character.
2. The time that has elapsed between their commencement and
the last meal, dose of medicine, &c.
3. Have the symptoms continued without intermission or
remission, and in an aggravated form, till death?
4. The order of their occurrence.
5. The previous health or illness of the patient.
6. Have the symptoms any relation to a particular meal or
article of food, &c.?
7. If patient has vomited, have the vomited matters,
especially the first, been carefully preserved?
8. Preserve all vomited matters, food, medicines, &c.
9. How many were at the meal, and was what was taken common
to all, or only taken by a few?
2. =Evidence from= _Post-mortem_ =Appearances=.--The morbid
appearances found in cases of poisoning will be treated more in
detail when each poison, or group of poisons, comes to be separately
considered. A caution may be given here against allowing the
_post-mortem_ signs of disease or external injury to exclude the
idea of poisoning; for death may to all appearance be the result
of disease or injury, and yet be caused by poison. An attention to
the _post-mortem_ appearances is important in all cases; for in
many instances, where the symptoms were unknown to the experts at
the time the inspection was made, they were subsequently found to
correspond with the morbid changes which the autopsy revealed. The
normal appearance of the stomach is white or nearly so, except during
digestion, when it is reddened; yet we may sometimes come across cases
in which the mucous membrane of this organ may be found so reddened as
to lead to a suspicion of poisoning. The knowledge of this fact, and
the absence of symptoms, will prevent an error in diagnosis. Ulceration
from disease and from irritant poisoning must be distinguished. In
that due to disease, the ulcers formed are, as a rule, small and
circumscribed; in those from poison, there is diffused inflammatory
redness over other parts of the stomach, and even in the intestines;
and the poison, as in the case of arsenic, may be found adhering to the
sides of the ulcer. Ulceration is more frequently the result of disease
than of the action of poisons. Perforation of the stomach or intestines
may be due to ulceration or to corrosion. The condition of the mouth
and gullet will help the diagnosis. The appearance of the ulcer and
the parts around it, together with the hints just given, must guide
the diagnosis. Of _post-mortem_ softening little need be said, beyond
stating that it very rarely occurs, and is of course not preceded
by symptoms. (For the diagnosis between inflammatory redness of the
intestines and _post-mortem_ staining, see page 45.)
3. =Evidence from Chemical Analysis.=--The objects of a chemical
analysis are to determine: (1) The presence and nature of the poison.
(2) The proportion or quantity of the poison taken. (3) The solution of
certain questions connected with the administration of the poison.
The detection of poison in the body is of course the most important
proof of poisoning; but it may be suggested that the poison was
introduced after death, which, to say the least, is a most ingenious
line of defence, but which, at the same time, must be held to be highly
improbable, and impossible if found deposited in one or more of the
solid organs. Again, granting that poison has been taken, is it the
cause of death? This question may arise when injuries are found on the
body, and it then becomes a matter of importance to know something of
the symptoms which preceded death, and the morbid appearances found
after death. The case of the girl who took arsenic to escape a beating
by her father is a case in point. The father was tried for causing the
death of the girl by undue severity, but it was subsequently shown
that arsenic self-administered was the true cause of death. The poison
may disappear from the body. This disappearance may be effected by
vomiting, purging, or by the urine, or the poison may become absorbed
and decomposed. The person poisoned may live sufficiently long to allow
of the entire elimination of the poison, and yet die of the induced
exhaustion. (See case of Dr. Alexander, _ante_.)
Some poisons, especially those which are sparingly soluble, are with
difficulty removed from the stomach, even by the most incessant and
violent vomiting. This is notably the case with arsenic, which adheres
to the mucous coat of the stomach with considerable tenacity. But
even after all traces of the poison have left the stomach, it may be
detected in the solid viscera.
Temporary deposit of poison in the organs or tissues (Taylor): (1) The
Liver. (2) The Kidneys. (3) The Spleen. (4) The Heart. (5) The Lungs.
(6) The Muscles. (7) The Brain. (8) The Fat. (9) The Bones.
With regard to arsenic, the following table, taken from Taylor, is of
importance, as showing the amount of the poison which may be found in
the liver at certain intervals:
After taking the Poison. Total Weight of Arsenic.
In 5½ to 7 hours 0.8 grains.
8¾ hours 1.2
15 hours 2.0
17 to 20 hours 1.3
10½ days 1.5
14 days 0.17
17 days _nil_
Is it necessary that the poison should be found in the body or in the
evacuations to lead to a conviction for poisoning? On this point,
Christison was of opinion that if the symptoms, _post-mortem_,
appearances, and moral evidence are very strong, it is not necessary
that the poison be found in order to establish a charge of poisoning.
This opinion was also supported by the late Dr. Geoghehan, Professor
of Medical Jurisprudence in the Royal College of Surgeons, Ireland,
and was also virtually acted upon in the case of Palmer, where the
non-detection of strychnia was strongly dwelt upon by the counsel for
the defence, but without success. Many of the vegetable poisons almost
defy detection, except by the symptoms, _post-mortem_ appearances, and
some experiments on animals of doubtful value. The detection of poison
in the food taken, or in the vomited matters, is of great importance;
but it is of still greater importance if it can be found in the
urine, drawn from the bladder, this being a proof that it has passed
through the system. Here again a caution is necessary--for it must be
remembered that poisoning may be _feigned_ or _imputed_--the poison
being mixed with the food and evacuations, and an innocent person
accused.
The following suggestions should be carefully considered by every
analyst when substances are sent to him for examination:
He should carefully note when and from whom the substances were
received; in what state they were received--secured, or exposed--the
number of articles, and whether properly labelled. He must make the
analysis himself, and state where it was made. The character and
nature of the substances examined should be noted, and he must be
prepared to give an outline of the methods or processes used for their
determination. He must also be able to guarantee the purity of his
reagents, and be prepared to answer the following questions:
1. Is the poison free or combined?
2. What is the strength and quantity found?
3. Could the poisonous substance exist naturally?
4. How much of the poison found is a fatal dose?
5. If no poison is found, is there anything noxious
or injurious to health?
The analyst may have the following submitted to him for examination:
(1) Substances found on the accused, or in the room, or on the person
of the deceased. (2) Articles of food. (3) Vomited matters, urine, &c.
(4) Contents of the stomach. (5) Solid organs of the body.
He may also have his results called in question for the following
reasons: (1) Purity of his reagents. (2) Faulty processes. (3) Hasty
conclusions. (4) Experiments on animals.
Death may undoubtedly be due to the action of a poison, and yet its
presence may fail to be detected, due to--(1) The nature of the
poison-strychnia, hydrocyanic acid, &c. (2) Vomiting and purging. (3)
Absorption and elimination. (4) Decomposition--phosphorus, chloral
hydrate, chloroform. (5) Smallness of the dose.
(For directions for conducting a _post-mortem_ examination in cases of
poisoning, see page 61.)
=4. Evidence from Experiments on Animals.=--The evidence derived from
experiments on animals with the contents of the stomach and vomited
matters must not be too implicitly trusted, as these may give rise to
vomiting and other symptoms when no poison is present. All animals are
not alike affected with man by the same poisons; and it appears that
the dog and the cat are the only animals that at all approach man with
regard to the effects produced. Experiments on the lower animals are
useless to decide--(1) The fatal dose of any poison. (2) The rate of
absorption, deposition, or elimination of poisons. (3) The rapidity of
the action of certain poisons.
In the case, however, of some vegetable poisons, the effects produced
on animals by a portion of the substance taken by the person
suspected of having been poisoned, may afford corroborative evidence
of poisoning. In the case of Lamson, executed for poisoning his
brother-in-law with aconite, experiments on animals formed the chief
evidence against the accused.
=5. Moral Evidence.=--The moral evidence of poisoning is generally
furnished by the common witnesses of the Crown; but the value of this
kind of evidence, in many cases, can only be fully appreciated by a
medical witness. To render this part of the subject as complete as
possible, a few remarks may not be out of place. The suspicious conduct
of the prisoner before and after the event, the recent purchase of
poison, the mode of administration, the object of the prisoner in
getting rid of his supposed victim, and the fact of several persons
being alike affected, should be carefully noted down. The anxiety
evinced during the illness of the deceased, and the hurry in the
funeral arrangements, showing an over-anxiety to remove all traces of
his guilt, are suspicious. The probability of suicide is weakened by
the state of the mind and the nature of the dying declarations of the
deceased. In the case of a person indicted for poisoning, evidence to
show motive in another case is admissible. (R. _v._ Geering, 18 L.J.
[M.C.] 215; R. _v._ Heeson or Johnson; R. _v._ Garner, 3 F. & F. 681.)
Lastly, it remains to be considered--
_What is the duty of a Medical Man who suspects the Action of Poison in
a Patient on whom he is in attendance?_
In the case of R. _v._ Wooler, Baron Martin, who tried the case, in
his charge to the jury, stated that, in his opinion, the medical men
in attendance ought, “when the idea of poisoning struck them, to have
communicated their suspicion to the husband, if they did not suspect
him; and if they did suspect him, they ought to have gone before a
magistrate.” Suppose they had acted as the learned judge suggested,
and spoken to the husband, who, had he been guilty, would in all
probability have desisted from his terrible design for a time, then
a great criminal would have been let loose on society, and without
punishment. Then, again, had they applied to the magistrates, the delay
caused by the indecision of the magistrates how to act in so delicate
a case would have allowed the criminal to remove all traces of his
design, and the means of testing their suspicions would have been lost;
and, along with this, would have been lost the professional character
and fortunes of the authors of the investigation. “There is a third
course,” said the late Sir R. Christison, “and in my opinion it is the
fittest of all: When the medical attendant is satisfied of the fact of
poisoning, he should communicate his conviction to the patient himself.
His predicament, in every other way, is so embarrassing, that he ought
not to be deterred by the chance of injury to his patient from making
so dreadful a disclosure.” (See an account of the same course being
adopted in the case of Mr. Blandy by his physician, Dr. Addington,
reported in Howell‘s _State Trials_, vol. xviii.)
Table giving the names of Diseases, the Symptoms
of which resemble those the result of Irritant Poisons,
together with such points of difference as may assist in
distinguishing the one from the other:
Irritant Poison.--Symptoms of violent irritation in one or more
portions of the alimentary canal. Pricking and burning of the tongue
and mouth, and intense thirst, frequently accompanied with great
constriction in the throat. Great abdominal pain and tenderness.
Vomiting and purging are also usually present. The skin is hot and
cold at intervals; the pulse small, frequent, and irregular. In the
last stage the skin may become icy cold. _An acrid, metallic, or
burning taste in the mouth precedes the vomiting._ The vomit and alvine
discharges are generally mixed with _blood_. Death occurs in from six
hours to two days and a half.
Cholera.--Extreme and sudden prostration. The breath is cold to the
hand in the last stages. The body is cold, shrivelled, and livid, or
of a leaden hue. Vomiting and purging are present; the former is never
bloody, the latter resembling rice-water. The thirst is intense, and in
this particular alone resembles the effects of irritant poison. Death
in from one to two days, or even less.
Summary of the General Evidence of Poisoning,
in a Tabular Form
----------------------------------+----------------------------------
Poison. | Natural Causes.
----------------------------------+----------------------------------
1. The symptoms come on suddenly,| 1. Many diseases come on
and rapidly progress. | suddenly--cholera, gastritis,
| &c--and run a rapid course to
| a fatal termination.
|
2. The symptoms begin while | 2. Some acute diseases begin
the person is in sound health.| under like circumstances.
|
3. The symptoms of poisoning | 3. This is also the case with
go on from bad to worse in a | many common diseases.
steady increase. |
|
4. Uniformity in the nature of | 4. The uniformity of the symptoms
the symptoms. | is common to many diseases;
| but in some cases the absence
| of uniformity may be a proof
| of disease.
|
5. The symptoms come on | 5. Apoplexy, colic, cholera, and
immediately after a meal. | some other diseases may follow
| a meal. But the fact that some
| hours have elapsed since the
| last meal is against the
| probability of poisoning.
|
6. Several persons are attacked, | 6. As a general principle it may
after partaking of the same | be stated that there is no
meal, with the same symptoms. | disease likely to attack
| several persons at once, but
| there are cases on record of
| this having occurred.
|
7. Poison found in the food, | 7. Poison may be mixed with food,
vomited matters, urine, &c. | &c, in cases of imputed
| poisoning.
----------------------------------+----------------------------------
English Cholera.--In this disease all the symptoms of irritant
poisoning are present. Pain in the belly, and vomiting. But in this
disease the vomit and alvine discharges are _never_ bloody, most
frequently bilious. _An acrid taste in the mouth and throat succeeds
the vomiting._ This is due to the acrid nature of the vomited matters.
The stools contain bile in English cholera; in irritant poisoning,
sometimes blood. Death is rare within three days.
Gastritis.--Acute idiopathic gastritis is so rare in this country as
scarcely to need description. Most of the cases recorded of acute
gastritis have been found to be due to irritants. We must, therefore,
consider the period and order of the occurrence of the symptoms in
relation to the last meal. Costiveness of the bowels would point to the
presence of gastritis or enteritis, violent purging and vomiting to
irritant poisoning.
Enteritis.--Though more common than gastritis, enteritis is a rare
disease. The bowels are generally _confined_. Tubercular and aphthous
inflammation of the intestines may simulate irritant poisoning,
especially chronic poisoning by arsenic. The _post-mortem_ and a
chemical analysis will reveal the true cause of death.
Peritonitis.--In the early stages of the disease vomiting is rare,
and constipation is the rule, with marked tenderness over the whole
abdomen. The morbid appearances in the peritoneum are seldom caused by
irritants.
Perforation of the Stomach.--The symptoms supervene immediately after
a meal; the pain, which is very acute, gradually extending over
the abdomen. In most cases the patient has suffered for some time
previously from dyspepsia.
Hernia.--Examine the seat of pain, the cause will be soon detected.
But an omental hernia may be present, giving rise to twisting pain at
umbilicus.
Intussusception of the Bowels.--Pain, sudden and confined to one
spot below the stomach. Vomiting is present _without_ purging, thus
differing from diarrhœa and cholera. After a time the vomit becomes
fæcal.
