course of the alimentary canal, particularly in the throat. The belly was swelled, and so tender that he could not bear the weight of fomentation-cloths. The pulse was 112, small and sharp; the skin intensely hot and pungent; micturition scanty, frequent, and difficult; the breathing very much oppressed; the purging bilious. The patient had likewise a tendency to doze, and was affected with occasional convulsive twitches of the face and extremities, and with constant cramps in the limbs. Next morning all the symptoms were sensibly mitigated; and they went on decreasing till convalescence was established in eight days. In the course of a few weeks he recovered his usual health, without suffering salivation.[1]—In Vautier's case, where sixteen grains had been swallowed, the patient was immediately attacked with pain in the throat and stomach, cold extremities, trembling of the arms and legs, vomiting, paleness of the features, and great feebleness of the pulse. Vomiting being promoted by frequent draughts of warm water, and white of egg given subsequently, no further symptoms ensued, those first excited slowly subsided, and in a few days recovery took place, without any salivation. Yet it was upwards of half an hour before any measures could be taken for his relief.[2]
The only material and common symptom which was wanting in the case now related was blood in the stools and in the matter vomited. In other respects they are good examples of the ordinary train of symptoms in cases of the present variety. For other examples of the same nature the reader may refer particularly to the paper of Mr. Valentine, who has described five cases that happened at one time in the same family, the mother having attempted to poison herself and four children.[3]
It may sometimes be necessary to know the usual duration of this variety of mercurial poisoning, and also the extremes of its duration. On these points I have not hitherto had opportunities of consulting a sufficient number of cases to be able to lay down the general rule with precision. But, so far as my inquiries go, the ordinary duration in fatal cases is from twenty-four to thirty-six hours. It is probable that a few may last three days,[4] but only one instance has come under my notice where the duration was greater; and in that instance, which is described by Dr. Venables, life was prolonged under great agony from pain of the belly, bloody vomiting, diarrhœa and suppression of urine, but without salivation, for no less than eight days.[5] In cases of recovery the symptoms of irritation may continue very long, and nevertheless not pass into the second variety of this kind of poisoning,—a transition, however, which on the whole is uncommon. In the case of which an analysis has been given from Orfila's narrative, and likewise in one of Mr. Valentine's patients who recovered, the symptoms all along were those of irritation in the
