CASTOR OIL SEEDS. THE ELDER. 125 In June, 1850, I was consulted in a case in which it was supposed that this liquid had been employed for the purpose of destroying life; and although arsenic was found in the stomach, it became a question to determine what was the fatal dose of this oil. In this instance, sixty drops had been sold, mixed with two ounces of linseed oil. This is considered a proper dose for cattle. In man, a dose of from fifteen to twenty drops of the pure oil, might give rise to excessive purging, and thus cause death by exhaustion. The cases recorded of its fatal operation are very few, and do not enable us to solve this question from observed facts. According to Landsberg, as quoted by Christison, (Dispensatory, p. 382) thirty drops of the oil have killed a dog, and Dr. Christison has known four grains of the oil to produce an alarming degree of purging. It is frequently adulterated with Castor oil and other substances, and these adulterations must of course influence the dose required to act fatally. In a recent volume of the Medical Gazette, there is a report of a case in which a woman died from the effects of an embrocation containing croton oil-with other drugs. A teaspoonful was incautiously given to her; she immediately complained of a hot burning sensation in her throat. She was an aged person, and died in convulsions in three days. (Med. Gaz. vol. xliii. page 41.) CASTOR SEEDS. Of castor oil itself nothing need be said. It is not commonly known that the seeds from which this oil is extracted contain in the embryo a very active poison, and that a few of them are sufficient to produce violent purging and death. The following is an instance of poisoning by these seeds, the only one with which I have met. The deceased, aged eighteen, was the sister of a gentleman who was at the time attending my lectures at Guy's Hospital. The deceased, it appears, ate about twenty castor-oil seeds; one of her sisters ate four or five, and another two. This was on a Wednesday evening. In the night they were all taken ill. About five hours after the seeds were eaten, the deceased felt faint and sick; vomiting and purging came on, and continued through the night. On the following morning, she appeared like one affected with malignant cholera. The skin was cold and dark-coloured, the features contracted, and the breath cold; the pulse was small and wiry; there was restlessness, thirst, pain in the abdomen, and she lay in a sort of drowsy, half conscious state. Whatever liquid was taken was immediately rejected, and the matters passed by stool consisted chiefly of a serous fluid, with blood. She died in five days without rallying; the two other sisters recovered. On inspection, a very large portion of the mucous membrane of the stomach was found abraded and softened in the course of the great curvature. There was general vascularity of the organ, and the abraded portion presented the appearance of a granulating surface of a pale rose colour; it was covered by a considerable quantity of slimy mucus. The small intestines were inflamed, and the inner surface of them was abraded. The effects produced on the sisters who recovered bear out the statement of Dr. Christison, that two or three of the seeds will operate as a violent cathartic. [We have known the castor-bean, as it is called in this country, to be eaten freely with impunity, and in other cases to produce the most violent and even fatal emeto-catharsis. The oil itself is sometimes a powerful irritant. Devergie notices two cases where death followed in three hours after the administration of an ounce of this oil.-H.] THE ELDER. (SAMBUCUS NIGRA.) Dr. Christison states that the leaves and flowers of the common elder act as an irritant poison, having caused in a boy severe inflammation of the bowels, which lasted for eight days. (Ed. Med. and Surg. Jour. xxxiii. 73.) The berries of this tree do not appear to possess, in the ripe state, any noxious properties. The 126 NOXIOUS EFFECTS OF MOULDY BREAD. following case of poisoning by the expressed juice of the roots, is reported in the Med. Gaz. xxxv. 96. A weakly woman, fifty-four years of age, who had been sick all day, and thrown up a quantity of greenish matter, which she regarded as bile, was persuaded by her husband to take two tablespoonfuls of the juice of the fresh elder root, which he himself had dug up, shaved down, and pressed. The woman soon after complained of severe pain in the abdomen. She was ordered some infusion of senna, but did not take it, as the bowels began almost immediately to act copiously. Next day the symptoms were those of enteritis, which proved fatal. OIL OF TURPENTINE. The few cases in which this liquid has produced any noxious symptoms, have occurred among children. From these it appears to have rather the effects of a narcotic than an irritant poison. In a dose of three drachms it produced intoxication. A dose of a tablespoonful caused in a child aged eighteen months, symptoms bearing a strong resemblance to those occasioned by an overdose of opium, although they were not so rapidly manifested. (See case by Mr. Johnson, Med. Times, Oct. 11, 1851, page 380.) In three hours there was complete insensibility; stertorous breathing, strongly contracted pupils, rapid and weak pulse,coldness of surface, pallor of the countenance,-general relaxation of the muscles, with occasional convulsive movements. In no instance yet recorded has this oil caused death. A case of recovery in an infant that had swallowed four ounces, is recorded in