I have no where seen any notice taken by authors of narcotic symptoms as the effect of poisoning with euphorbium; and indeed this substance has always been considered a pure irritant. I am informed, however, by the Messrs. Herring, wholesale druggists in London, that their workmen are subject to headache, giddiness and stupor, if they do not carefully avoid the dust thrown up while it is ground in the mill; and that the men themselves are familiarly acquainted with this risk. An analogous fact has likewise been communicated to me by Dr. Hood of this city, relative to the effects of the seeds of the E. lathyris. A child two years of age ate some of the seeds, and soon after vomited severely, which is the usual effect. Drowsiness, however, succeeded; and after a few returns of vomiting, which were promoted by an emetic, deep sleep gradually came on, broken by convulsions, stertorous breathing and sighs. Sensibility was somewhat restored by blood-letting and the warm bath; after which the tendency to sleep was interrupted by frequent agitation and exercise in the open air. The vomiting then recurred for a time; but the child eventually got well.
Castor-oil at present so extensively used as a mild and effectual laxative, is nevertheless derived from a plant hardly inferior in activity as a poison to that just considered. It is the expressed oil of the seeds of the Ricinus communis or Palma Christi. Much discussion has taken place as to the source of the acrid properties of this seed, some supposing that they reside in the embryo, others in the perisperm, others in the cotyledon, others in a principle formed from the oil by heat; and the question is scarcely yet settled. It is certain, however, that, although castor oil owes its occasional acridity to changes effected by the heat to which it is sometimes exposed in the process of separation, nevertheless the cotyledons are in themselves acrid.[1418]
Two or three of the seeds will operate as a violent cathartic. Bergius, as quoted by Orfila, says he knew a stout man who was attacked with profuse vomiting and purging after having masticated a single seed. Lanzoni met with an instance where three grains of the fresh seeds, taken by a young woman, caused so violent vomiting, hiccup, pain in the stomach, and faintness, that for some time her life was considered in great danger.[1419] Mr. Alfred Taylor met with three cases of poisoning with castor-oil seeds. Two sisters, who took each from two to four seeds, suffered severely; and a third, who took twenty, died in five days, with symptoms like those of malignant cholera.[1420] Climate probably affects their activity; for I have known a person eat without any effect several seeds ripened in the open air in this neighbourhood. Dogs vomit so easily that they may take thirty seeds without material inconvenience, if the gullet is not tied. But if the gullet is secured, a much less quantity will occasion death in six hours. They produce violent inflammation when applied to a wound.[1421]
The plants of the genus Jatropha, belonging to the same natural family, have all of them the same acrid properties as the castor-oil tree. The seeds of the J. curcas, the physic-nut of the West Indies, when applied in the form of powder to a wound, produce violent spreading inflammation of the subcutaneous cellular tissue; and when introduced into the stomach they inflame that organ and the intestines.[1422] Four seeds will act on man as a powerful cathartic.[1423] I have known violent vomiting and purging occasioned by a few grains of the cake, left after expression of the fixed oil from the bruised seeds; and in some experiments performed a few years ago, I found that twelve or fifteen drops of the oil produced exactly the same effects as an ounce of castor-oil, though not with such certainty. In the last edition of this work some observations were made, on the authority of MM. Pelletier and Caventou, respecting the properties of a pure oil and a volatile acid, supposed by them to exist in the physic-nut; but they analyzed the croton seed by mistake for it.
Two other species have been also examined, but not with care, namely, the Jatropha multifida, and the Jatropha or Janipha manihot. It is probable that the seeds of both are acrid, and also the oil which may be extracted from them by pressure. But a much more interesting part of the latter species in a toxicological point of view is the root; the juice of which is a most energetic poison. The Janipha manihot, or cassava-plant, has two varieties, one of which produces a small, spindle-shaped, bland root, called, in the West Indies, sweet cassava, while the other has a much larger, bitter, poisonous root, called bitter cassava, and in universal use for obtaining the well-known amylaceous substance, tapioca. The juice of the bitter variety is watery, and so poisonous that, according to Dr. Clark of Dominica, negroes have been killed in an hour by drinking half a pint of it.[1424] It has been commonly, but erroneously, arranged among acrid poisons. It really belongs to the narcotic class, for it occasions coma and convulsions. And we now know the cause of this extraordinary anomaly in the natural family to which the species belongs; because MM. Henry and Boutron ascertained that the juice imported into France, as well as what they expressed from fresh roots sent from the West Indies, contains hydrocyanic acid, produces in animals all the usual effects of that poison, and is rendered inert by such means as will remove the acid,—for example, by the addition of nitrate of silver.[1425] I confirmed this singular discovery in 1838 by examination of some well-preserved juice from Demerara. It is easy to see how tapioca, which is obtained from the poisonous root by careful elutriation, becomes quite bland during the process.
