HYDROCARBONS—CAMPHOR—ALCOHOL—AMYL NITRITE—ETHER—CHLOROFORM AND OTHER ANÆSTHETICS—CHLORAL—CARBON DISULPHIDE—CARBOLIC ACID—NITRO-BENZENE—PRUSSIC ACID—PHOSPHORUS.
§ 137. Petroleum is a general term for a mixture of hydrocarbons of the paraffin series, which are found naturally in certain parts of the world, and are in commerce under liquid and solid forms of various density. Crude petroleum is not imported into England, the original substance having previously undergone more or less rectification. The lighter and more volatile portions are known under the name of cymogene, rhigolene, gasolene, and naphtha.
§ 138. Cymogene has a specific gravity of ·590, and boils at 0°. It has been employed in refrigerating machines. It appears to consist chiefly of butane (C4H10).
§ 139. Rhigolene is now used in medicine in the form of spray to produce local anæsthesia. It boils at 18°, and has a density of ·650.
§ 140. Gasolene has a density of ·680-·688; it has received technical applications in the “naphthalising” of air and gas.
§ 141. Benzoline (mineral naphtha, petroleum naphtha, petroleum spirit, petroleum ether) is a mixture of the lighter series of hydro-carbons; the greater part consists of heptane, and there is also a considerable quantity of pentane (C7H16) present. The specific gravity varies from ·69 to ·74. It is very inflammable, and is used in sponge lamps, and also as a solvent for gutta-percha, naphthalene, paraffin, wax, and many other bodies. By the practical chemist it is much employed.
The similarity of the terms benzoline and benzene has caused benzoline to be often confused with benzol or benzene, the leading constituent of coal-tar naphtha (C6H6). Mr Allen[132] gives in the following table a summary of the chief points of distinction, both between petroleum naphtha, shale naphtha, and coal-tar naphtha. The table is founded upon the examination of particular samples, and commercial samples may present a few minor deviations.
[132] Commercial Organic Analysis, vol. ii. p. 31.
TABLE OF THE VARIETIES OF NAPHTHA.
| Petroleum Naphtha. | Shale Naphtha. | Coal-tar Naphtha. |
|---|---|---|
| Contains at least 75 per cent. of heptane, C7H16, and other hydrocarbons of the marsh gas or paraffin series; the remainder apparently olefins, CnH2n, with distinct traces of benzene and its homologues. | Contains at least 60 to 70 per cent. of heptylene, C7H14, and other hydrocarbons of the olefin series; the remainder paraffins. No trace of benzene or its homologues. | Consists almost wholly of benzene, C6H6, and other homologous hydrocarbons, with a small percentage of light hydrocarbons in some samples. |
| Specific gravity at 15°, ·600. | Specific gravity at 15°, ·718. | Specific gravity ·876. |
| Distils between 65° and 100°. | Distils between 65° and 100°. | Distils between 80° and 120°. |
| Dissolves coal-tar pitch, but slightly; liquid, but little coloured even after prolonged contact. | Behaves similarly to petroleum naphtha with regard to the solution of pitch. | Readily dissolves pitch, forming a deep brown solution. |
| On shaking three measures of the sample with one measure of fused crystals of absolute carbolic acid, no solution. Liquids not miscible. | When treated with fused carbolic acid crystals, the liquids mix perfectly. | The liquids form a homogeneous mixture when treated with fused carbolic acid crystals. |
| Combines with 10 per cent. of its weight of bromine in the cold. | Combines with upwards of 90 per cent. of its weight of bromine. | Combines slowly with 30-40 per cent. of its weight of bromine. |
§ 142. Paraffin Oil (or kerosine, mineral oil, photogen, &c.) is the chief product resulting from the distillation of American petroleum—the usual specific gravity is about ·802—it is a mixture of hydrocarbons of the paraffin series. It should be free from the more volatile constituents, and hence should not take fire when a flame is applied near the surface of the cold liquid.