another work. (On Poisons, 528.) OIL OF TAR. This is a powerful vegetable irritant. In 1832, about ten drachms of it caused the death of a gentleman, to whom it had been sent by mistake for a black draught. The party who sent it was tried for manslaughter, but acquitted. MOULDY BREAD. There is a common article of food, namely, bread, upon the noxious effects of which some observations have been lately made by toxicologists. In the Ann. d'Hygiène, 1843, pp. 35 and 347, will be found communications on this subject from MM. Guérard, Chevallier, and Gaultier de Claubry. The changes which take place in the decomposition of flour and bread, and the production of various kinds of mouldiness, are here investigated, together with the effects of such bread upon the animal system. It would appear that in some parts of France the peasantry manifest no repugnance to the eating of mouldy bread, and that in many instances the practice appears to be attended with no ill effects. The nature of the mould produced, however, is subject to great variation, and it is not improbable, as M. Chevallier suggests, that in some cases a poisonous principle is actually developed. In two instances of children, who had partaken of mouldy rye-bread, symptoms resembling those of irritant poisoning supervened. The countenance was red and swollen; the tongue dry; the pulse quick; there were violent colics, with pain in the head, and intense thirst. Vomiting and purging supervened with a state of collapse, but the children eventually recovered. These symptoms were ascribed to the production of "mucor mucedo" in the bread. In 1829, alarming effects having followed from the use of a certain kind of bread in Paris, M. Barruel was called upon to determine whether any irritant poison had or had not become accidentally intermixed with it. The bread was simply in a mouldy state; there was no trace of poison. It is unnecessary to enter further into this subject; the facts adduced, together with experiments performed on animals, show that bread, in a state of mouldiness, may not only produce symptoms of poisoning, but actually cause death; and as it is impossible to distinguish the noxious from the innoxious kind of mould, the use of all bread in such a condition should be avoided. NOXIOUS EFFECTS OF MOULDY BREAD. 127 Even fresh bread may occasionally seriously affect the body. The brown bread of London has been known to produce vertigo, lethargy, and other unpleasant symptoms, indicative of an affection of the brain and nervous system. This has been ascribed, with some probability, to the "lolium temulentum" (darnel) becoming accidentally mixed with the corn. In one instance in which Darnel seeds were mixed in the proportion of one tenth part with rye, the persons partaking of the bread suffered from vertigo, headache, nausea, vomiting, deafness, and cramps. (Med. Gaz., xlv. 872.) Rye-bread is not much used in this country, but the accidental presence of the ergot might here, in some cases, account for the symptoms which have been observed. (See Ann. d'Hyg. 1834, ii. 179; 1835, ii. 240; 1843, i. 41, 347; Henke, Zeitschrift der S. A. 1842, ii. 185; 1844, i. 286, ii. 215.) Other vegetable irritants might be enumerated, but these are the principal which have given rise to medico-legal inquiries. The treatment of such cases must depend on the nature of the symptoms; the main object should always be to remove the poison either from the stomach or bowels, with as little delay as possible. The nature of the poison is commonly apparent from the circumstances; for these cases, if we except the substance Savin, which is sometimes criminally administered, are generally the result of accident. These vegetable poisons are beyond the reach of chemical processes: they are only to be recognised either by their physical properties, or by the botanical characters of the berries, seeds, or leaves. 128 POISONING BY ANIMAL IRRITANTS. ANIMAL IRRITANTS. CHAPTER XV. POISONOUS FOOD CANTHARIDES OR SPANISH FLY-SYMPTOMS AND EFFECTS-ANALYSIS. CANTHARIDES. (SPANISH FLY.) Symptoms and effects.-This poison has been frequently administered, either in the state of powder or tincture, for the purpose of exciting aphrodisiac propensities, or of procuring abortion. When taken in powder, in the dose of one or two drachms, it gives rise to the following symptoms :-A burning sensation in the throat, with great difficulty of swallowing-violent pain in the abdomen, with nausea, and vomiting of bloody mucus; there is also great thirst and dryness of the fauces, but in a few cases observed by Mr. Maxwell, salivation was a prominent symptom. As the case proceeds, pain is commonly experienced in the loins, and there is incessant desire to void urine, but only a small quantity of blood or bloody urine is passed at each effort. The abdominal pain becomes of the most violent griping kind. Diarrhoea supervenes, but this is not always observed;the matters discharged from the bowels are mixed with blood and mucus, and there is often tenesmus, (straining.) In these, as well as in the vomited liquids, shining green particles may be commonly seen on examination, whereby the nature of the poison taken is at once indicated. After a time, there is often severe priapism, and the genital organs are swollen and inflamed both in the male and female. In one instance, observed by Dr. Pereira, abortion was induced, probably owing to the excitement of the uterus, from the severe affection of the bladder; for there is no proof that this substance acts directly on the uterus to induce abortion. With respect to the aphrodisiac propensities caused by cantharides, these can seldom be excited in either sex, except when the substance is administered in a dose which would seriously endanger life. When the case proves fatal, death is usually preceded by syncope, vertigo, and convulsions. The tincture of cantharides produces similar symptoms: they are, however, more speedily induced, and the burning sensation and constriction of the throat and stomach are more strongly marked: it is often so severe as to render it impossible for the individual to swallow; and the act of swallowing gives rise to the most excruciating pain in the throat and abdomen. Post-mortem appearances.