The manchineel [Hippomane mancinella], another plant of the same natural family, contains a milky juice, which is possessed of very acrid properties. Orfila and Ollivier have made some careful experiments with it on animals,[1426] and M. Ricord has since added some observations on its effects on man.[1427] From the former it appears that two drachms of the juice applied to a wound in a dog will cause death in twenty-eight hours, by exciting diffuse cellular inflammation; and that half that quantity will prove fatal in nine hours when introduced into the stomach. From the observations of M. Ricord it follows that inflammation is excited wherever the juice is applied, even in the sound skin; but he denies the generally received notion, that similar effects ensue from sleeping under the branches of the tree, or receiving drops of moisture from the leaves. This notion, however, it is right to add, has been adopted by other recent authors. Descourtils, for example, states that it is dangerous to sleep under the tree; that drops of rain from the leaves will blister any part of the skin on which they fall; and that on these accounts the police of St. Domingo were in the practice of destroying the trees wherever they grew.[1428] Other species of Hippomane are equally poisonous. The H. biglandulosa and H. spinosa are peculiarly so, especially the latter, which is known to the negroes of St. Domingo by the name of Zombi apple, and is familiarly used by them as a potent poison.[1429]
The oil of the Croton Tiglium has been familiarly known for some years as a very powerful hydragogue cathartic in the dose of a few drops; and therefore little doubt could exist that both the oil and the seed which yields it must be active irritant poisons in moderate doses. Accordingly it has been lately found by experiments in Germany that forty seeds will kill a horse in the course of seven hours;[1430] and Rumphius mentions that it was a common poison in his time at Amboyna among the natives. I have known most violent watery purging and great prostration caused by four drops of the expressed oil. A fatal case of poisoning with it occurred not long ago in France. A young man who swallowed two drachms and a half of the oil by mistake, instead of using it as an embrocation, was soon seized with tenderness of the belly, violent efforts to vomit, cold sweating, laborious respiration, blueness of the lips and fingers, and an almost imperceptible pulse,—then with profuse, involuntary discharges by stool, burning along the throat and gullet, and insensibility of the skin;—and in four hours he expired. The villous coat of the stomach was soft, but not otherwise injured.[1431]
The activity of the seed and oil seems to depend on a peculiar volatile acid, which was discovered by MM. Pelletier and Caventou when they analysed the croton seed by mistake as the seed of the Jatropha curcas, or physic-nut. When the oil was saponified by potash and then freed of the acid by distillation, it became inert. On the other hand, the acid was found by them to excite inflammation of the stomach, and spreading inflammation of the cellular tissue, according as it was administered internally or applied to a wound.[1432]
The next natural family in which plants are to be found that possess the properties of the acrid poisons, is the Cucurbitaceæ, or gourds. This family, it should be remarked, does not in general possess poisonous properties. On the contrary, they are, with a few exceptions, remarkably mild; and many of them supply articles of luxury for the table. The melon, gourd, and cucumber belong to the order. The only poisons of the order which have been examined with any care are elaterium, bryony, and colocynth.
The roots of the Bryonia alba and Dioica possesses properties essentially the same with those of euphorbium. The B. dioica is a native of Britain, where it grows among hedges, and is usually known by the name of wild vine, or bryony. The flowers are greenish, and are succeeded by small, red berries. The root, which is the most active part of the plant, is spindle-shaped, and varies in size from that of a man’s thigh to that of a radish.
Orfila found that half an ounce of the root introduced into the stomach of a dog, killed it in twenty-four hours, when the gullet was tied; and that two drachms and a half applied to a wound brought on violent inflammation and suppuration of the part, ending fatally in sixty hours.[1433]
Bryony root owes its power to an extractive matter discovered in it by Brandes and Firnhaber, to which the name of Bryonine has been given. According to the experiments of Collard de Martigny, bryonine acts on the stomach and on a wound exactly as the root itself, but more energetically. When introduced into the cavity of the pleura it causes rapid death by true pleurisy, ending in the effusion of fibrin.[1434]
Before bryony-root was expelled from medical practice, it was often known to produce violent vomiting, tormina, profuse watery evacuations, and fainting. Pyl mentions a fatal case of poisoning with it, which happened at Cambray in France. The subject was a man who took two glasses of an infusion of the root to cure ague, and was soon after seized with violent tormina and purging, which nothing could arrest, and which soon terminated fatally.[1435] Orfila quotes a similar case from the Gazette de Santé, which proved fatal within four hours, in consequence of a strong decoction of an ounce of the root having been administered, partly by the mouth and partly in a clyster, to repel the secretion of milk.[1436]
Colocynth, or bitter-apple, is another very active and more common acrid derived from a plant of the same family, the Cucumis colocynthis. It is imported into this country in the form of a roundish, dry, light fruit, as big as an orange, of a yellowish-white colour, and excessively bitter taste. Its active principle is probably a resinoid matter discovered by Vauquelin, which is very soluble in alcohol and sparingly so in water, but which imparts even to the latter an intensely bitter taste.[1437] It is termed Colocynthin.
According to the experiments of Orfila, colocynth powder or its decoction produces the usual effects of the acrid vegetables on the stomach and on the subcutaneous cellular tissue. Three drachms proved fatal in fifteen hours to a dog through the former channel when the gullet was tied, and two drachms killed another when applied to a wound.[1438]
A considerable number of severe cases of poisoning with this substance have occurred in the human subject; and a few have proved fatal. Tulpius notices the case of a man who was nearly carried off by profuse, bloody diarrhœa, in consequence of taking a decoction of three colocynth apples.[1439] Orfila relates that of a rag-picker, who, attempting to cure himself of a gonorrhœa by taking three ounces of colocynth, was seized with vomiting, acute pain in the stomach, profuse diarrhœa, dimness of sight, and slight delirium; but he recovered under the use of diluents and local blood-letting.[1440] In 1823 a coroner’s inquest was held at London on the body of a woman who died in twenty-four hours, with incessant vomiting and purging, in consequence of having swallowed by mistake a tea-spoonful and a half of colocynth powder.[1441] M. Carron d’Annecy has communicated to Orfila the details of an instructive case, which also proved fatal. The subject was a locksmith, who took from a quack two glasses of decoction of colocynth to cure hemorrhoids, and was soon after attacked with colic, purging, heat in the belly, and dryness of the throat. Afterwards the belly became tense and excessively tender, and the stools were suppressed altogether. Next morning he had also retention of urine, retraction of the testicles and priapism. On the third day the retention ceased, but the other symptoms continued, and the skin became covered with clammy sweat, which preceded his death only a few hours. The intestines were red, studded with black spots, and matted together by fibrinous matter; the usual fluid of peritonitis was effused into the belly; the villous coat of the stomach was here and there ulcerated; and the liver, kidneys, and bladder also exhibited traces of inflammation.[1442]
Elaterium, which is procured from a third plant of the cucurbitaceæ, the Momordica elaterium or squirting cucumber, possesses precisely the same properties with the two preceding substances. It appears, however, to be more active; for a single grain has been known to act violently on man. There can be no doubt that small doses will prove fatal; but its strength and consequently its effects are uncertain. British elaterium, which is the feculence that subsides in the juice of the fruit, is the most powerful; French elaterium, which is the extract of the same juice, is much weaker; and a still weaker preparation sometimes made is an extract of the juice of the whole plant. The plant itself is probably poisonous. But the only case in point with which I am acquainted is a singular instance of poisoning, apparently produced in consequence of the plant having been carried for some time betwixt the hat and head. A medical gentleman in Paris, after carrying a specimen to his lodgings in his hat, was seized in half an hour with acute pain and sense of tightness in the head, succeeded by colic pains, fixed pain in the stomach, frequent watery purging, bilious vomiting, and some fever. These symptoms continued upwards of twelve hours.[1443]
The active properties of this substance reside in a peculiar crystalline principle, discovered by Mr. Morries-Stirling, and named by him Elaterine. It is procured by evaporating the alcoholic infusion of elaterium to the consistence of thin oil, and throwing it into boiling distilled water; upon which a white crystalline precipitate is formed, and more falls down as the water cools. This precipitate when purified by a second solution in alcohol and precipitation by water, is pure elaterine. In mass it has a silky appearance. The crystals are microscopic rhombic prisms, striated on the sides. It is intensely bitter. It does not dissolve in the alkalis, or in water, is sparingly soluble in diluted acids, but easily soluble in alcohol, ether, and fixed oil. It has not any alkaline reaction on litmus.—It is a poison of very great activity. A tenth of a grain, as I have myself witnessed, will sometimes cause purging in man; and a fifth of a grain in two doses, administered at an interval of twenty-four hours to a rabbit, killed it seventeen hours after the second dose. The best British elaterium contains 26 per cent. of it, the worst 15 per cent.; but French elaterium does not contain above 5 or 6 per cent.[1444] These facts account for the great irregularity in the effects of this drug as a cathartic. The principle discovered by Mr. Morries-Stirling was also discovered about the same time by Mr. Hennell[1445] of London.
