burning in the throat often continue throughout the whole duration of the poisoning; and may be so excessive as to cause complete inability to swallow,[1] or even to speak.[2] Occasionally the affection of the throat is the only material injury inflicted by the poison, as in a case related by Dr. J. Johnstone of a young woman, who tried to swallow two drachms of corrosive sublimate in the solid state, but was unable to force it down on account of the constriction it caused in the gullet. She died in six days of mortification of the throat.[3] The greater violence of the action of corrosive sublimate on the throat, compared with that of arsenic, is evidently owing to its greater solubility and powerful chemical operation on the animal textures.
Fourthly, instead of the contracted ghastly countenance observed in cases of poisoning with arsenic (but which, it will be remembered, is not invariable in that kind of poisoning), those who are suffering under the primary effects of corrosive sublimate have frequently the countenance much flushed, and even swelled.[4]
Corrosive sublimate seems to occasion more frequently than arsenic the discharge of blood by vomiting and purging,—obviously because it is a more powerful local irritant.
It likewise gives rise more frequently to irritation of the urinary passages. This irritation generally consists in frequent, painful micturition; but the secretion of urine is often suppressed altogether. Instances of this kind have been related by Mr. Valentine,[5] by my colleague, Professor Syme,[6] by an anonymous writer in the Medical and Physical Journal,[7] by Dr. Venables,[8] by Mr. Blacklock,[9] and by M. Ollivier, in whose case, however, the poison was the bicyanide of mercury.[10] In the last three cases the suppression was total, and continued till death; which did not ensue, in one till eight, in the next till five, and in the last till nine days after the poison was taken. Sometimes, as in Ollivier's case, the urinary irritation is attended with symptoms of excitement of the external parts, such as swelling and blackness of the scrotum and erection of the penis.
Another distinction seems to be that corrosive sublimate is more apt than arsenic to cause nervous affections during the first inflammatory stage. The tendency to doze, which sometimes interrupts the inflammatory symptoms caused by arsenic, has been more frequently observed in cases of poisoning with corrosive sublimate.[11] The same may be said of tremors and twitches of the extremities. Sometimes the stupor approaches even to absolute coma;[12] and the twitches occasionally amount to distinct, nay violent convulsions.[13] In other instances paraplegia has been witnessed.[14]
- ↑ Mr. Valentine's Cases, Edin. Med. and Surg. Journal, xiv. 470.
- ↑ Mr. Anderson's case in Edin. Med. and Surg. Journal, xiv. 474.
- ↑ Essay on Mineral Poisons, p. 52.
- ↑ Dumonceau in Journ de Med. lxix. 36; Orfila, Tox. Gén. i. 264; and Blacklock's case.
- ↑ Edin. Med. and Surg. Journal, xiv. 468.
- ↑ Ibid. xliv. 26.
- ↑ xli. 204.
- ↑ London Medical Gazette, viii. 616.
- ↑ Edin. Med. and Surg. Journal, xxxvi. 92.
- ↑ Archives Gén. de Méd. ix. 99.
- ↑ Orfila, Tox. Gen. i. 265.
- ↑ Mr. Valentine's cases.
- ↑ Ollivier's case, and Fontenelle's.
- ↑ Case by Devergie in Arch. Gén. de Méd. ix. 463.
