XXXIV. OF POISONS OF THE UMBELLIFEROUS ORDER OF PLANTS
The Natural Order Umbelliferæ contains a variety of plants, to which narcotico-acrid properties have been at different times ascribed. But these properties have been satisfactorily traced in the instance of four species only, the Conium maculatum, Œnanthe crocata, Cicuta virosa, and Æthusa cynapium. It is supposed that others may be poisonous. But the facts on the subject are equivocal; for the several species of the family are very apt to be confounded with one another, and there is reason to think that other species have repeatedly been mistaken for one of the four already mentioned.
The symptoms caused by the umbelliferous narcotics comprehend chiefly coma, convulsions, paralysis, and delirium. But the knowledge possessed on this head is rather vague, and the phenomena are not unfrequently complex and difficult to observe with accuracy; so that their nature has been sometimes misunderstood. The irritant properties of the poisons of this tribe of narcotico-acrids are seldom well defined.
Of Poisoning with Hemlock.
The first to be mentioned is the common hemlock, or Conium maculatum, one of the most abundantly diffused of umbelliferous vegetables. It is distinguished from all those which it resembles by its tall, smooth, spotted stem,—its smooth leaves,—the rugged edge of the five ribs of its fruit,—its singular mousy odour,—and the very peculiar odour of conia, emitted when the pulp or juice of the leaves is mixed with caustic potash. The only other umbelliferous native which has a spotted stem, the Myrrhis temulenta, is easily distinguished from hemlock by the whole plant being very hairy.
Cases of poisoning with hemlock are not infrequent on the continent, the root having been mistaken for fennel, asparagus, parsley, but particularly parsnep.[2217] It is generally believed to have furnished the poison which was used in ancient times, and especially among the Greeks, for despatching criminals; but we have not any precise information on the subject.
A peculiar alkaloid was indicated in hemlock not long ago by Brandes, half a grain of which killed a rabbit with symptoms like those of tetanus.[2218] Other chemists were unable to obtain his results. But the subject was afterwards taken up with success by Geiger, who obtained from the plant a volatile, oleaginous alkaloid, which possesses great energy as a poison.[2219] Mr. Morries-Stirling procured from hemlock by destructive distillation an empyreumatic oil similar in properties to those of hyoscyamus, stramonium and tobacco, but producing in animals a state of pure coma.[2220]
The effects of hemlock on the animal system have been variously described by different observers. Sometimes they have appeared to be purely soporific like those of opium; at other times they have resembled the effects of belladonna and thorn-apple; and in the lower animals they are quite different, as I have witnessed them, from what they have been described to be in man,—the phenomena being simply those of asphyxia from paralysis of the muscles, without material convulsions and without insensibility. Its irritant action is not well established.
Orfila observed that an ounce of the extract of the leaves killed a dog in forty-five minutes when swallowed, ninety grains killed another through a wound in an hour and a half, and twenty-eight grains another through a vein in two minutes. It therefore acts by entering the blood-vessels. The extract is a very uncertain preparation; the reason of which is, that the alkaloid conia is very easily decomposed in its natural state of mixture by heat or age, being converted into an inert resinoid matter,—that the dried leaves of hemlock contain scarcely any of it,—and that even an extract of the fresh leaves contains little, unless prepared with a gentle heat, yet speedily.[2221] The symptoms remarked by Orfila were convulsions and insensibility; and in the dead body the blood of the left cavities of the heart was sometimes found arterial.—The result of my observations is quite at variance with this statement. In various experiments with a strong extract prepared from the green seeds with absolute alcohol, the only effect I could remark were palsy, first of the voluntary muscles, next of the chest, lastly of the diaphragm,—asphyxia in short from paralysis, without insensibility, and with slight occasional twitches only of the limbs, and the heart was always found contracting vigorously for a long time after death. Thirty grains of a soft extract introduced between the skin and muscles of the back killed a rabbit in five minutes, and a five months’ puppy in twenty minutes.[2222]
The root is much less energetic than is represented by some authors, and probably varies in this respect at different seasons. I have found that four ounces and a half of juice, the produce of twelve ounces of roots collected in November, had no effect on a dog when secured in its stomach by a ligature on the gullet; and that four ounces obtained from ten ounces of roots in the middle of June, when the plant was coming into flower, merely caused diarrhœa and languor. Orfila had previously observed that three pounds of roots had no effect in the month of April; but that two pounds in the end of May, when the plant was in full vegetation, killed a dog in six hours.[2223] The alcoholic extract of the juice obtained from six ounces of roots on the last day of May, I have found to kill a rabbit in thirty-seven minutes, when introduced in a state of emulsion between the skin and muscles of the back; and the effects were analogous to those obtained with the extract of the leaves. The differences depending on season will probably account for various persons having found the juice of the root harmless. Gmelin quotes an instance where four ounces of the juice were taken without injury. He adds another where three ounces of the juice of the herb were swallowed daily for eight days with as little effect. But, as he judiciously observes, other less active plants have probably been sometimes mistaken for hemlock.[2224]
The alkaloid, conia, seems to be the active principle of hemlock, and is a poison of extraordinary virulence. On investigating this subject in 1835,[2225] I found that it is a local irritant, possessing an acrid taste, and capable of exciting redness or vascularity in any membrane to which it is applied; but that these topical effects are readily overwhelmed by its swift and intense narcotic action. This action consists of swiftly spreading palsy of the muscles, which affects first those of voluntary motion, then the respiratory muscles of the chest and abdomen, and lastly the diaphragm, so as to terminate by causing asphyxia. The paralytic state is usually interrupted from time to time by slight convulsive twitches of the limbs and trunk at the beginning. The muscular contractility is impaired or annihilated by the topical action of the poison, but not by its indirect action through absorption. The heart is not appreciably affected; for it contracts vigorously long after all motion, respiration, and other signs of life are extinct; and it contains after death, not florid but dark blood in its left cavities. The blood undergoes no alteration. The external senses are little, if at all impaired, until the breathing is almost arrested; and volition too is retained. But a contrary inference may be drawn by a careless observer, in consequence of the paralytic state taking away the means, by which in animals sensation is expressed and volition exercised. The action of conia, in short, is confined to the spinal cord; and it acts as a sedative, by exhausting the nervous energy.
Conia is probably a deadly poison to all orders of animals: at least I found it to be so to the dog, cat, rabbit, mouse, frog, fly, and flea; and Geiger killed the kite, pigeon, sparrow, slow-worm, and earth-worm with it. It acts through every texture where absorption is carried on readily, through the stomach, eye, lungs, cellular tissue, peritonæum, or veins; and its activity is in proportion to the speed with which absorption is carried on in the part. It acts therefore through absorption. Its activity is increased by neutralization with an acid, by which it is rendered much more soluble in water. Few poisons equal it in subtility and swiftness. A single drop, applied to the eye of a rabbit, will kill it in nine minutes; and three drops in the same way will kill a strong cat in a minute and a half. Five drops, introduced into the throat of a little dog, began to act in thirty seconds, and proved fatal in one minute. And when two grains, neutralized with thirty drops of weak hydrochloric acid, were injected into the femoral vein of a young dog, it died before there was time to note the interval, so that only two or three seconds at most had elapsed, before all internal signs of life were extinct. This extraordinary rapidity of action seems incompatible with its operation taking place by conveyance of the poison with the blood to the spinal cord. Mr. Blake, as formerly mentioned (p. 15), denies that its action in this way was ever so swift in his hands, and alleges that he could never observe the interval to be shorter than fifteen seconds. If the reader, however, will consult the original account of my experiment,[2226] which was made along with Dr. Sharpey, he will see that we could scarcely be mistaken as to the interval in that instance.
Symptoms in Man.—M. Haaf, a French army-surgeon, has described a fatal case of poisoning with hemlock, which closely resembled poisoning with opium. The subject of it, a soldier, had partaken along with several comrades of a soup containing hemlock leaves, and appeared to them to drop asleep not long after, while they were conversing. In the course of an hour and a half they became alarmed on being all taken ill with giddiness and headache; and the surgeon of the regiment was sent for. He found the soldier, who had fallen asleep, in a state of insensibility, from which, however, he could be roused for a few moments. His countenance was bloated, the pulse only 30, and the extremities cold. The insensibility became rapidly deeper and deeper, till he died, three hours after taking the soup.[2227] His companions recovered.
Dr. Watson has briefly described two cases which were fatal in the same short space of time. The subjects were two Dutch soldiers, who, in common with several of their comrades, took broth made with hemlock leaves and various other herbs. Giddiness, coma, and convulsions were the principal symptoms. The men who recovered were affected exactly as if they had taken opium.[2228]
When the dose is not sufficient to prove fatal, there is sometimes paralysis, attended with slight convulsions, as in a case noticed by Orfila.[2229] More commonly there is frantic delirium. Matthiol has related an instance of this last description, occurring in the cases of a vine-dresser and his wife, who mistook the roots for parsneps Both of them became in the course of the night so delirious that they ran about the house, knocking themselves against every object which came in their way.[2230] Kircher, as quoted by Wibmer, tells a parallel story of two monks who became so raving mad after eating the roots, that they plunged into water, imagining that they were turned into geese, and they were affected for three years with incomplete palsy and neuralgic pains.[2231] These and some other cases of the like kind, recorded by the older medical authors, must be received with reserve. Independently of other considerations, there is often no certainty that the poison was really the hemlock of modern botanists, and not some other umbelliferous vegetable.
Morbid Appearances.—In Haaf’s case the vessels of the head were much congested; and the blood must have been very fluid, for on the head being opened a quantity flowed out, which twice filled an ordinary chamber-pot. This state of the blood likewise occurred in a case which I examined here some years ago along with Dr. C. Coindet of Geneva. A hypochondriacal old woman took by advice of a neighbour two ounces of a strong infusion of hemlock leaves with the same quantity of whisky, which she swallowed in the morning fasting. She died in an hour, comatose and slightly convulsed. The vessels within the head were not particularly turgid; but the blood was everywhere remarkably fluid. Dr. Coindet subsequently found that a small portion of the infusion prevents fresh drawn blood from coagulating; but I suspect there must have been some mistake here, for a carefully prepared alcoholic extract of very great power, which was used in my experiments alluded to above, had no such effect on blood fresh drawn from rabbits and dogs. On account of this extreme fluidity of the blood, it often flows from the nose, but the skin is much marked with lividity.[2232] The fluidity of the blood is nothing more than the result of the proximate cause of death,—slowly formed asphyxia.
Of Poisoning with Water-Hemlock.
Another plant of the order Umbelliferæ, the water-hemlock or Cicuta virosa, possesses also great energy as a poison; and in its effects it appears to resemble considerably the hydrocyanic acid. The plant is indigenous. It is easily known from other umbelliferous species inhabiting watery places by the peculiar structure of its root-stock, which is not fleshy, but hollow, and composed of a number of large cells with transverse plates.
From a numerous set of experiments with the root of the cicuta performed by Wepfer, it appears to cause true tetanic convulsions in frequent paroxysms, and death on the third day.[2233] Simeon ascertained that the alcoholic extract of the root is very poisonous.[2234] Schubarth found that an ounce of the juice of the stems and leaves, collected after the flowers had begun to blow, produced no effect on the dog.[2235] It is probably inert, or at all events feebly poisonous in this climate, although it grows luxuriantly in many localities. I have found that twelve ounces of juice, expressed from sixteen ounces of roots in the beginning of August, merely caused some efforts to vomit, when secured in the stomach of a dog by a ligature on the gullet; that the alcoholic extract of twelve ounces of leaves gathered at the same time had no effect when introduced in the form of emulsion between the skin and muscles of the back of a rabbit; and that the alcoholic extract of two ounces of unripe seeds proved equally inert when imployed in the same way.
Symptoms in Man.—Wepfer has likewise related several instances which occurred in the human subject. Among the rest he has described the cases of eight children who ate the roots instead of parsneps. Of those who were seriously affected, one, a girl six years old, who ultimately recovered, had tetanic fits, followed by deep coma, from which it was impossible to rouse her for twenty-four hours. Two of them died. The first symptoms in these two were swelling in the pit of the stomach, vomiting or efforts to vomit, then total insensibility, with involuntary discharge of urine, and finally severe convulsions, during which the jaws were locked, the eyes rolled, and the head and spine were bent backwards, so that a child might have crept between the body and the bed-clothes. One of them died half an hour after being taken ill, and the other not long after.[2236] Mayer of Creutsburg mentions four cases, which were occasioned by the roots. One of the individuals, a child three years old, was attacked with colic, vomiting, and convulsions, and died in a few hours. The three others, the eldest of whom was six years of age, had coldness, paleness of the features, dilated immoveable pupils, violent colic, general spasms, and insensibility. The action of the heart was intermitting and the breathing oppressed. After the remains of the roots were brought up by emetics, and infusion of gall was administered, they gradually recovered. They had eaten between them no more than a single root weighing about two ounces, as they had in their possession another of that weight, which they said was not so large. This accident happened in the middle of March.[2237]
According to Guersent, poisoning with the cicuta commences with dimness of sight, giddiness, acute headache, anxiety, pain in the stomach, dryness in the throat, and vomiting.[2238]
Mertzdorff has related the particulars of the inspection of three cases which proved quickly fatal with convulsions and vomiting. Nothing remarkable seems to have been found except great gorging of the cerebral vessels.[2239]
Of Poisoning with Hemlock Dropwort.
The Œnanthe crocata of botanists, the hemlock dropwort, five-finger-root, or dead-tongue of vernacular speech in England, a species of the same family with the last two, and an abundant plant in some localities throughout this country, has usually been held one of the most virulent of European vegetables. It seems well entitled to this character in general; but climate, or some other more obscure cause, renders it inert in some situations.
It is said to be liable to be confounded with common hemlock, or Conium maculatum,—a mistake which can happen only in very ignorant hands. It has smooth, dark-green leaves, more fleshy, and much less minutely divided, than those of hemlock; it presents a purplish appearance at the joints only of the stem, and no diffused purple spots; its fruit is oblong and black, not round, rough, and light brown; and its root, instead of being single, long, tapering, and little branched, consists of from two to ten tubers, like fingers, which are white, and terminate in a few rootlets. These tubers are formed annually in summer from the flowering stem of the season, and send out flowering stems the subsequent year. During the first autumn, winter, and spring they are firm, white, and amylaceous; but in their second summer they become more pulpy, less amylaceous, and grayer. At all times they emit, when broken across, an oleo-resinous juice, which quickly becomes yellow; this juice abounds most when the plant, which is growing at their expense, is about to flower; and it abounds much more at this period in localities in the south of England, than in Scotland, especially in the neighbourhood of Edinburgh.
Brotero and some others have attempted to subdivide the species into two, the Œnanthe crocata proper, and the Œ. apiifolia. But the best authorities deny that these can be distinguished; and from what I have now seen in sundry localities, it appears to me that the distinctions pointed out by Brotero, confessedly obscure enough in themselves, are the result of differences in climate, soil, and situation.
The only analysis of this plant with which I am acquainted is one executed in 1830 by MM. Cormerais and Pihan-Dufeillay, who found in the root a resinoid matter, which adheres obstinately to the solid portion of it, and which seems to be the active ingredient.[2240] I have subjected the roots to various processes, and among the rest to that by which Geiger detected conia in hemlock, but without discovering any indication of the existence of an alkaloid. My materials, however, were not well fitted for a chemical analysis; because the œnanthe root of this neighbourhood is inert or nearly so. The whole plant contains a heavy-smelling volatile oil, which may be obtained by distillation in the usual way, and most abundantly from the ripe seeds. This oil is yellowish, viscid, and inert.
It is strange that a plant, so universally considered a potent poison, and so frequently the cause of fatal accidents, has not yet been made the subject of physiological investigation. A few imperfect experiments by M. Cormerais and his companion, made with the resinoid matter of the roots, show that this substance produces in animals dulness, convulsions of the voluntary muscles, a semi-paralytic state of the hind legs, and sometimes shortness of breath, vomiting, and fluid evacuations by stool. All the animals experimented on recovered. On repeating these experiments with larger quantities I found the resin of the root, grown near Woolwich, and kindly sent to me by Dr. Pereira, to be a poison of great energy and singular properties. Twenty-four grains obtained from eight ounces of roots in the middle of December, when introduced in the form of emulsion between the skin and muscles of the rabbit, caused in half an hour depression, uneasiness, and hurried breathing,—then twitches of the ears, neck, and fore-legs,—next combined spasm and convulsive starting of the head and limbs,—then, after a quiet interval, a more violent fit of the same kind, affecting the whole body with a singular combination of tetanus and convulsive starting,—finally, after several such fits, a paroxysm more violent than before, ending in immoveable tetanic rigidity, which speedily proved fatal, 78 minutes after the application of the poison. No morbid appearance could be detected in the body. The heart contracted vigorously for some time after death. These phenomena correspond in the main with what has been recorded of the symptoms caused by the roots in man.—Dr. Pereira informs me he had found the juice both of the root and leaves to act as a poison, either when introduced into the peritonæum, or when injected into the veins; and in the latter way it was so energetic as to prove fatal in one minute.
Symptoms in Man.—Since Lobel first took notice of the poisonous properties of the œnanthe root in 1570, an uninterrupted series of observations has been published, down to the present day, showing that in France, Germany, Holland, Spain, and various parts of England as far north as Liverpool, it is at all seasons of the year, even in October and in the beginning of January, a poison of great activity. In several of the cases death has been occasioned by a single handful of the roots, in one instance by a piece no bigger than the finger, or even in consequence of the individuals merely tasting them. A girl seems to have had a narrow escape after eating, with an interval of three hours, two pieces of the size of a walnut. Very seldom has death been delayed beyond four hours, and on some occasions a single hour has been sufficient. Sometimes the symptoms have been slow in making their appearance, an hour and a half having occasionally elapsed before the effects were evident; but in every instance their progress was rapid, once the symptoms had fairly set in; and some died in convulsions almost immediately after being taken ill.
The particular effects have been variable. Most generally the first symptoms have been giddiness and staggering, as if from ordinary intoxication, occasionally headache, and often extreme feebleness of the limbs. Stupor has then generally succeeded, sometimes with the intervention of efforts to vomit, sometimes too with an interval of delirium. Convulsions have also commonly made their appearance in the next place; and ere long a state of insensibility has ensued attended in every instance with occasional violent convulsive fits like epilepsy, and with permanent locked-jaw; which symptoms have continued till near death. In one or two cases the individual has suddenly, without any premonitory symptoms, fallen down convulsed, and died almost immediately. In one or two instances again, the effects have rather been those of irritant poisoning, namely, inflammation of the mouth and throat, spasms of the muscles of the throat, vomiting, and excessive weakness and faintness, without any convulsions or insensibility.—It appears then that this plant is a true narcotico-acrid poison. The emanations from the plant are said on some occasions to have proved injurious; but the effect here was probably the work of the imagination.
Aware of these singular properties being generally ascribed to the Œnanthe crocata, I was anxious to make a methodical examination of the subject, physiologically as well as chemically,—especially as the plant grows in great abundance and very luxuriantly in a locality not far from Edinburgh. But I have found it in that situation, to all appearance, quite inert. The juice of fourteen ounces of the root in the end of October had no effect on a little dog when secured in the stomach by a ligature on the gullet. The juice of sixteen ounces in the middle of June was also without effect. An alcoholic extract of four ounces of the full grown leaves in the end of June, introduced into the cellular tissue in the form of emulsion, had no effect on a rabbit. An alcoholic extract of three ounces of the ripe seeds was administered in the same way with the same result. Finally, the resinoid extract of eight ounces of the root, analogous to that which had proved so deadly in my hands when obtained from Woolwich plants, had also no effect whatever, when prepared from those growing in the neighbourhood of Edinburgh. Relying upon these results, I ate a whole tuber weighing an ounce, without observing any effect, except its disagreeable taste; which was the only circumstance that prevented me from trying a larger quantity.—It may be well to add, that, amidst the numerous cases of poisoning with œnanthe now on record, there is not one that has occurred in Scotland. At the same time, the common people in Scotland are not at all given to rash experiments in cookery, or to make use of vegetables not produced by the care of the gardener or farmer.[2241]
The only other locality from which I have been hitherto able to obtain plants for examination is the neighbourhood of Liverpool, where a fatal case of poisoning with it occurred near the close of last century. When the juice of sixteen ounces of this root in the beginning of September was secured in the stomach of a dog, efforts to vomit were produced, followed by several fits of violent convulsions and spasm of the voluntary muscles, a paralytic state of the fore-legs, and a constant tendency to fall backwards; but the animal recovered.
No morbid appearances of any note have been observed after death in any of the fatal cases which are recorded.—The most appropriate treatment consists in the prompt employment of emetics, and diffusible stimulants.