§ 143. Effects of Petroleum.—Since we have here to deal with a commercial substance of such different degrees of purity, and various samples of which are composed of such various proportions of different hydrocarbons, its action can only be stated in very general terms. Eulenberg[133] has experimented with the lighter products obtained from the distillation of Canadian petroleum. This contained sulphur products, and was extremely poisonous, the vapour killing a rabbit in a short time, with previous insensibility and convulsions. The autopsy showed a thin extravasation of blood on the surface of each of the bulbi, much coagulated blood in the heart, congested lungs, and a bloody mucus covering the tracheal mucous membrane. An experiment made on a cat with the lighter petroleum (which had no excess of sulphur) in the state of vapour, showed that it was an anæsthetic, the anæsthesia being accompanied by convulsions, which towards the end were tetanic and violent. The evaporation of 1·5 grm. in a close chamber killed the animal in three hours. The lungs were found congested, but little else was remarkable. Much petroleum vapour is breathed in certain factories, especially those in which petroleum is refined.[134] From this cause there have been rather frequent toxic symptoms among the workmen. Eulenberg[135] describes the symptoms as follows:—A person, after breathing an overdose of the vapour, becomes very pale, the lips are livid, the respiration slow, the heart’s action weak and scarcely to be felt. If he does not immediately go into the open air away from the poisonous vapour, these symptoms may pass on to insensibility, convulsions, and death. It often occasions a condition of the voluntary muscles similar to that induced by drunkenness, and on recovery the patient is troubled by singing in the ears and noises in the head. The smell and taste of the poison may remain for a long time.
[133] Gewerbe-Hygiene.
[134] The vapour most likely to rise at the ordinary temperature, and mix with the atmosphere, is that of the lighter series, from cymogene to benzoline.
[135] Op. cit.
§ 144. Poisoning by taking light petroleum into the stomach is not common. In a case recorded by Taylor,[136] a woman, for the purpose of suicide, swallowed a pint of petroleum, There followed a slight pain in the stomach, and a little febrile disturbance, and a powerful smell of petroleum remained about the body for six days; but she completely recovered. In August 1870 a sea-captain drank a quantity of paraffin, that is, lighting petroleum, and died in a few hours in an unconscious state. A child, 2 years old, was brought to King’s College Hospital within ten minutes after taking a teaspoonful of paraffin. It was semi-comatose and pale, with contracted pupils; there was no vomiting or purging. Emetics of sulphate of zinc were administered, and the child recovered in twenty-four hours. In another case treated at the same hospital, a child had swallowed an unknown quantity of paraffin. It fell into a comatose state, which simulated tubercular meningitis, and lasted for nearly three weeks.[137] In a case recorded by Mr Robert Smith,[138] a child, 4 years of age, had swallowed an unknown quantity of paraffin. A few minutes afterwards, the symptoms commenced; they were those of suffocation, with a constant cough; there was no expectoration; the tongue, gums, and cheeks were blanched and swollen where the fluid touched them; recovery followed. A woman, aged 32, who had taken a quarter of a pint of paraffin, was found unconscious and very cold; the stomach-pump was used, and she recovered.[139] Hence it is tolerably certain, from the above instances, that should a case of petroleum poisoning occur, the expert will not have to deal with infinitesimal quantities; but while the odour of the oil will probably be distinctly perceptible, there will be also a sufficient amount obtained either from matters vomited, or the contents of the stomach, &c., so that no difficulty will be experienced in identifying it.
[136] Poisons, p. 656
[137] Brit. Med. Journ., Sept. 16, 1876, p. 365.
[138] Brit. Med. Journ., Oct. 14, 1876.
[139] Pharm. Journ., Feb. 12, 1875; also for other cases see Brit. Med. Journ., Nov. 4, 1876; and Köhler’s Physiol. Therap., p. 437.
§ 145. In order to separate petroleum from any liquid, the substances under examination must be carefully distilled in the manner recommended under “Ether.” The lighter petroleums will distil by the aid of a water-bath; but the heavier require a stronger heat; redistillation of the distillate may be necessary. The odour of the liquid, its inflammable character, and its other properties, will be sufficient for identification.
§ 146. Coal-tar-naphtha in its crude state, is an extremely complex liquid, of a most disagreeable smell. Much benzene (C6H6) is present with higher homologues of the benzene series. Toluene (C7H8), naphthalene (C10H8), hydrocarbons of the paraffin series, especially hexane (C6H14), and hydrocarbons of the olefin series, especially pentylene, hexylene, and heptylene (C5H10, C6H12 and C7H14). Besides these, there are nitrogenised bases, such as aniline, picoline, and pyridine; phenols, especially carbolic acid; ammonia, ammonium sulphide, carbon disulphide, and probably other sulphur compounds; acetylene and aceto-nitrile. By distillation and fractional distillation are produced what are technically known “once run” naphtha, 90 per cent. benzol, 50 and 90 per cent. benzol,[140] 30 per cent. benzol, solvent naphtha, and residue known as “last runnings.”
