of Berlin, that of an infant who died in twelve hours under incessant vomiting after receiving a small quantity of arsenic, none could be detected in the stomach;[1] in another which I have described in a paper on arsenic, although the person lived only five hours, the whole arsenic which could be detected in the tissues and contents of the stomach did not exceed a fifteenth part of a grain;[2] in an American Journal there is a striking case of a grocer, who died eight hours after swallowing an ounce of arsenic, and in whose body none could be found chemically,—at a period however antecedent to the late improvements in analysis;[3] and in a case communicated to me not long ago by Mr. Hewson of Lincoln, where arsenic was given in solution, and death ensued in five hours, none of the poison could be detected either in the contents or tissues of the stomach by a careful analysis conducted according to the most modern principles.
Nevertheless, it is singular how ineffectual vomiting proves in expelling some poisons from the stomach. Those which are not easily soluble, and have been taken in a state of minute division, may remain adhering to the villous coat, notwithstanding repeated and violent efforts to dislodge them by vomiting. Many instances to this effect have occurred in the instance of arsenic. Metzger has related a case, where, after six hours of incessant vomiting, three drachms were found in the stomach.[4] Mr. Sidey, a surgeon of this city, has mentioned to me an instance of poisoning with king's yellow, in which he found the stomach lined with the poison, although the patient had vomited for thirty hours. In three cases which I have investigated arsenic was detected, although the people lived and vomited much for nearly two days;[5] and Professor Orfila has noticed a similar instance in which that poison was found in the contents of the stomach, although the person had vomited incessantly for two entire days.[6]
It is not easy to specify the period after which a poison that has excited vomiting need not be looked for in the stomach. It must vary with a variety of circumstances whose combined effect it is almost impossible to appreciate, such as the solubility and state of division of the poison, the frequency of vomiting, the substances taken as remedies, and the like. When the poison is in solution and the patient vomits much, an analysis may be expected to prove frequently abortive, even though the individual survive but a few hours, as in Mr. Hewson's case already noticed. In other circumstances, however, as various facts quoted above will show, poisons may frequently be found after two days incessant vomiting; and on the whole it may be stated, that the recent improvements in analysis render the period much longer than it has generally been, and would naturally be imagined. Metzger has related the case of a woman poisoned with
- ↑ Archiv für Medizinische Erfahrung, 1834, p. 754.
- ↑ Edinburgh Medico-Chirurgical Transactions, ii. 303.
- ↑ New York Medical and Philosophical Journal, iii. No. 1.
- ↑ De Veneficio caute dijudicando in Schlegel's Collectio opusculorum, &c. iv. 22.
- ↑ Edinburgh Medico-Chirurgical Transactions, ii. 291, Edinburgh Medical and Surgical Journal, xxvii. 457, and xxix. 26.
- ↑ Archives Générales de Médecine, ii. 58.
