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MEDICAL
JURISPRUDENCE
FORENSIC MEDICINE
AND
TOXICOLOGY
BY
R. A. WITTHAUS, A. M., M. D.
Professor of Clieinistry , Toxicology and Medical Jurisprudence in Cornell University
AND
TRACY C. BECKER, A.B., LL.B.
Counsellor at Law,
Professor of Criminal Law and Medical Jurisprudence in the University of Buffalo
Wllb lb* (Tollaboratlon of
August Becker, Esq.; A. L. Becker, Esq.; Chas. A. Boston, Esq.;
Hon. Goodwin Brown; W. N. Bullard, M.D.; G. C. Cameron,
M.D.; J. Clifton Edgar, M.D.; Jas. Ewing, M.D.;
E. D. Fisher, M.D.; A. S. Geyser, M.D.; J. C.
Johnson, M.D.; D. S. Lamb, M.D;
H. P. LooMis, M.D.; W. B. Outten, M.D.; Roswell Park, M.D.;
J. Parmenter, M.D.; Irving C. Rosse, M.D.; E. V.
Stoddard, M.D.; George Woolsey, M.D.;
J. H. Woodward, M.D.
Stconb TEiltlon
VOLUME FOUR
NEW YORK
WILLIAM WOOD AND COMPANY
MDCCCCXI
MAY 21 1952
-^ /^ ^''^■
.n
(I
oM^\'^
Copyright, 191 i
By WILLIAM WOOD AND COMPANY
54t^rO^
Printid and Electrotypcd
by The Maple Press
York, Pa.
TABLE OF CASES REFERRED TO IN
THIS VOLUME.
Adams, Mrs., Case of, 68
Aina Sainio, Case of, 1026
Andr^, Affaire, 877
Angus, Rex v., 1097
Ashford, Mary Ann, Reg. v., 1019
Baker, Reg. v., 711
Ball, Reg. v., 799
Barlow, Reg. v., 1022
Bartlett and Dyson, Reg. v., 1151
Bateman, Mary, Rex v., 733
Belaney, Reg. v., 800
Bellemey, alias Barnett, Reg. v., 3.54,
362
Benham, Peo. v., 207, 802
Benmore, Reg. v., 717
Bennett, Peo. v., 207, 1028
Berry, Reg. v., 733
Bianchini, Affaire, 871
Bibby, Reg. v., 949
Blackburn, Case of, 1021
Blandy, Rex. v., 401, 403, 456
Bocarm^ Affaire, 29, 155, 1003,
1006
Booth, May, Case of, 1023
Boothman, Reg. v., 316
Boroughs, Reg. v., 799
Boschieter Case, 148, 1178
Bowman, State v., 1022
Bowyer, Reg. v., 922
Bradford Lozenge Case, 69, 418
Brandes-Krebs, Process, 928
Bravo Case, 354
Breband, Affaire, 711
Bridon, Affaire, 733
Brinvilliers Poisonings, 22, 733
Brockmann, Case of, 25, 77, 414
Buchanan, Peo. v., 75, 208, 871, 951,
982
Buckle, Reg. v., 249, 1018
Buchoo, Case of, 1025
Buffenbarger Case, 505
Burdock, Reg. v., 586
Burgess, Peo. v., 54, 75
Burke, Reg. v., 1019, 1056
Butterfield, Rex v., 733
Byers and Byers, Rex ik, 949
Callandine, Reg. v., 1020
Canaby, Affaire, 120, 508, 555
Canovan, Reg. v., 1027
Castaing, Affaire, 25, 29, 950
Chantrelle, Reg. v., 949, 1119, 1120
Chapman, Com. v., 474
Chesham, Reg. v., 482
Clapp, Reg. v., 736
Clauderoy, Reg. v., 1091
Coates, Emma C, Case of, 1024
Cochrane, Reg. v., 828
Cole, Case of, 441
Converse (see Freet)
Cotton, Reg. v., 77, 414
Couvelance, Affaire, 432
Cox and Fournier, State v., 208, 355,
356, 362, 367
Cream, Case of "Dr.," 78
Cream, Peo. v. (see Neill), 1023
Cronin, Reg. v., 799
Cumnock Shortbread Case, the,
1028
Daniel, Reg. v., 736
Danton, Affaire, 801
Delaporte, Affaire, 1023
Delcombre, Jeanne, Affaire, 809, 899
Deffarge, Peo. v., 75
Demme-Trilmpy, Fall, 1019
Denisty, Affaire, 230, 279, 2S7
Devereaux, Reg. v., 951
Dickman, Reg. v., 828
Dinsmore, Frank, State v., 229
IV
TABLE OF CASES.
Donellan, Rex. v., 795, 800
Dore and Spry, Reg. v., 431, 4S3
Dove, Reg. v., 1018
Druaux, Affaire, 1114, 1119, 1130
Dupuy, Affaire, 708, 711
Dutt, Empr. v., 1189
Dyer, State v., 1023
Edmttnds, Reg. v., 1020
Edwards, Reg. v., 715, 717
Eldridge, Peo. v., 474
Fisher, Reg. v., 800
Flannagan, Reg. v., 77
Fleming, Peo. v., 148, 209
Ford, Peo. v., 518, 574
Foster, Reg. v., 482
Franklin and Randall, Reg. v., 67, 578
Freeman, Reg. v., 353
Freeman, Rex v., 800, 804
Freet and Converse, State v., 1019
Fritz, Peo. v., 75
Galtie, Affaire, 555
Gaudot, Affaire, 579
Gavan, Reg. v., 329
Gaylor, Reg. v., 276
Gloeckler, Affaire, 139, 456
Goersen, Com. v., 399, 425
Gottfried, Case of, 25, 77, 414
Green, State v., 1017
Griffin, Peo. v., 1025
Grisard, Affaire, 1019
Groocock, Mrs., Case of, 1021
Gu^ho, Affaire, 711
Guy, Reg. v., 401
Hall, Reg. v., 355, 362
Halloway and Chase, State v., 1026
Hamilton, Reg. v., 949
Harbaum, Case of, 789
Harden, State v., 401
Hardmann, Reg. v., 353, 362
Hargreaves, Reg. v., 736
Harrington, Peo. v., 518
Harris, Peo. v., 75, 214, 951, 982
Hartung, Case of, 481
Hartley, Reg. v., 232
Hayden, F. E., Com. v., 461, 467
Hayden, H. H., State v., 397
Haydon, Reg. v., 328
Haynes, Reg. v., 276
Heggi, Peo. v., 75
Hendricks, State v., 1022
Hendrickson, Peo. v., 853
Henke, Case of, 416
Hennah, Reg. v., 54, 55
Hersey, Com. v., 1019
Hickman, Reg. v., 960, 981
Higbee Case, 578
Higgins, Reg. v., 77
Hodgson, Peo. v., 734
Holmes, Reg. v., 456
Hoops, Arthur F., Peo. v., 802
Horsford, Reg. v., 1027
Hoyet, Affaire, 1025
Hume, Reg. v., 715, 717
Hunter, Reg. v., 456, 478
Humphreys, Jean, Case of, 214
Hyde, State v., 65, 1029
Hyeres poisonings, 69
J. B ., Affaire, 1113
Jahn, Doctor, Case of, 922
Jarrey, Reg. v., 1019
Jennie Cramer, Case of (see Malley),
201
Jones, V. Fay, 724
Joniaux, Affaire, 951
Journy, AfTaire, 1074
Kalby, Reg. v., 733
Kavanagh, Reg. v., 949
Keefe and Turner, Reg. v., 715, 717
Kerr, State v., 1178
Kessler, Peo. v., 456
Kidder, Peo. v., 1096
King, Reg. v., 1021
Kline, Maggie, State v., 1016
Klose Case, 496
Klowsowski, Rex v., 355
Kluhn, State v., 1026
Kropf Fall, 1020
LAfosTE, Affaire, 526, 529
Lamson, Reg. v., 853, 856, 861, 862,
863
Langford, Reg. v., 1020
Lapeyre, Affaire, 711
TABLE OF CASES.
Lebkuchner, Peo. v., 75
L'H^ritier, Affaire, 801
Lichtemberg, Affaire de, 270
Linden v. d (see Swaneiiberg)
Lipski, Reg. v., 230, 272, 308
Lloyd, State v., 428
Lodge, Doctor, Case of, 938
Lofthouse, Reg. v., 447
Lustig, Peo. v., 1029
Macdonald, Reg. v., 829
Macleod, Reg. v., 950
Magoon, State v., 1021
Major, State v., 1021
Manchester Cab Mystery, 1177
Mann, Reg. v., 715, 717
Markus, Reg. v., 913
Marsh and Buzzell, State v., 456
Martin, Mary, Case of, 1023
Martini, Affaire, 1024
Massey and Ferrand, Reg. v., 1093
Masson and Coleman, Reg. v., 940
Maybrick, Reg. v., 215, 218, 426, 428,
456, 463, 467, 478, 494, 508, 518,
519, 520
McAllister, Death, and Campbell,
State «., 148, 1178
MoConkey, Reg. v., 853
McCormick, Case of, 1021
McCracken, Reg. v., 496 ■
McCraney, Peo. v., 432
McMuUen, Reg. v., 353, 356, 362
Medlicott, State v., 950
Meeker and Meeker, State v., 67, 202,
1023
Mercier, Affaire, 483
Merle, Affaire, 717
Merrihew, Peo. v., 1022
Metivier, Affaire, 639
Meyer, Peo. v., 75, 77, 355, 362, 576
Millard, Peo. v., 574
MoHneaux, Peo. v., 75, 742
Moore, Reg. v., 736, 1097
Moreau, Affaire, 708, 713
Morris, Reg. v., 829, 853
Morse, State v., 1025
Neill, Reg. V. (see Cream), 78,
1026, 1032
Newton, Reg. v., 198, 496
Nichols, Peo. v., 75
Noakea, Reg. v., 855
Northrup, Peo. v., 869
Obee-Todtmann, Case of, 456
Oldham Case, 733
Otto Case, 581
Overbury, Sir Thomas, Case of, 733
Palethorpe, Reg. v., 949
Palmer, Ann, Case of, 353, 362
Palmer, Reg. v., 135, 363, 800, 1017,
1032, 1068
Panchenko-DeLassy Case, 65
Parton, Reg. v., 1178
PasCoe, Reg. v., 1097
Pastr6-Bea ussier. Affaire, 77, 121,
508, 541
Patrick, Peo. v., 75, 137, 207, 1147
Patterson, William, Rex v., 733
Paul V. Travellers' Insurance Co., 63
Pel, Affaire, 77, 203, 414, 427
Perine, Crisfield v., 136
Peterson, Peo. v., 1189
Phares, State v., 1028
Poindron, Affaire, 279
Poirier, Affaire, 1113
Pommerais, Affaire, 1082
Pont de Beauvoisin, Affaire de, 1032
Pouchon, Affaire, 717
Pralet, Affaire, 801
Praslin, Due de. Case of, 455, 482,
526, 553
Preller-Maxwell Case, 1146
Pritchard, Reg. v., 354, 362, 366
QuENAEDBD, Affaire, 279
Ramier, Affaire, 353
Ramus, Affaire, 801
Reed, Com. v., 1025
Reger Case, 415
Reynolds, Reg. v., 711
Rhymes, Case of, 454
Rice, Case of, 1147
Richards, v. Cocking, 783
Richardson, State v., 1018
Riddle Case, 428
Rittinghausen, Affaire, 708
VI
TABLE OF CASES.
Robbins, State v., 1018
Robbins v. State, 101 S
Robinson, Case of, 783
Robinson, Com. v., 77
Rodanbosh, Reg. v., 1095
Rogers, Case of, 1146
Rouan, Affaire, 1025
Royal, Reg. v., 1114
Russel and Leny, Rex v., 454
Sagbe, State v., 447
Salisbury, Peo. v., 1019
Schmidmaier, Case of, 456, 480
Schmit, Affaire, 1119
Schultz Case, the, 1026
Sealiam, Reg. v., 736
Shann, Mattie C, State v., 139, 203,
734
Smethurst, Reg. v., 353, 362
Smith, Reg. v., 711, 740
Smith, Azenath, Reg. v., 1017
Smith, Elijah, Case of, 1023
Smith, Madeleine, Reg. v., 214, 399,
402, 416, 462, 497, 519
Smith, Mary, Rex. v., 451
Somers, Reg. v., 232, 279
Sonzogno Case, 999
Sorroghan, Reg v., 232
SoufHard, Case of, 2S, 78, 477, 485,
497
Spara, Case of, 21
Speichert Case, 504, 571
Sprague, Reg. v., 223, 868, 870
Stannard Case (see Hayden), 201
Stansfield, Reg. v., 1021
Steele, Reg. v., 870
Stephens, Peo. v., 75
Stewart and Stewart, Rex v., 949
Stickles, State v.. 1022
Stokes, Peo. v., 97, 210
Stone, Peo. j'., 950
Struth, Reg. v.. 829
Sturt, Reg. v., 410
Sutton, Jane, Case of, 829
Swanenburg, Case of, 25, 77, 414,
505
Sup6rieure de Saint Saturnin, Affaire,
690
T.^RBE DBS Sablous, Affaire, 1121
Tawell, Reg.'i)., 800
Taylor and Taylor, Reg. v., Ill
Taylor, Louisa Jane, Reg. v., 715, 717
Thomas, Peo. v., 493
Thompson, Reg. r., 800
Thormahlen, Anna, Case of, 951
Toffana, Case of, 21
Tollner, Case of, 456
Torkington, Reg. v., 949
Toulza, Affaire, 1022
Troppmann, Affaire, 801
Trumpy (see Demme)
U. S. Mux. Ace. Ix.s. Co. v. Nora
Newman, 63
Urbino de Freitas, Case of, 951
Ursinus, Case of, 25, 77, 414, 504
Vamplew, Reg. v., 1019
Vaughn and Hull, State v., 1029
Volckmer, Peo. i'., 75, 951
Vosburgh, State v., 354
Vyse, Reg. v., 1018
Wainwhight, Case of, 1014
Walker, Reg. v., 800
Walkup, Case of, 519
Walsh, Reg. v., 733
Warden, Peo. v., 1119
Waters, Reg. v., 950
Watkins, Reg. v.. 843
Weber, Affaire, 842
Welbeck, Cases at, 1104
Wharton, State !■., 209, 354, 362
Whiteling, Com. v., 11
Williams, Peo. v., 75
Williams, Reg. v., 456, 556
Wilson, Catherine, Reg. v., 232, 242
Wilson, Reg. v., 914
Winslow, Reg. v., 353, 362
Wishart, Rex v., 475, 494
Woodford, Reg. v., 949
Woodward, State v., 1027
Wooler, Reg. v., 456, 515
Woudreton, Case of, 412
Wren, Reg. v., 1029
Zw.\NziGER, Case of, 25, 77, 414,
504
CONTENTS.
PAGE
Table of Cases iii
Toxicology. R. A. Witthaus, 3
Introductory, 5
Historical, 5
Bibliographical, 30
General Toxicology, 50
Definition of Poison, 50
Causation of Poisoning, 64
Statistics of Poisonings, 71
Absorption of Poisons, 78
Distribution of Poisons, 88
Methods of Action of Corrosives and Poisons, 89
Elimination of Poisons, 108
Treatment of Poisoning, 110
Prognosis of Poisoning, 118
Evidence in Cases of Murder by Poison, 118
Evidence from the Living Body, 121
Duties of Physician in Cases of Poisoning, 127
Evidence from the Dead Body, 132
Evidence from the Presence of Poison in the Cadaver, . . 146
Post-mortem Imbibition, 199
Forensic Questions, 201
Classification of Poisons, 224
Special Toxicology, 227
Corrosives, 227
Mineral Acids, 227
Sulfuric Acid, 242
Hydrochloric Acid, 276
Nitric Acid, 293
Other Mineral Acids, . / 308
Fixed Mineral Alkahes, 314
Ammonium Hydroxid, etc., 326
The Halogens, 334
Mineral Poisons, 345
Antimonials, 345
Arsenical Poisons, 381
Elementary Arsenic, 382
vii
VUl CONTENTS.
PAGE
Hydrogen Arsenid, 387
Arsenic Trioxid, 394
Arsenical Poisoning, 410
Acute Arsenical Poisoning, 434
Chronic Arsenical Poisoning, 507
Arsenophagia, 513
Absorption, Elimination, etc., 522
Forensic Questions, 557
Arsenical Greens 577
Sulfids of Arsenic, 584
Arsenates, 586
Organic Compounds of Arsenic, 587
Analytical, 593
Phosphorus, 630
Hydrogen Phosphid, 679
Chronic Phosphorus Poisoning, 681
Metallic Poisons, 682
Barium, 682
Bismuth, 686
Chlorates, 690
Chromates, 701
Copper, 705
Lead (Acute Poisoning), 715
Mercury, 721
Acute Mercurial Poisoning, 745
Chronic Mercurial Poisoning, 771
Analytical, 773
Zinc, 782
Vegetable Poisons, 7S'J
Acids, 789
Acid of the Acetic Series, 789
Hydrocyanic Acid and Cyanic Poisons, 791
Oxalic Acid, 825
Tartaric Acid, 842
Alkaloidal Poisons, 845
Aconite and Aconitin, 847
The Atropa Group, 863
Cocain, 893
Colchicum, 910
Coniin and Coniuni 920
Other Poisonous Umbelliferous Plants, 929
Gelsemium, 935
Morphin and Opium 944
Nicotin and Tobacco, 1001
Strychnin and Nux Vomica, 1011
Veratrum, Veratin, etc 1072
CONTENTS. IX
PAGE
Glucosidal Poisons, 1080
Digitalis, etc., 1080
Miscellaneous Vegetable Poisons, 1088
Camphor, 1088
Cocculus Indicus, 1090
Croton Oil, 1093
Essential oils, 1094
Animal Poisons, 1100
Poisonous Foods, 1100
Cantharides, 1113
Synthetic Poisons, . . .• 1116
Carbon Monoxid, 1116
Chloroform, 1144
Chloral Hydrate, 1176
Phenols, 1185
Nitrobenzene, 1212
Index 1225
TOXICOLOGY.
BY
R. A. WITTHAUS, A.M., M. D.
Professor oj Chemistry, Toxicology and Medical Jurisprudence in Cornell
University; Emeritus Professor of Medical Chemistry and
Toxicology in the University of Vermont.
INTRODUCTION.
HISTORICAL.
It seems probable that the deleterious qualities of poisonous
plants and the effects of the bites of venomous reptiles must
have been recognized by prehistoric man at a time long ante-
dating the historical period. The most ancient writings which
have come down to us, if they deal with things medical, indi-
cate a knowledge of toxicology in the early civilization of Egypt
and India. Duteil' has interpreted a passage in an extremely
ancient papyrus in the Louvre as follows: "Speak not of the
name of Yao under the penalty of the peach," from which
it would be difficult to draw any other inference than that the
Egyptian priests were acquainted with the preparation of a
poisonous substance (hydrocyanic acid) from peach leaves or
kernels with which those who betrayed the secrets of the priest-
hood were destroyed. The papyrus Ebers^ also makes mention
of both mineral and vegetable poisons (lead, antimony, copper,
opium, hyoscyamus) without, however, referring to their poi-
sonous qualities.
The translations of the early Sanskrit medical writings con-
tained in the Ayur-Veda (ca. b. c. 900?) and the commentaries
thereupon (Shastras) of Charaka and Sushruta {ca. b. c. 600?)
which have been made by Wise,^ indicate an extensive knowl-
edge of poisons among the Hindus of that early period. The
Ayur-Veda contained a division treating of the administration
of antidotes for poisons, and of the prevention of the effects
of the diseases produced by mineral, vegetable, and animal poi-
sons, and by the bites of venomous serpents, insects, etc. The
'Flandin: "Tr. d. Poisons," Par., ^"Commentary on the Hindu
1846, i., 31; Hoefer, "Hist. d. 1. System of Medicine," T. A. Wise,
Chimie," Par., 1842, i., 226. Calcutta, 1845.
^ "Papyros Ebers," Joachim, Ber-
lin, 1890.
6 TOXICOLOGY — WITTHAUS.
Shastras of Charaka and Sushruta contain sections devoted to
poisons and their antidotes (kalpa, panata) in which the actions
of vegetable, animal, and mineral poisons are described,^ includ-
ing a lucid account of alcoholic intoxication, and the following,
which we quote to show that criminal poisoning was then
guarded against :
" It is necessary for the practitioner to have a knowledge of the symp-
toms of the different poisons and their antidotes. As the enemies of
the Raj^., bad women, and ungrateful servants sometimes mix poison
with food. On this account the cook should be of good family, virtu-
ous, faithful, and not covetous, nor subject to anger, pride, or laziness.
. . . The practitioner should have like qualities, with an intimate
knowledge of poisons; and should examine the food to be eaten by a
Raja in the cooking room. This should be large, airy, light, and sur-
rounded with faithful servants, and no one should be allowed to enter
unless he is first examined. ... A person who gives poison may be
recognized. He does not answer questions, or they are evasive answers ;
he speaks nonsense, rubs the great toe along the ground, and shivers;
his face is discolored; he rubs the roots of the hair with his fingers;
and he tries by every means to leave the house. The food which is
suspected should be first given to certain animals, and if they die, it
is to be avoided."
Apart from references to the venom of serpents,^ Mosaic
history contains but few allusions to poison,* but it is not
probable that the Hebrews during the Egyptian captivity failed
to acquire some knowledge of the action of poisons. The " bitter
water"* and "water of gall,"^ used by the Hebrews as an ordeal
and for punishment, must have contained some poison, at least
in those cases in which it possessed any efficacy."
The Greeks at a very early period were acquainted with the
action of poisons and venoms. Homer relates that Ulysses'
sought to obtain from Ephyra a poison (<^apjaaKov a.vSpo<l>6vov) with
which to anoint his arrows; and, according to Ovid,* the ar-
rows of Hercules were charged with the venom of the Ler-
neian serpent. It is from the use of poisons in this manner that
' Wise, I. c, pp. 391-412. * Numbers v. 17-28.
' Gen. ui. 15; Deut. xxxii. 24, 33. ' Jeremiah ix. 15.
^See "Hierobotanicon," O. Cel- ° Cf. also Mark xvi. 18.
sius, Upsala, 1745, i., 8, 78; ii., 23, '"Od.," i., 261.
119,408. «"Metam.,"ix., 158.
INTRODUCTION, 7
the word "toxicology," common to most modern languages, is
derived.' Hecate, the daughter of Perseus, is said by Diodorus
Siculus to have been skilled in the preparation of poisons; to
have discovered that called aconite,^ and to have tested the virtues
of her preparations by mixing them with the food of her guests.
Having acquired great experience in the art, she poisoned her
husband. Her daughters, Circe and Medea, also became pro-
ficient in" toxicology, and the former profited by her mother's
example, and removed her husband by the same means.* To
protect himself from the poisons and spells of Circe, Ulysses
obtained from Hermes an herb with black root and milk-white
flower, which acted as a narcotic*
In the historical period there are numerous evidences of an
early knowledge of the action of poisons among the Greeks and
neighboring nations. It is related by Plutarch^ that Alexander
the Great (b. c. 333) drank the medicine offered by his physi-
cian, Philip, and recovered, although he had been warned that
Philip had been bribed to poison him. Xenophon {ca. b. c.
400) relates that the use of poison was so frequent among the
Medes that it was an ancient custom for the cup-bearers to
taste of the wine before presenting it to the king, and that
among the Persians the children were instructed in the proper-
ties of plants that they might know which were deleterious."
Of the fifteen orations of Antiphon (born ca. b. c. 480) one was
in the matter of an accusation of poisoning.' Among the Athe-
nians an indictment for poisoning (<^ap/AaKO)i/ vel (JMpixaKiia^ ypa-<t>v)
was tried before the Areiopagus, and a malicious intent was a
necessary ingredient of the crime, for which the punishment
was death. Women appear to have been most addicted to the
crime of poisoning in the Grecian period, as they are at the
' TiloK, a bow; to|ik6s, for the ^Diodorus Siculus, "Hist.," iv.,
bow; from which Dioscorides 45.
(Alexiph., XX.) derived the name *"0d.," x., 305; v., 236. Theo-
to|ik6i' ((pdpfiaKov) to apply to the phrastus and Dioscorides consider
poison with which the barbarians this /iuXu to have been a species of
smeared their arrows. ' garlic. Pliny, " Hist. Nat.," xxv., 8.
' Whether this was the plant now ^ " Vit. Alexandri," c. 19.
known under this name or some ° "Cyropaedia," i., 3; viii., 8.
other (possibly conium) is not ' KarTiyopla (papfmKhas Kara ttjs
known. The Latin writers used the jUi/TpuiSs.
word to refer to poisonous plants in
general (Virgil, "Geor.," ii., 152).
8 TOXICOLOGY WITTHAUS.
present time. ^ The earliest works extant, treating specially of
poisons, are the "Theriaca" and " Alexipharmaca" of Nicander,
written between b. c. 185 and b. c. 135,^ which, although con-
taining much that is fabulous, set forth so wide a knowledge of
the effects of many vegetable, animal, and mineral poisons that
it is impossible to doubt that the work of Nicander was but the
expression in poetical form of information previously obtained
by an extensive experience with the agents whose effects he de-
scribes, probably by others whose writings, if such existed,
have been lost. Indeed, the "History of plants" of Theo-
phrastus,^ written about b. c. 300, contains many references to
the poisonous as well as the medicinal action of the vegetable
poisons, including most of those mentioned by Nicander.
Hemlock was used among the Greeks for the execution of
criminals, both at Athens and at Marseilles,* then a Greek
colony,^ and was the means of execution of Socrates, b. c. 339."
It is also related by Valerius Maximus^ that the senate of Mar-
seilles kept hemlock at the disposal of those who wished to de-
stroy themselves for reasons which the senate deemed to be ade-
quate. In B. c. 317 Olympias, widow of Philip of Macedon,
having captured her rival Eurydice, sent to the latter in her
prison a sword, a rope, and a cup of hemlock with orders to
choose her mode of death.'
"The Materia Medica" of Dioscorides, written in the first
century of our era,' which, with the commentary of Matthio-
' See the oration of Antiphon destroyed was in fact conium macu-
above, and Kennedy, Smith's " Die- latum was a question among the ear-
tionary of Greek and Roman An- lier toxicologists. Wepfer ("Hist,
tiquities," London, 1870, p. 895; Cicut. Aquat.," vi. Ed., Basil.,
Friedreich's " Bl. f. ger. Anthrop.," 1679, p. 5) gives a full account of
1850, i., 65; 1853, i., 40; 1854, ii., the controversy. The evidence ap-
32, 78. _ pears to be in favor of the afErma-
' Poems in hexameter verse. The tive, as is shown by Schultze :
enipioLKd of nearly a thousand lines, "Toxicologia Veterum," Halle,
and the ' Kke^KpapnaKa of more than 1788, p. 34, s. 2, and particularly by
six hundred hnes. Imbert-Gourbeyre: "La Mort de
' Ilepi tl>vTG>v ia-Topla. The best Socrate, " Paris, 1876.
editions are those of Bodteus a ' Lib. xxi., cap. 6.
Stapel, fol., Amstelod., 1644, and ' Diodorus, xix., 11; Justin., xiv.,
Schneider, 5 vols., Lips., 1818-21. 5; ^lian, V. H., xiii., 36.
" Cicuta quoque venenum est pu- » The first Greek edition, fol.,
blica Atheniensium poena invisa, Venet., 1499, ap. Aldum Manutium;
ad multa tamen usus non omittendi. the first Latin translation, attrib-
Pliny, "Hist. Nat.," XXV., 95. uted to Petrus Aponensis, fol.,
' Valerius Max., ii., 6. Colle, 1478. Of the numerous later
" Diogenes Laertius, ii. Whether editions probably the best is that of
the poison by which Socrates was Saracenus, fol., Francof., 1598.
INTRODUCTION. 9
hia^ remained the standard work upon the subject down to the
sixteenth century, contained a treatise on poisons and their
antidotes.^
The search for antidotes was probably coeval with the dis-
covery of the deleterious effects of poisons. The earliest refer-
ences to the use of counter-poisons are those contained in the
Odyssey^ and in the Shastras.* Theophrastus and Nicander also
direct what remedies shall be used to combat the effects of poisons.
It was in the first century b. c, however, that the idea of an-
tagonizing the action of one poison by another, or by habitua-
tion, was first developed. According to Galen^ Zopyrus, a
physician of Alexandria, invented an antidote which he recom-
mended to Mithridates, king of Pontus; and Celsus refers to a
similar composition which the same physician prepared for one
of the Ptolemies. The extended acquaintance of Mithridates
with the action of poisons and of their antidotes is frequently
referred to in classical literature, and it is related that when
(in B. c. 63) he wished to commit suicide, his constitution had
been so long inured to antidotes that poison had no effect upon
him and he was compelled to have a mercenary dispatch him with
his sword. ° The Mithridatic antidote is described by Celsus' as
consisting of thirty-six ingredients. As, according to Pliny,^
Pompey caused a translation of the work of Mithridates on
poisons to be made by Lenseus, it is not improbable that the
Mithridatic served as a. model for the "Theriac" of Andro-
machus, and the numerous other theriacs and alexipharmacs,
the use of which continued down to the beginning of the eigh-
teenth century.
