There is a singular uncertainty, however, in the action of one or more large doses. Magendie says he has taken two drachms of the tincture, containing about ten grains of iodine, without injury;[342] Dr. Gully, that he has given three times as much daily for some time; Dr. Kennedy, that he gave an average of twelve grains daily in the form of tincture for eighty days without observing any effect at all; and Mr. Delisser, that he has given a patient thirty grains in a day without injury.[343] Dr. Samuel Wright met with the case of an infant, not more than three years old, who took three drachms of the tincture at once, and suffered only from attempts to cough, some retching and much thirst.[344]
It further appears that in medicinal doses, such as a quarter of a grain, frequently repeated, it is a dangerous poison, unless its effects are carefully watched. For in consequence of accumulation in the system, or gradually increasing action, it produces when long used some very singular and hazardous symptoms; and like mercury, foxglove, and some other poisons, it may be taken long without effect, and at length begin to operate suddenly. The symptoms which it then occasions are sometimes those of irritation; namely, incessant vomiting and purging, acute pain in the stomach, loaded tongue, rapid and extreme emaciation, violent cramps and small frequent pulse. These symptoms may continue many days, and even when subdued to a certain extent, vomiting and cramps are apt to recur for months after.[345] A fatal case of this form of affection has been related by M. Zink, a Swiss physician. His patient, after taking too large doses of iodine for about a month, was seized with restlessness, burning heat of skin, tremors, palpitation, syncope, excessive thirst, a sense of burning along the gullet, frequent purging of bilious and black stools, priapism, and tremulous pulse. The symptoms of local inflammation went off in a few days; but those of general fever continued; and he died after six weeks’ illness.[346] Another fatal case has been described in Rust’s Journal. The leading symptoms were pain in the region of the liver, loss of appetite, emaciation, quartan fever, diarrhœa, excessive weakness; and after the emaciation was far advanced a hardened liver could be felt. The patient appears to have died of exhaustion.[347] From this case, and another of which the appearances after death will be presently noticed, it is not improbable that iodine possesses the power of inflaming the liver.
In another and more common affection, the patient is attacked with tremors, at first slight and confined to the fingers, afterwards violent and extending to the whole muscles of the arms and even of the trunk. At the same time there is excessive and rapidly increasing weakness, a sense of anxiety and sinking, a total suspension of the function of digestion, rapid and extreme muscular emaciation, tendency to fainting, and violent continued palpitation,[348] accompanied sometimes with absorption of the testicles in man, and of the mammæ in females. In the midst of these phenomena the curative powers of the poison over the disease for which it has chiefly been used, namely, goître, are developed. It has been remarked in particular, that the diminution of the goître keeps pace with the diminution of the breasts, though at times either effect has been developed without the other. An instance is related in Rust’s Journal of a female, whose breasts began to sink after she had used iodine for four months; and in four weeks hardly a vestige of them remained; but her goître was not affected.[349] An American physician, Dr. Rivers, has twice noticed barrenness apparently induced by the prolonged use of iodine; and as in these instances the females were young and previously very prolific, but ceased to bear children from the time the iodine was used, his observations seem worthy of attention.[350] Dr. Jahn[351] specifies among the leading effects of the poison when slowly accumulated in the body,—absorption of the fat,—increase of all the excretions,—dinginess of the skin, with frequent clammy sweat,—hurried anxious breathing,—diuresis and an appearance of oil floating in the urine,—increased discharge of fæces, which are unusually bilious, but free of mucus,—increased secretion of semen,—increased menstrual discharge,—swelling of the subcutaneous veins and lividity of the lips,—feebleness of the pulse, with superabundance of serosity in the blood,—impaired digestion and diminished secretion of saliva and mucus. This affection, which, in conformity with the name he has given it, may be termed Iodism [Iodkrankheit], he contrasts with mercurialism, the constitutional effect of the accumulation of mercury in the body; and he considers the former not more unmanageable than the latter. The dose required to produce these effects are very various. Some people appear almost insensible to its action; in one instance, nine hundred and fifty-three grains were taken in daily portions varying from two to eighteen grains, without any bad effect;[352] and I have known an average of four grains daily taken for fifteen months, with the effect only of increasing the appetite. On the other hand, Dr. Gairdner has seen severe symptoms commence when half a grain was taken three times a day for a single week;[353] and Coindet has seen bad effects from thirty drops of the solution of ioduretted hydriodate taken daily for five days.[354]
Iodine and iodide of potassium in medicinal doses have been supposed by Dr. Lawrie to be capable of exciting in certain constitutions an affection resembling cynanche laryngea in its symptoms, consisting of inflammation of the salivary glands, glottis, and other adjacent parts, and proving sometimes fatal.[355] This property is doubtful; but several instances have been published of profuse salivation and soreness of the mouth during a course of iodine; it is apt to cause chronic irritation of the Schneiderian membrane; and some think that it may affect in like manner the bronchial membrane in the lungs.[356]
Morbid Appearances from Iodine.—The only account I have seen of the appearances left in the body after death from slow poisoning with iodine is contained in the essay of Dr. Zink. In a second fatal case which came under his notice he found enlarged abdomen from distension of the intestines with gases, enlargement of the other viscera and serous effusion into the peritonæum; adhesion of the viscera to one another; redness of the intestines, in some places approaching to gangrenous discoloration; redness and excoriation of the peritonæal coat of the stomach, and also of its villous coat; enlargement and pale rose-red coloration of the liver. In the chest serum was found in the sac of the pleura. The gullet was contracted in diameter, and red internally.
To these remarks on iodine a few observations may be added on the iodide of potassium, one of its compounds, which is now generally substituted in medicine for the simple substance. The tests and actions of this poison have been examined by M. Devergie; and more lately its medico-legal chemistry has been investigated by Dr. O’Shaughnessey and Professor Orfila.
It is sold in the shops of various degrees of purity. Pure iodide of potassium is in white crystals, tending to the cubical form, permanent in the air, possessing a faint peculiar odour, and easily soluble in both water and rectified spirit. Another variety has the same form, but possesses an odour of iodine, is often yellowish in colour, and deliquesces slightly in moist air. This contains an excess of iodine, but may be otherwise pure. A third variety is impure. It presents less tendency to assume a crystalline form, is more or less deliquescent, dissolves but partially in alcohol, and when dissolved effervesces with acids. The principal ingredient in this article is carbonate of potass; and sometimes the proportion of iodide is inconsiderable. In one specimen I procured 74·5 per cent. of carbonate of potass, 16 of water, and only 9·5 of iodide of potassium.
