently the pulse
became extremely rapid, the belly tympanitic, and the bladder paralyzed,
but with frequent involuntary stools, probably owing to the
administration of cathartics; and death took place in twenty-four hours.
At an early period twenty seeds were discharged by an emetic: the stools
contained eighty; and none were found in the alimentary canal after
death. There was never any marked sign of congestion of blood in the
head, except flushed face at the beginning.[2185] Dr. Droste of Osnaburg
has related a fatal case occasioned by a decoction of 125 seeds given to
remove colic. In fifteen minutes the patient became delirious, but soon
fell apparently fast asleep, and died in seven hours without again
awaking.[2186]
Dangerous effects may result from the application of the thorn-apple to
the skin when deprived of the cuticle. An instance has been lately
published of alarming narcotism from the application of the leaves to an
extensive burn.[2187]
_Morbid Appearances._—As to the _morbid appearances_, Droste found in
his case redness of the cardiac end of the stomach, which contained two
table-spoonfuls of a pulpy matter mixed with black and white grains, the
remains of the teguments of the seeds; and there was also lividity of
the back, lividity of the lungs, emptiness of the cavities of the heart,
and gorging of the vessels of the brain. Haller says he once found
general congestion of the brain and sinuses,[2188]—an appearance which
may naturally be expected, considering the signs of strong determination
of blood towards the head, which often prevail during life. In Mr.
Duffin’s case, however, the brain was healthy, not congested; the
stomach and intestines presented no morbid appearance; and the only
unusual appearances observed were a slight blush over the pharynx,
larynx, and upper third of the gullet, thickening and swelling of the
rima glottidis, and a semi-coagulated state of the blood.
_Of Poisoning with Tobacco._
A plant of the same natural order with the two former, tobacco, the
_Nicotiana tabacum_ of botanists, is familiarly known to be in certain
circumstances a virulent poison. Every part of the plant possesses
active properties. It has been used as a poison in this country for
criminal purposes.
_Vauquelin_ analyzed it some time ago, and procured an acrid volatile
principle which he called nicotine.[2189] This substance, which was
afterwards obtained in a purer state as a crystalline body by
Hermbstädt, has been more recently ascertained by MM. Posselt and
Reimarus to be nothing else than essential oil of tobacco, which is sold
at ordinary temperatures; and they succeeded in procuring another
principle which they consider the true nicotina. This is fluid at 29°
F., volatile, extremely acrid, alkaline, and capable of forming
crystallizable salts with some of the acids.[2190] Tobacco then appears
to contain an acrid alkaline principle, and an essential oil to which
the alkaloid adheres with great obstinacy. The relation of the
empyreumatic oil of tobacco to these principles has not been accurately
ascertained, though it probably contains one or other of them. It is
well known to be an active poison, which produces convulsions, coma and
death. Mr. Morries-Stirling found that its active part is removed from
the oil by washing with weak acetic acid, as he also observed in the
instance of similar oils obtained from various narcotic
vegetables.[2191]
_Process for detecting Tobacco in Organic mixtures._—In a medico-legal
case which happened at Aberdeen in 1834, and of which some notice is
taken at page 651, Dr. Ogston of that city successfully employed the
following process for detecting tobacco in the contents of the stomach.
The contents, consisting of a pulpy fluid, were acidulated with acetic
acid, digested, and filtered; the liquid was treated with diacetate of
lead, filtered again, freed of lead by hydrosulphuric acid, filtered a
third time, treated with caustic potash, and then allowed to settle. The
supernatant liquid, which had the taste of tobacco-juice, was separated
and distilled to half its volume. The distilled liquor had a strong
tobacco odour and taste, and some acridity, and gave a precipitate with
infusion of galls. The residuum in the retort presented oily particles
on its surface, and when heated in an open basin filled the apartment
with a vapour which had a strong odour of tobacco smoke, and caused in
several persons present a sense of acridity of the throat, watering of
the eyes, and tendency to sneeze. Various additional experiments
confirmatory of these results were also performed; and a simultaneous
examination of tobacco-powder gave precisely the same indications. I am
indebted to Dr. Ogston for these particulars and a detailed narrative of
his investigation; which appears to supply a convenient and conclusive
process for the detection of tobacco.—Perhaps the ordinary process for
obtaining nicotina may also be employed with advantage. This consists in
distilling the suspected substance with caustic potash, neutralizing the
distilled liquor with sulphuric acid, concentrating the product to a
thin syrup, exhausting this with etherized alcohol, evaporating off the
solvent, and distilling the extract with strong solution of potash.
