Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/190

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peritonæal coats were here and there destroyed and cicatrized. Bretonneau farther adds, that ten or fifteen grains introduced into the rectum caused death sooner than three times as much given by the mouth.

The carbonate of potass possesses properties similar in kind, but inferior in degree to those of the caustic alkali. Two drachms given by Orfila to a dog killed it in twenty-five minutes, violent vomiting and great agony having preceded death. The stomach was universally of a deep red colour on its inner surface.

Potash and its carbonate are absorbed in the course of their action, and may be detected by Orfila's process in the liver, kidneys, and urine.[1]

The actions of soda and its carbonate seem on the whole the same with those of potash; but they are not so energetic. In one respect however soda and its salts differ most materially from those of potash. For while the latter, when admitted directly into a vein, act by arresting the action of the heart, soda and its salts, according to the inquiries of Mr. Blake, have no such effect, but cause death by obstructing the circulation of the pulmonary capillaries, and preventing the return of blood from the lungs to the left side of the heart. This conclusion seems to flow from the following facts. The respiration becomes in a few seconds laborious and soon ceases, whilst the heart continues to beat vigorously: arterial pressure is greatly reduced, while venous pressure is much increased owing to accumulation of blood in the right side of the heart: after death the lungs are found congested and often full of froth: and the heart continues contractile, very turgid in the right side, but quite empty of blood in its left cavities.[2]

Poisoning with the caustic alkalis is rare. In 1842, a lady suffering from inflammation of the bowels took an ounce of solution of potass by mistake for kali-water, or a solution of bicarbonate of potash surcharged with carbonic acid. She suffered severely at the time, and died in a fortnight, probably of the conjunct effects of her disease and the poison.[3] This is the only case I have found in print of poisoning with a caustic alkali. But the effects of their carbonates have been several times witnessed, and appear to resemble closely those of the concentrated mineral acids.

The symptoms are in the first instance an acrid burning taste, and rapid destruction of the lining membrane of the mouth; then burning and often constriction in the throat and gullet, with difficult and painful deglutition; violent vomiting, often sanguinolent, and tinging vegetable blues green; next acute pain in the stomach and tenderness of the whole belly; subsequently cold sweats, excessive weakness, hiccup, tremors and twitches of the extremities; and ere long violent colic pains, with purging of bloody stools and dark membranous flakes. So far the symptoms are nearly the same in

  1. Annales d'Hyg. Publique, xxviii. 212.
  2. Edin. Med. and Surg. Journal, liv. 341.
  3. London Medical Gazette, 1842-43, i. 188.