The earliest reference to criminal poisoning in Roman his-
' First published in Italian, 1544. ^ Appian, "Mithridat.," 107-111;
Many later editions in Latin, of Dion Cass., xxxvii., 3, 11-13; Plut.,
which the most esteemed is that of "Pompey," 41; Phny, "Hist. Nat.,".
Venice, 1565, fol. xxv., 3; Gelhus, "Noct. Att.,"
= Printed as the sixth book, vepl xvii., 16. Also Martial:
Sr)Xr]Tr]plav (papix&Koiv, in the Aldine, Profecit poto Mithridates saepe
1499, 1518, Cologne, 1529, and Paris, veneno,
1549, editions; and in that of Sara- Toxica ne possent sseva nocere sibi.
cenus as separate treatises, "Alexi- 'Celsus, v., 23. Galen, "De
pharmaca" and "Theriaka." Antid.," ii., 9, says forty-four, and
= See p. 6. Pliny, "Hist. Nat.," xxix., 8, fifty-
* See p. 5. four.
^ "De Antid.," ii., 8, vol. xiv., p. « "Hist. Nat.," xxv., 3.
150. Ed. Kuhn and Celsus, v., 23,
s. 2, p. 94.
10 TOXICOLOGY — WITTHAUS.
tory was in b. c. 331, when about twenty matrons, including
Cornelia and Sergia, were surprised in the act of preparing a
poison, which they were compelled by the magistrates to drink,
and thus perished. Following this, other matrons to the num-
ber of one hundred and seventy were convicted.' In b. c. 184
the praetor was directed by the senate to investigate cases of
poisoning (de veneficiis quaerere) growing out of the baccha;-
nalian orgies, and in b. c. 180 another Hke investigation was
directed during the prevalence of a pestilence. In both a great
number of persons were convicted.'
The first legislative enactment specifically relating to the
crime of poisoning was the Lex Cornelia de Sicariis et Vene-
ficiis, passed by the dictator Sulla in b. c. 82, which continued
in force, with some modifications, until the fall of the empire.
The punishment provided was deportatio in insulam and con-
fiscation of property if the prisoner was of high rank, and ex-
posure to wild animals if of low degree. A later provision
made the law applicable to druggists (pigmentarii) who care-
lessly administered poisons, and to women who, even without
evil intent, administered poison to produce conception, if the
person to whom it was given died. Women so convicted were
punished by banishment.^ In the legislation of Justinian poi-
soning was regarded as a more heinous crime than murder by
violent means. ^
Although many of the suspected poisonings during the later
years of the Republic and the Empire mentioned in Roman
literature were undoubtedly false accusations or mere suspi-
cions, the very prevalence of the fear and imputation of poison-
ing indicates a widespread popular knowledge of the action of
poisons and readiness to use them, which is further proved to
have existed at that period by a great number of murders by
poison, the historical proof of which cannot be questioned.
Livia, the wife of Augustus, was strongly suspected of
having poisoned Marcellus, the son of Octavia, and Caius and
Lucius, the children of Julia, and of having even hastened the
death of Augustus by administration of poison in a. d. 14, to
'Livy, viii., 18; Val. Max., ii., 'Plus est hominem exstinguere
S) s. 3. veneno, quam occidere gladio. Dig.
" Livy, xxxix., 8, 38, 41; xl., 37. xlviii, 8; iv., 3.
'Marcian, Dig. 48, tit. 8, s. 3;
Inst. 4, tit. 18, s. 5.
INTRODUCTION. 11
secure the succession to her son Tiberius,' who was believed to
have compassed the death of Germanicus by poison in a. d. 19,
with the aid of Cn. Piso and his wife Plancina.^ In this con-
nection Tacitus also states that in a. d. 50 Martina, a notorious
poisoner (famosa venefica), and the favorite of Plancina, was
sent to Rome for trial, but died suddenly on her arrival at
Brundisium.' During the reign of Tiberius, Sejanus seduced
Livia, the wife of Drusus, the son of the emperor, and with her
aid and that of the physician Eudemus, caused the death of
Drusus by poison administered by Lygdus in a. d. 23. The facts
were only brought to light eight years later upon the informa-
tion of Apicata, the wife of Sejanus, supported by the confes-
sions, under torture, of Eudemus and Lygdus.*
It is stated that Caligula left a large chest filled with several
sorts of poisons, which being, at the command of Claudius,
thrown into the sea not long after the death of Caligula, the
waters were so infected thereby that there died abundance of
fish.=
Agrippina and her son Nero, aided by Locusta and Xeno-
phon, made elaborate studies in experimental toxicology upon
the human subject, and applied the knowledge so gained to the
removal of Crispus Passienus, the second husband of Agrippina,
the emperor Claudius, Domitia, and Britannicus. Locusta was
executed under Galba."
One of the most masterly of the orations of Cicero was in
defense of A. Cluentius Habitus' (b. c. 66), accused by Oppi-
anicus, son of Statius Albius, of three distinct acts of poisoning,
two of which had proved successful, of which accusation he was
acquitted. Cluentius himself had previously (b. c. 74) accused
Statius Albius of an attempt to poison him, and, it was claimed,
had secured his conviction by bribery of the judices. In his
defense Cicero also accuses Statius Albius and Sassia, the
mother, and one of the accusers of Cluentius, of having poisoned
Cluentia, a former wife of Albius, and also makes a counter-
' Dion Cass., liii., 33. « Tacitus, "Ann., " xii., 61, 66, 67;
^Tac, "Ann.," ii., 73; iii., 16; xiii., 15, 19; Suetonius, "Nero," 33;
Pliny, "Hist. Nat.," xi., 71. Dion Cass., Ix., 34; Ixiv., 3; Juv.,
'"Ann.," ii., 7; iii., 7. i., 71.
^Sueton., "Tib.," 62; Tacit., 'Pro Cluentio. See also Blair,
"Ann.," iv., 3, 8, ll. "Lectures on Rhetoric," New York,
^Platina, "Lives of the Popes," 1829, pp. 298-311.
Ed. Ryoaut, p. 2.
12 TOXICOLOGY WITTHAUS.
charge against another accuser of his client, Clodia, the wife of
Q. Met. Celer, that she had poisoned her husband, and further,
refers to a physician, Clodius, as having been employed by
Oppianicus to poison his grandmother, Dinsea.
It is rarely that the nature of the poison used is referred to
by Greek or Roman writers. The word "aconitum," as used
by Juvenal, Martial, and others, applies to any form of vege-
table poison, but in one passage of Pliny it is specially applied
to a certain plant.' C. Papirius Carbo is said to have committed
suicide by cantharides in b. c. 119, and his brother, Cn. PajDi-
rius Carbo, destroyed himself in B. c. 119 with a "solution of
vitriol" (atramentum sutorium).^ Pliny states that opium was
frequently used as a means of suicide, and cites a specific in-
stance in the case of Post. Lie. Csecina.^ The blood of the ox
is reputed as poisonous by Nicander and Dioscorides, and
.iEson was said to have been forced to kill himself by drinking
of it."* Either the account is fabulous, or, as seems more prob-
able, the poisonous quality of putrid blood was recognized, par-
ticularly as Nicander refers to "black" blood. At a much later
period (a. d. 364) the death of the Emperor Jovian was probably
the subject of the first historical reference to poisoning by car-
bon monoxid.^
That permission to commit suicide by poison was granted dur-
ing the Empire, as at Athens, is evident by the case of Euphrates,
who, having reached an advanced age, asked and obtained of
Hadrian the permission to put an end to himself by poison. °
Simulation of poisoning was not unknown arrjong the Ro-
mans, as Pliny' relates that Drusus (b. c. 91) drank goat's blood
that the pallor so produced might aid in substantiating his ac-
cusation of poisoning against his brother-in-law, Capio.
'"Hist. Nat.," xxvii., 2. This tor objecit. Hinc ilia atrox pero-
passage also refers to a method of ad- ratio ejus in digitum.
ministration which has been very ^ Schmitz, in Smith's "Diet.," i.,
rarely imitated in modern times: 610, 611.
Sed antiquorum curam diligentiam- ^ "Hist. Nat.," xx., 76.
que quis possit satis venenari, cum * Nicand., " Alexiph.," 312; Diosc,
constet omnium venenorum ocys- "Alexiph.," cap. xxv.; Diod. Sic,
simum esse aconitum, et tactis iv., 50. See also Pliny, "Hist!
quoque genitalibus fceminini sexus Nat.," xxviii., 41.
animahum eodem die inferre mor- 'Plate in Smith's "Diet.," ii.,
tem? Hoc fuit venenum, quo in- 615; Hoffmann, "Op. Omn.' " i.'
teremtas dormientes a Calpurnio 229. Gibbon, iii., 232.
Bestia uxores M. Ca;cilius accusa- » Dion Cass., Ixix., 8.
' "Hist. Nat.," xxviii., 41.
INTRODUCTION. 13
During the interval between the division of the Roman Em-
pire (a. d. 364) and the Renaissance, a period of a thousand
years, toxicological science, so far as methods of detection and
symptomatology are concerned, made no step in advance, and
the armamentarium of the poisoner was only slightly extended
by the addition of a few new forms of poisons already known,
such as white arsenic, and other chemical compounds discov-
ered by the Greek and Arabian alchemists. The history of this
period is lacking in that precision which is essential to distin-
guish between mere suspicion of poisoning in cases of sudden
death of prominent persons and deaths truly attributable to
poison. Yet there is no lack of supposed poisonings, although
less concealed methods of disposing of obnoxious persons were
more freely resorted to than during the comparatively civilized
period of the Roman Empire. An indication of the customs of the
times is to be found in the methods of termination of the reigns
of the eighty-three emperors of the East from Valens (a. d. 364)
to Constantine XII. (obiit a. d. 1453); of these, thirty-nine died
from causes presumably natural, seventeen by assassination,
four were killed in battle, two by accident, seven by poison,'
and fourteen were disposed of by confinement in monasteries.
Constantine the Great is said to have caused the death of
his son Crisp us in a. d. 326, either "by the hand of the execu-
tioner or by the more gentle operation of poison."^ Nine of the
successors of Charlemagne as emperors of the Holy Roman
Empire, anterior to the accession of the house of Austria in
143S, died from the effects of poison.^
'Constantine III., A. D. 641, by ^ Charles the Bald (II.) by a He-
his stepmother, Martina (Gibbon, brew physician, Sedecias, in 877;
"Rom. Emp.," ed. Smith, London, Otho II. at Rome in 983; Otho III.
1862, vi., 73); Leo IV., a. d. 780 by Stephanie, widow of Crescen-
(Robertson, "Hist. Christ. Church," tins, in 1002 (Robertson, I. c, ii.,
ii., 151); Constantine VII., a. d. 435); Conrad III., by Roger of Sic-
959, by his son, Romanus II., at the ily in 1152; Henry VI. by his wife
instigation of his wife Theophano, Constance, in 1197; Frederick II.
who, four years later, a. d. 963, poi- by an illegitimate son, in 1250;
soned her husband as she had his Conrad IV., according to some by
father (Smith, "Diet. Biogr.," i., orders of the Pope, according to
840; iii., 656, 657; Gibbon, I. c, vi., others his physician, John Maurus,
103, 104); Zimisces, a. d. 975 (Gib- of Salernum, administered an enema
bon, Z. c, vi., 107; Smith, "Diet.," i., containing powdered diamond and
469) ; Romanus III., a. d. 1034, by scammony, in treatment for a fever,
his wife Zoe (Gibbon, I. c, vi., 109; whereof he died in 1254; Henry VII.
Smith, " Diet.," iii., 657) ; Henry by poison administered in the
a. d. 1216 (Smith, "Diet. " ii 382). sacrament by monks at the instiga-
^ Gibbon, ii., 352. tion of Robert, King of Naples,
14 TOXICOLOGY WaTTHAUS.
Of the Popes of Rome, up to the close of Platina's history,
at the death of Paul II. in 1471, five are said to have died of
poison.* In the " Acta Sanctorum" of the Bollandists are many
references to instances of poisoning which have been collected
by Marx.^
Rosamond, widow of Albion, King of Pannonia,whose mur-
der by Helmichis she had instigated, sought to poison her
confederate, in 575, with poison in wine. He drank half, and,
feeling the effects, compelled her to drink the remainder, so
that in a few hours both came to their end.^
Childebert, King of Austrasia, was poisoned in 596, either by
his mother Brunhilde or by Fridegonde, Queen of the Franks.
The life of the latter "could be summarized in a chronological
table of assassinations by steel or poison"; the former was ac-
cused of having poisoned her grandson, Thierry, and of having
murdered ten kings or sons of kings.''
In the first years of the twelfth century Bertrade, wife of
Philip I. of France, attempted to poison her stepson, afterward
Louis VI., who escaped death by a miracle and suffered long
from the effects of the poison.^
Early in the thirteenth century King John of England is
said to have caused the death of Maud Fitzwalter-in the Tower
of London by a poisoned egg.*
The Register of the Chatelet at Paris, under date of July
22d, 1390, contains an account of the examination of one Jehan
le Porchier, accused of intent to poison the king (Charles VI.)'
Charles the Bad (II.) of Navarre is said to have been well
versed in alchemy and toxicology. Godefroy of St. Denis and
Juvenal Ursinus recite the directions given by Charles to a
in 1313 (Infessura, Diarium, ed. made to poison Eugene IV in 1432
?'"'^,'"<J*' "Corp. Hist Med. Aevi.," (Infessura, I. c, ii., 1876; Platina,"
11., 1866. Platma, "Live's of the /. c, 358.)
Popes," ed. Rycaut, p. 304); Gun- ^"Lehre von den Giften," Gott ,
tiier, poisoned by a physician of 1827, p. 38
Frankfort in 1349. (See Hoefer, = Machiavelli, "Hist. Florence,"
Biog. g6n.," passim.) ed. Bohn, p. 12
•■ '/, m° n/"^" ^Pf T^^?nf *5S?' ^: "■' ' Thierry, " R^cits M^rovigniens."
11., 419); Clement II., 1046 (Platina, = Hoefer, "Biogr g^n "• Pru-
f^-^y^'''^''?-^^^:^°}>^''^^P^,l-c., dhomme, "Crimes des Reines de
u., 550) ; Damasus II., 1048 (Robert- France," Par 1791 p 83
son, ibid.) ; Victor III 1087 (Platina » Dixon, " Her M'ajesty's Tower,"
215; Robertson, 11., 668); Benedict London, 1869, i., 46.
" )?L?--)' .-^^^^ (Infessura, /. c, ' Introduction, vol. i., xiii.
u., 1865). An attempt was also
INTRODUCTION. 15
minstrel, Woudreton, that he shall purchase "sublimed arsenic,"
which he will find in the shops of the apothecaries, and poison
the King of France (Charles VI.), his brother, and two uncles,
by mixing it with their food or drink. Woudreton was cap-
tured and executed in 1384.^
In the writings of physicians during the Middle Ages are in-
dications in varied forms showing that criminal poisoning was
certainly not a lost art. Thus Oribasius includes in the elab-
orate collection of earlier medical writers, which he prepared at
the command of Emperor Julian (a. d. 361), a chapter on poi-
sons, the brevity of which is accounted for by the statement
that the dissemination of the knowledge of the action of poisons
would be an aid to the commission of crime. ^ The same view
was not entertained by Aetius of Amida, physician to Jus-
tinian I., who wrote in the middle of the sixth century, and
described the poisons then known, chiefly those already men-
tioned by Nicander and Dioscorides, and their effects and anti-
dotes.^ The fifth book of the "de Arte medendi," of Paulus
.iEgineta {circa a. d. 650), treats in the first twenty-six
chapters of venoms and in the remaining forty of poisons,^ and
is practically a transcript of Dioscorides.
From the middle of the seventh century to the rise of the
school of Salernum in the beginning of the eleventh century,
was a period practically without contributions to medical litera-
ture by Christian writers, although several Arab physicians of
note lived in the tenth and eleventh centuries, whose works con-
tain more or less of toxicological interest, particularly with ref-
erence to substances having poisonous qualities, such as cor-
rosive sublimate and white arsenic, which had been discovered
by the Arabian and Greek alchemists. The eighth book of the
"Almansor'"^ of Rhazes {oh. 923 or 932) treats of poisons and
antidotes. Corrosive sublimate-is described as being highly poi-
sonous, while liquid mercury was found non-toxic in an experi-
' Hoefer, "Histoire de la Chimie," qui hEec doceat, causam scelestis
ex Mangin, "Poisons," p. 36. For praebebit, ut multa mala faciat
other instances of poisoning during ("Deloc. affect.," iv., 63).
this period, see Marx, "Gifte," i., => Tetrabiblion IV., serm. i., 10,
42, seq. 45-81.
^De venenis neque tutum est in- * Ed. Basil., fol., 1532, pp. 304-
definite scribere, neque memoriae 331.
hterarum commendare omnes cura- ^" Liber medicinalis Almanso-
tiones neque nocumenta, quae (juis- ris."
quis ex eis nasci dicit, siquidem
16 TOXICOLOGY — WITTHAUS.
ment upon a monkey. In the "Liber Regius of Haly Abbas'"
(06. 994) directions are given for the treatment of poisoning.
Avicenna (980-1037) wrote at length concerning poisons, their
action and antidotes. ^ His death was due to a heroic treatment
to which he subjected himself, accelerated by a mithridatic con-
taining an excess of opium. The work of Serapion the Younger
(circa 1070), which is a compilation from previous writers, con-
tains much of toxicological interest. He describes nux vomica,
but does not refer to its tetanic action, mentions the depilatory
and escharotic power of arsenic trisulfid (Galen), and discusses
the bezoar and its virtue as a universal antidote.^
Several Arabian and European medical writers during the
twelfth, thirteenth, and fourteenth centuries described the ac-
tions of poisons and antidotes; among others, Johannes Actu-
arius, Averrhoes (ob. 1206), Maimonides (ob. 1208), Nicholaus
Praepositus, and Gilbertus Anglus. A few also contributed
special treatises upon poisons; Petrus of Abano (1250-1320);
Arnaldus of Villanova (ob. 1314); Antonius Guainierius (ob.
1445), and Santis de Ardoynis (ob. 1424-26).
With the Renaissance in Italy poisoning became an art,
practised for private vengeance or cupidity, or political murder
at the procurement of states as well as individuals. During
the fifteenth century no less than fourteen editions of the " De
Venenis" of Abano were printed, the rarity of all of which is
additional testimony of their popular use.
The despot of that period " protected his bedchamber with a
picked guard, and watched his meat and drink lest they should
be poisoned," and "no one beheved in the natural death of a
prince; princes must be poignarded or poisoned" (Symonds).
Of the long list' of poisonings of prominent persons during the
fifteenth and sixteenth centuries, a few may be cited as exam-
ples: Polissena, the first wife of Francesco Sforza, and her little
girl were poisoned by her aunt; Gian Galeazzo Sforza was poi-
soned in 1494 by his uncle, Ludovico; Cardinal Ippolito di Medici
was poisoned by his brother, Alessandro, in 1535, who also
caused the death of the poet Berni by the same means in 1536;
' I'i^. iv., c. 38. _ from the intestines of herbivorous
Kanon, lib. n., iv. animals) continued in vogue as an
' " De simplicium medicamento- antidote until the beginning of the
rum historia," Venet., 1552, iv., 16; eighteenth century. (See Marx,
VI., 6; VI., 31. The bezoar (calcuh "Gifte," 210-211.
INTRODUCTION. 17
Antonio Fiziraga was poisoned at Lodi in 1402; Biordo Miche-
lotti was stabbed between the shoulders with a poisoned dagger
by his relative, the abbot of S. Pietro, in 1416; a princess of the
house of Este was poisoned by her husband in 1493 to prevent her
poisoning him; while Lucchino Visconti was plotting to murder
his wife, Isabella Fieschi, she Succeeded in poisoning him in
1349; Gian Galeazzo Visconti poisoned his uncle Bernabo in
1385; Pietro Riario, Cardinal of San Sisto, died at Rome in
1474, poisoned, it is alleged, by the Venetians; Louisa Strozzi
was killed by a corrosive poison in 1534; Ladislas, King of
Naples, died in 1414 from the effects of a poison, which a phy-
sician of Perugia had placed upon the lips of his daughter, the
king's mistress; Leo X. (Medici) died suddenly in 1521, and,
according to the testimony of physicians, by poison. The his-
torian Guicciardini, in an essay upon the form of government
to which Florence was best suited, speaks of the manner in
which tyrants should be dealt with as follows: "The one true
remedy would be to destroy and extinguish them (the tyrants)
so utterly that not a vestige should remain, and to employ for
this purpose the poignard or poison, as may be most convenient;
otherwise the least surviving spark is certain to cause trouble
and annoyance for the future."^
That political murder by poison was considered as quite legit-
imate in Italy at that time is evidenced by the contents of the
secret archives of the Council of Ten at Venice, which have
been published by Lamansky:^
The second minute in the collection, under date of May 24th, 1419, is
an agreement of the Council to a proposition of Michaletus Mudacio to
poison Sigismund, King of Hungary, for a specified reward, and that
poison shall be furnished him for the purpose. This Mudacio seems
to have played a double game with the Council, for after experiments
with alleged poisons found to be harmless, and several discussions in
the Council concerning him in 1419, 1420, and 1432, the desired end
was not attained, and Sigismund died a natural death in 1437.^ The
third entry in the record, September 23d, 1419, relates to an offer by the
'For poisonings in Italy at this dies of the Medici," (1908); and the
period, other than the Borgian, see historians of the period: MachiaveOi,
Symonds, "Renaissance in Italy," Guicciardini, Sismondi, Varclii, In-
i.; Roscoe, "Life of Leo X."; fessura.
"Histoire des Papes," Paris, 1842- ^"Secrets d'Etat de Vemse," St.
44; Corvo: "Chronicles of the House Petersburg, 1884.
of Borgia," 1901; Staley: "Trage- 'See also Lamansky, I. c, p. 159.
IV.— 2
18 TOXICOLOGY WITTHAUS.
Archbishop of Trebizonde to procure the death by poison of Marsilius
of Carrara, which was accepted and payment of fifty ducats and a
horse ordered. In 1450, December 2d, "the Council received a poison in
the shape of balls, prepared at their express order, and killing by its odor
alone, when thrown into the fire. A distinguished person, discreet
and intelligent, subject of another state, having offered his services to
poison Count Francesco Sforza,' with only the condition that the
poison should be furnished him, the Council, in view of the advantages
which the State might gain from the death of the Count, decrees that
the effects of the poison shall be previously tested upon a person con-
demned to death." The same matter was further discussed by the
Council during 1451-53, and matters seem to have been pressing in
September and November, 1453, when the last references to the project
impose the condition that it shall be executed in December. Again,
August 24th, 1464, it accepts a proposition of a Manual Sardoun, to
poison the Sultan Mahomet II. for a stated compensation.^ Under
date of November 5th, 1477, the Council records its acceptance of the
proposition of Bishop Raditch, to cause the poisoning of Sanzach and
Ismael, two Turliish generals then besieging Croya. For this service a
pecuniary compensation is agreed upon, partly in the form of a pension
"until by the intercession of the Council with the Pope, the latter shall
have given him (the bishop), a benefice." Again, January 14th,
1478-79, it accepts the proposition of one Lazarus, "the Turk," to
poison the wells from which the Pasha and his army take their water;
and orders that poison in sufficient quantity be sent him. June 27th,
1492, the Council accepts an offer of one Jacob of Venice, to poison a sea-
captain, Barbetta, who had gone over to the Turks. February 13th,
1514-15, orders are sent to the Count of Lessina to poison or otherwise
assassinate the Turk Kara-Mustapha. On December 29th, 1525, the
Council took measures to avoid awkward complications arising from the
misdirection of certain letters relating to poisoning. April 27th, 1527,
it deliberates over an offer on the part of Don Babo de Naldo to poison
the Duke of Bourbon. October 29th, 1562, the Council orders the
rectors of Zara to cause the death of a prisoner, Camillo Pecchiari, by a
poison which they sent for the purpose, and which they direct to be
given in small and repeated doses, that the death may appear to be due
to disease. March 27th, 1563, orders are sent to the Venetian agent in
Constantinople, to cause the death of a dragoman, suspected of treach-
ery, by poison. September 20th, 1564, the Council sends letters denying
that it caused the poisoning of Giordano-Orsini. May 12th, 1568, the
destruction of a wounded prisoner, by the apphcation of poison to his
wound by the barber having charge of him, is ordered. February 5th,
' Sforza died of dropsy March 8th, ' Mahomet died May 3d, 1481.
1466.
INTRODUCTION. 19
1570-71, the Council sent a chest of poison to the proveditorin Dal-
matia, with orders to poison the wells and springs from which the
enemies of the Republic take their water. At various times during
1574-86 the Council discusses the cases of two Turkish captains,
finally causing their death by poison, and sending instructions to its
representative at Constantinople to ascribe their deaths to disease.
June 3d, 1592, the Council suggests to its envoy at Constantinople, that
he poison a dragoman in his employ, whose faithfulness it doubts.
During the seventeenth century the secret archives continue to refer
frequently to the poisoning of enemies of the Republic. Indeed, as
late as December 16th, 1755, the Council finds that the poisons in its
collection are in great disorder, and orders the Inquisitors to put them
in a more safe and serviceable condition.
That the Council at an early date sought to prevent the too vulgar
use of poisons is shown by a law passed by it in 1410, in which apothe-
caries are forbidden under severe penalties to give or sell poisons to any
person without an order from the judges.'
Three recipes for the preparation of poison are preserved as
"secreta secretissima" in the archives under date of 1540-44.
One of these shows the poison to have consisted of a mixture of
corrosive sublimate, white arsenic, arsenic trisulfid, and arsenic
trichlorid, prepared by sublimation.^
Of the numerous murders committed by Pope Alexander VI.
(1492-1503) and his son, Caesar Borgia, many were by poison.
The unfortunate Zizim, or Djem, son of Mahomet II., who had
sought refuge at Rome from his brother Bajazet, was poisoned
between Rome and Naples by Alexander in 1495, for a consid-
eration of 300,000 ducats paid by the Sultan. Agnelli, bishop
of Cosenza, was poisoned in 1497 by Ctesar, who also caused
the poisoning of the Bishop of Cette, in France, 1498, and that
of his own near relative, Giovanni Borgia, in 1500. At least
five cardinals, Giambattista Orsino; Ferrera, Cardinal of Mo-
'"Nullo mode vel ingenio possit piment); "sal armonia, g. 6" (am-
dare nee vendere talem speciem monium chlorid. See Kopp, I. c,
veneni sive tossici alicui persona de iii., 237); "sal gema, g. 6" (sodium
mondo— sine buleta prediota et chlorid) ; " verde rams, g. 4 " (verdi-
licentia dominorum justiciariorum," gris). Arsenic trichlorid would be
Lamansky, I. c, p. 533. produced by the action of the
" The materials used in the first chlorids upon the compounds of
subhmation were: "Suhmado, L. arsenic. In the second subhmation
2" (corrosive suMimate) ; "arseni- "radix napello, g. 4" (aconite),
cho," g. 6; "rexegal, g. 2" (real- and "aquade ciclamina, L. 10"
gar. See Kopp, " Gesch. d. Chem.," (cyclamen europaeum).
iv., 99); "oro pimento, g. 6" (or-
20 TOXICOLOGY WITTHAUS.
dena; Michiel, Cardinal St. Angelo; and the Cardinals of
Capua and Verona, were removed by poison between 1495 and
1503, to satisfy the rapacity of Alexander. " Having sold the
scarlet to the highest bidder, he used to feed his prelate with
rich benefices. When he had fattened him sufficiently, he poi-
soned him, laid hands upon his hoards, and recommenced the
game."' Alexander himself finally fell a victim to his own
poison in 1503, and Caesar only escaped death at the same time
after a severe illness; for the Pope's butler served the poisoned
wine, intended for some wealthy cardinals, to the Pope and his
son by mistake.
Catharine di Medicis, wife of Henry II. of France (1533-89)
is said to have had in her employ a Milanese named Reni, who
served her in the double capacity of perfumer and poisoner.^
A story in the memoirs of Henri de Guise, about the middle
of the seventeenth century (1648) indicates the popular feeling
with regard to poisoning: A soldier being requested to assas-
sinate Annese, the successor of Massaniello at Naples, shrank
with horror from the suggestion, but at the same time signified
his perfect willingness to poison him.
Nor was poisoning unknown in England during the six-
teenth and seventeenth centuries. In 1531 a statute of Henry
VIII. (22 Hen. VIII., c. 9) ordered poisoners to be boiled to
death. In 1537 particular precautions were taken for the safety
of the infant Edward, Prince of Wales: "The food supplied for
the child's use was to be largely 'assayed.' His clothes were
to be washed by his own servants, and no other hand might
touch them. The material was to be submitted to all tests of
poison."^ In 1542 a young woman was boiled ahve at Smith-
field for having poisoned three families.^ On September 15th,
1613, Sir Thomas Overbury died in the Tower of London, poi-
soned by corrosive subKmate, administered in an enema at the
' Symonds, I. c, 414. As to the 1649, pp. 43, 56, 64, 65, 78, 84, 116,
Borgian poisonings see also Roscoe, 154. The fii-st edition of this work
Lifeof LeoX."; Gordon, "Livesof incorrectlyattributedtoH. Estienne,
Alexander VI. and his son Cajsar dated 1575, was pubUshed in 1574
Borgia"; Tomasi, "Vita di Cesare See also Freer, "Life of Jeanne
Borgia ; Lamansky, op. c)(.,- Goetz, d'Albert," Lond., n. d., 399, 402-
Uiss. de Mensis Pontificiorum 405.