In the solid state the iodide of potassium may be known by the effect of strong sulphuric or nitric acid, which turns it brown with effervescence, and when aided by heat disengages violet fumes of iodine.
In solution many tests will detect it, such as chlorine, nitric acid, corrosive sublimate, acetate of lead, protonitrate of mercury, muriate of platinum, and starch with chlorine or nitric acid. Chlorine or nitric acid forms a brown or orange-coloured solution by disengaging iodine. Corrosive sublimate forms a fine carmine-red precipitate, the biniodide of mercury; acetate of lead a fine yellow precipitate, the iodide of lead; protonitrate of mercury a yellow protiodide of mercury, which gradually fades into a dirty brown. Solution of starch, followed by chlorine in solution or in vapour, strikes a deep blue colour, which, if the fluid is sufficiently diluted, disappears on boiling, reappears on sudden cooling, and is permanently removed by a stream of sulphuretted hydrogen gases. Of these tests the most characteristic is starch with chlorine; and it is also extremely delicate. Too much chlorine however bleaches the blue colour away.
In compound mixtures most and sometimes all of these tests are useless. If the mixture is deeply coloured, none will act characteristically. If carbonate of potass be present in such proportion as is often met with in the shops, the tests cannot be trusted to.
Process for Compound Mixtures.—The following method of analysis is applicable to all mixtures, organic and inorganic. Add water, if necessary, and filter; and if the fluid which passes through is tolerably free from colour, test a little of it with solution of starch and chlorine. If the colour is too deep to admit of this trial, or the test on trial does not act, unite the fluid and solid parts and transmit sulphuretted hydrogen to convert any free iodine into hydriodic acid. Drive off the excess of gas, supersaturate with a considerable excess of potass, filter, and evaporate to dryness. Char the residue at a low red heat in a covered crucible; pulverize the charcoaly mass, and exhaust with water. This solution will probably act characteristically with starch and chlorine; but on the whole it is better in the first instance to remove some of the salts by evaporating to dryness, and exhausting the residuum with alcohol. The alcoholic solution contains the hydriodate of potass, with some other salts; and on being evaporated to dryness, a residuum is left, on which, when dissolved in water, the starch and chlorine will act characteristically. No other test is necessary; and frequently no other test will act, on account of co-existing salts.
I have found that a grain of iodide of potassium may thus be easily detected in six ounces of urine, which must be considered a very complicated fluid. In the solution ultimately procured nitrous acid struck a pale brown tint, and on the addition of solution of starch a dark-blue precipitate was formed; which, after being sufficiently diluted, disappeared under ebullition, leaving a colourless fluid. On cooling, no change took place; but on the subsequent addition of a drop of sulphuric acid, the blue colour and precipitation were immediately restored. No other reagent acted characteristically, although there was a sufficient quantity of solution to try the starch test ten times at least.
Dr. O’Shaughnessey has proposed a more complex method by precipitation with chloride of platinum.[357] Professor Orfila says it is sufficient to boil and filter the suspected matter, and to heat first the liquid and then the solid part with solution of chloride, when violet vapours of iodine are disengaged, which may be condensed and subjected to various tests.[358] I have not compared this method with the one I have been in the practice of using; but, notwithstanding the strong assurances of its proposer, its superiority in point of delicacy seems dubious, although no one can deny its simplicity.[359]
Action and Symptoms in Man.—From the experiments of Devergie on animals, iodide of potassium seems to be in large doses an irritant, though not a powerful one. Two drachms in an ounce of water killed a dog in three days with violent vomiting, and signs of irritation were found in the stomach, namely, black extravasated spots and ulcers in the middle of them. A solution injected into the cellular tissue caused only local inflammation. Injected into the jugular vein in the dose of four grains, it produced tetanus and death in a minute and a half.[360] The latter investigations of Dr. Cogswell confirm essentially these results.
Discrepant accounts have been given of the effects of iodide of potassium on man. When first introduced into medicine, it was conceived to be an active poison, not much inferior to iodine itself. Many however have since had an opportunity of observing that it is in general by no means so energetic. Its medicinal doses were gradually raised from one grain to five, ten, twenty grains; and at last Dr. Elliotson gave to not a few patients so much as two, four, or even six drachms daily in divided doses, without observing any remarkable effect.[361] These and other similar observations however were made at a period when the salt used in British practice was much adulterated, often indeed containing eighty or ninety per cent. of impurity; at the same time it does appear that large doses of a pure salt have been occasionally taken with impunity. On the other hand it has evidently in some instances acted with great force. Mr. Alfred Taylor mentions a case, on the authority of Mr. Ericksen, where five grains produced alarming dyspnœa, attended with inflammation of the nostrils and conjunctiva of the eyes.[362] An instance has been published where twelve grains in four doses occasioned shivering, vomiting, purging, general fever, and extreme prostration; and the purging continued for some days.[363] Dr. Moore Neligan informs me he met with the case of an elderly lady in 1841, who, on taking three five-grain doses for two days, while labouring under irregular gout, was seized with severe headache, thirst, and swelling of the face; which symptoms were succeeded in two days by swelling of the tongue, ulceration of the gums, and profuse salivation for a week. Dr. Lawrie says he has known two grains and a half given thrice in one day, followed by great dyspnœa and irritation in the throat; and is even inclined to think that death resulted on two occasions from repeated medicinal doses.[364] It would farther appear from some important researches made in France, that the protracted use of iodide of potassium in small doses with the food may produce serious derangement of the health,—swelling of the face, headache, urgent thirst, inflammation of the throat, violent colic pains, and frequently bloody diarrhœa. A disease characterized by the symptoms now described appeared repeatedly as an epidemic a few years ago in various parts of France, and spread so widely in one parish, that not less than a sixth of the whole population were attacked. After several careful investigations, it seems to have been fully proved that the affection was owing to the use of salt fraudulently adulterated with an impure salt, obtained from kelp after the separation of carbonate of soda, and consequently impregnated with an appreciable proportion of hydriodate of potass.[365]
It is difficult to arrive at any satisfactory conclusions from these statements as to the nature and energy of the action of this salt as a poison. But on the whole it appears to be not in general very active; and the few instances of unusual activity which have occurred may probably be put to the account of idiosyncrasy. The most remarkable of its idiosyncratic effects from medicinal doses are salivation, and a series of symptoms which imitate sometimes catarrh, and sometimes a cold in the head. I do not know any facts to warrant the general statement of M. Devergie that 18 or 30 grains may constitute a fatal dose.[366] The present question is far from being unimportant in a medico-legal point of view. Mr. A. Taylor mentions the heads of a case, very dubious however in its nature, where it was suspected that a single dose of six grains of iodide of potassium had been the occasion of death.[367]
It is important to remember in medico-legal researches, that iodide of potassium may be detected in the blood, liver, spleen, muscles, urine, and other textures and secretions; and especially that it may be found in the urine, when it may no longer exist in the alimentary canal or in vomited matters. These interesting facts have been clearly proved by the researches of Wöhler,[368] Stehberger,[369] O’Shaughnessey,[370] and Dr. Cogswell.[371]
Of Poisoning with Bromine.—This singular substance is not an object of much interest in relation to medical jurisprudence, because it is rare, and only to be met with in the laboratory of the chemist. Hence, although it appears to be a poison of some activity, it scarcely requires to be dwelt on particularly.
