Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/525

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symptoms was the only unusual circumstance. Yet because the inspectors remarked in various parts of the body a peculiar odour, which they could not at the time characterise, but which they afterwards thought was the odour of bitter almonds,—and misled by the sudden invasion of the symptoms instantly after a meal,—they gave their opinion that death had arisen from some narcotic poison; a chemical examination was made of various textures of the body (not, however, of the contents of the stomach), which yielded obscure and very doubtful indications of hydrocyanic acid; poisoning with hydrocyanic acid was accordingly declared to have been the cause of death; and, in defiance of an able report by Professor Orfila, pointing out the error of the primary witnesses, the nephew and heir of the deceased was condemned.[1] It is almost unnecessary to point out the impossibility of death having arisen in this case from hydrocyanic acid. The length of time the deceased survived, the want of convulsions, the presence of deflexion of the mouth and tongue, the intermission of the symptoms, and the morbid appearances, all clearly indicate that death in the way supposed was impossible; and the chemical evidence, which it would require too much space to analyze here, was proved by Orfila to be completely unsatisfactory.


Of the Distinction between Epilepsy and Narcotic Poisoning.

Of the Symptoms.—Epilepsy is distinguished from other diseases by the abolition of sense and by convulsions. It resembles closely the symptoms caused by prussic acid, and by some of the narcotic gases, such as carbonic acid gas and the asphyxiating gas of privies. It also bears the same resemblance to the effects of many narcotico-acrid poisons, such as belladonna, stramonium, hemlock, and others of the first group of that class, also camphor, cocculus indicus, and the poisonous fungi.

Epilepsy is in general a chronic disease, and for the most part ends slowly in insanity. But sometimes it proves fatal during a paroxysm. The circumstances by which an epileptic fit may be distinguished from narcotic poisoning are the following:

1. The epileptic fit is sometimes preceded by certain warnings, such as stupor, a sense of coldness, or creeping, or of a gentle breeze proceeding from a particular part of the body towards the head. Warnings, however, are by no means universal. M. Georget, indeed, has even stated that they do not occur in more than five cases in the hundred.[2] But this estimate probably underrates their frequency.

2. The symptoms of the epileptic fit almost always begin violently and abruptly. The individual is suddenly observed to cry out, often to vomit, and instantly falls down in convulsions. The effects of the narcotic poisons, if we except some cases of poisoning with hydrocyanic acid, the narcotic gases, and a few rare alkaloids, never begin otherwise than gradually, though their progress towards their extreme

  1. Annales d'Hygiène-Publique, 1841, xxvi. 399.
  2. Article Epilepsie in Dictionnaire de Médecine, viii. 209.