"*'''?f°atis," Lubeck, 1715. 3 proude, " His. of Eng., " iii. 246
Discours merveiUeux de la Vie • AVriotherlevs Chronicle, ex
. . . de Catherine de Medicis," Blyth.
INTRODUCTION. 21
instigation of Robert Carr, Earl of Somerset, and his notorious
countess, both of whom were tried and convicted of the crime in
1616 and condemned to death, but escaped through the weak-
ness of James I., although their humbler instruments were
executed.^
In Italy and France during the latter part of the seventeenth
and the beginning of the eighteenth century, the use of poison
as an agent of secret murder became so common as to warrant
the violation of the secret of the confessional and the establish-
ment of special tribunals. During the pontificate of Alexander
VII., in 1659, the clergy of Rome informed the supreme pontiff
of the great number of poisonings revealed to them in the con-
fessions of young widows. An investigation led to the discov-
ery of a secret society, which met at the house of Hieronyma
Spara, who, in return for "charitj^," dispensed an "acquetta"
so graduated in potency as to cause the death of those to
whom it was administered within the period of time desired.
La Spara and thirteen of her companions were hanged, a large
number of the culprits were whipped half-naked through the
streets of Rome, and some of the highest rank were punished
with fines and banishment. The Pope caused the papers to be
brought to St. Angelo that the iniquitous secret should not be-
come known. At about the same time, but somewhat later, the
still more notorious Toffana carried on a similar traffic at Naples,
where she was arrested in 1709, but escaped to a monastery,
whence she continued to dispense Manna di San Nicola di
Bari, until she was again apprehended and executed, after
having caused the death of six hundred persons, probably in
1719, she being then about seventy years of age.^ The most
fantastic statements have been made concerning the nature of
the poison used by Spara and Toffana. The most trustworthy
' Amos, "The Great Oyer of Poi- next note) Toffana was a prisoner
soning," Lond., 1846. in Naples at least as late as 171S.
^ The Spara is said to have been If she was then seventy years of
the pupil of Toffana, as both were age she could only have been
Sicilians. If there was any relation eleven years old when La Spara
between them, however, it was was' executed. The statement of
more probably the reverse. La Keysler, that the Toffana was still
Spara was certainly executed dur- alive at Naples in 1730, is, if true,
iug the pontificate of Alexander proof positive that Toffana was the
VII., probably in 1659. From in- successor of La Spara in point of
ternal evidence in the letter of time.
Gavelli to Hoffmann (quoted in the
22
TOXICOLOGY — WITTHAUS.
contemporaneous evidence, however, is that it was an aqueous
solution of white arsenic.^ The statement of the Abb6 Gagliani
quoted and apparently favored by Beckmann,^ that it was a
mixture of opium and cantharides, is not consistent with the
further statement of the Abb6 that it was as limpid as rock
water and without taste, nor with that of Haller,^ that it was
without taste or odor. The absence of taste and odor is also in-
consistent with the supposition that it was a putrid product. On
the other hand, an aqueous solution of arsenic trioxid is odorless
and colorless and practically tasteless.
While information concerning the Spara and Toffana poi-
sonings is only to be found in fragmentary references of an un-
official character, the record of the contemporaneous poisonings
in France by the Marchioness of Brinvilliers and her accom-
plices and imitators is quite as complete as in most cases of the
present day. Indeed what would correspond to our "appeal
'Halle ("Gifthistorie," 1787, p.
80) says that it was prepared by ban-
dits from the froth of the mouths of
victims tortured to death; and
Blyth ("Poisons," p. 11), after stat-
ing that two popes, Pius HI. (ob-
1503) and Clement XIV. (ob. 1775)
between whose deaths nearly two
hundred and seventy-two years
elapsed, were both victims of Tof-
fana, advances the theory of the
formation of putrid arsenical de-
rivatives, based upon alleged facts
for which we can find no authority.
As against these fables we have the
contemporaneous statements of
Wepfer and Hoffmann: Wepfer
("De Cicuta aquatica," etc., Basil,
1679, p. 295) says that J. A. Bartho-
lin, of Turin, etc., had recently
told him that the poison with which
certain Roman (female) poisoners
had, under the impious cloak of
religion, caused much damage and
had suffered the merited punish-
ment for their crimes under Alex-
ander VII. was arsenical, and called
by them "acquetta." This clearly
refers to the poisonings of La Spara.
Fr. Hoffmann ("Med. rat.," ii., pr.
ii., c. 12, s. xix., ed. Genev., 1753,
p. 198), after referring to the
poisonings under Alexander VII.,
reproduces this letter received by
him from Garelli, the physician of
the Emperor: "Your elegant disser-
tation on the errors concerning poi-
soning recalls that slow poison with
which a famous (female) poisoner
now living in the prisons of Naples
used fatally in six hundred cases.
This is really nothing but crystal-
lized arsenic dissolved by simple
decoction in a large quantity of
water, to which cymbellaria is
added, with what object I know not.
This was communicated to me by the
Emperor, to whom the minutes of
the trial, confirmed by the confession
of the poisoner, were transmitted.
The solution was known commonly
at Naples as Aqua della Toffanina."
The dissertation referred to in the
above was first published in 1718.
Professor Wegler, of Coblenz, in
1814, said that he had in his pos-
session a bottle of the original Aqua
Toffana, which was cubical in
shape, of blue glass, with the letters
S.N. blown in the glass, hermetically
sealed, with one end drawn out to a
point and the other bent into a
hook, and filled with a perfectly
clear and transparent liquid. (Jahrb.
d. Staatsarznk., 1814, vii., 425.)
^"Hist. Inventions," ed. Bohn,
1884, i., 47-63.
^ Vorlesungen, Bern, 1784, ii.,
191.
INTRODUCTION. 23
books" in the cases of the Marchioness and one of her accom-
plices are extant.^
In 1665 two Italians, one named Exili, had associated them-
selves with a German apothecary, named Glazer, in the manu-
facture and sale of poisons at Paris. A priest, learning of the
nefarious traffic through the confessional, informed the govern-
ment, and the two Italians were lodged in the Bastile, where
one died. Glazer does not appear to have been under suspicion
at that time. At about the same time Gaudin de Sainte-Croix,
a captain of cavalry, was committed to the Bastile at the in-
stance of the civil lieutenant Dreux d'Aubray, in consequence
of an intrigue between the captain and the daughter of d'Au-
bray, the Marchioness of Brinvilliers. Exili and Sainte-Croix
were confined in the same room. At the end of a year Sainte-
Croix was liberated, after having learned the secrets of Exili
and the address of Glazer, and renewed his connection with the
Brinvilliers. Glazer and Sainte-Croix manufactured poisons
with which the Marchioness poisoned a maid-servant, her father
and two brothers, and attempted to poison her sister, with the
aid of Sainte-Croix and of his valet, Lachauss6e. They also es-
tablished a commerce in poisons, their most lucrative client
being one Reich de Penautier, who was tried for poisoning in
1673.^ Both Glazer and Sainte-Croix fell victims of their own
poisons. The apothecary became ill and died, and Sainte-
Croix, too weak to leave his dwelling, set up a furnace there
and was found dead beside it.^ After the death of Sainte-Croix
the authorities seized the contents of his laboratory, among
which were numerous poisons: corrosive sublimate, opium, an-
timony, lapis infernalis; and papers implicating the March-
ioness and Penautier. Lachauss6e was seized and executed in
1673, after having confessed to the particulars of the poisoning
of the brothers of Brinvilliers. The Marchioness escaped to
Belgium, where she was subsequently captured, brought back
' "Factum pour Dame Marie Mag- Croix, pour raison des empoisonne-
delaine d'Aubray, Marquise de ments des Sieurs d'Aubray," Am-
Brinvilliers, Accus^e, contre Dame sterdam, 1676.
Marie Therese Mangot, veusve du ^ "Factum contre Maitre Pierre-
Sieur d'Aubray, Lieutenant Civil, Louis Reich de Penautier."
Accusa trice; et Monsieur le Pro- 'It seems highly probable that
cureur-G^n6ral," Paris, 1676. 'Fac- their deaths were due to poisoning
tum du Procez extraordinairement by hydrogen arsenid.
fait k Lachauss^e, Valet de Sainte
24 TOXICOLOGY — WITTHAUS.
to Paris, tried and executed, after having confessed her crimes,
July 17th, 1676.
The execution of the Brinvilliers did not put a stop to the
poisonings, and in 1679 a special commission,' the chambre
ardente or chamhre des poisons, was appointed to try cases of
alleged poisoning, and sat, first at the Arsenal and afterward
at the Bastile, until it was discontinued in 1680. Two years
later, 1682, an edict for the punishment of poisoners was regis-
tered in the Parliament.^ The chambre ardente condemned
two fortune-tellers. La Voisin and La Vigoureux, who sold
poisons, called "succession powders," which, like that of the
Brinvilliers, consisted of corrosive sublimate. La Voisin was
burnt alive February 22d, 1680. Two priests, named Le Sage
and Guibourg, and some forty other persons were tried by the
same tribunal on charges of poisoning. Among those arraigned
before this tribunal were Franqois Henri de Montmorenci, duke
of Luxembourg; the Duchesse de Bouillon, niece of Mazarin;
the Comtesse de Soissons, mother of Prince Eugene; the Com-
tesses de Polignac and du Roure; the Comte de Soissons and the
Marquis de Feuquieres, whose prosecutions were probably due
to the political machinations of Louvois and the Montespan.^
La Voisin was and will probably remain the last "poisoner
for hire" in a civilized community,* as in the present era of
phosphorus matches, rat poisons, soothing syrups, and indis-
criminate embalming such a traffic would not be lucrative. If
the occupation of the mercenary poisoner is no more, it is, how-
ever, because the principal, since the beginning of the eighteenth
' "Memoirs sur la Bastille," Paris, iv., 376; and the Factums and Me-
1789, i., 116. moirs of the trials.
2 Pitaval, " Causes C^lSbres," i., « If we except that early manufac-
317. turer of soothing syrup, whose case
^Concerning the poisonings of is referred to by Fod6r6 ("Med.
this period, see: Flandin, "Poi- Leg.," iv., 20), who about 1770
sons," Paris, 1846, i., 100-120; "practised baby farming," and who,
Pitaval, "Causes C^l^bres," La before execution, confessed that it
Haye, 1746, i., 267-326; Memoirs was her practice to prepare the food
. . . sur la Bastille, London, 1789, of the infants confided to her with
i., 113, 115, 116, 12.5, 127, 136, 140, a decoction of poppies in place of
ui., 306; Anquetil, "Louis XIV.," ordinary water; "^ which put them
Paris, 1819, i., 215; Beckmann, loc. to sleep and prevented their crying;
cit.; Dumas, "Crimes C616bres"; soon they did not eat and perished
"Letters de Mad. de S6vign4," ed. in marasmus." Concerning profes-
1726; pp. 140, 143, 154, 158-161, sional poisoners in India at the
168-170, 196-198; "Lettres histo- present time, see Irving: Ind.
riques et galantes par Mad. de Ann. m. Sc, Calc. 1862-63 xv
C /' Cologne, 1709-11, ii., 101; 46, 1864, s. xvii., 1.
INTRODUCTION. 25
century, has found it more safe and economical to do the sinister
work himself — or herself. After a century and a quarter, dur-
ing which only isolated cases are reported, and during which
repeated poisonings by the same criminal were uncommitted
or undetected, the theatre of such crimes was transferred to
Germany. In 1803 the widow Ursinus, a "FrauGeheimrilthinn,"
in Berlin, was brought to trial and condemned to life imprison-
ment for one of at least four poisonings of which she was
guilty.^ Soon afterward, September 17th, 1811, Anna Mar-
garetha Zwanziger was executed in Bavaria to expiate the
death of one of the several victims of her sixty or seventy at-
tempts at poisoning, she having conceded before execution that
"her death would be a benefit to mankind, as it would be im-
possible for her to abstain from poisoning."^ On April 20th,
1831, Gesche Margaretha Gottfried was executed at Bremen,
having, during a criminal career of fifty years killed forty per-
sons by poison.^ The imitativeness of poisoners, so frequently
observed at the present time, was exemplified in the case of
Gesche Margaretha Brockmann, who, having read Voget's ac-
count of her namesake's career, was prompted to poison her
father, brother, sister, and child, for which she was condemned
to life imprisonment, that being the maximum penalty in Olden-
burg at the time.* In the male line the case of Dr. Castaing
in France may be cited, he having been executed for one
murder by poison, although suspected with good reason of thir-
teen besides.* These were the worthy precursors of Mary Ann
Cotton (1873), Maria Katharina Swanenburg (1883), Flannagan
and Higgins (1884), Pastre-Beaussier (1886-88), and Sarah Rob-
inson (1889). But the causes cilebres of modern times will be
sufficiently discussed in the sequel.
Previous to the ninetenth century the methods for the de-
tection of poisoning depended, so far as they were of any value,
upon the circumstances attending the administration. Apart
from these they were mere superstitions, modified only to a
slight extent, even as late as the middle of the eighteenth cen-
" Hitzig und Haring, " Neue Pi- Gesche Margarethe Gottfried," Bre-
taval," ii., 161. men, 1831.
2 Op. cit., ii., 218-255. " Vrtjrschr. f. ger. Med., 1855,
' Op. cit., ii., 256-359; Voget, vii., 300-335.
" Lebensgeschichte der Giftmorderin ' " Causes Criminelles," Paris,
1828, iv., 1-103.
26 TOXICOLOGY WITTHAUS.
tury, by the more extended knowledge of post-morten appear-
ances in the cadaver caused by disease, which followed the per-
mission to dissect the human subject.
It was believed by the Romans that the bodies of those who
were poisoned resisted fire better than those of persons who died
from natural causes, and that the heart particularly was incom-
bustible. Thus Phny' tells us that Vitellius, in his oration ac-
cusing Piso of poisoning Germanicus, used the argument that
the heart of the deceased could not be cremated; and that the
defence of Piso was that this was due to heart disease. Sueto-
nius^ mentions lividity of the body as another sign of poisoning.
Lividity of the surface and incombustibility of the heart
were recognized as evidence of poisoning even to the eighteenth
century; and Zacchias, who considers the former a reliable
sign, while stating his belief that the latter is fallacious, con-
cedes that the opposite opinion is entertained by "that very
learned man Fortunius Nattius.'"
The statements of Zacchias afford a good account of the history of
this question up to his time, and its condition at the time, and is a curi-
ous combination of ancient superstitions and glimmerings of future
developments. After devoting a section* to substantiating his opinion
that poisons, which are the causes of certain diseases, may be generated
in the body as well as introduced from without,* he discusses in three
sections (Qusest. vi., vii., viii.) the signs of the poisoning and the means
of distinction between the effects of those introduced from without and
those of such as are produced in the body (diseases) . Different poisons
cause different signs. It cannot be determined from the signs alone
whether a person has died of poison from without or from within."
But if we consider a particular case and make use of certain conditions
and conjectures, as well as of the signs, we may attain positive indica-
tion of administered poison. We may have positive knowledge that a
man was not poisoned. The signs of poisoning are divided into ante-
' "Hist. Nat.," xi., 72. name. Probably the reference is to
- "Caligula," cap. i. the work of Fortunatus Fidelio (see
'The reference to this "Nattius" vol. i., p. xv.).
is not contained in the edition of * " Quajst. Med. Leg.," lib. ii., tit.
Lips., 1630, but is found in those ii., Q. iv.
of Frankfurt, 1666 and 1688, No- ' See "Causation."
rimb., 1726, and Venice, 1737 and " The word " signs " (signa) is not
1751. We have not seen the inter- used as synonymous with "symp-
mediate editions of Amst., 1651, and toms" (symptomata) , but includes
Avignon, 1655, 1657, and 1660. We these as well as post-mortem appear-
know of no medical writer of this ances.
INTRODUCTION. 27
mortem and post-mortem. The former are derived from the condition
of the patient at the time, and the circumstances of the attack. Symp-
toms arising suddenly in a healthy person are indications of poisoning.
But various natural foods are poisonous to some persons. All poisons
have an offensive and abominable odor and a horrible taste. When
poison is taken the gullet is wounded, the mouth at the fauces is con-
stricted, there is itching, burning, and inflammation in the mouth,
etc., etc. (an account of the symptoms caused by corrosives and pow-
erful irritants). But while the symptoms of poison are usually sudden
in their appearance, they may be long delayed. Of the post-mortem
signs the most valuable is the lividity of the body,' the hair and nails
fall off easily or spontaneously, and the latter become black after
death. ^ The cadavers of those who die by poison are not eaten by wild
beasts or birds. The occurrence of froth at the mouth, and the lack of
combustibility of the heart are fallacious signs. Among the "less
safe" signs are ulcerations (or sphacelation) of the mouth, gullet,
stomach, and intestines; discolorations and coldness of the internal
organs; and coagulation of the blood in and around the heart. ^
Poisoning from without may be distinguished from auto-intoxication
by the lack of fever and the occurrence of thirst in the former. The
existence of contagion points away from poison as the cause of death.
Rapid putrefaction indicates death from internal poison, as the bodies
of poisoned persons putrefy with difficulty. The occurrence of inter-
missions indicates disease. Vomiting caused by poison is persistent.
The matters vomited are to be tested by administration to hens.
It is not astonishing that in the dawn of modern chemistry
Plenck should, in discarding these ancient superstitions, have
made the extreme statement that the only certain sign of poison-
ing is the botanical character of a vegetable poison or the chem-
ical identification of a mineral poison found in the body.*
The development of methods of medico-legal recognition of
poisoning to the point which it has reached at the present time,
' Maxime in considerations habet cadaveribus observata et minus tuta
colorem cadaveris quern primum sunt, et noa habent fortasse aliqua
citrinum apparere dicit, aut subli- eorum omniumodam veritatem.
vidum; post unius aut vero alterius . . . Tamen in cadaverum dissec-
horse spatium lividum ac nigrum tione pluries id ipsum apparet,
evaders (Qusest. vii., 30). absqus so, quod vensno fuent ex-
^ We havs known an allsged toxi- tincta (Quaest. vii., 34-37).
cological sxpert, in the year of our ^"Elsmsnta Med. st Chir. fo-
Lord 1895, to ssriously inform ths rens.," Visnnae, 1781, p. 36. Uni-
coronsr that hs was surs that a cum signum certum dati veneni est
dsath was due to poison because the notitia botanica invsnti vsnsni veg-
nails of the cadavsr had turned blus. etabilis, st analysis chemica invsnti
^ Itaqus signa haec hactenus in vsnsni mineralis.
28 TOXICOLOGY WITTHAUS.
and which we believe to be still far short of what it will attain
in the future, has followed the advances in those sciences upon
which they mainly depend, chemistry and pathology.
Of the two forms of post-mortem investigation of poisoning,
toxicological chemistry was the first to acquire a scientific foun-
dation, as chemistry, in its simpler branches, was a well-devel-
oped science half a century before the dawn of modern path-
ology. As mineral chemistry preceded organic, so the detection
and identification of mineral poisons became possible and certain
at an early date, while chemical proof of the presence of at least
some of the vegetable and organic poisons is even at the present
time unattainable by the means at our disposal.
In the history of toxicological chemistry six events may be
cited as marking important stages in the development of the
science: 1st. The first practical application of the previously ob-
served properties of hydrogen arsenid to the detection of arsenic
by James M. Marsh, in 1836,' whose method, in a greatly modi-
fied and improved form, still remains the most delicate and re-
liable test for arsenic. 2nd. In 1839 Orfila extracted notable
quantities of arsenic from the liver, spleen, kidneys, heart, and
muscle of the assassin-suicide Soufflard. This was the first in-
stance of the extraction of absorbed arsenic from the human
cadaver, previous analyses having been confined to the alimen-
tary canal. ^ 3d. In 1844^ Fresenius and von Babo devised a
scheme for the sytematic search for all mineral poisons, which
' "Description of a New Process length arsenic was deposited on its
of Separating Small Quantities of walls (J. of Nat. Phil., Chem., etc.,
Arsenic from Substances with which 2 Ser., i., 1802-3). Seriillas in 1821
it is Mixed" (Edinb. New Philos. proposed to utilize the decomposi-
J.,Oct., 1836, pp. 229-236). Scheele tion of the compound of hydrogen
had, as early as 1775, obtained a and arsenic, obtained by the action
gaseous compound from zinc and of water on an alloy of arsenic,
arsenic, which he found to be com- antimony, and potassium, to detect
bustible, and to deposit elemen- small quantities of arsenic in cases
tary arsenic [arzenikkonig] on the of suspected poisoning (J. d. Phys.,
walls of the vessel in which it was etc., 1821, xcv., 154). Marsh was,
burnt ("Phys. u. chem. Werke," however, the first to make the
Berlin, 1793, ii., 136-137; "Kongl. reaction practically available, and
Svensk. Vet. Ak. Handl,, " 1775, to suggest a simple form of appar-
XXX VI., 265-294). In 1803Tromms- atus, which has been subsequently
dorff was at the edge of the dis- greatly perfected,
covery and found that arsenical ^ M^m. Ac. roy. M^d., 1840, viii.,
hydrogen was evolved by the action 376-422.
of dilute sulfuric acid on arsenical ' Ann. d. Ch. u. Ph., 1844, xlix.,
zinc, and that when the gas was 308.
passed through a tube of sufficient
INTRODUCTION. 29
in a slightly modified form is still the best method, save in ex-
ceptional cases where certain poisons may be left out of consid-
eration. 4th. The separation of the vegetable alkaloids from
medicinal and poisonous plants, beginning with the investiga-
tion of opium by Serttirner in 1805, opened up a new field in
toxicology as in materia medica. The earliest case of death
from the administration of a vegetable alkaloid was that of C.
Auguste Ballet, who was poisoned at St. Claud May 29th, 1823,
by his relative and physician Castaing, who was convicted,
mainly on moral evidence, and executed. 5th. In connection
with the investigation of the cause of death of Gustave Fou-
gnies, poisoned by his brother-in-law, the Count Bocarm6, in
1850, by the forcible administration of nicotin, Stas devised a
process for the separation of alkaloidal poisons from the cadaver,
which,- in a more or less modified form, is that still in use.'
6th. In 1874 Selmi showed that the substance, supposed upon
an insufficient analj'sis to be morphin, which had been ex-
tracted from the cadaver of the widow Sonzogno, of Cremona,
after thirteen clays' burial, was really not mor2Dhin, but a pu-
trid product, a ptomain or cadaveric alkaloid.^
The history of the development of the pathology of poison-
ing may in one sense be said to be that of pathology itself,
for one of the most important applications of pathology, both
gross and microscopic, to toxicology is in the determination of
the existence or absence of so-called natural causes of death.
So far as positive evidence of poisoning from post-mortem ap-
pearances is concerned, the history of toxicological pathology
remains to be made. While little or no conclusive evidence of
the action of the true poisons can be obtained from the observa-
tion of gross appearances, there is good reason to hope that the
investigations of microscopic changes caused by the action of
toxic agents, which have been but recently begun, may in the
near future afford the means of solving some questions which
are now unanswerable.
" Bull. Ac. roy. d. m^d. d. Belg., ^ See Ptomains, in the division
Bruxelles, 1851-52, xi., 202-312. of Special Toxicology.
30 TOXICOLOGY WITTHAUS.
BIBLIOGRAPHICAL.'
A. WORKS EXCLUSIVELY TOXICOLOGICAL.
I. Printed Since 1850.
AccETTELLA, N. : Proiituario di tossicologia, 8vo, Torino, 1878.
Agnolesi, p.: Vade mecum di tossicologia, 32mo, Napoli, 1881.
Ahlbs: Unsere wichtigeren Giftgewachse, 2 pts., fol., col. pi., Stuttgart,
1874-6.
AuTENRiETH, W. : Kurzc Anleitung zur Auffindung der Gifte, etc., 8vo,
Freiburg i. B., 1892; 4te Aufl., Tiibing. and Leipzig, 1909. Also:
Transl. Wahren, H. H., 8vo, Phila., 1905.
Bandlin, 0. ; Die Gifte u. ihre Gegengifte, 12mo, 3 v., Basel, 1869-73.
Barillot, E. : Traits de chimie legale, etc., 8vo, Paris, 1894.
Baumert, G.: Lehrbuch d. gerichtlichen Chemie, Svo, Braunschweig,
1889-93. 2te Aufl., 2 Bde., 1906.
Bellini, R. : Delia importanza degli studi tossicologici, etc., Svo, Pisa,
1860.
Lezioni sperimentali di tossicologia, etc., 12mo, Firenze, 1865.
Manuale di tossicologia, Svo, Pisa, 1878.
Benoit, S. : De rempoisonnement criminel, etc., 8vo, Paris, 1888.
Bernard, C. : Legons sur les effets des substances toxiques, etc., 8vo,
Paris, 1857.
Blyth, a. W.: Poisons, etc., Svo, London, 1884; New York, 1SS5. 4th
Ed., London, 1906.
Boecker, F. W. : Die Vergiftungen, etc., Svo, Iserlohn, 1857.
Bonnal: Legons sur rempoisonnement, Bordeaux, 1871.
Brouardel, p.: Les empoisonnements, etc., Svo, Paris, 1902.
■ Les intoxications, Svo, Paris, 1904.
Brouardel, P., and Ogiee, J. : Le laboratoire de toxicologic, Svo, Paris,
1S91.
Browne, G. L., and Stewart, C. S. : Reports of Trials for Murder by
Poisoning, Svo, London, 1883.
Brundage, a. H.": Manual of Toxicology, 12mo, New York, 1902.
Sixth Ed., 1908.
Carnot, p. (et al.) : Intoxications, Svo, Paris, 1907.
Chandelon, T. : Trait6 de toxicologie, etc., Svo, Liege, 1888.
' Theses, dissertations, and arti- "Washington, 16 vols., 4to, 1880-
cles in medical and other journals 1895; Second Series, 1896-1909,
are not included. For these, as well i-xiv, and to the Index Medicus.
as for quite complete bibhographies Partial bibliographies of individual
of individual poisons, the reader is poisons will be found in the division
referred to the Index Catalogue of of Special Toxicology,
the Library of the Surgeon-General,
BIBLIOGRAPHICAL. 31
Chapuis, a.: Precis de toxicologie, 16mo, Paris, 1882. Deuxieme ed.,
16mo, Paris, 1889.
Chevallier, a. : Traits de toxicologie, etc., Paris, 1868.
Chiaja, S.: Enchiridio di tossicologia, etc., Napoli, n. d. Ed. terz.,
Napoli, 1858 (II.).
CouTANCE, A. : Empoisoneurs — Empoisonn(Ss, etc., 8vo, Paris, 1888.
Cracau, G. N. B. : Gift und Gegengift., 32mo, Leipzig, 1887.
Ceosby, T. R. : Chart of Poisons, fol.; n. p., n. d.
Dragendoeff, G. : Die gerichtlich-cliemische Ermittelung der Gifte, etc.,
8vo. St. Petersburg, 1868. Zweite Aufiage, 8vo, St. Petersburg,
1876. Dritte Aufl., 8vo, Gottingen, 1888. Vierte Aufl., 8vo,
Gottingen, 1895.
Id.oj). Trad. del'Allemand par E.Ritter,8vo, Paris, 1873. Deu-
zieme ed., trad. p. L. Gautier, 1886.
DuFLOs, A. : Priifung chemischer Gifte, etc., 8vo, Breslau, 1867.
Handbuch der angewandten gericlitlich-cheijiischen Analyse der
chemischen Gifte, 8vo, Breslau, 1873 (II.).
DwiGHT, E. D. : Toxicology, 12mo, Phila. and N. Y., 1904.
Dyrenfurth, M. : Die Gifte und Gegengifte, Berlin, 1879.
Eberle, J. J. : Notes on Toxicology, etc., 12mo, Easingwold, 1876.
Fabbri, a.: Del modo di riconoscere i principali avvelenamenti, 8vo,
Firenze, 1851.
Falck, F. a. : Lehrbuch d. praktischen Toxikologie, 8vo, Stuttgart,
1880 (II.).
Feeearis, C. : Veleni ed Avvelenamenti, 16mo, Milano, 1897.
FiRGAU, F. : Gifte, etc., 8vo, Berlin, 1901.
Fowzes-Diacon: Traite de Toxicologie, 8vo, Paris, 1903.
Frobhner, E. : Lehrbuch der Toxikologie fiir Thierarzte, 8vo, Stuttgart,
1890.
Gadamer, J., Herz, W., and Gaebel, G. O. : Lehrbuch der chemischen
Toxicologie, 8vo., Gottingen, 1909.
Galtier, C. P. : Traits de toxicologie g6nerale, etc., 8vo, Paris, 1855.
Traits de toxicologie mSdicale, etc., 2 v., 8vo, Paris, 1855 (II.).