Of Poisoning with Fool’s Parsley.
Another umbelliferous plant of great activity is fool’s parsley, or Æthusa cynapium. It has occasioned several accidents by reason of its resemblance to parsley,—from which, however, it is at once distinguished by the leaves being dark and glistening on their lower surface, and by the nauseous smell they emit when rubbed. It contains an alkaloid, which crystallizes in rhombic prisms, and is soluble in water and alcohol, but not in ether. It was discovered by Professor Ficinus of Dresden.[2242]
Orfila found that six ounces of the juice, when retained in the stomach of a dog, by a ligature, caused convulsions and stupor, and death in an hour.[2243]
Symptoms in Man.—Some interesting information on the characters and properties of this plant is contained in the Medical and Physical Journal. Among other cases the writer relates those of two ladies who ate a little of it in a sallad instead of parsley, and who were soon seized with nausea, vomiting, headache, giddiness, somnolency, pungent heat in the mouth, throat, and stomach, difficulty in swallowing and numbness of the limbs.[2244] Gmelin has related the case of a child, who died in eight hours in consequence of having eaten the æthusa. The symptoms were spasmodic pain in the stomach, swelling of the belly, lividity of the skin, and difficult breathing.[2245] In two children who recovered, the chief symptoms at the height of the poisoning were complete insensibility, dilated, insensible pupil, and staring of the eyes. In one of them there was also frequent vomiting, in the other convulsions. The treatment consisted in the administration of milk, sinapisms to the legs, and cold spunging with vinegar.[2246]
XXXV. OF THE NARCOTIC RANUNCULACEÆ
The greater part of the poisons belonging to the Natural Family Ranunculaceæ are acrid only in their action, and have been already taken notice of among the irritants. Two only are yet known to possess narcotic properties, namely, monkshood, and black hellebore. The latter is a true narcotico-acrid. The former has till lately been always considered so; but its acrid properties seem doubtful or feeble, while its action on the nervous system is most intense.
Of Poisoning with Monkshood.
Monkshood, the Aconitum napellus of botanists, is an active poison, and has commonly been considered a true narcotico-acrid. But its effects have been hitherto much misunderstood. It has been used for criminal purposes in Ireland; and in 1841, a woman, M’Conkey, who was executed there for poisoning her husband, was proved to have administered this substance [see p. 61]. The root of another species, the A. ferox, is well known to be in common use as a poison, under the name of Bikh, in Bengal, and Nabee, in the Madras Presidency.
The toxicological history of the genus, and of this species in particular, has been rendered complex and obscure, by the extreme difficulty of distinguishing accurately the several species from one another. The whole genus, now a numerous one, is generally conceived to be eminently poisonous. But from some observations of my own, as well as an elaborate inquiry, not yet made public, by Dr. Alexander Fleming,[2247] a recent graduate of this university, I am inclined to think that this is a mistake, that the poisonous species are not numerous, and that many aconites are inert, at least in this climate.
The A. napellus, a doubtful native of Britain, and the most common species in our gardens, shoots up annually a leafy stem from a black, tapering, spindle-shaped root. The stem, which is from two to five feet high, ends in a long dense spike of fine blue flowers; and when the seeds ripen in autumn, it dies down, and the root also shrivels and perishes. But in the spring, while the stem is rising, one or more tubers form near the crown of the root; each tuber quickly assumes the spindle-shaped form of its parent, but has a light brown, instead of a brownish-black tegument; and when the plant is in flower, the new tuber, destined for the root of next year’s plant, is as large as the parent one, firmer, more amylaceous, and not so apt to shrivel in drying. This mode of propagation has led some to describe the root erroneously as sometimes palmated. Dr. Fleming considers the young, full-grown tuber to be the most active part of the plant; but the root of the existing plant, the leaves, and also the seeds, are highly energetic; and every part is more or less so.
Every part of the A. napellus, but especially the root, affects remarkably the organs of taste, producing a very singular sense of heat, numbness, and tingling of those parts of the mouth to which it is applied. Dr. Fleming has ascertained, that this peculiar taste, or rather sensation, is a property belonging to the narcotic principle of monkshood, and that in all probability it is a measure of the activity of the plant as a poison. It is most intense in the root, next in the seeds, and next in the leaves before the flowers blow. Geiger first ascertained, and I have since observed, that the sensation thus occasioned by the leaves diminishes in intensity as the flowers expand, and almost disappears when the seeds ripen. Contrary to what has been often stated, it is not diminished by drying the leaves, even with the heat of the vapour-bath. Nor is it materially lessened by time, if the dried leaves be preserved with care; for I have found it intense after six years. Geiger observed some years ago, that several species or varieties do not possess it. I have ascertained that A. napellus, sinense, tauricum, uncinatum, and ferox, possess it intensely, A. schleicheri and nasutum feebly, A. neomontanum very feebly; all of which are therefore probably poisonous, in proportion to the intensity of their taste. A. ferox, well known as a deadly poison in the East, and undoubtedly the most virulent of all the species, produces by far the most intense and persistent effect on the mouth of all the species I have had an opportunity of examining. Those which do not produce it at all, at least in this climate, are A. paniculatum, lasiostomum, vulparia, variegatum, nitidum, pyrenaïcum, and ochroleucum. It would be premature to say that all these species are inert; but I suspect they are: and, at all events, I have ascertained that the leaves of A. paniculatum, although the officinal species recognised in the London Pharmacopœia, are quite inactive in this climate; and Dr. Fleming has found the root inert in medicinal doses of considerable magnitude.
The properties of monkshood have been traced by Geiger and Hesse to a peculiar alkaloid, named aconitina: which is white, pulverulent, fusible, not volatile, soluble in ether and alcohol, sparingly so in water, and capable of forming crystallizable salts with acids. It produces most intensely the peculiar impression caused by the plant on the mouth, tongue, and lips; and it is a poison of tremendous activity, probably indeed the most subtle of all known poisons. Although not a volatile principle, it has been supposed peculiarly liable to decomposition by heat, at least in its natural state of combination in the plant or its pharmaceutic preparations. This opinion is founded on the uncertainty of the medicinal action of the common extract of the shops, and on the results of experiments on animals by Orfila.[2248] In one experiment he found that half an ounce of the extract of the Parisian shops had no effect at all on a dog, while a quarter of an ounce killed another within two hours. Careless preparation may account for such differences; but at the same time an error in choosing the species of plant is an equally probable explanation. The properties of monkshood appear to me to resist a heat of 212°, either in drying the plant or in preparing an extract from it.
The medico-legal chemistry of monkshood has not been studied. If any of the suspected matter be obtained in a pure state, its best character is its remarkable taste; to which I have found nothing exactly similar in the numerous trials I have made with other narcotic and acrid plants. A complex substance, such as the contents of the stomach, or vomited matter, should be evaporated over the vapour-bath to the consistence of thin syrup, and agitated with absolute alcohol. The filtered alcoholic solution being then evaporated, the extract may be subjected to the sense of taste.
Action.—The action of monkshood is a subject of great interest, but has hitherto been much misunderstood. Sir B. Brodie, who was the first to examine it in recent times, found that the leading phenomena in animals, were staggering, excessive weakness, slow laborious respiration, and slight convulsive twitches before death.[2249] Had these observations been followed up by his successors with a discriminating eye, toxicologists would not have been so much misled as they have been. Orfila, who was the next to examine the subject experimentally, failed to appreciate the phenomena with exactness.[2250] He thinks monkshood acts peculiarly upon the brain, causing delirium, and that it is a local irritant, capable of developing more or less intense inflammation. A single experiment made in 1836 convinced me that the former statement is incorrect, and led me to consider that the symptoms depend in a great measure on gradually-increasing paralysis of the muscles, which terminates in immobility of the chest and diaphragm, and consequent asphyxia. Dr. Pereira, in some experiments with an alcoholic extract, published in 1842, took notice of two remarkable phenomena,—an extraordinary diminution of common sensation, evidenced by the animal being insensible to pinching and pricking,—and the total absence of stupor, as shown by the animal following its owner, and recognizing him when called.[2251] Similar observations have been made in poisoning with monkshood in man. The ablest investigation yet undertaken into the actions of this substance is contained in the unpublished Inaugural Dissertation of Dr. Fleming.
He found that the most remarkable symptoms are weakness and staggering, gradually increasing paralysis of the voluntary muscles, slowly increasing insensibility of the surface, more or less blindness, great languor of the pulse, and convulsive twitches before death. He farther observed that the pupil becomes much contracted; that the irritability of the voluntary muscles is impaired; that the veins are congested after death, the blood unaltered, and the heart capable of contracting for some time after respiration has ceased. Lastly, he maintains that this poison has not, as is generally thought, any irritant properties, that neither the plant, nor its extract, nor its alkaloid occasions vascularity in any membrane to which it is applied, even, for example, in the lips or tongue while burning and tingling from its topical action; that this peculiar effect is therefore merely a nervous phenomenon; and that he never could observe either the diffuse cellular inflammation described by Orfila to arise from the application of monkshood to a wound, or the inflammatory redness of the alimentary canal noticed by others as one of its effects when swallowed.
Orfila ascertained that monkshood exerts its action through the medium of the blood; for its effects are greater when it is introduced into a wound, than when it is swallowed, and they are still greater when it is injected directly into a vein. It is a poison of very great activity. I have found that thirty grains of an alcoholic extract, the produce of three-quarters of an ounce of fresh leaves, will kill a rabbit in two hours and a quarter, if introduced between the skin and muscles of the back. Five drachms of the root in one of Orfila’s experiments with the dog, occasioned death in twenty-one minutes, when swallowed.
The alkaloid, aconitina, seems to produce in animals precisely the same effects as the plant or its extract. Orfila and Dr. Pereira agree in this; and my own observation, limited to a single experiment, is to the same effect. It is probably the most subtile of all known poisons. Dr. Pereira mentions that the fiftieth part of a grain has endangered life when used medicinally.[2252] In my experiment the tenth of a grain, introduced in the form of hydrochlorate into the cellular tissue of a rabbit, killed it in twelve minutes.
Symptoms in Man.—A perplexing discrepance exists in the accounts that have been published of the effects of monkshood on man; which seems to have arisen, less from any actual contrariety in the phenomena, than from loose observation, or a misunderstanding of the facts; for most of the recent statements of competent observers are consistent with one another.
Dr. Fleming says that in medicinal doses it occasions warmth in the stomach, nausea, numbness and tingling in the lips and cheeks, extending more or less over the rest of the body, diminution in the force and frequency of the pulse, which sometimes sinks to 40 in the minute, great muscular weakness, confusion of sight or absolute blindness; and if the dose be unduly large, there is a sense of impending death, sometimes slight delirium, and a want of power to execute what the will directs, but without any loss of consciousness. The warmth which is excited is unattended with any elevation of temperature, vascularity of the skin, or acceleration of the pulse. No true hypnotic effect is produced; but by inducing serenity, or deadening pain, it may predispose to sleep. The highest degree of these effects is not unattended with danger.
When it is administered in doses adequate to occasion death, it seems in general to operate by inducing extreme depression of the circulation. Dr. Fleming recognizes two other modes of death in animals,—first, by an overwhelming depression of the nervous system, proving fatal in a few seconds, without arresting the action of the heart,—and secondly, by asphyxia, or arrestment of the respiration, the result of paralysis gradually pervading the whole muscular system, respiratory, as well as voluntary. But these effects, he thinks, cannot be recognized in the cases which have been published of poisoning in man, because the dose required to produce either of them is very large. The least variable symptoms in the human subject are, first, numbness, burning, and tingling in the mouth, throat, and stomach,—then sickness, vomiting, and pain in the epigastrium,—next, general numbness, prickling, and impaired sensibility of the skin, impaired or annihilated vision, deafness, and vertigo,—also frothing at the mouth, constriction at the throat, false sensations of weight or enlargement in various parts of the body,—great muscular feebleness and tremor, loss of voice, and laborious breathing,—distressing sense of sinking and impending death,—a small, feeble, irregular, gradually-vanishing pulse,—cold, clammy sweat and pale bloodless features,—together with perfect possession of the mental faculties, and no tendency to stupor or drowsiness,—finally, sudden death at last, as from hemorrhage, and generally in a period varying from an hour and a half to eight hours. The symptoms may begin in a few minutes, as in a case observed by Dr. Fleming, which was occasioned by the tincture of the root; or they may be postponed for three-quarters of an hour, as in an instance recorded by Dr. Pereira,[2253] which arose from the root being used by mistake for horse-radish. Two or three drachms of the root are sufficient to kill a man; and Dr. Fleming mentions one instance where two grains of the alcoholic extract occasioned alarming effects, and another where four grains proved fatal. I may observe, however, that I have given six grains of a carefully prepared alcoholic extract (the same of which thirty grains killed a rabbit in little more than two hours), to a female suffering from rheumatism, without being able to observe any effect whatsoever.
If all the reports of cases now on record are to be trusted, the following anomalies have occurred. Some persons are said to have presented convulsions. Slight spasmodic twitches of the muscles are not uncommon, and probably depend, as Dr. Fleming suggests, on venous congestion, the result of incomplete asphyxia. Stupor and even apoplectic insensibility are also sometimes represented to have been observed. If really ever present, they must depend on the same cause; but there is reason to apprehend, that extreme nervous depression and faintness have been mistaken for stupor and coma. Delirium of the frantic kind, mentioned by some of the older authors, is justly considered by Dr. Fleming to be of doubtful occurrence, as it has never been observed in recent times. Irritation in the alimentary canal is distinctly mentioned as indicated by prominent symptoms, even in some cases observed but a few years ago, and apparently with care. Dr. Fleming properly objects to nausea, vomiting, or pain in the epigastrium as evidence of irritation in the stomach; for these symptoms may all depend on the same local nervous impression which is produced on the organs of taste. And he denies that purging is ever produced in any genuine case of poisoning with monkshood. The following, however, seem unequivocal examples of irritation in the alimentary canal. M. Pallas[2254] mentions, that three out of five persons, who took a spirituous infusion of the root by mistake for lovage [Ligusticum levisticum], died in two hours with burning in the throat, vomiting, colic, swelling of the belly and purging. A similar set of cases is described by M. Degland.[2255] Four persons took the tincture of the root by mistake for tincture of lovage; and three of them were seized with burning pain from the throat to the stomach, a sense of enlargement of the tongue and face, colic, tenderness of the belly, vomiting, and purging. One of these, who ultimately recovered, had frantic delirium for some time after the other symptoms went off. The two others died, one in two hours, the other half an hour later. Dr. Pereira[2256] and Dr. Fleming doubt the authenticity of these cases; and it may be, that such unusual symptoms may have arisen either from some other root mistaken by the narrators for monkshood, or from irritant substances given along with or after it. At the same time I may mention, that in the first trials I made with monkshood as a medicine, using a carefully prepared extract of the root, I was deterred from proceeding by two patients being attacked with severe vomiting, griping, and diarrhœa.
It may be well to conclude these general statements by the particulars of a few well authenticated cases. Dr. Pereira describes two that were occasioned by the root having been dug up in February by mistake for horse-radish.[2257] The parties, a gentleman and his wife, ate, the former about a root and a half, the latter not much more than half a root. Both of them in three-quarters of an hour had burning, and numbness in the lips, mouth, and throat, extending to the stomach and followed by vomiting. The husband had subsequently violent and frequent vomiting, partly owing to an emetic. His extremities became cold, the lips blue, the eyes glaring, and the head covered with cold sweat. There was no spasm or convulsion, but some tremor. He had no delirium, or stupor, or loss of consciousness, but complained of violent headache. The respiration was not affected; and although he felt very weak, he was able to walk with a little assistance only a few minutes before death; which took place, as if from fainting, about four hours after the poison was swallowed.—His wife, in addition to the early symptoms already mentioned, had such weakness and stiffness of the limbs that she was unable to stand; and she could utter only unintelligible sounds; but she had no spasms or convulsions. She experienced a strange sensation of numbness in the hands, arms, and legs, diminution of sensibility over the whole integuments, especially of the face and throat, where the sense of touch was almost extinguished. She had also some dimness of vision, giddiness, and at times an approach to loss of consciousness, but no delirium, sleepiness, or deafness. She recovered, under the use of emetics, laxatives, and stimulants. In neither of these cases was there any diarrhœa.—A patient of Mr. Sherwen,[2258] five minutes after taking a tincture of the root, suffered from the same incipient symptoms as above, but without actual vomiting. The face seemed to her to swell, and the throat to contract; she became nearly blind, and excessively feeble, but did not lose her consciousness. The eyes were fixed and protruded, and the pupils contracted, the jaws stiff, the face livid, the whole body cold, the pulse imperceptible, the heart’s action feeble and fluttering, and the breathing short and laborious. An emetic was followed first by violent convulsions, and then by vomiting; after which she slowly recovered. At all times she was so sensible as to be able to tell how the accident happened.—Dr. Ballardini of Brescia met with twelve simultaneous cases of poisoning with the juice of the leaves, used by mistake for scurvy-grass [Cochlearia officinalis]. Each person had three ounces of juice. Three of them died in two hours; but the rest were saved. The chief symptoms were extreme weakness and anxiety, paleness and distortion of the features, dilatation of the pupils, dulness of the eyes, giddiness, headache, chiefly occipital, some distension and pain of the belly, vomiting of a green matter, and in some diarrhœa. The whole body was cold, the nails livid, the limbs cramped, the pulse small and scarcely perceptible. In the fatal cases there were convulsions.[2259]—MM. Pereyra and Perrin mention, that, while using the alcoholic extract in the Hospital of St. André at Bordeaux, the sample of the drug happened to be changed when the dose had been raised so high as ten grains; and that the patients who were taking it were then all seized with burning in the mouth and throat, vomiting, pungent pains in the extremities, cold sweating, anxiety, extreme general prostration, great slowness and irregularity of the pulse, convulsions, and congestion in the venous system. One patient died; the others recovered under no other treatment than stimulant friction along the spine.[2260] An infant at Suippe, in the French Department of the Marne, ate a few leaves and flowers of monkshood, while walking in a garden. Soon afterwards he began to stagger as if tipsy, and to complain of pain in the belly. In two hours an emetic was given; but a few minutes afterwards, the eyes became convulsed, the jaws locked, the trunk bent rigidly backward, and the limbs convulsed; and death ensued in five minutes more.[2261]
Morbid Appearances.—In Ballardini’s fatal cases the pia mater and arachnoid were much injected; there was much serosity under the arachnoid and in the base of the cranium; the lungs were considerably gorged with blood; the heart and great vessels contained but a little black fluid blood: the villous coat of the stomach was spotted with red points; and the small intestines presented inwardly red patches and much mucus. In the Bordeaux case there was venous congestion in the head and chest, the lungs particularly being much gorged with blood. The right side of the heart was full of blood, of gelatinous consistence. In Pallas’s cases the gullet, stomach, small intestines and rectum were very red, the lungs dense, dark, and gorged, and the cerebral vessels turgid.
Few trustworthy observations have been made on the effects of the other species of aconite. Dr. Pereira found the A. ferox of the East Indies to be a much more deadly poison to animals than common monkshood; but its effects were otherwise identical.[2262] Three grains of the root put into the throat of a rabbit, killed it in nineteen minutes; one grain of the alcoholic extract, introduced into the peritonæum, proved equally deadly. Nine grains will kill a cat in four hours.[2263]——Of the other aconites the A. cammarum, and A. lycoctonum are said to have proved fatal frequently in Germany; but no accurate facts on the subject are on record.—It was stated above that the A. paniculatum, supposed by De Candolle to have been the true aconite of Baron Störck, is inert in this country. I introduced the alcoholic extract of three ounces of the fresh leaves collected near the end of June, into the cellular tissue between the skin and muscles of a young rabbit, having previously converted the extract into an emulsion with mucilage and water. This was four times the dose of A. napellus, which I had found sufficient to kill a strong adult rabbit in two hours and a quarter; but no effect whatever was produced.—Mr. Ramsay of Broughty Ferry has described a case of fatal poisoning with a handful of aconite leaves which were mistaken for parsley, and which he supposes to have been those of A. neomontanum. The subject, a boy of fourteen, was attacked with a sense of burning in the mouth, throat, and stomach, afterwards with vomiting and convulsions, and died considerably within five hours.[2264] The very feeble taste of this species—which besides is little cultivated in Scotland,—inclines me to doubt whether it was the species that produced such violent effects.
Of Poisoning with Black Hellebore.
