- hausting fever, with dyspepsia and singultus, carried him off in twenty-three
days.[1]
Among the fatal cases the smallest dose has been half an ounce; but there can be little doubt that less would be sufficient to cause death. Dr. Babington of Coleraine has published a case where very severe effects were produced by only two scruples.[2]
Very few persons have recovered where the quantity was considerable.
In every instance in which the dose was considerable, and the solution concentrated, the first symptoms have been immediate burning pain in the stomach, and generally also in the throat. But when the dose was small, more particularly if the solution was also rather diluted, the pain has sometimes been slight, or slow in commencing. Mr. Hebb's patient, who took only half an ounce dissolved in ten parts of water, and diluted it immediately after with copious draughts of water, had not any pain in the belly for six hours.
In general, violent vomiting follows the accession of pain, either immediately, or in a few minutes; and it commonly continues till near death. Some, however, have not vomited at all, even when the acid was strong and in a large dose; and this is still more apt to happen when the poison has been taken much diluted. The man last mentioned did not vomit at all for seven hours, except when emetics were administered. The vomited matter, as in this man's case, and in that of Mr. Frazer's patient, is sometimes bloody. Instant discharge of the poison by vomiting does not always save the patient's life: A woman who swallowed two ounces died in twenty minutes, although she vomited almost immediately after taking the poison.[3]
The tongue and mouth occasionally become inflamed if the case lasts long enough. In an instance of recovery, which happened not long ago in St. Thomas's Hospital, London, the tongue was red, swollen, tense and tender, the day after the acid was swallowed.[4]
Death commonly takes place so soon, that the bowels are seldom much affected. But when life is prolonged a few hours, they are evidently much irritated. Dr. Arrowsmith's patient, who lived thirteen hours, had severe pain in the bowels and frequent inclination to go to stool, and Mr. Hebb's patient, who also lived thirteen hours, had a constant, involuntary discharge of fluid fæces, occasionally mixed with blood. Bloody diarrhœa is very common in dogs.
The signs of depressed circulation are always very striking. In general the pulse fails altogether, it is always very feeble, and the skin is cold and clammy. Contrary to the general fact, however, I once remarked in a dog the pulsation of the heart so strong as to be audible at a distance of several yards.
In some cases nervous symptoms have occurred, but in none so distinctly as in animals that have taken the diluted acid. It should
