The first group of the narcotico-acrids comprehends these whose principal symptom in the early stage of their effects is delirium. All the plants of the group belong to the natural order Solanaceæ, and Linnæus’s class Pentandria Monogynia. Those which have been particularly examined are deadly nightshade, thorn-apple, and tobacco.
The deadly nightshade, or Atropa belladonna, is allied in physiological and botanical characters to the hyoscyamus and solanum formerly mentioned; and by the older writers, indeed, was confounded with the latter. It is a native of Britain, growing in shady places, particularly on the edge of woods. The berries, which ripen in September, have a jet-black colour. Their beauty has frequently tempted both children and adults to eat them, although they have a mawkish taste; and many have suffered severely. It is not the berry alone which is poisonous; the whole plant is so; and the root is probably the most active part.[2127] From one to four grains of the dried powder of the root will occasion dryness in the throat, giddiness, staggering, flushed face, dilated pupils, and sometimes even delirium.[2128] The juice of the leaves is very energetic, two grains of its extract being, when well prepared, a large enough dose to cause disagreeable symptoms in man. It is a very uncertain preparation, unless when procured by evaporation in vacuo; for some samples from the Parisian shops have been found by Orfila to be quite inert.
It contains a peculiar alkaloid, named atropia. In the belladonna Brandes obtained a volatile, oily-like, alkaloidal fluid, of a penetrating narcotic smell, and bitterish, acrid taste, which he supposed to be the active principle of the plant.[2129] The ulterior researches of Geiger and Hesse, however, as well as the simultaneous analysis of Mein, have proved that this fluid is not the pure alkaloid of belladonna, and that the real atropia is a solid substance, forming colourless, silky crystals, soluble in ether and alcohol, sparingly so in water, slightly bitter, liable to decomposition under contact with air and moisture, volatilizable, but with some decomposition, a little above 212°, and capable of forming definite crystallizable salts with acids.[2130] The aqueous solutions of its salts exhale during evaporation a narcotic vapour, which dilates the pupil, and causes sickness, giddiness, and headache.[2131]
The ordinary extract of belladonna in the dose of half an ounce will kill a dog in thirty hours when introduced into the stomach. Half that quantity applied to a wound will kill it in twenty-four hours. And forty grains injected into the jugular vein prove even more quickly fatal. Convulsions are rarely produced, but only a state like intoxication.[2132]
The oleaginous atropia of Brandes in a dose of two or three drops kill small birds instantaneously like concentrated hydrocyanic acid; in less doses it occasions staggering, gasping, and in a few minutes death amidst convulsions; and the dead body presents throughout the internal organs great venous turgescence and even extravasation of blood, but more especially excessive congestion within the head.[2133] The pure crystalline atropia of Mein, when dissolved in water and greatly diluted, causes extreme and protracted dilatation of the pupils.
Symptoms in Man.—On man the effects of belladonna are much more remarkable. In small doses, whatever be the kind or surface to which it is applied,—such as the skin round the eye, or the surface of a wound, or the inner membrane of the stomach,—it causes dilatation of the pupil. This effect may be excited without any constitutional derangement. When the extract is rubbed on the skin round the eye, or a solution of it dropped upon the eyeball, vision is not impaired; but when it is taken internally so as to affect the pupils, the sight is commonly much obscured. The effects of large or poisonous doses have been frequently witnessed in consequence of children and adults being tempted to eat the berries by their fine colour and bright lustre. From the cases that have been published the leading symptoms appear in the first instance to be dryness in the throat, then delirium with dilated pupils, and afterwards coma. Convulsions are rare, and, when present, slight.
The dryness of the throat is not a constant symptom. It is often, however, very distinct. It occurred, for example, in 150 soldiers who were poisoned near Dresden, as related by M. Gaultier de Claubry,[2134] and in six soldiers whose cases have been described by Mr. Brumwell.[2135] The former had not only dryness of the throat, but likewise difficulty in swallowing.
The delirium is generally extravagant, and also most commonly of the pleasing kind, sometimes accompanied with immoderate uncontrollable laughter, sometimes with constant talking, but occasionally with complete loss of voice, as in the cases of the 150 soldiers. At other times the state of mind resembles somnambulism, as in the instance of a tailor who was poisoned with a belladonna injection, and who for fifteen hours, though speechless and insensible to external objects, went through all the customary operations of his trade with great vivacity, and moved his lips as if in conversation.[2136] Sometimes frantic delirium is almost the only symptom of consequence throughout the whole duration of the poisoning. Thus a gentleman at Perigueux in France, who took by mistake a mixture containing a drachm and a half of extract, was attacked in half an hour with delirium, which soon became furious, and continued till next day, when it gradually left him.[2137] In others the delirium is attended with a singular and total loss of consciousness, but without coma, as in the following case which occurred not long ago at St. Omer. A young man having taken by mistake an infusion of two drachms of dried leaves, was seized in an hour with great dryness of the mouth and throat, afterwards slight delirium, loss of consciousness, and dilatation of the pupil, next with retention of urine, convulsive twitches of the face and extremities, and incessant tendency to walk up and down. In three hours, after the action of an emetic and a clyster, he lay down, but still in a state of total unconsciousness and muttering delirium. Blood-letting being at last resorted to as a remedy, he speedily recovered his senses, and eventually got well, after suffering for some time from headache, fatigue, and much debility.[2138]
The pupil is not only dilated in all cases, but likewise for the most part insensible;[2139] and, as in the soldiers at Dresden, the eyeball is sometimes red and prominent. The vision also, as in these soldiers, is generally obscure; sometimes it is lost for a time;[2140] and so completely that even the brightest light cannot be distinguished.[2141]
The sopor or lethargy, which follows the delirium, occasionally does not supervene for a considerable interval. In a case related by Munnik it did not begin till twelve hours after the poison was taken.[2142] Sometimes, as in the same case, the delirium returns when the stupor goes off. A patient of my colleague Dr. Simpson, after using a belladonna suppository consisting of two grains of extract, was attacked with dryness of the throat and delirium, followed soon by drowsiness and stupor; and in five or six hours more, as the stupor wore off, the delirium returned, prompting to constant movements as if she was busy with her toilette and various other ordinary occupations. Sometimes the relation of the delirium to the coma is reversed, as in a case related by Mr. Clayton, where sopor came on first, and delirium ensued in six hours. The dose in this instance was forty grains of the extract.[2143] Frequently the stupor is not distinct at any stage.—Even the delirium is not always formed rapidly. A man whose case is described by Sir John Hill did not become giddy for two hours after eating the berries, and the delirium did not appear till five hours later.[2144] In Mr. Brumwell’s cases, the delirium was not particularly noticed till the morning after the berries were taken.