It is easily known from all other substances by its fluidity, its great density, which is thrice as great as that of water, its reddish-brown colour by reflected, and blood-red colour by transmitted light, the orange fumes which occupy the upper part of a bottle partly filled with it, and its intensely acrid suffocating vapour, which is so irritating that an incautious inhalation is followed by all the phenomena of severe coryza and catarrh. Its odour, however, apart from its acridity, is very far from being so disagreeable as its discoverer in naming it seems to have imagined. In its properties it bears a close resemblance to chlorine and iodine.
The toxicological effects and medico-legal relations of bromine have been examined by M. Barthez,[372] Dr. Butske,[373] Dr. Dieffenbach,[374] and Dr. M. Glover.[375]
M. Barthez has given the following process for detecting bromine in compound mixtures, such as the contents of the stomach or vomited matter. First separate the fluid matter by filtration, and subject it to the action of chlorine, which will produce a fine orange colour. Should this effect not result, or the change of colour be observed by the deep tint of the fluid, treat the solid matter with solution of caustic potass; filter and add what passes through to the former fluid; evaporate to dryness and char by a red heat; act on the residue with distilled water. The solution contains the bromide of potassium, and is therefore turned orange-red by chlorine. The orange tint, whether struck at once in the fluid part of the mixture, or after carbonization and solution of the residue, is removed by agitation with ether; and the etherial solution of bromine in its turn loses colour when treated with solution of caustic potass, hydro-bromate of potass being again formed.
M. Barthez found, that a solution of twelve grains injected into the jugular vein of a dog, sometimes occasioned immediate tetanus and death; and that the heart was gorged with clotted blood. Sometimes however even seventeen drops did not prove fatal, but produced merely restlessness, difficult breathing, dilated pupil, frequency of the pulse, and sneezing. Dieffenbach remarked similar effects in the rabbit: The animal either died immediately, or soon recovered altogether. In a cat, after the injection of twelve drops of a concentrated solution into its jugular vein, death took place in fifteen minutes; but in another from which a little blood was drawn after the symptoms were fully formed, complete recovery gradually ensued. Butske found a horse suffer so much from mortal prostration immediately after five grains dissolved in two ounces of water were injected into its jugular vein, that he supposed it was about to die; but it quickly revived, and ultimately got quite well. Dr. Glover obtained similar results. When recovery took place, the leading symptoms were panting, sneezing, discharge from the nostrils, rigors and debility.
When introduced into the stomach of dogs, M. Barthez found that twenty drops on a full stomach had no particular effect; that thirty drops occasioned vomiting, and temporary acceleration of the pulse and breathing; and that from forty to sixty drops on an empty stomach brought on violent vomiting, sneezing, cough, dilated pupil and prostration, succeeded in a few hours by languor without any other symptom, and by death in four or five days. In the dead body he remarked numerous little ulcers of the villous coat, some of which had an ash-gray appearance at the bottom, while others were covered with a black slough, easily removed by friction. When the gullet was tied to prevent vomiting, less doses proved more quickly fatal. He likewise observed that the matter vomited in these experiments, even a few minutes after the administration of the poison, had no appearance or odour of bromine; whence it is reasonable to conclude, that, as in the instance of iodine, a chemical change takes place with the aid of certain vital operations, so that the bromine becomes hydrobromic acid.—The experiments of Dr. Butske assign to it more activity as a poison than those now related. For he found that a dog died in a day from taking only five grains dissolved in two ounces of water; and the symptoms were laborious breathing, loud cries, and convulsions. In the dead body he found the stomach internally chequered with bloody extravasation, and filled with bloody mucus, the duodenal mucous membrane universally injected, but the rest of the alimentary canal in a healthy state.—Dr. Glover remarked in such cases, besides the usual symptoms of an irritant action on the stomach, coryza, sneezing, salivation and difficult breathing. Sixty minims killed a cat in seventeen minutes, two fluid drachms a dog in five hours and a half, ten grains a rabbit in five minutes. A dog twice got twenty grains in solution and recovered, but died after a third dose of the same amount. Another got twenty grains in solution every two or three days for a month without injury. In some of these experiments hydrobromic acid was detected in the blood and urine.
Little is yet known of the effects of bromine on man. Butske found that a drop and a half in half an ounce of water produced a sense of heat in the mouth, gullet, and stomach, and subsequently colic pains; and that two drops and a half in an ounce of mucilage excited, in addition to the preceding symptoms, great nausea, hiccup, and increased secretion of mucus. On the other hand M. Fournet, who gave doses gradually increasing from two to sixty drops daily for many weeks, observed that the lowest doses excited itching in the hands and feet, and sometimes colic; that an increase in the quantity caused heat in the chest and nausea; and that forty-five drops occasioned also severe burning and sense of acidity in the stomach, which however were temporary. The appetite was in general rather improved, and the body became more plump.[376]—Bromine appears on the whole to be a pure local irritant. It acts most energetically when most thoroughly dissolved in water.
