- stitutional action of the poison begins sooner than after an interval of
above twenty-four hours.
As to the total duration of this variety in fatal cases, I have found an instance fatal on the fourth day, salivation having begun on the second;[1] and Orfila quotes a case from Degner, in which the gastro-enteritic symptoms were succeeded by ptyalism about the same period, and which proved fatal in fifteen days.[2] These periods, however, probably do not form the extremes; for in such cases as the former death is the consequence of the primary affection, and may therefore ensue immediately after the secondary stage has begun to develope itself; and when death arises from profuse salivation, as in Degner's patient, or from the ravages committed by ulceration and gangrene, it may be delayed almost as long as in cases of the third variety of mercurial poisoning, in which there is no precursory stage of inflammation in the alimentary canal.
Death may arise, not only from the primary action of the poison, or from the exhaustion caused by mercurial erethysm, but likewise from incidental occurrences. Thus, in Dr. Alexander Wood's case, referred to above, death arose directly from sudden profuse hemorrhage from the bowels, to the amount of six pounds.
The present variety of poisoning with corrosive sublimate may be concluded with the heads of an excellent example related in the Medical and Physical Journal. The patient, a stout young girl, swallowed soon after supper a drachm of corrosive sublimate dissolved in beer, and in a few minutes she was found on her knees in great torture. All the primary symptoms of this kind of poisoning were present in their most violent form,—burning in the stomach, extending towards the throat and mouth, followed in no long time by violent vomiting of a matter at first mucous, afterwards bilious and bloody; by purging of a brownish, fetid fluid; suppression of urine and much tenderness of the urethra and bladder; small, contracted, frequent pulse, anxious countenance, and considerable stupor, interrupted frequently by fits of increased pain. All these symptoms were developed in four hours. Subsequently the pain in the stomach became much easier, but that in the throat much worse. At length in the course of the second day, the teeth became loose, the gums tender, the saliva more abundant than natural; profuse pytalism and great fetor of the breath ensued, and the patient expired towards the close of the fourth day.[3]
3. The third variety of poisoning with mercury comprehends all the forms of what is called mercurial erethysm. Without endeavouring to settle the precise meaning of this term, which is now used in rather a vague sense, I shall consider under the present head all the secondary and chronic effects of mercury. These may be caused by any of its preparations, but are most frequently seen as
