Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/17

 *nected with appreciable organic change, may arise from the action of poisons. Yet the existence of impressions of the kind is essential to the stability of the doctrine of the sympathetic operation of poisons,—that is, of the transmission of their influence from organ to organ along the nerves. Nay, in the instance of many poisons supposed to act in that manner, we must still farther believe in the existence of primary nervous impressions, which are not only unconnected with organic change, but likewise undistinguishable by any local sign whatsoever.

Of the three varieties in the local effects of poisons—corrosion, irritation, and nervous impressions,—the first two may take place in any tissue or organ; for example, they have been observed on the skin, on the mucous membrane of the stomach, intestines, windpipe, air tubes, bladder, and vagina, in the cellular tissue, in the serous membranes of the chest and abdomen, in the muscular fibre. We are not so well acquainted with the nature of local nervous impressions on different tissues; but it is probable that in some textures of the body they are very indistinct.

So much for the local effects of poisons.

On tracing the phenomena which follow more remotely, we observe that the affected part sometimes recovers without any visible change, sometimes undergoes the usual processes consequent on inflammation, sometimes perishes at once and is thrown off; and if the organ is one whose function is necessary to life, death may gradually ensue, in consequence of that function being irrecoverably injured. The purest example of the last train of phenomena is to be seen in the occasional effects of the mineral acids or alkalis: death may take place simply from starvation, because the inner surface of the stomach and intestines is so much injured that a sufficient quantity of nutriment cannot be assimilated.

But death and its antecedents can seldom be accounted for in this way. For symptoms are often witnessed, which bear no direct relation to the local injury: death is generally too rapid to have arisen from the function of the part having been annihilated: and the rapidity of the poisoning is not proportional in different cases to the local injury produced. Even the mineral acids and alkalis seldom kill by impeding or annihilating digestion, because they often prove fatal in a few hours; and among other poisons there are few which ever cause death simply by disturbing the function of the part primarily acted on. Death and the symptoms preceding it arise from an injury of some other organ, to which they are not and cannot be directly applied. We are thus led to consider their remote action.

The term remote is here used in preference to the common phrase general action, because the latter implies an action on the general system or whole body; whereas it appears that an action of such a kind is rare, and that most poisons which have an indirect action exert it on one or more of the important organs only, and not on the general system.

There is not a better instance of the remote action of poisons than