Hydrobromic acid seems from the experiments of Dr. Glover to be a pure irritant and corrosive, allied in action and energy to hydrochloric acid. The same experimentalist found that bromine of potassium in the dose of forty grains had sometimes little or no effect on dogs when injected into the blood-vessels, while in other instances less doses cause speedy death by paralysing the heart. Barthez observed that half a drachm in solution produced dulness and depression in dogs, but no other bad effect; and that two drachms retained in the stomach by tying the gullet occasioned death in three days with symptoms of irritant poisoning. M. Maillet observed that two ounces of this salt in the form of ointment, administered to a dog by rubbing it over his nose, and letting him lick it off and swallow it, had no effect whatever.[377]
Acetic acid, although in its ordinary state undoubtedly possessed of little activity as a poison, has nevertheless proved in some circumstances deleterious, and capable of occasioning death even in the human subject. It exists in various forms. The most common is ordinary vinegar, in which it is much diluted. Another common form is the pyroligneous vinegar, pyroligneous acid, or pyroligneous acetic acid, as it is variously called, which when impure has a reddish-brown colour, but when pure is almost or altogether colourless, and the strength of which is much greater than that of common vinegar. What is called proof vinegar has a density about 1005, and contains about four per cent. of concentrated acid. The pyroligneous acid sold in the shops of this town has a density about 1035, and contains about 25 per cent.; but the pyroligneous acid of the London Pharmacopœia is stronger, for its density is 1050, and 100 parts contain about 50 of the strong acid. A third form is the concentrated or pure acetic acid of the apothecary, which is familiarly known as the chief ingredient and menstruum of a common perfume, aromatic vinegar.
In all its forms acetic acid is easily known by its very peculiar odour, together with its acid reaction on litmus. But if farther evidence of its nature be required, it will be requisite to neutralise the fluid suspected to contain it with carbonate of potass, and then to procure the acetate of potass by evaporation. This salt is known by its extreme tendency to deliquesce, and by a concentrated solution in water, yielding, when distilled with sulphuric acid, a fluid possessing the peculiar odour and pungency of concentrated acetic acid.
When in a state of compound admixture with organic substances, such as the contents of the stomach, it has been proved by late researches of Orfila,[378] that this acid may be present in considerable proportion without distinctly reddening litmus. For such mixtures the following process of analysis, devised by the Parisian professor, will be found convenient and effectual. The fluid being put into a retort with a receiver attached, the retort is to be heated in a muriate of lime bath till the residuum be dry. The distilled fluid may then be tested tentatively for sulphuric and muriatic acids; and these being proved to be absent, the acidity and peculiar smell of the liquid will supply strong presumption of the presence of acetic acid. This presumption may be turned to certainty by forming acetate of potass, as already directed for the pure diluted acetic acid.
Orfila has omitted in his paper a serious fallacy to which this, as well as every process for the detection of acetic acid in the contents of the stomach is exposed,—namely, that the natural secretions of the stomach, according to the researches of many physiologists, but more especially in recent times those of Tiedemann and Gmelin in Germany, and those of Leuret and Lassaigne in Paris, frequently contain a small proportion of acetic acid. Hence, the inference in favour of the introduction of acetic acid into the stomach from without, founded on the process related above, is only legitimate when the quantity discovered is considerable.—The medical jurist ought also to keep in mind that vinegar is a common remedy with the vulgar for many diseases, and especially for poisoning.
In the first edition of this work, it was stated that acetic acid could scarcely be considered a poison. And in illustration, a case was mentioned which fell under my own notice,—that of a gentleman, who during dinner swallowed at a draught about eight ounces of vinegar by mistake for beer, and who nevertheless sustained no harm although he retained it all, and as the only measure of precaution, swallowed after it an equal quantity of port wine. In farther confirmation of what is here mentioned, it may be added, that an ounce of acid equal in strength to the pyroligneous vinegar, has been found by Schubarth of Berlin to produce very little effect when administered to a dog. The animal merely frothed a little at the mouth; cried and became restless for a time; then had one or two attacks of vomiting; and in an hour appeared quite well again.[379] Nay, it has even been found by Pommer of Heilbronn, that a considerable quantity of diluted acetic acid may be injected into the blood without causing any mischief. He injected six drachms of distilled vinegar into the femoral vein of one dog, and an ounce into the jugular vein of another, but observed no effect whatever, except a slight labour of respiration for a short time afterwards.[380]
It appears, however, from some experiments performed by Professor Orfila on occasion of a judicial case to be mentioned presently, that all the forms of acetic acid will prove injurious and even fatal to dogs, if given in sufficient quantity and prevented from being discharged by vomiting. An ounce of pyroligneous vinegar, administered to dogs of middle size, and retained in the stomach by a ligature on the gullet, produces efforts to vomit, evident suffering, prostration of strength, and death in five, seven, or nine hours. An ounce of concentrated acetic acid occasioned death in one hour and a quarter; and four or five ounces of common vinegar proved fatal in ten or fifteen hours. These experiments would make it appear that acetic acid is scarcely less active as an irritant poison than even the mineral acids.[381] They are in some measure confirmed by the prior experiments of Schubarth; who operated, however, with an impure reddish-brown pyroligneous acid, and was led to ascribe its energy to the presence of some empyreumatic oil, because he found, as was already remarked, that a pure acid of equal strength appeared almost inert. From half an ounce to an ounce of the impure acid given to dogs, caused fruitless efforts to vomit, sometimes free vomiting, occasionally great flow of tears, always weakness in the hind-legs, and feeble, irregular pulse, and death either in two days without any new symptom of consequence, or more rapid death in four or five hours, with previous convulsions, and sometimes insensibility.[382] These experiments were made with an acid which neutralized 50 grains of carbonate of lime per ounce, consequently contained at least 50 grains of concentrated acid, or about a tenth of its weight.
To these observations it may be added, that according to the experiments of Hébréart, a small quantity of acetic acid dropped into the windpipe, produces hissing respiration, rattling in the throat, and death in three days from true croup.[383]
In all the preceding experiments distinct evidence was obtained in the dead body of the irritant action of the poison. The stomach contained brownish-black blood, the villous coat was blackish, and the subjacent cellular tissue injected with black blood; sometimes there was an appearance of erosion on the surface of the villous coat; and in the instance of the concentrated acid perforations were found. In the experiments of Hébréart the lining membrane of the windpipe was covered with a fibrinous pseudo-membrane, exactly as after croup.
