Treatise on Poisons by Sir Robert Christison
160. In twenty-four hours more the breathing became laborious and
841 words | Chapter 201
rattling, and the lips livid; and death took place near the close of the
third day. The only appearances of any note in the dead body were
general injection of the arachnoid membrane of the brain, and effusion
of frothy mucus into the bronchial ramifications.[2516] Similar to these
is the following extraordinary case which has been communicated to me by
Dr. Traill. A boy seven years of age, who was persuaded by two
miscreants to take nearly five ounces of undiluted whisky, suffered for
two days from the ordinary symptoms of excessive intoxication, which
were then immediately followed by epileptic convulsions. These continued
to recur with more or less violence, but always frequently, for two
months down to the date of the judicial investigation to which the case
gave rise. All these forms of the effects of drinking ardent spirits can
scarcely be considered as simple poisoning, but as the result of
poisoning developing a tendency to diseases of the head.
The third variety of poisoning with spirits in the second degree proves
fatal, not in itself, but by some trivial accident happening, from which
the individual cannot escape on account of his powerless insensibility.
Thus, it is no uncommon thing for persons in a state of deep
intoxication to fall down in an exposed place, where they perish from
cold, or to tumble with the face in a puddle, and so be suffocated, or
to be choked by inhaling the contents of the stomach imperfectly
vomited, or by lying in such a posture that their neck-cloth produces
strangulation. These statements are so familiar, that it is unnecessary
to illustrate them by special facts. The reader’s attention was called
to such accidents in the previous editions of this work. Two well-marked
cases of the kind have been since published by Mr. Skae.[2517]
In cases of simple poisoning in the second degree the progress of the
symptoms is on the whole remarkably uniform, gradual and uninterrupted.
But there are likewise some anomalies which it may be well to notice.
Thus, occasionally after the phenomena of ordinary intoxication have
gone on gradually increasing without having attained a very great
height, sudden lethargy supervenes at once, and may prove fatal with
singular rapidity. My colleague, Dr. Alison, has communicated to me the
particulars of a case of the kind where death took place from simple
intoxication, twenty minutes after the state of lethargy began. The
individual reached his home in a state of reeling drunkenness, but able
to speak and give an indistinct account of himself. He then became
lethargic, and died in the course of twenty minutes. On examining the
body, Dr. Alison could not discover any morbid appearance, except some
watery effusion on the surface of the brain and in the ventricles; but
the contents of the stomach had a strong smell of spirits. Instances of
such excessive rapidity, however, are rare, unless from the third form
of poisoning.—An anomaly of a different kind, of which a remarkable
example was brought judicially under my notice, is sudden supervention
of deep insurmountable stupor, without the usual precursory symptoms,
yet not till after a considerable interval subsequently to drinking. In
May, 1830, a lad of sixteen, in consequence of a bet with a
spirit-dealer, swallowed sixteen ounces of whisky in the course of ten
minutes, and, pursuant to the terms of the wager, walked up and down the
room for half an hour. He then went into the open air, apparently not at
all the worse for his feat; but in a very few minutes, while in the act
of putting his hand into his pocket to take out some money, he became so
suddenly senseless as to forget to withdraw his hand, and so insensible
that his companions could not rouse him. A surgeon, who was immediately
procured, contented himself with giving several clysters and a dose of
tartar-emetic, which did not operate; and the young man died in the
course of sixteen hours. The cause of the retardation of the symptoms
was partly perhaps that he had taken supper only an hour before drinking
the spirits, but chiefly, I presume, because the stupor was kept off for
a time by the stimulus of determination to win his bet.—Several cases
somewhat similar have been described by Dr. Ogston. In these sudden
insensibility came on while the individuals had been drinking freely for
some time, without showing any marked sign of approaching
intoxication.[2518] The cause of the postponement and sudden invasion of
the stupor does not exactly appear; but a familiar cause of its abrupt
invasion in ordinary cases of drunkenness is sudden exposure to cold.
It is impossible to fix the extremes of duration of the present form of
poisoning in fatal cases. For, on the one hand, one or other of the
accidents mentioned above may bring the case to a speedy close; and, on
the other hand, the supervention of apoplexy may protract it to several
days. The ordinary duration in fatal cases seems to be from twelve to
eighteen hours.
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