Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/556

 *pearance was found.—Of the same kind was a case communicated to me by Dr. Simson of this city, where the administration of three drops of laudanum in a chalk mixture, for diarrhœa, to a stout child fourteen months old, was followed by coma, convulsions, and death in about six hours. Dr. Simson satisfied himself, as far as that was possible, that the apothecary who made up the mixture did not commit a mistake.—Dr. Kelso of Lisburn met with a similar case in an infant of nine months, who died in nine hours after taking four drops. —My colleague, Dr. Alison, tells me he has met with a case where an infant a few weeks old died with all the symptoms of poisoning with opium after receiving four drops of laudanum, and that he has repeatedly seen unpleasant deep sleep induced by only two drops.—These remarks being kept in view, it will, I suspect, be difficult to go along with an opinion against poisoning expressed by a German medico-legal physician in the following circumstances. A child's maid, pursuant to a common but dangerous custom among nurses, gave a healthy infant, four weeks old, an anodyne draught to quiet its screams. The infant soon fell fast asleep, but died comatose in twelve hours. There was not any appearance of note in the dead body; and the child was therefore universally thought to have been killed by the draught. But the inspecting physician declared that to be impossible, as the draught contained only an eighth of a grain of opium and as much hyoscyamus. In the first edition of this work an opinion was expressed to the same purport. But the facts stated above throw doubt on its accuracy, and rather show that the dose was sufficient in the circumstances to occasion death.

A very important circumstance to attend to in respect to the dose of opium required to prove fatal is the influence of constitutional circumstances in rendering this drug unusually energetic. In some persons this peculiar anomaly exists always, even during a state of health. Thus, I am acquainted with a gentleman on whom seven drops of laudanum act with great certainty as a hypnotic. In such a one doses, which are safely taken by many, might prove dangerous.

It is more usual, however, to meet with this anomaly in the course of some diseases. These have not yet been satisfactorily indicated. I have several times, however, met with unusually energetic action from medicinal doses in elderly persons affected with severe habitual catarrh; and in one instance death occurred after a dose of twenty-five drops in the advanced stage of acute catarrh supervening on its chronic form, the symptoms being those of poisoning with opium, succeeding apparently a state of comfortable sleep.—A case seemingly of the same nature, where the dose was fifteen drops of Battley's Sedative Liquor, occurred at Islington in 1841. An elderly lady, in delicate health, and affected severely with asthma, which for ten days prevented her from sleeping, got from a neighbouring druggist a draught of Battley's solution, syrup, and camphor-mixture. Next morning she was found insenssible and livid in the face, with cold