Black hellebore, or Christmas-rose, the Helleborus niger of botanists, is a true narcotico-acrid poison. It is a doubtful native of this country. It produces a large white ranunculus-like flower about midwinter. The root, the only part used in medicine, or to be found in the shops, consists of a short root-stock and numerous, long, black undivided rootlets. The fresh root in January is not acrid to the taste. Its active principle appears from the researches of MM. Feneulle and Capron, to be an oily matter containing an acid.[2265]
Its action has not yet been examined with particular care. Two or three drachms of the root killed a dog in eighteen hours, when swallowed; two drachms killed another in two hours, when applied to a wound; and six grains in a wound caused death in twenty-three hours. In all cases the leading symptoms are efforts to vomit, giddiness, palsy of the hind-legs, and insensibility.[2266] Ten grains of the extract introduced into the windpipe killed a rabbit in six minutes.[2267] Orfila found redness of the rectum, when the animals survived a few hours. But none of these experiments show the powerful irritant action exerted by the root upon man.
The Bulletins of the Medical Society of Emulation mention two cases of poisoning with hellebore, which arose from the ignorance of a quack doctor. Both persons, after taking a decoction of the root, were seized in forty-five minutes with vomiting, then with delirium, and afterwards with violent convulsions. One died in two hours and a half, the other in less than two hours.[2268] Morgagni has related a case which proved fatal in about sixteen hours, the leading symptoms of which were pain in the stomach, and vomiting. The dose in this instance was only half a drachm of the extract.[2269] In a case not fatal, related by Dr. Fahrenhorst, the symptoms were those of irritant poisoning generally, that is, burning pain in the stomach and throat, violent vomiting, to the extent of sixty times in the first two hours, cramps of the limbs, and cold sweating. The most material symptoms were at this time quickly subdued by sinapisms to the belly and anodyne demulcents given internally; and in four days the patient was well. The dose here was a table-spoonful of the root in fine powder.[2270] In small doses of ten or twenty grains, it is well known to be a powerful purgative to man. I have known severe griping produced by merely tasting the fresh root in January.
The morbid appearances in Morgagni’s case were the signs of inflammation in the digestive canal, particularly in the great intestines. In the case described in the French Bulletins, there was gorging of the lungs, and the stomach had a brownish-black colour as if gangrenous.
The other species of hellebore have not been carefully examined; but it is probable that they all possess similar properties. The H. hyemalis and viridis are said by Buchner to be weaker than the H. niger; and the H. fœtidus is the most poisonous of all.[2271]
XXXVI. OF POISONING WITH SQUILL, MEADOW-SAFFRON, WHITE HELLEBORE, AND FOXGLOVE
The natural family Liliaceæ, and the allied family, Melanthaceæ, contain many species which possess narcotico-acrid properties. Those which are best known in Europe are squill, meadow-saffron, cevadilla, and white hellebore. To these may be added foxglove, as possessing properties in some measure analogous, and also rue and ipecacuan.
Of Poisoning with Squill.
The root of the squill, or Squilla maritima, possesses the properties of the narcotico-acrids. Orfila’s experiments on animals, indeed, assign to it only an action on the nervous system. He found that two ounces and a half of the fresh root, when secured in the stomach of a dog by a ligature on the gullet, excited efforts to vomit, dilated pupil, and lethargy; and in two hours the animal suddenly fell down in a violent fit of tetanus, and expired. From thirty-six grains injected into the jugular vein no effect followed for sixteen hours; when at last, as in the former case, the animal dropped down convulsed and died immediately.[2272]
The effects, however, caused by squill on man leave no doubt that it is also an active irritant; for it causes sickness, vomiting, diarrhœa, gripes, and bloody urine, when given in over-doses. It has likewise produced narcotic symptoms in man. Lange mentions an instance of a woman, who died from taking a spoonful of the root in powder to cure tympanitis. She was immediately seized with violent pain in the stomach; and in a short time expired in convulsions. The stomach was found every where inflamed, and in some parts eroded.[2273]—A woman, whose case is mentioned in a French journal, after taking from a female quack a vinous tincture made with seventy-five grains of extract of squill, was seized with nausea and severe colic, to which were added in twenty-four hours a small contracted pulse, extreme tenderness of the belly, and cold extremities; and she died in the course of the second day.[2274] Twenty-four grains of the powder have proved fatal.[2275] I have seen a quarter of an ounce of the syrup of squills, which is a common medicinal dose, cause severe vomiting, purging, and pain.
An acrid principle, named scillitin, has been discovered in the squill. A difference of opinion prevails as to its nature. Some chemists consider it to be a resin; but Landerer has obtained it in the crystalline form, with alkaline properties. A grain of it will kill a dog.
Of Poisoning with White Hellebore and Cevadilla.
White hellebore, the root-stock of Veratrum album, and cevadilla, the seed and capsules of Asagræa officinalis, and possibly of Veratrum sabadilla, seem to be characteristic examples of the narcotico-acrid poisons. They both possess a strong bitter taste, followed by acridity. The cevadilla-seed in particular has an intensely disagreeable and persistent bitter taste, and produces at the same time a combination of acridity and numbness of the lips, tongue, and cheeks. They owe their active properties chiefly to an alkaloid of great energy, termed veratria.
White hellebore root is familiarly known to be a virulent poison. The best account of its effects is contained in a Thesis by Dr. Schabel, published at Tübingen in 1817. Collecting together the experiments previously made by Wepfer, Courten, Viborg, and Orfila, and adding a number of excellent experiments of his own, he infers that it is poisonous to animals of all classes,—horses, dogs, cats, rabbits, jackdaws, starlings, frogs, snails, and flies;—that it acts in whatever way it is introduced into the system,—by the stomach, rectum, windpipe, nostrils, pleural membrane of the chest, an external wound, or the veins;—that it produces in every instance symptoms of irritation in the alimentary canal, and injury of the nervous system;—and that it is very active, three grains of the extract applied to the nostrils of a cat having killed it in sixteen hours.[2276]
Symptoms in Man.—Its effects on man are similar. A singular account of several cases of poisoning with the root is contained in Rust’s Journal. A family of eight people, in consequence of eating bread for a whole week, in which the powder of the root had been introduced by mistake instead of cumin seeds, were attacked with pains in the belly, a sensation as if the whole intestines were wound up into a clue, swelling of the tongue, soreness of the mouth, and giddiness; but they all recovered by changing the bread and taking gentle laxatives.[2277]
Another set of cases of a more aggravated nature, though still not fatal, is given in Horn’s Archives.[2278] Three people took the root by mistake for galanga. The symptoms that ensued were characteristic of its double action. In an hour they all had burning in the throat, gullet, and stomach, followed by nausea, dysuria, and vomiting; weakness and stiffness of the limbs; giddiness, blindness, and dilated pupil; great faintness, convulsive breathing, and small pulse. One of them, an elderly woman, who took the largest share, had an imperceptible pulse, stertorous breathing, and total insensibility even to ammonia held under the nose. Next day she continued lethargic, complained of headache, and had an eruption like flea-bites. A fatal case is quoted by Bernt from Schuster’s Medical Journal. A man took twice as much as could be held on the point of a knife, was attacked with violent and incessant vomiting, and lived only from morning till night. The gullet, stomach, and colon were here and there inflamed.[2279]
No detailed inquiry has yet been made respecting the properties of cevadilla; but there can be no doubt that it will prove an energetic poison, similar in its effects to white hellebore, and probably more active. Wibmer quotes Villemet for the fact, that half a drachm of the seeds excites vomiting and convulsions in the cat and dog, and Lentin for the case of a child, who died in convulsions in consequence of the powder having been used inwardly and outwardly.[2280]
The alkaloid, veratria, has been made the subject of experiment by various physiologists. The most complete investigation yet undertaken is that of Dr. Esche;[2281] who found that it causes in a few minutes restlessness, anxiety, salivation, slowness and irregularity of the pulse, slow respiration, nausea, violent vomiting, borborygmus, spasms of the abdominal muscles and brisk purging of watery mucus, often tinged with blood;—that by and by the muscles become extremely feeble, so that the animal cannot support itself;—that coldness of the surface succeeds, together with spasmodic contractions of the throat, face, and extremities, but without any stupor;—and that finally the respiration and pulse gradually become extinguished, extreme prostration ensues, and death takes place in a fit of tetanic spasm. No particular morbid appearance was found in the dead body, and especially no sign of inflammation. Magendie found, that one grain in the form of acetate killed a dog in a few seconds when injected into the jugular vein, and in nine minutes when injected into the peritonæum; and that the principal symptom in such rapid cases was tetanic spasm.
Of Poisoning with Meadow-Saffron.
The Colchicum autumnale, meadow-saffron, or autumn-crocus, is a more familiar poison in this country than white hellebore, and seems to possess very similar properties. Two parts of the plant are met with in the shops, the cormus or bulb, and the seeds; both of which are poisonous. Both have a strong, disagreeable, persistent, bitter taste. The seeds, and probably the bulb also, contain a bitter crystalline principle, called colchicina, which is soluble in water, neutralizes acids, and possesses intense activity as a poison.
A good physiological investigation into the action of colchicum as a poison is still wanting. Baron Störck found that two drachms of the dried bulb caused in dogs violent diarrhœa and diuresis, ending fatally.[2282] Sir Everard Home observed that the active part of about two drachms dissolved in sherry, caused in a dog, when injected into the jugular vein, slow respiration, languor of the pulse, vomiting, diarrhœa, extreme prostration, and death in five hours.[2283]—Geiger and Hesse, the discoverers of colchicina, gave a cat a tenth of a grain, which occasioned salivation, vomiting, purging, staggering, extreme languor, colic, and death in twelve hours.[2284]
The effects of colchicum on man, like those observed in animals, rather associate it with the acrid than with the narcotic poisons.
In the Edinburgh Journal a case is briefly noticed of a man who took by mistake an ounce and a half of the wine of the bulb, and died in forty-eight hours, after suffering much from vomiting, acute pain in the stomach, colic, purging, and delirium.[2285]—Chevallier has described a similar case arising from the wine of the bulb having been given intentionally as a poison. In a few minutes burning pain, urgent thirst, and frequent vomiting of mucus ensued; and death took place in three days.[2286]—Three American soldiers, who drank by mistake a large quantity of colchicum wine prepared from the bulb, died with similar symptoms. One of them, who took eighteen ounces, and died in two days, presented the leading symptoms of malignant cholera, namely, frequent vomiting, copious rice-water stools, cramps of the abdominal muscles and flexion of the extremities, coldness of the skin, tongue, and breath, blueness of the nails, dull, sunken eyes, contracted pupils, and collapse of the features. The two others had at first similar symptoms, which passed into those of chronic dysentery, and proved fatal in a few weeks.[2287]—M. Caffe has related the case of a young lady who destroyed herself by taking five ounces of the wine containing the active matter of rather more than the fourth part of one bulb. She was soon seized with acute pain in the stomach, then with frequent vomiting, general coldness and paleness, a sense of tightness in the chest and oppression of the breathing, a slow thready pulse, and extreme prostration,—and subsequently with severe and constant cramps in the soles of the feet. In eleven hours she had less frequent efforts to vomit, but was excessively exhausted; in twenty hours the pulse was imperceptible; and in two hours more she died. There was no suppression of urine, no purging, no diminution of sensibility, delirium, convulsions, or change in the state of the pupils.[2288] About a twelvemonth afterwards the sister of this patient put an end to herself with the same preparation, of which she took the same quantity; and she died, with precisely the same symptoms, in twenty-eight hours.[2289] M. Ollivier met with two cases of death within twenty-four hours, in consequence of a tincture being taken which contained the active part of forty-eight grains of the dry bulb; and a third case of death in three days caused by three doses of a watery decoction made each time with 46 grains of the bruised bulb collected in July. Severe purging and prostration followed each dose. There was no symptom of any affection of the brain.[2290]—Mr. Henderson describes a case occasioned by an ounce of the tincture. No injury accrued for three hours. The patient then had gnawing pain in the stomach followed by vomiting, and then by purging, at first bilious, afterwards watery, and attended with numbness in the feet, and subsequently a sense of prickling. In the course of the second day there was intense gnawing pain in all the joints of the extremities, profuse acid sweating, tightness in the head, and pain in the hindhead and nape of the neck. Blood-letting, laxatives, and hyoscyamus were employed with success; but the case seems very nearly to have proved fatal.[2291]
The seeds produce similar effects. Bernt has noticed the cases of two children who were poisoned by a handful of colchicum seeds, and who died in a day, affected with violent vomiting and purging.[2292] Mr. Fereday of Dudley relates a carefully detailed case of a man who died in forty-seven hours after swallowing by mistake two ounces of the wine of the seeds, and in whom the symptoms were acute pain, coming on in an hour and a half, then retching, vomiting, and tenesmus, feeble pulse, anxious expression, afterwards incessant coffee-coloured vomiting, suppression of urine, excessive weakness of the limbs and feeble respiration, and, for a short period before death, profuse, dark, watery purging. There was neither insensibility nor convulsions.[2293]—Blumhardt relates a similar case caused by an infusion of a large table-spoonful of the seeds. In three-quarters of an hour the man was seized with griping, and then profuse diarrhœa and vomiting. Next morning, twelve hours after the poison was taken, his physician found him still affected with vomiting and purging, but not with pain. He seemed, indeed, to suffer so little, and to improve so much under the use of emollients, that he was thought to be fairly recovering. But next day the pulse was almost imperceptible, the countenance and extremities were cold, the voice hoarse, the breathing hurried, the eyes sunk, the pupils dilated, the epigastrium tender, and the forehead affected with pain; and he died at twelve the same day.[2294]
The leaves, too, are poisonous. Dr. Bleifus has related a case in proof of this. A man gathered the leaves in the middle of May, and, after cooking them, ate about two ounces for supper. In six hours he was seized with violent colic, vomiting, and purging. In fifteen hours, when his physician first saw him, the countenance was ghastly as in malignant cholera, the pupils dilated and scarcely contractile, but the mind entire. He complained of rheumatic pains in the neck, and burning pain in the pit of the stomach. He had frequent vomiting and purging, spasms of the muscles of the belly, coldness of the skin, a slow, small, wiry pulse, and cramps of the fingers and the calves of the legs. Coffee and lemon-juice allayed the vomiting, and a temporary amendment ensued. But early on the third morning he became worse, and soon afterwards the narrator of the case found him dying.[2295]
The flowers are not less poisonous than the bulbs, leaves, and seeds. A case is noticed in Geiger’s Journal of poisoning with a decoction of some handfuls of the flowers, where death occurred within twenty-four hours, under incessant colic, vomiting and purging.[2296]
Doubts exist as to the degree of activity of colchicum. Some practitioners direct half an ounce of the tincture of the seeds to be given as a medicinal dose,[2297] even four times a day.[2298] Others administer from one to two drachms night and morning. According to more general experience, these are dangerous doses. Dr. Lewins, junior, has seen dangerous symptoms from a drachm given thrice a day for a week;[2299] a fatal case occurred a few years ago in the Edinburgh Infirmary, from this amount having been given for a few days only; I have known very violent effects produced by half an ounce taken by mistake, although most of it was brought away by emetics in an hour; and, in medical practice, I have seldom seen the dose of a sound preparation gradually raised to a drachm thrice a day, without such severe purging and sickness ensuing as rendered it prudent to diminish or discontinue the remedy. There is no doubt, however, that larger doses have occasionally been taken without any ill effect. Constitutional peculiarity can alone account for such differences in the instance of the tincture of the seeds. As to the preparations of the bulb, an additional source of diversity of effect is a difference in the activity of the bulb according to season. On this point no accurate facts have yet been brought forward. The bulb is usually directed to be gathered in July, when it is most plump and firm, and most charged with starch. Orfila, however, says that three bulbs, collected at this time, had no effect whatever on a dog;[2300] and Buchner maintains that it is most energetic in the autumn, when the flowering stem is rising.[2301] I suspect, on the other hand, that it is very energetic in the spring, when it is watery, more membranous, and shrivels much in drying; for it is then very bitter.
The morbid appearances are chiefly those of inflammation of the alimentary canal.
In the bodies of the children mentioned by Bernt there was considerable redness of the stomach and small intestines; in Geiger’s case inflammation of the stomach and duodenum only; in the case mentioned in the Edinburgh Journal, and in that related by Chevallier, there was no morbid appearance at all to be found. In Mr. Fereday’s case the omentum was curled and folded up between the stomach on the one hand, and the liver and diaphragm on the other; the stomach and intestines were coated with much mucus; there was no appearances of inflammation there but on two points, one in the stomach, the other in the jejunum, where a red patch appeared, owing to blood effused between the muscular and peritoneal coats; the bladder was empty, the pleura red, the lungs much gorged, their surface, as well as that of the diaphragm and heart, covered with ecchymosed spots; and the skin over most of the body presented patches of a purple efflorescence.—In Blumhardt’s case the muscles were rigid twenty-three hours after death; the heart and great vessels contained coagulated blood; the cardiac end of the gullet was internally dark-violet; the stomach externally of a clear violet hue, and its veins turgid; the gall-bladder turgid with greenish-yellow bile; and the inner membrane of the whole small intestines chequered here and there with red, inflamed-like spots.[2302]—In one of M. Caffe’s cases there was congestion of the cerebral vessels, coagulated blood in the heart, uniform grayness, softness, and brittleness of the mucous coat of the stomach, and enlargement of the muciparous follicles of the small intestines, as well as unusual distinctness and lividity of the Peyerian glands. In the other case putrefaction was so far advanced in forty-eight hours as to make the appearances equivocal.
The treatment consists in evacuation of the stomach and bowels by emetics and oleaginous laxatives in the early stage, and afterwards in the employment of opium, stimulants, the warm bath, and occasionally blood-letting.
Of Poisoning with Foxglove.
Foxglove, or Digitalis purpura, a plant which is common in this country both as a native and in gardens, possesses powerful and peculiar properties. The leaves are considered its most active part. They contain an alkaloid; but chemists have not fixed its nature with precision. M. Le Royer of Geneva procured a pitchy, deliquescent, uncrystallizable substance;[2303] but more lately M. Pauguy obtained a principle in fine acicular crystals, soluble in alcohol and ether, but insoluble in water, alkaline in its reaction, and of a very acrid taste. This principle is called digitalin.[2304] It seems to be the same substance, which has also been detected by Radig, as quoted by Dr. Pereira.[2305] The leaves, like those of other narcotic vegetables, yield by destructive distillation an empyreumatic oil similar in chemical qualities and physiological effects to the empyreumatic oil of hyoscyamus.[2306]
From an extensive series of experiments on animals by Orfila with the powder, extract and tincture of the leaves, foxglove appears to cause in moderate doses vomiting, giddiness, languor, and death in twenty-four hours, without any other symptoms of note; but in larger doses, it likewise produces tremors, convulsions, stupor and coma. It acts energetically both when applied to a wound, and when injected into a vein.[2307] Mr. Blake has inferred from his researches, that when injected into the jugular vein, it occasions both obstruction of the pulmonary capillaries, and direct depression of the heart’s action. In the dog an infusion of three drachms of leaves arrested in five seconds the action of the heart; which was motionless after death, turgid, inirritable, and full of florid blood in its left cavities. An infusion of an ounce, injected back into the aorta from the axillary artery, caused in ten seconds great obstruction of the systemic capillaries, indicated by sudden increase of arterial pressure in the hæmadynamometer; the heart was unaffected for forty-five seconds, when it became slow in its pulsations, and the arterial pressure diminished; and in four minutes the heart ceased to beat, although for a little longer it continued excitable by stimulation. As no affection of the brain or spine was apparent before the heart became affected, the author infers that the action depends on the poisoned blood being circulated through the substance of the heart, and not on any intermediate influence upon the nervous centre.[2308]
Symptoms in Man.—Upon man its effects as a poison have been frequently noticed, partly in consequence of its being given by mistake in too large a dose as a medicine, partly on account of the singular property it possesses, in common with mercury, of accumulating silently in the system, when given long in moderate doses, and at length producing constitutional effects even after it has been discontinued. The effects of a dose somewhat larger than is usually given, are great nausea, frontal headache, sense of disagreeable dryness in the gums and pharynx, some salivation, giddiness, weakness of the limbs, feebleness and increased frequency of the pulse, in a few hours an appearance of sparks before the eyes, and subsequently dimness of vision, and a feeling of pressure on the eyeballs. These effects may be occasioned by so small a dose as two or three grains of good foxglove.[2309] The symptoms arising from its gradual accumulation are in the slighter cases nausea, vomiting, giddiness, want of sleep, sense of heat throughout the body, and of pulsation in the head, general depression, great languor and commonly retardation of the pulse, sometimes diarrhœa, sometimes salivation, and for the most part profuse sweating. A good instance of this form of the effects of foxglove is mentioned in the Medical Gazette. A man took it at his own hand for dropsy during twenty days, when the pulse sank to half its previous frequency, he was seized with restless, want of sleep, incoherent talking with imaginary persons, dilated pupils, nausea, thirst, and increase of urine; and these complaints did not materially subside for six days.[2310] The depressed action of the heart may be the occasion of death in particular circumstances. Mr. Brande mentions from the experience of Dr. Pemberton the case of an elderly woman, who, while under the full influence of foxglove, fell in a fainting fit on walking across the floor; after which, although she at first got better, there were frequent attacks of fainting and vomiting till she died.[2311] In other instances convulsions also occur; and it appears from a case mentioned by Dr. Blackall, that the disorder thus induced may prove fatal. One of his patients, while taking two drachms of the infusion of the leaves daily, was attacked with pain over the eyes and confusion, followed in twenty-four hours by profuse watery diarrhœa, delirium, general convulsions, insensibility, and an almost complete stoppage of the pulse. Although some relief was derived from an opiate clyster, the convulsions continued to recur in frequent paroxysms for three weeks; in the intervals he was forgetful and delirious; and at length he died in one of the convulsive fits.[2312]
A case which exemplifies the effects of a single large dose is related in the Edinburgh Journal. An old woman drank ten ounces of a decoction made from a handful of the leaves in a quart of water. She grew sick in the course of an hour, and for two days she had incessant retching and vomiting, with great faintness and cold sweats in the intervals, some salivation and swelling of the lips, and a pulse feeble, irregular, intermitting, and not above 40. She had also suppression of urine for three days.[2313]
A somewhat similar instance may be found in the Journal de Médecine. A man, fifty-five years old took by mistake a drachm instead of a grain for asthma, and was attacked in an hour with vomiting, giddiness, excessive debility, so that he could not stand, loss of sight, colic, and slow pulse. These effects continued more or less for four days, when the vomiting ceased; and the other symptoms then successively disappeared, the vision, however, remaining depraved for nearly a fortnight.[2314]
A very interesting fatal case, which arose from an over-dose administered by a quack doctor, and which became the ground of a criminal trial at London in 1826, is shortly noticed in the same Journal. Six ounces of a strong decoction when taken as a laxative early in the morning. Vomiting, colic, and purging, were the first symptoms; towards the afternoon lethargy supervened; about midnight the colic and purging returned; afterwards general convulsions made their appearance; and a surgeon, who saw the patient at an early hour of the succeeding morning, found him violently convulsed, with the pupils dilated and insensible, and the pulse, slow, feeble, and irregular. Coma gradually succeeded, and death took place in twenty-two hours after the poison was swallowed.[2315]
This is the only case in which I have seen an account of the appearances in the dead body, and they are related imperfectly. It is merely said that the external membranes of the brain were much injected with blood, and the inner coat of the stomach red in some parts.