Although acetic acid in its various forms is daily in the hands of every body, one case only of poisoning with it in the human subject has hitherto been made public. It is described by MM. Orfila and Barruel.[384] A girl was seen in a village near Paris at eleven at night apparently intoxicated. Five hours afterwards she was found lying on the ground in great agony; and after complaining of pain in the stomach and experiencing several attacks of convulsions, she expired. On the subsequent examination of the body considerable lividity was observed on the skin of the depending parts. The back of the tongue was brownish and leathery, and the inner membrane of the gullet blackish-brown, intersected by a fine network of vessels. The stomach presented internally several large, black, firm elevations, owing to the injection of coagulated blood into the submucous cellular tissue; and elsewhere it had a grayish-white tint, with here and there a reddish colour; but the mucous membrane was perfectly entire. The cavity contained above eight ounces of a thick, blackish fluid; and a thicker pulpy matter of the same colour adhered firmly to the villous coat. The intestines were healthy, and so also were the other organs in the belly and chest. The uterus contained a fœtus two months and a half old. The contents of the stomach were subjected to a careful analysis by MM. Orfila and Barruel, who found that they did not contain any appreciable quantity of free sulphuric or muriatic acid, or of any of the common metallic poisons; and by the process of analysis formerly described, they succeeded in separating from the impure mass three drachms of a pure, and tolerably concentrated acetic acid, besides two drachms more from the contents of the intestines. As the residue of the distillation left behind in the retort did not yield any bitter principle to boiling alcohol, so as to countenance the idea of a vegetable alkaloid having been given along with the acetic acid, they inferred that this acid had been swallowed alone; and the experiments of Orfila on dogs, performed for the occasion, induced them to conclude that it was the cause of death.
To these observations it is only farther necessary to add, that the concentrated acid is a powerful irritant and even corrosive when applied externally; which properties are owing to its power of dissolving many of the soft animal solids.[385]
The last poison of this order is oxalic acid. It is a substance of very great interest; for it is a poison of great energy, and in this country is in common use for committing suicide, and has been often taken by accident for Epsom salt.
It is certainly ill adapted for the purposes of the murderer; for although it might be easily given to a sick person instead of a laxative salt, yet its real nature would betray itself too soon and too unequivocally for the chief object of the prisoner,—secrecy. Nevertheless, attempts of the kind have been made. At the trial of James Brown for assaulting his wife, held at the Middlesex Autumn Assizes 1827, it was brought out in evidence that he had previously tried to poison her by giving her oxalic acid in gin;[386] and Mr. Alfred Taylor says he is acquainted with two similar cases, where an attempt was made to administer it in tea.[387]
It was first made known as a poison by Mr. Royston in 1814.[388] Its properties have been examined by Dr. A. T. Thomson of London,[389] and Dr. Perey of Lausanne;[390] in 1823, the whole subject of poisoning with oxalic acid in its medico-legal relations was examined by Dr. Coindet of Geneva and myself;[391] and in 1828, another experimental inquiry, which confirms most of the results we obtained, was published by Dr. Pommer of Heilbronn.[392]
Oxalic acid is commonly in small crystals of the form of flattened six-sided striated prisms, transparent, colourless, free of odour, very acid to the taste, and permanent in the air. Two other common vegetable acids, the citric and tartaric acids, present a totally different crystalline form. In general appearance it greatly resembles the sulphate of magnesia, for which it has been so often and so fatally mistaken. So close, indeed, is the resemblance, that repeatedly, on desiring several persons to point out which was the poison and which the laxative, I have found as many fix on the wrong as on the right parcel. The sulphate of magnesia has of course a very different taste, being strongly bitter. Various plans have been devised for preventing the accident to which this unlucky resemblance has given rise. The best of them imply the use of a safeguard by the patient before he takes his laxative draught. It seems to have escaped the notice of those who have proposed the plans in question, that, if accidents are to be prevented in this manner, by far the simplest and most effectual security will be to let the public know, that a laxative salt ought always to be tasted before being swallowed. Its solubility has been much overrated by some chemists. It does not appear to me soluble in less than eleven parts of water.
In determining the medico-legal tests for oxalic acid, it will be sufficient to consider it in two states,—dissolved in water,—and mixed with the contents of the stomach and intestines or vomited matter. If the substance submitted to examination is in the solid state, the first step is to convert it into a solution.
1. In the form of a pure solution, its nature may be satisfactorily determined by the following process.
The acidity of the fluid is first to be established by its effect on litmus-paper.—A small portion is next to be tested with ammonia, which, if the solution of the acid be sufficiently concentrated, will produce a radiated crystallization, as the oxalate of ammonia formed is much less soluble than oxalic acid itself. This property, according to Dr. O’Shaughnessey, distinguishes it from every other acid.[393] The remainder of the fluid is next to be subjected to the following reagents.
Hydrochlorate of lime causes a white precipitate, the oxalate of lime; which is dissolved on the addition of a drop or two of nitric acid,—and is not dissolved when similarly treated with hydrochloric acid, unless the acid is added in very large proportion.
The easy solubility of the oxalate of lime in nitric acid distinguishes the precipitate from the sulphate of lime, which the present test might throw down from solutions of the sulphates, and which is not soluble in a moderate quantity of nitric acid without the aid of heat. The insolubility of the oxalate of lime in hydrochloric acid on the other hand distinguishes the precipitate from the tartrate, citrate, carbonate and phosphate of lime, which the test might throw down from any solution containing a salt of these acids. The last four precipitates are redissolved by a drop or two of hydrochloric acid; but the oxalate is not taken up till a large quantity of that acid is added.
Sulphate of lime in solution causes a white precipitate with oxalic acid, and not with any other.[394]
Sulphate of copper causes a faint bluish-white, or greenish-white precipitate, which is not redissolved on the addition of a few drops of hydrochloric acid. The precipitate is the oxalate of copper. It is redissolved by a large proportion of hydrochloric acid.
This test does not precipitate the sulphates, hydrochlorates, nitrates, tartrates, citrates. But with the carbonates and phosphates it forms precipitates resembling the oxalate of copper. The oxalate, however, is distinguished from the carbonate and phosphate of copper by not being redissolved on the addition of a few drops of hydrochloric acid.
Nitrate of silver causes a dense, white precipitate, the oxalate of silver; which, when collected on a filter, dried and heated, becomes brown on the edge, then fulminates faintly and is dispersed.
The object of the supplementary test of fulmination is to distinguish the oxalate of silver from the numberless other white precipitates which are thrown down by the nitrate of silver from solutions of other salts. The property of fulmination, which is very characteristic, requires, for security’s sake, a word or two of explanation, in consequence of the effect of heat on the tartrate and citrate of silver. The citrate when heated becomes altogether brown, froths up, and then deflagrates, discharging white fumes and leaving an abundant, ash-gray, coarsely fibrous, crumbly residue, which on the farther application of heat becomes pure white, being then pure silver. The tartrate also becomes brown and froths up, but does not even deflagrate, white fumes are discharged, and there is left behind a botryoidal mass, which, like the residue from the citrate, becomes pure silver when heated to redness. Another distinction between the oxalate and tartrate is that the former continues permanent at the temperature of ebullition, while the latter becomes brown. The preceding process or combination of tests will be amply sufficient for proving the presence of oxalic acid, free or combined, in any fluid, which does not contain animal or vegetable principles.