The natural family of the Ranunculaceæ abounds in acrid poisons. Indeed few of the genera included in it are without more or less acrid property.
The genus Ranunculus is of some interest to the British toxicologist, because many species grow in this country, and unpleasant accidents have been occasioned by them. The most common are the R. bulbosus, acris, sceleratus, Flammula, Lingua, aquatilis, repens, Ficaria, which are all abundant in the neighbourhood of this city. The Ranunculus acris is the only species that has been particularly examined. Five ounces of juice, extracted by triturating the leaves with two ounces of water, killed a stout dog in twelve hours when taken internally. Two drachms of the aqueous extract applied to a wound killed another in twelve hours by inducing the usual inflammation.[1446]
Krapf, as quoted in Orfila’s Toxicology, found by experiments on himself, that two drops of the expressed juice of the Ranunculus acris produced burning pain and spasms in the gullet and griping in the lower belly. A single flower had the same effect. When he chewed the thickest and most succulent of the leaves, the salivary glands were strongly stimulated, his tongue was excoriated and cracked, his teeth smarted, and his gums became tender and bloody.[1447] Dr. Withering alleges that it will blister the skin. A man at Bevay in the north of France, after swallowing by mistake a glassful of the juice which had been kept for some time as a remedy for vermin on the head, was seized in four hours with violent vomiting and colic, and expired in two days.[1448] The acridity of the genus ranunculus is entirely lost by drying, either with or without artificial heat. The R. acris, however, is far from being the most active species of the genus. The taste of the leaves of R. bulbosus, alpestris, gramineus, and Flammula, and also of the unripe germens of R. sceleratus, is much more pungent. The R. repens, Ficaria, auricomus, aquatilis, and Lingua, I have found to be bland.
The genus Anemone produces similar effects on the animal economy. The most pungent species I have examined are the A. pulsatilla, A. hortensis, and A. coronaria; the A. nemorosa and A. patens are less active; and the A. hepatica, as well as the A. alpestris, are bland. The powder of the A. pulsatilla causes itching of the eyes, colic and vomiting, if in pulverizing it the operator do not avoid the fine dust which is driven up; and Bulliard relates the case of a man who, in applying the bruised root to his calf for rheumatism, was attacked with inflammation and gangrene of the whole leg.[1449] The same author mentions an instance where violent convulsions were produced by an infusion of the A. nemorosa, and the person was for some time thought to be in great danger.[1450] The acridity of the anemone is retained under desiccation even in the vapour-bath; but is very slowly lost under exposure to the air, not entirely, however, in two months. The ripe fruit of the A. hortensis is bland. The activity of the anemones is owing to a volatile oil, which, when left for some time in the water with which it passes over in distillation is converted into a neutral crystalline body called anemonine, and a peculiar acid termed anemonic acid.[1451]
The Caltha palustris, or marsh marigold, a plant closely allied in external characters to the ranunculus, is considered by toxicologists a powerful acrid poison. Wibmer observes that it has an acrid, burning taste,[1452]—a remark which has been also made by Haller.[1453] On the continent the flower buds are said to be sometimes pickled and used for capers on account of their pungency. The following set of cases which happened in 1817 near Solingen will show that in some localities it possesses energetic and singular properties. The poison was taken accidentally by a family of five persons, in consequence of their having been compelled by the badness of the times to try to make food of various herbs. They were all seized half an hour after eating with sickness, pain in the abdomen, vomiting, headache, and ringing in the ears, afterwards with dysuria and diarrhœa, next day with œdema of the whole body, particularly of the face, and on the third day with an eruption of pemphigous vesicles as large as almonds, which dried up in forty-eight hours. They all recovered.[1454]
Notwithstanding these apparently pointed facts, however, I have no doubt that the marsh marigold is in some circumstances bland, and is commonly so in this country, or at least but feebly poisonous. Haller, in speaking of its acrid taste, adds that when young it is eaten with safety by goats. For my own part I have never been able to remark any distinct acridity in tasting it either before inflorescence, or in the young flower-buds, or in any part of the plant while in full flower. It produces a peculiar, disagreeable impression on the back of the tongue, when collected in dry situations; but never occasions that pungent acridity which so remarkably characterizes many species of ranunculus, anemone, and clematis.