Convulsions, it has been already stated, are rare. In the case from the 24th volume of Sedillot’s Journal, the muscles of the face were somewhat convulsed: there is also at times more or less locked-jaw,[2145] or subsultus tendinum;[2146] and occasionally much abrupt agitation of the extremities.[2147] But well-marked convulsions do not appear to be ever present.
The effects now detailed are by no means so quickly dissipated as those of opium. Almost every person who has taken a considerable dose has been ill for a day at least. The case from Sedillot’s Journal lasted three days, delirium having continued twelve hours, the succeeding stupor for nearly two days, and the departure of the stupor being attended with a return of delirium for some hours longer. One of Mr. Brumwell’s patients, too, was delirious for three days; and Plenck has noticed several instances where the delirium was equally tedious.[2148] Sage has related a case in which the individual was comatose for thirty hours.[2149] Blindness is also a very obstinate symptom, which sometimes remains after the affection of the mind has disappeared. This happened in Plenck’s cases. In two children whose cases have been described in a late French journal, the eyes were insensible to the brightest light for three days.[2150] In general, the dilated state of the pupils continues long after the other symptoms have departed. It further appears from an official narrative in Rust’s Journal, that dilated pupil is not the only symptom which may thus continue, but that various nervous affections, such as giddiness, disordered vision, and tremors, may prevail even for three or four weeks.[2151]
Hitherto little or no mention has been made of symptoms of irritation from this poison. They are in fact uncommon, and seldom violent. In the cases related by Gaultier de Claubry and by Mr. Brumwell, dryness and soreness of the throat and difficult deglutition were remarked, and appear not unusual. These symptoms were especially noticed by Buchner, who by way of curiosity took half a drachm of seeds digested in beer. The sense of dryness and constriction of the throat were such as to prevent him swallowing even the saliva.[2152] Sage’s patient passed blood by stool; and after the symptoms of narcotic poisoning ceased, he had aphthous inflammation in the throat, and swallowing was so difficult as for some time to excite convulsive struggles. Aphthæ in the throat and swelling of the belly also succeeded the delirium in Munnik’s case. Mr. Wibmer alludes to the case of a man who, besides difficult deglutition at the beginning, had violent strangury towards the close.[2153] An instance of violent strangury with suppression of urine and bloody micturition is also related by M. Jolly. In the early stage, the patient had redness of the throat and burning along the whole alimentary canal, combined with the customary delirium and loss of consciousness. The symptoms were caused by forty-six grains of the extract given by mistake instead of jalap.[2154] Nausea and efforts to vomit are not infrequent at the commencement.
If the accident be taken in time, poisoning with belladonna is rarely fatal; for, as the state first induced is delirium, not sopor, suspicion is soon excited, and emetics may be made to act before a sufficient quantity of the poison has been absorbed to prove fatal. Hence few fatal instances have occurred in recent times. Mr. Wilmer, however, has mentioned two fatal cases occurring in children, and terminating within twenty-four hours.[2155] M. Boucher, a writer in the old French Journal of Medicine, has referred to several cases of the same nature;[2156] Gmelin has described the particulars of a good example;[2157] and many others have been succinctly quoted by Wibmer, chiefly from the older authors.[2158]
Cases of poisoning with this plant have occurred in man through other channels besides the stomach. Allusion has already been made to the instance of a tailor who was poisoned by an injection. A small quantity will sometimes suffice when administered in that way. A woman, whose case is mentioned in Rust’s Journal, was attacked with wild delirium, flushed face and glistening eyes, in consequence of receiving, during labour, a clyster, that contained six grains of the common extract;[2159] and Dr. Simpson’s patient, who was severely affected, had only two grains.
Perhaps the berry is in some circumstances not very active. A French physician, M. Gigault of Pontcroix, says he has frequently had occasion to treat cases of poisoning with it, as accidents of the kind are extremely common in his neighbourhood; that he never knew it prove fatal; and that in one instance a young man took a pound of the berries before going to bed, and was not subjected to treatment till next morning, when he was found in a state of delirium, but speedily recovered after the free operation of emetics.[2160]
Morbid Appearances.—I have hitherto seen but one good account of the appearances after death from poisoning with belladonna. It is described by Gmelin. The subject was a shepherd who died comatose twelve hours after eating the berries. When the body was examined twelve hours after death, putrefaction had begun, so that the belly was swelled, the scrotum and penis distended with fetid serum, the skin covered with dark vesicles, and the brain soft. The blood-vessels of the head were gorged, and the blood every where fluid, and flowing profusely from the mouth, nose, and eyes.[2161] In the only other fatal case I have read, where the body was inspected, there appears to have been no unusual appearance at all.[2162]
As the husks and seeds of the berries are very indigestible, some of them will almost certainly be found in the stomach, as happened in the instance last quoted. It should likewise be remembered that the best possible evidence of the cause of the symptoms may be derived during life from the presence of the seeds, husks, or even entire berries, in the discharges. If vomiting has not been brought on at an early period, we may expect to find these remains both in the vomited matter and in the alvine evacuations. Mr. Wilmer mentions an instance in which the black husks appeared in the stools brought away by laxatives at least thirty hours after the poison was swallowed.[2163] One of Mr. Brumwell’s patients vomited the seeds towards the close of the third day.[2164] Several patients of M. Boucher vomited fragments of the fruit on the second day, and passed more by stool and injections on the third, although they had been treated with activity from the commencement.[2165]
While most of the cases of poisoning with belladonna have originated in accident, at the same time they have not been all of this description. Gmelin has quoted an instance of intentional and fatal poisoning by the juice of the berries being mixed with wine; and another singular case of poisoning with the decoction of the buds, given by an old woman for the purpose of committing theft during the stupor of the individual.[2166]
Other species of atropa are probably similar to belladonna in properties. Wibmer quotes a single instance of frantic delirium occurring among several shepherds, as well as their cattle, from eating the herb of the A. mandragora.[2167] This is well known to have been used anciently as a medicinal narcotic.