The affections induced by poisoning with digitalis are often much more lasting than the effects of most other vegetable narcotics. Dr. Blackall’s case is one instance in point, and another no less remarkable in its details is described in Corvisart’s Journal. The usual local and constitutional symptoms were produced by a drachm of the powder being taken by mistake; and the slowness of the pulse did not begin to go off for seven days, the affection of the sight not for five days more.[2316]
The preparations of foxglove are very uncertain in strength. From what I have observed in the course of their medicinal employment, I conceive few powders retain the active properties of the leaves, and even not many tinctures. Two ounces of the tincture of the London College have been taken in two doses with a short interval between them, yet without causing any inconvenience.[2317] This assuredly could not happen with a sound preparation.
Of Poisoning with Rue.
The Ruta graveolens, or rue, although its wild variety is expressly declared by Dioscorides to be mortal when taken too largely, has attracted little attention as a poison in recent times, and is indeed scarcely considered deleterious. Orfila seems to have found it by no means active; for the juice of two pounds of leaves, secured in the stomach of a dog by tying the gullet, did not prove fatal till the second day, the symptoms were not well marked, and the only appearances in the dead body were the signs of slight inflammation in the stomach. Even when the distilled water was injected into a vein, the only effects were a temporary nervous disorder similar to intoxication.[2318]
According to the late experimental inquiry, however, by M. Hélie,[2319] rue is possessed of peculiar and energetic properties. All parts of its organization, especially the roots and leaves, produce the effects of the narcotico-acrid poisons; and although he never met with any instance of a fatal result, its activity is such as to render this event not improbable, even when the dose is by no means very large. His attention was drawn to the subject in consequence of finding, that it was often employed in his neighbourhood for producing abortion,—a property ascribed to it immemorially by the country people of France; and all the instances he has seen of its poisonous action were cases in which it had been given with this object. Sometimes the juice of the leaves is given, sometimes an infusion of them, sometimes a decoction of the root; and in one instance a woman took a decoction of two roots, each about as thick as the finger. The effects were, severe pain in the stomach, followed by violent and obstinate vomiting, drowsiness, giddiness, confusion, dimness of sight, difficult articulation, staggering, contracted pupils, convulsive movements of the head and arms, like those of chorea, retention of urine, slowness of the pulse, and great prostration. There was never any purging. In the course of two days or a little more miscarriage took place, preceded by the usual precursors, and followed by abatement of the symptoms of poisoning. At the period of the milk-fever, however, these symptoms again increased, and the patient was also attacked with swelling and pain in the tongue and copious salivation. In about ten days the pulse began to increase in frequency; and a mild typhoid fever commonly succeeded, from which recovery took place slowly. In another case the symptoms throughout their whole course were so mild, that, although miscarriage occurred, the subject of it was not confined to bed, and in fifteen days recovered her health completely. M. Hélie adds, that with full knowledge of the doubts entertained by eminent authorities, whether any substance whatever possesses a peculiar property of inducing miscarriage, he is strongly persuaded that rue is really a substance of the kind, and that it will take effect even when there is no natural tendency to miscarriage, or any particular weakness of constitution.
Notwithstanding these statements, it may be suspected that M. Hélie has overrated both its poisonous properties and its virtues as a drug capable of inducing miscarriage.
Of Poisoning with Ipecacuan.
Ipecacuan is well known as an emetic. It is procured from a plant of the natural family Rubiaceæ, the Cephaëlis ipecacuanha. It contains a peculiar principle, not yet crystallized, which is white, permanent in the air, sparingly soluble in water, easily soluble in alcohol and ether, fusible about 122° F., capable of forming crystallizable salts with acids, and possessing an alkaline reaction on litmus. It was discovered by M. Pelletier.[2320]
Ipecacuan itself is not known to be a poison; because in consequence of its emetic properties it is quickly discharged from the stomach. But in doses of considerable magnitude it would probably be dangerous. In some constitutions the odoriferous effluvia from the powder induce difficult breathing, anxiety, and imperfect convulsions. I have met with several instances of this singular idiosyncrasy, and one in particular where the subject of it, a surgeon’s apprentice, suffered so often and so severely as to be induced to abandon the medical profession. A German physician, Dr. Prieger, has published a remarkable case of a druggist’s servant, who, in consequence of incautiously inhaling the dust of ipecacuan powder, was attacked with a sense of tightness in the chest, vomiting, and soon after an alarming sense of suffocation from tightness of the throat. When these symptoms had continued several hours the uneasiness in the throat was removed after the use of a decoction of uva-ursi and rhatany-root; but the dyspnœa remained several days.[2321]
Its active principle, emeta, is a powerful poison. Two grains of the pure alkaloid will kill a dog; and the symptoms are frequent vomiting, followed by sopor and coma, and death in fifteen or twenty-four hours. In the dead body the lungs and stomach are found inflamed. The same effects result from injecting it into a vein, or applying it to a wound.[2322] It appears, then, to be a narcotico-acrid. But its irritant properties are so prominent that it might be properly arranged with the vegetable acrids.
XXXVII. OF POISONING WITH STRYCHNIA, NUX VOMICA, AND FALSE ANGUSTURA
The next group of the narcotico-acrids includes a few vegetable poisons that act in a very peculiar manner. They induce violent spasms, exactly like tetanus, and cause death during a fit, probably by suspending the respiration. But they do not impair the sensibility. During the intervals of the fits the sensibility is on the contrary heightened, and the faculties are acute.
Death, however, does not always take place by tetanus. In some cases the departure of the convulsions has been followed by a fatal state of general and indescribable exhaustion.
Besides thus acting violently on the nervous system, they also possess local irritant properties; but these are seldom observed on account of the deadliness and quickness of their remote operation on the spine and nerves.
They exert their action by entering the blood-vessels. The dose required to prove fatal is exceedingly small. The organ acted on is chiefly the spinal cord; but sometimes they seem also to act on the heart.
They seldom leave any morbid appearances in the dead body. Like the other causes of death by obstructed respiration, such as drowning and strangling, they produce venous congestion; but this is frequently inconsiderable. Sometimes, however, they leave signs of inflammation in the alimentary canal.
Their energy resides in peculiar alkaloids. The only poisons included in this group, are derived from the genus Strychnos. The bark of Brucea antidysenterica was long supposed also to possess similar properties; but it is now known that the bark of Strychnos nux-vomica was mistaken for the bark of that tree.
Several species of Strychnos have been examined, namely, the S. Nux-vomica, the S. Sancti Ignatii or St. Ignatius bean, the S. colubrina, or snake-wood, the S. tieuté, which yields an Indian poison the Upas tieuté, the S. Guianensis, and likewise the S. potatorum and Pseudo-kina; and all have been found to possess the same remarkable properties, except the last two, which are inert.
All of them, except the S. pseudo-kina, and probably the S. potatorum,[2323] contain an alkaloid to which their poisonous properties are owing. This is strychnia or strychnin, a substance which has lately been made the subject of many experiments by chemists and physiologists.
Of Poisoning with Strychnia.
Strychnia was discovered by Pelletier and Caventou soon after the discovery of morphia.[2324] For an account of the best process for preparing it, the reader may consult a paper by M. Henry in the journal quoted below.[2325]
Its leading properties are the following. Its crystals when pure are elongated octaedres. It has a most intensely bitter taste, perceptible, it is said, when a grain is dissolved in 80 pounds of water.[2326] It is very sparingly soluble in water, but easily soluble in alcohol and the volatile oils. Its alcoholic solution has an alkaline reaction. It forms neutral and crystallizable salts with the acids. In its ordinary form it is turned orange-red by the action of nitric acid; which tint becomes violet-blue on the gradual addition of hydrosulphate of ammonia. The action of nitric acid is owing to the presence of a yellow colouring matter, or of another alkaloid, brucia, which is also contained in nux vomica, but exists in larger quantity in the false angustura bark. Pure strychnia is not turned orange-red by nitric acid.[2327]
No poison is endowed with more destructive energy than strychnia. I have killed a dog in two minutes with a sixth part of a grain injected in the form of alcoholic solution into the chest; I have seen a wild-boar killed in the same manner with the third of a grain in ten minutes; and there is little doubt that half a grain thrust into a wound might kill a man in less than a quarter of an hour. It acts in whatever way it is introduced into the system, but most energetically when injected into a vein. The symptoms produced are very uniform and striking. The animal becomes agitated and trembles, and is then seized with stiffness and starting of the limbs. These symptoms increase till at length it is attacked with a fit of violent general spasm, in which the head is bent back, the spine stiffened, the limbs extended and rigid, and the respiration checked by the fixing of the chest. The fit is then succeeded by an interval of calm, during which the senses are quite entire or unnaturally acute. But another paroxysm soon sets in, and then another and another, till at length a fit takes place more violent than any before it; and the animal perishes suffocated. The first symptoms appear in 60 or 90 seconds, when the poison is applied to a wound. When it is injected into the pleura, I have known them begin in 45 seconds, and Pelletier and Caventou have seen them begin in 15 seconds.[2328] M. Bouillaud has recently found that it has no effect when directly applied to the nerves.[2329] The experiments of Mr. Blake tend to show, that its action is exerted solely on the nervous system, and that it has no direct action on the heart, even when directly admitted into the blood by the jugular vein.[2330] It appears to act peculiarly by irritating the spinal cord.
Dangerous effects have often been occasioned by an accidental over-dose in ordinary medical practice. These are well exemplified by a case communicated to Dr. Bardsley by Dr. Booth of Birmingham. A man of 46, affected with hemiplegia for nearly four weeks, began to use strychnia, and had been affected by it for eleven days without particular inconvenience. During this period he took twice a day gradually increasing doses, till the amount of one grain was attained; when the usual physiological effect having ceased to occur, the quantity was increased to a grain and a half. But the first dose caused anxiety and excitability, in three hours stupor and loss of speech, and at length violent tetanic convulsions, which proved fatal in three hours and three-quarters.[2331] A fatal case, occasioned by the large dose of two scruples, has been recorded by a German physician, Dr. Blumhardt. In fifteen minutes, imperfect vomiting was brought on by emetics. At this time, the patient, a lad of seventeen, lay on his back, quite stiff, and with incipient fits of locked-jaw. The spasms gradually extended to the rest of the body, till at last violent fits of general tetanus were established, under which the whole body became as stiff as a board, the arms spasmodically crossed over the chest, the legs extended, the feet bent, so that the soles were concave, the breathing arrested, the eyeballs prominent, the pupils dilated and not contractile, and the pulse hurried and irregular. In the second severe fit he died, one hour and a half after taking the poison.[2332] I have known very dangerous tetanic spasm induced by so small a dose as two-thirds of a grain of the ordinary impure strychnia of the shops; and Dr. Pereira describes a case, communicated by a friend, where death was occasioned by a dose of half a grain administered three times a day.[2333] As each fit of spasm went off, respiration, which was found to have ceased, was maintained artificially; but no sooner did natural breathing return, than the paroxysm of tetanus returned also; and at length artificial inflation of the lungs failed to restore life.
The only accounts I have seen of the morbid appearances after death from strychnia are in the cases of Dr. Booth and Dr. Blumhardt. In the former, the muscles were in a rigid state, the fingers contracted, the vessels of the brain gorged, the membranes of the spinal cord highly injected; and four patches of extravasated blood were found between the spinal arachnoid and the external membrane. In the latter, twenty-four hours after death, there was general lividity of the skin, and extraordinary rigidity of the muscles. Fluid blood flowed in abundance from the spinal cavity, where the veins were gorged, the pia mater injected, the spinal column softened at its upper part, and here and there almost pulpy. There was also congestion and softening of the brain. The head and great vessels were flaccid, and contained scarcely any blood. The inner membrane of the stomach and intestines presented some redness, but not more than is often seen independently of irritation there.
Strychnia has been found by Pelletier and Caventou in four species of Strychnos, the S. nux vomica, Sancti Ignatii, Colubrina, and Tieuté; and from the researches of MM. Martius and Herberger on the composition and properties of the American poison Wourali, it is also probably contained in the S. guianensis.[2334] Vauquelin could not find it in the S. pseudo-kina, which is destitute of bitterness.
Of Poisoning with Nux Vomica.
Tests of Nux Vomica.—Nux vomica, the most common of these poisons, is a flat, roundish seed, hardly an inch in diameter, of a yellowish or greenish-brown colour, covered with short silky hair, and presenting a little prominence on the middle of one of its surfaces. In powder it has a dirty greenish-gray colour, an intensely bitter taste, and an odour like powder of liquorice. It inflames on burning charcoal, and when treated with nitric acid acquires an orange-red colour, which is destroyed by the addition of protochloride of tin. Its infusion also is turned orange-red by nitric acid, and precipitated grayish-white with tincture of galls.
Orfila and Barruel have made some experiments on the mode of detecting it in the stomach, and the following is the plan recommended by them. The contents of the stomach, or the powder, if it can be separated, must be boiled in water acidulated with sulphuric acid. The liquid after filtration is neutralized with carbonate of lime, and then evaporated to dryness. The dry mass is then acted on with successive portions of alcohol, and evaporated to the consistence of a thin syrup. The product has an intensely bitter taste, yields a precipitate with ammonia, becomes deep orange-red with nitric acid, and will sometimes deposit crystals of strychnia on standing two or three days.[2335] By this process Dr. R. D. Thomson, in a case which proved fatal in three hours, detected nux-vomica, although vomiting had been induced by emetics.[2336]
These experiments it is important to remember, because, contrary to what takes place in regard to vegetable poisons generally, nux vomica is often found in the stomachs of those poisoned with it.
Its Mode of Action and Symptoms in Man.—The poisonous properties of nux vomica are now well known to the vulgar; and in consequence it is occasionally made the instrument of voluntary death, although no poison causes such torture. It is difficult to conceive, considering its intensely bitter taste, how any one could make it the instrument of murder. But a fact is stated in Rust’s Journal, which shows that it may be used for that purpose. At a drinking party one man wagered with another, that if he took a little Cocculus indicus in beer, he would be compelled to walk home on his head. The wager was taken and the potion drunk; but nux vomica was substituted for the Cocculus indicus, itself too a virulent poison; and the man went home and died in convulsions fifteen minutes afterwards.[2337]
Many experiments have been made on animals with nux vomica; but the first accurate inquiry was that of Magendie and Delille read before the French Institute in 1809. The symptoms they remarked were precisely the same with those produced by strychnia. Half a drachm of the powder killed a dog in forty-five minutes, and a grain and a half of the alcoholic extract thrust into a wound killed another in seven minutes. The animals uniformly experienced dreadful fits of tetanic spasm, with intervals of relaxation and sensibility, and were carried off during a paroxysm.
The cause of death appears to be prolonged spasm of the thoracic muscles of respiration. The spasm of these muscles is apparent in the unavailing efforts which the animals make to inspire. The external muscles of the chest may be felt during the fits as hard almost as bone; and, according to an experiment of Wepfer, the diaphragm partakes in the spasm of the external muscles.[2338]
On account of the singular symptoms of irritation of the spinal cord, uncombined with any injury of the brain, this poison is believed to act on the spinal marrow alone. This is farther shown by the experiments of Mr. Blake with strychnia alluded to above. But from some experiments by Segalas it appears also to exhaust the irritability of the heart: for in animals he found that organ could not be stimulated to contract after death, and life could not be prolonged by artificial breathing.[2339] A similar observation was made long ago by Wepfer, who found the heart motionless and distended with arterial blood in its left cavities;[2340] and a case of poisoning in the human subject to the same effect will be presently related. The pulse is always very weak, often wholly suppressed during a paroxysm; and in the case alluded to it was found on dissection pale, flaccid and empty, having been apparently affected with spasm. The action exerted through the medium of the spinal cord on the muscles is wholly independent of the brain; for Stannius found that in frogs the removal of the brain does not interfere with the effects.[2341]
Of late poisoning with nux vomica has been common. The most characteristic example yet published is a case related by Mr. Ollier, of a young woman, who in a fit of melancholy, took between two and three drachms of the powder in water. When the surgeon first saw her, half an hour afterwards, she was quite well. But going away in search of an emetic, and returning in ten minutes, he found her in a state of great alarm, with the limbs extended and separated, and the pulse faint and quick. She then had a slight and transient convulsion succeeded by much agitation and anxiety. In a few minutes she had another, and not long afterwards a third, each about two minutes in duration. During these fits, “the whole body was stiffened and straightened, the legs pushed out and forced wide apart; no pulse or breathing could be perceived; the face and hands were livid, and the muscles of the former violently convulsed.” In the short intervals between the fits she was quite sensible, had a feeble rapid pulse, complained of sickness with great thirst, and perspired freely. “A fourth and most violent fit soon succeeded, in which the whole body was extended to the utmost from head to foot. From this she never recovered: she seemed to fall into a state of asphyxia, relaxed her grasp, and dropped her hands on her knees. Her brows, however, remained contracted, her lips drawn apart, salivary foam issued from the corners of the mouth, and the expression of the countenance was altogether most horrific.” She died an hour after swallowing the poison.[2342]—A case precisely similar, produced by three pence worth of the powder, and fatal in little more than an hour, is related by Mr. Watt of Glasgow.[2343]—Another apparently also similar but fatal in three hours, is related by Dr. R. D. Thomson.[2344] There is in fact very little variety of symptoms in different cases, where death occurs in the primary stage.—Occasionally even in such rapid cases there is a little vomiting in the first instance. This was remarked in Mr. Watt’s case, and also in another described by MM. Orfila and Ollivier.[2345]
When death does not take place thus suddenly in a fit of spasm, the person continues to be affected for twelve or sixteen hours with similar, but milder paroxysms; and afterwards he may either recover without farther symptoms, or expire in a short time apparently from exhaustion, or suffer an attack of inflammation of the stomach and intestines, which may or may not prove fatal.
M. Jules Cloquet has described a case, where the patient seemed to die of the excessive exhaustion produced by the violent, long continued spasms. The tetanic fits lasted about twenty-four hours, the sensibility in the intervals being acute. Slight signs of irritation in the stomach succeeded; and death ensued on the fourth morning.[2346]
In the Bulletins of the Medical Society of Emulation another case is related, which arose from an over-dose of the alcoholic extract being taken by an old woman who was using it for palsy. She took three grains at once. Violent tetanus was soon produced; and afterwards she had a regular attack of inflammation of the stomach and intestines, which proved fatal in three days.