[140] Or 50⁄90 benzol, this indicates that 50 per cent. distils over below 100°; and 40, making in all 90, below 120°.
§ 147. Taylor[141] records a case in which a boy, aged 12, swallowed about 3 ozs. of naphtha, the kind usually sold for burning in lamps, and died with symptoms of narcotic poisoning. The child, after taking it, ran about in wild delirium, he then sank into a state of collapse, breathing stertorously, and the skin became cold and clammy. On vomiting being excited, he rejected about two tablespoonfuls of the naphtha, and recovered somewhat, but again fell into collapse with great muscular relaxation. The breathing was difficult; there were no convulsions; the eyes were fixed and glassy, the pupils contracted; there was frothing at the mouth. In spite of every effort to save him, he died in less than three hours after taking the poison. The body, examined three days after death, smelt strongly of naphtha, but the post-mortem appearances were in no way peculiar, save that the stomach contained a pint of semi-fluid matter, from which a fluid, having the characteristics of impure benzene, was separated.
[141] Op. cit., p. 657.
§ 148. The effects of the vapour of benzene have been studied by Eulenberg in experiments on cats and rabbits, and there are also available observations on men[142] who have been accidentally exposed to its influence. From these sources of information, it is evident that the vapour of benzene has a distinctly narcotic effect, while influencing also in a marked degree the spinal cord. There are, as symptoms, noises in the head, convulsive trembling and twitchings of the muscles, with difficulty of breathing.
[142] Dr. Stone, Med. Gaz., 1848, vol. xii. p. 1077.
§ 149. Benzene is separated from liquids by distillation, and may be recognised by its odour, and by the properties described at p. 130. The best process of identification, perhaps, is to purify and convert it into nitro-benzene, and then into aniline, in the following manner:—
1. Purification.—The liquid is agitated with a solution of caustic soda; this dissolves out of the benzene any bodies of an acid character, such as phenol, &c. The purified liquid should again be distilled, collecting that portion of the distillate which passes over between 65° and 100°; directly the thermometer attains nearly the 100°, the distillation should be stopped. The distillate, which contains all the benzene present, is next shaken with concentrated sulphuric acid in the cold; this will dissolve out all the hydrocarbons of the ethylene and acetylene series. On removing the layer of benzene from the acid, it must be again shaken up with dilute soda, so as to remove any trace of acid. The benzene is, by this rather complicated series of operations, obtained in a very fair state of purity, and may be converted into nitro-benzene, as follows:—
2. Conversion into Nitro-Benzene.—The oily liquid is placed in a flask, and treated with four times its volume of fuming nitric acid. The flask must be furnished with an upright condenser; a vigorous action mostly takes place without the application of heat, but if this does not occur, the flask may be warmed for a few minutes.
After the conversion is over, the liquid, while still warm, must be transferred into a burette furnished with a glass tap, or to a separating funnel, and all, except the top layer, run into cold water; if benzene was originally present, either oily drops of nitro-benzene will fall, or if the benzene was only in small quantity, a fine precipitate will gradually settle down to the bottom of the vessel, and a distinct bitter-almond smell be observed; but, if there be no benzene in the original liquid, and, consequently, no nitro-benzene formed, no such appearance will be observed.
3. Conversion into Aniline.—The nitro-benzene may itself be identified by collecting it on a wet filter, dissolving it off the filter by alcohol, acidifying the alcoholic solution by hydrochloric acid, and then boiling it for some time with metallic zinc. In this way aniline is formed by reduction. On neutralising and diluting the liquid, and cautiously adding a little clear solution of bleaching-powder, a blue or purple colour passing to brown is in a little time produced.
§ 150. The terpenes are hydrocarbons of the general formula CnH2n-4. The natural terpenes are divided into three classes:—
1. The true terpenes, formula (C10;H16)—a large number of essential oils, such as those of turpentine, orange peel, nutmeg, caraway, anise, thyme, &c., are mainly composed of terpenes.