-In one well-marked case of poisoning by this substance, the whole of the alimentary canal, from the mouth downwards, was in a state of inflammation, as well as the ureters, kidneys, and internal organs of generation. The mouth and tongue seemed to be deprived of their mucous membrane. In another instance, where an ounce of the tincture was swallowed, and death did not occur for fourteen days, the mucous membrane of the stomach was not inflamed, but it was pulpy, and easily detached. The kidneys were, how CANTHARIDES. FATAL DOSE. 129 ever, inflamed. The brain has been found congested, and ulceration of the blacder is said to have been met with. There are very few fatal cases reported, in which the appearances have been accurately noted; indeed, the greater number of those who have taken this poison have recovered. In a case which occurred to Mr. Saunders, death took place in about twenty-four hours. The deceased must have taken the greater part of half an ounce of cantharides in powder. This was followed by the usual symptoms. On inspection, the vessels of the brain were filled with dark-coloured blood, and the ventricles were distended with serum. Both lungs were highly engorged with dark-coloured blood. The gullet was partially inflamed, and there were patches of inflammation on the mucous coat of the stomach, which had become detached in several places. The same inflammatory appearance existed in the small intestines, in the folds of which the powder of cantharides was abundantly seen. The vessels were distended, and the liver was engorged with dark blood. The gall-bladder was much distended with bile, and none of this secretion appeared to have passed into the bowels. The spleen and kidneys were highly congested: the ureters were inflamed; the bladder contracted and empty, and its internal surface pale. The glittering of the particles of cantharides in the viscera during this inspection by candlelight was very remarkable. (Medical Times, Feb. 3, 1849, p. 287.) Cantharides have no local action of a chemical nature. The poison is a pure irritant, and the effects observed are entirely due to irritation and inflammation. The quantity of this poison required to produce serious effects, or to destroy life, has been a frequent subject of medico-legal inquiry. Dr. Thomson represents the medicinal dose of the powder to be from one to three grains. On a late criminal investigation, one medical witness stated that one grain was the maximum dose, but this is an under-statement; according to Thomson it is three grains. The dose of the London Pharmacopoeial tincture is from ten minims gradually increased to one fluid-drachm, of the powder, from one to two grains. (Pereira, Mat. Med. ii. 1846.) Doses above this, whether of the powder or of the tincture, are likely to be injurious, and to give rise to symptoms of poisoning. On a trial which took place at Aberdeen, in 1825, it appeared that a drachm of the powder had been administered: severe symptoms followed, but the person recovered. Dr. Dyce, the medical witness, said he had given ten grains of the powder at a dose as a medicine. In three cases, observed by Mr. Maxwell, a drachm of the powder mixed with six ounces of rum, was taken by each person; they were robust, healthy negroes,-they suffered severely, but recovered in about ten days: in these cases, irritation of the urinary organs did not appear until after the men had been bled. The smallest quantity of powder which has been known to destroy life was in the case of a young female, quoted by Orfila,—the quantity taken was estimated at twenty-four grains in two doses. She died in four days; but as abortion preceded death, it is difficult to say how far this may have been concerned in accelerating that event. Her intellect was clear until the last. In one instance a man recovered after having taken twenty grains of the powder, (Ed. Med. and Surg. Journ. Oct. 1844;) and in another, after having taken two drachms. (Med. Gaz. xlii. 873.) An ounce of the tincture has been known to destroy life. It was taken by a boy, aged seventeen, and he died in fourteen days. This, I believe, is the smallest dose of the tincture which has killed. In the following instance a similar dose produced only serious symptoms. A woman, aged twenty-nine, swallowed an ounce of tincture of cantharides. Some time afterwards, there was severe pain in the abdomen, increased by pressure: it became swollen and tympanitic. She passed in the night a pint and a half of urine unmixed with blood. In two days, the pulse became feeble and scarcely perceptible:-there was delirium, with severe pain in the region of the kidneys and bladder: the urine was continually drawn off by a catheter. It was more than a fortnight before she was convalescent. (Med. Gaz. xxix. 63.) Four drachms, and even six drachms have been |