Colic.--May be confounded with poisoning by the salts of lead. If lead
be taken in large doses, it produces the symptoms common to irritant
poisons added to those of colic. In chronic lead poisoning, the blue
line round the gums, the aspect of the patient, and history of the
case, will point to the true cause of the symptoms. Lead colic is also
generally accompanied with extreme depression of spirits.
Rupture of Internal Organs.--Rupture of the stomach, duodenum,
gall-bladder, and impregnated uterus, is of rare occurrence. The
autopsy will show the true cause of death.
Table giving the names of Diseases the Symptoms of which
resemble those the result of Narcotic Poisoning, together with
such points of difference as may assist in distinguishing the
one from the other:
Narcotic Poisoning.--Giddiness, headache, drowsiness, and considerable
difficulty in keeping awake. Paralysis of the muscles, convulsions,
ending in profound coma and death. The symptoms of narcotic poisoning
begin not later than an hour, or at most two hours, after the poison
is taken, except in the case of poisonous fungi and spurred rye, when
a day or two may elapse. The symptoms of narcotic poisoning advance
gradually. The person may, in _most_ cases, be roused from the deepest
lethargy. The pupil in opium poisoning is, as a rule, _contracted_.
Recovery seldom occurs after twelve hours; in most cases, death takes
place in six or eight hours--the shortest time being three hours.
Apoplexy.--In some cases apoplexy is preceded by warning
symptoms--headache and giddiness. As a rule apoplexy is a disease of
old age, and of stout, plethoric people. If the symptoms do not come
on for some hours after food or drink has been taken, this disease is
to be suspected; but it may occur _at_ or _immediately_ after a meal,
too soon to be the result of the action of narcotics--ten to thirty
minutes always elapsing before these poisons act. Apoplexy generally
comes on suddenly, coma at once present. It is seldom possible to rouse
the person when the sopor of apoplexy is fully developed. The pupils in
apoplexy are _usually unequal or dilated_; but should the effusion of
blood take place into the pons Varolii, the pupils may be contracted,
hence closely simulating opium poisoning. Apoplexy may last for days,
or death may occur in an hour.
Epilepsy.--Loss of consciousness and presence of convulsions mark this
disease; and in these it resembles poisoning by prussic acid. Epilepsy
is in most cases a chronic disease. Warnings--_aura epileptica_--are
often present. The fit begins violently and abruptly. The paroxysm
generally lasts for some time, and death rarely occurs during the first
attack.
Table showing Points of Difference in the Action of
Corrosive and Irritant Poisons
------------------------------------+------------------------------
Corrosives. | Irritants.
------------------------------------+------------------------------
1. Destruction of the parts to | 1. Irritation of the parts
which they are applied. No | to which they are applied
remote action on the system. | producing inflammation.
| Remote action present in
| most of the irritants.
|
2. Symptoms supervene immediately | 2. Symptoms may rapidly
they are swallowed, and consist | supervene after they are
of a burning, scalding pain | taken, or some delay may
felt in the mouth, gullet, and | occur, due to the state of
stomach. | concentration or dilution
| of the poison. Pain in
| the stomach and bowels,
| more or less severe, is
| always present with the
| other signs of irritation.
|
3. Death may result from-- | 3. Death may result from--
(1) Shock. | (1) Shock.
(2) Extensive destruction | (2) Irritation, causing
of the parts touched. | convulsions.
(3) Starvation. | (3) Protracted suffering.
(4) Suffocation, the result | (4) Starvation.
of œdema, or spasms due |
to acid in larynx. |
4. _Post-mortem_ appearances: | 4. _Post-mortem_
corrosion and extensive | appearances: irritation
destruction of tissue. | and signs of inflammation,
| ulceration, &c.
------------------------------------+------------------------------
GENERAL TREATMENT OF CASES OF POISONING
The principal modes of procedure are as follows:
1. To remove the poison from the digestive tract, or neutralise it or
render it insoluble by the administration of suitable antidotes.
2. To overcome the effects of that which has been absorbed.
3. To promote its elimination.
4. To alleviate dangerous symptoms, and endeavour to keep the patient
alive until the effects of the poison have passed off.
To forcibly empty the stomach, emetics may be administered or other
means used to induce vomiting, or the stomach pump or tube may be
employed.
Suitable emetics are sulphate of zinc in thirty-grain doses dissolved
in warm water, a dessert-spoonful of mustard in half a pint of warm
water, ipecacuanha wine in tablespoonful doses, copious draughts of hot
water. Tartar emetic and sulphate of copper should be avoided, except
in cases of phosphorus poisoning, when the latter may be used. The
hypodermic injection of ⅒ grain of apomorphine is a very useful emetic,
especially in cases of narcotic poisoning. Irritation of the fauces
with the finger or a feather promotes vomiting, and may be useful in
the absence of an emetic.
The stomach tube or pump is most useful in that it is under the
control of the operator and enables him to thoroughly wash out the
stomach. After passing the tube, previously lubricated with vaseline
or glycerine, through the œsophagus down to the stomach, a pint of warm
water should be first injected before withdrawing any of the contents.
By alternate injection of water and its withdrawal, the stomach may
be efficiently cleansed, and at the same time solutions of suitable
antidotes may be passed into it. It must be remembered that neither
the stomach pump, syphon tube, nor emetics, are to be used in cases of
poisoning with corrosives, with the exception of carbolic acid. The
tube should be used with great caution in cases of irritant poisoning.
Antidotes are remedies which counteract the effects of poisons. They
act mechanically, _e.g._ flour and water, chalk mixture; chemically,
as magnesia and chalk in mineral acid poisoning, alkaline sulphates in
lead and barium poisoning; and physiologically, as antagonists, such
as morphine and atropine, atropine and physostigmine, strychnine and
chloral hydrate.
To counteract the effects of the portion of the poison absorbed,
special treatment is necessary: purges and diuretics may be called for;
artificial respiration may be necessary; cardiac depressants require
cardiac stimulants; the cold douche as a restorative and external
warmth are desirable in certain cases. Sedatives may be administered
to alleviate convulsive seizures. Tracheotomy may be required in cases
with laryngeal complications; and pain, exhaustion, excessive vomiting
or purging are to be treated by appropriate remedies.
EXAMINATION OF THE CONTENTS OF THE STOMACH, VISCERA, ETC., FOR POISON
The number and condition of the vessels received should be noted and
copies made of any affixed labels.
The appearance, smell, colour, and reaction to test paper of the
contents should be noted, and their weights and volumes determined.
All jars, wrappers, labels, and seals should be preserved for future
reference.
The stomach contents should be carefully examined in reference to their
nature, colour, and smell, and the presence or absence of any abnormal
constituents. The mucous membrane of the stomach should be examined
with the naked eye and by the aid of a lens, the surface washed with
distilled water, and the washings added to the contents.
There is often some clue as to the nature of the poison afforded, and
the investigation should be made for it first; the presence or absence
of other poisons, however, must be determined. If there be no clue,
then a systematic examination must be carried out. The poison must be
looked for not only in the contents of the stomach, but in the viscera
as well; it must be remembered that poison may be introduced into the
stomach after death.
Volatile poisons, such as alcohol, chloroform, prussic acid, may be
separated by distillation after acidulation with tartaric acid. Arsenic
is best separated by drying the organic material, and distilling after
adding strong hydrochloric acid.
Other metallic poisons may be tested for, with or without destruction
of organic matter. To destroy the organic matter, the _moist method_
is the one in general use: After reducing the contents of the stomach
or the viscus to a pulp, they are mixed with distilled water to the
consistency of thin gruel, and placed in a flask with some crystals
of potassium chlorate--half an ounce to each pound of the liquid.
Pure hydrochloric acid is added, and the flask gently heated on a
water bath, a mixture of chlorine and oxides of chlorine is given off
and gradually breaks up the organic matter, converting at the same
time any mineral poison present into the chloride. This procedure is
followed until the material becomes quite limpid, more chlorate or
hydrochloric acid may be added if necessary. It is then transferred to
an evaporating dish and heated on the water bath until the smell of
chlorine disappears. It is then filtered while hot, to allow chloride
if present to pass through; a stream of sulphur dioxide is passed
through the filtrate when cold, to reduce any metals present to a lower
state of oxidation. Silver chloride will not pass through the filter in
this process, so it has to be dealt with in a special manner.
In making a systematic analysis, volatile poisons must be tested for
first, then ascertain the presence or absence of alkaloids, after which
the inorganic poisons must be dealt with.
CHAPTER II
DIVISION I.--CHEMICAL
CORROSIVE POISONS
THE MINERAL ACIDS
_General Characters._--The mineral acids have no remote effects on the
system; their action is purely local. They are seldom used for the
purpose of homicide, except in the case of young children. By suicides
they are more frequently employed.
The _Symptoms_ common to the action of these acids supervene
_immediately_ the acid is swallowed, and consist in a sensation of
burning in the mouth and gullet. Dreadful pain is felt in the stomach,
attended with constant eructations, and vomiting of a brownish or
blackish matter, mixed with blood. Mucus, together with, in severe
cases, portions of the mucous membrane of the stomach, may be detected
in the vomited matters, which have an intensely acid reaction, changing
the colour and destroying the texture of cloth or other material on
which they may fall. The act of swallowing is attended with intense
pain, and not infrequently is rendered quite impossible. The thirst
is intense, the bowels are confined, and the urine is diminished
in quantity. The pulse is small and weak, and the skin clammy and
cold. Respiration is performed with difficulty, and the countenance
expresses the most intense anxiety. Sometimes, when the upper part of
the windpipe is implicated, there is more or less cough and difficulty
of speech. Death may even result from suffocation--the skin, in this
case, presenting a cyanosed appearance. The mouth is excoriated, the
lips shrivelled and blistered. In children, when the acid has been
poured far back into the mouth, by forcing the bottle backwards before
emptying it of its contents, the mouth may more or less escape injury,
and the signs in it of corrosive poisoning be absent. The teeth may
become loose, and fall out of the mouth. The mental faculties remain
clear, death generally coming on suddenly, the patient dying convulsed
or suffocated. The period at which death ensues is very variable, and
considerable power for locomotion may be retained by the sufferer,
though, as a rule, he is found writhing in exquisite agony on the floor
or elsewhere. Some cases recover, leaving the coats of the stomach more
or less injured, and the general health greatly impaired.
_Post-mortem Appearances._--The body externally is healthy. The lips
and external parts of the body, which have come in contact with the
acid, are charred. The mucous membrane of the mouth, shrivelled and
eroded, is whitish, yellowish, or brownish, sometimes appearing “as
if it had been smeared with white paint” or thin arrowroot. Many of
the appearances above described will depend upon the rapidity with
which death has followed the swallowing of the poison. The mouth,
gullet, and trachea may alone show any signs of the corrosive action of
the poison, and it is important to remember that death may be due to
sulphuric acid, and yet the acid may never have reached the stomach.
In one or two cases where the poison was poured into the mouth during
sleep, and in the case of children in whom the mouth was held open,
there were no signs of the poison on the lips, and the mouth even
escaped in one or two cases. The stomach, in some cases more or less
contracted and perforated by the corroding action of the acid, may
contain a dark grumous liquid, the acidity of which will depend upon
the treatment adopted, or the length of time that may have elapsed from
the swallowing of the acid to the fatal termination. The stomach also
appears as if carbonised, this being due to the action of the acid on
the effused blood; no such appearance being produced when sulphuric
acid is poured into the dead stomach. Corrosive action may be found in
the duodenum. In cases where the patient has survived from sixteen to
twenty hours, the small intestines have been found inflamed. The blood,
Casper states, is never fluid in acute poisoning by sulphuric acid,
but always “syrupy at least, and sometimes ropy; it has a cherry-red
colour, and acid reaction.” Sulphuric acid is also said to possess
powerful antiseptic properties, and that bodies of those who have died
from its effects remain long fresh.
There are two things which may render the diagnosis difficult--(1)
Gastric ulcer. (2) _Post-mortem_ digestion of the stomach.
Gastric ulcers vary in size from that of a threepenny-piece to that
of a florin, or larger. In shape they are round or oval, and present
the appearance of shallow but level pits, with sharp, smooth, vertical
edges--appearing as if they had been punched out. The peritoneal
opening is smaller than that on the internal surface of the stomach.
The absence of injury to the mouth and gullet will distinguish gastric
ulcer and _post-mortem_ softening from the action of corrosive poisons.
_General Treatment._--Chalk, carbonate of magnesia, bicarbonate of
soda, the plaster from the walls or ceiling of the apartment stirred in
water, and followed by diluent drinks--barley water, linseed tea, &c.
The use of the stomach pump is contra-indicated.
SULPHURIC ACID
_Forms._--Sulphuric acid occurs in two forms--_concentrated_ and
_diluted_.
_Characters._--Concentrated sulphuric acid or oil of vitriol (specific
gravity, 1.800 to 1.845), as it is found in commerce, is a heavy, oily,
colourless, or slightly brownish-coloured liquid, not fuming when
exposed to the atmosphere; but, when added to water, causing a rapid
increase of temperature, which may crack the glass vessel in which
the mixture is made. Sulphuric acid chars and destroys the texture of
organic bodies placed in it. _Dilute sulphuric acid_ is a colourless,
strongly acid liquid, reddening litmus, and charring paper dipped into
it when subsequently dried, care being taken not to scorch the paper.
_Symptoms, &c._--The symptoms and _post-mortem_ signs have been already
described, p. 246.
_Chemical Analysis and Tests._--The acid will have to be examined under
the following heads: (1) Simple, concentrated acid. (2) Dilute acid.
(3) Mixed with organic liquids, food, vomit, &c. (4) On the clothes of
the person injured.
I. Concentrated Acid
1. _Chars Organic Matter._--A piece of wood or paper placed in the
strong acid rapidly becomes blackened.
2. _Heat when added to Water._--Equal quantities of acid and water
added together produce intense heat.
3. _Evolution of Sulphurous Acid._--When boiled with chips of wood,
copper cuttings, or mercury, fumes of sulphurous acid are evolved,
detected by their sulphur-like odour, and by their power of first
bluing and then bleaching starched paper dipped in iodic acid.
II. Dilute Acid
1. _Chars Paper._--This only occurs when the paper is dried by the aid
of heat, subsequently to moistening it in the dilute acid.