The thorn-apple, or Datura stramonium, is another plant of the same natural order, which it is proper to notice, because people have often been poisoned with it, and it has become a common ornament of our gardens. The cases of poisoning which have occurred in recent times in this country have been all accidental. But not long ago the thorn-apple appears to have been extensively used in Germany to cause loss of consciousness and lethargy, preparatory to the commission of various crimes.[2168] It was also proved to have been used lately in France for this purpose. Some thieves made a man insensible with wine in which stramonium seeds had been steeped, and robbed him of five hundred francs while in this state. For twenty-four hours the victim knew nothing of what became of him; he was met wandering in a wood, affected with delirium, unconsciousness, staring of the eyes, and oppression of the breathing; and for some time he was taken for a madman.[2169] In the Eastern Archipelago, according to Mr. Crawford, this is a common mode of committing theft and robbery.[2170]
It is chiefly the fruit and seeds that have hitherto been examined; but the whole plant is probably poisonous. Brandes discovered in it a volatile, oleaginous, alkaline substance, which he supposed to be its active principle.[2171] But, though his observations were confirmed by Bley,[2172] it now appears that the real principle is a colourless, crystalline alkaloidal substance, of an acrid taste like tobacco, which was discovered more lately by Geiger and Hesse; this is named daturine, or daturia.[2173]
The physiological effects of the extract have been determined by Orfila. He found that half an ounce killed a dog within twenty-four hours after being swallowed, that a quarter of an ounce applied to a wound killed another in six hours, and that thirty grains killed another when injected into the jugular vein. The symptoms were purely nervous, and not very prominent. Hence this poison, like the former, acts through the blood-vessels, and probably on the brain.[2174] Bley’s daturia proves quickly fatal to small animals in the dose of a few drops. The crystalline daturia of Geiger and Hesse kills a sparrow in the dose of an eighth of a grain, and occasions great and persistent dilatation of the pupil when applied to the eye.
Symptoms in Man.—The symptoms produced by a poisonous dose in man are variable. The leading features are great delirium, dilatation of the pupils, and stupor; but sometimes spasms occur, and occasionally palsy.
Dr. Fowler has related the case of a little girl who took a drachm and a half of the seeds. In less than two hours she was attacked with maniacal delirium, accompanied with spectral illusions; and she remained in this state most of the following night, but had some intervals of lethargic sleep. Next morning, after the operation of a laxative, she fell fast asleep, and after some hours she awoke quite well.[2175] In a case somewhat like this, related in Henke’s Journal, the child had general redness of the skin, swelling of the belly, locked jaw, tremors of the extremities, and an attitude and expression as if about to tumble into a pit. Recovery took place after the action of an emetic.[2176]
In two instances, one related by Vicat in his treatise on the poisonous plants of Switzerland,[2177] the other by Dr. Swaine[2178] in the Edin. Phys. and Lit. Essays, the leading symptoms were furious delirium and palsy of the whole extremities. In the instances of three children related by Alibert there were delirium, restlessness, constant incoherent talking, dancing and singing, with fever and flushed face.[2179] In another recorded by Dr. Young, there were some convulsions, and livid suffusion of the countenance.[2180] In an instance communicated to me by my colleague Dr. Traill, where eighteen or twenty grains of extract of stramonium were taken by mistake for sarsaparilla, the symptoms were dryness of the throat immediately afterwards, then giddiness, dilated pupils, flushed face, glancing of the eyes, and incoherence, so that he seemed to his friends to be intoxicated: and subsequently there was incessant unconnected talking, like that of demency. Emetics were given without effect, and little amendment was obtained from blood-letting, leeches on the temples, cold to the head, or purgatives. But after a glass of strong lemonade vomiting took place, the symptoms began to recede, in ten hours he recognized those around him, and next day he was pretty well. Kaauw Boerhaave has related with great minuteness the case of a girl who very nearly lost her life in consequence of a man having given her the powder in coffee with the view of seducing her. The symptoms were redness of the features, delirium, nymphomania, loss of speech; then fixing of the eyes, tremors, convulsions, and coma; afterwards tetanic spasm and slow respiration with the coma. She was with much difficulty roused for a time by the operation of emetics, and eventually got well after her lethargy had lasted nearly a day.[2181] In another related in Rust’s Magazin, and caused by a decoction of the fruit, which was mistaken for thistle-heads, the leading symptoms were spasmodic closing of the eyelids and jaws, spasms also of the back, complete coma, and excessive dilatation and insensibility of the pupil.[2182] This case, which seems to have been a very dangerous one, was rapidly cured by free blood-letting. Blood-letting, indeed, seems peculiarly called for in poisoning with thorn-apple, on account of the strong signs of determination of blood to the head.—Gmelin has quoted several fatal cases, one of which endured for six hours only;[2183] and Dr. Young says, that a child has been killed by a single apple.[2184] The most complete account yet published of the phenomena of poisoning with stramonium when fatal is given by Mr. Duffin of London. A child of his own, two years old, swallowed about 100 seeds without chewing them. Soon after she became fretful and like a person intoxicated; in the course of an hour efforts to vomit ensued, together with flushed face, dilated pupils, incoherent talking, and afterwards wild spectral illusions and furious delirium. In two hours and a half she lost her voice and the power of swallowing, evidently owing to spasms of the throat. Then croupy breathing and complete coma set in, with violent spasmodic agitation of the limbs, occasional tetanic convulsions, warm perspiration, and yet an imperceptible pulse. Subsequently the pulse became extremely rapid, the belly tympanitic, and the bladder paralyzed, but with frequent involuntary stools, probably owing to the administration of cathartics; and death took place in twenty-four hours. At an early period twenty seeds were discharged by an emetic: the stools contained eighty; and none were found in the alimentary canal after death. There was never any marked sign of congestion of blood in the head, except flushed face at the beginning.[2185] Dr. Droste of Osnaburg has related a fatal case occasioned by a decoction of 125 seeds given to remove colic. In fifteen minutes the patient became delirious, but soon fell apparently fast asleep, and died in seven hours without again awaking.[2186]
Dangerous effects may result from the application of the thorn-apple to the skin when deprived of the cuticle. An instance has been lately published of alarming narcotism from the application of the leaves to an extensive burn.[2187]
Morbid Appearances.—As to the morbid appearances, Droste found in his case redness of the cardiac end of the stomach, which contained two table-spoonfuls of a pulpy matter mixed with black and white grains, the remains of the teguments of the seeds; and there was also lividity of the back, lividity of the lungs, emptiness of the cavities of the heart, and gorging of the vessels of the brain. Haller says he once found general congestion of the brain and sinuses,[2188]—an appearance which may naturally be expected, considering the signs of strong determination of blood towards the head, which often prevail during life. In Mr. Duffin’s case, however, the brain was healthy, not congested; the stomach and intestines presented no morbid appearance; and the only unusual appearances observed were a slight blush over the pharynx, larynx, and upper third of the gullet, thickening and swelling of the rima glottidis, and a semi-coagulated state of the blood.