The stavesacre, or Delphinium staphysagria, another plant of the same natural family, is interesting in a scientific point of view, because its properties have been distinctly traced to a peculiar alkaloid. The seeds, which alone have been hitherto examined, were analyzed by MM. Lassaigne and Feneulle, who, besides a number of inert principles, discovered in them an alkaloid, possessing in an eminent degree the poisonous qualities of the seeds. This alkaloid is solid, white, pulverulent but crystalline, fusible like wax, very bitter and acrid, almost insoluble in water, very soluble in ether and alcohol, and capable of forming salts with most of the acids.[1455] It has been named delphinia. It was also discovered about the same time by Brandes.[1456]
Orfila found that six grains of it diffused through water, introduced into the stomach of a dog and retained there with a ligature on the gullet, brought on efforts to vomit, restlessness, giddiness, immobility, slight convulsions, and death in two or three hours. The same quantity, if previously dissolved in vinegar, will cause death in forty minutes. In the former case, but not in the latter, the inner coat of the stomach is found to be generally red.[1457]
An ounce of the bruised seeds themselves killed a dog in fifty-four hours when introduced into the stomach, and two drachms applied to a wound in the thigh killed another in two days. In the former animal a part of the stomach was crimson-red; in the latter there was extensive subcutaneous inflammation reaching as high as the fourth rib.[1458]
Besides these four genera of the ranunculaceæ many other genera of the same natural order are equally energetic. The Clematis vitalba or traveller’s-joy is said to be acrid, but does not taste so: the C. flammula, however, is pungently acrid to the taste; it reddens and blisters the skin; and when swallowed excites inflammation in the stomach. The trollius or globe flower is also considered acrid; and its root in appearance, smell, and taste, has been said to resemble closely that of the black hellebore. The herb, however, in Scotland, has certainly none of the peculiar acrid pungency of the ranunculus, anemone, or clematis, but is on the contrary bland. Some other genera of equal power have been usually arranged with the narcotico-acrid poisons on account of their action on the nervous system; and probably some of the present group of acrids might with equal propriety be removed to the same class.
Of plants possessing acrid properties and interspersed throughout other natural families, the only species I shall particularly notice are the mezereon, cuckow-pint, gamboge, daffodil, jalap-plant, and savine.
The mezereon and several other species of the genus Daphne to which it belongs are powerfully acrid. They belong to the natural order Thymeleæ. The active properties of the bark of mezereon have been traced to a very acrid resin; and those of the allied species, Daphne alpina, to a volatile, acrid acid.[1459]
The experiments of Orfila have been confined to a foreign species, the D. Gnidium or garou of the French. Three drachms of the powder of its bark retained in the stomach of a dog killed it in twelve hours; and two drachms applied to a wound killed another in two days.[1460] The action of the other species has not been so scientifically investigated; but fatal accidents have arisen from them when taken by the human species. Children have been tempted to eat the berries of the D. mezereon by their singular beauty; and some have died in consequence. Three such cases, not fatal, have been related by Dr. Grieve of Dumfries. Two of the children had violent vomiting and purging: in the third narcotic symptoms came on in five hours, namely, great drowsiness, dilatation of the pupils, extreme slowness of the pulse, retarded respiration, and freedom from pain.[1461] Vicat relates the case of a man who took the wood of it for dropsy, and was attacked with profuse diarrhœa and obstinate vomiting, the last of which symptoms recurred occasionally for six weeks.[1462] A fatal case, in a child about eight years of age, occurred a few years ago in this city. Linnæus in his Flora Suecica says that six berries will kill a wolf, and that he once saw a girl die of excessive vomiting and hæmoptysis, in consequence of taking twelve of them to check an ague.[1463] The D. laureola or spurge-laurel, a common indigenous species, abounding in low woods, is said by Withering to be very acrid, especially its root.[1464]
The Arum maculatum, or cuckow-pint, one of our earliest spring flowers, not uncommon in moist ground, under the shelter of woods, is one of the most violent of all acrid vegetables inhabiting this country. I have known acute burning pain of the mouth and throat, pain of the stomach and vomiting, colic and some diarrhœa, occasioned by eating two leaves. The genus possesses the same properties in other climates, the several species being everywhere among the most potent acrid poisons in their respective regions. The Arum seguinum, or dumb cane of the West Indies, is so active that two drachms of the juice have been known to prove fatal in a few hours.[1465] It is not a little remarkable that the acridity of the arum is lost not merely by drying, but likewise by distillation. I have observed that when the roots are distilled with a little water, neither the distilled water nor the residuum possesses acridity. Reinsch says he has eaten powder of arum root, which, though not acrid to the taste, produced severe burning of the throat not long after it was swallowed.[1466]
The familiar pigment and purgative gamboge is one of the pure acrids, and possesses considerable activity. It appears from the researches of Orfila,[1467] some experiments by Schubarth,[1468] and various earlier inquiries quoted by Wibmer,[1469] that two drachms will kill a sheep; that a drachm and a half will kill a dog if retained by a ligature on the gullet, while much larger doses have little effect without this precaution, as the poison is soon vomited; that an ounce has little effect on the horse; that eighteen grains will prove fatal to the rabbit within twenty-four hours; and that the symptoms are such as chiefly indicate an irritant action. Orfila farther found that it produces intense spreading inflammation when applied to a recent wound, and in this way may occasion death as quickly and with as great certainty as when administered internally.
Gamboge in its action on man is well known to be one of the most certain and active of the drastic cathartics, from three to seven grains being sufficient to cause copious watery diarrhœa, commonly with smart colic. Larger doses will induce hypercatharsis. A drachm has proved fatal, as is exemplified by a case in the German Ephemerides where the symptoms were excessive vomiting, purging, and faintness.[1470]
Under this head are probably to be arranged the repeated cases, which have lately occurred in this country, of fatal poisoning with a noted quack nostrum, Morison’s pills. Almost every physician in extensive practice has met with cases of violent hypercatharsis occasioned by the incautious use of these pills; and three instances are now on record where death was clearly occasioned by them.[1471] No toxicologist will feel any surprise at such results, when he learns that one sort contains, besides aloes and colocynth, half a grain of gamboge, and another three times as much, in each pill; and that ten, fifteen, or even twenty pills are sometimes taken for a dose once or oftener in the course of the day.[1472] The symptoms in the cases alluded to were sickness, vomiting and watery purging, pain, tension, fulness, tenderness, and heat in the abdomen, with cold extremities and sinking pulse; and in the dead body the appearances were great redness of the stomach with softening of its villous coat, in the intestines softening and slate-gray coloration of the same coat, and in one instance intestinal ulceration.