2. The cedrenes, formula (C15H24)—the essential oil of cloves, rosewood, cubebs, calamus, cascarilla, and patchouli belong to this class.
3. The colophene hydrocarbons, formula (C20H32), represented by colophony.
Of all these, oil of turpentine alone has any toxicological significance; it is, however, true that all the essential oils, if taken in considerable doses, are poisonous, and cause, for the most part, vascular excitement and complex nervous phenomena, but their action has not been very completely studied. They may all be separated by distillation, but a more convenient process for recovering an essential oil from a liquid is to shake it up with petroleum ether, separating the petroleum and evaporating spontaneously; by this means the oil is left in a fair state of purity.
§ 151. Various species of pine yield a crude turpentine, holding in solution more or less resin. The turpentine may be obtained from this exudation by distillation, and when the first portion of the distillate is treated with alkali, and then redistilled, the final product is known under the name of “rectified oil of turpentine,” and is sometimes called “camphene.” It mainly consists of terebenthene. Terebenthene obtained from French turpentine differs in some respects from that obtained from English or American turpentine. They are both mobile, colourless liquids, having the well-known odour of turpentine and highly refractive; but the French terebenthene turns a ray of polarised light to the left -40·3° for the sodium ray, and the English to the right +21·5°; the latter terebenthene is known scientifically as austra-terebenthene. This action on polarised light is retained in the various compounds and polymers of the two turpentine oils.
The specific gravity of turpentine oil is ·864; its boiling point, when consisting of pure terebenthene, 156°, but impurities may raise it up to 160°; it is combustible and burns with a smoky flame. Oil of turpentine is very soluble in ether, petroleum ether, carbon disulphide, chloroform, benzene, fixed and essential oils, and by the use of these solvents it is conveniently separated from the contents of the stomach. It is insoluble in water, glycerin, and dilute alkaline and acid solutions; and very soluble in absolute alcohol, from which it may be precipitated by the addition of water.
It is polymerised by the action of strong sulphuric acid, the polymer, of course, boiling at a higher temperature than the original oil. With water it forms a crystalline hydrate (C10H20O2,H2O). On passing nitrosyl chloride gas into the oil, either pure or diluted with chloroform or alcohol, the mixture being cooled by ice, a white crystalline body is deposited, of the formula C10H16(NOCl). By treating this compound with alcoholic potash, the substitution product (C10H16NO) is obtained. By treating turpentine with an equal bulk of warm water, and shaking it in a large bottle with air, camphoric acid and peroxide of hydrogen are formed. When turpentine oil is left in contact with concentrated hydrochloric acid, there is formed terebenthene dihydrochloride (C10H162HCl), which forms rhombic plates, insoluble in water, and decomposable by boiling alcoholic potash, with formation of terpinol, (C10H17)2O. The dihydrochloride gives a colour-reaction with ferric chloride. This is an excellent test—not, it is true, confined to oil of turpentine—but common to the dihydrochlorides of all the terpenes. A few drops of the oil are stirred in a porcelain capsule with a drop of hydrochloric acid, and one of ferric chloride solution; on gently heating, there is produced first a rose colour, then a violet-red, and lastly a blue.
§ 152. Effects of the Administration of Turpentine.—L. W. Liersch[143] exposed animals to the vapour of turpentine, and found that a cat and a rabbit died within half an hour. There was observed uneasiness, reeling, want of power in the limbs (more especially in the hinder extremities), convulsions partial, or general, difficulty of respiration; and the heart’s action was quickened. Death took place, in part, from asphyxia, and in part was attributable to a direct action on the nervous centres. The autopsy showed congestion of the lungs, ecchymoses of the kidney, and much blood in the liver and spleen. Small doses of turpentine-vapour cause (according to Sir B. W. Richardson)[144] giddiness, deficient appetite, and anæmia. From half an ounce to an ounce is frequently prescribed in the country as a remedy for tape-worm; in smaller quantities it is found to be a useful medicine in a great variety of ailments. The larger doses produce a kind of intoxication with giddiness, followed often by purging and strangury, not unfrequently blood and albumen (or both) is found in the urine. When in medical practice I have given the oil, and seen it given by others, in large doses for tape-worm to adults, in perhaps 40 cases, but in no one instance were the symptoms severe; the slight intoxication subsided quickly, and in a few hours the patients recovered completely. Nevertheless it has been known to destroy the lives of children, and cause most serious symptoms in adults. Two fatal cases are mentioned by Taylor; one was that of a child who died fifteen hours after taking half an ounce of the oil; in another an infant, five months old, died rapidly from a teaspoonful. The symptoms in these fatal cases were profound coma and slight convulsions; the pupils were contracted, and there was slow and irregular breathing. Turpentine is eliminated in a changed form by the kidneys, and imparts an odour of violet to the urine; but the nature of the odoriferous principle has not yet been investigated.