A plant of the same natural order with the two former, tobacco, the Nicotiana tabacum of botanists, is familiarly known to be in certain circumstances a virulent poison. Every part of the plant possesses active properties. It has been used as a poison in this country for criminal purposes.
Vauquelin analyzed it some time ago, and procured an acrid volatile principle which he called nicotine.[2189] This substance, which was afterwards obtained in a purer state as a crystalline body by Hermbstädt, has been more recently ascertained by MM. Posselt and Reimarus to be nothing else than essential oil of tobacco, which is sold at ordinary temperatures; and they succeeded in procuring another principle which they consider the true nicotina. This is fluid at 29° F., volatile, extremely acrid, alkaline, and capable of forming crystallizable salts with some of the acids.[2190] Tobacco then appears to contain an acrid alkaline principle, and an essential oil to which the alkaloid adheres with great obstinacy. The relation of the empyreumatic oil of tobacco to these principles has not been accurately ascertained, though it probably contains one or other of them. It is well known to be an active poison, which produces convulsions, coma and death. Mr. Morries-Stirling found that its active part is removed from the oil by washing with weak acetic acid, as he also observed in the instance of similar oils obtained from various narcotic vegetables.[2191]
Process for detecting Tobacco in Organic mixtures.—In a medico-legal case which happened at Aberdeen in 1834, and of which some notice is taken at page 651, Dr. Ogston of that city successfully employed the following process for detecting tobacco in the contents of the stomach. The contents, consisting of a pulpy fluid, were acidulated with acetic acid, digested, and filtered; the liquid was treated with diacetate of lead, filtered again, freed of lead by hydrosulphuric acid, filtered a third time, treated with caustic potash, and then allowed to settle. The supernatant liquid, which had the taste of tobacco-juice, was separated and distilled to half its volume. The distilled liquor had a strong tobacco odour and taste, and some acridity, and gave a precipitate with infusion of galls. The residuum in the retort presented oily particles on its surface, and when heated in an open basin filled the apartment with a vapour which had a strong odour of tobacco smoke, and caused in several persons present a sense of acridity of the throat, watering of the eyes, and tendency to sneeze. Various additional experiments confirmatory of these results were also performed; and a simultaneous examination of tobacco-powder gave precisely the same indications. I am indebted to Dr. Ogston for these particulars and a detailed narrative of his investigation; which appears to supply a convenient and conclusive process for the detection of tobacco.—Perhaps the ordinary process for obtaining nicotina may also be employed with advantage. This consists in distilling the suspected substance with caustic potash, neutralizing the distilled liquor with sulphuric acid, concentrating the product to a thin syrup, exhausting this with etherized alcohol, evaporating off the solvent, and distilling the extract with strong solution of potash. Nicotina passes over, and may be recognized by its sensible and chemical qualities.
The effects of tobacco are somewhat different from those of belladonna and thorn-apple; but it is here arranged with them, as it belongs to the same natural family. Orfila remarked that 5½ drachms of common rappee, introduced into the stomach of a dog and secured by a ligature, caused nausea, giddiness, stupor, twitches in the muscles of the neck, and death in nine hours; and that two drachms and a quarter applied to a wound proved fatal in a single hour. Mr. Blake thinks tobacco has no direct action on the heart, even when admitted directly into the blood by the jugular vein;—that it acts primarily on the capillary circulation of the lungs, by obstructing which it prevents the blood from reaching the left cavities of the heart, and thus acts on that organ indirectly. For he observed, that laboured respiration always preceded any sign of depressed action of the heart, that forcible action of the heart often returned after its first cessation, and that its contractility continued after death.[2192] An infusion of ten grains caused laborious breathing in ten seconds, and in twenty seconds temporary arrestment of the heart’s action, which then returned, and was attended for a time with increased arterial pressure. Soon afterwards the animal recovered, without any convulsions or loss of sensibility. Two scruples had the same effect. But when three drachms were used, convulsions succeeded similar phenomena, and death ensued in two minutes, the heart continuing to act for some time after respiration had ceased, until at length it was stopped by the usual consequences of asphyxia.[2193] On the other hand, Sir B. Brodie found that the effects are very different, according to the form in which the poison is used. Thus four ounces of a strong infusion, when injected into the anus of a dog, killed it in ten minutes by paralyzing the heart; for after death the blood in the aortal cavities was arterial. But the empyreumatic essential oil does not act in that manner: it excites convulsions and coma, without affecting the heart. It may prove fatal in two minutes.[2194] Like other violent poisons, tobacco has no effect when applied directly to the brain or nerves.[2195] Two drops of the alkaloid, nicotina, injected into the jugular vein of a dog, begin to act in ten seconds, and will prove fatal in a minute and a half.[2196]
Symptoms in Man.—The effects observed in man are allied to those produced in dogs by the infusion. In a slight degree they are frequently witnessed in young men, while making their first efforts to acquire the absurd practice of smoking. The first symptoms are acceleration and strengthening of the pulse, with very transient excitement, then sudden giddiness, fainting and great sickness, accompanied with a weak, quivering pulse. These effects are for the most part transient and trifling, but not always. Some degree of somnolency is not uncommon. Dr. Marshall Hall has given an interesting account of a young man who smoked two pipes for his first debauch, and in consequence was seized with nausea, vomiting, and syncope, then stupor, stertorous breathing, general spasms and insensible pupils. Next day the tendency to faint continued, and in the evening the stupor, stertor and spasms returned; but from that time he recovered steadily.[2197] Gmelin has quoted two cases of death from excessive smoking,—caused in one by seventeen, in the other by eighteen pipes, smoked at a sitting.[2198] It is likewise mentioned by Lanzoni that an individual fell into a state of somnolency and died lethargic on the twelfth day in consequence of taking too much snuff;[2199] Dr. Cheyne says, “he is convinced apoplexy is one of the evils in the train of that disgusting practice;”[2200] and I have met with an instance where the excessive use of snuff, occasioned twice, at distant intervals, an attack resembling imperfect apoplexy, united with delirium. Such cases, however, must be admitted to be rare; and the practice of taking snuff is in general unattended with injury.