The last instance to be noticed exemplifies very well the effects of the poison when the quantity is insufficient to cause death. A young woman swallowed purposely a drachm mixed in a glass of wine. In fifteen minutes she was seized with pain and heat in the stomach, burning in the gullet, a sense of rending and weariness in the limbs succeeded by stiffness of the joints, convulsive tremors, tottering in her gait, and at length violent and frequent fits of tetanus. Milk given after the tetanus began excited vomiting. She was farther affected with redness of the gums, inflammation of the tongue, burning thirst, and pain in the stomach. The pulse also became quick, and the skin hot. Next day, though the fits had ceased, the muscles were very sore, especially on motion. The tongue and palate were inflamed, and there was thirst, pain in the stomach, vomiting, colic and diarrhœa. These symptoms, however, abated, and on the fourth day disappeared, leaving her exceedingly weak.[2347]
This and the previous case show clearly the double narcotico-acrid properties of the poison.
With regard to the dose requisite to prove fatal, the smallest fatal dose of the alcoholic extract yet recorded is three grains, which was the quantity taken in the case from the Parisian bulletins: Hoffmann mentions a fatal case caused by two fifteen grain doses of the powder;[2348] and in Hufeland’s Journal there is another caused by two drachms, which was fatal in two hours.[2349]—A dog has been killed by eight grains of the powder, and a cat by five.[2350] It is even said that a dog has been killed by two grains.[2351]
It has been thought, from some observations by Mr. Baker on the medicinal use of nux vomica in Hindostan that, by the force of habit, the constitution may become to a certain extent accustomed to large doses of this poison, in the same manner as it acquires the power of enduring large doses of opium. The natives of Hindostan, often take it morning and evening for many months continuously, beginning with an eighth part of a nut, and gradually increasing the dose to an entire nut, or about twenty grains. If it is taken either immediately before or after meals, it never occasions any unpleasant effects; but if this precaution be neglected, spasms are apt to ensue.[2352] As it is found unsafe, however, to increase the dose beyond one nut, and the poison is taken in the form of coarse powder, in which state it must be slowly acted on by the fluid in the stomach, it is probable that the modifying influence of habit is inconsiderable. Habit certainly does not familiarize the system to strychnia used medicinally. The same dose, which has once excited its peculiar physiological action, will for the most part suffice to excite it again, however frequently the dose may be repeated.—The facts mentioned by Mr. Baker show that nux vomica is not a cumulative poison; and European experience, in the instance of strychnia, is to the same effect.
Morbid Appearances.—The morbid appearances differ according to the period at which death occurs. In Mr. Ollier’s case, where death took place in an hour, the appearances were insignificant. The stomach was almost natural, the vessels of the brain somewhat congested, the heart flaccid, empty, and pale. In the case in Hufeland’s Journal there was general inflammation of the stomach, duodenum and part of the jejunum. In Cloquet’s case, a slower one, there was very little appearance of inflammation. In that from the Parisian bulletins, on the contrary, the stomach was highly inflamed, the intestines violet-coloured, in many places easily lacerated and apparently gangrenous. In an interesting dissection of a case, which was quickly fatal,—that related by Orfila and Ollivier, there was found much serous effusion on the surface of the cerebellum, and softening of the whole cortical substance of the brain, but especially of the cerebellum. Blumhardt too, found softening of the cerebellum and congestion of the cerebral vessels, together with softening of the spinal cord and general gorging of the spinal veins. This is some confirmation of an opinion advanced not long ago in France by Flourence and others, that nux vomica acts particularly on the cerebellum.[2353] In Dr. R. D. Thomson’s case, which was examined by Mr. Taylor, there was found much congestion of the whole membranes and substance of the brain and cerebellum, and even some extravasation of blood within the cavity of the arachnoid over the upper surface of the former. Mr. Watt remarked in his case (sixty hours, however, after death in summer) softening of the substance of the brain and the lumbar part of the spinal cord.—In Orfila and Ollivier’s case the lungs were found much gorged with black fluid blood.—In Blumhardt’s case the heart and great vessels were entirely destitute of blood.—There is sometimes seen, as in Dr. R. D. Thomson’s case, a brown powder lining the stomach, even although vomiting may have occurred.
The body appears sometimes to retain for a certain period after death the attitude and expression impressed on it by the convulsions during life. In the instance mentioned by Orfila and Ollivier the muscles immediately after death remained contracted, the head bent back, the arms bent, and the jaws locked. This state may even continue for some hours, so that the body appears to pass into the state of rigidity which precedes decay, without also passing through the preliminary stage of flaccidity immediately after death. In the case related by Mr. Ollier, the body five hours after death “was still as stiff and straight as a statue, so that if one of the hands was moved the whole body moved along with it;” and in Blumhardt’s case the rigidity twenty hours after death was unusually great. This state of rigidity, however, does not invariably occur. On the contrary, in animals the limbs become very flaccid immediately after death; but the usual rigidity supervenes at an early period.[2354] In Dr. R. D. Thomson’s case flaccidity immediately followed death.
Treatment.—Little is known of the treatment in this kind of poisoning. But it is of the greatest moment to evacuate the stomach thoroughly, and without loss of time. Hence emetics are useful; but if the stomach-pump is at hand it ought to be resorted to without waiting for the operation of emetics. Torosiewicz describes the case of a young woman who, after the usual symptoms had begun to appear in consequence of the administration of a tea-spoonful of powder, recovered under the action of an emetic followed by rhatany-root.[2355] When nux vomica is taken in powder,—the most frequent form in which it has been used,—it adheres with great obstinacy to the inside of the stomach. Consequently whatever means are employed for evacuating the stomach, they must be continued assiduously for a considerable time. If the patient is not attacked with spasms in two hours, he will generally be safe.
M. Donné of Paris has stated that he has found iodine, bromine, and chlorine to be antidotes for poisoning with the alkaloid of nux vomica, as well as for the other vegetable alkaloids. Iodine, chlorine, and bromine, he says, form with the alkaloid compounds which are not deleterious,—two grains and a half of the iodide, bromide, and chloride of strychnia, having produced no effect on a dog. Animals which had taken one grain of strychnia or two grains of veratria, did not sustain any harm, when tincture of iodine was administered immediately afterwards. But the delay of ten minutes in the administration of the antidote rendered it useless. In the compounds formed by these antidotes with the alkaloids, the latter are in a state of chemical union, and not decomposed. Sulphuric acid separates strychnia, for example, from its state of combination with chlorine, iodine, or bromine, and forms sulphate of strychnia, with its usual poisonous qualities.[2356] It remains to be proved that the same advantages will be derived from the administration of these antidotes in the instance of poisoning with the crude drug, nux vomica, as in poisoning with its alkaloid.
In general little difficulty will be encountered in recognizing a case of poisoning with nux vomica. Tetanus or locked-jaw is the only disease which produces similar effects. But that disease never proves so quickly fatal as the rapid cases of poisoning with nux vomica; and it never produces the symptoms of irritation observed in the slower cases. Besides, the fits of natural tetanus are almost always slow in being formed; while nux vomica brings on perfect fits in an hour or less. It is right to remember, however, that nux vomica may be given in small doses, frequently repeated, and gradually increased, so as to imitate exactly the phenomena of tetanus from natural causes. Medical men will be at no loss to discover, on reflection, how the preparations of this drug may be rendered formidable secret poisons.
Of Poisoning with the St. Ignatius Bean and Upas Tieuté.
The Strychnos Sancti Ignatii, or St. Ignatius bean, contains about three times as much strychnia as nux vomica, namely, from twelve to eighteen parts in the 1000. It is very energetic. Dr. Hopf has mentioned an instance of a man, who was attacked with tetanus of several hours’ duration after taking the powder of half a bean in brandy, and who seems to have made a narrow escape.[2357]
The Strychnos tieuté is the plant which yields the Upas tieuté, one of the Javanese poisons. This substance has been analyzed by Pelletier and Caventou, and found to contain strychnia.[2358] From the experiments of Magendie and Delille, the Upas tieuté appears to be almost as energetic as strychnia itself.[2359] Mayer found that the bark of the plant which yields it, when applied in the dose of fifty grains to a wound, killed a rabbit in two hours and a half.[2360] Dr. Darwin has given an account of its effects on the Javanese criminals, who used formerly to be executed by darts poisoned with the tieuté. The account quoted by him is not very authentic; yet it accords precisely with what would be expected from the known properties of the poison. He says, that a few minutes after the criminals are wounded with the instrument of the executioner, they tremble violently, utter piercing cries, and perish amidst frightful convulsions in ten or fifteen minutes.[2361]
Of Poisoning with False Angustura Bark.
Besides these poisons of the genus Strychnos, the present group comprehends another, of the same properties, which was once supposed to be derived from a plant of a different family, the Brucea antidysenterica.
A species of bark, commonly called the false angustura bark, was introduced by mistake into Europe instead of the true angustura, cusparia, or bark of the Galipea officinalis. It was long supposed to be the bark of the Brucea antidysenterica; but it is now known to be the bark of S. nux vomica.[2362] It is a poison of great energy. It gave rise to so many fatal accidents soon after its introduction, that in some countries on the continent all the stores of angustura were ordered to be burnt. It contains a less proportion of strychnia, but more of the alkaloid brucia than nux vomica, the seed of the plant.
According to Andral, brucia is twenty-four times less powerful than strychnia;[2363] but the bark itself is as strong nearly as nux-vomica, for Orfila found that eight grains killed a dog in less than two hours.[2364]
The symptoms it induces are the same as those caused by nux vomica. They are minutely detailed in a paper by Professor Emmert of Bern.[2365] It appears that during the intervals of the fits the sensibility is remarkably acute: a boy who fell a victim to it implored his physician not to touch him, as he was immediately thrown into a fit. Professor Marc of Paris was once violently affected by this poison, which he took by mistake for the true angustura to cure ague. He took it in the form of infusion, and the dose was only three-quarters of a liqueur-glassful; yet he was seized with nausea, pain in the stomach, a sense of fulness in the head, giddiness, ringing in the ears, and obscurity of vision, followed by stiffness of the limbs, great pain on every attempt at motion, locked-jaw, and impossibility of articulating. These symptoms continued two hours; and abated under the use of ether and laudanum.[2366]
Some interesting experiments were made by Emmert with this poison to show that it acts on the spine directly, and not on that organ through the medium of the brain. If an animal be poisoned by inserting the extract of false angustura bark into its hind-legs after the spinal cord has been severed at the loins, the hind-legs as well as the fore-legs are thrown into a state of spasm; or if the medulla oblongata be cut across and respiration maintained artificially, the usual symptoms are produced over the whole body by the administration of it internally or externally,—the only material difference being that they commence more slowly, and that a larger dose is required to produce them, than when the medulla is not injured. On the other hand, when the spinal cord is suddenly destroyed after the symptoms have begun, they cease instantaneously, although the circulation goes on for some minutes.[2367]
The true angustura bark has a finer texture than the other, and is darker coloured, aromatic, pungent, and less bitter. The ferro-cyanate of potass causes in a muriatic infusion of the false bark a precipitate, which is first green and then becomes blue; and the same reagent converts into blue the reddish powder which lines the bark. No such effects are produced on the true angustura bark. Nitric acid renders the rusty efflorescence of the spurious bark deep dirty blue, but has no such effect on the true bark; which, besides, never exhibits a yellow efflorescence.
With the preceding poisons Orfila has arranged also some poisons used by the American Indians; but, as in Europe they are mere objects of curiosity, it is scarcely necessary to treat of them particularly here.
The most interesting and best known of them is the wourali poison of Guiana, variously called woorara, urari, or curare, by different authors. It is believed to have been traced by Martius to a new species of strychnos, the S. guianensis, and more recently by Dr. Schomburg to a different species, the S. toxicaria of that traveller. But the action it exerts does not correspond exactly with what would be expected of a plant belonging to that genus.
The effects of wourali have been investigated by Sir B. Brodie in the Philosophical Transactions for 1811–12, in Orfila’s Toxicology, in Magendie’s Memoir on Absorption, and in Fontana’s Traité des Poisons. But the most detailed inquiry is that by Emmert, published in 1818. It produces, not convulsions or spasm of the muscles, but on the contrary paralysis, and probably occasions death in this way by suspending the respiration, in the same way as hemlock and conia. According to Emmert’s experiments the spine only is acted on, and not the brain also.[2368] Some remarkable experiments were made in 1839 by Mr. Waterton, to show the power of artificial respiration in accomplishing recovery from its effects. After the animals had fallen down motionless from the action of the poison introduced through a wound, and when the action of the heart had become so feeble as not to affect the pulse, artificial respiration, continued in one instance for seven hours and a half, and in another for two hours, had the effect of restoring the animals to health.[2369]
XXXVIII. OF POISONING WITH CAMPHOR, COCCULUS INDICUS, ETC
The third group of the narcotico-acrids resemble strychnia in their action so far, that they occasion in large doses convulsions of the tetanic kind. But they differ considerably by producing at the same time impaired sensibility or sopor. They are camphor, Cocculus indicus, its active principle picrotoxin, the Coriara myrtifolia, the Upas antiar, a Java poison, and perhaps also the yew-tree.
Of Poisoning with Camphor.
Camphor dissolved in oil soon causes in dogs paroxysms of tetanic spasm. At first the senses are entire in the intervals; but by degrees they become duller, till at length a state of deep sopor is established, with noisy laborious breathing, and expiration of camphorous fumes; and in this state the animal soon perishes. A solution of twenty grains in olive oil will kill a dog in less than ten minutes when injected into the jugular vein. When camphor is given to dogs in fragments, it does not excite convulsions, but kills them more slowly by inducing inflammation of the alimentary canal. These are the results of numerous experiments by Orfila.[2370]
They are confirmed by others performed more lately by Scudery of Messina; but this experimentalist likewise remarked, that the convulsions were attended with a singular kind of delirium, which made the animals run up and down without apparent cause, as if they were maniacal. He also found the urinary organs generally affected, and for the most part with strangury.[2371] Lebküchner discovered camphor in the blood of animals poisoned with it.[2372]
Symptoms in Man.—The symptoms caused by camphor in man may not have been observed; but so far as they have been witnessed, they establish its claim to be considered a narcotic and acrid poison. Its effects appear to be singularly uncertain: at least they are very discrepant; and the reason for this is not apparent.
Its narcotic effects are well exemplified in an account given by Mr. Alexander from personal experience, and by Dr. Edwards of Paris, as they occurred in a patient of his who received a camphor clyster.
Mr. Alexander, in the course of his experiments on his own person with various drugs, was nearly killed by this poison, and has left the best account yet published of its effects in dangerous doses on man. After having found, by a previous experiment, that a scruple did not cause any particular symptom, he swallowed in one dose two scruples mixed with syrup of roses. In the course of twenty minutes he became languid and listless, and in an hour giddy, confused, and forgetful. All objects quivered before his eyes, and a tumult of undigested ideas floated through his mind. At length he lost all consciousness, during which he was attacked with strong convulsive fits and maniacal frenzy. These alarming symptoms were dispelled, on Dr. Monro, who had been sent for, accidentally discovering the subject of his patient’s experimental researches, and administering an emetic. But a variety of singular mental affections continued for some time after. The emetic brought away almost the whole camphor which had been swallowed three hours before.[2373]
In Dr. Edwards’s patient, the symptoms were excited by an injection containing half a drachm of camphor. In a few minutes he felt a camphrous taste, which was followed by indescribable uneasiness. On then going down stairs for assistance, he was astonished to feel his body so light, that he seemed to himself to skim along the floor almost without touching it. He afterwards began to stagger, his face became pale, he felt chilly, and was attacked with a sense of numbness in the scalp. On then taking a glass of wine, which he asked for, he became gradually better; but for some time his mind was singularly affected. He felt anxious, without thinking himself in danger; he shed tears, but could not tell why; they flowed in fact involuntarily. For twenty-four hours his breath exhaled a camphrous odour.[2374]
Hoffmann has related a case analogous to those of Alexander and Edwards. The dose was two scruples taken in oil; the symptoms vertigo, chilliness, anxiety, delirium, and somnolency.[2375]
These cases would seem to indicate very considerable activity; yet there can be little doubt that even larger doses have been at times taken with much less effect. Thus, from an account given by Dr. Eickhorn of New Orleans, of its operation on himself, when incautiously swallowed to the amount of two drachms in frequent small doses within three hours, it would appear that the only result was great heat, palpitation, hurried pulse, and pleasant intoxication, then moisture of the skin, next profound sleep for some hours, attended with excessive sweating, and finally no ultimate ill consequence except great debility.[2376] I am assured by a correspondent, Dr. Jennison of Cambridge, U. S., that a medical friend of his has given 90 grains of camphor four times a day in phrenitis, with safety and advantage.
Professor Wendt of Breslau has related an instance, which proves the irritant action of camphor on man, and likewise the uncertainty of the dose required to act deleteriously. In the case of Mr. Alexander, two scruples would in all probability have proved fatal, had they not been discharged in time by vomiting. In the case now to be noticed, 160 grains were taken in a state of solution in alcohol, and were not vomited; yet the individual recovered. He was a drunkard, who took four ounces of camphorated spirit, prescribed for him as an embrocation. Soon afterwards he was attacked with fever, burning heat of the skin, anxiety, burning pain in the stomach, giddiness, flushed face, dimness of sight, sparks before the eyes, and some delirium. He soon got well under the use of almond oil and vinegar, but did not vomit.[2377]
Morbid Appearances.—The morbid appearances caused by camphor have not, so far as I know, been witnessed in man. In dogs examined immediately after death, the heart is no longer contractile, and its left cavities contain arterial blood of a reddish-brown colour. When the poison has been given in fragments, it leaves marks of inflammation in the stomach and intestines. Orfila found these organs much inflamed in such circumstances.[2378] Scudery found the membranes of the brain much injected, and the brain itself sometimes softened; the inner membrane of the stomach either very red, or checkered with black, gangrenous-like spots of the size of millet-seeds; the duodenum in the same state; the ureters, urethra, and spermatic cords inflamed; and every organ in the body, even the brain, impregnated with the odour of camphor.[2379]
Of Poisoning with Cocculus Indicus.
The Menispermum cocculus, Cocculus suberosus, or Anamirta cocculus of botanists, is a creeping plant which grows in the island of Ceylon, on the Malabar coast, and in other parts of the East Indies. Its fruit, which is the only part of the plant hitherto particularly examined, is like a large, rough, grayish-black pea, and is known in the shops by the name of Cocculus indicus. It has a rough, ligneous pericarp, enclosing a pale grayish-yellow, brittle kernel, of a very strong lasting bitter taste. The medical jurist should make himself well acquainted with its external characters, because, besides being occasionally used in medicine, it is a familiar poison for destroying fish, and has also been extensively used by brewers as a substitute for hops,—an adulteration which is prohibited in Britain by severe statutes. It has been analyzed by M. Boullay of Paris,[2380] who found in it besides other matters, a peculiar principle termed picrotoxin. This principle constitutes, according to Boullay, about a fifth part of the kernel; according to Nees von Esenbeck, only a hundreth part:[2381] and my own experiments agree with the results of the latter. It is moderately soluble in water, and crystallizes readily from a hot acidulous watery solution. It is more soluble in hot alcohol, from which it crystallizes in granular masses. Ten grains of it killed a dog in twenty-five minutes in the second paroxysm of tetanus.
The seeds themselves occasion vomiting soon after they are swallowed; so that animals may often swallow them, if not without injury, at all events without danger. But if the gullet be tied, the animal soon begins to stagger; the eye acquires a peculiar haggard expression, which is the sure forerunner of a tetanic paroxysm; and the second, third, or fourth fit commonly proves fatal. Three or four drachms will kill a dog when introduced into the stomach; less will suffice when it is applied to a wound; and still less when it is injected into a vein.[2382] Wepfer has related a good experiment, from which he infers that Cocculus indicus acts by exhausting the irritability of the heart. In the intervals of the fits the pulse could not be felt; and on opening the chest immediately after death, he found the heart motionless and all its cavities distended.[2383] Orfila also sometimes found the heart motionless, and its left cavities filled with reddish-brown blood.[2384]
This poison does not seem to possess distinct acrid properties in regard to animals. M. Goupil indeed found that it produced vomiting and purging,[2385] but Orfila could not observe any such effect. According to Goupil it possesses the singular property of communicating to the flesh of animals, more particularly of fish, that have been killed with it, some of the poisonous qualities with which it is itself endowed. The accuracy of this statement may be doubted, the alleged fact being contrary to analogy. Besides, this poison has been used immemorially in the East for taking fish; and it is familiarly used for the same purpose in some parts of France, though prohibited by statute. Chevallier mentions that in a particular parish the inhabitants live half the year on fish caught with this poison; and that a friend of his made trial of fish so caught, without the slightest injury.[2386]
Symptoms in Man.—Although it is well known that malt liquors have often been adulterated with Cocculus indicus for the purpose of economizing hops, cases of poisoning in the human subject are rare, because the quantity required to communicate the due degree of bitterness is small. Professor Bernt has shortly noticed a set of cases, which arose in consequence of an idiot having seasoned soup with it by mistake. Nine people were taken ill with sickness, vomiting, pain in the stomach and bowels; and one died in twelve days.[2387] The symptoms under which this person died are not stated; but the account of the accident sent to Bernt imputed death to the poison,—which is improbable, considering the length of the interval before death.
