Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/240

 been able to ascertain any precise instance of the kind; and so far as my own experience goes, the habit of taking arsenic in medicinal doses has quite an opposite effect from familiarizing the stomach to it.

Oxide of arsenic being sparingly soluble, its operation is often much influenced by the condition of the stomach as to food at the time it is swallowed. If the stomach be empty, it adheres with tenacity to the villous coat and acts with energy. If the stomach be full at the time, the first portions that come in contact with the inner membrane may cause vomiting before it can be diffused, so that the whole or greater part is discharged. One remarkable case of this nature has been quoted in page 29. In another, where severe symptoms did supervene, and recovery was ascribed to the use of magnesia as an antidote, the favourable result seems to have been really owing to the circumstance, that the patient had supped heartily not long before taking the arsenic. An extraordinary case related by Mr. Kerr, in which nearly three-quarters of an ounce were retained for two hours without causing any serious mischief, probably comes under the same category; for the arsenic was taken immediately after a meal, and the stomach was cleared out by emetics.

In the following detail of the symptoms caused by arsenic in man, its effects when swallowed will be first noticed; and then some remarks will be added on the phenomena observed when it is introduced through other channels.

The symptoms of poisoning with arsenic may be advantageously considered under three heads. In one set of cases there are signs of violent irritation of the alimentary canal and sometimes of the other mucous membranes also, accompanied with excessive general depression, but not with distinct disorder of the nervous system. When such cases prove fatal, which they generally do, they terminate for the most part in from twenty-four hours to three days. In a second and very singular set of cases there is little sign of irritation in any part of the alimentary canal; perhaps trivial vomiting or slight pain in the stomach, but sometimes neither; the patient is chiefly or solely affected with excessive prostration of strength and frequent fainting; and death is seldom delayed beyond the fifth or sixth hour. In a third set of cases life is commonly prolonged at least six days, sometimes much longer, or recovery may even take place after a tedious illness; and the signs of inflammation in the alimentary canal are succeeded or become accompanied, about the second or fourth day or later, by symptoms of irritation in the other mucous passages, and more particularly by symptoms indicating a derangement of the nervous system, such as palsy or epilepsy. The distinctions now laid down will be found in practice to be well defined, and useful for estimating in criminal cases the weight of the evidence from symptoms.

1. In one order of cases, then, arsenic produces symptoms of