Gamboge is one of the poisons whose energy seems to be irregularly modified by the co-existence of certain constitutional states in disease. Physicians in Britain cannot but be startled to hear of the practice, prevailing among the followers of Rasori in Italy, of administering this purgative in doses of a drachm and upwards in inflammatory diseases. But it is nevertheless undeniable, that it has been given to that extent in such circumstances, with no further consequence than brisk purging. Professor Linoli mentions two cases of inflammatory dropsy, in which he gave gamboge-powder in gradually increasing doses, till he reached in one instance an entire drachm, and in the other 86 grains. In the course of a month one of his patients got 1044 grains, and the other took 850 grains in twelve days. Both recovered from their dropsy, and the purging was never great.[1473]
The common daffodil, the Narcissus pseudo-narcissus of botanists, though commonly arranged with the vegetable acrids, seems not entitled to a place among them. At least the experiments of Orfila rather tend to show that it acts through absorption on the nervous system. Four drachms of the aqueous extract of this plant secured in the stomach in the usual way killed a dog in less than twenty-four hours; and one drachm applied to a wound killed another in six hours. In both cases vomiting or efforts to vomit seemed the only symptom of note; and in both the stomach was found here and there cherry-red. The wound was not much inflamed.[1474]
Jalap, the powder of the root of the Ipomæa purga, and a common purgative, is an active poison in large doses; and this every one should know, as severe and even dangerous effects have followed its incautious use in the hands of the practical joker. Its active properties reside in a particular resinous principle. It contains a tenth of its weight of mixed resin, which, like the resin of euphorbium, has been separated by Drs. Buchner and Herberger into two, one possessing some of the properties of acids, the other some of the properties of bases; and the latter they consider the active principle, and have accordingly named Jalapine.[1475] Mr. Hume of London some time ago procured from the crude drug a powdery substance, to which he gave the same name, and which he conceived to be the active principle. His analysis has not been generally relied on by chemists; but it is not improbable that his principle differs little from that of the German chemists.
The action of jalap has been examined scientifically by M. Felix Cadet de Gassicourt, who found that it produced no particular symptom when injected into the jugular vein of a dog in the dose of twenty-four grains, or when applied to the cellular tissue in the dose of a drachm. But when rubbed daily into the skin of the belly and thighs it excited in a few days severe dysentery; when introduced into the pleura it excited pleurisy, fatal in three days; when introduced into the peritonæum it caused peritonitis and violent dysentery, fatal in six days; and when introduced into the stomach or the anus, the animals died of profuse purging in four or five days, and the stomach and intestines were then found red and sometimes ulcerated. Two drachms administered by the mouth proved fatal.[1476] Scammony, which is procured from another species of the same family, the Convolvulus scammonea, has been found by Orfila to be much less active. Four drachms given to dogs produced only diarrhœa.[1477]
The leaves of the Juniperus sabina, or savin, have been long known to be poisonous. They have a peculiar heavy, rather disagreeable odour, and a bitter, acrid, aromatic, somewhat resinous taste. They yield an essential oil, which possesses all their qualities in an eminent degree.
A dog was killed by six drachms of the powdered leaves confined in the stomach. It appeared to suffer pain, died in sixteen hours, and exhibited on dissection only trivial redness of the stomach. Two drachms introduced into a wound of the thigh caused death after the manner of the other vegetable acrids in two days; and besides inflammation of the limb there was found redness of the rectum.[1478]
Savin is a good deal used in medicine for stimulating old ulcers and keeping open blistered surfaces; which may be done without danger, although it cannot be applied to a fresh wound without risk of diffuse inflammation. Both the powder and the essential oil are of some consequence in a medico-legal point of view, as they have been often used with the intent of procuring abortion. The oil is generally believed by the vulgar to possess this property in a peculiar degree. Doubts, however, may be entertained whether any such property exists independently of its operation as a violent acrid on the bowels. It has certainly been taken to a considerable amount without the intended effect; of which Foderé has noticed an unequivocal example. The woman took daily for twenty days no less than a hundred drops of the oil, yet carried her child to the full time.[1479] The powder has likewise been taken to a large extent without avail. A female, whose case is noticed by Foderé, took without her knowledge so much of the powder that she was attacked with vomiting, hiccup, heat in the lower belly, and fever of a fortnight’s duration; nevertheless she was not delivered till the natural time.[1480] There is no doubt, however, that if given in such quantity as to cause violent purging, abortion may ensue; but unless there is naturally a predisposition to miscarriage, the constitutional injury and intestinal irritation required to induce it are so great, as to be always attended with extreme danger, independent of the uterine disorder. Of this train of effects the following case, for which I am indebted to Mr. Cockson of Macclesfield, is a good illustration. A female applied to a pedlar to supply her with the means of getting rid of her pregnancy: and under his direction appears to have taken a large quantity of a strong infusion of savin-leaves on a Friday morning and again next morning. A very imperfect account was obtained of the symptoms, as no medical man witnessed them; but it was ascertained that she had violent pain in the belly and distressing strangury. On the Sunday afternoon she miscarried; and on the ensuing Thursday she died. Mr. Cockson, who examined the body next day, found extensive peritonæal inflammation unequivocally indicated by the effusion of fibrinous flakes,—the uterus presenting all the signs of recent delivery,—the inside of the stomach of a red tint, checkered with patches of florid extravasation,—and its contents of a greenish colour, owing evidently to the presence of a vegetable powder, as was proved by separating and examining it with the microscope. My colleague Dr. Traill has communicated to me the particulars of a similar case. A servant-girl, after being for some time in low spirits, was seized with violent colic pains, frequent vomiting, straining at stool, tenderness of the belly, dysuria and general fever; under which symptoms she died after several days of suffering. The stomach was inflamed, in parts black, and at the lower curvature perforated. The uterus with its appendages was very red, and contained a fine membrana decidua, but no ovum. The lower intestines were inflamed. There was found in the stomach a greenish powder, which, when washed and dried, had the taste of savin.