In the same group with camphor and Cocculus indicus Orfila has arranged Upas antiar, a Javanese poison. This poison is a very bitter milky juice or extract, which is known in Europe only as an article of curiosity. It has been sometimes confounded with the Upas tieuté. It owes its properties to a neutral principle called antiarin.[2388] From the experiments of MM. Magendie and Delille,[2389] as well as from those of Sir B. Brodie[2390] and of Emmert[2391] it appears to act in the same manner, and to produce the same effects, as camphor and Cocculus indicus. In small doses it acts as an irritant; in large doses it causes convulsions and coma.
It is here noticed principally because it is one of the poisons which act violently on the heart. If the body of an animal be examined immediately after death from the Upas antiar, the heart is found to have lost its irritability, and the left ventricle to contain florid blood: Schnell found, that, like many other active poisons, it has no effect when applied to the divided end of a nerve.[2392]
The Coriaria myrtifolia is also supposed by some to possess the properties of the present group, and is sufficiently important from its energy, and its occasional injurious effects on man, to claim some notice here.
Its toxicological action has been investigated by Professor Mayer of Bonn, who found that it excites in most animals violent fits of tetanus, giving place to apoplectic coma; and that in the dead body the brain is seen gorged with blood, the blood in the heart and great vessels fluid, the heart not irritable immediately after death, and the inner membrane of the stomach yellowish and shrivelled. A drachm of the extract of the juice killed a cat in two hours when swallowed; half a drachm applied to a wound killed another in eighty-five minutes; and six grains in the same way killed a kitten in three hours and a half. A drachm swallowed by a young dog killed it in two hours and a half. Ten grains of the extract of the infusion applied to a wound killed a kitten in six hours; and three grains another in three hours. A buzzard was killed in three-quarters of an hour by half a drachm of the extract of the juice. Frogs are also soon killed by it. Rabbits, it is remarkable, are scarcely affected by this poison, either administered internally, or applied to a wound,—a drachm in the former way, and half as much in the latter, having produced no effect at all. A grain, however, injected into the jugular vein occasioned in about five hours a single convulsive paroxysm, which proved immediately fatal.[2393]
Instances of poisoning with this substance have occurred in the human subject,—generally in consequence of its having been taken in various parts of the continent with senna, which it is employed to adulterate. Sauvages has recorded two cases of death occasioned by the berries. In one, a child, death took place within a day under symptoms like epileptic convulsions; and in the other, an adult, who swallowed only fifteen berries, convulsions, coma, and lividity of the face were produced, ending fatally the same evening, though the greater part of the berries were discharged by emetics.[2394] In recent French journals various similar cases are recorded. M. Fée describes five cases, one of them fatal. In this instance, a male adult, death occurred within four hours after he took an infusion of senna adulterated with the coriaria; and the symptoms were violent convulsions, locked-jaw and colic.[2395] M. Roux has noticed a great number of cases in the fullest paper yet published on its effects on man, and gives the details of three which came under his own notice, and of which one proved fatal. In the fatal case, that of a child three years and a half old, who took between eighty and a hundred berries, the symptoms were heat and pricking of the tongue, sparking and rolling of the eyes, loss of voice, locked-jaw, and convulsions recurring in occasional fits of eight or ten minutes in duration. Death ensued in sixteen hours and a half.[2396] Roux refers also among other instances to those of no fewer than ten soldiers, who were attacked at the same time in consequence of eating the berries, and of whom two died. In Roux’s fatal case there was injection of the membranes of the brain, and no other particular appearance; in that mentioned by Fée, there was inflammation of the stomach and bowels; and in one of Sauvages’s cases no morbid appearance at all was discovered.
Considering these very pointed proofs of the poisonous qualities of the coriaria, it is not a little singular that doubts have lately arisen whether it is a poison at all. Peschier of Geneva says he has ascertained that tanners, who use it in their trade on account of the powerful astringency of the leaves, also take it internally for gleet, and that he gave a decoction of an ounce to chickens, dogs, and men, without witnessing any ill effect.[2397]
Of Poisoning with Yew.
The leaves and berries of the Taxus baccata, or yew, are known to be poisonous; but their effects have not been investigated with care. I have arranged it in the meantime with the present group.
M. Grognier, as quoted by Orfila, ascertained that a decoction of eight ounces of berries without seeds had no effect on a dog; that a pound and a half of seeds had no effect on a horse; that three ounces of the juice of the leaves given to a large dog merely caused vomiting; and that a decoction of twelve ounces of leaves, confined in the stomach of a dog by a ligature on the gullet, had also no effect. But two ounces of the juice of the leaves killed a small dog; and Orfila himself ascertained, that thirty-six grains of extract of the leaves, injected into the jugular vein, caused giddiness, stupor, and death.[2398]
Accidents have repeatedly happened to children in this country from yew-berries. Mr. Hurt of Mansfield has given the particulars of an interesting case. A child, three years and a half old, two hours after eating the berries, was observed to look ill at dinner, and became affected with lividity and heaviness of the eyes, as if he was about to fall asleep. Vomiting followed, without any pain; and he died before a medical man, who was sent for, could arrive. Four other children, somewhat older, who had eaten the seeds, were made to vomit by emetics, and got well. The dead body of the first child presented many livid spots, redness of the villous coat of the stomach, and gorging of the brain and membranes with blood. A mass of berries, seeds, and potatoes was found in the stomach.[2399]—Dr. Hartmann of Frankfort mentions that a girl, who took a decoction of the leaves to produce abortion, died in consequence, but without having miscarried.[2400]—Dr. Percival has related other cases in his essays.[2401]
XXXIX. OF THE POISONOUS FUNGI
A fourth group of poisons possessing narcotico-acrid proper ties, includes the poisonous fungi or mushrooms.
Accidents arising from the deadly fungi being mistaken for eatable mushrooms are common on the continent, and especially in France. They are not uncommon, too, in Britain; but they are less frequent than abroad, because the epicure’s catalogue of mushrooms in this country contains only three species, whose characters are too distinct to be mistaken by a person of ordinary skill; while abroad a great variety of them have found their way to the table, many of which are not only liable to be confounded with poisonous species, but are even also themselves of doubtful quality.
The present subject cannot be thoroughly studied without a knowledge of the appearance and characters of all the fungi which have been ascertained to be esculent, as well as of those which are known to be deleterious. This information, however, I cannot pretend to communicate, as it would lead to great details. In what follows, therefore, a simple list will be given of the two classes, with references to the proper source for minute descriptions of them, and some general observations on the effects of the poisonous species.
List of the wholesome and poisonous Fungi.—The only good account yet published of the innocent or eatable fungi of Great Britain is contained in an elaborate essay on the subject by Dr. Greville of this place. He enumerates no fewer than twenty-six different species, which grow abundantly in our woods and fields, and which, although most of them utterly neglected in this country, are all considered abroad to be eatable, and many of them delicate. They are the following: Tuber cibarium, or common truffle; T. moschatum and T. album, two species of analogous qualities; Amanita cæsarea or aurantiaca, the Oronge of the French, a species which is often confounded by the ignorant with a very poisonous one, the A. muscaria, or pseudo-aurantiaca; Agaricus procerus; A. campestris, the common mushroom of meadows; A. edulis, or white caps; A. oreades, or Scotch bonnets; A. odorus; A. uburneus; A. ulmarius; A. ostreatus; A. violaceus; A. deliciosus; A. piperatus; and A. acris; Boletus edulis; and B. scaber; Fistulina hepatica; Hydnum repandum; Morchella esculenta, the common morelle; Helvella mitra, and H. leucophæa. Of these the Agaricus acris, procerus, and piperatus are probably unwholesome; and the Amanita cæsarea is very rare in this country, if indeed it is indigenous at all. The A. muscaria, with which it is apt to be confounded, is common enough. The species to which our cooks confine their attention are the Tuber cibarium or truffle, the Agaricus campestris, or common mushroom, and the Morchella esculenta, or morelle. The Agaricus edulis is also to be met with in some markets, but is not in general use.[2402]
The best description of the poisonous species is to be found in Orfila’s Toxicology. He enumerates the Amanita muscaria, alba, citrina, and viridis; the Hypophyllum maculatum, albocitrinum, tricuspidatum, sanguineum, crux-melitense, pudibundum and pellitum; the Agaricus necator, acris, piperatus, pyrogalus, stypticus, annularis, and urens.[2403] To these may be added the Agaricus semiglobatus, on the authority of Messrs. Brande and Sowerby,[2404] the A. campanulatus,[2405] the A. procerus, on the authority of a case by Dr. Peddie of this city,[2406] the A. myomica, on the authority of Ghiglini,[2407] the A. panterinus on that of Dr. Paolini of Bologna,[2408] the A. bulbosus of Bulliard, or Amanita venenata, on that of Pouchet,[2409] the Agaricus vernus, insidiosus, globocephalus, sanguineus, torminosus and rimosus, on that of Letellier,[2410] and the Hypophyllum niveum on the authority of Paulet.
Circumstances which modify their qualities.—The qualities of the fungi as articles of food are liable to considerable variety. Some, which are in general eaten in safety, occasionally become hurtful; and some of the poisonous kinds may under certain circumstances become inert, or even esculent. But the causes which regulate these variations are not well ascertained.
It has been thought by some that most fungi become safe when they have been dried;[2411] and there may be some truth in this remark, as their poisonous qualities appear to depend in part on a volatile principle. But it is by no means universally true. Foderé mentions that the Agaricus piperatus continues acrid after having been dried.[2412]
Climate certainly alters their properties. The Agaricus piperatus is eaten in Prussia and Russia;[2413] but is poisonous in France. The Agaricus acris and A. necator, also enumerated above as meriting their names, are used freely in Russia.[2414] The Amanita muscaria in France and Britain is a violent poison, and is considered so even in Russia;[2415] but in Kamschatka it yields a beverage which is used as a substitute for intoxicating liquors.[2416]
There is some reason to believe also that the weather or period of the season influences some of the esculent species. Thus Foderé has mentioned instances of the common morelle having appeared injurious after long-continued rain.[2417]
Even the Agaricus campestris or common mushroom is generally believed to become somewhat unsafe towards the close of the season, or as it turns old. Its external characters at that time are sensibly altered; the margin of the cap is more acute, its white colour less lively, and the fleshy hue of its lamellæ is changed to brown or black. In this state, however, I have often eaten it freely and with impunity.
Cooking produces some difference on their effects. The very best of them are indigestible when raw; and some of the poisonous species may lose in part their deleterious qualities when cooked, because heat expels the volatile principle; but, on the whole, I believe the effect of cooking has not been satisfactorily shown to be considerable. Dr. Pouchet of Rouen seems to have clearly proved, that the poisonous properties of two of the most deadly fungi, the Amanita muscaria and A. venenata, may be entirely removed by boiling them in water. A quart of water, in which five plants had been boiled for fifteen minutes, killed a dog in eight hours, and again another in a day; but the boiled fungi themselves had no effect at all on two other dogs; and a third, which had been fed for two months on little else than boiled amanitas, not only sustained no harm, but actually got fat on this fare.[2418] Pouchet is inclined to think that the whole poisonous plants of the family are similarly circumstanced.—On the other hand some cryptogamous botanists have maintained that the qualities of the esculent mushrooms are injured by cooking, and that when used in the raw state they may be taken for a long time as a principal article of food without injury. This statement, as to the effect of mushrooms when used for a length of time as food, will be more fully considered presently. It is easy to understand how boiling may remove their active properties, although other modes of cookery may not do so. Roasting had no effect in impairing the activity of Agaricus procerus in the case observed by Dr. Peddie.
On certain persons all mushrooms, even the very best of the eatable kinds, act more or less injuriously. They cause vomiting, diarrhœa, and colic. In this respect they are on the same footing with the richer sorts of fish, which by idiosyncrasy act as poisons on particular constitutions. It is probably under this head that we must arrange an extraordinary case mentioned by Sage of a man who died soon after eating a pound of truffles. He was seized with headache, a sense of weight in the stomach, and faintness; and he lived only a few hours.[2419]
Lastly, it is not improbable from a singular set of cases to be related presently, that, contrary to what some botanists have alleged, the best mushrooms when taken in large quantity, and for a considerable length of time, are deleterious to every one.
Foderé,[2420] Orfila,[2421] Decandolle,[2422] and Greville,[2423] have laid down general directions for distinguishing the esculent from the poisonous varieties; but it is extremely questionable whether their rules are always safe; and certainly they are not always accurate, as they would exclude many species in common use on the continent. It appears that most fungi which have a warty cap, more especially fragments of membrane adhering to their upper surface, are poisonous. Heavy fungi, which have an unpleasant odour, especially if they emerge from a vulva or bag, are also generally hurtful. Of those which grow in woods and shady places a few are esculent, but most are unwholesome; and if moist on the surface they should be avoided. All those which grow in tufts or clusters from the trunks or stumps of trees ought likewise to be shunned. A sure test of a poisonous fungus is an astringent, styptic taste, and perhaps also a disagreeable, but certainly a pungent, odour. Some fungi possessing these properties have indeed found their way to the epicure’s table; but they are of very questionable quality. Those whose substance becomes blue soon after being cut are invariably poisonous. Agarics of an orange or rose-red colour, and boleti which are coriaceous or corky, or which have a membranous collar round the stem, are also unsafe; but these rules are not universally applicable in other genera. Even the esculent mushrooms, if partially devoured and abandoned by insects, are avoided by some as having in all probability acquired injurious qualities which they do not usually possess; but this test I have often disregarded.—These rules for knowing deleterious fungi seem to rest on fact and experience; but they will not enable the collector to recognise every poisonous species. The general rules laid down for distinguishing wholesome fungi are not so well founded, and therefore it appears necessary to specify them.
On the Poisonous Principle of the Fungi.—Few attempts have been hitherto made to discover by chemical analysis the principles on which the effects of the poisonous mushrooms depend. M. Braconnot analyzed a considerable number both of the esculent and poisonous species, and found in some a saccharine matter, in others an acrid resin, in others an acrid volatile principle, and in all a spongy substance, which forms the basis of them, and which he has denominated fungin.[2424] The last ingredient is innocuous, and it does not appear that M. Braconnot could trace the peculiar powers of the fungi to any of the acrid principles. The subject was afterwards resumed by M. Letellier, who says he found in some of them one, in others two poisonous principles. One of these is an acrid matter so fugacious, that it disappears when the plant is either dried, or boiled, or macerated in weak acids, alkalis, or alcohol. To this principle he says are owing the irritant properties of some fungi. The other principle is more fixed, as it resists drying, boiling, and the action of weak alkalis and acids. It is soluble in water, has neither smell nor taste, and forms crystallizable salts with acids; but he did not succeed in separating it in a state of purity. To this principle he attributes the narcotic properties of the fungi. He found it in the Amanita bulbosa, muscaria, and verna; and he therefore proposed to call it amanitine. Its effects on animals appear to resemble considerably those of opium.[2425]—Chansarel found that the poisonous principle resides in the juice, and not in the fleshy part after it is well washed.[2426]
Of the Symptoms produced in Man by the Poisonous Fungi.—The mode of action of the poisonous fungi has not been particularly examined; but the experiments of Paulet long ago established that they are poisonous to animals as well as to man.[2427]
The symptoms produced by them in man are endless in variety, and fully substantiate the propriety of arranging them in the class of narcotico-acrid poisons. Sometimes they produce narcotic symptoms alone, sometimes only symptoms of irritation, but much more commonly both together. It is likewise not improbable, that fungi, even though not belonging to the varieties commonly acknowledged as poisons, induce, when taken for a considerable length of time, a peculiar depraved state of the constitution, leading to external suppuration and gangrene. Each of these statements will now be illustrated by a few examples.
The following is a good instance of pure narcotism. A man gathered in Hyde Park a considerable number of the Agaricus campanulatus by mistake for the A. campestris, stewed them, and proceeded to eat them; but before ending his repast, and not above ten minutes after he began it, he was suddenly attacked with dimness of vision, giddiness, debility, trembling, and loss of recollection. In a short time he recovered so far as to be able to go in search of assistance. But he had hardly walked 250 yards when his memory again failed him, and he lost his way. His countenance expressed anxiety, he reeled about, and could hardly articulate. The pulse was slow and feeble. He soon became so drowsy that he could be kept awake only by constant dragging. Vomiting was then produced by means of sulphate of zinc; the drowsiness gradually went off; and next day he complained merely of languor and weakness.[2428]—An equally remarkable set of cases of pure narcotism, which occurred a few years ago in this city, has been related by Dr. Peddie. Half an hour after eating the Agaricus procerus, an elderly man and a boy of thirteen were attacked with giddiness and staggering, as if they were intoxicated; and in an hour they became insensible, the man indeed so much so that for some time he could not be roused by any means. Emetics having little effect, the stomach was cleared out by the pump, and powerful stimulants were employed both inwardly and outwardly, by means of which sensibility was in some degree restored. Occasional convulsive spasms ensued, and afterwards furious delirium, attended with frantic cries and vehement resistance to remedies, and followed by a state like delirium tremens. The pupils were at first much contracted, afterwards considerably dilated as sensibility returned, and in the boy contracted while he lay torpid, but dilated when he was roused. In neither instance was there any pain felt at any time; nor were the bowels affected. Another boy who took a small quantity only had no other symptom but giddiness, drowsiness, and debility.[2429]—A singular form of the narcotic effects of the fungi occurred in the case of a boy of fourteen, who had eaten the Agaricus panterinus near Bologna. In the course of two hours he was seized with delirium, a maniacal disposition to rove, and some convulsive movements. Ere long these symptoms were succeeded by a state resembling coma in every way, except that he looked as if he understood what was going on: and in point of fact really did so. He recovered speedily under the use of emetics.[2430]
In the next set of cases the symptoms were those of almost pure irritation. Several French soldiers in Russia ate a large quantity of the Amanita muscaria, which they had mistaken for the Amanita cæsarea. Some were not taken ill for six hours and upwards. Four of them, who were very powerful men, thought themselves safe, because while their companions were already suffering, they themselves felt perfectly well; and they refused to take emetics. In the evening, however, they began to complain of anxiety, a sense of suffocation, frequent fainting, burning thirst, and violent gripes. The pulse became small and irregular, and the body bedewed with cold sweat; the lineaments of the countenance were singularly changed, the nose and lips acquiring a violet tint; they trembled much; the belly swelled, and a profuse fetid diarrhœa supervened. The extremities soon became livid, and the pain of the abdomen intense; delirium ensued; and all four died.[2431]
Such cases, however, do not appear to be very common; and much more generally the symptoms of poisoning with the fungi present a well-marked conjunction of deep narcotism and violent irritation, as the instances now to be mentioned will show.
Besides the four soldiers whose cases have just been described, several of their comrades were severely affected, but recovered. Two of these had weak pulse, tense and painful belly, partial cold sweats, fetid breath and stools. In the afternoon they became delirious, then comatose, and the coma lasted twenty-four hours.
A man, his wife, and three children, ate to dinner carp stewed by mistake with the Amanita citrina. The wife, the servant, and one of the children had vomiting, followed by deep sopor; but they recovered. The husband had true and violent cholera, but recovered also. The two other children became profoundly lethargic and comatose, emetics had no effect, and death soon ensued without any other remarkable symptom. The individuals who recovered were not completely well till three weeks after the fatal repast.[2432] This set of cases shows the tendency of the poisonous fungi to cause in one person pure irritation, and in another pure narcotism.