2. The only important modifications in the analysis rendered necessary by the admixture of organic principles, occur in the case of the contents of the alimentary canal or vomited matters.
Dr. Coindet and I proved, that oxalic acid has not any chemical action with any of the common animal principles except gelatin, which it rapidly dissolves;—and that this solution is of a peculiar kind, not being accompanied with any decomposition, either of the acid or of the gelatin.[395] Consequently oxalic acid, so far as concerns the tissues of the stomach or its ordinary contents, is not altered in chemical form, and remains soluble in water.
In such a solution, however, a variety of soluble principles are contained, which would cause abundant precipitates with two of the tests of the process,—sulphate of copper and nitrate of silver; so that the oxalates of these metals could not possibly be detached in their characteristic forms. The process for a pure solution, therefore, is inapplicable to the mixtures under consideration.
But changes of still greater consequence are effected on the poison by exhibiting antidotes during life. It is now generally known, that the proper antidotes for oxalic acid are magnesia and chalk. Each of these forms an insoluble oxalate; so that if either had been given in sufficient quantity, no oxalic acid will remain in solution, and the proofs of the presence of the poison must be sought for in the solid contents of the stomach or solid matter vomited.
The following process for detecting the poison will apply to all the alterations which it may thus have undergone.
Process for Compound Mixtures.—If chalk or magnesia has not been given as an antidote, the suspected mixture is to be macerated if necessary for a few hours in a little distilled water, then filtered, and the filtered fluid neutralized with carbonate of potass. If on the other hand chalk or magnesia has been given, the mixture is to be left at rest for some time, and the supernatant fluid then removed. This fluid, if not acid, may be thrown away; but if acid, it may be treated as already directed for a suspected mixture, where chalk or magnesia has not obtained entrance. After the removal of the supernatant liquid, pick out as many solid fragments of animal or vegetable matter as possible; and add as much pure water to the insoluble residue as will give the mass a sufficiently thin consistence. Add now to the mixture about a twentieth of its weight of carbonate of potass, and boil gently for two hours, or till the organic matter is all dissolved. While dissolution thus takes place, a double interchange is effected between the elements of the carbonate of potass on the one hand, and those of the earthy oxalate on the other, so that an oxalate of potass will at length exist in solution. The fluid when cold is next to be filtered, then rendered very faintly acidulous with nitric acid, then filtered and rendered very faintly alkaline with carbonate of potass, and filtered a third time. At each of these steps some animal matter will be thrown down.
From this point onwards the process proceeds in the same way, whatever may have been the original form in which the acid existed in the mixture; for the oxalate of lime or magnesia in the second case is converted into oxalate of potass.
Add now the solution of acetate of lead to the fluid as long as any precipitate is formed. Collect the precipitate on a filter, wash it well, and dry it by compression between folds of bibulous paper. Remove this precipitate, which consists of oxalate of lead and organic matter in union with oxide of lead, and rub it up very carefully while damp with a little water in a mortar. Transmit sulphuretted hydrogen gas briskly for an hour, so that the whole white precipitate shall be thoroughly blackened; filter and boil. In this manner is formed a sulphuret of lead, which retains a great deal of animal matter; and the oxalic acid being set free, is found in the solution tolerably pure. Filtration before boiling is an essential point in this step, to prevent animal matter being dissolved by the water from the sulphuret of lead. More animal matter may still be separated by evaporating the liquid to dryness at 212°, keeping it at that temperature for a few minutes, and redissolving and filtering. The solution will now exhibit the properties of oxalic acid.
I have found that when this process was applied to a decoction of an ounce of beef in six ounces of water, with which one grain of anhydrous oxalic acid had been mixed, all the tests acted characteristically on the solution ultimately procured. I have farther found, that when two grains of oxalate of lime, which correspond with one grain of oxalic acid, were mixed with a similar decoction in which some fragments of beef were purposely left to complicate the process, a solution was eventually obtained, which gave with muriate of lime a white precipitate insoluble in a little muriatic acid, with sulphate of copper a greenish-white precipitate also insoluble in a little muriatic acid, and with nitrate of silver a white precipitate which fulminated and was almost all dispersed, but left a little charcoal, owing to its containing a small proportion of animal matter. In a case which lately happened in London, every test acted as here described, except that the oxalate of lime did not fulminate, owing to the presence of organic impurities.[396] In order to try the test of fulmination in such circumstances, it is essential to dry the precipitated oxalate of silver thoroughly before raising the temperature to the point at which fulmination usually occurs.
The process now recommended is both delicate and accurate. An objection has been advanced against it,—that acetate of lead will throw down chloride of lead as well as the oxalate of lead; that both will subsequently be decomposed by the sulphuretted-hydrogen? and that the hydrochloric acid thus brought into the solution with the oxalic acid will be precipitated by the nitrate of silver, and form a mixture of salts which will not fulminate characteristically.[397] This objection is not well founded. Chloride of lead being soluble in thirty parts of temperate water, it will seldom be thrown down from such fluids as occur in medico-legal inquiries; and besides it is easily removed, as I have ascertained, by washing the precipitate with moderate care on the filter.
Professor Orfila has advanced another objection,—that the process will yield all the indications mentioned above, if binoxalate of potash be present, or sorrel-soup, which contains a little of that salt.[398] The objection is valid, were these substances apt to come in the way. But the binoxalate of potash is not put to any medicinal use in Britain, and English cookery does not acknowledge the “soupe à l’oseille.” The process he recommends to meet the difficulty, an important one in France, is the following: 1. Having made a watery solution as above, evaporate nearly to dryness, agitate the residue with cold pure alcohol, repeatedly during a period of several hours; decant the tincture, and repeat this step with more alcohol; evaporate to obtain crystals, if possible; dissolve these again in cold pure alcohol, and crystallize a second time by evaporation. If crystals do not form on first concentrating the alcoholic solution, evaporate it till a pellicle begins to form, agitate the residue with cold pure alcohol, and concentrate again to obtain crystals. Lastly, examine the crystals by the tests for pure oxalic acid. The object of these steps in the process is to separate binoxalate of potass, oxalate of magnesia and oxalate of lime, which, he says, are all either not soluble, or very sparingly so, in absolute alcohol. 2. More oxalic acid may be got by acting with distilled water on the matter left by the action of alcohol, evaporating this watery solution nearly to dryness, agitating the residuum with cold alcohol as before, and so on. 3. The preceding operations may have left oxalate of magnesia and oxalate of lime unacted on by the water among the solids remaining on the filter. The former compound may be dissolved out by cold hydrochloric acid diluted with four times its volume of water; and by an excess of pure carbonate of potass, the oxalate of magnesia in the solution is converted into insoluble carbonate of magnesia and soluble oxalate of potass, from which oxalic acid is to be obtained by a salt of lead and sulphuretted-hydrogen, as explained in my own process. 4. Oxalate of lime, which may still remain, is to be sought for by boiling the residuum of the action of hydrochloric acid with solution of bicarbonate of potash, so as to obtain here also an oxalate of potass in solution. I have not had an opportunity of trying this method. But I find, that, contrary to Orfila’s statement, binoxolate of potass, though sparingly soluble in cold alcohol of the density of 800, is sufficiently so to vitiate the principle on which the process is founded.