Gauthiee, V. : Manuale di tossicologia, etc., Svo, Milano, 1898.
GeORGANTAS, a. D. : M^SoSos Trphs ivlxvevavv driXrjT-nploip, io\., ''Ev'Aeijvais,
1876.
GuERiN, G. : Traits pratique . . . de recherches toxicologiques, Svo,
Paris, 1893.
V. Hasselt, a. W. M: Handleiding der vergiftleer, etc., 2 v., 8vo,
Utrecht, 1850-54.
Handbuch der Giftlehre, etc., bearb. v. G. B. Henkel, 2 Th., 8vo,
Braunschweig, 1862.
Helwig, a.: Das Mikroscop in der Toxicologie, 8vo, Wiesbaden, 1864;
also 8vo, 16 pi., Mainz, 1865.
32 TOXICOLOGY WITTHAUS.
Hendess, H. : AUgemeine Giftlehre, 8vo, Berlin, 1880.
Hermann, L. : Lehrbuch der experimentellen Toxicologie, 8vo, Berlin,
1874.
Hildebrandt, H.: Kompendium der Toxikologie, 8vo, Freiburg, 1893.
HoH, T.: Gift und Kontagium, etc., 8vo, Leipzig, 1862.
HoRSLEY, J.: The Toxicologist's Guide, etc., 12mo, London, 1866.
Huart, L. : Des empoisonnements, 12mo, Louvain, 1895.
HuGOUNENQ, L. : Traite des poisons, etc., 8vo, Paris, 1890.
HusEMANN, Th. and A. : Handbuch der Toxicologie, etc., 8vo, Berlin,
1862. Supplement-band, 8vo, Berlin, 1867.
Jacob, J. : Poisons et Contrepoisons, Paris, 1877.
Joannes, J. G. : 'ETxeipiSioi/ to^iko^ojlos, 8vo, 'Ad-qvais, 1869.
VON JuvALTA, F.: Vergiftungen w. in d. Jahren 1884-1894 a. d. Ziir-
icher med. Kl. beobachtet wurden, 8vo, Zurich, 190.5.
KioNKA, H. : Grundriss der Toxikologie, 8vo, Leipzig, 1901.
Kippenbergbr, C. : Grundlagen ftir den Nachweis von Giftstoffen, 8vo,
Berlin, 1897.
Klein, J.: Elemente der forensisch-chemischen Analyse, 16mo, Ham-
burg u. Leipzig, 1890.
Kg BERT, R. : Kompendium der praktischen Toxikologie, 8vo, Leipzig,
1884. Zweite Aufl., 8vo, Stuttgart, 1887. Dritte Aufl., 8vo, Stutt-
gart, 1894. Vierte Aufl., 1903. Also transl. Friedburg, J. H., Svo,
New York, 1897.
Lehrbuch der Intoxicationen, 8vo, Stuttgart, 1893. 2te Aufl.,
Bd. I, 1903, Bd. II, 1906.
Krattbr, J. : Beitriige zu der Lehre von den Vergiftungen, Leipzig,
1906.
KuNKEL, A. J. : Handbuch der Toxikologie, 2 vols., Svo, Jena, 1899,
1901.
KuPFERSCHLAEGER, S. : Elements de chimie toxicologique, etc., 8vo,
Liege et Bruxelles, 1879.
Lewin, G. : Toxikologische Tabellen, etc., 8vo, Berlin, 1856.
Lewin, L. : Lehrbuch der Toxicologie, 8vo, Wien, 1885. 2te Aufl. 1897;
also: Trad. p. S. Pouchet, Paris, Svo, 1903.
Lewin, L., and Guillery, H. : AVirk. v. Arzneim. u. Giften a. d. Auge,
2 vols. Svo, Berl., 1905.
Liebermann, L. : Anleitung zur chemischen Untersuchung, etc., Svo,
Stuttgart, 1877. Zweite Aufl., Svo, Stuttgart, 1S83.
Lindenmayer, J.: Die Vergiftungen, etc. [tables], 12mo, Wien,
1898.
LoEW, O. : Ein natiirliches System der Giftwirkung, Svo, Miinchen, 1893.
Lopez, Arrojo L. : Toxicologia chnica, 2d ed., Svo, Madrid, 1889.
Lopez, Duenas S., and Lopez-Giron, J.: Resumen general de venenos,
etc., foL, Madrid, 1872.
BIBLIOGRAPHICAL. 33
LoRiNSER, F. W. : Schwamme, 8vo, and fol. atl. col. pi., 4te Aufl.,
Wien, 1889.
LucHiNi, A. : Chimica applicata alia tossicologia, 8vo, Napoli, 1888.
LuDWiG, E. : Medicinische Chemie, 8vo, Wien u. Leipzig, 1885. Zweite
Aufl., 1895.
Chemie und Rechtspflege, 8vo, Wien, 1892.
DE Macbdo Pinto, J. F.: Toxicologia judicial e legislativa, etc., 8vo,
Coimbra, 1860.
Mangin, a. : Les poisons, 8vo, Tours, 1869.
Masselmann, G., and Hebrant, G. : Precis de toxicologie v^t^rinaire,
8vo, Bruxelles, 1895.
Mata, p. : Compendio de toxicologia, etc., ed. 3, Madrid, 1857. Ed.
5, Madrid, 1875.
Meister, J. C. F. : Leitfaden zu Vorlesungen iiber Gifte, etc., 8vo,
Breslau, 1856.
MoHR, F.-: Chemische Toxicologie, etc., 8vo, Braunschweig, 1874.
Toxicologie chimique, trad. p. L. Gautier, 8vo, Paris, 1875.
Monperranti, R.: Manuele pratiche dei ricerche tossicologiche, 8vo,
Napoli, 1872.
de Montgarny, H. : Essai de toxicologie, etc., 8vo, Paris, 1878.
MucciOLi, A.: Tossicologia moderna, 8vo, Roma, 1895.
Murrbll, W. : What to do in cases of poisoning, 10th ed., 24mo,
London, 1907.
Naquet, a. : Precis de chimie legale, 16mo, Paris, 1872.
Legal Chemistry. Transl. by J. P. Battershall, 16mo, New
York, 1884.
Ogier, J. : Traits de chimie toxicologique, 8vo, Paris, 1899.
Obfila, p. [M. J. B.]: Traite de toxicologie, cinqui^me ed., 2 vol., 8vo,
Paris, 1852 (II.).
Legons de toxicologie, 8vo, Paris, 1858.
Zwolf 'Vorlesungen tiber die Lehre von den Vergiftungen, etc.,
Deutsch V. Handel, 8vo, Weimar, 1858.
Lehrbuch der Toxicologie, a. d. franz. m. Zusatz. v. G. Krupp, 2
Th., 8vo, Braunschweig, 1852-53.
Otto, F. J.: Anleitung zur Ausmittelung der Gifte, etc., 8vo, Braun-
schweig, 1856. Zweite Aufl., 8vo, Braunschweig, 1857. Dritte
Aufl., 8vo, Braunschweig, 1867. Vierte Aufl., nach dem Tode des
Verfassers herg. v. R. Otto, 8vo, Braunschweig, 1870. Fiinfte
Aufl., 8vo, Braunschweig, 1875. Sechste Aufl., 8vo, Braunschweig,
1884. Zweiter Abdruck, 1892.
— On the Detection of Poisons. Notes by Prof. W. Elderhorst, 8vo,
London, 1857, New York, 1857.
Instruction sur la recherche des poisons, trad, de la 46me ed.
all. par G. E. Strohl, 8vo, Paris, 1872.
IV— 3
34 TOXICOLOGY WITTHAUS.
Pascal, N.: Empoisonnements, 8vo, Paris, 1871.
Pelikan, E. : Beitrage zur gerichtlichen Medicin, etc., 8vo, Wlirzburg,
1858.
Poison (the) Register, etc., 3d ed., 12mo, New York, 1891.
V. Praag, Leonides u. Opuijeda: Leerbock voor practische Giftleer,
2 Th., 8vo, Utrecht, 1871.'
Rabuteau, a. p. a. : Elements de toxicologie, etc., 12mo, Paris, 1873.
Rabuteau and Bourgouin, E. : Elements de toxicologie, etc., 2eme ed.,
8vo, Paris, n. d. [1887.]
Reale, N. : Lezioni di chimica farmaceutica e tossicologica, 8vo, Napoli,
1877.
Reese, J. J. : A Manual of Toxicology, etc., 8vo, Philadelphia, 1874.
Ricci, A. : Prontuario di tossicologia clinica, 8vo, Milano, 1882.
Riley, C. il. : Toxicology, 12mo, St. Louis, 1902, 3d ed., 1906.
DE RocHEBEUNE, A. T. : Toxicologic africaine, etc., 8vo, Paris, 1896.
RossMAESSLER, F. A. : Toxicologie, 8vo, Wien and Leipzig, 1908.
Sainz y Rgzas, J. A. : Tratado de toxicologia, etc., 2 ed., 12mo, Zara-
goza, 1874.
Savtschenko, p. : Atlas des poissons veneneux, fol., col. pi., St. Peters-
burg, 1886.
Sbiriziolo, M, : Trattato . . . di tossicologia, etc., 2 vols., 8vo, Napoli,
1885.
Vade mecum degli avvelenamenti, etc., 16mo, Napoli, 1888.
ScHMiD, W. : Anleitung zur . . . Untersuchungen fiir Staatschemiker,
8vo, Zurich, 1868.
Schmidt, G. A. : Alfabetisk ordnet Forteguelse over Gifte og Modgifte,
8vo, Kjobenh., 1883.
Schneider, F. C. : Die gerichthche Chemie, etc., Svo, Wien, 1852.
Schneider, K.F. R. : Deutsches Gif tbuch, 2dAufl., Svo, Wittenberg, 1861.
Selmi, F. : Studi di Tossicologia chimica, 8vo, Bologna, 1871.
Sgnnenschein, F. L. : Handbuch der gerichtlichen Chemie, 8vo, Berlin,
1869. Zweite Aufl., neu bearb. v. A. Classen, 8vo, Berlin, 1881.
Handbook der geregtelijke scheikunde, etc., door. J. F. Snyder,
Svo, Amsterdam, 1872.
Spica, p.: Chimica medico-farmaceutica, etc., Svo, Peltre, 1892.
SupiNO, R. : Veleni e contra vveleni, 12mo, Milano [1892].
TAKAYAiLt, M.: Beitrage zur Toxikologie, etc., Svo, Stuttgart, 1905.
Tanner, T. H. : Memoranda on Poisons, 3d ed., ISmo, London, 1872.
4th Amer. ed., Phila., 1S79. 6th Am. ed., rev. by H. Leffmann,
Phila., ISSS. 7th Am. ed., rev. by J. J. Reese, Phila., 1S92.
Tardieu, a., and Roussin, Z. : Etude medico-legale et clinique sur I'em-
poisonnement, Svo, Paris, 1867. Deuzieme ed., Svo, Paris, 1875.
Die Vergiftungen, etc., Deutsch von F. AV. Thiele u. H. Ludwig,
Svo, Erlangen, ISGS.
BIBLIOGRAPHICAL. 35
Tayloe, a. S. : On Poisons, etc., 2d ed., 12mo, London, 1859. 3d ed.,
12mo, London, 1875. Edited, with notes and additions, by R. E.
Griffith, 8vo, Phila., 1848. 3d Amer. ed., 8vo, Phila., 1875.
• — ■ Die Gifte, etc., Uebersetzt v. R. Seydeler, 3 Bd., 8vo, Coin,
1862-63.
Trousseau, A., and Reveil, P. O. : Traite de I'art de formuler . . . ter-
mini par un abreg^ de toxicologic, 2eme ed., 12mo, Paris, 1859.
Also: English transl., Ed. J. B. Nevins, 12mo, London, 1852.
Compendio di tossicologia, Trad, da P. Pepere, 12mo, Napoli, 1864.
Valentini, N.: Manuale di chimica legale (Tossicologia), 8vo, Milano,
1902.
Valenti y Viro, I. : Tratado elemental de toxicologia, tec, 8vo, Barce-
lona, 1877.
--. — Atlas de micro-quimica, etc., 4to, Barcelona, 1878.
Vauthier, J. Z. F. : Les poisons, etc., Svo, Bruxelles, 1880.
ViBERT, Ch.: Precis de toxicologie, Svo, Paris, 1900. 7eme ^d., 1908.
ViTALi, D.: Manuale di chimica tossicologica, 8vo, Milano, 1893.
Werber, a. : Lehrbuch der praktischen Toxikologie, 8vo, Erlan'gen,
1869.
Leerbock v. d. pract. vergiftleer. Bew. d. J. L. v. Praag en R. J.
Opuijrda, Svo, Utrecht, 1878.
WiNCKLER, E. : Memoranda der gerichtlich-chemischen Priifung auf
Gifte, 12mo, Weimar, 1852.
WoRMLEY, T. G. : Micro-chemistry of Poisons, etc., Svo, 13 pi., New
York, 1867. 2d ed., Svo, 17 pi., Phila., 1885.
Wretland, E. W. : Forgiftningar och deras behandling, Svo, Stockholm,
[1903].
V. Wyss, H. : Kurzes Lehrbuch der Toxicologie, etc., Svo, Leipzig u.
Wien, 1895.
Yamasaki, Kensu: Mada K. Katai, 12mo, Tokio, 1894.
II. Between 1700 and 1850.
Ackermann, J. F. : De venenorum actione . . . 4to, Kiel, 17S2.
Addison, T., and Morgan, J.: An Essay on the Operation of Poisonous
Agents, etc., Svo, London, 1829.
Anglada, J. : Traite de toxicologie, etc., Svo, Paris, 1835. 12mo,
Bruxelles, 1837.
Artus, W. : Anleitung zur Auffindung der ilineralgifte, Svo, Leipzig,
1843.
Attumonelli, M. : Trattado de' Veleni, etc., 2 v., 4to, Napoli, 1785.
AuGE, A. : Table toxicologique, etc., n. p., n. d.
Baigneres, J. B. : An post-mortem physica veneni certitude difficile
comparanda? 4to, Paris, 1777.
36 TOXICOLOGY — WITTHAUS.
Babonio, G. : Notizie per servire alia storia de' veneni, in Oposcoli
scelti . . . 4to, Milano, 1787.
Barsb, J. : Manuel de la cour d'assises dans les questions d'empoisonne-
ment, 8vo, Paris, 1845.
Berlin, N. J. : Nachricht die gewohnlichen Gifts chemisch zu entdecken,
8vo, Stockholm, 1845.
Bertrand, C. a. H. a.: Manuel mMico-l^gale des poisons, etc., 8vo,
Paris, 1817.
Billard: Considerations medico legales sur les empoisonnements
par les irritants. 4to, Paris, 1821.
Bischoff: Vergiftungen . . . 8vo, Wien, 2d ed., 1846.
BoERMOE, R. : De venenis praecipue vero patriae, 4to, Groeningen,
1816.
■ VoUstaendiges Giftbuch . . . 8vo, Sondershausen, 1815.
Bosius, E. S. : De diagnosi veneni ingesti et sponte in corpore geniti,
4to, Leipzig, 1774.
Brandt, Phoebus and Ratzenbitrg: Deutschland's Giftgewachse, 2
vols, fol., col. pL, Berlin, 1834-38.
Browne, L. : Physical experiments upon brutes, 8vo, London, 1747.
Buchner, a. : Toxikologie, etc., 8vo, Ntirnberg, 1822, 2te Aufl., 8vo,
Nurnberg, 1827.
BuECHNER, A. E. : De venenis eorumque diverso agendi modo, 4to,
Halle, 1756.
Camerarius, E. : De venenorum dijudicatione, 4to, Tubingen, 1725.
Cartheuser, J. F. : De venenis eorumque signis . . . 4to, Francfort-
a. O., 1741.
Chansarel: Observations sur diverses substances veneneuses, 8vo, ■
Bordeaux, 1807.
Chaussier, H. : Contre-poisons . . . 8vo,Paiis, 36meed.,1819; 4^me ed.,
1824.
Chatin, G. a. : Recherches et considerations sur quelques principes de
la toxicologie, 4to, Paris, 1844.
D. Chiaje, S.: Enchiridio di tossicologia, etc., 8vo, Napoli, 1835.
Christian: Abhandling tiber die Gifte, Weimar, 1831.
Christison, R. : A Treatise on Poisons, etc., 8vo, Edinburgh, 1829. 2d
ed., 8vo., Edinburgh, 1832. 3d ed., 8vo, Edinburgh, 1836. 4th
ed., 8vo, Edinburgh, 1845. 1st Am. ed., 8vo, Phila., 1845.
• Abhandlung iiber die Gifte, 8vo, Weimar, 1831, 1833.
Cooke, J. : A Treatise on Poisons, etc., 8vo, London, 1770.
Coppens, B. B. : De substantiis venenatis . . . Svo, Louvain, 1777.
CosTiLL, O. H. : A Practical Treatise on Poisons, etc., 12mo, Phila 1848 •
Phila., 1864.
CouRTEN, W. : Experiments and observations on the effects of several
sorts of poisons on animals . . . 4to, London, 1712.
BIBLIOGRAPHICAL. 37
Dalaus, C. G. : Bemerkungen . . . iiber Gifte und Gegengifte, 8vo,
Spire, 1781.
DoELTZ, G. O. : Nova experimenta circa quaedam venena . . . 8vo,
Altorf, 1793.
DucACHET, H. W. : An inaugural essay on the action of poisons, 8vo,
New York, 1817.
DucATEL, J. T. : Manual of Practical Toxicology [condensed from Chris-
tison], 8vo, Baltimore, 1833.
DuFLOS, A. : Pharmakologische Chemie, etc., Svo, Breslau, 1842.
Lehre v. d. chem. Arzneim. u. Giften, Svo, Breslau, 1842.
• Die chemische Heilmittel und Gifte, etc., Breslau, 1839.
Duval, M. : Sur la toxicologie, 4to, Paris, 1806.
DzoNDi, K. H. : Ueber Kontagion, Miasmen und Gifte, 8vo, Leipzig,
1822.
Erndl, C. H. : Diss, ex veneno salus, 4to, Leipzig, 1701.
Ettmulleb, M. E. : Programma ad Diss. Bosii . . . 4to, Leipzig, 1729.
Fischer, D. J. B.: Assertiones de venenis, Svo, Prague, 1770.
Flandin, C.: Traite des poisons, etc., 3 vol., Svo, Paris, 1846-53.
FoNTANA, F. : Traits sur le venin de la vipere, sur les poisons am^ricains,
sur le laurier-cerise, at sur quelques autres poisons v^g^taux, etc.,
2 vol., 4to, Florence, 1781 ; Germ, ed., 4to, Berlin, 1787.
Frank, J. : Handbuch der Toxicologie, Svo, Wien, ISOO. 2te Aufl., Svo,
Wien, 1803.
Manuel de toxicologie, etc.. Trad. . . . par. L. H. J. Vrancken,
Svo, Anvers, An xi. [1803].
— ■ Manuale di tossicologia, etc., Trad. . . . di G. Mathey, Svo,
Milano, 1S09.
Friccii, M. (Frick, M.) : Paradoxa de Venenis, etc., 16mo, Aug. Vindel,
1710.
Tract, med. de virtute venenorum medica, Svo,Ulmae, 1707.
Gastaldy, J. B. : Diss, an venena essentialiter inter se dififerant . . .
12mo, Arigum, 1715.
GiFTBucH (vollstandige), col. pL, Svo, Sondersheim, 1817.
Gmelin, J. F. : Allgemeine Geschichte der Gifte, Erster Th., Svo, Leipzig,
1776.
Gmelin, P. F. : De materia toxicorum hominis vegetabilium simplicium
in medicamentum convertanda, 4to, Tubingen, 1765.
Graeteb, S. L. : De venenis in genere, 4to, Strasbourg, 1767.
Grueneb, C. G. : De veneni notione dubia nee foro satis apta, Svo, Jena,
1795.
De forensi veneficii notione rite confirmanda, Svo, Jena, 1796.
GuBRiN, DE Mamers: Nouvelle toxicologie, etc., Svo, Paris, 1826.
Haartmann, G. E. : Toxicologise primse linese, 4to, Abo, 1797.
Ha gen: Isagoge ad chemiam forensem, Regiomont, 1789.
38 TOXICOLOGY — WITTHAITS.
Halle, J. S. : Gifthistorie, etc., 8vo, Berlin, 1787.
Hannius, J. D.: De usu venenorum in niedicina, 8vo, Leipzig, 1775.
Haemand de Montgomery, T. : Essai de toxicologie, etc., 8vo, Paris,
1818.
Heise, J. L. : De venenorum actione in corpus humanum, 8vo, Regio-
monti, 1801.
Heegang, K. G. : Vollstandiges Giftbuch, etc., Sondershausen, 181.5.
Lehrreiche Unglucksfiille . . . 8vo, Gellitz, 1811.
HiLLEFELD, G. C. : Expcrimenta qusedam circa venena, 4to, Gottingen,
1760.
HiLSCHEN, C. H. : De signis veneni dati diagnosticis, 4to, Giessen, 1748.
Hinze, J. F. : De veneni effectu, 8vo, Erlangen, 1792.
Hoffmann, F. : De erroribus circa venena vulgaribus, 4to, Halle, 1718.
De cauta et circumspecta venenorum accusatione, 4to, Halle,
1736.
HouLSTON, T. : Bemerkungen tiber die Gifte, etc., Altenburg, 1786.
HuENEFBLD, F. L. : Lehrbuch der polizeylich-gerichtlichen Chemie, 8vo,
Berlin, 1832.
IsENFLAMM, F. J. : De remediis suspectis et venenatis, 4to, Erlangen,
1767.
Kiel, H. J. : De nonnuUis venenis, 4to, Leyden, 1820.
KiECHEE, A. : De venenis liber, etc., 18mo, Grascii, 1739.
KoLBANi, P. : Ueber die herrschenden Gifte, etc., 8vo, Presburg, 1792.
Gifthistorie, etc., 8vo, Wien, 1798. Zweite Aufl., 8vo, Wien,
1807.
KuEHN, O. B. : Practische Anweisung zu gerichtlich-chemischen Unter-
suchungen, 8vo, Leipzig, 1829.
Lanzoni, J. : Tractatus de venenis, in ejus 0pp., 4to, Lausanne, 1738.
Lemaitee: Essai sur I'analyse des poisons, 4to, Paris, 1S17.
LiNDEE, J.: De venenis in genere, etc., 12mo, Lugd. Bat., 1708.
LiNDES, W. : Praktische Anleitung zu . . . gerichtlich-chemischen
. . . Untersuchungen, 8vo, Berlin, 1849.
LiNDESTOLPE, J. (Lindee) : Liber de venenis, etc., 8vo, Lipsise, 1739.
Logan, G. : De Venenis, 8vo, Edinburgh, 1779.
LowRiE, W. F. : Toxicologia, etc., 8vo, New York, 1S32.
Luthee: De venenis eorumque differentia ac actione, 4to, Erfurth, 1773.
LuTTER, E. : Medicinische und chirurgische Bemerkungen iiber Gifte,
etc., 8vo, Speyer, 1792.
Maclagan, D. : Contributions to Toxicology, etc., Svo, Edinburgh, 1849.
Malle, p. : Analyse toxique g^n^rale, 2 pi., 8vo, Strassbourg, 1839.
DE ]\Iamees, G. (See Guerin).
Manual of Toxicology, etc., 16mo, London, 1821.
Maec, C. C. H. : AUgemeine Bemerkungen iiber die Gifte, etc., Svo, Er-
langen, 1795.
BIBLIOGRAPHICAL. 39
Marx, K. F. H. : Die Lehre von den Giften, 2 Th., 8vo, Gottingen,
1827-29.
Mayer, J. : Sammlung von den Wirkungen der gewohnl. Gifte und ihrer
Heilart, 8vo, Wien, 1834.
Mead, R. : A Mechanical Account of Poisons, 4to, London, 1702. 2d ed.,
1708. 3d ed., 1738. 4th ed., 1743. 5th ed., Dublin, 1729. 6th
ed., Latin version, J. Nelson, London, 1737. 7th ed., 1750. 8th ed.,
Leiden, 1737. 9th ed., 1750. Napoli, 1739; 1758. Other editions,
Amstel., 1749; Frankof., 1763; Gottingen, Ed. Oedems, 1749.
MoLLEB, H. : Die Lehre von den Giften und den Vergiftungen, 8vo,
Quedlingen, 1825. '
DE MoNTG.\ENY, A.: Essai de toxicologie . . . 8vo, Paris, 1817.
DE MoNTMAHON, E. S. : Manuel medico-l^gale des poisons, etc., 18mo,
Paris, 1824.
Mueller, A. G. ; Tractatus de venenis, 8vo, Halse, 1807.
Mueller, J. B. : Die Gifte und ihre Wirkung auf den Organismus . . .
8vo, Niirnberg, 1840.
MuTEL, P.: Des poisons, etc., 8vo, Paris, 1830. Also Ital., 8vo, Milano,
1831.
Navier: Contre-poisons de I'arsenic, du sublime-corrosif, du vert-de-
gris et du plomb, suivis de trois dissertations sur le mercure, le
fer et I'etain, 2 vols., 12mo, Paris, 1777.
Precis du moyen de secourir les personnes empoisonn^es par les
poisons corrosifs, 8vo, Paris, 1778.
Nebel, G. B.: De signis intoxicationis, 4to, Heidelberg, 1733.
Neues voUstandiges Handbuch der Giftkunde, etc., 16mo, Chur u. Leip-
zig, 1840.
Neumann, S. : Chymia medica dogmatica-experimentalis ... 4 vols.,
4to, Ziillichau, 1749-53.
Oberkamp, F. J.: De nunnullorum venenorum virtute deleteria . . .
4to, Heidelberg, 1730.
Orfila, p. [M. J. B.]: Traits des poisons, 2 vol. in 4 pt., 8vo, Paris,
1814-15. Deuxieme ed., 2 vol., 8vo, Paris, 1818. Troisieme ed., 2
vol., 8vo, Paris, 1827 [1826]. Quatrieme ed., 2 vol., 8vo, Paris
1843 (I).
Recherche medico-legale des poisons, 8vo, Paris, 1845.
A General System of Toxicology, etc., transl. by J. G. Nancrede,
8vo, Phila., 1817.
• Toxikologie, etc., bearb. v. J. A. Seemann u. A. 0. S. F. Karls,
2 vol., 8vo, Berlin, Posen u. Bromberg, 1829-31.
Tossicologia pratica, etc., comp. da D. L. Miohelotti, 12mo,
Livorno, 1827.
Appendix to the General System of Toxicology, etc., transl. by
J. A. Waller, 8vo, London, 1821.
40 TOXICOLOGY — WITTHAUS.
— Allgemeine Toxicologie, etc., m. Zusatze u. Ann. v. Hermbstadt,
4 Bd., 8vo, Berlin, 1818-19.
Idem., Deutsch von O. B. Kiihn, 2 Bd., Svo, Leipzig, 1839.
Otto, C: Haandbog i toxikologien, Svo, Kjobenh., 1838.
Paujanus, H. L. : Versuch einer Toxicologie, Svo, Halle, 1S03.
Pallas, E. : Essai sur une nouvelle classification des poisons, etc., Svo,
Paris, 1822.
Pahe, a. : Des venins, in (Euvres lib. 23, ed. Malgaigne, T. iii., 283.
Plenck, J. J.: Toxicologia, etc., Svo, Vienna;, 17S5. (An edition in
German of the same place and date.) Ed. secunda, Svo, Viennse, 1801.
Tossicologia, etc., 12mo, Venezia, 1789.
Toxicologia, etc., Svo, Madrid, 1816.
Plouquet, F.: Essai sur la nature des poisons, etc., Svo, Caen, 1809.
Plouquet, W. G. : Warnung an das Publikum vor einem in manchen
Branntweinen enthaltenen Gift, Svo, Tubingen, 1780.
PoEHLMANN, J. B. : Die Giftgefahren welche das Leben taglich be-
drohen . . . Svo, Nordlingen, 1837.
Physiolog.-toxicolog. Untersuchungen, Svo, Erlangen, 1838.
Prestwich, J.: Dissertation on . . . poisons, etc., Svo, London,
1775.
Remer, W. H. G. : Lehrbuch der polizeilich-gerichtlichen Chemie, Svo,
Helmstedt, 1803. 3te Aufl., 2 Bd., Svo, Helmstedt, 1827.
Ricohd-Madianna, J. B.: Recherches et experiences sur les poisons
d'Am^rique, etc., 4to, Bordeaux, 1S26.
RiNALDiNi, B.: Trattado di tossicoscopia, etc., Svo, Pavia, 1831.
Robinson: Toxicological illustrations, col. pL, 1835.
Rossi, P. : De nonnullis plantis quse pro venenatis habentur observationes
et experimenta Florentiffi instituta, Svo, Pisa, 1762.
Roupell, G. L.: Illustrations of the Efiects of Poisons, fol., 4 col.
plates, London, 1833.
DE Salle, E. : Table synoptique des poisons, etc., 2 ed., Paris, 1824.
Sage, B. G.: Moyen de rem^dier aux poisons . . . Svo, Paris, 1811.
Sauvages, F. B. de. : De venenatis Gallise animalibus et venenorum
. . . 4to, Montpellier, 1764.
