other times vomiting occurs at a much later period. Pyl, in his Essays and Observations, gives a case in which, some hours after thirty grains were swallowed, vomiting took place spontaneously, and recurred frequently afterwards; in the same paper is an account of another case by the individual himself, who attempted to commit suicide by taking a large dose of laudanum, but was disappointed in consequence of the poison being spontaneously vomited after the sopor had fairly set in;[1] and a similar case is related by M. Mascarel, where, after seven ounces of Sydenham's laudanum had been taken, vomiting occurred spontaneously, and was followed only by inconsiderable stupor.[2]—Vomiting is a common enough symptom after the administration of emetics, or subsequent to the departure of the somnolency.[3]
The ordinary duration of a fatal case of poisoning with opium is from seven to twelve hours. Most people recover who outlive twelve hours. At the same time fatal cases of longer duration are on record: Réaumur mentions one which proved fatal in fifteen hours,[4] Orfila another fatal in seventeen hours,[5] Leroux another fatal in the same time,[6] Alibert another fatal in nearly twenty-four hours.[7] An instance has even been related, which appeared to prove fatal not till towards the close of the third day;[8] but the whole course of the symptoms was in that case so unusual, that some other cause must have co-operated in occasioning death. Sometimes, too, death takes place in a shorter time than seven hours; six hours is not an uncommon duration; I once met with a judicial case, which could not have lasted above five hours; an infirmary patient of my colleague, Dr. Home, died in four hours; in the 31st volume of the Medical and Physical Journal, there is one which proved fatal in three hours.[9] This is the shortest I have read of.
The dose of opium requisite to cause death has not been determined. Indeed it must vary so much with circumstances, that it is almost vain to attempt to fix it. Pyl relates a case, quickly fatal, where the quantity taken was 60 grains;[10] Lassus an instance of
- ↑ Aufsätze und Beobachtungen, i. 94, 100.
- ↑ Archives Gén. de Méd. li. 495.
- ↑ These effects must not be confounded with those which poppy-juice has been known to cause when spoiled. A whole family of Jews were attacked with violent vomiting and purging, in consequence of partaking of a decoction of poppy-heads, which had been kept four days in a hot stove, and had consequently undergone decomposition. The usual narcotism was not produced at all. (Rust's Magazin, xxii. 484.)
- ↑ Mém. de l'Acad. des Sciences, xxxviii. 1735.
- ↑ Toxicol Gén. from Bibliothêque Médicale, Aout, 1806.
- ↑ Corvisart's Journal de Médecine, iv. 3.
- ↑ Nouveaux Elémens de Thérapeutique, ii. 60.
- ↑ London Med. and Phys. Journal, xxviii. 81. This patient took at 4 A.M. two ounces of wine of opium, became drowsy at 6, was capable of being roused at 9, vomited by emetics a liquid coloured with laudanum, and was kept awake for the rest of the day. But at 7 P.M. having previously had a cough and brown sputa from vinegar entering his windpipe, he became gradually more and more insensible, till at last he was quite comatose; and in this state he continued till his death on the evening of the third day. On dissection nothing was found in the brain or stomach attributable to opium.
- ↑ London Med. and Phys. Journal, xxxi. 468.
- ↑ Aufsätze und Beobachtungen, i. 85.