Serious consequences have resulted from the application of tobacco to the abraded skin. In the Ephemerides an account is given of three children who were seized with giddiness, vomiting, and fainting from the application of tobacco-leaves to the head for the cure of ring-worm.[2201] Dr. Merriman has also alluded to an instance of death in a child from the incautious employment of a strong decoction of tobacco as a lotion for ring-worm of the scalp.[2202] And in Leroux’s Journal there is an account of a man, who, after using a tobacco decoction for the cure of an eruptive disease, was seized with symptoms of poisoning, and died in three hours.[2203]
In recent times poisoning with tobacco has been often produced by the employment of too large doses in the way of injection. Richard has mentioned a case, not fatal, which arose from an infusion of five leaves in a choppin of water, used as an injection by a lady for costiveness. She was immediately seized with colic, giddiness, buzzing in the ears, headache, nausea, and then syncope of seven hours’ duration. During this period the breathing was difficult, the pulse very slow, the pupils dilated, the skin cold and moist, the urine suppressed, the efforts to vomit constant, and the belly depressed, contracted, and affected with constant borborygmus. She recovered under the use of emollient injections and fomentations.[2204] Dr. Grahl of Hamburg has related minutely a fatal case, which arose from an ounce of rather more, boiled for fifteen minutes in water, and administered by advice of a female quack. The individual, who laboured merely under dyspepsia and obstinate costiveness, was seized in two minutes with vomiting, violent convulsions, and stertorous breathing, and died in three-quarters of an hour.[2205] Another accident of the same kind is noticed in the Journal de Chimie Médicale, where the person became as it were intoxicated, and died immediately. Instead of an infusion of two drachms she had used a decoction of two ounces.[2206]—M. Tavignot describes the following remarkable case occasioned by a similar dose. An infusion prepared by mistake with two ounces and one drachm, instead of a drachm and a half, was used as an injection for a stout man affected with ascarides. In seven minutes he was seized with stupor, headache, paleness of the skin, pain in the belly, indistinct articulation, and slight convulsive tremors, at first confined to the arms, but afterwards general. Extreme prostration and slow laborious breathing soon ensued, and then coma, which ended fatally in eighteen minutes.[2207]—Even two drachms, however, or a drachm and a half, are by no means a safe dose. An anonymous writer in the Medical and Surgical Journal says a patient of his died in convulsions an hour or two after receiving a clyster composed of two drachms infused in eight ounces.[2208] Nay, in the Acta Helvetica there is an account by an anonymous writer of the case of a woman, who, after an injection made with one drachm only, was seized with pain in the belly, anxiety and faintings, proving fatal in a few hours.[2209] And a case, fatal in thirty-five minutes, which was occasioned by the same dose, occurred not long ago in Guy’s Hospital, London.[2210]
Tobacco is an equally deadly poison when swallowed in large quantity. M. Caillard has related the particulars of the case of a lunatic, who, having swallowed half an ounce of snuff during a lucid interval, was seized with vomiting, and afterwards with oppression, incoherence, cold sweats, a slow full pulse, and dilated pupils; but he slowly recovered.[2211] The French poet Santeuil was killed in this way by a practical joker at the Prince of Condé’s table. When the bottle had circulated rather freely, a boxful of Spanish snuff was emptied into a large glass of wine, and thus administered to the unlucky victim, who was in consequence “attacked with vomiting and fever, and expired in two days amidst the tortures of the damned.”[2212] The following important case has been communicated to me by Dr. Ogston of Aberdeen, who was employed in the judicial investigations connected with it. An elderly man, a pensioner, was seen to enter a brothel, while in perfect health; and in an hour he was carried out insensible and put down in a passage, where he was found by the police unable to speak or move. While carrying him to the watch-house hard by, the officers observed him attempt to vomit; but he was scarcely laid down before the fire, when he expired. It was ascertained, that he had drunk both rum and whisky in the brothel, and that something had been given him “to stupefy him or set him asleep.” On dissection the blood was found every where very fluid, and four ounces of serosity were collected from the lateral ventricles and base of the skull. But there was no other unusual appearance, except that the stomach contained about four ounces of a thick brownish pulp, in which were seen several pellets of a powder resembling snuff. In these contents Dr. Ogston could not detect any opium; but he detected tobacco by the process mentioned above. No doubt could exist that the man died of poisoning with tobacco; but as no evidence could be obtained to inculpate any one in particular of many individuals who were in the brothel with him, the case was not made the subject of trial.