The last set of cases to be mentioned were produced by the Hypophyllum sanguineum, a small conical fungus of a mouse colour, well known to children in Scotland by the name of puddock-stool. This species seems to cause convulsions as well as sopor. A family of six persons, four of whom were children, ate about two pounds of it dressed with butter. The incipient symptoms were pain in the pit of the stomach, a sense of impending suffocation, and violent efforts to vomit; which symptoms did not commence in any of them till about twelve hours after the poisonous meal, in one not till twenty hours, and in another not till nearly thirty hours. One of the children, seven years of age, had acute pain of the belly, which soon swelled enormously; afterwards he fell into a state of lethargic sleep, but continued to cry; about twenty-four hours after eating the fungi the limbs became affected with permanent spasms and convulsive fits; and in no long time he expired in a tetanic paroxysm. Another of the children, ten years old, perished nearly in the same manner, but with convulsions of greater violence. The mother had frequent bloody stools and vomiting; the skin became yellow; the muscles of the abdomen were contracted spasmodically, so that the navel was drawn towards the spine; profound lethargy and general coldness supervened; and she too died about thirty-six hours after eating the fungus. A third child, after slight symptoms of amendment had shown themselves, became worse again, and died on the third day with trembling, delirium, and convulsions. This patient, who had taken very little of the poison, was not attacked till about thirty hours after the meal. The fourth child, after precursory symptoms like those of the rest, became delirious, and had an attack of colic and inflammation of the bowels, without diarrhœa; but he eventually recovered. The father had a severe attack of dysentery for three days, and remained five days speechless. For a long time afterwards he had occasional bloody diarrhœa; and, although he eventually recovered, his health continued to suffer for an entire year.[2433] The cases now mentioned illustrate clearly the simultaneous occurrence of narcotic and irritant symptoms in the same individuals.
A striking circumstance in respect to the symptoms of poisoning with the fungi, is the great difference in the interval which elapses before they begin. In the first case the symptoms appear to have commenced in a few minutes; but, on the contrary, an interval of twelve hours is common; and Gmelin has quoted a set of cases, seventeen in number, in which, as in one of those related by Picco, the interval is said to have been a day and a half.[2434] The tardiness of the approach of the symptoms is owing to the indigestibility of most of the fungi. Their indigestibility is in fact so great, that portions of them have been discharged by vomiting so late as fifty-two hours after they were swallowed.[2435]
Another circumstance, worthy of particular notice, is the great durability of the symptoms. Even the purely narcotic effects of some fungi have been known to last above two days. In the instance just alluded to, the vomiting of the poison was the first thing that interrupted a state of deep lethargy, which had prevailed for fifty-two hours. The symptoms of irritation, after their violence has been mitigated, might continue, as in the instance quoted from Orfila, for about three weeks.
It was stated above, that some people are apt to suffer unpleasant effects from eating even the best and safest of the esculent mushrooms. These effects, which depend on idiosyncrasy, are confined chiefly to an attack of vomiting and purging, followed by more or less indigestion. Some persons have been similarly affected, even by the small portion of mushroom-juice which is contained in an ordinary ketchup seasoning. This accident, however, may very well be often unconnected with idiosyncrasy; as I have seen those who gather mushrooms near Edinburgh, for the purpose of making ketchup, picking up every fungus that came in their way.
There is some reason for suspecting that even the best mushrooms, when taken as a principal article of food for a considerable length of time, will prove injurious, and that they then induce a peculiar depraved habit, which leads to external suppuration and gangrene. The only cases which have hitherto appeared in support of this statement, were lately published in Rust’s Journal. A family, consisting of the mother and four children, were seized with a kind of tertian fever, and the formation of abscesses, which discharged a thin, ill-conditioned pus, passed rapidly into spreading gangrene, and proved fatal to the mother and one of the children. No other cause could be discovered to account for so extraordinary a conjunction of symptoms in so many individuals, except that for two months they had lived almost entirely on mushrooms; and the probability of this being really the cause, was strengthened by the fact, that the father who slept always with his family, and who alone escaped, lived on ordinary food at a place where he worked not far off.[2436] In opposition, however, to the natural inference from this narrative, some have believed, that mushrooms may be safely eaten to a large amount and for a long time, provided they be used raw. A botanist of Persoon’s acquaintance, while studying the cryptogamous plants in the vicinity of Nuremberg, says he found that the peasants ate them in large quantities as their daily food; and, in imitation of their custom, he ate for several weeks nothing but bread and raw mushrooms; yet at the end he experienced an increase rather than a diminution of strength, and enjoyed perfect health. He adds that they lose their good qualities by cooking; but he has supplied no facts in support of that statement.[2437] It is said that eatable fungi, used for a considerable time as a principal article of food, as in Russia, cause greenness of the skin.[2438] There is no reason for supposing, as some have done,[2439] that wholesome mushrooms may produce the effects of the poisonous kinds, if eaten in large quantity.
Of the Morbid Appearances.—The morbid appearances left in the bodies of persons poisoned by this deleterious fungi have been but imperfectly collected.
The body is in general very livid, and the blood fluid; so much so sometimes, that it flows from the natural openings in the dead body.[2440] In general, the abdomen is distended with fetid air, which, indeed, is usually present during life. The stomach and small intestines of the four French soldiers (p. 705), presented the appearance of inflammation passing in some places to gangrene. In two of them especially, the stomach was gangrenous in many places, and far advanced in putrefaction. The same appearances were found in Picco’s cases. In these there was also an excessive enlargement of the liver. The lungs have sometimes been found gorged or even inflamed. The vessels of the brain are also sometimes very turgid. They were particularly so in a case related by Dr. Beck, where death was occasioned in seven hours by an infusion of the Amanita muscaria in milk. The whole sinuses of the dura mater, as well as the arteries were enormously distended with blood; the arachnoid and pia mater were of a scarlet colour; the vessels of the membrane between the convolutions, together with the plexus choroides, were also excessively gorged; and the substance of the brain was red. Lastly, a clot of blood, as big as a bean, was found in the cerebellum.[2441]—The stomach, unless there had been vomiting or diarrhœa, will usually contain fragments of the poison, if it has not been taken in a state of minute division; and this evidence of the cause of death may be obtained, even although the individual survived two days or upwards. Sometimes fragments are found in the intestines. In one of Picco’s patients who lived twenty-four hours, there was found in the neighbourhood of the ileo-cæcal valve, which was much inflamed.[2442]
Of the Treatment.—The treatment of poisoning with the fungi does not call for any special observations. Emetics are of primary importance; and after the poison has been by their means dislodged, the sopor and inflammation of the bowels are to be treated in the usual way. No antidote is known. Several have at different times been a good deal confided in; but none are of any material service. Chansarel found acids useless, but thought infusion of galls advantageous.[2443]
In concluding the present chapter it is necessary to take notice of a variety of poisoning, not altogether unimportant in a medico-legal point of view. A person may seem to die of poisoning with the deleterious fungi, from eating esculent mushrooms intentionally drugged with some other vegetable or mineral poison. It must be confessed, that if the murderer is dexterous in the choice and mode of administering the poison, such cases might readily escape suspicion, and even when suspected might not be cleared up without difficulty. The ascertaining the species of mushroom, by finding others where it has been gathered, will not supply more than presumptive proof of the wholesomeness of that which has been eaten; because the esculent and poisonous species sometimes grow near one another, and have a mutual resemblance, so that a mistake may easily occur. The presumption may be somewhat strengthened by evidence derived from the interval which elapses before the symptoms begin, from the nature and progress of the symptoms themselves, and from the morbid appearances. Some one or other of these circumstances may establish the fact of poisoning with a deleterious fungi. It is impossible, however, that they shall ever establish satisfactorily that the fungus was naturally wholesome; and, on the whole, the only decided evidence of poisoning by some other means will be the actual discovery of another poison.
The case now under consideration is not a mere hypothetical one. Ernest Platner has related a very interesting example, which proves how easily poisoning of the kind supposed may be accomplished without suspicion. A servant-girl poisoned her mistress by mixing oxide of arsenic with a dish of mushrooms. She died in twenty hours, after suffering severely from vomiting and colic pains. On dissection there were found inflammation of the stomach, gangrenous spots in it, clots of blood in its contents, and redness of the intestines. Her death, however, was ascribed to the mushrooms having been unwholesome; and the real cause was not discovered till thirteen years after, when the girl was convicted of murdering a fellow-servant in a somewhat similar way by mixing arsenic with her chocolate, and then confessed both crimes.[2444]
Poisonous Mosses.—It is not improbable that some of the mosses possess poisonous properties similar to those of the deleterious fungi. Dr. Winkler of Innsbruch mentions that the Lycopodium selago is used in the Tyrol in the way of infusion for killing vermin on animals; and that unpleasant accidents have been produced in man by its accidental use. Its effects appear to be sometimes irritant, but more generally narcotic in their nature.[2445]
XL. OF THE EFFECTS OF POISONOUS GRAIN AND PULSE
The different sorts of grain are subject to certain diseases, in consequence of which meal or flour made from them is apt to be impregnated with substances more or less injurious to animal life. It is likewise believed, that unripe grain possesses properties which render it to a certain extent unfit for the food of man.
It is for the most part difficult to trace satisfactorily the operation of the poisons now alluded to, because they are seen acting only in times of famine and general distress, when it is not always easy to make due allowance for the effect of collateral circumstances. There is one poison of the kind, however, whose baneful influence has been so frequently and unequivocally witnessed, that no doubt now exists regarding its properties, I mean spurred rye, or ergot. It is a poison of no great consequence, perhaps, to the English toxicologist; for indeed I am not aware that a single instance of its operation has hitherto been observed in Britain.[2446] But its effects are so singular, and the ravages it has often committed on the continent have been so dreadful, that a short account of it cannot fail to interest even the English reader. Besides, it has lately been introduced into the materia medica, as possessing very extraordinary medicinal qualities; and since its use is gaining ground, every medical jurist ought to be conversant with its properties as a poison. I have also met with an instance where it was administered for the purpose of procuring miscarriage.
Of Poisoning with Spurred Rye.
Spurred Rye, or Secale cornutum, the Seigle ergoté, or Ergot of the French, and Mutterkorn, or Roggenmutter, of the Germans, is a disease common to various grains, in consequence of which the place of the pickle is supplied by a long, black substance, like a little horn or spur. It has been known to attack many plants of the order Graminaceæ;[2447] and among those used as food by man, it has been observed on barley, oats, spring-wheat, winter-wheat, and rye. But the rye seems peculiarly subject to it, almost all the poison which has caused epidemics, as well as what is now used in medicine, being produced by that grain.
Of the Cause and Nature of the Spur in Rye.—The spur attacks rye chiefly in damp seasons, and in moist clay soils, particularly those recently redeemed from waste lands in the neighbourhood of forests. Of all the places where the spur has been hitherto observed none combines these conditions so perfectly, and none has been so much infested with the disease, as the district of Sologne, situated between the rivers Loire and Cher, in France. According to the statistical researches of the Abbé Tessier, who in 1777 was deputed by the Parisian Society of Medicine to investigate the causes of the extraordinary prevalence of the ergot in that district, the country was then so much intersected by belts of wood around the fields, that the traveller in passing along might imagine he was constantly approaching an immense forest; the arable land was so poor, that, although it lay fallow every third season, it was exhausted in nine or twelve years at farthest, and then remained a long time in pasture before it could again bear white crops; the surface was so level, and consequently so wet, that crops were obtained only when the seed was sown on the tops of furrows a foot high; and the climate is so moist, that from the month of September till late in spring the whole country is overhung by dense fogs.[2448] Here the rye, the common food of the peasantry, appears to have been in Tessier’s time more liable to be attacked by the spur than in any other part of the continent. Tessier found, that after being thrashed it contained on an average about a forty-eighth part of ergot, even in good seasons; but in bad seasons, and taking into account a considerable proportion which is shaken out of the ears and sheaves before they reach the barn, the proportion of ergot in the whole crop has been estimated so high as a fourth or even a third. In Sologne the disease was farther observed by Tessier to be always most prevalent in the dampest parts of a field, and to affect above all the first crop of fields redeemed from waste land, or from land which had previously been for some time in pasture.[2449] The same connexion between moisture and the development of the ergot has been repeatedly traced in other parts of France, as well as in Germany.[2450] And according to the experiments of Wildenow, it may be brought on at any time, by sowing the rye in a rich damp soil, and watering the plants exuberantly in warm weather.[2451]
Opinions are much divided as to the cause and nature of the spur. It had been conceived by some that nothing else is required for its production but undue moisture combined with warmth; and that under these circumstances the spur is formed simply by a diseased process from the juices of the plant.[2452] By others, such as Tillet, Fontana, and Réad, who also consider it to be simply a diseased formation, it has been held to arise from the germen being punctured when young by an insect;[2453] and in support of this statement, General Field says he saw flies puncture the glumes in their milky state where spurs afterwards formed, and imitating the operation with a needle obtained the same result.[2454] On the other hand, Decandolle, reviving a previous doctrine that the spur is a kind of fungus, conceived he had given strong grounds for believing this excrescence to be a species of sclerotium, which he terms S. clavus. Wiggers supports this doctrine by chemical analysis; for he endeavours to show that the basis of the structure of the spur is almost identical in chemical properties with the principle fungin.[2455] Lastly, the most recent researches, those of Smith,[2456] Queckett,[2457] and Bauer,[2458] founded chiefly on microscopical observations, tend to a union and modification of these two views,—namely, that the great mass of the spur is a peculiar morbid formation, and that the whitish bloom which covers fresh specimens consists of a multitude of microscopic fungi in the form of sporidia, which thickly envelope and impregnate the parts of fructification in the nascent state of the embryo, and are in all probability the exciting cause of the morbid degeneration of the pickle.[2459]
Various opinions have been formed as to the mode of propagation of the spur. Fontana has alleged that one variety of it may spread from plant to plant over a field; and that he has expressly transmitted it by contact from one ear to another.[2460] His opinion and statement of facts are at variance with experiments lately made by Hertwig, a German physician, who found that even when the ear while in flower was surrounded for twelve days with powder of spurred rye, the healthiness of the future grain was not in the slightest degree affected.[2461] The same results have also been obtained by Wiggers, and more recently by Dr. Samuel Wright.[2462] Wiggers, however, although he could not produce spurs in the way indicated by Fontana, observed that the white dust on the surface of the spurs will produce the disease in any plant, if sprinkled in the soil at its roots, appearing therefore to be analogous to the sporules or spawn of the admitted fungi. Mr. Queckett has made the most precise experiments on the mode of reproduction of the disease. He succeeded in infecting rye repeatedly with ergot by means of the sporidia developed on the spurs; but it is remarkable that he could not in the same way infect wheat or barley.[2463]
Description and analysis of Spurred Rye.—The spur varies in length from a few lines to two inches, and is from two to four lines in thickness. If it is long, there is seldom more than one or two on a single ear, and the remaining pickles of the ear are healthy. But the ears which have small spurs have generally several, sometimes even twenty; and when there are many, few of the remaining pickles are altogether without blackness at the tips.[2464] The substance of the spur is of a pale grayish-red tint; and externally it is bluish-black or violet, with two, sometimes three, streaks of dotted gray. It is specifically lighter than water, while sound rye is specifically heavier, so that they are easily separated from one another.[2465] It is tough and flexible when fresh, brittle and easily pulverized when dry. The powder is disposed to attract moisture. It has a disagreeable heavy smell, a nauseous, slightly acrid taste, and imparts its taste and smell both to water and alcohol. Bread which contains it is defective in firmness, liable to become moist, and cracks and crumbles soon after being taken from the oven.[2466]—It is easily known, when entire, by its external characters. Its powder, which is of an obscure grayish-red hue, is best known by the action of solution of potash, which immediately disengages a powerful odour of ergot, and forms a lake-red pulp; and this pulp yields by filtration a splendid lake-red solution, which gives a beautiful lake-red flaky precipitate, when either neutralized by nitric acid, or treated with an excess of solution of alum.
Spurred rye has been repeatedly subjected to analysis. The earlier researches of Vauquelin[2467] and of Pettenkofer[2468] do not lead to any pointed results. The presence of hydrocyanic acid indicated by Robert,[2469] would not account for the very peculiar effects of ergot, and has besides been denied by Wiggers. Winkler obtained various principles from it, and among the rest a thick, rancid, slightly acrid oil, and a nauseous, sweetish, acrid fluid; but he did not determine, any more than his predecessors, in which of these principles the active properties of the spur reside.[2470] Wiggers supplied more definite information on the subject. He denies the presence of hydrocyanic acid, and says he found ergot to consist chiefly of a heavy-smelling fixed oil, fungin, albumen, osmazome, waxy matter, and an extractive substance of a strong, peculiar taste and smell, in which, from experiments on animals, he was led to infer that its active properties reside. I have obtained all his chief results, except the most important of them; for the substance which ought to have been his ergotin was destitute of marked taste or smell of any kind.[2471] Dr. Wright too could not obtain the ergotin of Wiggers, and concludes from his own experiments, that the spur consists of fungin, modified starch, mucilage, gluten, osmazome, colouring matter, various salts, and thirty-one per cent. of fixed oil, in which the active properties of the poison seemed to him to reside.[2472] Buchner, however, thinks that the oil is not itself active, but owes its apparent energy to an acrid principle which alcohol removes from it, and which is not removed from the crude substance in separating the oil in the usual way by sulphuric ether, unless the ether be somewhat alcoholized.[2473] However this may be, it seems ascertained by the experiments of Dr. Wright, that the fixed oil, obtained by means of common ether, concentrates in itself the peculiar properties possessed by ergot, either in small doses as a medicine, or in a single large dose as a poison.
Effects of Spurred Rye on Man and Animals.—Before proceeding to relate the effects of this poison on man, it should be mentioned, that at different times doubts have been entertained, whether the baneful effects ascribed to it might not really arise from some other cause. But independently of the connexion which has been frequently traced between the poison and the diseases imputed to it in the human subject, the question has been set at rest by the experiments which have been tried on animals, and which indeed were instituted with a view to settle the point in dispute.
The experiments hitherto made on animals are variable in their results, yet sufficient to show that spurred rye is an active poison of a very peculiar kind. According to the observations collected by Dr. Robert from a variety of authors, it follows that it is injurious and even fatal to all animals which are fed for a sufficient length of time with a moderate proportion of it, unless they escape its action by early vomiting; that dogs and cats, in consequence of discharging it by vomiting, suffer only slight symptoms of irritant poisoning;—but that swine, moles, geese, ducks, fowls, quails, sparrows, as well as leeches and flies, are sooner or later killed by it;—and that the symptoms it causes in beasts and birds are in the first instance giddiness, dilated pupil, and palsy, and afterwards diarrhœa, suppurating tumours, scattered gangrene throughout the body, and sometimes dropping off of the toes. Wiggers ascertained that nine grains of the substance he has considered its active principle occasioned in a fowl dulness, apparent suffering, gradually increasing feebleness, coldness and insensibility of the extremities, and in three days a fit of convulsions, ending in death.[2474] Taddei lately found, that sparrows were killed by six grains of it in six or seven hours, with symptoms merely of great weakness, torpor, and indisposition to stir.[2475]
Dr. Wright, whose experiments are the most extensive and precise yet made on this subject, found that a single dose, consisting of a strong infusion of between two drachms and a half and six drachms of ergot, if introduced into the jugular vein of a dog, occasions death, sometimes in a few minutes, sometimes not for more than two hours, with symptoms of alternating spasm and paralysis, occasionally a tendency to coma, and often depressed or irregular action of the heart, or even complete arrestment of its function;—that, when introduced into the cellular tissue, it produces inflammation and suppuration, sometimes circumscribed, sometimes diffuse, and always attended with an unhealthy discharge and great exhaustion;—and that, when admitted into the stomach, it excites irritation of the alimentary canal, excessive muscular prostration, at first excitability, but afterwards singular dulness or even complete obliteration of the senses, and occasional slight spasms; but that it is not a very active poison through this channel, as above three ounces are required to prove fatal to a dog. When it was administered in frequent small doses, he could not observe the effects remarked by Robert, but found that it induced a peculiar cachectic state, indicated by extreme muscular emaciation and weakness, loss of appetite, frequency of the pulse, repulsive fetor of the secretions and excretions, congestion of the alimentary mucous membrane, excessive contraction of the spleen, enlargement of the liver and absorbent glands, and non-formation of callus at the ends of fractured bones.[2476]
With regard to its effects on man, it has been found by express experiment, that a single dose of two drachms excites giddiness, headache, flushed face, pain and spasms in the stomach, nausea, and vomiting, colic, purging, and a sense of weariness and weight in the limbs.[2477] But it is not in this way that it has been usually introduced into the system; nor are these precisely the symptoms already hinted at as particular in its action. The effects now to be mentioned form a peculiar disease, which has often prevailed epidemically in different territories on the continent, and which arises from the spur being allowed to mix with the grain in the meal, and being taken as food for a continuance of time in rye-bread. The affection produced differs much in different epidemics and even in different cases of the same epidemic. Two distinct disorders have been noticed; the one a nervous disease, characterized by violent spasmodic convulsions; the other a depraved state of the constitution, which ends in that remarkable disorder, dry gangrene; and it does not appear that the two affections are apt to be blended together in the same case.
