Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/321

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  • rhœa by corrosive sublimate in single large doses, communicated by

Mr. Addington of West Bromwich to Dr. Beddoes, it is stated that a grain and a half, taken at once in half an ounce of rectified spirit, causes immediately "a great burning in the throat and stomach, and quickly afterwards a copious salivation, lasting between an hour and a half and two hours, and amounting frequently to more than a quart."[1] These facts have been appealed to by authors in medical jurisprudence as proving the rapid production of mercurial salivation. But the effect produced is not the specific ptyalism of mercury; for its brief duration is scarcely consistent with this supposition. And farther, the author goes on to observe, that, if the dose be taken on going to bed, the latter part of the night is passed quietly, and no inconvenience is felt afterwards, even when the dose is taken five or six times at intervals of three or four days. The effects here observed is a sympathetic phenomenon depending on the topical action of the poison. And such, I have no doubt, has been the nature of the salivation in several cases of poisoning with corrosive sublimate, which have been supposed to be at variance with the general rule, that this affection does not begin till about twenty-four hours have elapsed. Such seems to have been the nature of the salivation in a case published by Dr. Perry,[2] that of a girl who was attacked with swelling of the cheeks and lower lip, burning in the throat, flushed face, feeble,, pulse, and cold, clammy extremities after swallowing corrosive sublimate, and who had a copious flow of saliva in an hour and a half; for there is no mention made of fetor, and the girl was well enough to leave the hospital in a few days,—which could scarcely happen if she had been affected with ptyalism from the constitutional action of mercury.—In like manner Dr. Alexander Wood has related a case, fatal in fourteen days, in which the patient said salivation came on in seven hours.[3] But, notwithstanding Dr. Wood's argument in support of the patient's statement,—for he did not see him till nine days after the poison was taken,—there is no satisfactory evidence that the salivation was the true constitutional salivation of mercury, and not simply the result of its topical action, which seems to have been very severe.—Farther, in an instance related by Dr. H. Anderson of Belfast, where salivation appeared to him to begin in nineteen hours, it seems not improbable that he mistook for mercurial ptyalism the common salivation arising from inability to swallow on account of sore throat; for this patient too was quite convalescent in three days.[4]—Mr. Alfred Taylor alludes to a case in Guy's Hospital of salivation occurring in four hours; but so briefly, that its true influence on the present question cannot be judged of.[5]—On the whole, then, although it is clear that ptyalism of one kind or another may occur very soon after corrosive sublimate is swallowed, it remains a matter of doubt, whether the true, specific ptyalism, depending on the con-*

  1. Beddoes' Contributions to Physical and Medical Knowledge, 1799, p. 231.
  2. London Medical Gazette, 1842-43, i. 941.
  3. Edinburgh Med. and Surg. Journal, li. 114.
  4. Ibidem, xiv. 474.
  5. Manual of Medical Jurisprudence, 162.