Caustic potass must not be used for decomposing oxalate of lime or magnesia, because the pure alkali, as Gay-Lussac has shown, produces oxalic acid in acting on animal substances at a boiling temperature. Carbonate of potass has no such effect.
The discovery of oxalic acid in the form of oxalate of lime in the stomach or vomited matter is exposed to a singular fallacy, if a material quantity of rhubarb has been taken recently before death, or before the discharge of the vomited matter. For according to the researches of M. Henry of Paris, rhubarb root always contains some oxalate of lime, and some samples yield so much as 30 and even 33 per cent.[399]
The action of oxalic acid on the animal economy is very peculiar.
When injected in a state of concentration into the stomach of a dog or cat, it causes exquisite pain, expressed by cries and struggling. In a few minutes this is succeeded by violent efforts to vomit; then by sudden dulness, languor, and great debility; and death soon takes place without a struggle. The period which elapses before death varies from two to twenty minutes, when the dose is considerable,—half an ounce, for example. After death the stomach is found to contain black extravasated blood, exactly like blood acted on by oxalic acid out of the body; the inner coat of the stomach is of a cherry-red colour, with streaks of black granular warty extravasation; and in some places the surface of the coat is very brittle and the subjacent stratum gelatinized, evidently by the chemical action of the poison.[400] If the stomach is examined immediately after death, little corrosion will be found, compared with what is seen if the inspection be delayed a day or two.[401]
Such are the effects of the concentrated acid. When considerably diluted, the phenomena are totally different. When dissolved in twenty parts of water, oxalic acid, like the mineral acids in the same circumstances, cease to corrode; nay it hardly even irritates. But, unlike them, it continues a deadly poison; for it causes death by acting indirectly on the brain, spine, and heart. The symptoms then induced vary with the dose. When the quantity is large, the most prominent symptoms are those of palsy of the heart; and immediately after death that organ is found to have lost its contractility, and to contain arterial blood in its left cavities. When the dose is less the animal perishes after several fits of violent tetanus, which affects the respiratory muscles of the chest in particular, causing spasmodic fixing of the chest and consequent suffocation. When the dose is still less, the spasms are slight or altogether wanting, and death occurs under symptoms of pure narcotism like those caused by opium: the animal appears to sleep away.
This poison acts with violence, and produces nearly the same effects to whatever texture of the body it is applied. It causes death with great rapidity when injected into the sac of the peritonæum, or into that of the pleura; it acts with still greater quickness when injected into a vein; and it also acts when injected into the cellular tissue beneath the skin, but with much less celerity than through any other channel. Eight grains injected into the jugular vein of a dog occasioned almost immediate death: Thirty-three grains injected into the pleura killed another in twelve minutes. The same quantity did not prove fatal, though it caused violent effects, when retained in the stomach by a ligature on the gullet. One hundred and sixty grains injected under the skin of the thigh and belly did not prove fatal for about ten hours. The symptoms were nearly the same in every case.[402]
It is probable from the facts now stated, that oxalic acid, when not sufficiently concentrated to occasion death by the local injury produced, acts on the nervous system through the medium of the blood. Nevertheless it is a remarkable circumstance that it cannot be detected in that fluid. Mention has already been made of an experiment performed by Dr. Coindet and myself (p. 22), where even after the injection of eight grains of oxalic acid into the femoral vein, and the consequent death of the animal in thirty seconds, none of the poison could be detected in the blood of the iliac vein or vena cava. Similar results have been more lately obtained by Dr. Pommer. In dogs killed by the gradual injection of from five to thirty grains into the femoral vein, he never could detect the poison in the blood of the right side of the heart or great veins, except in the instance of the largest doses, where a little could be detected near the opening in the vein. Dr. Pommer’s experiments likewise agree with those of Dr. Coindet and myself as to the absence of any change in the physical qualities of the blood.[403] When to these circumstances it is added that very small quantities of oxalic acid may be detected in blood, into which it has been introduced immediately after removal from the body by venesection, it appears reasonable to conclude that the poison is quickly decomposed in the blood by vital operations.
According to Orfila, however, it may be detected in the urine, in which crystals of oxalate of lime form on cooling, and more may be obtained on the addition of hydrochlorate of lime. Yet he could not detect any oxalic acid in the liver or spleen.[404]
In man the most prominent symptoms hitherto observed have been those of excessive irritation, because it has been almost always swallowed in a large dose and much concentrated.
It is the most rapid and unerring of all the common poisons. The London Courier contains an inquest on the body of a young man who appears to have survived hardly ten minutes;[405] an equally rapid case of a young lady, who poisoned herself with an ounce, is mentioned in the St. James’s Chronicle;[406] and few of those who have died survived above an hour. This rule, however, is by no means without exception. Mr. Hebb has described a case which did not prove fatal for thirteen hours;[407] Dr. Arrowsmith of Coventry has favoured me with the particulars of a very interesting case which lasted for the same period: and Mr. Frazer has accurately described another, in which, after the patient seemed to be doing tolerably well, an exhausting fever, with dyspepsia and singultus, carried him off in twenty-three days.[408]
Among the fatal cases the smallest dose has been half an ounce; but there can be little doubt that less would be sufficient to cause death. Dr. Babington of Coleraine has published a case where very severe effects were produced by only two scruples.[409]
Very few persons have recovered where the quantity was considerable.
