- —distressing sense of sinking and impending death,—a small,
feeble, irregular, gradually-vanishing pulse,—cold, clammy-sweat and pale bloodless features,—together with perfect possession of the mental faculties, and no tendency to stupor or drowsiness,—finally, sudden death at last, as from hemorrhage, and generally in a period varying from an hour and a half to eight hours. The symptoms may begin in a few minutes, as in a case observed by Dr. Fleming, which was occasioned by the tincture of the root; or they may be postponed for three-quarters of an hour, as in an instance recorded by Dr. Pereira,[1] which arose from the root being used by mistake for horse-radish. Two or three drachms of the root are sufficient to kill a man; and Dr. Fleming mentions one instance where two grains of the alcoholic extract occasioned alarming effects, and another where four grains proved fatal. I may observe, however, that I have given six grains of a carefully prepared alcoholic extract (the same of which thirty grains killed a rabbit in little more than two hours), to a female suffering from rheumatism, without being able to observe any effect whatsoever.
If all the reports of cases now on record are to be trusted, the following anomalies have occurred. Some persons are said to have presented convulsions. Slight spasmodic twitches of the muscles are not uncommon, and probably depend, as Dr. Fleming suggests, on venous congestion, the result of incomplete asphyxia. Stupor and even apoplectic insensibility are also sometimes represented to have been observed. If really ever present, they must depend on the same cause; but there is reason to apprehend, that extreme nervous depression and faintness have been mistaken for stupor and coma. Delirium of the frantic kind, mentioned by some of the older authors, is justly considered by Dr. Fleming to be of doubtful occurrence, as it has never been observed in recent times. Irritation in the alimentary canal is distinctly mentioned as indicated by prominent symptoms, even in some cases observed but a few years ago, and apparently with care. Dr. Fleming properly objects to nausea, vomiting, or pain in the epigastrium as evidence of irritation in the stomach; for these symptoms may all depend on the same local nervous impression which is produced on the organs of taste. And he denies that purging is ever produced in any genuine case of poisoning with monkshood. The following, however, seem unequivocal examples of irritation in the alimentary canal. M. Pallas[2] mentions, that three out of five persons, who took a spirituous infusion of the root by mistake for lovage [Ligusticum levisticum], died in two hours with burning in the throat, vomiting, colic, swelling of the belly and purging. A similar set of cases is described by M. Degland.[3] Four persons took the tincture of the root by mistake for tincture of lovage; and three of them were seized with burning pain from the throat to the stomach, a sense of enlargement of the