2. _Precipitation of Sulphate of Barium._--A solution of the nitrate or
of the chloride of barium is precipitated by sulphuric acid in the form
of a white insoluble powder, unaffected by nitric or hydrochloric acid,
even when heat is applied. This test is so delicate, that a liquid
containing ¹/₂₅₀₀₀th part by weight of the acid is precipitated by
either of the test solutions.
3. _Action of Heat._--The dilute acid is entirely volatilised by heat.
III. Mixed with Organic Liquids, &c.
In tea, coffee, or beer the mode of applying the tests are the same,
the mixture being previously filtered, or the acid separated from the
organic mixture by dialysis, or the following cautions are necessary:
_Objection A._--Alum, or any acid sulphate, would give all the
reactions with the nitrate and chloride of barium.
_Answer A._--Evaporate a portion of the doubtful liquid; if pure acid,
there will be no residue, sometimes only the _slightest trace_ of
sulphate of lead.
_Objection B._--Erroneous estimation of free sulphuric acid, in
consequence of the presence of some saline or neutral sulphates.
_Answer B._--Evaporate as before. The free sulphuric acid separated
by warming the liquid is then added to a known weight of powdered
carbonate of baryta until effervescence ceases. The resulting
precipitate when weighed, represents the free sulphuric acid present.
Calculate in the following manner--
BaCO₃ + H₂SO₄ = BaSO₄ + H₂O + CO₂.
BaCO₃ = 197.
H₂SO₄ = 98.
CO₂ = 44.
In the above equation, 98 parts of H₂SO₄ take the place of 44 parts of
CO₂. If, therefore, 100 grains of BaCO₃ renders the liquid neutral,
the amount of free SO₄ present will be represented by the increased
weight of the precipitate in the proportion of 54 to 98, the difference
between 44 and 98 the equivalent of CO₂ + SO₄.
To extract the acid from organic mixtures, digestion with alcohol is
required: filter and neutralise the filtrate with caustic potash,
evaporate to dryness, and dissolve the residue in distilled water
acidulated with hydrochloric acid; the previous tests may then be
applied. Extraction with alcohol leaves behind combined acid in the
form of sulphates. The presence of free acid in the filtrate or
original mixture may be detected by the change of tropæolin solution
from yellow to crimson or ruby colour when added to it; or on adding a
few drops of the mixture or filtrate to a solution of potassio-tartrate
of iron B.P. in water, so as to make it of a yellow tinge, and to which
potassium sulphocyanide has been added, the liquid changes from a
yellow to a port-wine colour.
IV. Stains on the Clothes, &c.
1. The strong acid changes the colour of black woollen cloth to a dirty
brown, the edges of the spots assuming a reddish tint after a few days.
The dilute acid on the same cloth produces a red stain, which in time
becomes brown.
2. The spots made by the strong acid remain damp for some time--strong
sulphuric acid, having a great affinity for water, continually absorbs
moisture from the atmosphere.
3. The spot should be cut out, boiled in distilled water, or digested
with alcohol, filtered and tested for free sulphuric acid.
4. A portion of the cloth not touched by the acid should be tested, in
order to show that the sulphuric acid found is not due to sulphates
present in the cloth.
5. An acid sulphate--bisulphate of potash--gives a reddish stain to
black cloth like that produced by the dilute acid. Test for this salt
by incineration.
_Fatal Period._--Average time before death ensues is from two to
twenty-four hours. The shortest time was one hour, but in children
death may be instantaneous. Life, however, may be prolonged for some
weeks, or even months.
_Fatal Dose._--One drachm in a healthy adult has proved fatal; on the
other hand, however, four ounces have been swallowed without being
fatal.
_Treatment._--As before mentioned.
_N.B._--This acid in past years has given rise to several actions, it
having been employed to disfigure the person by throwing it in the
face.
NITRIC ACID
_Forms._--Strong nitric acid, and dilute nitric acid.
_Characters._--This acid is commonly known as _aqua fortis_, or red
spirit of nitre. It is seldom used as a poison.
The _strong acid_ varies in colour from a pale yellow to a deep
orange. The colour is due to admixture with peroxide of nitrogen. On
_cloth_ and _articles of dress_ it produces _yellow stains_, which are
darkened by the application of an alkali. If poured on copper cuttings,
reddish fumes of nitrous acid are given off. _Dilute nitric acid_ is
a colourless acid liquid, not precipitated by nitrate of barium or
nitrate of silver, showing absence of sulphuric and hydrochloric acids.
All its alkaline salts are soluble in water.
_Symptoms._--The symptoms have been before described, and are similar
to those produced by sulphuric acid, though not quite so severe. The
_vapour_ of this acid has caused death in eleven hours by congestion of
the bronchial tubes and lungs; care should, therefore, always be taken
not to inhale the fumes given off by the acid in the manufacture of
gun-cotton, &c.
_Post-mortem Appearances._--Same as the mineral acids generally, but
the tissues touched are turned yellow, and if bile be in the stomach it
is turned green. The stomach is rarely perforated.
_Chemical Analysis._--Nitric, like sulphuric, acid will be examined
under four heads; but being a volatile acid, easily decomposed, and
also having its nature changed by contact with organic substances, its
presence on clothes may fail to be detected after a few weeks. The
colour of the stain on cloth may also remain, although the acid has
been entirely removed by washing. 1. Strong, concentrated acid. 2.
Dilute acid. 3. Mixed with organic liquids, &c. 4. On the clothes of
the person injured.
I. Concentrated Acid
1. _Volatility._--When exposed to the atmosphere, strong nitric acid
gives off colourless or orange-coloured acid fumes. Heated in a
watch-glass, it is evaporated without residue.
2. _Action on Organic Matter._--The acid leaves on woollen clothes
a _yellow-coloured stain_, which is darkened by the addition of an
alkali. The colour of the stain is due to the formation of picric acid.
3. _Action on Metals._--Gently heated in a test tube with copper
filings, orange-coloured fumes are given off, which redden but do not
bleach litmus paper. Starch paper treated with iodide of potassium
becomes purple.
4. _Solution of Gold._--If a small portion of gold leaf be put into
the acid, no effect is produced; but on the addition of concentrated
hydrochloric acid, the metal is rapidly dissolved.
II. Dilute Acid
1. Absence of sulphuric and hydrochloric acids, proved by no
precipitate being formed with nitrate of barium and nitrate of silver.
2. It does not char paper when the paper is heated, as is the case with
sulphuric and hydrochloric acids.
3. If a piece of filtering paper be dipped into a solution of the acid
saturated with carbonate of potash, dried and ignited, it will burn
like touch-paper.
4. The acid liquid, saturated with carbonate of potash and evaporated,
deposits _fluted_ prisms which do not effloresce or deliquesce on
exposure. Neutralised with soda, the crystals are of a _rhombic_ form.
5. A crystal, so formed, moistened with distilled water on a plate, and
then heated with strong sulphuric acid and allowed to cool, gives with--
(1) A piece of _green sulphate of iron_--a dark green
ring round the crystal.
(2) A small portion of _morphia_--a rich orange colour,
a yellow liquid being formed.
(3) A small portion of _brucine_--a blood-red colour.
6. If an aqueous solution of diphenylamine be added to a solution
containing nitric acid, in a test tube, and pure sulphuric acid be
poured down the side of the tube to form a layer at the bottom, a blue
colour forms at the junction of the two liquids.
III. Mixed with Organic Liquids, &c.
Due to the measures employed by way of treatment the vomited matters
may be neutral and yet nitric acid be present. The method adopted
with viscid and turbid organic mixtures is to dilute them with pure
water, and then filter. If the filtrate be acid, it is neutralised with
carbonate of potash, evaporated, and then set aside to crystallise,
and the crystals purified by digesting them in ether or alcohol. The
crystals are again dissolved and re-crystallised. The tests just
mentioned should then be employed. It should be remembered that nitric
acid has a strong tendency to combine with solid organic structures,
and to become decomposed. The parts of the body stained by the acid
should, therefore, be digested in water at a gentle heat, the liquid
cooled, filtered, and neutralised with carbonate of potash, and then
examined for nitre.
IV. Stains on the Clothes, &c.
Macerate the piece of cloth in distilled water by the aid of heat. If
the solution be acid, neutralise with carbonate of potash, and filter.
Test the solution as before mentioned.
The action of the dilute solution of caustic potash on the following
stains on cloth is characteristic: Nitric acid stain becomes of a clear
orange tint. Iodine stain disappears. Bile stain remains unchanged.
_Fatal Period._--Death may take place in an hour and a half, or life
may be prolonged for some months.
_Fatal Dose._--Two drachms; recovery has taken place after half a fluid
ounce of the strong acid has been taken.
_Treatment._--As before mentioned when speaking of the acids generally.
HYDROCHLORIC ACID
_Forms._--Strong and the dilute acid. It is known as muriatic acid, or
spirits of salts.
_Characters._--_Strong hydrochloric acid_ is either colourless or has
a bright yellow tint, due to the presence of the perchloride of iron.
It fumes in the air, and gives rise to dense white fumes when a glass
rod moistened with ammonia is held over the surface of the acid. The
_dilute acid_ is colourless.
_Symptoms._--Poisoning with muriatic acid is so rare that the symptoms
have not been well studied, but they do not appear to differ much from
those produced by the action of the other acids. It does not stain the
skin, but may darken the mucous membranes. The fumes are apt to attack
the air-passages.
_Chemical Analysis._--The acid will have to be examined under the
following heads: 1. Simple, concentrated acid. 2. Dilute acid. 3. Mixed
with organic liquids, food, &c. 4. On the clothes of the person injured.
I. Concentrated Acid
1. _Action on Organic Matter._--The strong acid tinges most organic
tissues, when immersed in it, a _yellow colour_. The stains on black
cloth are at first distinctly _red_, becoming reddish-brown after a few
days.
2. _Action on Metals._--This acid does not act on copper or mercury,
even when boiled with them, and this distinguishes it from the other
acids.
3. Hydrochloric acid, added to peroxide of manganese and then warmed,
gives off chlorine gas, detected by its greenish-yellow colour and
suffocating odour. The vapour thus produced bleaches litmus paper,
and causes a blue coloration on starch paper moistened with iodide of
potassium.
II. Dilute Acid
1. Decomposes alkaline carbonates, chlorides being formed which, when
heated in the solid state with strong sulphuric acid and peroxide of
manganese, evolve chlorine gas, known by the before-mentioned tests.
2. _Precipitation of Chloride of Silver._--A white curdled precipitate
of chloride of silver is thrown down when a solution of nitrate of
silver is added to hydrochloric acid. This precipitate becomes grey
on exposure to light. If a portion of the precipitate be added to
ammonia it will dissolve; another portion, when boiled with nitric
acid, is unaffected; and a third portion, ignited in a capsule, becomes
converted into a horny mass.
In any case where there is a doubt as to whether the hydrochloric
acid exists in the free state, or is only present in the form of
chlorides, the following test should be resorted to, which will not
only discriminate between the two forms, but give the relative amount
of each present:
Take two equal measures of the acid liquid. Precipitate one with
nitrate of silver, after the addition of nitric acid, and weigh the
precipitate. Evaporate the second portion of the acid liquid to
dryness, and dry the residue in a water bath; dissolve this residue
in distilled water, and treat the solution with nitrate of silver as
before, weighing any precipitate which occurs. The weight of chloride
of silver obtained from the first portion of the liquid will give
all the hydrochloric acid present, both in the free state and in
combination; while the weight of the silver precipitate in the second
portion of liquid only gives the chlorides, all free--hydrochloric acid
having passed off during the process of evaporation.
III. Mixed with Organic Liquids, &c.
The suspected acid liquid should be filtered, and then distilled
almost to dryness. The portion of the distillate which comes over at
first may be thrown away; but the latter portion will give all the
reactions before described for hydrochloric acid, if that be present.
Distillation is adopted in the case of this acid, as it is more
volatile than either sulphuric or nitric acid. It may be objected that
the acid found in the vomited matters is from the gastric juice. In
answer to this, it may be stated that the free hydrochloric acid in
normal gastric juice is only about five grains in sixteen ounces, an
amount which would give but slight reaction with the tests.
IV. Stains on the Clothes, &c.
The spots produced by the action of the acid on black cloth are at
first of a _bright red_ colour, changing in ten or twelve days to
reddish-brown. These spots may be cut out and macerated in warm water;
the liquid thus obtained then tested by nitrate of silver and the other
tests before noticed. Another portion of the cloth should be treated
in the same manner, and the resulting liquid tested, as a control
against the objection that the acid might have been present in the
cloth. Hydrochloric acid has been used to erase writing from paper in
attempts at forgery, &c. The paper must be treated in the same manner
as mentioned for the cloth, and the tests used. Sometimes oxalic acid
is employed for a like purpose, in which case the nitrate of silver
will give a precipitate; but the oxalate of silver is soluble in nitric
acid; the chloride is not soluble even when boiled.
_Fatal Period._--From two or five hours to thirty hours or more.
_Fatal Dose._--One fluid drachm to one ounce; recovery has taken place
after swallowing two fluid ounces.
_Treatment._--The same as for the other acids.
Table showing the Colour produced by the Action of
the Mineral Acids on the Skin and on Cloth
+-------------+----------------------+--------------------------+
| | Skin. | Cloth. |
+-------------+----------------------+--------------------------+
|Sulphuric |Brown colour. |Dirty-brown edges becoming|
| acid. | | red after a |
| | | few days from absorption|
| | | of moisture. |
| | | |
|Nitric acid. |Bright yellow, due to |Yellow, orange-red, or |
| | the formation of | brown. |
| | picric acid. Colour | |
| | heightened by | |
| | alkalies. | |
| | | |
|Hydrochloric |Greyish-white. |Bright red changing |
| acid. | | after some days to |
| | | reddish-brown. |
| | | |
+-------------+----------------------+--------------------------+
SULPHATE OF INDIGO
A dark blue liquid formed by dissolving indigo in strong sulphuric
acid. Used as a dye. The symptoms are much the same as those detailed
under sulphuric acid, with the additional bluing of the mouth and lips.
It may be detected with the tests given under sulphuric acid, the blue
colour being first discharged by boiling it with nitric acid.