In every instance in which the dose was considerable, and the solution concentrated, the first symptoms have been immediate burning pain in the stomach, and generally also in the throat. But when the dose was small, more particularly if the solution was also rather diluted, the pain has sometimes been slight, or slow in commencing. Mr. Hebb’s patient, who took only half an ounce dissolved in ten parts of water, and diluted it immediately after with copious draughts of water, had not any pain in the belly for six hours.
In general, violent vomiting follows the accession of pain, either immediately, or in a few minutes; and it commonly continues till near death. Some, however, have not vomited at all, even when the acid was strong and in a large dose; and this is still more apt to happen when the poison has been taken much diluted. The man last mentioned did not vomit at all for seven hours, except when emetics were administered. The vomited matter, as in this man’s case, and in that of Mr. Frazer’s patient, is sometimes bloody. Instant discharge of the poison by vomiting does not always save the patient’s life: A woman who swallowed two ounces died in twenty minutes, although she vomited almost immediately after taking the poison.[410]
The tongue and mouth occasionally become inflamed if the case lasts long enough. In an instance of recovery, which happened not long ago in St. Thomas’s Hospital, London, the tongue was red, swollen, tense and tender, the day after the acid was swallowed.[411]
Death commonly takes place so soon, that the bowels are seldom much affected. But when life is prolonged a few hours, they are evidently much irritated. Dr. Arrowsmith’s patient, who lived thirteen hours, had severe pain in the bowels and frequent inclination to go to stool, and Mr. Hebb’s patient, who also lived thirteen hours, had a constant, involuntary discharge of fluid fæces, occasionally mixed with blood. Bloody diarrhœa is very common in dogs.
The signs of depressed circulation are always very striking. In general the pulse fails altogether, it is always very feeble, and the skin is cold and clammy. Contrary to the general fact, however, I once remarked in a dog the pulsation of the heart so strong as to be audible at a distance of several yards.
In some cases nervous symptoms have occurred, but in none so distinctly as in animals that have taken the diluted acid. It should be remarked, however, that few published cases contain good histories of the symptoms; since they commonly come to an end before being seen by the physician. Convulsions appear to have occurred in some instances either at the time of death or soon before it. In the slower cases various nervous affections have been observed. A girl, who swallowed by mistake about two drachms, and did not vomit till emetics were given, complained much at first of pain, but afterwards chiefly of great lassitude and weakness of the limbs, and next morning of numbness and weakness there as well as in the back. This affection was at first so severe that she could hardly walk up stairs; but in a few days she recovered entirely.[412] Analogous effects took place in Mr. Hebb’s patient and in Dr. Arrowsmith’s case. The first thing the former complained of was acute pain in the back, gradually extending down the thighs, occasioning ere long great torture, and continuing almost till the moment of death. Dr. Arrowsmith’s patient had the same symptoms, complained more of the pain shooting down from the loins to the limbs than of the pain in the belly, and was constantly seeking relief in a fresh change of posture. Mr. Frazer’s patient had from an early period a peculiar general numbness, approaching to palsy. Dr. Babington’s patient, who took two scruples by mistake for tartaric acid in an effervescing draught, suffered, after the first twenty-four hours, chiefly from headache, extreme feebleness of the pulse, and a sense of numbness and tingling or pricking in the back and thighs. In a recent case described by Mr. Tapson, which occurred in London, and where it was supposed, but on insufficient grounds,[413] that so much as two ounces had been taken, violent symptoms of irritation in the alimentary canal came on as usual, but soon afterwards a sense as if the hands were dead, loss of consciousness for eight hours, and then lividity, coldness, and almost complete loss of the power of motion in the legs; which symptoms were not entirely removed for fifteen days. In a case related by Mr. Alfred Taylor, where death was caused by seven drachms in fifteen or twenty minutes, there was first violent vomiting, then severe pain in the stomach, and finally clammy perspiration and convulsions, with two or three deep inspirations before death.[414] The effects in this case came very near those generally observed in animals.
In Dr. Arrowsmith’s case two symptoms occurred, which I have not seen mentioned in any other. The first was an eruption or mottled appearance of the skin in circular patches, not unlike the roundish red marks on the arms of stout healthy children, but of a deeper tint. The second was the poisoning and death of leeches applied to the stomach. “They were healthy,” says Dr. Arrowsmith in the notes with which he obligingly furnished me, “small, and fastened immediately. On looking at them in a few minutes I remarked that they did not seem to fill, and on touching one it felt hard and immediately fell off, motionless and dead. The others were all in the same state. They had all bitten and the marks were conspicuous; but they had drawn scarcely any blood. They were applied about six hours after the acid was taken.” This curious fact illustrates the observations formerly quoted from Vernière’s experiments [p. 67]. It will be observed that the leeches were applied several hours after the poison was swallowed, and in a case in which the acid was largely diluted in the stomach;—so that it might have entered the blood and been diffused throughout the body before the observation was made.
The external appearance of the body is commonly natural. In one instance the cellular tissue was distended with gases ten hours after death.[415] Violent marks of irritation have been commonly found in the stomach; and sometimes that organ has been even perforated.[416] It is probable that the extensive destruction of the coats noticed by some authors has taken place in part after death from the action of the acid on the dead tissues.—The usual conjunction of morbid appearances is well described by Mr. Hebb. The mucous coat of the throat and gullet looked as if it had been scalded, and that of the gullet could be easily scratched off. The stomach contained a pint of thick fluid. This is commonly dark, like coffee-grounds, as it contains a good deal of blood. The inner coat of the stomach was pulpy, in many points black, in others red. The inner membrane of the intestines was similarly but less violently affected. The outer coat of both stomach and intestines was inflamed. The lining membrane of the windpipe was also very red.—The appearances have also been excellently described in the case published by Mr. Alfred Taylor. The inside of the gullet was pale, as if boiled, strongly corrugated and brittle, and covering a ramification of vessels filled with consolidated blood. The stomach presented externally numerous vessels in the same state; and its villous coat was pale, soft, brittle, but here and there injected with vessels. The duodenum and part of the jejunum were red, the other intestines natural, the liver, spleen, and kidneys congested. The stomach contained a brownish jelly, in which gelatin was detected, as well as oxalic acid. The blood was fluid every where except in the vessels of the gullet and stomach.[417] The consolidated condition of the blood there was evidently owing to the local action of a strong acid, and is the same with what has been observed in poisoning with the mineral acids.—In Mr. Frazer’s patient the whole villous coat of the stomach was either softened or removed, as well as the inner membrane of the gullet, so that the muscular coat was exposed; and this coat presented a dark gangrenous-like appearance, being much thickened and highly injected.