Schmidt, C. F. G. : De veneni actione recti definienda, Svo, Leipzig,
1802.
Schneider, J. : Populare Toxicologie, etc., Svo, Frankfurt, 1838.
ScHNEroER, P. J. : Ueber die Gifte, etc., 12mo, Wiirzburg, 1815. Zweite
Aufl., Svo, Tiibingen, 1821.
ScHUH, F. : Diss, sistens experimenta de influxu venenorum nonnul-
lorum in ceconomiam animalem, Svo, Wien, 1831.
Schultze, J. E. F.: Toxicologia veterum, etc., 4to, Halse, 17S8.
Medizinische und chirurgische Bemerkungen iiber Gifte und
Gegengifte . . . 8\o, Spire, 1792.
BIBLIOGRAPHICAL. 41
ScHULZE, E. F.: Toxicologia veterum plantas venenatis exhibens
Theophrasti, Galeni, Dioscoridis, Plinii . . . 4to Halle, 1788.
Seiller, B. G. : Progr. de nonnullorum venenorum in corpus huma-
num effectibus, 4to, Wittemberg, 1811.
SiGWAET, G. F. : Diss, sistens venenorum discrimina . . . 4to, Tii-
bingen, 1765.
DA SiLVA Pereira e Cunha, C. a. : Tractado dos venenos, etc., 8vo, Lis-
boa, 1845.
Sobernheim, J. F., AND SiMON, J. F. : Handbuoh der praktischen Toxi-
cologie, 8vo, Berlin, 1838.
Sproegel, J. A. T. : Experimenta circa varia venena in viris animalibus
instituta, 4to, Gottingen, 1753.
Stobe, W.: Giftkundige Tafeln, 4to, Francfurt, 1825.
Stowe, W. : A Manual of Toxicology, etc., 24mo, London, 1823.
A Toxicological Chart, etc., foL, London, 1821. [Ind. cat.
mentions 8tli, 9th, and 13th eds., London, n. d. There was also a
German transl., Weimar, 1821.]
Stentzel, C. G. : De venenis acutis, 4to, Wittemberg, 1732.
• Toxicologia pathologica-medica . . . 4to, Wittemberg apd Leip-
zig, 1732.
Stuecke, C. : Toxicologische Tabellen, etc., oblong 4to Coin, 1828. 2te
Aufl., 1837.
SuENDELiN, Karl: Handbuch der medizinischen Chemie, etc., 8vo,
Berlin, 1823.
Taddei, G. : Repertorio dei veleni e contravveleni, 2 T., 8vo, Firenze,
1835.
Taylor, A. S. : On Poisons, etc., 12mo, London, 1848 (I.)
Idem. Ed. with notes and additions, by R. E. Griffith, 8vo,
Phila., 1848.
Thomson, A. T. : Anleitung zur Erkenntniss und Behandlung der
Vergiftungen, etc., bearb. v. A. Reumont, 12mo, Aachen, 1846.
[A translation of an appendix to his " Conspectus of the Phar-
macopoeias."]
Versuch uber den sichern und wirksamen Gebrauch der Gifte,
etc., 8vo, Lipsiae, 1774.
Vater, C. J. : De venenis et philtris . . . 4to, Wittemberg, 1706.
ViBORG, E. : Ueber die Wirkung der allgemeinsten bis jetzt bekannten
Gifte . . . . in: Sammlung von Abh. fiir Thierarzte.
Vo GEL, R. A.: De insigni venenorum quorumdam virtu temedica . . .
4to, Gottingen, 1762.
Wagner, G. F. : De signis veneno infectorum, 4to, Konigsberg, 1707.
Whinrey, G. : De viribus venenorum, 4to, Leyden, 1710.
WiBMER, K. : Die Wirkung der Arzneimittel und Gifte ... 5 vol.,
8vo, Miinchen, 1831-1842.
42 TOXICOLOGY WITTHAUS.
Wiedemann, C. R. W. : Anweisung zur Rettung . . . der Vergifteten,
8vo, Braunschweig, 1797.
Wilmer: Obs. on the poisonous vegetables which are indigenous in
Great Britain, 8vo, London, 1780.
Essay on cuhnary poisons, 8vo, London, 1781.
WiTTiNc, E.: Uebersicht der wichtigsten Erfahrungen im Felde der
Toxicologie . . . 8vo, Hanover, 1827.
Zaiaczkowski, T. : Tabella toxicologica, 8vo, Turici, 1836.
III. Befobb 1700.
Abano [vel Abbano; Apono; Aponensis] Peteus de: Tractatus de
Venenis, Mantuse, fol., 1472; 4to, 1473. Venet., 4to, 1473, 1476,
1485, 1487, 1520, 1537; 8vo, 1550; fol., 1565, 1567, 1595. Paduse,
4to, 1473. Roma, 4to, 1475, 1484-85, 1490. Mediol., 4to, 1475.
Patav., 4to, 1476, 1487. Lipsise, 4to, 1489, 1500. Basil., 8vo,
1531. Marpur., 8vo, 1537, 1550, fol., 1565. Rivini, fol., 1548.
Argent., 8vo, 1566. Paris, 8vo, 1567. Lyon, 16mo, 1593, 1595.
Francof., fol, 1679. La Haye, 8vo, 1742, n. p., n. d. Saec. xv.,
ed. ii.
Abra, H.: De curandis venenis, etc., 12mo, Leovardiae, 1601; Arnheim,
1603.
Albinus, B. : De venenis, 4to, Francfort-S. O., 1682.
Androm.\chus : Theriaca, ed. Fr. Tidicaeus, 4to, Tiguri, 1607.
Ardoynis, Santes de: Liber de venenis, etc., fol., Venet., 1492; fol.,
Basil., 1540, 1562.
Arma, J. F. : De venenis dialogus, 8vo, Taurini, 1557.
Arnaujus da Villanova: De arte cognoscendi venena, 4to, n. p., n. d.
4to, n. p., n. d.; 4to, Mediol., 1475, 4to, Paduse, 1487.
Averroes: Liber de venenis, fol., n. p., n. d.; 4to, Paris, 1506. [Also
in Regimen sanitatis, Leyden, 1517.]
Baccius, a. : De venenis et antidotis TrpoKeyoiieva, etc., 4to, Romse, 1586.
Bra, H.: De curandis venenis . . . 8vo, Leovard, 1616.
Bulgetus, a.: De morbis venenatis venenisque tractatus, etc., 4to,
Patav., 1657. [In his "De affectionibus cordis," etc.]
Cardanus, H. : De venenorum differentiis, etc., 4to, Patav., 1563; Basil.,
1564; 4to, Padua;, 1653; fol., Genev, 1624; fol., Lyon, 1663.
De venenis libri tres, fol, Lugd., 1663. [In his "opera."]
Carrerius, p.: Qusestio an dentur venena ad tempus ann Conciliatore
edita, fol., Patav., 1548; Venet., 1548; 4to, Venet., 1565.
A Castro, R. : De morbis venenatis, etc., Tolosae, 1636.
Cesalpinus, a.: Venena omnia ... in Qusest. med., lib. i, 4to,
Venet, 1593.
BIBLIOGRAPHICAL. 43
CoDRONCHius, B. : De morbis veneficis ac veneficiis libri quatuor, 16mo,
Venet., 1591, 1595; Mediol., 1613.
DiOSCORIDES: Trepl S'qXTjT'riptdv (papiidKwi/ — De venenis. wepl lo[i6\wv — De
venenatis animalibus. [Either separately or as books of his Materia
Medica.] Of the great number of editions, the ed. princ. of the
Greek text is the extremely rare foL, Venet., 1499, ap. Aldum Manu-
tium, and the most recent and valuable that of Lips., 1829-30,
8vo, ed. Cur. Sprengel. The earliest Latin version is by Petrus de
Abano, foL, Colle, 1478. There are also Latin versions by H.
Barbaras, foL, n. p., n. d.; J. Ruellius, foL, Paris, 1516; M. Vergilius,
fol., Florent., 1518; P. A. Matthiolus, fol., Venet., 1554 [with
extensive commentaries]: and J. A. Saracenus, fol. [Francof.-a.-
M.], 1598, of all of which there are numerous editions. There are
also translations in Italian, Spanish, German, French, and Bo-
hemian. [See Choulant, Handb. d. Biicherkunde f. d. alt. Med.,
Leipz., 1841, 76-82.]
A FoNSECA, R. : De venenis eorumque curatione, 4to, Romae, 1587.
FoRESTi, P. : Liber de venenis et fuois, Lugd. Bat., 1606.
Gaehausen, H. ; Decisio trium quaestionum de veneficiis, 4to, Rintel.,
1629.
Galenus, C. : De antidotis, lib. ii. {i^epl avriSbTav), in ed. Chartier xiii.;
in ed. Junta, vii., 5; in ed. Kuhn, xiv.
GocKBL, E. : Libellus de venenis, etc., 8vo, Aug. Vind., 1669.
Libellus alter de venenis, etc., 8vo, Aug. Vind., 1669.
GoDELMANN, J. G. : Tractatus de Magis, Veneficiis et Lamiis, etc., 4to,
Francof., 1591; 8vo, Norimb., 1676.
Grataholus, G. : Universale consilium de praeservatione a venenis, etc.,
8vo, n. p., n. d. [1561].
Grevin, J.: Deux livres des venins, etc., 2 T. in iv., 4to, Anvers, 1568.
De venenis libri duo, etc., 4to, Antw., 1571.
Gu-iiNBRius, A. : De peste et de venenis, etc., fol., n. p., n. d. [Saec.
XV.]
Liber de venenis, 4to, Papiae, 1518; Paris, 1518; Lugd., 1525.
Lebzelter, S/: De natura venenorum, 4to, Leipzig, 1631.
LiBAVius, A. : Tract, de venenis, in tom. I. Singularium, 8vo, Francfort,
1599.
LiEBAULT, J.: De prsecavendis curandisque venenis, etc., 8vo, Paris,
1577.
LoEBER, v.: Mantissa de venenis, etc., 8vo, Hamburg, 1671.
Matthiolus, P. A. : [See Dioscorides.]
Mercati, M. : Instruttioni sopra i veleni occultamenti ministrati, 4to,
Roma, 1576.
Mercurialis, H. : De venenis et morbis venenosis, etc., 8vo, Francof.,
1584; 4to, Patav., 1588; Venet., 1601.
44 TOXICOLOGY WITTHAUS.
Meyssonier, L.: Trait6 des maladies veneneuses, etc., 7th ed., 4to,
Lyon, 1678.
MoiBANus, J. : Giftjager, etc., 1567.
Nadde: An magnum homini venenis periculam, 12mo, Romse, 1632.
Nicander: Theriaca — Alexipharmaca. The first edition of the Greek
text is, accompanying that of Dioscorides, in the Aldine fol. of 1499.
Other editions of Greek alone are: 4to, Venet., 1523, and 4to,
Colon, 1530. Greek and Latin: 8vo, Paris, 1549 [Alexipharmaca
alone]; 8vo, Valentiae, 1552 [Theriaca alone]; 4to, Paris, 1557;
8vo, Florent., 1764; 8vo, Halse, 1792 [Alexipharmaca]; 8vo, Lips.,
1816 [Theriaca]. Latin: 4to, Colon., 1531; 8vo, Francof., 1532.
French: Anvers, 4to [with Grevin, q. v.\ The best editions are
those of J. G. Schneider, Hate, 1792, and Lips., 1816.
[Nicander]: Scholia vetere in Nicandri Alexipharmaca, etc. Rec. ab.
E. Abel., 8vo, Berol., 1892.
OcHUS RiSETTUS, H. : De venenis ac pestilentibus morbis . . . 4to,
Brescia, 1650.
Pabst [or Babst], M.: Giftjagende Kunst, etc., 4to, Leipz., 1541.
Parous [Pare], A. : Des venins et morsure des chiens enragez, etc., 4to,
Paris, 1582.
Plinius, B. : Carmen de venenis et venenatis, etc., 8vo, Viteb., 1597;
Norimb., 1689.
Plinius, C. C. : Hist, nat., lib. xxxvii., 'passim,.
PoNA, F. : Trattato de' Veleni e lor cura, 4to, Verona, 1643.
Pons, J. : Avertissement pour la preservation et cure generale contre les
poisons, Lyon, 1634.
PoNZBTTus, F. : De venenis, etc., fol., Venet., 1492; Romse, 1521, Basil.,
1540, 1562.
Pr^votius, J.: De venenis eorumque Alexipharmacis, etc., 12mo,
Francfort, 1641; 32mo, MedioL, 1646; 24mo, Lugd., 1660; 12mo,
Hanov., 1666.
Rambsey, W. : 8av6.(nn.a, Kal B-qKriTripla. Tractatus de venenis, or a
treatise of poysons, etc., 16mo, London, 1661.
[Ramsay, W.]: Life's security, or the names, natures and ^'ertues
of all sorts of venoms and venomous things, 8vo, Lond., 1665.
Ramirez, C. B. de S. : De suspicione exhibiti veneni, etc., 4to, Colon.,
1671.
Ranchinus, F. : Traite des venins, etc. [In his CEuvres pharm.], 12mo,
Lyon, 1624.
Rast, G. : De veneno in genere., 4to, Konigsberg, 1644.
RoBSER, J. S. : De venenis, 4to, Wittemberg, 16S7.
RuDius, E.: De morbis occultis et venenatis, fol., Venet., 1610
ScHAHFF, L. B.: To|iKSXo7i(i, sive de natura venenorum, etc., Svo, Jense,
1678.
BIBLIOGRAPHICAL. 45
Antidotus prophylactica, etc., 16mo, Erffurth, 1698.
ScHELLHAMMER, C. : Disp. de venenis, 4to, Jena, 1649.
ScHENCK A Grafenburg, J.: De venenis, 8vo, Tubingen, 1597.
ScHLEGEL, J. A. : De venenis et morbis venenosis . . . 4to, Erfurt,
1679.
ScHRADER, F. : De venenis et antidotis, 8vo, Leyden, 1679.
Sennert, D. : De venenis, in Praot. med., lib. vi., 4to, Wittemberg, 1628.
Stubing, J.: Liber de venenis, 4to, Vindeb., 1561.
Theatrum de Venficiis, etc., fol., Frankf., 1586.
Trillo, a. : Tratado general de todas las tres especias de venenos, etc.,
8vo, Toledo, 1679.
Vater, C. J. : De venenis et philtris . . . 4to, Wittemberg, 1700.
VoETius, L. : Tractatus de venenis, 12mo, Venet., 1550.
Wedel, G. W. : De venenis et bezoardicis, 4to, Jena, 1682.
Weickart, a. : Diss, de venenis, 4to, Bale, 1608.
ZuccARiNUS, M. : Methodus occurrendi venenatis corporibus, 4to, Neap.,
1611.
B. MODERN WORKS ON MEDICAL JURISPRUDENCE, ETC.,
HAVING REFERENCE TO TOXICOLOGY.
Abercrombie, J. : The Student's Guide to Medical Jurisprudence, 12mo,
Phila. [London], 1885.
Baetholow, R. : A Practical Treatise on Materia Medica and Therapeu-
tics, 7th ed.. New York, 1889.
Bayard, H. : Manuel pratique de mMecine legale, 8vo, Paris, 1843.
Beck, T. R. and J. B. : Elements of Medical Jurisprudence, etc., 12th ed.,
2 v., 8vo, Phila., 1863. [In this edition the articles on poisons have
been revised by B. W. McCready and S. St. John. The first edition
(T. R. Beck alone) was in 2 v., 8vo, Albany, 1823.]
Bellini, R., and Fillipi, A.: Bibliotheca medico-legale, 8vo, Pisa, 1878.
[T. iii. is Manuale di Tossicologia.]
Belloc, J. J.: Cours de medecine legale, 8vo, Paris, 1807, 3eme ed.,
1819.
Binz, C. : Intoxicationen. [In Gerhardt's Handbuch der Kinderkrank-
heiten, iii. Halfte, Tubingen, 1878.]
Boentraeger : Compendium der gerichtsarztlichen Praxis, Leipzig, 1894.
Brend, W. a.: Handb. of Med. Jur. and Tox., 16mo, London, 1906.
Briand, J., Chaudb, E., and Bouis, J.: Manuel complet de medecine
legale, etc., lO^me ed., 2 v., royal 8vo, Paris, 1880. [The Legal
Chemistry by L. Bouis. The 1st ed. (Briand alone) was 8vo,
Paris, 1821.]
BucHNER, E. : Lehrbuch der gerichthchen Medicin, etc., 3te Aufl., 8vo,
Miinchen, 1872.
46 TOXICOLOGY — WITTHAUS.
Buck, A., et al. : A Reference Handbook of the Medical Sciences, etc., 8 v.,
4to, New York, 1885, 1889. [Articles on Toxicology by B. V. Ab-
bott, R. H. Chittenden, C. Harrington, W. B. Hills, H. Leffmann, F.
Peyre Porcher, R. A. Witthaus, and H. C. Yarrow] 2d ed., 1900-1904.
Caspee, J. L., LiMAN, K. : Handbuch der gerichthchen Medicin, 8te Aufl.,
2 v., 8vo., Berhn, 1889. 9te Aufl., herausg. von A. Schmidtmann.
Toxicology by L. Wachholz, 2 vols., 8vo, Berlin, 1905-1906. [The
1st ed. was in 2 v., 8 vo, BerUn, 1857-58; with an atlas of 9 col. pi. in
4to. There is an English translation, 4 v., 8vo, Lond. (New Syden-
ham Soc), 1861-65, from the 3d Germ. ed. (1860); and a French
translation, 2 v., 8vo, Paris, 1862, also from the 3d Germ, ed.]
Casper, J. L. : Khnische Novellen, etc., 8vo, Berhn, 1863.
ChaPiMan, H. C: a Manual of Medical Jurisprudence and Toxicology,
8vo, Phila., 1892. 3d ed., Phila., 1903.
Chevers, N. : A ;\Ianual of Medical Jurisprudence for India, etc., 3d ed.,
8vo, Calcutta, 1870.
Dennstedt, M. : Die Chemie in der Rechtspflege, 8vo, Leipzig, 1910.
Devergie, a.: Medecine legale, etc., 3eme ed., 3 v., 8vo, Paris, 1852.
DiTTRicH ET al. : Haudbuch d. arztl. sachverstiindigen Tiitigkeit, Wien
u. Leipzig, 1906-1909. Toxicology by v. Jaksch, v. Wartenhorst,
Gintl, Corin and Reuter, in vol. vii.
Draper, F. W.: A Text-Book of Legal Medicine, 8vo, Phila., 1905.
El WELL, J. J.: A Medico-Legal Treatise on Malpractice and Medical
Evidence, 4th ed., 8vo, New York, 1881.
Emerson, R. L.: Legal Medicine and Toxicology, 8vo, London, 1909.
Emmert, C: Lehrbuch der gerichthchen Medizin, 8vo, Leipzig, 1900.
EuLENBERG, H. : Haudbuch der Gewerbe-Hygiene, 8vo, Berlin, 1876.
Falck, C. p. : Handbuch der gesammten Arzeneimittellehre, etc., i. Bd.
[aU publ.], foL, Marburg, 1850.
[Falck, C. P.]: Die klinischwichtigen Intoxikationen [in Bd. ii. of R.
Virchow's Handb. d. spec. Path. u. Therap., 8vo Erlangen, 1854].
Falck, C. P. and F. A. : Beitrage zur Physiologic, . . . und Toxikologie,
Stuttgart, 1875.
FiLippi, A., Severi, a., and JIontalti, A. : Manuale di medicina legale,
etc., 2 v., 8vo, Milano, 1889. [The toxicology is contained in vol i.]
FoDEHE, F. E. : Traite de medecine Mgale, etc., 6 v., 8vo, Paris, 1813.
Fresenius, C. R. : Anleitung zur quahtativen chemischen Anah'se, 16te
Aufl., 8vo, Braunschweig, 1894-95.
Anleitung zur quantitativen chemischen Analyse, 6te, Aufl., 2 v.,
8 vo., Braunschweig, 1875-87.
Gribblb, J. D. B., AND Hehir, P. : Outhnes of Medical Jurisprudence for
India, 4th ed., 8vo, Madras, ISdS.
Guy, W. a., and Ferrier, D. : Principles of Forensic Medicine, 6th ed.,
12mo, London, 1888.
BIBLIOGRAPHICAL 47
Hamilton, A. McL., bt At. : A System of Medical Jurisprudence, 2 v.,
8vo, New York, 1894. [Articles on poisons by C. E. Pellew, W. S.
Haines, and V. C. Vaughan.]
H.\RNACK, E. : Lehrbuch der Arzneimittellehre, 8vo, Hamburg, 1883.
Handbuch der praktische Medizin, 8vo, Stuttgart, 1901.
Hemming, W. D. : Aids to forensic medicine and toxicology, 8vo,
London, 1877.
Herold, J. : A Manual of Legal Medicine, 8vo, Phila., 1899.
V. HoFMANN, E. R. : Lehrbuch 'der gerichtlichen Medicin, 9te Aufl., 8vo,
Wien, 1903, ed. A. Kohsko.
Husband, H. A. : Forens. Med., Tox. and Publ. Health, 7th. ed., Svo,
Edinburgh, 1904.
Husemann, a., and Hilger, a. : Die Pfianzenstoffe, etc., 2te Aufl., 2 vols.,
Svo, Berhn, 1882.
V. Jaksch, R. : Die Vergiftungen, 2te Aufl., Wien, 1910.
KoEHLER, R. : Handbuch der speciellen Therapie, einschliesslich der
Behandlung der Vergiftungen, 3te Aufl., 2 v., Svo, Tubingen, 1869.
KoLiSKO, see von Hofmann.
KoRNFELD, H. : Handbuch der gerichtlichen Medicin in Beziehung zu der
Gesetzgebung Deutschlands und des Auslandes, Svo, Stuttgart,
18S4.
Legrand du Saulle, H., Berryer, G., and Pouchet, G.: Traits de
medecine legale, de jurisprudence m^dicale et de toxicologie, etc.,
2eme ed., Svo, Paris, 1886. [The toxicology by G. Pouchet.]
Lesser, A. : Atlas der gerichtlichen Medicin, 2 v., foL, Berhn, 1883-91.
[Toxicology in vol. i.]
Lewin, L. : Die Nebenwirkung der Arzneimittel, etc., 2te Aufl., Svo, Ber-
hn, 1893.
Lewin, L., and Brenning, M. : Die Fruchtabtreibung durch Gifte, etc.,
Svo, Berhn, 1899.
Luff, A. P. : Text-book of Forensic Medicine and Toxicology, 2 vols.,
Svo, London and New York, 1895.
LuTAUD, A.: Manuel de medecine legale et de jurisprudence medicale,
etc., 5eme ed., 12mo, Paris, 1892.
Mann, J. D. : Forensic Medicine and Toxicology, Svo, London and Phila.,
1893; 4th ed., 1908.
V. Maschka, J. : Handbuch der gerichthchen Medicin, 4 v., Svo, Tubin-
gen, 1SS1-S2. [The toxicology is contained in Bd. ii. and is by B.
Schuchardt, M. Seidel, Th. Husemann, and A. Schauenstein.]
Sammlung gerichtsarztlicher Gutachten, etc., 4 v., Svo, Prag u.
Leipzig, 1853, 1858, 1867, 1873.
Mata, p.: Tratado de medicina legal, 6 ed., 5 v., Svo, Madrid, 1903-4.
Mende, L. J. K. : Ausfiihrhches Handbuch der gerichtlichen Medicin,
etc., 6 v., Svo, Leipzig, 1819-32.
48 TOXICOLOGY — WITTHAUS.
MuRRELL, W. : Aids to Forensic Medicine and Toxicology, 7th ed., 12mo,
London, 1909.
NicoLAi, J. A. H. : Handbuch der gerichtlichen Medicin, 8vo, Berlin,
1841.
NoTHNAGBL, H., ET AL. : Specielle Pathologie und Therapie, 21 v., Svo,
Wien, 1894. [Bd. i., Vergiftungen, von R. v. Jaksch.]
Ogston, F. : Lectures on Medical Jurisprudence, Svo, London, 1878.
Oefila, p. (M. J. B.) : Traite de m^decine legale, 4^me ed., 4 v., 8vo, and
Atl, Paris, 1848.
Paris, J. A., and Fonblanque, J. S. M. : Medical Jurisprudence, 3 v.,
Svo, London, 1823.
Paulier, A. B., AND Hetet, F. : Traits ^lementaire de m^decine legale,
de jurisprudence m^dicale et de toxicologic, 2 v., 18mo, Paris,
ISSl.
Penzoldt, F., AND Stintsing, R. : Handbuch der speciellen Therapie in-
nerer Krankheiten, 6 v., Svo, Jena, 1894. ["Die Vergiftungen"
are treated of in Bd. ii. by Binz, Schuchardt, Wollner, Husemann,
Moeli, Erlenmeyer, Tuczek, and Liebreich.]
Peterson, F., AND Haines, W. S. : Text-book of Legal Medicine and
Toxicology, 2 vols., Svo, Phila., 1903-1904.
Rapmund, O., Cramer, A., Puppe, G., and Stolper, P.: Der beamteta
Arzt und arztliche Sachverstandige. 2 vols., Svo, Berlin, 1904.
Reese, J. J. : Text-book of Medical Jurisprudence and Toxicology, 7th
ed., revised by H. Leffmann, Svo, Phila., 1906.
Robertson, W. S. A.: Manual of Medical Jurisprudence, Toxicology,
etc., Svo, London, 1908.
Schmidtmann, A. : See Casper.
Schmiedebbrg, O. : Grundriss der Pharmakologie, Svo, Leipzig, 1902.
Schuermayer, J. H. : Lehrbuch der gerichtlichen Medicin, 4te Aufl., Svo,
Erlangen, 1874.
Seydel, K. J.: Leitfaden der gerichthchen Medicin, etc., Svo, Berlin,
1895.
Smith, F. F.: Lectures on Med. Jur. and Tox., 2d. ed., 12mo, London,
1908.
Stille, a. : Therapeutics and Materia Medica, etc., 4th ed., 2 v., Svo,
Phila, 1874.
Strassmann : Lehrbuch der gerichtlichen Medicin, Svo, Stuttgart, 1895.
Taylor, A. S. : A Manual of Medical Jurisprudence, 12th ed., edit, by T.
Stevenson, 12mo, London, 1891. 12th Am. ed., edit, by Clark Bell,
Svo, Phila., 1897. [The 1st ed. was Svo, London, 1836, Elements
of Medical Jurisprudence.]
The Principles and Practice of Medical Jurisprudence, 3d ed.,
edit, by T. Stevenson, 2 v., Svo, London, 1883. 6th ed. Edit, by
F. J. Smith, 2 v., Svo, London, 1910.
BIBLIOGRAPHICAL. 49
Tellez y. Lopez: Manual de toxicologia )' medicina legal, 8vo, Madrid,
1905.
ViRCHOW, R.: Handbuch der specielle Pathologie und Therapie, 8vo.
[Bd. ii., Die klinischwichtigen Intoxikationen, by C. P. Falck.]
Wharton, F., and Stille, M.: Medical Jurisprudence, 4th ed., edit, by
R. Amory and E. S. .Wood, 3 v., 8vo, Phila., 1884. [Vol. ii. con-
tains the toxicology.]
Wiener, D.: Sammlung gerichtlich-medicinischer Obergutachten, 2te
Aufl., 8vo, Berlin, 1893.
WiTTHAUS, R. A., AND Becker, T. C. : Medical Jurisprudence, Forensic
Medicine and Toxicology, 4 vols, 8vo, New York, 1893-96
(Toxicology, WitthaUs, vol. iv.).
Wood, H. C. : A Treatise on Therapeutics, comprising Materia Medica
and Toxicology, etc., 7th ed., 8vo, Phila., 1890.
Woodman, W. B., and Tidy, C. M.: Forensic Medicine and Toxicology,
8vo, Phila. (London), 1877.
v. ZiEMSSEN, H. : Handbuch der speciellen Pathologie und Therapie, 16
v., 8vo, Leipzig, var. dates. [Bd. xv., 2te Aufl., 1880, is devoted
to Intoxicationen, articles by R. Boehm, B. Naunyn, and H. v.
Boeck. In the English transL, New York, 1881, the supplement
contains an article by E. S. Wood.]
GENERAL TOXICOLOGY.
DEFINITION.
Toxicology is the science of poisons. The name is derived
from the ancient custom of anointing the points of arrows with
poison {roiov = a bow; To|t/cds = of or for a bow).^ The subject
may be divided into medical toxicology, whose object is the
recognition, prevention, and cure of all forms of poisoning; and
forensic toxicology, whose aim is the detection of criminal poison-
ing. The two branches overlap to a certain extent. All poisons
are of medical interest, but only those which may be criminally
used are of forensic interest. On the other hand, the physician
has little to do with toxicologlcal chemistry, which is of the first
forensic importance.
No substance is under all circumstances deleterious. The
poisonous quality is not one which is essential and necessary,
but one which is manifested only under certain conditions.