CARBOLIC ACID
Phenol. Phenic Acid. Coal-tar Creosote. Oil of Tar
Carbolic acid is obtained in the dry distillation of coal, and forms
the acid portion of coal-tar oil, from which it is subsequently
extracted by shaking the crude coal-tar oil with a mixture of slaked
lime and water. After allowing the mixture to stand for some time,
the watery portion is separated from the undissolved oil, the former
treated with hydrochloric acid, and the resulting oily fluid purified
by careful distillation. Up to the year 1900 no restrictions were
put upon the sale of carbolic acid, but owing to the large number
of suicidal and accidental deaths from its use, it was by Act of
Parliament scheduled as a poison, and all preparations containing more
than 3 per cent. of it, cresylic acid, or their homologues, must be
sold as poisons.
Pure carbolic acid forms long, colourless, prismatic needles, which
melt at 35° C. into an oily liquid. It boils at 180° C., and greatly
resembles creosote, for which it is very frequently substituted in
commerce, but from which it differs in the following characters:
It does not affect polarised light as creosote does; it forms a
jelly-like mass with collodion, and is soluble in a solution of
potash, whereas creosote is unaffected by collodion, and is insoluble
in a solution of potash. It possesses a penetrating, characteristic
odour; burning taste; is slightly soluble in water, but freely so in
glycerine, ether, and alcohol; and gives no acid reaction to test
paper. When undiluted, it attacks the skin, which it shrivels up.
Creosote is obtained from wood-tar, which imparts to it its caustic
properties.
Carbolic acid acts as a corrosive and anæsthetic on the skin and mucous
membranes, and as a narcotic on the brain. Its poisonous properties
are exerted whether it be swallowed or merely applied to the skin,
especially if a wound be present.
_Effects on the Skin, &c._--Strong carbolic acid, when applied to the
skin, corrugates, hardens, and destroys its sensibility, and is said
to whiten it; though in one case, in which the crude acid had been
taken with a suicidal intent, there was after death a dark brownish
ring about half an inch wide surrounding the mouth; and in another,
that of a child who, in climbing to a shelf, poured over its face and
neck about half a saucerful of diluted acid, the colour of the skin
touched by the acid was yellowish-white and yellowish-brown, dry and
parchment-like. The action of the acid on the mucous membranes is
similar to that on the skin, but the corrugation is more marked, and
considerable softening and peeling may also take place.
_Effects on the Nervous System._--Rapidly supervening stupor, total
muscular relaxation, anæsthesia, and stertorous breathing are among
the most prominent symptoms. Nearly all the sufferers die comatose.
Carbolic acid appears to act principally on the central nervous ganglia
at the base of the brain and on the spinal cord. The evidence is more
in favour of its action on the brain than on the spinal cord, and not
at all on the periphery of the nerves. The muscles contract vigorously
after death, in response to galvanic stimulation applied either to the
nerves or to the muscles themselves.
_Effects on the Circulation._--The action of carbolic acid on the
circulation has not yet been fully worked out, but it appears to be a
cardiac depressant, the heart being arrested in diastole.
_General Symptoms._--As soon as the acid is swallowed, the patient
complains of intense burning pain in the mouth, throat, and stomach,
the pupils are contracted, the conjunctiva insensible to touch, the
skin cold and clammy, the temperature rapidly falls, and the pulse
becomes weaker and weaker, till it is almost imperceptible. The
breathing is laboured, and, as the fatal issue approaches, becomes
stertorous; vomiting of frothy mucus occurs in some cases. The invasion
of the symptoms is most rapid, and many of the patients have been
in an insensible condition when found. The above symptoms have even
supervened when the strong acid has been used for dressing wounds.
Dr. J. Hamilton records a case where the acid was used as an
application to a wound four inches long, in a child four and a half
years of age. Direct contact of the acid with the wound was prevented.
About an hour after the dressing was applied he saw the patient, who
was then supposed to be suffering from the effects of chloroform
used during the operation on the child‘s arm. She was suffering from
symptoms like those before described. On removing the dressing, some
of the carbolic acid, it was found, had melted and run into the wound,
and to this Dr. Hamilton attributed the symptoms. The child ultimately
died. (See _British Medical Journal_, 1873, vol. i. p. 226.)
The urine and fæces, when passed, are of a dark colour, and it has
been frequently noticed that the urine passed by the assistants in
surgical hospitals, who, under the antiseptic methods adopted, are
constantly washing their hands in solutions of carbolic acid, is of
an olive-green colour. This shows that absorption takes place readily
through the skin. Bilroth, in his work on _Clinical Surgery_, gives
several instances of absorption in this way. Nephritis with casts in
the urine may occur. The hypodermic administration of carbolic acid,
twelve to twenty-four grains in a day, has failed in five cases under
my observation to be followed by carboluria.
_Post-mortem Appearances._--If the poison has been drunk, a dark
brownish horny rim may be found soon after death round the lips; the
mucous membrane of the mouth and stomach is whitened, corrugated, and
softened, and looks as if smeared with white lead--in some cases, horny
in patches; inflammatory signs being absent or only slightly visible.
The blood is uniformly fluid, becoming a bright red on exposure. The
smell of carbolic acid is detected in the stomach, and sometimes in
the small intestine, and even in the spleen, liver, and kidneys. In
Dr. Ferrier‘s case, the urine found in the bladder after death had a
slight olive-greenish tint with a peculiar mixed odour, which gave the
usual reactions to the tests for carbolic acid. The dark colour of the
urine is not due to the presence of hæmin, as the urine, in poisoning
by carbolic acid, does not contain more than a normal amount of iron;
the colour is, therefore, probably due to some product formed by the
partial oxidation of the acid as hydroquinone. Signs of nephritis may
be present. The left ventricle of the heart is, in most cases, found
contracted, the right flaccid. The lungs are congested, and this may
also be the case with the vessels of the brain; but there may be an
entire absence of any _post-mortem signs_ to point to the probable
cause of death, where the poison has gained entrance through a wound
when the acid has been used as a surgical dressing.
_Chemical Analysis._--Carbolic acid may be separated from mixture
with organic substances by distillation with dilute sulphuric acid,
from urine by agitation with ether. Bromine water, as recommended
by Landolt, gives a bulky yellowish precipitate of tribromo-phenol.
The precipitate should then be collected, well washed, and gently
warmed in a test tube with sodium-amalgam and water. The liquid poured
into a dish and acidulated, will, if phenol be present, give the
characteristic odour of that substance, and it may be seen floating
in the liquid as an oily fluid. By this test, one part of phenol in
43,700 of water may be detected. It must be remembered that, according
to Landolt, carbolic acid is normally present in the urine, but
Hoppe Seyler contends that it is not originally present in urine,
but is formed by the action of sulphuric acid, probably from indican.
Carbolic acid urine, treated with nitric acid, and then with potassæ,
and concentrated, becomes blood-red, brown-red, and then changes from
pea-green to violet. Carbolic acid mixed with urine does not give the
above reactions (Schmidt‘s _Jahrbücher_, Bd. clxiv. p. 144).
A solution of carbolic acid, mixed with one-fourth of its volume of
ammonia and a few drops of bleaching powder solution (1 in 20 of
water), and then warmed, but not boiled, assumes a blue colour (green
in very dilute solutions), becoming red on the addition of sulphuric or
hydrochloric acid. The perchloride of iron gives a violet colour with
carbolic acid.
_Fatal Period._--Death has occurred in three minutes; also delayed to
sixty hours; usually three to four hours.
_Fatal Dose._--One drachm has caused death in twelve hours. A child
six months old died from the effects of a quarter of a teaspoonful of
a solution of one part of the acid to five of glycerine. Recovery has
taken place after an ounce of 90 per cent. strength liquefied acid,
also after four ounces of the crude acid; after six ounces of the crude
acid, 14 per cent. strength; and in a child of two after half an ounce
of crude acid of 30 per cent. strength.
_Treatment._--Stomach pump. Wash out the stomach with equal quantities
of alcohol and water mixed--whisky, brandy, gin, or rum will do until
absolute alcohol or rectified spirit be obtained. The washing should be
repeated every 5 to 15 minutes from four to eight times; apomorphine
hydrochlorate gr. ⅒ should be given hypodermically at the commencement,
and the administration of demulcent drinks. Emetics are of little
or no use, owing to the anæsthesia of the mucous membrane of the
stomach. The sulphate of soda, Glauber salts, has been proposed as an
antidote. Any soluble sulphate may be tried. Oil or vinegar is the best
outward application to the skin, after washing with spirit of wine or
methylated spirits.
OXALIC ACID
This is a powerful corrosive and cardiac poison, but on account of its
strongly acid taste it is ill-adapted for the purposes of the murderer.
Deaths have not infrequently followed the accidental substitution of
this substance for Epsom salts--sulphate of magnesia--which it somewhat
closely resembles.
The ordinary crystals of oxalic acid are in the form of four-sided
prisms, colourless, transparent, odourless, or with a slight acid
smell, very acid taste, and not deliquescent in the air. It is
largely used in the arts, by brass-polishers, straw-bonnet makers,
book-binders, and others. The acid is also used to remove writing-ink
from parchment, paper, &c., for the purposes of forgery, &c.
_Symptoms._--These present many strange anomalies. In a large dose--an
ounce or more--oxalic acid acts as a corrosive; in a smaller, as
an irritant; and in a still smaller dose, as a cardiac sedative.
Death has been known to occur so rapidly as to prevent any attempt
at treatment. When the dose is large, an acid taste is experienced
during swallowing, followed by burning pain in the throat and stomach.
Vomiting then sets in, and in most cases continues till death, which
may, however, occur when this symptom has existed from the first.
The vomited matters may be simply mucus, mucus and blood, or dark
coffee-grounds-looking matter. Unless the case is protracted, the
bowels are rarely much affected, though purging and tenesmus have been
noticed. Occult blood may be present in the fæces. Collapse now sets
in; the pulse becomes feeble and scarcely perceptible, the skin cold
and clammy, showing the action of the poison on the heart probably
through the central nervous, as well as through the intra-cardiac
ganglia. Should the treatment adopted prove successful, and life be
prolonged, the patient complains of tenderness of the mouth, soreness
of the throat, and painful deglutition. Pressure over the abdomen
causes pain. Vomiting and purging are also frequently present; and if
recovery takes place, convalescence is generally very gradual. The
urine may contain a large quantity of albumen, casts are numerous, and
oxalates in crystal form are present.
[Illustration: Fig. 28.--Photo-micrograph of crystals of oxalic acid, ×
50. (R. J. M. Buchanan.)]
Oxalic acid acts as a poison when applied to a wound in any part of the
body; and although this substance undoubtedly acts on the brain through
the medium of the blood, it is a remarkable fact that _it cannot be
detected in that fluid_, even when injected into the femoral vein of
an animal which died in thirty seconds (Christison). Leeches, it is
recorded, have been poisoned by the blood drawn by them from persons
suffering from oxalic acid poisoning. The blood does not appear to
undergo any physical change. Unlike the mineral acids, oxalic acid is
still poisonous even when its corrosive and irritant properties have
been destroyed by dilution.
_Post-mortem Appearances._--The mucous membrane of the mouth, tongue,
and throat is corrugated, white, and softened. The tongue is sometimes
of a brownish colour, and sordes appear on the teeth. The stomach is in
some cases pale, soft, and very brittle, and contains a dark, grumous,
acid liquid; at other times it presents several semi-gelatinous spots,
looking as if they had been boiled. Enlarged blood-vessels filled
with dark-coloured blood are also seen ramifying over the internal
surface of the organ. Perforation is of rare occurrence. The intestines
generally escape with some slight inflammatory redness, unless the case
is unusually prolonged. In some cases the stomach is quite healthy, no
morbid appearance being found in any portion of the alimentary canal.
[Illustration: Fig. 29.--Photo-micrograph of crystals of oxalic acid, ×
50. (R. J. M. Buchanan.)]
_Chemical Analysis._--From organic mixtures the acid may be separated
by dialysis, and the tests applied, or it may be obtained in crystals
by precipitating it from the boiled and filtered organic mixture
with acetate of lead. The precipitate washed is then decomposed by
sulphuretted hydrogen and filtered, the filtrate concentrated to drive
off excess of sulphuretted hydrogen, and then set aside to crystallise,
which, if the acid be present, it does in slender prisms. From the
contents of the stomach the acid may be separated by partial drying
over a water bath, extraction with hot alcohol acidulated with a little
hydrochloric acid, filtering the alcoholic solution, evaporating to
dryness, and dissolving the residue in water. Should, owing to the
treatment adopted, oxalate of lime in white chalky masses be found in
the stomach, these should be washed and then boiled with pure carbonate
of potash. A partial decomposition takes place, insoluble carbonate of
lime and soluble oxalate of potash are present in the liquid, which,
when filtered and neutralised with nitric acid, may be tested with the
following reagents:
1. _Nitrate of silver_ gives a white precipitate, _soluble_ in _cold_
nitric acid; the precipitate dried and heated on platinum foil is
dissipated in a white vapour with slight detonation.
2. _Calcium chloride or sulphate_ produces a white precipitate with
oxalic acid; the test is more delicate if the acid be first neutralised
with ammonia. The precipitate is immediately dissolved by hydrochloric
or nitric acid, but not dissolved by oxalic, tartaric, acetic, or other
vegetable acid. Lime-water should not be used as a test, as it gives
precipitates with other acids; the sulphate largely diluted is not open
to this objection.
3. _Lead acetate_ gives a white precipitate soluble in nitric acid. On
clothes, parchment, &c., the spot or spots must be well boiled, and
the above tests applied to the solution. The stains may vary from a
brownish-red to orange-red colour.
_Fatal Dose._--Three drachms have caused death in one hour; sixty
grains caused the death of a boy sixteen years of age, but recoveries
have been known to take place after an ounce and an ounce and a half
had been swallowed.
_Fatal Period._--Death has resulted in _ten minutes_ from a dose of
_one ounce_. The shortest period has been three minutes. The time
varies with individuals, even when the same quantity is taken. In the
case of two girls who each swallowed _an ounce_ of oxalic acid, one
died in _ten minutes_, and the other in _thirty minutes_. Death usually
takes place within from half an hour to an hour, although it has been
delayed for five days.
_Treatment._--Water should not be given, as it increases the solubility
of the acid, and thus assists in the more extensive absorption and
diffusion of the poison. The carbonates of potash and soda should be
avoided, as the oxalates of these alkalies _are themselves_ poisonous.
The stomach tube should not be used. Lime is the best antidote, as the
oxalate of lime is insoluble, and may be given in the form of common
_whiting_; a pint of saccharated lime water may be given. Vomiting
should be promoted. In the stage of collapse the case must be treated
on general principles.