Nicotina passes over, and may be recognized by its sensible and chemical
qualities.
The effects of tobacco are somewhat different from those of belladonna
and thorn-apple; but it is here arranged with them, as it belongs to the
same natural family. Orfila remarked that 5½ drachms of common rappee,
introduced into the stomach of a dog and secured by a ligature, caused
nausea, giddiness, stupor, twitches in the muscles of the neck, and
death in nine hours; and that two drachms and a quarter applied to a
wound proved fatal in a single hour. Mr. Blake thinks tobacco has no
direct action on the heart, even when admitted directly into the blood
by the jugular vein;—that it acts primarily on the capillary circulation
of the lungs, by obstructing which it prevents the blood from reaching
the left cavities of the heart, and thus acts on that organ indirectly.
For he observed, that laboured respiration always preceded any sign of
depressed action of the heart, that forcible action of the heart often
returned after its first cessation, and that its contractility continued
after death.[2192] An infusion of ten grains caused laborious breathing
in ten seconds, and in twenty seconds temporary arrestment of the
heart’s action, which then returned, and was attended for a time with
increased arterial pressure. Soon afterwards the animal recovered,
without any convulsions or loss of sensibility. Two scruples had the
same effect. But when three drachms were used, convulsions succeeded
similar phenomena, and death ensued in two minutes, the heart continuing
to act for some time after respiration had ceased, until at length it
was stopped by the usual consequences of asphyxia.[2193] On the other
hand, Sir B. Brodie found that the effects are very different, according
to the form in which the poison is used. Thus four ounces of a strong
infusion, when injected into the anus of a dog, killed it in ten minutes
by paralyzing the heart; for after death the blood in the aortal
cavities was arterial. But the empyreumatic essential oil does not act
in that manner: it excites convulsions and coma, without affecting the
heart. It may prove fatal in two minutes.[2194] Like other violent
poisons, tobacco has no effect when applied directly to the brain or
nerves.[2195] Two drops of the alkaloid, nicotina, injected into the
jugular vein of a dog, begin to act in ten seconds, and will prove fatal
in a minute and a half.[2196]
_Symptoms in Man._—The effects observed in man are allied to those
produced in dogs by the infusion. In a slight degree they are frequently
witnessed in young men, while making their first efforts to acquire the
absurd practice of smoking. The first symptoms are acceleration and
strengthening of the pulse, with very transient excitement, then sudden
giddiness, fainting and great sickness, accompanied with a weak,
quivering pulse. These effects are for the most part transient and
trifling, but not always. Some degree of somnolency is not uncommon. Dr.
Marshall Hall has given an interesting account of a young man who smoked
two pipes for his first debauch, and in consequence was seized with
nausea, vomiting, and syncope, then stupor, stertorous breathing,
general spasms and insensible pupils. Next day the tendency to faint
continued, and in the evening the stupor, stertor and spasms returned;
but from that time he recovered steadily.[2197] Gmelin has quoted two
cases of death from excessive smoking,—caused in one by seventeen, in
the other by eighteen pipes, smoked at a sitting.[2198] It is likewise
mentioned by Lanzoni that an individual fell into a state of somnolency
and died lethargic on the twelfth day in consequence of taking too much
snuff;[2199] Dr. Cheyne says, “he is convinced apoplexy is one of the
evils in the train of that disgusting practice;”[2200] and I have met
with an instance where the excessive use of snuff, occasioned twice, at
distant intervals, an attack resembling imperfect apoplexy, united with
delirium. Such cases, however, must be admitted to be rare; and the
practice of taking snuff is in general unattended with injury.