The genus "poison" does not exist as a class apart. Substances
which are commonly known to be actively deleterious ma}', in
certain forms and quantities and in certain conditions of the
system, act as remedies, and substances which are in daily use
as medicines, condiments, or foods may cause poisoning under
certain conditions. It has been said that "the idea 'poison'
cannot be circumscribed and that consequently its definition is
impracticable."- But if there be no definition possible for the
term "poison" because the same substance may under different
conditions be a medicine or a poison, the term "medicine" must
be equally incapable of definition. Yet the distinction between
the poisonous and the medicinal action is most simple, and is
popularly recognized as consisting in the harmful action of the
former and the beneficial quality of the latter.
■ The definition of toxicology given was not used in Greek literature in
in the " Century Dictionary " is too that meaning.
narrow, being limited to medical ^Lewin: " Lehrbuch der Tox.,"
toxicology. The word To^mbv, a 1SS5, p. 4.
poison, there given in the derivation
DEFINITION. 51
If, therefore, a definition be sought which shall set apart a
class of substances called poisons, as a genus is differentiated
in a classification of natural history, the search will be in vain.
It is with the poisonous quality, not with the thing which ex-
hibits it, that we have to deal.
In defining a poison we have to express the quality of its
action and the method by which such action is produced, in so
far as it differs from the methods by which similar results may
be caused by agents other than poisons.
The effect of the poison is harmful and may be fatal. The
damage caused by a poison is due neither to mechanical action,
as with a bullet or club; nor to direct physical action, as with fire
or lightning; nor to parasitic growth, as by trichina or tuberculo-
sis; but to an interior action, chemical or physico-chemical in its
nature, upon some tissue or fluid of the body whereby the compo-
sition of the tissue or the normal chemical changes constituting
life are modified or interfered with. Poisons, like medicines, do
not act until after they have entered the circulation.
A poison is a substance which, being in solution in, or
acting chemically upon, the blood may cause death or serious
bodily harm. ^
In order that a substance shall be considered a poison within
this definition, it is essential that it act after or by reason of its
presence in the blood, and therefore chemical agents which may
cause death or injury by their destructive action upon the
skin or stomach do not come within it. Such substances are
"corrosives."
A corrosive is a substance capable of causing death or injury
' The following definitions more adopted by Chapius, "Precis de
or less closely resemble that given Tox.," 2eme ed., 1888, p. 25). "A
in the text: "A poison is a substance substance may be called a poison if
which, when absorbed into the it is capable of being taken into any
blood, is capable of seriously affect- living organism, and causes by its
ing health or of destroying life" own inherent chemical nature im-
(Taylor: "Poisons," 3d Am. ed., pairment or destruction of function "
1875, p. 18). "Poisons are sub- (Blyth: "Poisons," 4th ed., 1906, p.
stances which, introduced by absorp- 23). "Any body which, in con-
tion into the organism, cause sequence of its local chemico-dynam-
structural alterations and functional ical action, and particularly of its
derangements more or less grave, absorption, causes grave or fatal
and can even, when their action accidents is considered a poison"
reaches a high degree of intensity, (Galtier: "Traits du Tox.," 1855,
cause death, or at least put. life in * i., 1.).
danger" (Vulpian, quoted and
52 TOXICOLOGY WITTHAUS.
by its chemical action upon a tissue with which it comes in direct
contact.
The distinction between poisons and corrosives is in the
method of application partly, but mainly in the nature of the
subsequent effects. Thus belladonna applied to the skin acts as a
true poison, because its local effects are insignificant as com-
pared with the systemic action due to the passage of atropin
so applied into the blood. Sulfuric acid, on the other hand,
when applied to the skin may be absorbed to some extent, but
the destruction of cutaneous tissue is the principal injury, and
resembles that caused by a burn or a scald.
The difference between poisons and corrosives seems, at first
sight, hardly to warrant their separation into distinct classes.
Indeed, many of the older toxicologists and some of recent date
expressly include the corrosives in their definitions of poisons.'
Nevertheless, the difference is such practically that it must be
recognized. A person pours a quantity of concentrated sul-
furic acid into the mouth of a child or of a sleeping adult, who
swallows a portion, and dies in consequence of the destruction of
the stomach caused by the corrosive. This is unquestionably ad-
ministration in the meaning of the statute (see- p. 57), and for
legal purposes it is not material whether the acid be considered
a "poison" or a "noxious thing." Two workmen in a chemical
factory quarrel, and one throws the other into a vat of sulfuric
acid, in which he is immersed up to the armpits. The victim
dies in consequence of the extensive destruction of skin. This
is certainly not administration of sulfuric acid, be it poison or
not, and neither in a popular nor a legal sense would the victim
be said to have been poisoned. The nature of the action of sul-
furic acid in the two cases is the same, the only difference being
in the organ destroyed; but in both cases the application is di-
■" Venenum est quid, quod exigua cally" (Guy and Ferrier: "Forens.
mole corpori nostro vel ingestum, Med.," 6th ed., 1888, p. 319). The
vel externe apphcatum, morbum following also include " outward ap-
gravem, aut mortem causat" plication" in their definitions:
(Planck: "Elem. Med. et Chir. for- Van Hasselt: "Handb.d. Giftlehre,"
ens.," VienniE, 1781, p. 32). "A 1862, p. 1. Briand, Chaud6 et
poison is any substance or matter Bouis, 1880, lOeme ed., i., 636.
(sohd, hquid, or gaseous) which, Mann: "Forens. Med. and Tox.,"
when applied to the body outwardly, 1893, p. 381. Devergie: "M6d. Ug.,"
or m any way introduced into it, can 1852, 36me ed., iii., 8. Mata: "Trat.
destroy hfe by its own inherent * de Med. y Cir. leg.," 1875, 5ta ed.,
quahties, without acting mechani- iv., 145.
DEFINITION. 53
rect and the action is different from that of the true poisons,
which, so long as they remain in contact with the sldn or unab-
sorbed in the stomach or intestines, are inert.
There is another difference between the action of corrosives
and that of poisons not included in the definitions. The inten-
sity of the action of the corrosives is directly proportionate to
the degree of concentration of the agent. Dilute hydrochloric
acid is not only administered medicinally, but is a normal and
necessary constituent of the gastric secretion; concentrated
hydrochloric acid is a powerful corrosive. With the true poi-
sons the degree of concentration has no influence, unless it be
that, within certain limits, a dilute solution may be more rap-
idly and completely absorbed than one which is concentrated,
and may consequently act more rapidly. The intensity of the
poisoning depends upon the amount of the poison which enters
the blood.
It is true that certain agents, such as oxalic acid, and even
the mineral acids, are both corrosives and poisons, but with these
the symptoms of corrosion predominate when the substance is
taken in a 'Solid or concentrated form, while these symptoms
may be entirely absent, and replaced by those due to the poison-
ous action of the acid or of its soluble salts, when the substance
is taken in dilute solution or in combination. Moreover, as
most poisons are also medicines under other conditions, there
is no reason why the same substance may not be considered
as included in the two classes of poisons and corrosives.
But while the expert may answer the question: "What is a
poison?" the question: "Is morphin a poison?" cannot be an-
swered by "yes" or "no" without qualification. A quarter of
a grain of morphin administered to a normal infant would act
as a poison, and might cause death in the absence of treatment.
The same quantity of the same drug given to an adult not ad-
dicted to its use would produce the indicated therapeutic action,
while in an infant or adult habituated by previous medical or
toxicophagic use it would be practically inert.
Although all reference to quantity is omitted in the defini-
tion, the question of quantity is one which cannot be neglected
in determining whether the substance administered in a given
ca^e is or is not a "poison" or a "noxious thing." In the pop-
ular acceptation no substance ie a poison which does not kill in
54 TOXICOLOGY WITTHAUS.
small doses — strychnin and prussic acid are commonly recog-
nized as poisons, while potassium chlorate and common salt are
not, simply because small quantities of the former may cause
death, while the lethal doses of the latter are very much greater.*
In many scientific works an attempt is made to include the con-
sideration of quantity in the definition of poisons^ by the inser-
tion of the words "in small quantity" or an equivalent. But
as the quantity varies within wide limits, not only with different
poisons, but with the same poison under different conditions,
the question of quantity, although of great importance in the
consideration of each individual case, cannot be regarded in the
strict limitations of a definition.
The question whether the substance is capable of producing
deleterious effects in the dose administered must be consid-
ered, whether it be a poison or a "noxious thing." The ruling
of Lord Chief-Justice Cockburn in Reg. v. Hennah (Cornwall
Lent Ass., 1877) criticised by Taylor and by Mann,^ is un-
doubtedly sound in so far as he held that " unless the thing was
noxious in the quantity administered, it cannot be said that
there has been a noxious thing administered." In this case
the defendant attempted to administer two or three grains of
cantharides, not with intent to murder, to "injure, aggrieve,
or annoy" (unless the object of exciting erotic feelings come
within the meaning of one of the latter terms), and hence, it
appearing by the testimony (whether truly or not is not here
material) that this quantity of cantharides is not sufficient to
be "noxious," the Lord Chief-Justice very properly directed an
acquittal. In the case of Peo. v. Burgess* it was also held that
in order to sustain conviction for assault in the first degree
under sec. 217, 2, of the New York penal code,= it must be
shown that the life of the person was endangered b}- adminis-
1 We may infer from the provisions P.: "Trat. de Med. y Cir. leg.,"
of Sec. 1743 of the criminal law of 1875, 5ta ed., iv., 145. Schuchardt,
New York that a substance "liable B.: in Maschka's "Handb. d. ger.
to be destructive of adult human Med., " ii., 7, etc.
life in quantities of sixty grains or 'Taylor: "Med. Jur.," 11th Am.
less" may be considered to be a ed., 1892, p. 74. Mann: "For Med
poison. See p. 59. and Tox., '' 1893, p. 382.
^Hofmann, E. R. v.: "Lehrb. d. M5 Hun, 157; 5 N. Y. Cr. Rep.,
ger. Med.," 1891, 5te Aufl., p. 612. 514.
Ogston, F.: "Lect. on Med. Jur.," =Sec. 240, 2 of the present penal
1878, p. 568. Devergie, A.: "M^d. law (1909).
Ii5g.," 1852, 36me ed., iii., 8. Mata,
DEFINITION. 55
tering poison. Casper and Liman, in two cases of administra-
tion with malicious intent of phosphorus and of sulfuric acid in
extreme dilution, expressed the opinion that these substances in
such dilution are not poisons in the medical or scientific sense,
whatever they might be held to be from the legal point of view
in connection with the intent to cause injury.'
It is quite true (as stated by Taylor and by Mann) that the
ruling in Reg. v. Hennah throws great responsibility upon the
medical witness, and further, that it renders a quantitative de-
termination by the chemist highly desirable when it is possible,
and in many ways increases the difficulty by proof. Yet the
expression of Taylor that " the quantity of a poison willfully ad-
ministered ought not to affect the culpability of the person ad-
ministering it" applies solely to the question of responsibility for
intent, which is one entirely foreign to the function of the
medical or chemical expert.
It remains to be considered whether our definition excludes
those substances which are not properly poisons. A recent
French definition affords an excellent text upon this point.
According to it, " a poison is any substance which, taken into
the interior, or applied to the exterior of the bod}', is capable of
causing death, or at least of destroying or seriously affecting
health."^
Under this definition not only are corrosives and mechanical
irritants, such as pounded glass, poisons, but pathogenic bacteria
also. The case of a person who died in consequence of the lodg-
ment of a cork in the air passages, that of a man who swallowed
a silver fork, and all cases of injury from "vitriol throwing" or
immersion in caustic liquids are cases of poisoning. Indeed,
under a strict interpretation of the words " applied to the ex-
terior," a person who is clubbed to death or sandbagged must
be considered as poisoned. In a case communicated to me by
Dr. E. E. W. Given air was apparently a poison under this defini-
tion. It appears that the deceased was ascending a ladder;
the defendant who was immediately behind and below him, hold-
ing the nozzle of a hose from which was coming compressed air
' Casper-Liman: "Handb. d. ger. donner la mort, ou tout au moins de
Med., " 8te Aufl., ii., 361-367. d^truire ou d'alt^rer profond^ment
^ Le poison est toute substance la sant6 (Lutaud, A.: "Man. d.
qui, prise a I'int^rieur on appliqu^e k MM. Ug.," 1892, 5eme ed., p. 454).
I' ext^rieur du corps, est capable de
56 TOXICOLOGY WITTHAUS.
having a pressure of 80 to 90 pounds, and that the defendant put
this nozzle against the boy's "seat," the boy being immediately
distended with air, and dying from the effects of such disten-
tion nine hours after admission to the hospital. In another
similar case a young man was killed at the Cooke Locomotive
Works in Paterson, in 1902, by compressed air under 150 pounds
pressure injected into his rectum by four fellow-workmen; while
being "hazed."
In the biochemical literature of the present day the term
poison (gift) is used in a manner which is misleading, to apply to
substances such as sodium chlorid, in pure solutions of which the
life of isolated organs or of the lower animal organisms is ex-
tinguished, while it will survive in solutions of the same salt also
containing other salts likewise necessary to life. In these cases
the death of the organ or organism is due rather to deprivation of
a material essential to its nutrition than to a toxic action of one
salt which may be antidoted by other salts.
If we consider the alimentary canal as the channel of en-
trance to the economy, we may divide noxious substances into:
(a) Mechanical or Physical Agents — e.g., sharp, insoluble
bodies, such as pounded glass/ boiling water, etc.;
(b) Corrosives, substances which destroy the organs with
which they come in contact by virtue of their chemical action
thereupon, such as sulfuric acid;
(c) Poisons, which, being dissolved in the blood, act either
upon it or upon deeper-seated organs and tissues;
(d) Bacteria, which enter the system as individual organ-
isms, whose processes of nutrition produce disease and death in
their host. Although the bacteria themselves are not properly
poisons, their products, the toxins and toxalbumins are, and are
included in our definition.
The definitions of some recent Continental writers appear to us to
be needlessly diffuse, and yet in some respects deficient. Thus Robert:'
"Poisons are substances, some inorganic, some organic, either pro-
duced in the organism or introduced from without, some unorganized
substances pre-existent in nature, which from their chemical nature,
' See Lancet, 1899, i., 174. Also tion is a modification of that of
Maschka's case, cited on p. 478. Husemann (" Handb. d. Tox.,"
^"Leiirbuch der Intoxikationen," Berl., 1862, p. 2) which is derived
Stuttgart, 1893, p. 9. This defini- from that of C. P. von Falck
DEFINITION. 57
under certain circumstances so affect any organ of the living economy,
that the health or relative well-being of this economy is thereby tem-
porarily or permanently prejudiced."
The definition of Vitah' is still more verbose:
"All substances are poisons which, by their nature or by their form
of combination foreign to the human economy, when introduced into
it or, applied upon it in whatever manner, in certain doses even to the
smallest, and without therapeutic indication, are capable of producing
death or causing more or less severe disturbances of health, acting on
the anatomical elements and on the liquids of the animal economy, and
changing the normal transformations and functions of that organism."
In most legislative enactments relating to poisoning, either
the necessity of strict definition of the term "poison" is avoided
by use of some such general expression as " other noxious things "
to include all deleterious agents which may not be considered
to be poisons; or the act itself contains a definition, as in the
French law, sufficiently broad to cover all possibly harmful
substances.
In the Penal Law of the State of New York the definitions of mur-
der and manslaughter^ consider only the intent, and the circumstances
attending the homicide, without reference to the material agent, except
in some forms of manslaughter. Thus sees. 1050, 1052 refer to the use
of "any medicine, drug, or substance, or any instrument or other means "
for the procurement of abortion, and sec. 1052 fixes the liability of a
physician who shall, while intoxicated, administer "a poisonous drug or
medicine " which causes the death of the person to whom it is given.
And, even if death do not result, if the intoxicated physician endangers
life or seriously affects health by the administration of poison, drug, or
medicine, he is guilty of a misdemeanor.^ In cases of homicide, therefore,
in this State, the question whether the instrument of death is or is not
called a poison is in no way material. It is only in the definitions of the
different degrees of assault that the word " poison " is used.
Sec. 240. A person who, with an intent to kill a human being or to
commit a felony upon the person or property of the one assaulted, or
of another,
1. Assaults another with ....
2. Administers to, or causes to be administered to or taken by
another, poison, or any other destructive or noxious thing so as to en-
danger the life of such other.
Is guilty of assault in the first degree.
' "Manuale ^i Chim. tossicolog.," = Sees. 1043-105a.
Milano, 1893, p. 6. ' Sec. 1761.
58 TOXICOLOGY WITTHAUS.
Sec. 242. A person who, under circumstances not amounting to the
crime specified in section 240:
1. With intent to injure, unlawfully administers to, or causes to be
administered to, or taken by another, poison, or any other destructive
or noxious thing, or any drug or medicine the use of which is danger-
ous to life or health; or, 2. With intent thereby to enable or assist
himself or any other person to commit any crime, administers to, or
causes to be administered to, or taken by another, chloroform, ether,
laudanum, or any other intoxicating narcotic or anaesthetic agent; or . . .
Is guilty of assault in the second degree.
In other sections of the law, however, the word "poison" is used
in such manner that a strict definition of its meaning is necessary:
Sec. 1760. A person who willfully mingles poison with any food,
drink, or medicine, intended or prepared for the use of human beings,
and a person who willfully poisons any spring, well, or reservoir of
water, is punishable. . . .
Sec. 1742, 1743 refer to the sale of "poisons or poisonous sub-
stances " by apothecaries or druggists.
The English law' provides: Sec. 11. Whosoever shall administer, or
cause to be administered or taken by any person, any poison or other
destructive thing, with intent to commit murder, shall be guilty of felony.
Sec. 23. Whosoever shall unlawfully and maliciously administer to,
or cause to be administered to or taken by any other person, anj' poison
or other destructive thing, so as thereby to endanger the life of such
person, or so as thereby to inflict upon such person any grievous bodily
harm, shall be guilty of felony.
Sec. 24. Whosoever shall unlavs'fully and maliciously administer to,
or cause to be administered to or taken by any other person, any poison
or other destructive or noxious thing, with intent to injure, aggrieve,
or annoy such person, shall be guilty of a misdemeanor.
The German law,^ after defining and fixing the penalties for the dif-
ferent degrees of murder and manslaughter, sees. 211 to 222, without
reference to the material agent used, further provides :
Sec. 212. He who intentionally kills a human being, if the killing has
been without premeditation, is guilty of Todtschlag,' punishable by not
more than five years imprisonment.
Sec. 229. Whosoever shall intentignally administer to another, for
the purpose of injuring his health, poison or other substances capable
of destroying the- health, shall be punished with imprisonment for a
term of ten years or less.
» 24 and 25 Vict., c. 100. ^The crime of Todtschlag imder
^ Strafgesetzb. f. d. Deutsche the German law is the equivalent of
Keich Casper-Schmidtmann that of murder in the second degree
Handb. d. ger. Med.," 1905, i, 707. under the Xew York law; but crimes
DEFINITION. 59
If a severe bodily injury has been caused by the administration, the
imprisonment shall be for not less than five years, and when death has
been caused, it shall be for not less than ten years or for life.
The Austrian law' (sec. 135) recognizes four varieties of murder
(Mord): "1. Assassination (Meuchelmord), which is accomplished by
poison or by other insidious means; 2. Murder for robbery (Raub-
mord) . . . ; 3. Murder by procurement (bestellte Mord) ... 4. Or-
dinary murder." Administration of poison by force is ordinary (ge-
meine) murder.
Sec. 140. When the act, which has caused the death of a human
being, was performed, not with the intention of causing death, but with
other inimical intent, the crime is Todtschlag.^
The French law' defines poisoning in the following comprehensive
terms: "Poisoning is every attempt upon the life of a person by -the
action of substances which can cause death more or less rapidly, in
whatever manner these substances may have been used or administered
and whatever may have been the consequences." *
In the State of New York, and probably in other States of
the Union, no restriction or supervision is placed upon the use
of poisons in trades or manufactures. In Massachusetts, in
1891, a strenuous effort was made to secure the passage of a law
regulating the use of arsenic in the manufacture of wall papers,^
but the opposition of parties whose pecuniary interests were sup-
posed to be affected proved successful until 1900, when by Chap.
325 of the laws of that year, a penalty was imposed upon the
manufacture, sale, etc., of any dress goods or articles of dress
containing more than 1/100 grain, or paper more than 1/10 grain
of arsenic per square yard of material. The sale of poisons is in
a measure restricted. The provisions in the Penal Law of the
State of New York referring to the sale of poisons are:
Sec. 1743. It shall be unlawful for any person to sell at retail or
furnish any of the poisons mentioned in the schedules hereinafter set
forth, without affixing or causing to be affixed, to the bottle, box, vessel,
coming within the Austrian defini- also, v. Hofmann: "Lehrb. d. gar.
tion of the same term, would be here Med.," 9te Aufl. (Kolisko), 258.
punishable as murder in the first ' See note 3, p. 58.
degree if the " other inimical intent " ' Code p6nal, art. 310.
constituted a felony, but otherwise * See also Briand, Chaud6 et
as manslaughter. Bouis: "Manuel de m6d. I^g.,"
' Burgerhches Gesetzbuch, Straf- lOeme ed., i., 624-635.
gesetz uber Verbrechen, etc. See ' See Arsenical Wall Papers.
60 TOXICOLOGY — WITTHAUS.
or package, a label containing the name of the article and the word
"poison" distinctly shown, with the name and place of business of the
seller, all printed in red ink, together with the name of such poisons
printed or written thereupon in plain, legible characters, which schedules
are as follows, to wit:
Schedule A. Arsenic, cyanide of potassium, hydrocyanic acid,
cocaine, morphine, strychnia, and all other vegetable poisonous alka-
loids and their salts, oil of bitter almonds, containing hydrocyanic acid,
opium and its preparations, except paregoric and such others as contain
less than two grains of opium to the ounce.
Schedule B. Aconite, belladonna, cantharides, colchicum, conium,
cotton root, digitalis, ergot, hellebore, henbane, phytolacca, strophanthus,
oil of tanzy, veratrum viride and their pharmaceutical preparations,
. arsenical solutions, carbolic acid, chloral hydrate, chloroform, corrosi^'e
sublimate, creosote, croton oil, mineral acids, oxalic acid, paris green,
salts of lead, salts of zinc, white hellebore, or any drug, chemical or
preparation, which, according to the standard works on medicine or
materia medica, is liable to be destructive to adult human life in quan-
tities of sixty grains or less, and such other poisons as the state board of
pharmacy, under the authority given to it by the public health law,
may from time to time add to either of said schedules. Every person
who shall dispose of or sell at retail or furnish any poisons included
under schedule A shall, before delivering the same, make or cause to be
made an entry in a book kept for that purpose, stating the date of sale,
the name and address of the purchaser, the name and the quantity of
the poison, the purpose for which it is represented by the purchaser to be
required and the name of the dispenser, such book to be always open for
inspection by the proper authorities, and to be preserved for at least
five years after the last entry. He shall not deliver any of the said
poisons without satisfying himself that the purchaser is aware of its
poisonous character and that the said poison is to be used for a legitimate
purpose. The foregoing portions of this section shall not apply to the
dispensing of medicines or poisons on physicians' prescriptions. Whole-
sale dealers in drugs, medicines, pharmaceutical preparations or chem-
icals shall affix or cause to be affixed to every bottle, box, parcel, or
outer enclosure of an original package containing any of the articles
enumerated under said schedule A, a suitable label or brand in red ink
with the word ''poison" upon it.
Any person who violates any of the provisions of this section shall
be guilty of a misdemeanor.'
Sec. 1745. A person who, except on the written or verbal order of a
'For abstracts of the pharmacy Lemberger: Amer. J.ofPharm.,1902,
laws of tlie several states, see l.xxiv, 428.
DEFINITION. 61
physician, refills more than once prescriptions containing opium, mor-
phine, or preparations of either, in which the dose of opium exceeds
one-fourth grain, or morphine one-twentieth grain, is guilty of a mis-
demeanor.
Sec. 1746. It shall be unlawful for any person to sell, furnish or
dispose of alkaloid cocaine or its salts, or alpha or beta eucaine or their
salts or any admixture of cocaine or eucaine, except upon the written
prescription of a duly registered physician, which prescription shall be
retained by the person who dispenses the same, shall be filled but once
and of which no copy shall be taken by any person; except,
however, that such alkaloid cocaine or its salts, and alpha and beta
eucaine or their salts may lawfully be sold at wholesale upon the written
order of a licensed pharmacist or licensed druggist, duly registered
practicing physician, licensed veterinarian or licensed dentist provided
that the wholesale dealer shall affix or cause to be affixed to the bottle,
box, vessel or package containing the article sold, and upon the outside
wrapper of the package as originally put up, a label distinctly display-
ing the name and quantity of cocaijie or its salts, alpha or beta eucaine
or their salts, sold, and the word "poison" with the name and place
of business of the seller, all printed in red ink; and provided also that
the wholesale dealer shall before delivering any of the articles make or
cause to be made in a book kept for the purpose an entry of the sale
thereof stating the date of the sale, the quantity, name and form in
which sold, the name and address of the purchaser, and the name of the
person by whom the entry is made; and the said book shall always
be open for inspection by the proper authorities and shall be preserved
for at least five years after the date of the last entry made therein;
and provided also that any manufacturer may sell to another manu-
facturer of the same article, or to a wholesale dealer in drugs, or, a
wholesale dealer in drugs may sell to a manufacturer of the same article,
or to another wholesale dealer in drugs, alkaloid cocaine or its salts or
alpha or beta eucaine in the original package. Such package shall
be labelled as herein provided and shall be securely sealed. Each manu-
facturer and each Wholesale dealer in drugs shall, before the delivery
or at the time of the receipt, as the case may be, of any such drug,
enter or cause to be entered in a book to be kept by them respectively
for that purpose a record of the purchase and sale of such drug stating
the date of purchase and the name and address of the person from
whom purchased; the date of sale and the name and address of the
person to whom sold ; the quantity, name, and form in which sold and a
description of the package or container in which sold and how sealed ;
and there shall also be entered in such book at the place of such record
a statement that such drug was sold or purchased, as the case may be,
in the original package; that the seals thereon were undamaged and
62 TOXICOLOGY WITTHAUS.
unbroken and the labels were attached thereto as herein provided
and were not in any manner defaced or damaged, which statement
shall be signed by the person selling such drug and the person
purchasing such drug in the books herein required to be kept by them
respectively. '
Any person who violates any of the provisions of this section shall
be guilty of felony punishable by imprisonment of not more than one
year or a fine of not more than one thousand dollars, or both. ^
Sec. 1742 makes omission to properly label drugs, or to falsely
label them, or to substitute a different article for the one prescribed
a misdemeanor.
Sec. 1747 makes the careless distribution of drugs, medicines, or
chemicals a misdemeanor.
Sec. 1748 makes the adulteration of drugs, or the sale of adulterated
drugs a misdemeanor.
While the druggist may not sell arsenic, or phosphorus, or
strychnin without the formalities prescribed, "Rough on rats,"
which contains ninety-six per cent, of white arsenic, and nu-
merous other rat and vermin poisons containing large propor-
tions of the poisons named are sold without question. And,
while the apothecary may not refill more than once a prescrip-
tion in which the dose exceeds one-twentieth grain of morphin,
he may sell "soothing syrups," which contain from half a grain
to a grain to the ounce ad libitum.
The frequent use of "knock-out drops," saturated solution of
chloral, to facilitate the commission of various crimes led to the
enactment of the following law by the New York legislature in
1897, and many convictions have been had under it:
Sec. 1752. 1. A person, other than a duly licensed physician or
surgeon engaged in the lawful practice of his profession, who has in his
possession any narcotic or anaesthetic substance, compound or prepara-
tion, capable of producing stupor or unconsciousness, with intent to
administer the same or cause the same to be administered to another,
without the latter's consent, unless by direction of a duly licensed
physician, is guilty of a felony, punishable by imprisonment in the state
prison for not more than ten years.
2. The possession by any person, other than as exempted in the
foregoing subdivision, of any narcotic or anaesthetic substance or
' See also L., 1910, ch. 131. erly, includes opium, morphin, her-
= The Maryland Law, which went oin, chloral hydrate, or any salt or
into effect June, 1906, contains compound thereof. See Magruder:
similar provisions but, very prop- Maryland M. J., 1907, 1, 142
DEFINITION. 63
compound, concealed or furtively carried on the person, is presumptive
evidence of an intent to administer the same or cause the same to be
administered in violation of the provisions of this section.
Sec. 82. A person who manufactures, gives or sells an instrument,
a medicine or drug, or any other substance, with the intent that the
same may be unlawfully used in procuring the miscarriage of a woman,
is guilty of a felony.
In France, Germany, and other European countries the sale or
use of poisonous substances by manufacturers and others as vi^ell
as by druggists is restricted and under government supervision.'
Although the wording of statutes treating of poisoning
avoids the necessity of a strict definition in criminal cases, ex-
cept in the instances above referred to, questions arise in civil
actions in which the lack of such definition has proved an em-
barrassment. Thus, in the case of U. S. Mutual Accident Assoc.