[143] Clarus in Schmidt’s Jahrbücher, Bd. cxvii., i. 1863; and Vierteljahrsschr. für ger. Med., xxii., Oct. 1862.
[144] Brit. and For. Med.-Chir. Review, April 1863.
§ 153. A great many essential oils deposit, after exposure to air, camphors produced by oxidation of their terpenes. Ordinary camphor is imported in the rough state from China and Japan, and is prepared by distilling with water the wood of Camphora officinarum; it is resublimed in England. The formula of camphor is C10H10O; it has a density of ·986 to ·996; melts at 175°, and boils at 205°. It is readily sublimed, especially in a vacuum, and is indeed so volatile at all temperatures, that a lump of camphor exposed to the air wastes away. It is somewhat insoluble in water (about 1 part in 1000), but this is enough to impart a distinct taste to the water; it is insoluble in chloroform, ether, acetone, acetic acid, carbon disulphide, and oils. It has a fragrant odour and a burning taste. A 10 per cent. solution in alcohol turns a ray of polarised light to the right +42·8°. By distillation with zinc chloride, cymene and other products are produced. By prolonged treatment with nitric acid, camphor is oxidised to camphoric acid (C10H16O4). Camphor unites with bromine to form a crystalline, unstable dibromide, which splits up on distillation into hydrobromic acid and monobrom-camphor (C10H15BrO). The latter is used in medicine; it crystallises in prisms fusible at 76°, and is readily soluble in alcohol.
§ 154. Pharmaceutical Preparations.—The preparations officinal in the British Pharmacopœia are camphor water—water saturated with camphor, containing about one part per thousand.
Camphor Liniment.—A solution of camphor in olive oil, strength 25 per cent.
Compound Camphor Liniment.—Composed of camphor, oil of lavender, strong solution of ammonia and alcohol; strength in camphor about 11 per cent.
Spirit of Camphor.—A solution of camphor in spirit; strength, 10 per cent.
Camphor is also a constituent of the compound tincture of camphor; but in this case it may be considered only a flavouring agent. There is a homœopathic solution of camphor in spirit (Rubini’s Essence of Camphor). The solution is made by saturating alcohol with camphor; it is, therefore, very strong—about half the bulk consisting of camphor. Camphor is used in veterinary medicine, both externally and internally.
§ 155. Symptoms.—Camphor acts energetically on the brain and nervous system, especially if it is given in strong alcoholic solution, and thus placed under conditions favouring absorption. Some years ago, Dr. G. Johnson[145] published a series of cases arising from the injudicious use of “homœopathic solution of camphor,” from 7 to 40 drops of Rubini’s homœopathic camphor taken for colds, sore throat, &c., having produced coma, foaming at the mouth, convulsions, and partial paralysis. All the patients recovered, but their condition was for a little time alarming.
[145] Brit. Med. Journ., Feb. 27, 1878, p. 272; see also ibid., Feb. 1875.
The cases of fatal poisoning by camphor are very rare. A woman, aged 46, pregnant four months, took 12 grms. (about 184 grains) in a glass of brandy for the purpose of procuring abortion. In a very short time the symptoms commenced; she had intolerable headache, the face was flushed, and there was a sensation of burning in the stomach. In eight hours after taking the dose, she had strangury and vomiting, and the pain in the epigastrium was intense. These symptoms continued with more or less severity until the third day, when she became much worse. Her face was pale and livid, the eyes hollow, the skin cold and insensible, pulse weak and thready, breathing laboured. There were violent cramps in the stomach and retention of urine for twenty-four hours, and then coma. The patient lingered on yet another three days, aborted, and died.[146]
[146] Journ. de Chim. Méd., May 1860.