Serious consequences have resulted from the application of tobacco to
the abraded skin. In the Ephemerides an account is given of three
children who were seized with giddiness, vomiting, and fainting from the
application of tobacco-leaves to the head for the cure of
ring-worm.[2201] Dr. Merriman has also alluded to an instance of death
in a child from the incautious employment of a strong decoction of
tobacco as a lotion for ring-worm of the scalp.[2202] And in Leroux’s
Journal there is an account of a man, who, after using a tobacco
decoction for the cure of an eruptive disease, was seized with symptoms
of poisoning, and died in three hours.[2203]
In recent times poisoning with tobacco has been often produced by the
employment of too large doses in the way of injection. Richard has
mentioned a case, not fatal, which arose from an infusion of five leaves
in a choppin of water, used as an injection by a lady for costiveness.
She was immediately seized with colic, giddiness, buzzing in the ears,
headache, nausea, and then syncope of seven hours’ duration. During this
period the breathing was difficult, the pulse very slow, the pupils
dilated, the skin cold and moist, the urine suppressed, the efforts to
vomit constant, and the belly depressed, contracted, and affected with
constant borborygmus. She recovered under the use of emollient
injections and fomentations.[2204] Dr. Grahl of Hamburg has related
minutely a fatal case, which arose from an ounce of rather more, boiled
for fifteen minutes in water, and administered by advice of a female
quack. The individual, who laboured merely under dyspepsia and obstinate
costiveness, was seized in two minutes with vomiting, violent
convulsions, and stertorous breathing, and died in three-quarters of an
hour.[2205] Another accident of the same kind is noticed in the Journal
de Chimie Médicale, where the person became as it were intoxicated, and
died immediately. Instead of an infusion of two drachms she had used a
decoction of two ounces.[2206]—M. Tavignot describes the following
remarkable case occasioned by a similar dose. An infusion prepared by
mistake with two ounces and one drachm, instead of a drachm and a half,
was used as an injection for a stout man affected with ascarides. In
seven minutes he was seized with stupor, headache, paleness of the skin,
pain in the belly, indistinct articulation, and slight convulsive
tremors, at first confined to the arms, but afterwards general. Extreme
prostration and slow laborious breathing soon ensued, and then coma,
which ended fatally in eighteen minutes.[2207]—Even two drachms,
however, or a drachm and a half, are by no means a safe dose. An
anonymous writer in the Medical and Surgical Journal says a patient of
his died in convulsions an hour or two after receiving a clyster
composed of two drachms infused in eight ounces.[2208] Nay, in the Acta
Helvetica there is an account by an anonymous writer of the case of a
woman, who, after an injection made with one drachm only, was seized
with pain in the belly, anxiety and faintings, proving fatal in a few
hours.[2209] And a case, fatal in thirty-five minutes, which was
occasioned by the same dose, occurred not long ago in Guy’s Hospital,
London.[2210]
Tobacco is an equally deadly poison when swallowed in large quantity. M.
Caillard has related the particulars of the case of a lunatic, who,
having swallowed half an ounce of snuff during a lucid interval, was
seized with vomiting, and afterwards with oppression, incoherence, cold
sweats, a slow full pulse, and dilated pupils; but he slowly
recovered.[2211] The French poet Santeuil was killed in this way by a
practical joker at the Prince of Condé’s table. When the bottle had
circulated rather freely, a boxful of Spanish snuff was emptied into a
large glass of wine, and thus administered to the unlucky victim, who
was in consequence “attacked with vomiting and fever, and expired in two
days amidst the tortures of the damned.”[2212] The following important
case has been communicated to me by Dr. Ogston of Aberdeen, who was
employed in the judicial investigations connected with it. An elderly
man, a pensioner, was seen to enter a brothel, while in perfect health;
and in an hour he was carried out insensible and put down in a passage,
where he was found by the police unable to speak or move. While carrying
him to the watch-house hard by, the officers observed him attempt to
vomit; but he was scarcely laid down before the fire, when he expired.
