of Siegen, in reporting two cases of death caused by the vapours of burning wood, notices paleness of the countenance as a singular accompaniment of cerebral congestion; and calls the attention of medical jurists to the extreme calmness of the features as a general character of this variety of poisoning.[1] Although the same appearance has also been noticed by others,[2] the countenance nevertheless is often livid. But whether livid or pale, it is always composed.—It appears from an account in Pyl's Essays of several cases of suffocation from the fumes of burning wood, that besides the appearances mentioned by Portal, there is usually great livor of the back, frothiness as well as fluidity of the blood, and more or less gorging of the lungs with blood.[3]—A common appearance where the poisonous emanation has been charcoal vapour, is a lining of dark, or sometimes actually black dust on the mucous membranes of the air passages, thickest near the external opening of the nostrils, and disappearing towards the glottis. There are obvious reasons why this appearance cannot always be expected to occur; but when present, it may be in doubtful circumstances a very important article of evidence.[4] In Wildberg's collection of cases there is a report on two people who were suffocated in bed, in consequence of the servant having neglected to open the flue-trap when she kindled the stove in the bed-chamber; and in each of them Wildberg found all the appearances now quoted from Portal and Pyl. The tongue was black and swelled.[5]—Mertzdorff has related a case of death from the same cause, in which, together with the preceding appearances, an effusion of blood was found between the arachnoid and pia mater over the whole surface of both hemispheres.[6] In one of Dr. Bright's cases there was a small ecchymosis in the cortical substance on the outer side of the anterior lobe, and not extending into the medullary matter. Fallot mentions an instance of suffocation from charcoal vapour, where a little coagulated blood was found between the layers of the arachnoid membrane of the cerebellum in the region of the left occipital hollow.[7] Three instances of extravasation are enumerated in a list of German cases analysed by Dr. Bird.[8] Such appearances might be expected more frequently, considering the manifest tendency of this kind of poisoning to cause congestion in the head.—The blood is generally described as being liquid and very dark. But M. Ollivier has lately called attention to the fact, that the blood both before and after death is not unusually more florid in the veins than natural.[9] In a case mentioned by M. Rayer globules of an oily-looking matter were found swimming on the surface of the blood and urine.[10] This is a solitary
- ↑ Horn's Archiv für Medizinische Erfahrung, 1823, i. 93.
- ↑ London Medical Gazette, 1838-39, i. 923.
- ↑ Aufsätze und Beobachtungen, i. 1. and vii. 95.
- ↑ See various cases quoted in detail in Wibmer, die Wirkung der Arzneimittel, &c. ii. 49, 51, 55
- ↑ Practisches Handbuch für Physiker, iii. 278.
- ↑ Beiträge zur gerichtl. medizin.—Horn's Archiv für Medizinische Erfahrung, 1823, i. 296.
- ↑ Journal Complémentaire, Mai, 1829.
- ↑ Guy's-Hospital Reports, ut supra.
- ↑ Annales d'Hygiène-Publique, xx. 114.
- ↑ Revue Médicale, 1827, iii. 528.