Essential Salt of Lemons
The binoxalate of potash or salt of sorrel, or, as it is more commonly
known, salt of lemons, occurs as a constituent of many plants. The
common sorrel--_Rumex acetosa_--contains it in large quantities.
_Symptoms._--Those of poisoning by oxalic acid, on which its poisonous
properties depend.
_Post-mortem Appearances._--Inflammation of the stomach and intestines.
Other appearances as in oxalic acid.
_Chemical Analysis._--See oxalic acid. The incinerated salt leaves a
white residue of potassium carbonate; oxalic acid leaves no residue.
_Fatal Period._--_Eight minutes_ in the case of a lady recently
confined, who took half an ounce of the salt by mistake for cream of
tartar.
_Fatal Dose._--Half an ounce.
_Treatment._--The same as recommended for poisoning by oxalic acid.
Table showing Symptoms, Post-mortem Appearances, Fatal Dose,
Period of Death, and Treatment of Poisoning by
+-------------------------+-----------------------------------+
| | Sulphuric Acid. |
+-------------------------+-----------------------------------+
| _Symptoms_ |Burning pain in the mouth, |
| |throat, and gullet. Constant |
| |vomiting of brownish or blackish |
| |matter containing blood. |
| |The lips shrivelled, blistered, |
| |and excoriated; and the corners |
| |of the mouth show signs |
| |of the corrosive action of the |
| |poison. Collapse and death. |
| | |
| _Post-mortem_ |Presence of the signs of powerful |
| _Appearances_ |corrosion; perforation of |
| |the stomach, which is blackened |
| |and softened. |
| | |
| _Fatal Dose_ |One drachm. |
| | |
| _Fatal Period_ |One hour. Average about ten |
| |hours. |
| | |
| _Treatment_ |Magnesia, chalk, whiting, soap |
| |suds, milk, and mucilaginous |
| |drinks. |
+-------------------------+-----------------------------------+
| | Hydrocyanic Acid. |
+-------------------------+-----------------------------------+
| _Symptoms_ |Giddiness, insensibility, difficult|
| |respiration, dilated pupil, |
| |tetanic spasms, and convulsions. |
| |In acute cases, death |
| |by shock; in those more prolonged, |
| |suffocation ends the |
| |scene. |
| | |
| _Post-mortem_ |Face pale and countenance composed;|
| _Appearances_ |congestion of the brain, |
| |and traces of inflammation in |
| |the stomach and bowels. |
| |Odour of prussic acid may be |
| |detected in most cases in the |
| |stomach and other parts of the |
| |body. |
| | |
| _Fatal Dose_ |About 45 minims of the Pharmacopœia|
| |acid. |
| | |
| _Fatal Period_ |Two to five minutes. |
| | |
| | |
| _Treatment_ |Chlorine in vapour and in water, |
| |and the mixed oxides of iron. |
| |Cold affusion to the head and |
| |face, galvanism, artificial |
| | respiration, &c. |
+-------------------------+-----------------------------------+
| | Oxalic Acid. |
+-------------------------+-----------------------------------+
| _Symptoms_ |Burning pain in the mouth and |
| |throat, vomiting of greenish-brown |
| |or grumous matter. |
| |Collapse sets in; skin cold and |
| |clammy; frequent pulse, and |
| |respiration hurried. Delirium |
| |and convulsions end in death. |
| |Effects depend on size of dose. |
| |Well diluted, it acts on brain, |
| |spine, and heart. |
| | |
| _Post-mortem_ |Lining membrane of mouth and |
| _Appearances_ |fauces white, shrivelled, and |
| |easily removed. Perforation |
| |of stomach rare. The _post-mortem_ |
| |appearances depend on |
| |dilution of acid. |
| | |
| _Fatal Dose_ |One drachm in a boy; in another |
| |case, half an ounce. |
| | |
| _Fatal Period_ |Less than ten minutes. |
| | |
| _Treatment_ |Chalk and water. Promote |
| |vomiting. Magnesia, lime |
| |water, and oil. Mucilaginous |
| |drinks. |
+-------------------------+-----------------------------------+
ACETIC ACID
In the glacial form this acid acts as a corrosive, the dilute acid as
an irritant. Cases have been recorded of poisoning by the glacial acid.
_Symptoms._--The parts with which the acid has come in contact are
softened and rendered yellowish-white in colour. The larynx is commonly
affected by the acid, as it is very volatile.
_Post-mortem Appearances_ are those of corrosive poisoning with
inflammatory action in the upper air-passages.
_Fatal Period_ is variable but rapid.
_Fatal Dose._--One drachm caused death in a child, but recovery has
taken place in an adult after taking six fluid ounces.
_Chemical Analysis._--Separate the free acid from organic matter by
distillation, if in combination it should be liberated by adding
phosphoric acid. With ferric chloride and ammonia to neutralisation a
red colour is produced, turned yellow by hydrochloric acid.
_Treatment._--Magnesia should be given to neutralise the acid and
vomiting produced. The laryngeal symptoms will require treating on
general principles; tracheotomy may be necessary.
THE ALKALIES
POTASH. SODA. AMMONIA
Poisoning by the use of the alkalies is very rare. For the sake of
convenience, and as the symptoms produced by the caustic preparations
of soda and potash, taken in large doses, do not greatly differ, one
description will do for both:
=Potash= is found in commerce as (1) caustic potash, either solid or in
solution; (2) carbonate and bicarbonate; (3) pearl-ash and soap-lees.
=Soda= is found as (1) caustic soda; (2) carbonate (washing soda) and
bicarbonate; (3) soap-lees, carbonate of soda mixed with caustic alkali.
_General Characters._--Like the inorganic acids, the alkalies destroy
the animal tissues with which they come in contact. Their action is
local, no specific remote effects being produced. They are seldom, if
ever, used for the purpose of homicide; the deaths caused by them are
in most cases the result of accident or suicide. When injected directly
into the veins of animals, the toxic action of potash and soda appears
to differ, the former arresting the action of the heart in diastole,
whereas the latter, according to Podocaepow and Guttman, does not, even
in large doses, affect the heart or temperature--Guttman, moreover,
asserting that soda has no influence upon the nerve centres, the
peripheral nerves, or the muscles. It is difficult to understand how,
with this asserted negative action, soda, like potash, causes death.
_Symptoms._--During the act of swallowing, the patient complains of a
caustic taste, accompanied with a sensation of burning in the mouth and
throat, extending into the stomach. Vomiting may or may not be present;
but in severe cases, when it does occur, the vomited matters may be
mixed with blood. The surface of the body is cold, and bathed in a cold
sweat. Purging is generally present, accompanied with intense pain and
straining. The pulse is weak and quick, and the countenance anxious.
The _post-mortem_ appearances are inflammation and softening of the
mucous membrane of the mouth, gullet, and stomach, which may also be
covered with chocolate-coloured or black spots. When life has been
prolonged for some months the stomach may become contracted, the
pyloric orifice scarcely admitting the passage of a fine probe.
_Chemical Analysis._--The caustic alkalies are known from their
carbonates by giving a brown precipitate with nitrate of silver;
whereas their carbonates give a white, and also effervesce on the
addition of an acid.
The following table will show the reaction of these alkalies with
reagents:
To distinguish Caustic Potash from Caustic Soda
+--------------------+--------------------------+-----------------+
| | Potash. | Soda. |
+--------------------+--------------------------+-----------------+
| Bichloride of | A canary-coloured | No precipitate. |
| platinum. | precipitate | |
| | in solutions | |
| | acidulated with | |
| | hydrochloric acid. | |
| | | |
| Strong solution of | Precipitate in granular | No precipitate. |
| tartaric acid. | white crystals. | |
| | | |
| Colour given to | Rose or lilac tint. | Yellow tint. |
| flame. | | |
| | | |
| Neutralised with | Crystallises in long, | Crystallises in |
| nitric acid. | slender, fluted prisms.| rhombic plates.|
+--------------------+--------------------------+-----------------+
_In Organic Mixtures._--If the mixture be strongly alkaline, filter and
test as above.
_Fatal Period._--From three hours to as many years.
_Fatal Dose._--About half an ounce of the caustic alkali. The smallest
fatal dose recorded of caustic potash is forty grains.
_Treatment._--Water freely; drinks containing citric or acetic acid,
vinegar, lemon juice, oil, linseed tea, and other demulcent drinks. The
stomach tube should be avoided.
AMMONIA
In vapour, in solution, or solid.
_Symptoms._--The vapour may cause death by producing inflammation of
the larynx and lungs. The symptoms to which it gives rise are a feeling
of choking, and a suspension of the power of breathing. Intense heat
and pain are felt in the throat, which may remain for some time. When
ammonia is swallowed in solution, the symptoms produced are not unlike
those the result of the action of soda or potash, only more intense.
Dr. Patterson records the history of a case of a poor man who drank
about an ounce of the liquid ammonia. When seen, his lips were livid,
breathing stridulous, aspect anxious, extremities cold, pulse 100;
inside of mouth, tongue, fauces, as far as visible, red, raw, and
fiery-looking. He died suddenly, nineteen days after the accident, of
laryngeal spasm. Albuminuria occurred in one case.
The _post-mortem_ appearances are those found in most cases of
poisoning by corrosives.
_Chemical Analysis._--Ammonia can be separated from organic mixture by
distillation. Putrefaction must not have taken place. The vapour of
ammonia is easily set free and recognised by its pungent odour. The
carbonate effervesces when an acid is added to it, and gives a white
precipitate with salts of lime. Dense white fumes are given off in the
presence of hydrochloric acid. Nessler‘s reagent gives a reddish-brown
colour or precipitate.
_Fatal Period._--Death has been known to occur in _four minutes_, but
life may be prolonged for some time, the person dying of some thoracic
trouble.
_Fatal Dose._--A teaspoonful of the strong solution.
_Treatment._--Vinegar and water, lime-juice and oil, and leeches to
the throat if the inflammatory symptoms be severe. The rest of the
treatment will depend upon the symptoms present. Tracheotomy may be
necessary.
CAUSTIC SALTS
CHLORIDE OF ANTIMONY
Chloride of antimony (butter of antimony) is a corrosive liquid. The
colour varies from a light yellow to a dark red. Though a powerful
poison, it is seldom taken for that purpose. It has been taken
by mistake for ginger beer. On the addition of water, the white
oxychloride is precipitated.
_Symptoms._--The symptoms produced by swallowing this substance are
those of corrosive poisoning. The mouth and throat are excoriated, the
skin cold and clammy, and the pulse feeble and quick. Severe pain is
felt in the stomach, and vomiting is incessant.
_Post-mortem Appearances._--Those found after corrosive poisoning.
_Chemical Analysis._--When poured into water, the chloride is
precipitated; the precipitate, soluble in tartaric acid, becomes
orange-red on the addition of hydrogen sulphide. The supernatant liquid
will give a white precipitate with nitrate of silver, showing the
presence of hydrochloric acid. The salts of bismuth are precipitated by
the addition of water, but the precipitate is, unlike the antimonial,
insoluble in tartaric acid, and is blackened by hydrogen sulphide.
From _organic_ liquids, the antimony may be obtained by boiling them
with tartaric acid, filtering, and then applying the tests for antimony.
_Treatment_.--Milk, magnesia, and infusions containing tannin.
CHLORIDE OF ZINC
This substance is a powerful corrosive. It is employed as a
disinfectant, and is sold to the public under the name of “Sir W.
Burnett‘s Fluid.” This preparation, which is a strong solution of
the chloride of zinc, has caused death by being mistaken for “fluid
magnesia,” for “pale ale,” and in one case, on board one of the
American steamers, for “mineral water.” Chloride of zinc is also used
in the treatment of cancer and other tumours as an external application.
_Symptoms._--The symptoms come on immediately after the poison is
swallowed. Chloride of zinc acts as a powerful corrosive, accompanied
with all the symptoms which have been before described when speaking
under the head of corrosive poisons. The nervous system is also
powerfully affected.
_Post-mortem Appearances._--Those of corrosive poisoning in its most
violent form. The mouth, throat, stomach, and intestines are often
found hardened, white, opaque, and corrugated.
_Chemical Analysis._--Ammonium sulphide gives a white precipitate,
which is insoluble in caustic alkalies. Hydrogen sulphide gives a
white precipitate in neutral solutions, but no precipitate when the
free mineral acids are present. Potassium ferrocyanide gives a white
precipitate. Test for chlorine with nitrate of silver.
_Treatment._--White of eggs, emetics, followed by demulcent drinks.
CHLORIDES OF TIN
This metal requires but little notice; but the two
chlorides--protochloride and the perchloride--form a mixture used in
the arts, and known as _Dyer‘s Mixture_. They act as irritant poisons,
but are seldom used as such.
NITRATE OF SILVER
The only preparation of silver requiring notice is the nitrate--_lunar
caustic_, or _lapis infernalis_. It acts as a powerful corrosive.
If administered for some time in small doses it is deposited in the
skin, which acquires a permanent dark colour. It does not appear to
be eliminated by the urine, and has been discovered in the liver five
months after its administration was discontinued.
The symptoms come on immediately, the vomited matters becoming
blackened on exposure to light. The dark spots on the skin will also
help to point to the nature of the poison. A dose of salt and water may
be given by way of treatment.
VULNERANT
GLASS, ENAMEL, AND NEEDLES
None of the above can be considered as poisons; but should they be
taken, they give rise in most cases to irritation of the stomach and
bowels. Pins and needles have been swallowed without doing much harm.
Mixing ground-glass in food is a favourite mode of killing adopted by
the West Indian negroes.
CHAPTER III
DIVISION II.--VITAL
METALLOID IRRITANTS
PHOSPHORUS
Poisoning by this substance is more common in France than in England.
In England, the deaths due to this poison are more frequently the
result of accident, from the incautious use of phosphorus paste for the
destruction of vermin. These pastes generally contain from 3 to 4 per
cent. of phosphorus. Children have also been poisoned by sucking the
heads of lucifer matches. In one case, that of a child, death followed
from sucking about forty matches. It has most frequently been employed
as a means of suicide, but seldom for the purpose of homicide. One
case, however, occurred at the Bodmin Assizes in 1857. Kopf relates a
case of a young woman, aged twenty-four, who died on the fourth day
after swallowing the heads of six packets of lucifers (_Allg. Wien.