Evidence is not wanting, therefore, to prove that this plant is a very active poison; yet every one knows that under the influence of habit it is used in immense quantities over the whole world as an article of luxury, without any bad effect having ever been clearly traced to it. Its poisonous qualities were known in Europe as soon as it was brought from America; and the belief that such properties could not fail to be attended, as in the case of spirits and opium, with evil consequences from its habitual use, led to much opposition on the part of various governments to its introduction. Soon after it was brought to England by Sir W. Raleigh, King James wrote a philippic against it, entitled “The Counter-blaste to Tobacco.” Some countries even prohibited it by severe edicts. Amurath the 4th in particular made the smoking of tobacco capital; several of the Popes excommunicated those who smoked in the church of St. Peter’s; in Russia it was punished with amputation of the nose; and in the Canton of Bern it ranked in the tables next to adultery, and even so lately as the middle of last century a particular court was held there for trying delinquents.[2213] Like every other persecuted novelty, however, smoking and snuff-taking passed from place to place with rapidity; and now there appear to be only two luxuries which yield to it in prevalence, spirituous liquors and tea.
The only accounts I have seen of the morbid appearances after poisoning with tobacco are contained in the cases of Dr. Grahl and Dr. Ogston. In the former there was great lividity of the back, paleness of the lips, flexibility of the joints (two days after death), diffuse redness of the omentum without gorging of vessels, similar redness with gorging of vessels both on the outer and inner coats of the intestines, in some parts of the mucous coat patches of extravasation, unusual emptiness of the vessels of the abdomen; while the stomach was natural, the lungs pale, the heart empty in all its cavities, and the brain natural. The appearances in Dr. Ogston’s case have been already stated.
Writers on the diseases of artisans have made many vague statements on the supposed baneful effects of the manufacture of snuff on the workmen.[2214] It is said they are liable to bronchitis, dysentery, ophthalmia, carbuncles and furuncles. At a meeting of the Royal Medical Society of Paris, however, before which a memoir to this purport was read, the facts were contradicted by reference to the state of the workmen at the Royal Snuff Manufactory of Gros-Caillou, where 1000 people are constantly employed without detriment to their health.[2215] This subject was afterwards investigated with care by MM. Parent-Duchatelet and D’Arcet, who inquired minutely into the state of the workmen employed at all the great tobacco-manufactories of France, comprising a population of above 4000 persons; and the results at which they arrived are,—that the workmen very easily become habituated to the atmosphere of the manufactory,—that they are not particularly subject either to special diseases, or to disease generally,—and that they live on an average quite as long as other tradesmen.[2216] These facts are derived from accurate statistical returns, showing the number of days each person was annually off work from sickness, the ages at which superannuated allowances were granted, the period of death, and the prevalent diseases.
The Natural Order Umbelliferæ contains a variety of plants, to which narcotico-acrid properties have been at different times ascribed. But these properties have been satisfactorily traced in the instance of four species only, the Conium maculatum, Œnanthe crocata, Cicuta virosa, and Æthusa cynapium. It is supposed that others may be poisonous. But the facts on the subject are equivocal; for the several species of the family are very apt to be confounded with one another, and there is reason to think that other species have repeatedly been mistaken for one of the four already mentioned.
The symptoms caused by the umbelliferous narcotics comprehend chiefly coma, convulsions, paralysis, and delirium. But the knowledge possessed on this head is rather vague, and the phenomena are not unfrequently complex and difficult to observe with accuracy; so that their nature has been sometimes misunderstood. The irritant properties of the poisons of this tribe of narcotico-acrids are seldom well defined.
The first to be mentioned is the common hemlock, or Conium maculatum, one of the most abundantly diffused of umbelliferous vegetables. It is distinguished from all those which it resembles by its tall, smooth, spotted stem,—its smooth leaves,—the rugged edge of the five ribs of its fruit,—its singular mousy odour,—and the very peculiar odour of conia, emitted when the pulp or juice of the leaves is mixed with caustic potash. The only other umbelliferous native which has a spotted stem, the Myrrhis temulenta, is easily distinguished from hemlock by the whole plant being very hairy.
Cases of poisoning with hemlock are not infrequent on the continent, the root having been mistaken for fennel, asparagus, parsley, but particularly parsnep.[2217] It is generally believed to have furnished the poison which was used in ancient times, and especially among the Greeks, for despatching criminals; but we have not any precise information on the subject.
A peculiar alkaloid was indicated in hemlock not long ago by Brandes, half a grain of which killed a rabbit with symptoms like those of tetanus.[2218] Other chemists were unable to obtain his results. But the subject was afterwards taken up with success by Geiger, who obtained from the plant a volatile, oleaginous alkaloid, which possesses great energy as a poison.[2219] Mr. Morries-Stirling procured from hemlock by destructive distillation an empyreumatic oil similar in properties to those of hyoscyamus, stramonium and tobacco, but producing in animals a state of pure coma.[2220]
The effects of hemlock on the animal system have been variously described by different observers. Sometimes they have appeared to be purely soporific like those of opium; at other times they have resembled the effects of belladonna and thorn-apple; and in the lower animals they are quite different, as I have witnessed them, from what they have been described to be in man,—the phenomena being simply those of asphyxia from paralysis of the muscles, without material convulsions and without insensibility. Its irritant action is not well established.