It was ascertained, that he had drunk both rum and whisky in the
brothel, and that something had been given him “to stupefy him or set
him asleep.” On dissection the blood was found every where very fluid,
and four ounces of serosity were collected from the lateral ventricles
and base of the skull. But there was no other unusual appearance, except
that the stomach contained about four ounces of a thick brownish pulp,
in which were seen several pellets of a powder resembling snuff. In
these contents Dr. Ogston could not detect any opium; but he detected
tobacco by the process mentioned above. No doubt could exist that the
man died of poisoning with tobacco; but as no evidence could be obtained
to inculpate any one in particular of many individuals who were in the
brothel with him, the case was not made the subject of trial.
Evidence is not wanting, therefore, to prove that this plant is a very
active poison; yet every one knows that under the influence of habit it
is used in immense quantities over the whole world as an article of
luxury, without any bad effect having ever been clearly traced to it.
Its poisonous qualities were known in Europe as soon as it was brought
from America; and the belief that such properties could not fail to be
attended, as in the case of spirits and opium, with evil consequences
from its habitual use, led to much opposition on the part of various
governments to its introduction. Soon after it was brought to England by
Sir W. Raleigh, King James wrote a philippic against it, entitled “The
Counter-blaste to Tobacco.” Some countries even prohibited it by severe
edicts. Amurath the 4th in particular made the smoking of tobacco
capital; several of the Popes excommunicated those who smoked in the
church of St. Peter’s; in Russia it was punished with amputation of the
nose; and in the Canton of Bern it ranked in the tables next to
adultery, and even so lately as the middle of last century a particular
court was held there for trying delinquents.[2213] Like every other
persecuted novelty, however, smoking and snuff-taking passed from place
to place with rapidity; and now there appear to be only two luxuries
which yield to it in prevalence, spirituous liquors and tea.
The only accounts I have seen of the morbid appearances after poisoning
with tobacco are contained in the cases of Dr. Grahl and Dr. Ogston. In
the former there was great lividity of the back, paleness of the lips,
flexibility of the joints (two days after death), diffuse redness of the
omentum without gorging of vessels, similar redness with gorging of
vessels both on the outer and inner coats of the intestines, in some
parts of the mucous coat patches of extravasation, unusual emptiness of
the vessels of the abdomen; while the stomach was natural, the lungs
pale, the heart empty in all its cavities, and the brain natural. The
appearances in Dr. Ogston’s case have been already stated.
Writers on the diseases of artisans have made many vague statements on
the supposed baneful effects of the manufacture of snuff on the
workmen.[2214] It is said they are liable to bronchitis, dysentery,
ophthalmia, carbuncles and furuncles. At a meeting of the Royal Medical
Society of Paris, however, before which a memoir to this purport was
read, the facts were contradicted by reference to the state of the
workmen at the Royal Snuff Manufactory of Gros-Caillou, where 1000
people are constantly employed without detriment to their health.[2215]
This subject was afterwards investigated with care by MM.
Parent-Duchatelet and D’Arcet, who inquired minutely into the state of
the workmen employed at all the great tobacco-manufactories of France,
comprising a population of above 4000 persons; and the results at which
they arrived are,—that the workmen very easily become habituated to the
atmosphere of the manufactory,—that they are not particularly subject
either to special diseases, or to disease generally,—and that they live
on an average quite as long as other tradesmen.[2216] These facts are
derived from accurate statistical returns, showing the number of days
each person was annually off work from sickness, the ages at which
superannuated allowances were granted, the period of death, and the
prevalent diseases.