Med. Ztg._, No. 47, 1819; Schmidt, vol. cv. p. 296). The size of the
packets is not stated. In this case the bowels were confined, and the
_post-mortem_ revealed only the redness of inflammation in the stomach
and bowels. Death has followed inunction of phosphorus paste.
_General Characters._--There are two kinds--ordinary waxy, crystalline
phosphorus, and a peculiar form known as red allotropic or amorphous
phosphorus, prepared by heating waxy phosphorus to a temperature
of 240° C., in an atmosphere free from oxygen. The ordinary yellow
phosphorus is poisonous, the red or amorphous non-poisonous. As
found in the shops, phosphorus is preserved in water in the form
of translucent white or slightly yellow-coloured cylinders. It is
sparingly soluble in oil, alcohol, and other hydrocarbons, but greatly
so in bisulphide of carbon. White vapours are given off when it is
exposed to the air, these consisting of phosphorus and phosphoric acids.
_Symptoms._--Phosphorus acts as an irritant poison, but some days may
elapse after the poison is taken before the injurious effects become
apparent. The symptoms occur in three stages.
_First stage:_ The patient complains of a garlic-like taste in the
mouth, peculiar to poisoning by this substance. This is followed by a
burning sensation in the throat, accompanied with severe pain in the
stomach, and intense thirst. The belly becomes swollen, and there is
vomiting, in some cases, of blood from the stomach, which may continue
till death. The vomited matters are of a dark green or black colour,
with an odour of garlic, and sometimes appearing phosphorescent in the
dark. This condition may also be observed in the motions passed. There
is intense thirst. The pulse is feeble, the countenance anxious, and
the surface of the body bathed in a cold sweat. In males, priapism is
not infrequent. The nervous and muscular debility is intense, and the
patient may die in a state of collapse or during a fit of convulsions.
_Second stage:_ This is a stage of intermission of the symptoms which
may last for three days or more, the patient seems as if going to
recover, and only suffers from general malaise. A case is recorded
where the intermission lasted nine weeks. In cases proceeding to a
fatal termination the intermission is followed by the third stage.
_Third stage:_ Jaundice is the most notable symptom and rapidly
increases; the liver becomes much enlarged and the abdomen distended;
epigastric pain is severe and there is vomiting of grumous black
material consisting of altered blood; purging may be present and the
motions contain blood. There is a marked tendency for hæmorrhages to
occur from the mucous membranes and subcutaneously, producing purpuric
spots. The urine is diminished, high coloured, contains bile pigments,
albumen, blood, and casts. There are great prostration, a quick weak
pulse, sleeplessness, coldness of the surface, gradually increasing
weakness, apathy, convulsions, and coma, followed by death about the
fifth or sixth day.
The liver may diminish in size before death. It is rare for recovery
to take place after enlargement of the liver and jaundice have
supervened. It is by no means always easy to diagnose acute yellow
atrophy of the liver or malignant jaundice from phosphorus poisoning.
In phosphorus poisoning, the early symptoms, those of acute gastritis,
are more severe, are developed more rapidly, and run their course more
quickly than in acute atrophy, and there is a marked interval between
these and the appearance of the jaundice; in acute yellow atrophy
this interval is wanting, and from the beginning, on the contrary,
there are gradual malaise, slight gastric catarrh, and jaundice. The
jaundice and suffering, together with the increased action of the heart
in phosphorus poisoning, are wanting in malignant jaundice, but the
cerebral symptoms are more marked in the latter than in the former.
Acute yellow atrophy most frequently occurs in women, especially during
pregnancy. In acute atrophy leucin and tyrosin are present in the
urine; in phosphorus poisoning they may occur, but generally in the
urine voided just before death.
Chronic poisoning, accompanied with all the symptoms just mentioned,
may result from the action of the vapour on those engaged in the
manufacture of phosphorus or of lucifer matches. In persons thus
employed, necrosis of the jaws and caries of the teeth are not of
infrequent occurrence. The lower jaw is more commonly affected. Mr.
Lyons states that this form of necrosis cannot attack persons who have
perfectly sound teeth, but only those whose teeth are carious (_St.
Bartholomew‘s Hospital Report_, vol. xii.).
_Post-mortem Appearances._--Those of acute irritant poisoning,
including extensive destruction of the coats of the stomach, by
softening, ulceration, and perforation, terminating in gangrene.
The stomach may contain a quantity of white vapour, having a strong
smell of garlic. This white vapour has been noticed to pass from the
vagina and anus of those poisoned by phosphorus. The blood appears
to be thoroughly disorganised; the blood-cells are colourless and
transparent, their colouring matter being dissolved in the uncoagulated
liquor sanguinis; hæmorrhages may be present beneath the serous
membranes and in the pleural and pericardial cavities, and thromboses
are frequently present, due to a tendency for the blood-cells to
agglutinate. In a case recorded in the _British Medical Journal_, 1873,
fatty degeneration of the liver and kidneys was found a week after
the poison was taken. In phosphorus poisoning, the liver is enlarged,
of a dull appearance, doughy, uniformly yellow, with the acini well
marked; in acute atrophy, the liver is diminished in size, greasy on
the surface, leathery, of a dirty yellow colour, with traces only of
the obliterated acini. In the former, also, the hepatic cells are
either filled with oil globules or entirely replaced by them; in the
latter, the cells are filled with a fine granular detritus, and their
structure replaced by newly-formed connective tissue. Putrefaction
rapidly supervenes on death. Hæmorrhages may be found on the surface of
the brain and spinal cord, and the grey matter of the cortex and basal
ganglia rose-pink in colour. Fatty changes have been found in the walls
of the capillaries and the large cortical cells.
_Chemical Analysis._--The smell of phosphorus is characteristic, as is
also its luminosity when exposed in the dark. The following process,
suggested by Mitscherlich, may be adopted for its detection:
To render the suspected matter quite fluid water is added, previously
acidulated with sulphuric acid, in order to neutralise any ammonia
present. The liquid is then transferred to a glass retort, fitted with
a long condensing tube passing into a receiver containing solution of
nitrate of silver. Distillation is conducted in the dark, when the
minutest trace of phosphorus may be detected by the luminous appearance
of the vapour during condensation. Other modifications of this process
have been suggested, in order to increase the space occupied by the
phosphorescence.
By the above process, one part of phosphorus may be detected in 100,000
parts of substance. Another method for the detection of this poison in
very minute quantities is that proposed by Dussart (_Compt. Rend._,
xliii. 1126), and modified by Blondlot (_Compt. Rend._, lii. 1197).
The test is based on the fact that when phosphorus is exposed to the
action of _nascent hydrogen_ in a Marsh‘s apparatus, it burns with an
emerald-green flame. In order to avoid the yellow colouring of the
flame produced by the sodium in glass, Blondlot recommends the use of
a platinum jet. As the green colour is more or less interfered with by
the presence of organic matters, he passes the gas through a solution
of nitrate of silver; the resulting precipitate is then placed in
another hydrogen apparatus, as just mentioned, and the colour of the
flame of the issuing gas noted. Phosphorus may become decomposed in
the body; and as phosphoric acid is taken in most articles of food,
the only satisfactory evidence of phosphorus having been taken is to
produce it in its free state, or at least to exhibit its luminosity.
The detection of the colouring matter of lucifer matches in the stomach
or vomited matters will point to the probable nature of the poison, and
whence it was derived.
_Scherer‘s Test_ is based on the reducing action of phosphorus on
nitrate of silver, which it blackens. The suspected material should be
placed in a flask or in a Dowzard‘s apparatus for Gutzeit‘s test for
arsenic, lead acetate is added to the material to fix the H₂S, and some
lead acetate solution placed in each cell. A little ether is added to
the mixture, and the flask or top of the apparatus capped with paper
moistened with nitrate of silver, and set aside for some hours in a
dark place. If phosphorus be present the paper will be blackened from
deposition of metallic silver.
_Fatal Period._--From half an hour to twenty days or more.
_Fatal Dose._--One grain and a half. The smallest fatal dose recorded
for an adult is one-eighth of a grain. An infant five weeks old died
from sucking a single match head, which probably contained one-fiftieth
of a grain of phosphorus. Recovery has taken place after four and six
grains have been taken.
_Treatment._--The stomach pump or syphon tube should be used as soon as
possible, and the stomach well washed out with warm water containing
a drachm of old oil of turpentine to the pint. If the turpentine be
not readily obtained, “sanitas” should be used with the water, or a
1 per cent. solution of permanganate of potash. After washing the
stomach, the old oil of turpentine, or the French oil of turpentine, or
“sanitas” may be administered in half to one drachm doses in mucilage
and water every fifteen minutes for several doses, and afterwards three
or four times daily. The 1 per cent. solution of potassium permanganate
may be administered in copious drinks.
According to some observers, turpentine is said to be of no value;
but this failure in the use of turpentine has been shown to be due to
the employment of different varieties of oil. The crude acid French
oil, of the three kinds met with in commerce, appears to be the only
one that acts as described below. With turpentine, phosphorus forms a
spermaceti-like mass consisting of _turpentine phosphorus acid_. It
has an acid reaction, and is converted, on exposure to the air, into a
resinous substance smelling like pine-resin. With earths and metallic
oxides it forms insoluble salts. The acid is not poisonous; doses of
0.03 to 0.3 gram may be given to dogs and rabbits without any other
effect than that of lowering of the body temperature. To the formation
of this compound, the antidotal properties of turpentine in phosphorus
poisoning are attributed (_Kohler a. Schempf Dingl._, pol. Jcxcix.).
Turpentine is said by some to be valueless if not given within twelve
hours. Emetics of sulphate of copper may be administered, but the salt
is liable to cause severe gastro-enteritis. Further treatment may
consist of mucilaginous drinks containing magnesia and opium to relieve
pain. Oils or fats should not be given because of their solvent action
upon phosphorus.
=Synopsis of the Effects due to Poisoning by Phosphorus=
1. Which variety of phosphorus is poisonous?--The ordinary yellow
phosphorus usually kept in water. The allotropic form is inert.
2. What quantity is sufficient to kill an adult?--One grain and a half.
3. Symptoms as regards--
(1) _Alimentary Canal._--Pain in the stomach and belly,
eructation of gas smelling like garlic, vomiting, and
sometimes purging, with other signs of irritation.
(2) _Circulatory System._--Tendency to hæmorrhage from
the mouth, stomach, lungs, bladder, &c. Petechiæ and
ecchymoses may occur on all parts of the body. If the
case be prolonged, anæmia may be present. Pulse small,
weak, and scarcely perceptible.
(3) _Nervous System._--Cramps, creeping sensations in
the limbs, delirium, convulsions, paralysis, and extreme
nervous prostration.
(4) _Period of Invasion of the Symptoms._--Obscure and
insidious; some hours or even days may elapse before the
appearance of the symptoms.
(5) _Period of Fatal Termination._--In some cases as
short as four hours.
4. _Post-mortem_ Appearances--
(1) _Alimentary Canal._--Signs of irritation and
inflammation in the stomach and intestines. Gangrene and
perforation have been noticed. Strong smell of garlic
when the abdomen is laid open. Appearances not unlike
scurvy may be found.
(2) _Cellular Tissue._--Ecchymoses may be present in
the cellular tissue of the abdomen, chest, and other
parts of the body.
(3) _Muscular Tissue._--Fatty degeneration in the heart
and other organs of the body has been noticed in several cases.
(4) _Liver._--Fatty degeneration of the gland.
(5) Blood entirely disorganised, the cells transparent,
and their contents dissolved in the uncoagulated liquor
sanguinis. The colour, cherry-red.
5. _Name_ special affection produced by phosphorus in lucifer match
makers--Necrosis of the jaws, usually of the lower jaw. The disease
begins in a decayed tooth.
6. _Name_ a natural disease which phosphorous poisoning has been
supposed to resemble--Acute yellow atrophy of the liver.
IODINE
Iodine is seldom used as a poison, owing to the difficulty experienced
in disguising its colour. In the form of a strong solution it has been,
however, employed for throwing on the person with intent to cause
grievous bodily harm, as in this form it is corrosive, and destroys the
part which it touches.
_General Characters._--Iodine is a dark grey solid, with a bright
metallic lustre. It melts at 107° F., boils at 175° F., and gives off
at the ordinary temperature a faint odour not unlike chlorine. But
slightly soluble in pure water, it is, however, readily dissolved when
a soluble iodide is added to the water.
_Symptoms._--Those produced by irritant poisons generally; the severity
of the symptoms being increased by the strength of the solution, iodine
possessing corrosive as well as irritant properties. The vomited matter
will be stained with the iodine, and starchy material turned blue or
black.
_Post-mortem Appearances._--Those the result of acute irritant
poisoning.
_Fatal Period._--Two days.
_Fatal Dose._--One fluid drachm of the tincture has proved fatal;
recovery has taken place after taking one fluid ounce of the tincture.
_Treatment._--The stomach should be emptied by the aid of the stomach
pump, and then diluent drinks--arrowroot and barley water--may be given.
_Chemical Analysis._--Add bisulphide of carbon to the suspected
mixture, and shake them together. The sulphide will dissolve out
the iodine, which may be obtained on evaporation and sublimed. The
characteristic reaction of iodine, the development of a blue colour on
the addition of a small quantity of starch, will be conclusive evidence
of its presence. If chloroform be added to iodine in aqueous solution
and shaken up, the chloroform is coloured crimson by the iodine, and
falls to the bottom as the mixture is allowed to settle.
IODIDE OF POTASSIUM
This salt is largely used in medicine; and though poisonous effects may
be produced, due probably to some constitutional idiosyncrasy, it has
seldom been used as a poison. It must, however, be placed among noxious
irritant substances.
_General Characters._--Iodide of potassium--hydriodate of
potash--occurs in cubical crystals of a white or faint yellow colour,
very slightly deliquescent when pure, and with a feeble odour of iodine.
_Symptoms._--Iodide of potassium acts as an irritant in large doses,
producing also many of the symptoms which attend a violent catarrh,
with profuse discharge from the nose, lachrymation, and swelling
of the eyelids, also pustular eruptions like acne on the face and
body generally. Small doses--three to five grains--have produced in
some persons most unpleasant and even alarming symptoms. In chronic
poisoning, certain glands, the mammary and testicles, are said to
waste away. Salivation is not infrequently present. I have seen the
administration of the salt produce a severe bullous and hæmorrhagic
eruption, simulating hæmorrhagic smallpox, with sloughing. (See also
the account in _British Medical Journal_, 1878, of a case of purpura in
a child five months old, after a dose of two and a half grains of the
salt.)