A singular case is quoted by Wibmer of a woman who died from taking an infusion of the herb for the purpose of procuring miscarriage, and in whom death seems to have been occasioned by the gall-bladder bursting in consequence of the violent fits of vomiting.[1481]
In a charge of wilful abortion the mere possession of oil of savin would be a suspicious circumstance, because the notion that it has the power of causing miscarriage is very general among the vulgar; while it is scarcely employed by them for any useful purpose. The leaves in the form of infusion are in some parts of England a popular remedy for worms; and the oil is used in regular medicine as an emmenagogue.
The following list includes all the other plants which have been either ascertained experimentally to belong to the present order, or are believed on good general evidence to possess the same or analogous properties.
By careful experiment Orfila has ascertained that the Gratiola officinalis, Rhus radicans and Rhus toxicodendron, Chelidonium majus and Sedum acre, possess them; and the following species are also generally considered acrid, namely, Rhododendron chrysanthum and ferrugineum, Pedicularis palustris, Cyclamen Europæum, Plumbago Europæa, Pastinaca sativa, Lobelia syphilitica and longiflora, Hydrocotyle vulgaris. To these may be added the common elder or Sambucus nigra, the leaves and flowers of which caused in a boy, once a patient of mine, dangerous inflammation of the mucous membrane of the bowels lasting for eight days.
The second group of the present Order of poisons comprehends most of those derived from the animal kingdom. In action they resemble considerably the vegetable acrids, their most characteristic effect being local inflammation; but several of them also induce symptoms of an injury of the nervous system.
This group includes cantharides, poisonous fishes, venomous serpents, and decayed or diseased animal matter.
The first of these is familiarly known as a poison even to the common people. I am not aware that it has ever been used for the purpose of committing murder. But on account of its powerful effect on the organs of generation it has often been given by way of joke, and sometimes taken for the purpose of procuring abortion. Fatal accidents have been the consequence.
The appearance of the fly is well known. When in powder, as generally seen, it has a grayish-green colour, mingled with brilliant green points. It has a nauseous odour and a very acrid burning taste. Alcohol dissolves its active principle. This principle appears from a careful analysis by M. Robiquet to be a white, crystalline, scaly substance, insoluble in water, but soluble in alcohol as well as in oils, and termed cantharidin.[1482]
In compound mixtures cantharides may generally be detected by the green colour and metallic brilliancy even of its finest powder, if examined in the sunshine—and sometimes by making an etherial extract of the suspected matter, and producing with this extract the usual effects of a blister on a tender part of the arm. By these two tests Barruel discovered cantharides in chocolate cakes, part of which had been wickedly administered to various individuals.
From the late important researches of M. Poumet[1483] it appears, that cantharides cannot be detected by its chemical properties in the contents, or on the inner surface, of the alimentary canal of animals poisoned with it; and that in such circumstances it is seldom to be discerned even by the shining green colour of its particles, unless the matter to be examined be dried. The method he recommends for a medico-legal investigation is to detach the stomach, small intestines, and great intestines, each separately from the body,—to wash out their contents with rectified spirit, and dry the pulpy fluid on sheets of glass,—to dry the stomach and intestines by distending them, removing their mesentery, and hanging them up vertically with a weight attached to stretch them,—and then to examine both the surface of the glass, and the inside of the stomach and intestines with the aid of sunshine or a bright artificial light. In this way cantharides may be detected, by the peculiar green hue of its powder, in most cases where this poison may have proved fatal; for M. Poumet constantly found it in dogs. The same author ascertained that the green particles generally abound most in the contents of the great intestine or on its inner membrane, next in the small intestines, and least of all in the stomach; and that they may be seen in the bodies of animals at least seven months after interment. Orfila had previously ascertained, that cantharides powder may be recognized by its brilliancy in various organic mixtures after interment for nine months.[1484] Poumet farther states that the green particles of cantharides may be confounded with the particles of other coleopterous insects, and also somewhat resemble particles of copper and tin. But he with reason asks, what possible accident could introduce the powder of any other coleopterous insect into the alimentary canal? And as to particles of copper or tin, he ascertained, that, unlike cantharides, these substances are visible in the contents, or on the tissues, of the stomach and intestines only before desiccation, and never after it.
Cantharides, either in the form of powder, tincture, or oily solution, is an active poison both to man and animals. As to its action on animals, Orfila found that a drachm and a half of a strong oleaginous solution, injected into the jugular vein of a dog, killed it in four hours with symptoms of violent tetanus; that three drachms of the tincture with eight grains of powder suspended in it caused death in twenty-four hours, if retained in the stomach by a ligature on the gullet,—insensibility being then the chief symptom; and that forty grains of the powder killed another dog in four hours and a half, although he was allowed to vomit. In all the instances in which it was administered by the stomach, that organ was found much inflamed after death; and generally fragments of the poison were discernible if it was given in the form of powder. When applied to a wound the powder excites surrounding inflammation; and a drachm will in this way prove fatal in thirty-two hours without any particular constitutional symptom except languor.[1485] M. Poumet has since obtained results not materially different.
These experiments do not furnish any satisfactory proof of the absorption of the poison, but rather tend to show that it does not enter the blood. Such a conclusion, however, must not be too hastily drawn; since its well-known effects on man when used in the form of a blister lead to the conclusion that it is absorbed, and that it produces its peculiar effect on the urinary system through the medium of the circulation. On account of the magnitude of the dose required to produce severe effects on animals, Orfila’s experiments on the stomach and external surface of the body cannot, for reasons formerly assigned (452) be properly compared together.
The effect of cantharides, when admitted directly into the blood, seems much less than might be expected. Mr. Blake found that an infusion of two drachms injected into the jugular vein of a dog, caused some difficulty of breathing, irregularity of the pulse, and diminished arterial pressure, but apparently no great inconvenience to the animal.[1486] The greater effect observed in Orfila’s experiment was probably owing to obstruction of the pulmonary capillaries by the oil.