Orfila observed that an ounce of the extract of the leaves killed a dog in forty-five minutes when swallowed, ninety grains killed another through a wound in an hour and a half, and twenty-eight grains another through a vein in two minutes. It therefore acts by entering the blood-vessels. The extract is a very uncertain preparation; the reason of which is, that the alkaloid conia is very easily decomposed in its natural state of mixture by heat or age, being converted into an inert resinoid matter,—that the dried leaves of hemlock contain scarcely any of it,—and that even an extract of the fresh leaves contains little, unless prepared with a gentle heat, yet speedily.[2221] The symptoms remarked by Orfila were convulsions and insensibility; and in the dead body the blood of the left cavities of the heart was sometimes found arterial.—The result of my observations is quite at variance with this statement. In various experiments with a strong extract prepared from the green seeds with absolute alcohol, the only effect I could remark were palsy, first of the voluntary muscles, next of the chest, lastly of the diaphragm,—asphyxia in short from paralysis, without insensibility, and with slight occasional twitches only of the limbs, and the heart was always found contracting vigorously for a long time after death. Thirty grains of a soft extract introduced between the skin and muscles of the back killed a rabbit in five minutes, and a five months’ puppy in twenty minutes.[2222]
The root is much less energetic than is represented by some authors, and probably varies in this respect at different seasons. I have found that four ounces and a half of juice, the produce of twelve ounces of roots collected in November, had no effect on a dog when secured in its stomach by a ligature on the gullet; and that four ounces obtained from ten ounces of roots in the middle of June, when the plant was coming into flower, merely caused diarrhœa and languor. Orfila had previously observed that three pounds of roots had no effect in the month of April; but that two pounds in the end of May, when the plant was in full vegetation, killed a dog in six hours.[2223] The alcoholic extract of the juice obtained from six ounces of roots on the last day of May, I have found to kill a rabbit in thirty-seven minutes, when introduced in a state of emulsion between the skin and muscles of the back; and the effects were analogous to those obtained with the extract of the leaves. The differences depending on season will probably account for various persons having found the juice of the root harmless. Gmelin quotes an instance where four ounces of the juice were taken without injury. He adds another where three ounces of the juice of the herb were swallowed daily for eight days with as little effect. But, as he judiciously observes, other less active plants have probably been sometimes mistaken for hemlock.[2224]
The alkaloid, conia, seems to be the active principle of hemlock, and is a poison of extraordinary virulence. On investigating this subject in 1835,[2225] I found that it is a local irritant, possessing an acrid taste, and capable of exciting redness or vascularity in any membrane to which it is applied; but that these topical effects are readily overwhelmed by its swift and intense narcotic action. This action consists of swiftly spreading palsy of the muscles, which affects first those of voluntary motion, then the respiratory muscles of the chest and abdomen, and lastly the diaphragm, so as to terminate by causing asphyxia. The paralytic state is usually interrupted from time to time by slight convulsive twitches of the limbs and trunk at the beginning. The muscular contractility is impaired or annihilated by the topical action of the poison, but not by its indirect action through absorption. The heart is not appreciably affected; for it contracts vigorously long after all motion, respiration, and other signs of life are extinct; and it contains after death, not florid but dark blood in its left cavities. The blood undergoes no alteration. The external senses are little, if at all impaired, until the breathing is almost arrested; and volition too is retained. But a contrary inference may be drawn by a careless observer, in consequence of the paralytic state taking away the means, by which in animals sensation is expressed and volition exercised. The action of conia, in short, is confined to the spinal cord; and it acts as a sedative, by exhausting the nervous energy.
Conia is probably a deadly poison to all orders of animals: at least I found it to be so to the dog, cat, rabbit, mouse, frog, fly, and flea; and Geiger killed the kite, pigeon, sparrow, slow-worm, and earth-worm with it. It acts through every texture where absorption is carried on readily, through the stomach, eye, lungs, cellular tissue, peritonæum, or veins; and its activity is in proportion to the speed with which absorption is carried on in the part. It acts therefore through absorption. Its activity is increased by neutralization with an acid, by which it is rendered much more soluble in water. Few poisons equal it in subtility and swiftness. A single drop, applied to the eye of a rabbit, will kill it in nine minutes; and three drops in the same way will kill a strong cat in a minute and a half. Five drops, introduced into the throat of a little dog, began to act in thirty seconds, and proved fatal in one minute. And when two grains, neutralized with thirty drops of weak hydrochloric acid, were injected into the femoral vein of a young dog, it died before there was time to note the interval, so that only two or three seconds at most had elapsed, before all internal signs of life were extinct. This extraordinary rapidity of action seems incompatible with its operation taking place by conveyance of the poison with the blood to the spinal cord. Mr. Blake, as formerly mentioned (p. 15), denies that its action in this way was ever so swift in his hands, and alleges that he could never observe the interval to be shorter than fifteen seconds. If the reader, however, will consult the original account of my experiment,[2226] which was made along with Dr. Sharpey, he will see that we could scarcely be mistaken as to the interval in that instance.
Symptoms in Man.—M. Haaf, a French army-surgeon, has described a fatal case of poisoning with hemlock, which closely resembled poisoning with opium. The subject of it, a soldier, had partaken along with several comrades of a soup containing hemlock leaves, and appeared to them to drop asleep not long after, while they were conversing. In the course of an hour and a half they became alarmed on being all taken ill with giddiness and headache; and the surgeon of the regiment was sent for. He found the soldier, who had fallen asleep, in a state of insensibility, from which, however, he could be roused for a few moments. His countenance was bloated, the pulse only 30, and the extremities cold. The insensibility became rapidly deeper and deeper, till he died, three hours after taking the soup.[2227] His companions recovered.
Dr. Watson has briefly described two cases which were fatal in the same short space of time. The subjects were two Dutch soldiers, who, in common with several of their comrades, took broth made with hemlock leaves and various other herbs. Giddiness, coma, and convulsions were the principal symptoms. The men who recovered were affected exactly as if they had taken opium.[2228]
When the dose is not sufficient to prove fatal, there is sometimes paralysis, attended with slight convulsions, as in a case noticed by Orfila.[2229] More commonly there is frantic delirium. Matthiol has related an instance of this last description, occurring in the cases of a vine-dresser and his wife, who mistook the roots for parsneps Both of them became in the course of the night so delirious that they ran about the house, knocking themselves against every object which came in their way.[2230] Kircher, as quoted by Wibmer, tells a parallel story of two monks who became so raving mad after eating the roots, that they plunged into water, imagining that they were turned into geese, and they were affected for three years with incomplete palsy and neuralgic pains.[2231] These and some other cases of the like kind, recorded by the older medical authors, must be received with reserve. Independently of other considerations, there is often no certainty that the poison was really the hemlock of modern botanists, and not some other umbelliferous vegetable.