_Treatment._--The use of emetics and the stomach pump, starch, &c.
_Chemical Analysis._--In solution, iodide of potash gives the following
characteristic reactions:
1. With a salt of lead Bright yellow precipitate.
2. With corrosive sublimate Bright scarlet precipitate.
3. With strong nitric acid and starch A blue colour.
In organic mixtures the mode of detecting it is more complicated.
Sulphuretted hydrogen should be first passed through the mixture in
order to convert any free iodine into hydriodic acid. The excess of the
gas is then driven off by the application of heat, and potash added,
the resulting liquor filtered, and the filtrate evaporated to dryness.
To get rid of any organic matter, the residue left after evaporation is
charred at a low red heat, reduced to powder, and dissolved in water.
This solution is then concentrated, and strong nitric acid and solution
of starch added, when, if iodine be present, the blue colour will be
developed.
CHAPTER IV
METALLIC IRRITANTS
ARSENIC
Arsenic is found as metallic arsenic, as arsenious acid, in the form of
two sulphides--realgar and orpiment, and as a constituent of several
ores--iron, copper, &c.
Metallic arsenic is of a steel-grey colour, brittle, and sublimes at
a temperature a little below 400° F., without, however, previously
fusing. The vapour of the metal has a peculiar garlic-like odour, which
is not possessed by any of its compounds.
Arsenious Acid
Arsenious anhydride--white arsenic--the most important of all the
compounds of arsenic, is colourless, odourless, and almost devoid of
taste. As found in commerce, it occurs under two forms--as a white
powder, and as a solid cake, which is at first nearly transparent, but
soon becomes opaque, and then resembles white enamel. At a temperature
of about 380° F. it sublimes, but is again deposited on cool surfaces
in the form of octahedral crystals. It is but slightly soluble in cold
water, only about half a grain to a grain being taken up by an ounce of
water. Stirred in boiling water, and then allowed to cool, from a grain
to a grain and a quarter is dissolved in the same quantity of water;
but when it is boiled for an hour, about twelve grains are dissolved
in the ounce of water. This solubility is, however, diminished by the
presence of any organic matter in the liquid. It is therefore less
soluble in infusions of tea or coffee than in pure water. A teaspoonful
of powdered arsenic is said to weigh 150 grains, and a pinch 17 grains.
Arsenious acid is used in the arts in the manufacture of certain green
colours, in dyeing, and in calico printing. A weak solution is employed
in medicine in the treatment of certain diseases of the skin, in ague,
and in other diseases.
It has been proposed to use arsenious acid, on account of its caustic
properties, as an application for cancerous tumours. The employment of
this substance for this purpose is by no means new; but its use has
been revived from time to time by the charlatan. In the year 1844, a
man was tried at the Chester Winter Sessions (R. _v._ Port) for the
murder of a woman whom he pretended to cure of a cancer by the use of
an arsenical plaster. In another case, recorded by M. Flandin, where
death occurred, the quack declared that he had not applied more than
_four_ or _five_ grains to the woman‘s breast. The powder used for this
purpose is generally composed of arsenious acid, realgar, and oxide of
iron. The above cases, to which many more might be added, attest to the
danger which attends the application of arsenic to the surface of the
body; it should, therefore, never be used, especially as a more safe
and potent caustic for this purpose is found in the chloride of zinc.
Some years ago, in London, several cases of severe arsenical poisoning
were due to the presence of arsenic in some cheap violet powder. In one
case the navel and scrotum of a baby were fearfully excoriated, due to
the use of this powder.
Farmers employ arsenious acid (white arsenic) for destroying vermin:
for steeping corn in order to destroy any spores of fungi; and it
also forms an ingredient in the wash for sheep. Injurious effects
have followed the accidental use of the corn thus treated, and those
employed in washing the sheep have suffered more or less severely.
By an Act of Parliament (14 Vict. cap. xiii. sec. 3), it is ordered
that if sold in small quantities, it must be mixed with the sixteenth
part of its weight of soot, or the thirty-second part of its weight
of indigo, ten pounds being the smallest quantity allowed to be sold
unmixed.
The presence of this admixture must be remembered, as a medical man
may be led into an error when the vomited matters are coloured blue,
black, or green, from the mixture of bile with the indigo. Arsenic is
not, as a rule, a corrosive poison. One case is, however, on record
where it acted as a corrosive, but the purity of the arsenic in that
case has been questioned. Its action is that of an irritant, causing
inflammation in the stomach and bowels of those who have taken it;
and it appears that fatal effects are produced whether the poison be
swallowed or introduced into the system in any other way--_e.g._ by
injection into the rectum or vagina, or applied to the surface of the
body.
Some observers hold that arsenic cannot be considered in the light
of an accumulative poison, others that it is so to a certain extent,
and that its elimination is not so rapid as was previously thought.
Given in medicinal doses, it is eliminated in from fifteen to twenty
days. Hence, in cases which have survived the immediate action of the
drug, no arsenic may be found in the body fifteen days after its fatal
administration. This is a fact of considerable importance. In the
case of Pierre Emile L‘Angelier, for whose murder Madeline Smith was
tried, Dr. Penny found 88 grains in the stomach, although the deceased
survived eight or ten hours after the probable period of taking the
poison, and vomited repeatedly during that time. At the above trial,
the question was suddenly raised, that if such a large quantity was
found after death in the stomach, it was scarcely possible to infer
the administration of a much larger quantity; and thus, that the
quantity must have been larger than another party could have secretly
administered, or naturally would attempt to administer. Drs. Mackinlay
and Wylie, of Paisley, obtained 60 grains, and Sir R. Christison 30
grains more, from the stomach of a man poisoned by arsenic administered
in whisky-punch sweetened, the arsenic being kept in suspension by
constant stirring.
Symptoms of Arsenical Poisoning
_Acute._--The rapidity and virulence of the symptoms are more or less
modified by the form (_e.g._ solution) and the dose taken. From half
an hour to an hour is the usual time which elapses before the symptoms
of poisoning present themselves. In one case, in which the poison was
in solution, the symptoms came on immediately after it was swallowed;
in another, after the lapse of ten hours. The patient first complains
of a feeling of faintness and depression, followed by intense burning
pain in the stomach, increased by the slightest pressure. Nausea and
vomiting, the latter increased by the act of swallowing, now occur. The
vomited matters may be dark brown, black, or bilious; or they may be
greenish from the indigo mixed with the arsenic coming in contact with
the yellow colouring matter of the bile. Blood may also be vomited.
Purging, accompanied with straining at stool, and cramps in the calves
of the legs may occur--the purging, like the vomiting, being incessant,
and affording no relief to the sufferer; the stools may contain blood,
or resemble those of cholera. The thirst is intense, and there may
be a feeling of throat irritation, the pulse feeble and irregular,
and the skin cold and clammy. The urine may or may not be suppressed.
As a rule, the symptoms in this form of poisoning are _continuous_;
but cases occur in which there are distinct _remissions_, and even
_intermissions_. Coma, paralysis, or tetanic convulsions may supervene
before death closes the scene.
_Certain anomalies may occur._--The pain may be absent or but slight.
Vomiting and purging do not occur in all cases, nor is thirst, a
most common and persistent symptom, always present. In some cases
the symptoms resemble those which accompany an attack of cholera. In
others, signs of collapse first make their appearance, from which the
patient may rally, or he may die outright. These variations in the
symptoms do not appear to be due to the _form_ or _quantity_ of the
poison taken. It should also be remembered that arsenic may produce
symptoms closely resembling those the result of _narcotic poisoning_.
_Chronic._--In whatever way the poison be exhibited in small and
repeated doses, there follows a peculiar and characteristic train of
symptoms, associated with (_a_) the general nutrition of the body,
(_b_) the facial appearance, (_c_) irritative disturbance of the
alimentary canal, (_d_) skin eruptions, and (_e_) implication of the
nervous system.
(_a_) The nutrition of the body is altered, there is gradual loss of
flesh with ragged growth of the finger-nails and falling out of the
hair. There may be œdema and jaundice in some cases.
(_b_) The face presents a peculiar appearance, the eyes are inflamed
and watery, the conjunctivæ reddened and congested, there is excessive
secretion from the nose resembling coryza.
(_c_) The disturbance of the digestive organs is revealed by the
dryness of the mouth and occasional excoriation of the tongue, which
may be reddened or covered with white fur and silvery in appearance;
salivation may be present instead of dryness of the mouth; there may
also be irritation of the throat; symptoms of gastro-enteritis, _e.g._
nausea and vomiting, anorexia, diarrhœa, or alternating diarrhœa and
constipation.
(_d_) The skin eruptions are of various kinds, and comprise eczema,
herpes, urticaria, erythema, keratosis, marked pigmentation and
exfoliation.
(_e_) The nervous symptoms are those of peripheral neuritis, numbness,
formication, hyperæsthesia, and tenderness, especially of the soles
of the feet, the latter presenting appearances of erythro-melalgia;
there is some amount of paresis, in some cases amounting to absolute
paralysis of the limbs affected. The hands may be anæsthetic, while
the feet are hyperæsthetic and hyperalgesic, and the perspiration much
increased. Mental symptoms are not common, but there may be hebetude,
or delusions.
In the Maybrick case, tried at the Liverpool Assizes in 1889, the
following symptoms arose from repeated administration of arsenic during
a period of probably about fourteen days. On April 27 Mr. Maybrick was
seized with vomiting after taking tea. On the next day the vomiting
continued, with foulness of the tongue, and he complained of stiffness
in the lower limbs. On May 1 he complained of feeling unwell after
taking luncheon, and he was sick on the following three days, and
complained of a tickling sensation in the throat, with retching. On May
7 he was still suffering from vomiting, diarrhœa had commenced, and the
throat was very dry and inflamed. On May 8 the diarrhœa was accompanied
by tenesmus. On May 9 the tenesmus was distressing, and he died on May
11.
Dr. Prosper de Pietra Santa describes a disease to which workers in
manufactories of paper coloured with Schweinfurt-green are liable,
characterised by the appearance of vesicles, pustules, _plaques
muqueuses_, and ulcerations on the exposed parts of the body,
fingers, toes, and scrotum. Arsenical poisoning has been mistaken
for nettle-rash, scarlet fever, and Addison‘s disease. In cases of
slow poisoning the symptoms resemble very much those of gastritis and
ulcer of the stomach, and death due to the action of arsenic has been
referred to “spontaneous inflammation of the bowels.”
It must be remembered that in some cases of acute arsenical poisoning,
when the acute symptoms have passed away, the nervous system exhibits
its effects at a later period; in one case paresis came on on the
fifth day, in another at the end of a week, and in a case recorded by
Seeligmüller four weeks elapsed before the onset of nervous symptoms.
_Post-mortem Appearances._--The appearances found after death depend
upon the quantity of the dose and the length of time which supervenes
between the taking of the poison and death. Inflammation of the stomach
is a marked effect of the action of this substance on the system;
and this condition is in most cases present whether the poison be
swallowed, sprinkled on an ulcerated surface, or rubbed into the skin.
The inflammatory redness, which may assume the appearance of _crimson
velvet_, may be found in cases where death has taken place in _two_
hours. It is sometimes found spreading over the entire surface of
the stomach; at others, at the cardiac end only. The red colour is
increased on exposing the stomach to the air. When the poison has
been swallowed, the stomach may be found covered with white patches
of arsenic, embedded in dark-coloured thick mucus, mixed with blood.
Dr. Paterson thus describes the condition of a stomach he examined:
Its lining membrane was generally very red and injected; but in
addition there were very numerous stellated patches of vivid red,
leading to a darker tint; in the centre of some of them was noticed a
minute clot of blood; in others, an exceedingly rough particle of a
crystalline substance, which was afterwards found to be arsenious acid.
Perforation of the stomach is extremely rare, if it has ever occurred,
but ulceration of the same organ has been observed in a person who
died from the effects of arsenic in _five_ hours (Christison, on
_Poisons_, p. 340). In opposition to all the statements just made it
has been shown that arsenic may prove fatal without leaving any sign of
inflammatory action (R. _v._ M‘Cracken; R. _v._ Newton).
The mouth, pharynx, and gullet are generally found free from any
inflammatory action. The small intestines may or may not be affected:
in most cases the duodenum alone shows any signs of irritation. The
rectum is that part of the large intestine most prone to inflammation.
I have seen marked ulceration of the colon after death from inhalation
of arseniuretted hydrogen. The other internal organs--the liver,
spleen, and kidneys--do not appear to be appreciably affected by
arsenic.
Due probably to the antiseptic properties of arsenic, the stomach and
intestines retain for a long period after death the appearances of
irritant poisoning. In two cases, this was so well marked as to be
visible--in the one case, _twelve_ months, and in the other, _nineteen_
months after interment. In suspected cases portions of the liver should
always be preserved and examined for arsenic.
=The Period after Death when Arsenic may be Detected=
Arsenic is an indestructible poison, and may be found in the body after
many years. In one case it was detected after the lapse of fourteen
years. Arsenic has the power, to a certain extent, of arresting
putrefactive changes; the stomach may, therefore, be found well
preserved, and with the signs of inflammatory action present after the
lapse of many months, and after putrefaction has far advanced in other
parts of the body. When a person is suspected of having been poisoned
with arsenic, and nothing but the skeleton is left for investigation,
the arsenic should be looked for specially in the bones of the pelvis
and the neighbouring vertebræ (_Watt‘s Dictionary of Chemistry_, Sup.).