Orfila has examined with care not only the preparations of cantharides already mentioned, but likewise the various principles procured by M. Robiquet during his analysis; and it appears to result, that the active properties of the fly reside partly in the crystalline principle, and partly in a volatile oil, which is the source of its nauseous odour.
The symptoms produced by cantharides in man are more remarkable than those observed in animals. A great number of cases are on record; but few have been minutely related. Sometimes it has been swallowed for the purpose of self-destruction, sometimes for procuring miscarriage. But most frequently, on account of a prevalent notion that it possesses aphrodisiac properties, it has been both voluntarily swallowed and secretly administered, to excite the venereal appetite. That it has this effect in many instances cannot be doubted. But the old stories, which have been the cause of its being so frequently used for the purpose, are many of them fabulous, and all exaggerated. Often no venereal appetite is excited, sometimes even no affection of the urinary or genital organs at all; and the kidneys and bladder may be powerfully affected without the genital organs participating. It is established, too, by frequent observation, that the excitement of the genital organs can never be induced, without other violent constitutional symptoms being also brought on, to the great hazard of life.
The following abstract of a case by M. Biett of Paris gives a rational and unexaggerated account of the symptoms as they commonly appear. A young man, in consequence of a trick of his companions, took a drachm of the powder. Soon afterwards he was seized with a sense of burning in the throat and stomach; and in about an hour with violent pain in the lower belly. When M. Biett saw him, his voice was feeble, breathing laborious, and pulse contracted; and he had excessive thirst, but could not swallow any liquid without unutterable anguish. He was likewise affected with priapism. The pain then became more extensive and severe, tenesmus and strangury were added to the symptoms, and after violent efforts he succeeded in passing by the anus and urethra only a few drops of blood. By the use of oily injections into the anus and bladder, together with a variety of other remedies intended to allay the general irritation of the mucous membranes, he was considerably relieved before the second day; but even then he continued to complain of great heat along the whole course of the alimentary canal, occasionally priapism, and difficult micturition. For some months he laboured under difficulty of swallowing.[1487]—Another case very similar in its circumstances has been related by M. Rouquayrol. In addition to the symptoms observed in Biett’s patient there was much salivation, and towards the close of the second day a large cylindrical mass, apparently the inner membrane of the gullet, was discharged by vomiting.[1488]—A case of the same kind, but less severe, is related in the Medical Gazette. A woman, who had taken an ounce of the tincture, was observed throughout the day to be apparently intoxicated. Next morning, when she for the first time told what she had done, she had excruciating pain, great tenderness and distension of the belly, a flushed anxious countenance, a dry, pale tongue, a natural pulse, and urine loaded with sediment and fibrinous matter. In the evening there was extreme weakness, cold extremities, a scarcely perceptible pulse, and retention of urine; and at night she was delirious. After this she recovered progressively, the chief symptoms then being pain in the kidneys and inability to pass urine.[1489]
Among the symptoms the affection of the throat, causing difficult deglutition and even an aversion to liquids, appears to be pretty constant. The sense of irritation along the gullet and in the stomach is also generally considerable. Sometimes it is attended with bloody vomiting, as in four cases related by Dr. Graaf of Langenburg;[1490] and at other times, as in the instance of poisoning with the acids, there is vomiting of membranous flakes. These have been mistaken for the lining membrane of the alimentary canal, but are really in general a morbid secretion.[1491] At the same time there is reason to believe that a portion of the membrane of the gullet was discharged in Rouquayrol’s case; for there were ramified vessels in it, and one so large that blood issued on pricking it. A prominent symptom in general is distressing strangury, and it commonly concurs with suppression of urine and the discharge of blood.[1492] It would appear that, when the genital organs are much affected, the inflammation may run on to gangrene of the external parts. Ambrose Paré notices a fatal instance of the kind, which was caused by a young woman seasoning comfits for her lover with cantharides.[1493]
The preceding symptoms are occasionally united with signs of an injury of the nervous system. Headache is common, and delirium is sometimes associated with it.[1494] In a case communicated to Orfila the leading symptoms at first were strangury and bloody urine; but these were soon followed by violent convulsions and occasional loss of recollection.[1495] The quantity in that instance was only eight grains; and it was taken for the purpose of self-destruction. In one of Graaf’s four cases the patient was attacked during convalescence with violent phrensy of three days’ continuance.[1496] An instance is also related in the Transactions of the Turin Academy, of tetanic convulsions and hydrophobia appearing three days after a small over-dose of the tincture of cantharides was taken, and continuing for several days with extreme violence.[1497] The cause of the symptoms, however, is here doubtful.
A rare occurrence is relapse after apparent convalescence. In a case communicated to me by Dr. Osborne of Dundee, which there was every reason to believe had arisen from cantharides administered to a girl by an unprincipled scoundrel, the usual symptoms of violent irritation in the bladder and rectum prevailed for 36 hours; and an interval of quiet and apparent convalescence ensued for three days. But on the fifth day the urinary symptoms returned, and were attended with great prostration, a rapid feeble pulse, and severe diarrhœa for two days longer. She eventually recovered. Another girl, poisoned at the same time, had most distressing irritation in the bladder, and for some time passed nothing but drops of blood; but she got well in two days, and had no relapse.