Dr. Schaaf[147] has recorded three cases of poisoning—one of which was fatal. A woman gave about half a teaspoonful of a camphor solution to each of her three children, the ages being respectively five and three years and fifteen months. The symptoms noted were pallor of the face, a burning pain in the throat, thirst, vomiting, purging, convulsions, and afterwards coma. The youngest child died in seven hours; the others recovered. The smallest dose known to have produced violent symptoms in an adult is 1·3 grm. (20 grains); the largest dose known to have been recovered from is 10·4 grms. (160 grains).[148]
§ 156. Post-mortem Appearances.—The bodies of animals or persons dying from poisoning by camphor, smell strongly of the substance. The mucous membrane of the stomach has been found inflamed, but there seem to be no characteristic lesions.
§ 157. Separation of Camphor from the Contents of the Stomach.—The identification of camphor would probably in no case present any difficulty. It may be readily dissolved out from organic fluids by chloroform. If dissolved in fixed oils, enough for the purposes of identification may be obtained by simple distillation. It is precipitated from its alcoholic solution by the addition of water.
§ 158. The chemical properties of ordinary alcohol are fully described, with the appropriate tests, in “Foods,” pp. 369-384, and the reader is also referred to the same volume for the composition and strength of the various alcoholic drinks.
Statistics.—If we were to include in one list the deaths indirectly due to chronic, as well as acute poisoning by alcohol, it would stand first of all poisons in order of frequency, but the taking of doses so large as to cause death in a few hours is rare. The deaths from alcohol are included by the English registrar-general under two heads, viz., those returned as dying from delirium tremens, and those certified as due directly to intemperance.
During the twenty-five years, from 1868 to 1892, 30,219 deaths have been registered as due to intemperance, which gives an average of 1209 per year. The rate per million has varied during the period from 29 to 71; and the figures taken as a whole show that deaths from intemperance appear to be increasing; the increase may be only apparent, not real, for it is a significant circumstance that deaths registered under liver diseases show a corresponding decrease; it is, therefore, not unlikely that deaths which formerly would be ascribed to liver disease, are more often now stated to be the effects of intemperance.
Deaths directly due to large doses of alcohol are not uncommon; during the ten years ending 1892, 105 deaths (81 males and 24 females) were ascribed under the head of “accident or negligence” directly to alcohol.
CHART SHEWING DEATHS PER MILLION PERSONS LIVING, FROM INTEMPERANCE & FROM LIVER DISEASES.
Alcohol deaths| THE MEDICAL “OFFICERS OF HEALTH” CHART. | ENT. AT STA. HALL. |
| Notes. | |||
| Intemperance | Solid line | ||
| Liver disease | Dashed line | ||
| The Scale for Intemperance is as printed. | |||
| That for Liver diseases is 10 times larger. | |||
§ 159. Criminal or Accidental Alcoholic Poisoning.—Suicide by alcohol, in the common acceptation of the term, is rare, and murder still rarer, though not unknown. In the ten years ending 1892, only three deaths from alcohol (1 male and 2 females) are recorded as suicidal. Perhaps the most common cause of fatal acute poisoning by alcohol is either a foolish wager, by which a man bets that he can drink so many glasses of spirits without bad effect; or else the drugging of a person already drunk by his companions in a sportive spirit.
§ 160. Fatal Dose.—It is difficult to say what would be likely to prove a lethal dose of alcohol, for a great deal depends, without doubt, on the dilution of the spirit, since the mere local action of strong alcohol on the mucous membranes of the stomach, &c., is severe (one may almost say corrosive), and would aid the more remote effects. In Maschka’s case,[149] a boy of nine years and a girl of five, died from about two and a half ounces of spirit of 67 per cent. strength, or 48·2 c.c. (1·7 oz.) of absolute alcohol.