In reference to the preservative action of arsenic upon the tissues of
those poisoned by it, the appearances of the bodies of the victims of
Flannagan and Higgins, recorded by Whitford (_B. M. J._, 1884, vol. i.
p. 504), are interesting. Arsenical poisoning having been established
in one of three victims, the bodies of two others, Mary Higgins, aged
ten years, and John Flannagan, aged twenty-four years, were exhumed
and examined. The abdominal viscera of Mary Higgins yielded one grain
of arsenious acid, and although the body had been interred for about
thirteen and a half months, it was well preserved. A remarkable
state of preservation obtained in the body of John Flannagan, who
had been interred for thirty-seven and a half months; the face and
body generally could be easily identified. Three and a half grains of
arsenious acid were found in the abdominal viscera. In these cases a
peculiar appearance was found in the stomach and intestines, consisting
of a golden-yellow pigment or coating of the mucous membrane of the
parts. It was thought by some observers to be composed of arsenic
sulphide, but Campbell-Brown, and Davies of Liverpool, as a result of
their analysis of it, found that it did not contain any appreciable
amount of arsenic, but consisted mainly of bile pigment.
In trials for arsenical poisoning, where an exhumation has been made,
the question may arise whether the arsenic found in the body has been
carried into it from the earth surrounding the coffin.
In reply, the following points must be kept in mind:
1. Arsenic may occur in certain calcareous and ochrey soils.
2. In these soils no arsenical compound _soluble in
water_ has been found.
3. The arsenic of these soils is dissolved out by
hydrochloric acid, proving their previous insolubility.
4. The arsenic is, therefore, probably in the form of an
arsenite or arseniate of iron, lime, &c.
5. Careful experiments have rendered it evident that even
“under the most favourable circumstances the dead human
body does not acquire an impregnation of arsenic from
contact with arsenical earth” (Taylor).
6. It has been suggested that the arsenical compound in the
soil may be rendered soluble by the ammonia formed during
putrefaction.
This last suggestion is negatived by the following facts:
1. The production of ammonia ceases before the body arrives at that
stage of decomposition when it is at all likely to be exposed to the
action of the soil of the cemetery.
2. The production of hydrosulphuret of ammonia during decomposition
would tend to the production of sulphuret of arsenic forming yellow
patches in the substance of the organs, thus rather fixing the arsenic
on particular parts than allowing it to percolate through the tissues
of the body from external application.
_Analysis of the Suspected Earth._--About two pounds of the earth
should be boiled for some time in water; supernatant liquid should then
be poured off from the insoluble residue, and filtered. The filtered
liquid, after concentration, may then be examined by the tests about to
be described. If no arsenic be found, the earth may now be boiled with
dilute hydrochloric acid, filtered, concentrated, and then tested as
before. The first process shows that no compound of arsenic soluble in
water is present; the second shows that the arsenic is in a state of
combination, and therefore not likely to impregnate the body.
=The Detection of Arsenic=
_General Directions._--In cases of suspected poisoning by arsenic or
antimony, the contents of the stomach should be mixed with distilled
water acidulated with hydrochloric acid and filtered, and the filtrate
placed in a stoppered bottle lettered or numbered “A” or “1.” The
liver should be cut into pieces, some of which should be bruised in a
mortar with distilled water acidulated as above mentioned, pressed and
filtered, and the filtrate placed in a bottle marked “B” or “2.”
The kidneys and portions of the other solid organs may also be treated
as above. Each solution so obtained may be then tested by the processes
about to be described. By these means the amount of poison in each
organ may be estimated.
Before subjecting the organic mixture to Marsh‘s or Reinsch‘s
processes, Brande and Taylor strongly recommend a modified course of
procedure.
The contents of the stomach, vomited matters, &c., and the solid
organs, finely divided, must each be separated and _thoroughly_ dried
in a water bath, then mixed with an excess of _strong_ hydrochloric
acid in a flask, and slowly distilled by means of a sand bath, the
distillate carried into a receiver containing a little pure distilled
water, and the process continued nearly to dryness.
If arsenic be present, the distillate contains the arsenic as
chloride, and can be at once subjected with great facility to the
usual tests for the presence of that metal. This mode of proceeding
both facilitates and expedites the ordinary methods of testing, as it
separates the arsenic present from the complex organic mixtures with
which it is associated, and presents it in a comparatively pure form
for identification. The process also admits of the residue left in the
retort being examined for lead and the other metallic poisons.
Before the following processes are applied, some of the sediment from
the contents of the stomach, or the vomited matters, may be collected
and well washed. If this is boiled in distilled water and filtered,
the following tests, known as “the liquid tests for arsenic,” may be
applied to the filtrate:
1. _Ammonia Nitrate of Silver_, prepared by adding
a weak solution of ammonia to a strong solution of nitrate
of silver, gives with arsenic a yellow precipitate of
_arsenite of silver_ soluble in nitric, citric, acetic,
and tartaric acids, and ammonia.
2. _Ammonia-Sulphate of Copper_, prepared by
adding ammonia to a dilute solution of sulphate of copper,
gives with arsenic a green precipitate of _arsenite of
copper_. This precipitate is soluble in the mineral and
vegetable acids and ammonia, but is not affected by soda or
potash. The precipitate, dried and heated in a reduction
tube, yields octahedral crystals of arsenious acid.
3. _Sulphuretted Hydrogen._--The suspected liquid
should be first slightly acidulated with _pure_
hydrochloric acid _before_ the sulphuretted hydrogen
gas is passed into it, when, if arsenic be present, a yellow
precipitate is formed, known to be such by the following
tests:
(1) Insoluble in water, ether, alcohol, the vegetable acids,
and dilute hydrochloric acid, but decomposed by strong
nitric and nitro-hydrochloric acids.
(2) Dissolved, if no organic matter present, forming a
colourless solution, when potash, soda, or ammonia is
added.
(3) The yellow precipitate dried and heated with soda and
cyanide of potassium yields a sublimate of metallic
arsenic.
_N.B._--None of the above tests should be
applied in the presence of organic matter. The
soluble salts of cadmium and per-salts of tin give
yellow-coloured precipitates with sulphuretted
hydrogen.
(4) If stannous chloride dissolved in strong hydrochloric
acid be added to a solution of arsenic in hydrochloric
acid, metallic arsenic is thrown down as a precipitate.
This is a fairly delicate test.
The following Table gives the differences between
the Yellow Precipitates formed with Sulphuretted Hydrogen
and Arsenic, Cadmium, and Per-Salts of Tin:
+------------------+-----------------+------------+--------------+
| | | | Per-Salts |
| | Arsenic. | Cadmium. | of Tin. |
+------------------+-----------------+------------+--------------+
|Colour. |Yellow. |Yellow. | Dirty yellow.|
| | | | |
|Action of ammonia.|Soluble. |Insoluble. | Insoluble. |
| | | | |
|Action of |Insoluble. |Soluble. | |
|hydrochloric acid.| | | |
| | | | |
|With cyanide |Sublimes as |Sublimes as | No sublimate.|
|flux. |metallic arsenic.|brown oxide.| |
+------------------+-----------------+------------+--------------+
_Marsh‘s Process._--This method for the detection of arsenic is
founded on the fact that the several compounds of arsenic, except the
sulphide and metallic arsenic itself, form a gaseous compound with
nascent hydrogen, from which it may be readily separated by appropriate
treatment. The solution to be tested should, therefore, be prepared as
proposed by Brande and Taylor, given on a preceding page.
_Precautions._--(1) Absolute purity of reagents. (2) The sulphuric acid
should be diluted with five times its weight of water, and allowed to
cool. (3) The suspected fluid should be added gradually. (4) Generate
the gas regularly. (5) If no stain be at once produced, keep a portion
of the exit tube red-hot for at least one hour.
The usual form of the apparatus is that of a =U=-shaped glass tube,
about one inch in diameter and eight inches high, supported in a
vertical position on a wooden stand. One end of the tube is fitted with
a tap, and terminates in a glass tube drawn to a fine point; the other
end is closed with a cork.
The apparatus is used as follows: A piece of pure zinc is dropped into
the tube, and shaken into such a position that it occupies the bottom
of that limb of the tube which is furnished with the tap. Water is
then added, and subsequently sufficient pure sulphuric acid to cause
a moderately brisk evolution of hydrogen. The production of hydrogen
gas from pure zinc and pure sulphuric acid is sometimes slow, and may
be facilitated by adding a few drops of platinic chloride solution to
the contents of the flask previous to the addition of the sulphuric
acid. The gas being allowed to accumulate for a short time, the tap
is then partially turned on, and the gas ignited; if, on depressing
a piece of white porcelain momentarily in the flame, no deposit or
discoloration occur, the reagents used may be taken as pure. By the
use of Thorpe‘s apparatus for Marsh‘s test, in which the hydrogen is
obtained by the electrolysis of water, the absence of arsenic in the
reagents and apparatus is ensured. The tap is now connected with a tube
of thin, hard glass, drawn out to a fine point at the end and having a
constriction in the middle. The liquid to be tested being now placed in
the apparatus, the gas is again ignited, and a piece of white porcelain
momentarily depressed in the flame, when, if arsenic be present, a
black, circular, metallic-looking stain will appear, which has the
following composition. In the centre is the unoxidised metal, round
this is a mixed deposit, and outside this the zone of arsenious acid.
While the gas is passing, the exit tube should be heated to redness a
little behind the constricted part, when a dark ring will appear if
arsenic be present. The black deposit on the porcelain may be either
arsenic or antimony, but may be distinguished as follows:
--------------------+---------------------------+--------------------
| Arsenic. | Antimony.
--------------------+---------------------------+--------------------
Nature of the stain.|Metallic brilliancy. |Absence of metallic
| |lustre.
| |
Effect of heat. |Volatile. |Non-volatile.
| |
Heated with a little|Dissolves. |Oxidises to a white
nitric acid. | |insoluble powder.
| |
Warmed with a strong|Dissolves immediately. |Slowly dissolved.
solution of chloride| |
of lime. | |
| |
Treated with |Detached but not dissolved,|Soluble: on
bisulphide |but if heated |evaporation,
of ammonium. |to drive off ammonia |_orange-yellow_
|_yellow sulphide_ |sulphide formed.
|formed. |
| |
The nitric acid |A brick-red precipitate |No reaction, but if
solution |soluble in ammonia. |ammonia and potash
evaporated to | |are added, a black
dryness gives with | |precipitate is
nitrate of silver. | |ultimately formed.
--------------------+---------------------------+--------------------
The portion of the tube on which the dark ring has been deposited is
now cut off, broken into fragments, and heated in a small, hard glass
tube--when, if arsenic be present, a white sublimate will be obtained
of well-defined octahedral crystals. If the sublimate be treated with
sulphide of ammonium, it is detached but not perfectly dissolved,
and on evaporation of the solution to dryness, a residue of the
yellow sulphide of arsenic will remain, which, if heated with strong
nitric acid, and evaporated again to dryness, will give a brick-red
precipitate with nitrate of silver solution, soluble in ammonia. The
process of Marsh may be used quantitatively by passing the issuing
gas through a glass tube, dipping into a strong solution of argentic
nitrate. A portion of the tube is kept at a red heat, when, if arsenic
be present, it is deposited in the metallic form in the cool portion.
The glass tube containing the stain is cut with a file and weighed.
The stain is then removed by strong nitric acid, the tube dried and
weighed: the difference in weight equals the amount of metallic
arsenic. The nitrate of silver solution is now treated with pure
hydrochloric acid, filtered, and the filtrate neutralised with sodium
carbonate, titrated with standard solution of iodine. By dipping the
end of the issuing tube into a fresh solution of argentic nitrate, the
absence of colour will show that all the arsenic has been obtained.
Instead of the =U=-shaped tube a Wolff‘s bottle or Erlenmeyer‘s flask
may be used, and the exit tube carrying off the gas bent twice upon
itself and connected with a glass bulb containing calcium chloride.
From this bulb the long, hard glass tube proceeds, pointed at the end
to form a gas jet; the gas is lighted at the end, and if a Bunsen flame
be applied at a short distance from the end, a deposit of the arsenic,
if present, will form on the distal side of the point at which the
flame is applied.
_Reinsch‘s Process._--First obtain a clear solution by filtration or
otherwise, and then proceed as follows: Strongly acidify the liquid
with hydrochloric acid, introduce some pieces of copper foil, and
heat to near the boiling-point of the liquid. Both the acid and metal
must be previously tested to ensure their freedom from arsenic. Any
arsenic present will then be deposited on the copper in the metallic
state, either in the form of a black lustrous deposit when the arsenic
is present in any quantity, or else as a steel-grey coating when a
minute quantity only is present. In either case, the copper foil, after
remaining for some time in the suspected fluid, is taken out, cut
into small pieces, introduced into the bottom of a hard glass tube,
and heated to low redness, when the arsenic will sublime as arsenious
acid in octahedral crystals, forming a ring in the cooler portion of
the tube. The deposit is identified as arsenious acid by the form of
the crystals, and by its deportment with the various reagents, as in
the treatment of similar sublimates mentioned under _Marsh‘s Process_.
Two precautions have to be taken in applying this test: do not use too
large a portion of copper foil at first, and do not remove the copper
too quickly from the boiling fluid. A solution containing arsenic acid
or an alkaline arsenite, mixed with sulphuric acid, does not produce
any deposit on metallic copper even after long boiling, unless the
quantity of the arsenic present be considerable; the deposition may,
however, be ensured by adding sulphurous acid or a sulphite, whereby
the arsenic is reduced to arsenious acid (G. Werther, _J. Pr. Chem._,
lxxxii. 286; _Jahresb._, 1861, p. 851).
_Objections to Reinsch‘s Process._--The chief objection to Reinsch‘s
process is the possible impurity of the reagents used--both these
reagents, even when supplied as pure, being liable to contain traces of
arsenic. As met with in commerce, both hydrochloric acid and metallic
copper invariably contain minute quantities of arsenic, the former
generally containing the larger quantity of that impurity. Although,
by purchasing the purest possible reagents, specially prepared for
analysis, it may be possible to ensure their freedom from arsenic,
yet in all cases they should be tested before using them. Some of the
hydrochloric acid should be diluted with distilled water, and gently
heated with the copper foil. If no tarnishing or deposit of any kind
occur on the metal after a lapse of several hours, the reagents may be
taken as pure and the trial of the suspected substance at once made.
Professor Abel has proposed the following process to ensure the
purity of the copper and acid: Boil together equal portions of strong
hydrochloric acid and a solution of perchloride of iron. While the
mixture is boiling immerse the copper foil, which, if pure, will be
merely brightened in colour; if impure, a black deposit on the metal is
formed.
[Illustration: Fig. 30.--Photo-micrograph of sublimate of arsenious
acid obtained by Reinsch‘s process, × 250. (R. J. M. Buchanan.)]