V. Nora Newman,^ payment of an accident insurance policy
containing a provision in which the company excepted from
among the risks against which it insured "voluntary or invol-
untary taking of poison, or contact with any poisonous sub-
stance" was contested. The deceased, James E. Newman, had
died from inhalation of illuminating gas, which the company
claimed was a "poisonous substance." The case was decided
adversely to the company, largely upon the evidence of a pro-
fessor of chemistry in a Virginian univeristy, who defined a
poison as "a substance which, when taken into the body, is
capable of destroying some part or parts of the body, so as to
leave them permanently incapable of performing their func-
tions"'^a definition under which the case of the man who
was killed at the Eddystone lighthouse by melted lead dropping
into his open mouth, and in whose stomach a lump of lead
weighing nearly eight ounces was found,^ was one of poison-
ing; but under which, if the person recover, hydrocyanic acid
is not a poison. In consequence of this decision, which we be-
' See Legrand du Saule, Berryer State Bd. of Health, Lun. and Char.,
et Pouchet: "Med. I6g. et Tox.," Mass., 1884, 256-264.
1357-1361. Dubrac: "Jurisprudence ^Insurance Law Jour., xvii., 97.
ni6d. et pharm.," 2eme ed., 1893, See also Paul v. Traveller's Ins. Co.,
412-460, 704. Kornfeld: "Ger. N. Y. Rep., 112, 472.
Med.," 1884, 162/.; Pharm. J. ' Ins. Law Jour., Z. c, p. 104.
and Tr., 1868-69, n. s., x., 121- ^ Spry: Phil. Trans., Lend., 1756,
128. E. S. Wood: Fifth Ann. Rep. xlix., pt. 2, 477.
64 TOXICOLOGY — WITTHATJS.
lieve to have been based upon an improper definition of the
word "poison," the companies have subsequently added the
words "voluntary or involuntary inhalation of any gas, vapor,
or anaesthetic " in their pohcies.
CAUSATION OF POISONING.
Poisonings may be classified either with reference to the
origin of th« toxic agents producing them or according to the
motive or lack of motive attending their introduction into the
system.
With reference to their origin, poisons may primarily be di-
vided into two classes: Those which originate within the hu-
man body and those which are introduced from without.
I. Endogenous Poisonings. — These are produced either
by retention in the system of a poisonous substance normally
produced therein and constantly excreted therefrom in a state of
health, or to the formation within the body of a pathogenic poison.
Poisoning by retention is caused by interference with any of
the excretory functions. If the skin be varnished, death results
from arrest of the excretory function of the perspiration. When
the action of the kidneys is seriously interfered with by or-
ganic disease or by mechanical or non-mechanical suppres-
sion, the phenomena of uraemic poisoning are soon manifested,
and death is only delayed by a vicarious action of the skin or
intestines for a limited period. The well-known effects of
asphyxia, whether mechanical or due to the inhalation of an
inert though irrespirable gas, are due in part to deprivation of
oxygen, but also to accumulation of carbon dioxid in the blood.
Although in obstruction of the bowels the most violent symp-
toms are due to local inflammatory action, the reabsorption of
substances such as skatole, indole, and sulfur compotinds, usually
discharged with the alvine dejections, is the cause, to some ex-
tent, of the systemic disturbances.
Auto-intoxications are also the result, not of interference
with elimination, but of the production in the system either of
some normal excretory product in excessive amount, such as
oxalic acid, lactic acid, etc., or of substances which, probably
not produced in a state of health, are endowed with more ac-
tively toxic properties, such as oxybutyric acid. It is probable
CAUSATION OF POISONING. 65
that many, if not all, non-communicable diseases are truly auto-
intoxications.
Communicated poisonings are caused by the introduction
into the system of an organism which in its development gen-
erates poisonous substances. Several pathogenic bacteria have
already been shown to produce definite alkaloidal or protein
poisons (tetanin, typhotoxin, etc.), or toxins, to whose action the
phenomena of the corresponding diseases are due.
The study of endogenous poisoning is within the domain of
pathology. Its present forensic interest is relative only, and is
limited to the recognition of resemblances between the methods
of action and chemical characters of members of two classes
of poisons. In this respect the subject is one of vital impor-
tance, particularly with regard to alkaloidal poisonings.
In the Panchenko-De Lassy case, tried in Russia in 1911, a
physician, who appears to have followed the ancient calling of
poisoner for hire, and his "client" were convicted of a murder by
hypodermic injection of diphtheria cultures. A physician in
Kansas City, Mo., convicted of a murder by strychnin in 1910,
was suspected of having criminally infected other members of
the same family with typhoid germs. In such cases the methods
of examination of medicine and chemistry are powerless to dis-
tinguish between the effects of a "natural" infection and those
of a criminal act.
XL Exogenous Poisonings are caused by the introduc-
tion into the system, through one of the channels of absorp-
tion to be mentioned hereafter, of a substance possessing the
qualities of a poison, whether it be organic or inorganic, natu-
ral or synthetic, animal, vegetable, or mineral in its origin.
It is with this class of poisonings that forensic toxicology
has directly to deal.
With reference to the circumstances attending their origin,
poisonings may be classified for convenience of comparison into :
I. Homicidal. II. Suicidal. III. Accidental.
Among the homicidal cases are included not only such as
have been pronounced to be such by the finding of a trial jury,
but all which have been the subject of criminal proceedings, if
intent to cause death has been alleged, whatever may have been
the result of the trial.
Murders by poison have been accomplished by administration
IV— 5
66 TOXICOLOGY — WITTHAUS.
through every channel of entrance into the circulation/ by in-
halation,^ by the alimentary canal from either end,^ by the
vagina/ by the ear/ by hypodermic injection/ and by the use
of poisoned weapons.' In some cases the administration has
been in a single overwhelming dose, much greater than is neces-
sary to accomplish the object,^ in others in repeated minute doses
extending over long periods of time," and in rare instances during
forcible restraint of the victim.'" When the administration
is by the mouth one would suppose that a tasteless agent would
be used, but the numerous murders by strychnin and by the
mineral corrosives demonstrate that a strong taste of the poison
does not constitute a valid objection to the theory of murder,
nor is it proof that the case was one of suicide. The crime of
murder by poison is secret in essence, and requires no bodily
strength, although craftiness is desirable for its successful com-
mission without punishment; and is therefore frequently re-
sorted to by women.'' It has in a few instances been com-
mitted or attempted by lunatics.'^ Many of the celebrated
poisoners have been physicians,'* who have selected this means
because of their familiarity with and easy access to poisons.
Repeated poisonings by the same individual still occur,'* al-
' We know of no mention of a husband, grandmother, and brother,
modern case of introduction by the the quantity of arsenic found in the
male genitals. cadavers was "ten times enough to
^ Maxwell and Patrick cases, pp. cause death."
1146, 1147. ° Pastr^-Beaussier cases, arsenic,
^For cases of rectal introduction p. 508. Lesser: Vrtljschr. f. ger.
see pp. 231, 431, 432, 637, 733. Med.," 1897, 3 F., xiv., 305.
* See p. 432. "> Bocarm6 case, nicotin, p. 1003;
= Nitric acid, p. 230. Rogers case, chloroform, p. 1146.
"i Brouardel (Ann. d'hyg., 1901, " See Friedreich's Bl. f. ger. Med.,
3 S., xlvi, 484) states that a physi- 1850, i., 65; 1853, iii.,40; 1854, iv., 32,
wan m England poisoned by this 78; Dupr^ and Charpeutier: Rev.
method of administration a nephew Neurol., 1908, xvi., 893. In Prussia
from whom he expected to inherit. in the years 1863-77, 67.7 per cent.
We cannot identify this case; it is of those accused of poisoning were
not that of Lamson (p. 853) in which women (Falk: "Lehrb. d. Tox.," p.
aconitin was administered in a 18). In France, during the years
gelatin capsule, and the victim was 1825-80, 70 per cent, of the criminal
his brother-in-law. poisonings were by women (Vibert:
'See pp. 6, 17. Lewin: "Die "Precis de Tox.," 1890, p. 2).
Pfeilgifte," Berlin, 1894, p. 7, and '^ Krafft-Ebing: Friedreich's Bl.
passim. f. ger. Med., 1887, xxxvii., 186.
"Aconitm, p. 863; Atropin, p. "Castaing and Buchanan, mor-
884. In the Aff. Galtier (J. dem^d. phin, pp. 950, 951; Smethurst and
de Bordeaux, 1904, xxxiv, 830), in Pritchard, antimony, pp. 353, 354.
which a woman was convicted of Palmer, strychnin, p. 1017.
having caused the deaths of her " Holmes, Zanoli.
CAUSATION OF POISONING. 67
though not so frequently as in the past.' Only about 30 per
cent, of the criminal poisonings occur in cities.^
The motive for poisoning has included all of those which have
prompted the same crime by. other means; although the desire
for a change in sexual relations and the collection of life insur-
ance have predominated greatly. Occasionally nurses who
have been sexual perverts have resorted to poisoning for the
sake of the gratification afforded by the sufferings of the victim.^
One criminal in the seventeenth century, a grave digger, re-
sorted to poisonings to further his business, which also included
stealing, presumably from the dead.* In France, during the years
1825-80, 43 per cent, of the criminal poisonings were caused by
domestic dissensions, 24 per cent, were by mothers upon young
children, 10 per cent, due to adultery, 9 per cent, for vengeance,
9 per cent, due to cupidity, and 5 per cent, to unrequited love.'
Usually, upon a trial for murder by any means, the motive con-
stitutes an important element of the proof, as bearing upon the
questions of intent and premeditation; yet it is not essential. °
In the case of State v. Emeline and Almon Meeker, in Vermont,
no motive was even suggested by the prosecution, yet one de-
fendant was convicted and the other plead guilty.' When a
jury returns a verdict of murder in the second degree, in a trial
for murder by poison, it is one of compromise. Intentional kill-
ing by this means almost necessarily implies premeditation in
the obtaining or preparing of the poison. We find record of
but one instance of murder by poison in the heat of passion:
Proells^ states that Jesserich, of Berlin, communicated to him
orally a case in which a woman, during a quarrel with her
drunken husband, in which her life was threatened, seized rat-
' See pp. 21-25, 414, note 1. ' See p. 202, note 2.
2 See p. 75. » Friedreich's Bl. f. ger. Med., 1901,
^ Jeanneret, atropin, p. 871. lii., 200. Totschlag, see p. 58.
Zimmerm-ann : "Die Wonne des Weimann (Friedreich's Bl. f. ger.
Leides," Leipzig, 1885, p. Ill; Med., 1905, Ivi., 8) refers to another
Charpentier: "Les Empoisonneuses," case of like nature as having been re-
Paris, 1906, passim. ported by Taylor (Seydeler's transl.,
''Hausser: "Arch. f.Iir. Anthrop.," ii., 316). In this, however, there
1906-1907, xxvi., 221, transcript from was no intent to kill, an arsenical
Pract. Nov. Imp. Sax. Rer. Crim., green having been used to color a
Bened. Carpzov, Wittemberg, 1646, blancmange in the belief that it was
1, 99. extract of spinach. The defendants
^ Vibert: loc. cit. were convicted of manslaughter
° See cases cited in Cook: "Penal (Reg. v. Franklin and Randall: Tay-
Law," 1909, p. 279. lor: "Poisons," 3d Am. ed., 338).
68 TOXICOLOGY — WITTHAUS.
poison, which happened to be at hand, and put it into her hus-
band's drink. The man took the poison and died. The woman
related the circumstances herself, and was convicted of "Tot-
schlag."^ Sometimes poison intended for one person causes the
death of another. When this occurs the killing is murder in
the first degree under par. 2, sec. 1044 of the New York Criminal
Law.^
The greater number of suicides by poison are women, and
among men those having ready access to poisons (druggists,
physicians, photographers, etc.) most frequently resort to this
method of self-destruction. With most of the well-known
poisons suicidal cases outnumber the accidental or homicidal,
but with some, such as tartar-emetic, atropin, etc., they are in a
small minority. The selection of the agent used is influenced
partly by accessibility; potassium C3'anid by photographers,
mercuric chlorid by hospital nurses and attendants, oxalic acid
and matches by domestic servants, etc.; and partly by local
causes, the origin of which it is difficult to trace: paris green in
New York, phosphorus in France, hydrochloric acid and laud-
anum in England, the caustic alkalies in Austro-Hungary.
Suicides generally take large doses, and, therefore, when in an
alleged homicidal case large quantities of poison are found in
the cadaver, the defense usually appeals to that fact in support
of a theory of suicide. But suicides have been known to take
small and repeated doses,^ and in several cases of unquestionable
homicide very large doses have been administered.*
Accidental poisonings are all such as occur without intent
to cause death, and among them are consequently included so-
called accidents, due to criminal negligence or ignorance, which,
strictly speaking, are homicidal, and have in many instances
been the subject of trial for manslaughter. Yet the origin of
such a case more closely resembles that of a poisoning in which
the degree of negligence has been less than one in which there
has been deliberate intent to kill.
Accidental poisonings may be subdivided into:
(a) Industrial poisonings, which are the natural conse-
quence of contact with poisonous substances used in manufac-
'See note 3, p. .58. iSee pp. 863, 884, and Kratter:
Case of Mrs. Adams, p. 743. "Beitr.'' p. 3, 2.5313 ems. of arsenic
= Paterson: Edinb. M. J., 1857, iii., trioxid in the prim» viae.
395.
CAUSATION OF POISONING. 69
turing processes, such as poisoning by lead among the hands in
white-lead factories, by phosphorus in match factories, by mer-
cury among mirror silverers and thermometer makers, etc.
Such cases come more within the domain of public hygiene than
in that of forensic toxicology, yet they may be of legal interest
when the manufacturer is guilty of culpable negligence in ex-
posing his workmen to unnecessary and avoidable danger; or in
cases of alleged homicide in which the defense seeks to account
for the presence of the poison in the cadaver by attributing to it
this origin; or as affording an opportunity for the study of
chronic poisoning, which, in homicidal cases, may be produced
by the repeated administration of very small doses.
(b) Poisonings prom environment arise from contact with
poisonous substances or inhalation of poisoned air, not as a
consequence of employment in a particular trade, but from
the use of materials containing toxic agents. Thus arsenical
poisoning, usually non-fatal and of the chronic type, may be
caused by wearing clothing colored with arsenical dyes, or by
inhabiting rooms the walls of which are covered with arsenical
paint or paper; or lead poisoning by inhabiting apartments
freshly painted with white lead, etc.
(c) Food poisonings are the result of eating articles of food
which have been rendered poisonous either by the unintentional
or fraudulent admixture of mineral poisons, or by the genera-
tion in them of putrid poisons. Such cases are of frequent oc-
currence, and in them usually a number of persons are attacked
at the same time, sometimes an entire family and sometimes
hundreds of persons in a community. As instances of this class
of poisoning the Bradford lozenge cases, in which two hundred
persons were poisoned, and the Hyeres poisonings, in which
over four hundred persons suffered; in both instances, in conse-
quence of arsenic being used in mistake for plaster of Paris,
which was intended to be used as an adulterant; also the con-
stantly recurring poisonings by lead and copper, fraudulently or
negligently mixed with food, and the numerous cases of cheese,
sausage, ice-cream, fish, and meat poisonings.
(d) Medicinal poisonings are unfortunately of frequent oc-
currence and are not seldom the subjects of suits for malpractice,
or of prosecutions for manslaughter. For their occurrence either
the physician, the pharmacist, or the empiric is responsible.
70 TOXICOLOGY — WITTHAUS.
The first in many instances is excusable, as when a patient dies
from the effects of chloroform administered as an anaesthetic
with every possible precaution, or when a person manifests an
unusual susceptibility to the action of a drug, administered in
doses usually perfectly safe. But cases of severe poisoning and
even of death from the effects of powerful drugs administered
by physicians in heroic doses, either through ignorance, fool-
hardiness, or mistake, are by no means rare. For poisonings
caused by errors in writing prescriptions, the pharmacist is as
much to blame as the physician. For the pharmacist's error of
mistaking one bottle for another in compounding a prescription
there is no more excuse than for him who pleads that he did not
know the gun was loaded. For the recurrence of poisonings
caused by the administration or application of powerful reme-
dies by incompetent and ignorant persons, and for the wholesale
destruction of infant life by opiates in proprietary nostrums, a
community which permits the one to practise or the other to be
sold has itself to blame.
(e) Other criminal poisonings without intent to kill
arise from the administration or taking of drugs which have or
are presumed to have abortifacient properties to or by a preg-
nant woman;' or for the purpose of facilitating the commission
of another crime, as by the administration of chloral, dhatura,
etc., to permit the accomplishment of robbery or rape; or to pre-
vent pilfering, as by mixing tartar emetic with whiskey; or from
mere malice, as by purposely discharging chlorin gas into an in-
habited apartment.
While sec. 82 of the New York Criminal Law makes the selling
of instruments or drugs to procure a miscarriage a felony, sec. 80
does not specifically declare the crime of procurement of abortion
itself to be such, yet, as this crime is punishable by imprisonment
in a state prison, it is constructively a felony,^ therefore if the
woman die as a consequence of the act, another person who had
procured the abortion might be convicted of murder in the first
degree under sec. 1044. The same would apply if the poison or
• drug were administered to facihtate the commission of a
' For a comprehensive consider- ischr. f. ger. Med., 1905, 3 F.,
ation of the poisons used for this Suph. 43.
purpose see Lewin and Brenning: = See Cook: "Criminal Law,"
"DieFruchtabtreibungdurch Gifte," 1909, p. 3.
etc., Berhn, 1899; Hedron: Vrtl-
STATISTICS OF POISONING. 71
robbery or a rape, if the death of the victim result from the
administration.
The willful poisoning of animals, a misdemeanor under sees.
190, 191 of the New York Penal Law, may be classified here.
From the medical point of view poisonings are classified into
acute and chronic. Acute cases result from single large doses,
and proceed rapidly with violent symptoms. They are desig-
nated as peracufe when of very short duration and extreme
violence ; and as subacute when symptoms of the chronic type
are also manifested. Chronic cases usually, though not neces-
sarily, result from repeated and continuous absorption of small
quantities of poison, and the symptoms which are manifested
are different in character from those observed in the acute type.
STATISTICS OF POISONING.
Statistics of cases of poisoning can at best be but fragmen-
tary and incomplete, as in all countries the great majority of
non-fatal accidental and medical poisonings escape record en-
tirely, while in such records of vital statistics as are officially
kept, particularly in the United States, either the nature of the
poison is not determined with sufficient accuracy, or all cases
are classed under the general head -of poisoning. Confessedly
such records take notice only of fatal cases. The legal reports
refer only to the very small fraction of cases in which convic-
tion of criminal poisoning is followed by appeal.
The medical, pharmaceutical, and chemical journals contain
reference only to such cases as present points of novelty or of
exceptional scientific interest, and consequently indicate a pre-
ponderance of certain forms of poisoning over others which is
misleading. Kobert' gives the following table showing the
number of cases referred to in the medical journals during the
years 1880-89.
In this table the large number of food poisonings indicates
the interest in that subject then taken by the medical profession,
and the two hundred and seventy-three cases of lead poisoning
are probably, with very few exceptions, cases of chronic poison-
ing having hygienic interest, but of little forensic importance.
I "Intoxikationen," 1st Ed., 1893, p. 32.
72
TOXICOLOGY WITTHAUS.
1880
1881
1882 1883
1884
I
188511886
1887
1888
1889
1880
-89
Poisonous foods . . .
Bromin and com-
pounds
Potassium iodid . . .
Cantharidin
Rhus toxicoden-
dron
Iodoform
Phenol
Lead
Mercury
Arsenic
Tobacco
Santonin
Soda and salicylic
acid
Quinin, etc
Caffein
Camphor
Cannabis indica . . .
Hyoscin, etc
Stramonium
Aconitin
Atropin
Strychnin .......
Chloral hydrate . .
Alcohol
Cocain
Opium
Morphin
16
4
4
4
2
25
21
6
32
1
2
1
3
1
1
1
3
9
8
17
9
10
12
11
12
2
1
4
2
2
28
23
3
19
1
5
2
23
15
2
3
22
11
15
2
2
3
2
20
17
26
9
16
2
4
12
12
9
5
4
21
21
15
27
2
3
1
3
2
4
11
5
24
20 !
32
27
6
38
17
4
3
1
2
3
3
2
6
7
12
13
7
17
17
■1
1
7
5
4
16
19
14
11
26
2
1
4
7
1
1
2
4
4
11
13
16
36
20
28
14
11
12
5
2
1
2
4
4
2
3
4
1
4
3
1
1
4
3
5
3
17
14
9
6
2
1
9
9
11
24
17
13
IS
17
32
25
3
1
4
2
2
1
5
1
9
2
15
11
31
27
17
21
18
15
4
2
2
2
3
4
1
1
5
11
7
5
16
23
9
21
4
3
1
3
10
10
30
23
26
3
3
2 I 2
8 ; 6
1 4
1 1
1
4
5
10
7
2
18
28
11
10
6
1
3
8
14
1
26
23
12
17
200
24
31
19
23
76
179
273
165
191
34
16
23
34
13
18
22
20
31
55
131
116
42
115
114
148
184
That medical literature affords no adequate information upon
this subject is evidenced by the results of an attempt which
we have made to determine the number and character of accu-
sations of murder, manslaughter, and assault by poisoning in
the State of New York during the fifteen years 1879-93. Ac-
counts in the public press, verified and amplified by inquiry of
the district attorneys of the several counties, and by examina-
tion of the county records, show that sixty-four such accusations
were made during that period in twenty-four counties (pop.
4,026,278); of which twenty-one were bj- arsenic, eleven by
Paris green, eight by opiates, two each by corrosive sublimate,
strychnin, and potassium cyanid, and one each by cupric sul-
fate, carbolic acid, chlorid of lime, oxalic acid, and lauda-
num. In thirteen the nature of the poison was insufficientlv
determined. Of these sixty-four cases there are but three to
which we have found any reference in medical literature.
STATISTICS OF POISONING. 73
The statistics of fatal, accidental, and suicidal cases are some-
what more satisfactory, although it is probable that a large pro-
portion of so-called " accidental" poisonings are classified among
the deaths from natural causes, and the nature of the poison in
suicidal cases is frequently determined by the "guess" of the
coroner's physician. Such statistics are of value, however, to
indicate the influence of locality upon the kind of poison most
frequently causing death and most frequently used by suicides.
The following table, compiled from the returns of the coroners
of the county of New York, may be divided into three periods:
1841-43, 1866-80, 1889-92.
The most noticeable features of these statistics are: 1st.
The large number of poisonings by illuminating gas in the last
period. The large predominance of accidental over suicidal
deaths by this agent is due to the fact that only those cases in
which the suicidal intent was obvious are classified as suicides.
At the present time illuminating gas probably causes more
deaths in this city than any other poison. 2d. The large
number of poisonings by "Paris green." During the period
1866-80 morphin and the preparations of opium caused 251
deaths and Paris green 238; while in 1889-92 the opiates were
fatal in 75 cases and Paris green in 86.^ The predominance of
Paris-green poisoning is peculiar to the United States, where it
is traceable to the very general use of that dangerous agent for
the destruction of vermin. In England, poisonings by the
opiates, by the cyanic poisons, and by the mineral acids out-
number those by arsenic. In France at the present time phos-
phorus is the agent most frequently employed in criminal
poisoning," and the number of illicit administrations of the salts
of copper and of cantharides is much greater than in other
countries, while crimes in which the cyanic poisons and the
opiates are used are of very infrequent occurrence. In Germany
and Austria, on the other hand, poisonings by the cyanics are
only exceeded in number by those by illuminating gas and the
mineral acids. In the latter country the mineral alkalies are
more frequently the cause of death than elsewhere. In Finland
carbon monoxid, strychnin, and the mineral acids are the poisons
most frequently used. In India poisonings by arsenic still
maintain the predominance which they formerly had in Europe,
' See Arsenical Greens. ^ Tardieu: "Empois.," 1S75, p. 167.
74
TOXICOLOGY — WITTHAUS.
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STATISTICS OF POISONING. 75
but are very nearly equalled, and in some districts surpassed,
by the use of the opiates. In India also poisonings by mer-
curials, aconite, and dhatura are more often met with than in
Europe or America. The table on page 76, compiled from
various sources, indicates the relative number of poisonings by
the commoner poisons in various countries:
In the United States the apparent rarity of crimes by poison
in large cities is a subject for serious reflection. In the city of
New York during the past sixty years there have been but nine
trials for murder by poison, five of which resulted in the con-
viction of murder in the first degree,' one in the second degree,^
and three in acquittal.^ During the same period there was one
conviction for manslaughter* and two for assault in the first de-
gree,^ and two cases of murder and suicide.^ In three of the
five cases of murder by poison which (after an interval of twenty
years, during which no similar cause was tried) have been the
subject of trial since 1892, the body of the deceased was buried
upon the certificate of a physician in two instances, and after
an entirely insufficient investigation by the coroner in the third ;
and it was only after periods of 43, 53, and 98 days that, at the
instance or suggestion of unofficial persons, the bodies were
exhumed and submitted to proper examination. In the two
most recent cases official investigation followed promptly upon
the death. There is little room to doubt that the more frequent
occurrence of trials for poisoning in rural communities has been
due rather to the greater detective efficacy of public rumor
among these than to exceptional rarity of crimes of this nature
in large cities of such heterogeneous population as New York.
The inadequacy of our present police and legal machinery to
the prevention and detection of secret poisoning is further shown
by the occasional detection of a murder by poison constituting
the last of a series of similar crimes, escape from the conse-
quences of the earlier of which has finally led to carelessness on
the part of the perpetrator and to the awaking of suspicion by
the sheer number of rapidly succeeding deaths, all leading to
1 Williams, 1854; Stephens, 1859; upon the first trial, acquittal upon
Harris, 1892; Buchanan, 1893. the second.
Patrick, 1900. ■■ Nichols, 1893.
' Meyer, 1894. ^ Volkmer (Joseph and Mary),
' Heggi, 1872-73; Lebkuchner, 1879; Burgess, 1886.
1888. Molineux, 1898, conviction « Deffarge, 1879; Fritz, 1885.
76
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STATISTICS OF POISONING. 77
the pecuniary advantage of the same survivor. The defendant
Meyer was under indictment for a similar offense in Ohio,
where he would have been tried for murder had he escaped con-
viction in New York, and if the theory of the State be correct,
the crime for which he was convicted was but one of many
schemes for the defrauding of life-insurance companies, some
of which at least were attended with murder. In November,
1888, Sarah Jane Whiteling was convicted of murder in the
first degree for having killed one of her children by poison, hav-
ing previously destroyed another child and her husband by sim-
ilar means in order to collect a paltry life insurance upon each.
The three deaths occurred on March 20th, April 24th, and May
26th of the same year. In 1888 Sarah J. Robinson was convicted
of murder in the first degree after two trials, for one of a series
of probably eleven poisonings by arsenic at Somerville, a suburb
of Boston. The victims were relatives; the motive the collec-
tion of life-insurance money. Instances of repeated poisoning
are, however, by no means peculiar to this country. In Ger-
many the cases of Anna Margaretha Swanziger (3 murders and
several attempts), the widow Ursinus (4 murders), Gesche Mar-
garetha Gottfried (15 murders), and Gesche Margaretha Brock-
man (3 murders) are historical. In Holland the poisonings at-
tributed to Maria Catherine Swanenburg extended between 1877
and 1883. Besides the 4 persons for whose murder she was
convicted in 1885, she had destroyed 19 others, while 36 persons
were made ill by poison administered by her, of whom 5 twice,
2 three times, 1 four times, 1 five times, and 1 six times; and
had attempted to kill 14 others, 1 twice and 1 three times. In
Belgium in 1894 the wife of a prominent government official
was charged with successive poisoning of a sister, an uncle, and
a brother. In France, Pel (1884) was suspected of having de-
stroyed five persons by poison in a period of twelve years, and
Pastre-Beaussier (1886-88) was accused of having caused the
death of three persons and the serious poisoning of twelve
others. In England, two women (Reg. v. Flannagan and Hig-
gins, Liverpool Winter Assizes, 1884) were convicted of mur-
der, having caused the death of four persons by arsenic ex-
tracted from fly-paper. Taylor^ refers to the case of Mary Ann
Cotton (Durham Lent Assizes, 1873), convicted of the murder
I "Poisons," 3d Am. ed., 180.
78 TOXICOLOGY — WITTHAUS.
of a stepson, who had previously at various times destroyed her
mother, fifteen children, three of her husbands, and a lodger by
poison. In all of the cases cited the object was the same, the
obtaining of insurances upon the lives of the victims. The case
of the notorious "Dr." Cream, or Neill, executed for the mur-
der of Matilda Clover in England in 1892, shows that the whole-
sale poisoner may extend the field of his operations over two
continents.
ABSORPTION OF POISONS.
That poisons administered by the mouth or by inunction
pass into the blood and tissues was known early in the nineteenth
century. VoigteP in 1804 quoted several instances in which
mercury was obtained by distillation from the bones of those
who had taken corrosive sublimate for some time. Buchner^
relates that at a still earlier period Pickel had found mercury
in the brain of a similar patient, and that Eckel had obtained
mercury from the blood, urine, and saliva of a syphilitic patient
under treatment by inunction, and in the perspiration of an-
other treated by internal administration. Orfila was the first
to demonstrate the presence of arsenic in the blood, organs, and
urine after its administration by the stomach, first in a series
of experiments upon animals in 1839,^ and later in the same
year in the human subject in the case of SouflBard.^ Since that
time analyses have shown the presence of a great number of
poisons in the blood, tissues, and urine either in their own form
or in their products of decomposition, after their administration
by the stomach, by inhalation, and otherwise, and if any still re-
main whose absorption has not been thus proved, it is either be-
cause the necessary investigations have not been undertaken or
because of the inadequacy of our methods of research. In
some instances in which the usual chemical reactions have failed
•to show the presence of a given poison in the blood, its existence
there has been otherwise demonstrated. Thus while liquid re-
actions may fail to show the presence of lithium and thallium
'"Handb. d. path. Anat.," ' M^m. Ac. roy. de m^d., 1840,
1804-5, i., 153-258; ii., 10, 110. viii., 376.
