actually been found in the contents poured out from the stomach into the sac of the peritonæum.[1]
One would expect to find the acid always in the stomach when it is perforated. Nevertheless it is sometimes almost all discharged. In Mertzdorff's case, that of an infant who was killed in twelve hours, a hole was found in the stomach 3/4ths of an inch in diameter, and the contents of the stomach were effused into the belly: yet by a careful analysis the whole acid he could procure from the contents and tissues together was only 4-1/2 grains. Sometimes of course the disappearance of the acid may be owing, as in Dr. Craigie's case, to the effectual administration of antacids during life.
The inner coat of the duodenum often presents appearances closely resembling those of the stomach. Sometimes, however, as in the case just related from Mertzdorff, and in the infant I examined, the inner coat of the small intestines is not affected at all, probably because in such rapid cases the pylorus retains a state of spasmodic contraction till death or even after it.
The urinary bladder is commonly empty. The thoracic surface of the diaphragm is sometimes lined with lymph, indicating inflammation of the chest. In the case which was fatal in two hours [p. 131], Professor Remer found the surface of the lungs, as well as that of the liver and spleen, brown and of a leathern consistence, and the tissue beneath scarlet;—appearances which he thinks arose from the acid penetrating in vapour and acting chemically. I have not found this appearance mentioned by any other writer; but I have seen it in animals poisoned with oxalic acid. The blood in the heart and great vessels has been several times seen forming a firm black clot. Kerkring[2] relates an instance of the kind; in Dr. Latta's case the appearance was very distinct; and it is dwelt on strongly in a recent paper by M. Bouchardat.[3] Bouchardat thinks this state of the blood is simply the effect of the absorbed acid; but coagulation of the blood in the heart and great vessels,—a striking appearance in contradiction to what is observed after death from most other poisons,—is more probably the healthy state of the blood, and not the effect of the particular poison.
The general appearance of the body of those who have died of the second or chronic variety of poisoning with the acids, is that of extreme emaciation. The stomach and intestines are excessively contracted: The former has been found so small as to measure only two inches and a half from the cardia to the pylorus, and two inches from the lesser to the greater curvature.[4] Tartra says the intestines are sometimes no thicker than a writing quill. They are in other respects sound outwardly, except that they sometimes adhere together.
Internally the pylorus is contracted. In a case of slow poisoning, fatal in three months, which has been described by Dr. Braun of
