Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/36

 5. Difference of tissue is an interesting modifying power in a physiological point of view, but does not bear so directly on medico-legal practice as the rest, and may therefore be passed over cursorily.

On the corrosives and irritants a difference of tissue acts but indirectly: their effects vary not so much with the tissue as with the organ of which it forms part. But as to poisons which act through the blood, their energy must evidently depend on the activity of absorption in each texture.

The cutaneous absorption is slow, on account of the obstacle presented by the cuticle, and by the intricate capillaries of the true skin. Accordingly many active poisons are quite inert when applied to the unbroken skin, or even to the skin deprived of the cuticle. Hydrocyanic acid, perhaps the most subtle of all poisons, was found by Coullon to have no effect when dropped on the skin of a dog. Some authors have even gone so far as to deny that poisons can be absorbed at all through the skin, unless they are pressed by friction through the cuticle. But this is an error; most gaseous poisons, such as carbonic acid and sulphuretted hydrogen, and some solid poisons when volatilized, such as the vapours of cinnabar, will act though simply placed in contact with the skin; and there is distinct evidence that corrosive sublimate will bring on mercurial action in the form of warm bath, or when used as a liniment.

On the mucous membrane of the stomach and intestines, poisons act much more energetically than on the skin; which clearly depends in a great measure on the superior rapidity of absorption there,—or, according to some, on the facility with which poisons come in contact with the sentient extremities of nerves.

The serous membranes possess an activity of absorption which hardly any other unbroken texture can equal. Accordingly many poisons act much more rapidly through the peritonæum than through the stomach. When oxalic acid is introduced under the same collateral circumstances into the stomach of one dog and the peritonæum of another, the dose may be so apportioned, that the same quantity, which does not prove fatal to the former, kills the latter in fourteen minutes.

While the preceding modes in which poisons enter the blood are indirect, they may be introduced directly by a wound in the vein. There is no way in which poisons, that act through the blood, prove more rapidly fatal. Some which act very slowly through the stomach cause instant death when injected into a vein. A peculiar variety of this mode of introducing poisons deserves to be distinguished, namely, the application of them to a wound. If the surface bleeds freely, they may not act at all, because they are washed away. But if they adhere, they soon enter the divided veins. Hence, if they act in small doses, this mode of applying them is hardly less direct than if they were at once injected into a vein.

So far the effect of difference in tissue has been determined.