The following fatal cases deserve particular mention. Orfila quotes one from the Gazette de Santé for May, 1819, which was caused by two doses of twenty-four grains taken with the interval of a day between them, for the purpose of suicide. The ordinary symptoms of irritation in the bowels and urinary organs ensued, miscarriage then took place, and the patient died on the fourth day, with dilated pupils and convulsive motions, but with unimpaired sensibility.[1498] Another instance related by Dr. Ives of the United States, presented two stages, like that related by Orfila, but with the remarkable difference that an interval of several days intervened between the irritant and narcotic effects. A man swallowed an ounce of the tincture and was seized in a short time with hurried breathing, flushed face, redness of the eyes and lacrymation, convulsive twitches, pain in the stomach and bladder, suppression of urine and priapism; in the evening delirium set in, and next morning there was loss of consciousness; but from this time under the use of blood-letting, emetics, blisters, sinapisms, and castor-oil, he got well and continued so for fourteen days. But after that interval he was suddenly attacked with headache and shivering, then with convulsions, and subsequently with coma; which, however, was removed for a time by outward counter-irritants. Next day the coma returned at intervals, and on the subsequent day the convulsions also, which gradually increased in severity for three days more, and then proved fatal.[1499] In this case it admits of question whether the affection which proved the immediate cause of death really arose from the cantharides, or was an independent disease.—A third case, fatal on the fourth day, occurred in April, 1830, near Uxbridge in the south of England. I have not been able to learn the particulars exactly; but it appears to have been produced by cantharides powder, which was mixed with beer by two scoundrels at a dancing party for the purpose of exciting the venereal appetite of the females. A large party of young men and women were in consequence taken severely ill; and one girl died, who had been prevailed on to take the powder at the bottom of the vessel, on being assured that it was ginger.
The quantity of the powder or tincture requisite to prove fatal or dangerous has not been accurately settled. Indeed practitioners differ much even as to the proper medicinal doses. The smallest dose of the powder yet known was twenty-four grains (Orfila); and the smallest fatal dose of the tincture was one ounce, which is equivalent to six grains of powder.[1500] It is probable that this is one of the poisons whose operation is liable to be materially affected by idiosyncrasy. The medicinal dose is from half a grain to two grains of the powder, and from ten drops to two drachms of the tincture. But Dr. Beck has quoted an instance where six ounces of the tincture were taken without injury.[1501] On the other hand Werlhoff has mentioned the case of a lad who used to be attacked with erection and involuntary emission on merely smelling the powder.[1502] This statement, though extraordinary, is not without support from the parallel effects of other substances.
The familiar effects of cantharides on the external surface of the body are not unattended with danger, if extensive, or induced in particular states of the constitution. An ordinary blistered surface often ulcerates in febrile diseases; and in the typhoid state which characterizes certain fevers, this ulceration has been known to pass on to fatal sloughing, especially when the blister has been applied to parts on which the body rests. I have met with two such cases. On the other hand if the blistered surface be very extensive, death may take place in the primary stage of the local affection, in consequence of the great constitutional disturbance excited. Thus in 1841 a girl, affected with scabies, received cantharides ointment by mistake instead of sulphur ointment from an hospital-serjeant at Windsor Barracks; and having anointed nearly her whole body with it, was seized with violent burning pain of the integuments, followed by vesication, general fever, and the usual symptoms of the action of this poison on the urinary organs. These effects were so severe that she died in five days.[1503]
The only precise account I have hitherto seen of the morbid appearances caused by cantharides is contained in the history of the case from the Gazette de Santé. The brain was gorged with blood. The omentum, peritonæum, gullet, stomach, intestines, kidneys, ureters, and internal parts of generation were inflamed; and the mouth and tongue were stripped of their lining membrane.—In dogs Schubarth observed, besides the usual signs of inflammation in the alimentary canal, great redness of the tubular part of the kidneys, redness and extravasated patches on the inside of the bladder, and redness of the ureters as well as of the urethra.[1504] M. Poumet denies that any morbid appearance is ever found in any part of the genito-urinary organs of animals; but he sometimes found blood effused into the stomach and intestines.[1505] In Dr. Ives’s case the blood-vessels of the brain and cerebellum were gorged, the cerebellum spread over with lymph, the villous coat of the stomach softened and brittle, and the kidneys inflamed and presenting blood in their pelvis.
When the case has been rapid, the remains of the powder may be found in the stomach or intestines by Poumet’s process. From the researches of Orfila and Lesueur, confirmed by those of Poumet, it appears not to undergo decomposition for a long time when mixed with decaying animal matters. After nine months’ interment the resplendent green points continue brilliant.[1506]
The treatment of poisoning with cantharides is not well established. No antidote has yet been discovered. At one time fixed oil was believed to be an excellent remedy. But the experiments of Robiquet on the active principle of the poison, and those of Orfila on the effects of its oleaginous solution, rather prove that oil is the reverse of an antidote. The case mentioned in the Genoa Memoirs was evidently exacerbated by the use of oil. When the accident is discovered early enough, and vomiting has not already begun, emetics may be given; and if vomiting has begun, it is to be encouraged. Oleaginous and demulcent injections into the bladder generally relieve the strangury. The warm bath is a useful auxiliary. Leeches and blood-letting are required, according as the degree and stage of the inflammation may seem to indicate.
Many other insects besides the Cantharis vesicatoria possess similar acrid properties. Two of them, however, may be briefly alluded to, because they have caused fatal poisoning. The one is the Meloë proscarabæus, the Maiwurm of the Germans, a native of most European countries. In Rust’s Magazin there is an account of four persons who took the powder of this insect from a quack for spasms in the stomach. The principal symptoms were stifling and vomiting; and two of the people died within twenty-four hours.[1507] The other is the Bombyx, of which at least two species are believed to possess powerful irritant properties, the B. pityocarpa and B. processionea. The following is an instance of their effects. A child ten years old had a common blister applied to the neck and spine as a remedy for deafness; and four days afterwards her mother dressed the abraded skin with the leaves of beet-root, from which she had previously shaken a great number of caterpillars. The child soon complained of insupportable itching and burning in the part, and endeavoured to tear off the dressings. The mother persevered, however; and her child died in two days of gangrene of the whole integuments of the back. The surgeon who saw the child on the last day of her life, ascribed the gangrene to the insects mentioned above, and states that they possess the power of exciting erysipelas when applied even to the sound skin.[1508] It is probable that many other insects in Europe have similar properties. The Mylabris cichorii, which is partially used in Italy,[1509] and is in common use in India and China for blistering, possesses active irritant properties. The Cantharis ruficollis, another species used in the Nizam’s Territories in India, is also energetic. Other species known to possess activity are Mylabris fusselini, Meloe majalis, M. trianthemum, Coccinella bipunctata, C. septem-punctata, and Cantharis vittata.