The first form of disease, the convulsive ergotism of the French writers, has been very well described by Taube, a German physician, as it occurred in the north of Germany in 1770–1. In its most acute form, it commenced suddenly with dimness of sight, giddiness and loss of sensibility, followed soon by dreadful cramps and convulsions of the whole body, risus sardonicus, yellowness of the countenance, excessive thirst, excruciating pains in the limbs and chest, and a small, often imperceptible pulse. Such cases usually proved fatal in twenty-four or forty-eight hours. In the milder cases the convulsions came on in paroxysms, were preceded for some days by weakness and weight of the limbs, and a strange feeling as of insects crawling over the legs, arms, and face; in the intervals between the fits the appetite was voracious, the pulse natural, the excretions regular; and the disease either terminated in recovery, with scattered suppurations, cutaneous eruptions, anasarca or diarrhœa, or it proved in the end fatal amidst prolonged sopor and convulsions.[2478] Another more recent and very clear account of this form of the disease has been given by Dr. Wagner of Schlieben from his experience of an epidemic which prevailed in the neighbourhood of that place so lately as the years 1831 and 1832. In consequence of unusual moisture and late frosts in the summer of 1831, the rye was so much spurred in many fields that a fifth at least of the pickles was diseased. As soon as the country people proceeded to use the new rye, convulsive ergotism began to show itself, and it recurred more or less till next midsummer, when the diseased grain was all consumed. The usual symptoms were at first periodic weariness, afterwards an uneasy sense of contraction in the hands and feet, and at length violent and permanent contraction of the flexor muscles of the arms, legs, feet, hands, fingers and toes, with frequent attacks of a sense of burning or creeping on the skin. These were the essential symptoms; but a great variety of accessory nervous affections occasionally presented themselves. There was seldom any disturbance of the mind, except in some of the fatal cases, where epileptic convulsions and coma preceded death. Every case was cured by emetics, laxatives, and frequent small doses of opium, provided it was taken in reasonable time, and the unwholesome food was completely withdrawn.[2479]
The other form of disease, which has been named gangrenous ergotism, by the French writers, and is known in Germany by the vulgar name of creeping-sickness (kriebelkrankheit), has been minutely described by various authors. In the most severe form, as it appeared in Switzerland in 1709 and 1716, it commenced, according to Lang, a physician of Lucerne, with general weakness, weariness, and a feeling as of insects creeping over the skin; when these symptoms had lasted some days or weeks, the extremities became cold, white, stiff, benumbed, and at length so insensible that deep incisions were not felt; then excruciating pains in the limbs supervened, along with fever, headache, and sometimes bleeding from the nose; finally the affected parts, and in the first instance the fingers and arms, afterwards the toes and legs, shrivelled, dried up, and dropped off by the joints. A healthy granulation succeeded; but the powers of life were frequently exhausted before that stage was reached. The appetite, as in the convulsive form of the disease, continued voracious throughout.[2480] In milder cases, as it prevailed at different times in France, nausea and vomiting attended the precursory symptoms, and the gangrenous affection was accompanied with dark vesications.[2481] In another variety, which has been witnessed in various parts of Germany, the chief symptoms were spasmodic contraction of the limbs at first, and afterwards weakness of mind, voracity and dyspepsia, which, if not followed by recovery, as generally happened, either terminated in fatuity or in fatal gangrene.[2482]
These extraordinary and formidable distempers were first referred to the operation of spurred rye in 1597 by the Marburg Medical Faculty, who witnessed the ravages of the poison in Hessia during the preceding year. Since then repeated epidemics have broken out in Germany, Bohemia, Holstein, Denmark, Sweden, Lombardy, Switzerland, and France.[2483] About the close of last century, partly in consequence of the attention of the respective governments being turned to the subject, partly by reason of the improved condition of the peasantry in these countries, and the greater rarity of seasons of famine, the epidemics became much less common or extensive. Nevertheless the creeping-sickness has been several times noticed in Germany since the present century began.[2484]
Spurred rye is now generally believed to possess another singular quality, in consequence of which it has been lately introduced into the materia medica of this and other countries,—a power of promoting the contractions of the gravid uterus. This property seems to have been long familiar to the quacks and midwives of Germany; and towards the close of last century it rendered ergot so favourite a remedy with them, that several of the German states prohibited the use of it by severe statutes.[2485] It was first fairly brought under the notice of regular accoucheurs by the physicians of the United States between the years 1807 and 1814.[2486] There appears little reason for doubting that it possesses the power of increasing the contractions of the uterus when unnaturally languid; and consequently it has been employed, apparently with frequent good effect, to hasten languid natural labour, to promote the separation of the placenta, and to quicken the contraction of the womb after delivery. These facts, however, are mentioned chiefly as preparatory to the statement, that it has been also supposed to possess the power of producing abortion, and has been actually employed for that purpose in some foreign countries, and even in this city. Accurate information is still much wanted on this subject. No other poison seems so likely to possess a peculiar property of the kind. Nevertheless it is the opinion of the best authorities, that spurred rye has no such power, except in connexion with violent constitutional injury produced by dangerous doses; and that it is endowed with the property only of accelerating natural labour, not of inducing it, particularly in the early months of pregnancy.
It seems from the experiments of Dr. Wright to have no power whatever of inducing miscarriage in the lower animals.[2487] Notwithstanding the improbability, however, of its possessing the property of bringing on abortion, it is one of the substances at present occasionally employed with the view of feloniously causing this accident. In a case of attempt to procure abortion, which occurred not long ago in this city, one of the articles repeatedly employed, but without success, was powder of spurred rye,—as I had occasion to ascertain by chemical analysis.
Of Spurred Maize.—It has been already observed, that many other plants of the Natural Family of Grasses are subject to the ergot besides rye. But the only other species in which the disease has been particularly examined is Indian corn or maize [Zea Mays]. It appears from the inquiries of M. Roullin that maize is very subject to the spur in the provinces of Neyba and Maraquita in Colombia; that the spur forms a black, pear-shaped body on the ear in place of the pickle; and that in this state the grain, which is known by the name of maïs peladero, possesses properties injurious to animal life. Its effects, however, are somewhat different from those of spurred rye. Men who eat the ergotted maize lose their hair and sometimes their teeth, but are never attacked with dry gangrene or convulsions. When swine eat it, which after a time they do with avidity, the bristles drop off, and the hind-legs become feeble and wasted. Mules likewise lose their hair, and the hoofs swell. Fowls lay their eggs without the shell. Apes and parrots, which frequent the fields of spurred maize, fall down as if drunk; and the native dogs and deer experience similar effects.[2488]
Of the Rust of Wheat.
There are several other diseases to which grain is liable, and which are much more common in this country than the ergot. But very little is known of their effects on the animal body; which circumstance, since the wheat of this and other countries often suffers from them, is probably sufficient to show that their influence must be trifling, or at all events very seldom called forth. Wheat is liable to three diseases. One is a disease of the stalk and leaf rather than of the ear, and has the effect of preventing the development of the ear or its pickles, and of covering the plant with a brown powder. Of the two other diseases, which both attack the pickles of the ear, one consists in the substitution of a brown dry powder for the farina of the pickle, and the other of a deposition of black moist matter in the fissure of the pickle, the substance of which it also invades and partially destroys. One of these is called in Scotland brown rust, the other black rust.
Of the three diseases the only one which is apt to infect the flour is the black rust. The others, as they consist of a light dry powder, are almost entirely separated in thrashing and winnowing the grain. But the black rust being damp and adhesive, it is carried along with the pickles. Such pickles are almost invariably separated by the farmer if they are abundant; for otherwise, on account of the dark colour and disagreeable odour of the matter deposited on them, the flour possesses external qualities which would be at once recognized by a dealer of ordinary experience.
It is not improbable, that a moderate impregnation of bread with the powder formed by the diseases in question may take place, without leading to any unpleasant effect on the human body. Experiments to this effect were made by Parmentier with one of them, termed in France carie, or caries of wheat, which from his description appears to be the black rust of Scottish farmers. He gave two dogs each two drachms daily of the powder for fifteen days, without remarking any sign of ill health. Bread made with wheat flour containing a 64th of the powder, when eaten by various people, and Parmentier among the rest, to the amount of a pound daily for several days, caused slight headache and pain in the stomach the first day only; and in larger proportion it had as little effect.[2489]
It appears, then, that the introduction of any deleterious ingredient into wheat bread is hardly to be dreaded from the common diseases to which wheat is liable in this country.
Of Unripe Grain.
Wheat and other grains have been supposed to acquire qualities detrimental to health, from being cut down while unripe, or used immediately after being cut down, although ripe. I am not aware that accidents have ever been traced or even imputed to such causes in this country; and, on the whole, I believe it is generally considered here, that imperfect ripening of the pickle rather lessens the quantity, than impairs the quality, of the flour. But several times epidemics have been ascribed in France to unripe wheat. In 1801 M. Bouvier read a memoir to the Society of Medicine at Paris, ascribing to new and unripe wheat an epidemic dysentery, which laid waste several districts of the department of the Oise in the autumn of 1793. These districts abound in small farms of a few acres, on the produce of which the cultivators depend in great measure for their subsistence. Hence in unfavourable seasons the corn was commonly cut down before it was ripe, and made into bread soon after being reaped. It was accordingly among the peasantry of these farms only, and not among the agriculturists in large farms, which were under better management, that the epidemic prevailed. Bouvier remarks, that at all times when the long continuance of wet weather has compelled the inhabitants of a district to cut down the wheat before it is ripe, or a previous dearth has forced them to use it when newly cut, epidemic disorders of the bowels have been observed to rage in the latter months of autumn. And as an instance of this he refers to the year 1783, when the crops around Paris were believed to have been injured by the extraordinary prevalence of fogs, and were cut down unripe and used immediately. Various epidemics broke out in the metropolis, and still more in the surrounding country.[2490] This is an important subject for farther inquiry; but at present I cannot help thinking that M. Bouvier exaggerates the effects of the immaturity of the grain. At all events, the grain is often cut down in an unripe state in various districts of this country; and I have never heard that any epidemic diseases were produced. When M. Bouvier witnessed the epidemic of 1793 in the department of the Oise, he instructed the inhabitants of his own parish to dry the unripe corn before thrashing it, to repeat the process before the grain was converted into flour, and to mix with the flour a larger quantity than usual of yeast in making it into bread; and he states that in the succeeding year, which was even more unfavourable to the crops, they were enabled, by following these directions, to use unripe corn with safety.
Of Spoiled Bread.
This is the fittest opportunity for noticing certain injurious effects sometimes observed from the use of spoiled or mouldy bread. On the continent repeated instances have occurred of severe and even dangerous poisoning from spoiled rye-bread, barley-bread, and even wheat bread. Several instances have been observed of horses having been killed in a short space of time with symptoms of irritant poisoning after eating such bread with their ordinary food.[2491] And Ur. Westerhoff has given an account of its effects on two children and several adults. In children the symptoms were redness of the features, dry tongue, frequent weak pulse, violent colic pains, urgent thirst and headache, and subsequently vomiting and diarrhœa, alternating with great exhaustion and sleepiness. The bread in these instances was made of rye.[2492] It appears that in bread so spoiled a variety of mucedinous vegetables are developed, especially the Penicillium glaucum and P. roseum; and it is imagined by some, that this circumstance may account for the deleterious effect of the bread.[2493]
Of the Effects of Darnel-Grass.
Grain is also rendered more or less injurious by the accidental or intentional admixture of a variety of foreign substances, by which, in common speech, it is said to be adulterated. The subject of the adulteration of grain is a very important topic in medical police. But as this practice seldom imparts to the grain qualities decidedly poisonous, the consideration of it would be misplaced here. One variety, however, the accidental adulteration of flour with the seeds of the Lolium temulentum or darnel-grass calls for some notice; for it may occasion not only symptoms of poisoning, but even also death itself.
This is the only poisonous species of the natural order of the grasses. The seeds appear to be powerfully narcotic, and at the same time to possess acrid properties. Seeger gave a dog three ounces of a decoction of the flour, and observed that it was seized in five hours with violent trembling and great feebleness, which were succeeded in four hours by sopor and insensibility; but it recovered next day.[2494]
When mixed with bread and taken habitually by man, darnel-grass has been known to cause headache, giddiness, somnolency, delirium, convulsions, paralysis, and even death. M. Cordier found by experiment on himself, that very soon after eating bread containing darnel-grass flour, he felt confusion of sight and ideas, languor, heaviness, and alternate attacks of somnolency and vomiting. The bread was commonly vomited soon after he ate it.[2495] Seeger has related some cases in which the somnolency was much more deep; and states that general tremors are almost always present.[2496] A few years ago almost the whole inmates of the Poor’s House at Sheffield, to the amount of eighty, were attacked with analogous symptoms after breakfasting on oatmeal porridge; and it was supposed that the meal had been accidentally adulterated with the lolium. The chief symptoms were a piercing stare, violent agitation of the limbs, quivering of the lips, frontal headache, confusion of sight, dilated pupil, small tremulous pulse, twitches of the muscles, and palpitation. In twelve hours all of the persons attacked were well but two, who had strong convulsions in the subsequent night, but also eventually recovered.[2497] A similar accident is mentioned by Perleb, as having happened at Freyburg in the House of Correction. The inmates, soon after eating bread made with new flour, were attacked to the number of forty, with loss of speech and somnolency; and for some days afterwards they complained of sickness.[2498] The accident was ascribed to darnel-grass. In a recent instance which happened in the workhouse of Beninghausen, and which was traced to the lolium, seventy-four people were attacked with giddiness, tremor, convulsions, and vomiting. Those who had led a dissipated life suffered most, and children least of all.[2499]
Sometimes this poison appears to excite symptoms of intestinal irritation, without acting as a narcotic. A small farmer near Poicters in France saved five bushels of the seed from a field of wheat,—had it ground with a single bushel of wheat, and afterwards made bread with the mixture for his own family. He himself, with his wife and a servant, began to eat the bread on a Thursday; but the two last were so violently affected with vomiting and purging, that they refused to continue taking it. He persevered himself, however, till on the Sunday evening he became so ill that his wife wished to send for medical aid. This he refused to allow, and next day he expired after suffering severely from fits of colic.[2500]
Bley of Bemburg has examined chemically the grain of lolium. He obtained from it a bitter extractive matter, without any characteristic chemical properties, but which killed a pigeon. The seed has a very feeble bitterish taste. Bley maintains that its poisonous properties are essential to it, and not incidental, as some think.[2501]
Of the Effects of certain Poisonous Leguminous Seeds.
Among the injurious substances with which various grains are apt to be accidentally mixed from their growing together, two leguminous plants may be here shortly mentioned, as they have often been the source of disagreeable accidents on the continent.
In the department of the Cher and Loire in France, severe effects have been traced to bread made partly with flour of the Lathyrus cicera. M. Desparanches, in a report to the Prefect of the Department, says this flour occasionally forms one-half of that of which bread is made in some parishes; that it produces sometimes sudden incapability of walking, sometimes imperfect paraplegia and pain, with a draggling gait and turning in of the toes, and sometimes also slight convulsive movements of the thighs and legs.[2502] Similar effects have been traced to this substance formerly. Virey says it has been known to produce in particular a singular stiffness and state of semiflexion of the knee-joint, compelling the individual to move the limbs in one rigid mass.[2503]
The Ervum ervilia, or Bitter-vetch, which is not a native of this country, has also been found in France to possess analogous properties. In 1815, according to Virey, a great variety of herbs grew up with the grain, in consequence of the wetness of the summer; and their seeds were thus subsequently mixed with the wheat and rye. Among these he particularizes the bitter-vetch as peculiarly noxious, because it produces so great weakness of the extremities, but especially of the limbs, that the individual trembles while standing, and totters when he walks, or even requires the help of stilts; and he adds, that horses are similarly affected, so as to become almost paralytic.[2504]
The Cytisus laburnum, or laburnum tree, is another plant of the same family, which yields poisonous seeds. The whole plant is more or less deleterious. But it is chiefly the seed that has attracted attention hitherto.
I am not acquainted with any experiments relative to the action of the seeds on animals.—Its effects on man present considerable variety, and show that it is a true narcotico-acrid. In some instances they seem to have been purely narcotic. My colleague Dr. Traill has communicated to me two cases of this nature. In one of these, that of a child two years old, the first evident effects were sudden paleness and a fit of screaming, followed immediately by insensibility, and then by coldness of the whole body and lividity of the face; but vomiting having been induced by warm water and mustard, the seeds were discharged, the symptoms abated, and next day he was quite well. The other case was that of a boy who was left by his companions at Dr. Traill’s door in a state of complete insensibility, with froth at the mouth and a feeble pulse. An emetic, administered immediately, brought up a large quantity of laburnum seeds; after which the pulse became firmer, and sensibility quickly returned.—Mr. North has briefly noticed a similar case of a child, who after eating laburnum flowers, was seized with paleness and twitches of the face, coldness of the skin, laborious breathing, efforts to vomit, and great feebleness of the pulse. But recovery took place after the flowers were vomited.[2505]—In other instances the effects have been chiefly limited to an irritant action on the stomach and bowels. Dr. Bigsby of Newark informs me that a few years ago a little girl in his neighbourhood, in consequence of eating the seeds, was attacked with violent vomiting and purging, and became in other respects very ill, but recovered in forty-eight hours.—Most generally, however, the effects are partly irritant, partly narcotic. In 1839 Dr. Annan of Kinross communicated to me the case of a little boy, who in an hour after swallowing a small quantity of unripe seeds, was attacked with violent vomiting and ghastly expression of countenance, and then fell into a very drowsy state, from which he was constantly roused by shaking him and dashing cold water on his body. But for a month afterwards he continued subject to vomiting and diarrhœa.—Mr. Bonney of Brentford has related the particulars of eleven cases, which presented all the varieties of poisoning with the seeds. The subjects were children from seven to nine years of age; and they took, some of them one seed, and none more than five. Three scarcely suffered at all. One vomited the poison and got well at once. Of the others, some had only nausea and feebleness of the pulse, another had also dilatation of the pupils, some had vomiting and purging, others great drowsiness, others again both sets of symptoms. In all the pulse was weak and generally rapid. Emetics, laxatives and ammonia were administered with success.[2506]
The leaves of this plant are stated by Vicat, a good authority, to possess the property of acting violently as an emetic and purgative;[2507] and Cadet says the unripe pods have been known to produce in small quantities severe vomiting, and profuse, protracted diarrhœa.[2508]
My attention was lately turned by a criminal trial in this country to the effects of the bark, which is not alluded to as a poison by any author, although its properties seem well known to the peasantry in the north of Scotland. A lad Gordon was tried lately at Inverness for administering poison to a fellow-servant, and it was proved that he gave her laburnum-bark in broth. She immediately became very sick, and was soon attacked with incessant vomiting and purging, pain in the belly, rigor, and extreme feebleness; and several days elapsed before she could return to her work. The sickness, vomiting, purging and pain continued afterwards to recur more or less; great emaciation ensued; in six weeks she was so much reduced as to be compelled to quit service; and even six months afterwards, she continued so ill with a chronic dysenteric affection, that fears were entertained for her life, although eventually she did recover. Being consulted in the case, I was inclined to rely in the general properties of the plant and the peculiar, intense, nauseous bitterness of the bark, even more intense there than in the seeds, as adequate proof that the bark was capable of producing the effects observed in this case. I was scarcely prepared, however, to find it so deadly a narcotic poison, as it proved to be on careful experiment. Dr. Ross of Dornoch, who saw the woman and was also consulted on the part of the crown in the case, found that from twenty to seventy grains of dried laburnum-bark caused speedy and violent vomiting when administered to dogs, but no other marked effect. I found that when an infusion of a drachm of dried bark was injected into the stomach of a strong rabbit, the animal in two minutes began to look quickly from side to side, as if alarmed and uncertain in which direction to go, then twitched back its head two or three times, and instantly fell on its side in violent tetanic convulsions, with alternating opisthotonos and emprosthotonos so energetic that its body bounded with great force upon the side up and down the room. Suddenly in half a minute more all motion ceased, respiration was at an end, and, excepting that the heart continued for a little to contract with some force, life was extinct. No morbid appearance was visible anywhere. The heart was gorged, but irritable. Dr. Ross subsequently repeated this experiment, and obtained analogous results; but the animals he operated on did not die for half an hour or upwards.[2509]
MM. Chevallier and Lassaigne have discovered in the seeds an active principle called cytisin, a nauseous, bitter, brownish-yellow, neutral, uncrystallizable substance, of which small doses killed various animals amidst vomiting and convulsions, and eight grains taken by man in four doses brought on giddiness, violent spasms, and frequency of the pulse, lasting for two hours, and followed by exhaustion.[2510]
A great number of Brown’s division Papilionaceæ of the present natural family probably possess similar properties.