Part 11 (1/2)

There is commonly a wide difference between teta.n.u.s arising from a wound or from disease and that provoked by strychnia. In the former case some exciting cause can be detected; the symptoms come on gradually, and only attain their full development at the end of several hours; the rigidity of the muscles is more or less permanent, there being no intervals of relaxation as there are in poisoning; and death has hardly been known to occur in less than twenty-four hours, while frequently it is deferred for two or three days.

_Post-mortem Appearances._-Although the body may be relaxed at the time of death it usually quickly stiffens-frequently in the course of ten or fifteen minutes. The rigor mortis is persistent for some time: in the case of Cook, poisoned by Palmer, the rigidity of the body and limbs was said not to have pa.s.sed off after two months' interment. This is not however invariable, as a body may be flaccid or stiff after death from this cause as from any other. The hands are often clenched, and the soles of the feet arched and inverted. The membranes of the brain and of the upper part of the spinal cord are congested; and there is often considerable serous effusions under the spinal arachnoid. The lungs are generally loaded with dark fluid blood. The heart is usually contracted, but sometimes the right cavities are distended like the pulmonary vessels. The blood has been found black and liquid.

_Treatment._-Emetics are to be given at once, and repeated until very free vomiting is induced. If the tetanic spasms have not commenced, the stomach-pump ought to be used. Chloroform is to be given to relieve spasm and pain, but the patient should be disturbed as little as possible, as the least thing induces the tetanic attack. There is no very suitable antidote, but tannic acid, in the form of green or black tea, &c., might be given.

Iodine forms a crystallizable compound with strychnia. Dr. Bennett, of Sydney, has recorded an instance in which he attributed recovery to the employment of tincture of iodine. Hence from thirty minims to a drachm of this tincture combined with the iodide of pota.s.sium may be exhibited.

In its absence, three or four ounces of animal charcoal, diffused through water, ought to be given.

To prevent the spasms by paralyzing the motor nerves, a solution of curare has been recommended by Dr. George Harley to be injected under the skin; or, if it could be obtained, the active principle of this substance, curarina, would perhaps be deserving of trial.

The patient is to be kept warm and quiet.

To separate strychnia from organic admixture the process modified from Stas, given in the beginning of this book, is the most useful.

_Tests._-Strychnia is a white crystalline solid, very insoluble in water, soluble in alcohol or chloroform or weak acids, and having an intensely bitter taste.

1. Pure strychnia is not changed in color when treated with iodic acid or with either of the strong mineral acids; but as this alkaloid generally contains brucia, nitric acid reddens it.

2. Dissolved in sulphuric acid no change ensues; but on adding a fragment of b.i.+.c.hromate of pota.s.s to the solution a series of blue, violet, purple and red tints are produced. The same result is brought about by using ferricyanide of pota.s.sium, permanganate of pota.s.sium, the peroxide of lead, or the black oxide of manganese.

3. If the skin of a frog be dried, and a few drops of a solution containing strychnia applied to it, strong tetanic convulsions will ensue, and be reproduced every time the animal is touched or irritated.

According to Dr. Marshall Hall this strychnoscopic test will detect the 1/5000th of a grain, or even less.

4. An exceedingly useful cla.s.s of tests for many poisons has been introduced by Dr. Guy; we mean the crystalline appearances presented on subliming the substance and condensing it on a cool microscopic slide, or the crystalline form observed as modified by various reagents. Thus the strychnine sublimate, touched with a drop of carbazotic acid, forms groups of arborescent crystals, each branch forming part of a circle, when seen under the microscope.

CHAPTER XXVII.

HYPOSTHENISANTS.

NEUROTICS PRODUCING DEATH BY SYNCOPE.

ACONITE-PRUSSIC ACID.

ACONITE (_Aconitum Napellus_, _Monkshood_, _Wolfsbane_, _Blue Rocket_).-This beautiful plant is found in most parts of Europe.

_Aconitia_, the alkaloidal base of the plant, is the most deadly poison known; the fiftieth part of a grain having nearly caused death.

The chief _symptoms_ of poisoning by aconite are numbness and tingling in the mouth and throat, giddiness, abolition of muscular power, pain in the abdomen, with vomiting and purging. Sometimes delirium and slight stupor have been noticed. The pupils are usually dilated, the skin is cold, the pulse exceedingly feeble, the breathing oppressed, and there is a dread of approaching dissolution. Frequently the sufferer is perfectly conscious, though paralyzed, till death suddenly occurs after two or three hurried gasps. According to Dr. Fleming, death may be due to a sedative impression on the nervous system, or to asphyxia from paralysis of the respiratory muscles, or to syncope.

A fatal mistake is not very uncommonly made in eating the root of aconite for that of horseradish. The sense of tingling and numbness produced by the former is so different from the pungent taste of the latter that with due care no mistake should occur, except the plants be allowed to grow together, which should never be done.

A case occurred in Ireland where a woman poisoned one man and nearly killed another by sprinkling powdered aconite root over a dish of greens.

Of the root one drachm, of the tincture one drachm, and of the alcoholic extract four grains, have caused death. Death follows a considerable dose in less than an hour, but sometimes a longer period elapses.

The Bikh poison, formerly much used in India, and still not unfrequently employed, has as its basis the Aconitum ferox, a still more dangerous drug than our indigenous plant.

_Treatment._-No time must be lost in the use of remedies. In addition to emetics, castor oil, and animal charcoal, benefit may be derived from administering strong coffee. Brandy or ammonia should also be given, while the limbs and back are well rubbed with hot towels. Artificial respiration might prove useful.