Morbid Appearances.—In Haaf’s case the vessels of the head were much congested; and the blood must have been very fluid, for on the head being opened a quantity flowed out, which twice filled an ordinary chamber-pot. This state of the blood likewise occurred in a case which I examined here some years ago along with Dr. C. Coindet of Geneva. A hypochondriacal old woman took by advice of a neighbour two ounces of a strong infusion of hemlock leaves with the same quantity of whisky, which she swallowed in the morning fasting. She died in an hour, comatose and slightly convulsed. The vessels within the head were not particularly turgid; but the blood was everywhere remarkably fluid. Dr. Coindet subsequently found that a small portion of the infusion prevents fresh drawn blood from coagulating; but I suspect there must have been some mistake here, for a carefully prepared alcoholic extract of very great power, which was used in my experiments alluded to above, had no such effect on blood fresh drawn from rabbits and dogs. On account of this extreme fluidity of the blood, it often flows from the nose, but the skin is much marked with lividity.[2232] The fluidity of the blood is nothing more than the result of the proximate cause of death,—slowly formed asphyxia.
Another plant of the order Umbelliferæ, the water-hemlock or Cicuta virosa, possesses also great energy as a poison; and in its effects it appears to resemble considerably the hydrocyanic acid. The plant is indigenous. It is easily known from other umbelliferous species inhabiting watery places by the peculiar structure of its root-stock, which is not fleshy, but hollow, and composed of a number of large cells with transverse plates.
From a numerous set of experiments with the root of the cicuta performed by Wepfer, it appears to cause true tetanic convulsions in frequent paroxysms, and death on the third day.[2233] Simeon ascertained that the alcoholic extract of the root is very poisonous.[2234] Schubarth found that an ounce of the juice of the stems and leaves, collected after the flowers had begun to blow, produced no effect on the dog.[2235] It is probably inert, or at all events feebly poisonous in this climate, although it grows luxuriantly in many localities. I have found that twelve ounces of juice, expressed from sixteen ounces of roots in the beginning of August, merely caused some efforts to vomit, when secured in the stomach of a dog by a ligature on the gullet; that the alcoholic extract of twelve ounces of leaves gathered at the same time had no effect when introduced in the form of emulsion between the skin and muscles of the back of a rabbit; and that the alcoholic extract of two ounces of unripe seeds proved equally inert when imployed in the same way.
Symptoms in Man.—Wepfer has likewise related several instances which occurred in the human subject. Among the rest he has described the cases of eight children who ate the roots instead of parsneps. Of those who were seriously affected, one, a girl six years old, who ultimately recovered, had tetanic fits, followed by deep coma, from which it was impossible to rouse her for twenty-four hours. Two of them died. The first symptoms in these two were swelling in the pit of the stomach, vomiting or efforts to vomit, then total insensibility, with involuntary discharge of urine, and finally severe convulsions, during which the jaws were locked, the eyes rolled, and the head and spine were bent backwards, so that a child might have crept between the body and the bed-clothes. One of them died half an hour after being taken ill, and the other not long after.[2236] Mayer of Creutsburg mentions four cases, which were occasioned by the roots. One of the individuals, a child three years old, was attacked with colic, vomiting, and convulsions, and died in a few hours. The three others, the eldest of whom was six years of age, had coldness, paleness of the features, dilated immoveable pupils, violent colic, general spasms, and insensibility. The action of the heart was intermitting and the breathing oppressed. After the remains of the roots were brought up by emetics, and infusion of gall was administered, they gradually recovered. They had eaten between them no more than a single root weighing about two ounces, as they had in their possession another of that weight, which they said was not so large. This accident happened in the middle of March.[2237]
According to Guersent, poisoning with the cicuta commences with dimness of sight, giddiness, acute headache, anxiety, pain in the stomach, dryness in the throat, and vomiting.[2238]
Mertzdorff has related the particulars of the inspection of three cases which proved quickly fatal with convulsions and vomiting. Nothing remarkable seems to have been found except great gorging of the cerebral vessels.[2239]
The Œnanthe crocata of botanists, the hemlock dropwort, five-finger-root, or dead-tongue of vernacular speech in England, a species of the same family with the last two, and an abundant plant in some localities throughout this country, has usually been held one of the most virulent of European vegetables. It seems well entitled to this character in general; but climate, or some other more obscure cause, renders it inert in some situations.
It is said to be liable to be confounded with common hemlock, or Conium maculatum,—a mistake which can happen only in very ignorant hands. It has smooth, dark-green leaves, more fleshy, and much less minutely divided, than those of hemlock; it presents a purplish appearance at the joints only of the stem, and no diffused purple spots; its fruit is oblong and black, not round, rough, and light brown; and its root, instead of being single, long, tapering, and little branched, consists of from two to ten tubers, like fingers, which are white, and terminate in a few rootlets. These tubers are formed annually in summer from the flowering stem of the season, and send out flowering stems the subsequent year. During the first autumn, winter, and spring they are firm, white, and amylaceous; but in their second summer they become more pulpy, less amylaceous, and grayer. At all times they emit, when broken across, an oleo-resinous juice, which quickly becomes yellow; this juice abounds most when the plant, which is growing at their expense, is about to flower; and it abounds much more at this period in localities in the south of England, than in Scotland, especially in the neighbourhood of Edinburgh.
Brotero and some others have attempted to subdivide the species into two, the Œnanthe crocata proper, and the Œ. apiifolia. But the best authorities deny that these can be distinguished; and from what I have now seen in sundry localities, it appears to me that the distinctions pointed out by Brotero, confessedly obscure enough in themselves, are the result of differences in climate, soil, and situation.
The only analysis of this plant with which I am acquainted is one executed in 1830 by MM. Cormerais and Pihan-Dufeillay, who found in the root a resinoid matter, which adheres obstinately to the solid portion of it, and which seems to be the active ingredient.[2240] I have subjected the roots to various processes, and among the rest to that by which Geiger detected conia in hemlock, but without discovering any indication of the existence of an alkaloid. My materials, however, were not well fitted for a chemical analysis; because the œnanthe root of this neighbourhood is inert or nearly so. The whole plant contains a heavy-smelling volatile oil, which may be obtained by distillation in the usual way, and most abundantly from the ripe seeds. This oil is yellowish, viscid, and inert.