[149] Recorded by Maschka (Gutachten der Prager Facultät, iv. 239; see also Maschka’s Handbuch der gericht. Medicin, Band. ii. p. 384). The following is a brief summary:—Franz. Z., nine years old, and Caroline Z., eight years old, were poisoned by their stepfather with spirit of 67 per cent. strength taken in small quantities by each—at first by persuasion, and the remainder administered by force. About one-eighth of a pint is said to have been given to each child. Both vomited somewhat, then lying down, stertorous breathing at once came on, and they quickly died. The autopsy, three days after death, showed dilatation of the pupils; rigor mortis present in the boy, not in the girl; and the membranes of the brain filled with dark fluid blood. The smell of alcohol was perceptible on opening the chest; the mucous membrane of the bronchial tubes and gullet was normal, both lungs œdematous, the fine tubes gorged with a bloody frothy fluid, and the mucous membrane of the whole intestinal canal was reddened. The stomach was not, unfortunately, examined, being reserved for chemical analysis. The heart was healthy; the pericardium contained some straw-coloured fluid. Chemical analysis gave an entirely negative result, which must have been from insufficient material having been submitted to the analyst, for I cannot see how the vapours of alcohol could have been detected by the smell, and yet have evaded chemical processes.
In a case related by Taylor, a child, seven years old, died from some quantity of brandy, probably about 113·4 c.c. (4 ozs.), which would be equal to at least 56·7 c.c. (2 ozs.) of absolute alcohol. From other cases in which the quantity of absolute alcohol can be, with some approximation to the truth, valued, it is evident that, for any child below ten or twelve, quantities of from 28·3 to 56·6 c.c. (1-2 ozs.) of absolute alcohol contained in brandy, gin, &c., would be a highly dangerous and probably fatal dose; while the toxic dose for adults is somewhere between 71·8-141·7 c.c. (2·5-5 ozs.).
§ 161. Symptoms.—In the cases of rapid poisoning by a large dose of alcohol, which alone concern us, the preliminary, and too familiar excitement of the drunkard, may be hardly observable; but the second stage, that of depression, rapidly sets in; the unhappy victim sinks down to the ground helpless, the face pale, the eyes injected and staring, the pupils dilated, acting sluggishly to light, and the skin remarkably cold. Fräntzel[150] found, in a case in which the patient survived, a temperature of only 24·6° in the rectum, and in that of another person who died, a temperature of 23·8°. The mucous membranes are of a peculiar dusky blue; the pulse, which at first is quick, soon becomes slow and small; the respiration is also slowed, intermittent, and stertorous; there is complete loss of consciousness and motion; the breath smells strongly of the alcoholic drink, and if the coma continues there may be vomiting and involuntary passing of excreta. Death ultimately occurs through paralysis of the respiratory centres. Convulsions in adults are rare, in children frequent. Death has more than once been immediately caused, not by the poison, but by accidents dependent upon loss of consciousness. Thus food has been sucked into the air-tubes, or the person has fallen, so that the face was buried in water, ordure, or mud; here suffocation has been induced by mechanical causes.
[150] Temperaturerniedrigung durch Alcoholintoxication, Charité Annalen, i. 371.
A remarkable course not known with any other narcotic is that in which the symptoms remit, the person wakes up, as it were, moves about and does one or more rational acts, and then suddenly dies. In this case also, the death is not directly due to alcohol, but indirectly—the alcohol having developed œdema, pneumonia, or other affection of the lungs, which causes the sudden termination when the first effect of the poison has gone off. The time that may elapse from the commencement of coma till death varies from a few minutes to days; death has occurred after a quarter of an hour, half an hour, and an hour. It has also been prolonged to three, four, and six days, during the whole of which the coma has continued. The average period may, however, be put at from six to ten hours.
§ 162. Post-mortem Appearances.—Cadaveric rigidity lasts tolerably long. Casper has seen it still existing nine days after death, and Seidel[151] seven days (in February). Putrefaction is retarded in those cases in which a very large dose has been taken, but this is not a very noticeable or constant characteristic. The pupils are mostly dilated. The smell of alcohol should be watched for; sometimes it is only present in cases where but a short time has elapsed between the taking of the poison and death; putrefaction may also conceal it, but under favourable circumstances, especially if the weather is cold, the alcoholic smell may remain a long time. Alcohol may cause the most intense redness and congestion of the stomach. The most inflamed stomach I ever saw, short of inflammation by the corrosive poisons, was that of a sailor, who died suddenly after a twenty-four hours’ drinking bout: all the organs of the body were fairly healthy, the man had suffered from no disease; analysis could detect no poison but alcohol; and the history of the case, moreover, proved clearly that it was a pure case of alcoholic poisoning.