The valuable work of Mérat contains four inspections after death from the acute or comatose form of colica pictonum. The bodies were plump, muscular and fat. The alimentary canal was quite empty, and the colon much contracted,—in one to an extraordinary degree. The mucous coat of the alimentary canal was everywhere healthy. He therefore infers that the disease is an affection of the muscular coat only. It is a striking circumstance, and conformable with what will be afterwards established in regard to the true narcotics, that although both of the men died convulsed and comatose, no morbid appearance was visible within the head.[1] Another case, which confirms the foregoing facts, has been described by Mr. Deering. It was that of a lady who died convulsed after suffering in the usual manner, and in whose body no trace of disease could be detected any where.[2] Senac informed Tronchin that he had dissected above fifty cases of colica pictonum, and found no morbid appearances.[3] Schloepfer's observations on animals are to the same effect. In rabbits which died of colica pictonum the great intestines were excessively contracted, but all the other organs of the body were healthy except the liver, which was dark and brittle.[4] Mitscherlich observed in his animals extravasation of blood into the intestines, also sometimes into the cavities of the pleura and peritoneum, and occasionally under the peritoneal covering of the kidneys.[5] The only instance I have met with where morbid appearances were found within the head, was in a case mentioned by Sir G. Baker, of a gentleman who died apoplectic after many attacks of colica pictonum, and in whom the brain was found unusually soft, and blood extravasated on its surface to the amount of an ounce.[6]
The appearances in those who have been long affected with the paralytic form of colica pictonum have been rarely observed in modern times. I am indebted to my late colleague, Dr. Duncan, Junior, for an account of the appearances in the intestinal canal of a plumber, who had been long and frequently afflicted with colica pictonum and its sequelæ. The intestines were dark, tender, and far advanced in putrefaction. The cardiac orifice of the stomach was so narrow that it would admit a goose-quill. The mesenteric glands were enlarged and hardened. The thoracic duct was surrounded by many large bodies like diseased glands, exactly of the colour of lead, and composed of organized cysts containing apparently an inorganic matter. The analysis of this matter was unfortunately neglected. The muscles in similar circumstances are much diseased. When the paralysis is not of long standing, it appears from the experiments of Schloepfer (whose animals survived about three weeks), that the whole muscular system becomes pale, bloodless, and flaccid. When the palsy is of long standing, this change increases so much, that the muscles in some parts, as in the arms and thumbs, acquire the