^"Toxikologie," 2te Aufl., 1827, ^ "Toxicologie," 5Sme ed., i., 43,
544, 538. and Bull. Ac. de m^d., 1S3S-39,
iii., 664.
ABSORPTION OF POISONS. 79
in the blood and tissues after the administration of small doses,
their presence there has been distinctly shown by spectroscopic
examination of the ash. In the case of alkaloidal poisons reac-
tions approaching in delicacy the spectroscopic tests are want-
ing, and for many the known reactions require very appreciable
quantities of the substance. If the presence of snake poison in
the general circulation has not been demonstrated by chemical
means, its presence there may be inferred from the fact that
when injected in the distal end of a limb, whose communication
with the general circulation is temporarily cut off by a ligature,
its action is slight and local only, but on removal of the liga-
ture its rapidly fatal action is exerted. The "incarcerated" hy-
podermic use of cocain to produce local anaesthesia in a portion
of a limb separated from the general circulation by a bandage
is now generally practised.
At the present time the view of Bernard, that poisons only
act after absorption into the blood,* is so universally accepted
that we have considered it as the distinguishing element in the
method of action of the true poisons, in contradistinction to the
local chemical action of the corrosives, and to the physical
action of mechanical and thermal irritants. (See Definition,
P-51.)
When a poison is directly introduced into the circulation, as
by hypodermic or intravenous injection, or application of its
solution to a wounded surface, it is clear that absorption is
dispensed with, and that consequently the action of poisons or
medicines so administered is more rapid than when they are
taken by the mouth. Poisons so introduced begin to act imme-
diately, as the time required for their transmission to the organ,
tissue, or morphological element upon which they exert their ac-
tion is practically insignificant; and with rapidly acting poisons
I Pour qu'un poison agisse, il tion immediate ne se produira, et k
faut qu'il soit arriv6 dans le sys- la longue seulement un effet local
tSme art^riel, car ce n'est que lors- pourrait se montrer dans certains
qu'il sera parvenu dans le r^seau cas. II faut, ainsi que nous venons
capillaire, au moyen des artfires, de le dire, pour que les effets tox-
que ses effets se manifesteront. iques de ces substances se manifes-
Qu'on place, en effet, sur le cerveau tent, que I'absorption les ait ame-
I'un de oes poisons dont Taction sur n^es dans le courant artSriel, qui les
le syst^me nerveux est si puissant et conduit aux capillaires ("Sub-
cause si promptement la mort, de stances toxiques et m^dicamen-
la strychnine ou de I'acide cyan- tenses," 1857, p. 47).
hydrique, par exemple; aucune ac-
80 TOXICOLOGY WITTHAUS.
a fatal termination may follow in a very short time. Thus ani-
mals have been killed in half a minute by injection of cobra
poison (Fayrer) or of hydrocyanic acid (Preyer).
Almost all poisons also act more energetically when thus
introduced, by reason, partly, of the immediate entrance of
the entire dose, which, being gradually absorbed from the ali-
mentary canal, may be partly removed by elimination before
absorption is complete, and partly because by hypodermic injec-
tion the entire quantity administered certainly enters the circu-
lation, while a part of that given by the mouth frequently
escapes absorption entirely.
Substances, however, which are themselves non-poisonous,
but which are acted upon by the gastric secretion, with forma-
tion of a poisonous derivative, are inert when introduced directly
into the circulation, but actively poisonous when taken into the
stomach. Thus the neutral crotonglycerid, which exists in the
fresh seeds of croton tiglium, is inert when injected hypoder-
mically, but is decomposed when taken into the stomach, with
liberation of crotonic acid, which acts energetically. Potas-
sium myronate, a constituent of mustard, and amygdalin, a
glucosid from the bitter almond, may be given to herbivorous
animals under the skin without producing any ill effects, but, if
given by the mouth, they are decomposed in the intestine by
the action of bacteria therein contained, the former with the
hberation of oil of mustard, the latter with the formation of
hydrocyanic acid, whose actions are then manifested.'
On the other hand, there are some poisons which, although
extremely active when introduced hypodermically, are either
inert or much less violent in their action when taken by the
mouth. Such are the venoms of serpents, curare, ergotic acid,
which are either excreted more rapidly than they are absorbed,
or are converted into less harmful derivatives in the ahmen-
tary canal or hver.
The rapidity with which absorption takes place depends
upon: (1) The diffusibility of the substance; (2) its condition,
whether in solution or soHd, and, in the latter event, whether
readily or difficultly soluble; (3) other conditions existing which
favor or impede solution and diffusion; (4) the absorbent
surface.
' Kobert: "Intoxikationen," 2d Ed., 1902, ii., 24.
ABSORPTION OF POISONS. 81
The influence of variations in diffusibility upon the rapidity
of absorption is, in the case of solid poisons, dependent in large
measure upon variations in conditions influencing solution, as
in their case solution is preliminary and prerequisite to diffusion
or absorption. The rapidity of absorption by the pulmonary
mucous membrane is due in part at least to the rapid diffusi-
bility of gases and vapors. Vapor of chloroform when inhaled,
even if largely diluted with air, is rapidly absorbed, and has
been known to produce unconsciousness and muscular reso-
lution in animals in twenty-five seconds, while in the human
subject, administered for the purpose of causing ansesthesia, it
frequently accomplishes that object in less than half a minute,
and in some cases has destroyed life in less than a minute.'
But, when taken into the stomach, liquid chloroform, by reason
of its sparing solubility and its slight diffusibility under such
conditions, causes insensibility only after the lapse of half an
hour or more. Thus- Smith^ relates the case of a woman who
swallowed about an ounce of chloroform, after which she walked
about the streets for an hour, when she was found leaning
against a building, and walked to the police station, where she
became unconscious. She had walked between one and two
miles before losing consciousness.
In general terms it may be stated that anything which
favors solution of a poison accelerates its absorption, while any
condition which impedes its solution retards absorption. Phos-
phorus administered in a salad is absorbed more rapidly than
when taken in a watery liquid, while the reverse is the case with
powdered white arsenic. Oils favor the solution of the former
and impede that of the latter. Insoluble substances are non-
poisonous. Even if they be substances- which in a soluble form
are actively poisonous, when in an insoluble modification or com-
bination they are inert. Thus, while the yellow variety of
phosphorus is one of the most virulent of poisons, the red allo-
tropic modification, which is the same substance chemically,
and differs only in its physical properties, is practically harmless,
and that principally because it is not dissolved by the oils and
fats which are solvents of the yellow modification. Indeed, the
object of administering chemical antidotes in cases of poisoning
'Lyman: "Anesthesia," New =Phila. Med. News, 1891, lix.,
York, 1881, p. 195. 688.
IV— 6
82 TOXICOLOGY — WITTHAUS.
is usually to bring about the formation of an insoluble, and there-
fore non-poisonous, combination. But, while the toxic activity
of a given substance is proportionate to the quantity which can be
brought into solution, it by no means follows that readily soluble
substances are more poisonous than related substances of more
difficult solubility. Indeed, the reverse is known to be the case
in many instances, as in the series of alcohols of which ordinary
alcohol is a member, the higher terms are less soluble and more
actively poisonous than the lower.'
Absorption by the Respiratory Organs. — The absorption of
gases and vapors which are soluble in or act chemically upon the
blood takes place with great rapidity. Ammonia, however, al-
though very soluble in water is not absorbed by the lungs
(see p. 326). Indeed, volatile Hquid poisons are sometimes more
rapidly fatal when their vapor is inhaled than when the liquid is
injected directly into a blood-vessel. Thus Preyer,^ experiment-
ing with hydrocyanic acid, found that a rabbit died in twenty-six
seconds after inhaling the vapor of the concentrated acid for
three seconds, while in another rabbit into whose jugular vein 1
c.c. of a sixty-per-cent. acid was injected, although the interfer-
ence with respiration was immediate, the spasms only appeared
in twenty-nine seconds, and death followed in sixty-one seconds
after the injection. In guinea-pigs death followed inspiration of
air charged with vapor of hydrocyanic acid in five, six, and six-
teen seconds. It is clear that here absorption was practically
instantaneous.
The action of poisonous gases when inhaled in tolerably con-
centrated form, besides being favored by rapid absorption, is
also aided by interference with the principal channel of their
excretion. With gases which may be inhaled undiluted with
air, elimination by this channel is entirely arrested, and the
effects are very rapidly produced. Thus muscular resolution has
been produced by nitrous oxid in twenty-five seconds. In the
case of indifferent gases the interference with elimination of
carbon dioxid is the only cause operative, and several minutes
elapse before the accumulation of that gas in the blood causes
asphyxia.
'In this connection see also ="Die Blausaure," ii., 1870, 60,
Richet: C. rend. Soc. biol., Paris, 62, 71.
1893, 9 s., v., 775.
ABSORPTION OP POISONS. 83
Occasionally, by sudden acts of inspiration, liquids enter
the upper respiratory passages, when they not only act mechani-
cally, but are rapidly absorbed and behave as poisons. Sprays
are promptly absorbed and are frequently used for medication.
The mechanical detrimental action of solids entering the air pas-
sages gives no time for toxic action if the masses be of appreciable
magnitude, but small quantities of extremely finely divided
powders may be thus administered by insufflation.
Absorption by the Mouth. — Absorption by the buccal mu-
cous membrane is usually of slight practical importance, as
the poison is rarely retained in that cavity or given in a form
which permits of any extensive absorption during its brief so-
journ there.
Poisons of great activity, however, enter the circulation
from the mouth or lips or the nasal mucous membrane with
such rapidity that their contact with those surfaces may cause
death before an act of swallowing is attempted, or even pos-
sible. Thus Preyer* found that rabbits fell unconscious in
twenty-three seconds after the application of hydrocyanic acid
to the tongue, and in twelve seconds after its application to the
nostrils. Nicotin also, when applied to the mouth in doses of
two to four drops, may cause poisoning either immediately or
within half a minute.^ In cases of tobacco poisoning from ex-
cessive smoking, in which the smoke is not inhaled, the absorp-
tion is by the buccal mucous membrane, except in so far as it
may occur by swallowed saliva. Arsenic is also absorbed from
the mouth under exceptional circumstances, as in those in-
stances in which arsenical symptoms were traced to smoking
tobacco or cigars impregnated with arsenic.^ Gorochof zefE ^ has
shown that dogs after ligation of the oesophagus are killed by
strychnin more rapidly by the mouth than by the stomach.
Absorption by the Stomach. — The action of the stomach on
food constituents is preparatory rather than absorptive, and such
absorption as does occur there appears to be a purely physical
process, as salt or glucose is absorbed from the stomach when in-
troduced in solutions which are hypertonic to the blood plasma,
but not when the solutions are isotonic or hypotonic. Absorp-
'■ Loc. cit., p. 69. Ixiv., 13. Friedreich: Bl. f. ger.
^Husemann u. Hilger: "Pflan- Anth., 1858, ix., 3 Hft., 40. The
zent.," 2te Aufl., ii., 1, 173. latter a case of alleged homicide.
'Schlegel: J. d. pract. Hlk., 1827, "Deut. KHn., 1874, 316.
84 TOXICOLOGY — WITTHAUS.
tion from the stomach appears to be more rapid in the later than
in the earher stages of digestion, as potassium iodid, introduced
in capsules into the human stomach in the third hour of digestion
is absorbed within six to eleven minutes, while, when introduced
with the food, it is not absorbed for from twenty to forty minutes.
Diluted alcohol is absorbed rapidly, and substances in alcoholic
solution more rapidly than those in aqueous solution.
There are differences in the rates of absorption of certain sub-
stances from the stomach in different kinds of animal. Thus
strychnin is absorbed more slowly in cows and much more slowly
in horses than in dogs, pigs, or cats. Otto' found that strychnin
is absorbed frgm the ligated stomach in cats and dogs, but not
in rabbits or guinea-pigs, while the reverse is the case with potas-
sium iodid and sodium salicylate. Melzer^ found that strychnin,
dissolved in forty-per-cent. alcohol and introduced in large amount
into the stomach, ligated at both extremities, of fasting rabbits,
produces no effects in fifteen hours, but it becomes rapidly fatal
on removal of the pyloric ligature. The immunity of hens to
strychnin is ascribed in part to slow absorption from the alimen-
tary canal.^ According to Doyon and Morel,* arsenic is not ab-
sorbed from the alimentary canal in dogs. They gave a dog of
ten kilos, weight one gram of arsenic trioxid daily. There was no
vomiting, the animal increased in weight, and no arsenic was
found in the liver or other organs. To another dog of 18 kilos,
weight they gave 18 grams of arsenic trioxid at one time without
causing toxic effects. On the other hand, they quickly obtained
toxic and lethal action by subcutaneous injection of infinitely
smaller quantities.
But the failure or imperfection of absorption from the
stomach under normal circumstances is no impediment to the
passage of dissolved substances into the blood, as these pass
rapidly to the intestine, where absorption is active. Water
taken alone passes at once into the duodenum, and those portions
of the stomach contents which have attained a degree of liquidity
similar to that of thick pea soup begin to be discharged by the
stomach into the intestine within two or three minutes after
their ingestion. The pyloric sphincter is selective in its action;
' Arch. d. Verdaungsk., 1902, ' Molitoris: Vrtljschr. f. ger. Med.,
viii., 427. 1906, 3 F., xxxi., 322.
^ Ctbl. f. Physiol., 1893, x., 281. ' C. r. Soc. de biol., 1906, Ixi., 26,
116; Lyon m^d., 1907, cviii., 59.
ABSORPTION OF POISONS. 85
it relaxes to afford passage to materials of liquid consistency,
which are propelled toward the intestine by the contractions
of the gastric musculature, while it contracts to retain solid parti-
cles for a long time.
According to Harnack ' vapor of phosphorus is absorbed from
the stomach by gaseous diffusion through its walls.
Absorption by the Intestine. — As the small intestine is
the essential organ of absorption of the products of digestion, so
is it also a most active absorbent for poisons and medicinal
agents which, having reached it, are more rapidly absorbed
than from the stomach. Poisons, such as phosphorus, which
are soluble in oils but not in watery liquids, escape absorption
in solution in the stomach entirely, and only enter the circulation
indirectly from the intestine by the channel of the thoracic duct.
Absorption from the rectum is rapid with most poisons in solu-
tion. Thus Galtier^ cites the experiments of Roselli and Strom-
bio, who found that strychnin introduced into the rectum in alco-
holic solution caused tetanic spasms in dogs more rapidly than
the same quantity given in the same form by the mouth. Rectal
medication by means of suppositories is now frequently practised,
as it was by enemata formerly. Morphin and belladonna are
more rapid in their action when given by the rectum than when
swallowed, and the numerous accidents that have followed the
use of infusions of tobacco as enemata attest the facility of the
absorption of nicotin by the rectum. Instances of homicidal
administration of poisons by the rectum are of infrequent oc-
currence. (See Sulfuric Acid, Arsenic, Mercury.) Suicides
have in a few instances selected this method of administration.'
Poisons absorbed from the stomach and intestines are car-
ried by the gastric and mesenteric veins to the portal vein, by
which they enter the liver, where they are to some extent re-
tained or modified,'' or whence they pass by the hepatic veins into
the general circulation.
The duration of absorption from the alimentary canal will
depend largely upon the form in which the poison is taken and
upon the extent to which that not immediately absorbed is
either rendered insoluble by the action of antidotes or removed
'Munch, med. Wchnschr., 1909, 'Hofmann: "Lehrb. d. ger. Med.,"
xlii., 436. See p. 642. 5te Aufl., 615.
2 "Toxicol, gfe.," 1855, p. 8. ' See p. 101.
86 TOXICOLOGY — WITTHAUS.
by purgation, vomiting, or the stomach pump. When opium,
which causes neither vomiting nor purging, is taken in the solid
form in large amount and no successful effort to remove it from the
stomach is made, its gradual solution and absorption in solution
must continue until death puts an end to the process. In the
case of a woman' who died sixty hours after taking an unknown
quantity of white arsenic, that poison was found in substance in
the stomach. It goes without saying that, if life continue,
the same conditions which diminish the rapidity of gastro-
intestinal absorption increase its duration. Absorption from the
alimentary canal is notably retarded by previous intraperitoneal
injection of adrenalin.^
Absorption from the Skin. — The skin with its cuticle or
epidermis intact is pervious only to substances which are sol-
uble both in lipoids and in water. ^ The degree of solubility need
not, however, be high, as Lehmann* has shown that nitrobenzene,
which is very sparingly soluble in water, is absorbed by the unin-
jured skin in the cat. As a rule, salts are not absorbed by the
skin. But the experiments of Gallard' have shown that after
immersion of the arms in a five-per-cent. solution of sodium iodid
for half an hour daily, the urine of the succeeding twenty-four
hours contained from 0.066 to 3.863 mgm. of iodin. Kahlberg'
has also shown that traces of boric acid appear in the urine within
five minutes, and estimable quantities within ten minutes, by
immersion of the feet in a saturated solution; but that salts of
calcium, rubidium, and lithium, even the tetraborate of the last-
named, are not so absorbed. There are, however, some poisons
which act directly upon the skin, producing dermatitis, which in a
mild form may be limited to a simple redness or erjrthema, attended
with more or less itching and going on to the formation of vesicles,
pustules, or bullae, and, in extreme cases, even gangrene. Among
these are arsenic and the juices of certain plants. The epidermis
is, on the other hand, permeable to oils and fats, and mercury
and some other medicines, incorporated with fats in the shape of
ointments, are readily absorbed when rubbed upon the cuticle.
'Paterson: Edinb. M. J., 1857, * "Beitr. z. Physiol, u. Path.,"
111-. 394. Festschr. Hermann, 1908, 130.
2 Exner: Arch. f. exp. P. u. P., = C. r. Ac. sc, 1900, cxxx., 858.
1903, 1., 313. "Proc. Am. Soc. Biol. Chem.,
^ Sciiwenkenbecher: Arch. f. An. 1908, i., 118.
u. Physiol., Phys. Abt., 1904, 121,
with bibliography.
ABSORPTION OF POISONS. . 87
The menstruum best adapted to this purpose is lanolin (a fat, in
which glycerol is replaced by cholesterol), obtained from wool.
Finely divided powders, when rubbed upon the cuticle, are also
absorbed, probably by being dissolved in the oily sebaceous
secretion. Metals, also, whether in the shape of solids or vapors,
are absorbed through the cuticle, as is evidenced by the occur-
rence of lead poisoning among plumbers and others who handle
that metal and by the physiological action of mercury produced
by exposure of the skin to the vapor of that metal. Pronounced
symptoms of atropic poisoning have repeatedly been observed
after the application of belladonna plasters to the uninjured skin;
and death has resulted from similar application of antimonials.^
The abraded skin, exposing the very vascular subcutaneous
cellular tissue, becomes a very active absorbent surface, and
solutions applied to it are to all intents and purposes under the
same conditions as when hypodermically injected. Certain sub-
stances, such as bismuth subnitrate, are absorbed from wounds,
although their absorption from the alimentary canal is very
slight.
Absorption from Genito -Urinary Organs. — Several cases are
reported of women who have been poisoned by arsenic introduced
into the vagina with murderous intent.^ The occurrence of
mercurial poisoning in women, due to the use of corrosive sub-
limate solutions for vaginal and uterine irrigations, has been the
subject of several treatises. Uterine absorption is much more
active after delivery than at other times.
The male urethra and mucous membrane of the glans and pre-
puce are actively absorbent surfaces. So far as we are aware, no
modern instance is recorded of criminal introduction of poison by
these channels, although Zacchias relates' that Ladislas, King
of Naples, was killed by poison communicated during coitus.
The mucous membrane of the urinary bladder absorbs only
slowly and imperfectly. Stille* states that atropin may be ab-
sorbed from the bladder even after it has been eliminated from
the system by the kidneys. On the other hand, Falck^ found
that 0.03 gm. (gr. 1/2) of strychnin nitrate in solution introduced
'Seep. 364. "Wharton and Still^: "Med.
^ See Arsenic, p. 433. Jur.," 4th ed., ii., 11.
'"Qusest. med. leg.," Venet., = "Toxikologie," 1880, p. 8. Also
1737, i., 170. Cohnheim: Ztschr. f. Biol., 1901, xli.,
331.
5(5 . TOXICOLOGY WITTHAUS.
into the bladder of a dog did not produce the slightest symp-
toms of poisoning, while very much less quantities (from 0.75
to 3.9 mgm. per kilo) caused death by hypodermic injection, by
the rectum, and the empty stomach.
The experiments of Cazeneuve and Lepine' show that
strychnin is not absorbed from the uninjured bladder. They
injected 0.04 gm. (gr. 6/10) into the bladders of dogs by means
of a Dieulafoy syringe; the neck of the organ having been pre-
viously ligated. No symptoms whatever were manifested for
sixteen to twenty hours, after which they develojjed rapidly,
and terminated suddenly in death. As at the autopsy they
always found the bladder inflamed in the neighborhood of the
ligature they properly attributed the later effects to absorption
from this inflamed surface.
Absorption Through Other Channels. — Substances in solu-
tion injected into parenchymatous organs pass into the cir-
culation as rapidly as when injected into the subcutaneous tis-
sue. The serous membranes are actively absorbent. Cases of
medicinal poisoning have resulted from the introduction of
atropin solution into the auditory canal, and mineral acids have
been poured into the ear with murderous intent. The corneal
and palpebral conjunctiva is an absorbent surface, as is proved
by absorption of atropin applied to it, even in persons in whom
there is closure of the lachrymal duct; but absorption takes
place more slowly than from mucous surfaces.
That the foetus may be killed by poison taken by the mother
is proved by instances in which arsenic, phosphorus, lead, iner-
cury, and copper have been detected in the tissues of the foetus,
either after the death of the mother or after dead birth.
DISTRIBUTION OF POISONS.
The distribution of poisons in the system, i.e., the relative
proportion existing in different organs and tissues of the body
at various stages of absorption and elimination, has as yet
been studied with regard only to a few mineral poisons, such as
arsenic, antimony, copper, and lead. Concerning the first two
the number of observations is still small, and with regard to the
last two the investigations have been for the most part in cases
' Ct. rend. Ac. Sc, Paris, 18S1, xciii., 445.
ACTIONS OF CORROSIVES AND POISONS. 89
of chronic poisoning. Investigations hitherto made show that
the distribution is different with different poisons and very prob-
ably not the same in acute as in chronic poisoning, or in poison-
ing by repeated doses. (See Arsenic: Distribution, p. 529.)
METHODS OF ACTION OF CORROSIVES AND POISONS.
Two varieties of action are commonly recognized: a local
action, that produced at the point of application, whether ex-
ternal or internal; and a remote action, manifested in some
organ, tissue, or fluid to which the deleterious agent is not di-
rectly applied. The local action of the corrosives is intense,
and their remote action insignificant. With true poisons the
reverse is the case. (See Definition, p. 51 )
The local action is most intense with the mineral acids
and alkalies. These substances disorganize those tissues with
which they come in contact by chemical decompositions which
they bring about in dead and living tissues alike. The injuries
caused by them during life closely resemble those caused by
heat; to all intents and purposes they are burns (See Vol. L, p.
953). Some substances act both as corrosives and as true poi-
sons, the local or remote action predominating according to the
degree of concentration. This is true of oxalic acid, mercuric
chlorid, and phenol, substances which have a great tendency to
enter into chemical reaction with the nitrogenized constituents
of the body, thereby causing destruction of the cellular elements
of tissues with which they come into contact, either by direct
application or by the channel of the circulation. The local ac-
tion of such agents is manifested in erythema, eruptions, swell-
ing, with or without oedema, extravasation of blood, and even
formation of pus, and by sensations of pain, prickling, itching,
burning, or of cold, when they are applied to the cutaneous sur-
face; and in the symptoms of gastro-enteritis, more or less in-
tense, when they are taken by the mouth.
In the case of arsenic, and possibly also of other poisons, the
effects at the point of application, although in one sense local,
are direct only to a limited extent, and depend rather upon
absorption of the poison and its return by the circulation to the
part affected. Gastro-enteric inflammation is caused by arsenic
admiftistered by other channels than the mouth, and conse-
90 TOXICOLOGY — WITTHAUS.
quently without direct application to the gastro-enteric mucous
membrane.
The remote action of poisons, manifested after their en-
trance into the circulation, is local in the sense that it is exerted
upon organs or tissue elements with which the substance is
thus brought in contact. The view formerly held by some that
poisonous influences in the case of rapidly acting poisons, such
as hydrocyanic acid and nicotin, must, because of their rapidity
of action, be transmitted by the nerves is no longer entertained.
Even the most rapidly fatal poisons do not cause death with such
rapidity that their transmission by the blood to the part affected
is impossible.
Concerning the method of action of poisons upon cells and
tissue elements or their constituents but little is known. A few
poisons are, however, known to cause changes in the composi-
tion, chemical changes, in certain constituents of the tissues and
fluids which render these unfit to perform their normal func-
tion. Thus carbon monoxid combines with the red coloring
matter of blood corpuscles to form a compound more stable
than that which the same pigment produces with oxygen, and
thus extinguishes life by interference with the transfer of oxy-
gen from the lungs to the tissues. It has also been suggested
that the poisonous action of arsenic is due, in part at least, to
interference with normal chemical processes brought about by
modifications of oxidation.*
Rabuteau^ has sought to show that in the case of the mineral
poisons a relation exists between their atomic weights and their
toxic activity, the latter being the greater as the former is more
elevated; or that they are the more active the lower their spe-
cific heat.
Recent investigations of the actions of those organic poisons
whose chemical constitution is known indicate that their toxic
activity depends upon their molecular structure, and in the case
of certain series of related or homologous compounds is in-
creased or diminished by introduction of certain groups or
atoms, or in the case of isomeric bodies by variations in their
positions. Thus Gibbs and Reichert^ have shown that the
'Binz and Schultz: Arch. f. exp. Sc, Paris, Oct. 24th, ISSl, and
Path. u. Pharm., 1879-82, xi., 200; Blake: ibid., April 23d, 1888.
^l-ul^^'-^'Y-' ^'^^' ''^■' 322. ' Amer. Chem. Journ., 1894, xvi.,
Toxicologic," 2eme ed., 1887, 443-449.
p. 11. See also Richet: C. rend. Ac.
ACTIONS OF CORROSIVES AND POISONS. 91
lethal doses of propyl, butyl, heptyl and octyl alcohols are pro-
gressively diminishing quantities. Bauman and Kast,' investi-
gating the relative activity of the sulfones, found that those con-
taining the radical methyl (CHj) only are therapeutically inactive,
while the ethyl (C2H5) derivatives have hypnotic actions increas-
ing in activity with the number of ethyl groups contained in
their molecules. The introduction of methyl into hydrocyanic
acid or strychnin produces great diminution of toxicity, while
dimethyl resorcinol is much more actively toxic than resorcinol.
The introduction of either methyl or ethyl into morphin changes
the character of its action from narcotic to tetanic. The in-
fluence of orientation has been studied by Brieger and by Gibbs
and Hare,^ who found that the paratoluidins are much more
actively poisonous than the ortho compounds. But that, on the
other hand, of the three isomeric diphenols, catechol (ortho)
is the most actively poisonous, and resorcinol (meta) the least
so. The lethal doses of the three are given as catechol 5, quinol
(para) 10, and resorcinol 100.^
The remote actions of poisons are undoubtedly chemical in
their nature; i.e., attended with changes in the composition of
the cell constituents acted upon. Such changes may, however,
be brought about by physical processes, as in the case of a woman
who died in 24 hours after the administration by hypodermo-
clysis of one liter of an almost saturated solution of common
salt in mistake for a 0.9 per cent, solution.* In this case death
was due to the physical desiccating action of the hyperisotonic
blood plasma upon the blood corpuscles and the cells of the
central nervous system.
Circumstances and Conditions Modifying the Action of
Corrosives and Poisons.
External Conditions. — Usually conditions independent of
the toxic agent and of the subject have little influence upon the
action of a poison. Extremes of temperature, however, not
' Zeitschr. f. physiol. Chem., 1889, naturliches System der Giftwirk-
xiv., 52-74. ungen," Milnchen, 1893. Frankel:
^Arch. f. An. u. Phys., Phys. " Arzneimittel Synthese," Berlin,
Abth., 1889, Supplb., 271-291; 1901, passim.
1890, iii-iv., 344-359. " Combs: Amer. Med., 1905, ix.,
' For further information upon 640.
this subject see O. Loew: "Ein
92 TOXICOLOGY WITTHAUS.
only diminish the resisting power of the individual, but a low
temperature favors the activity of such poisons as lower the
body temperature, and a high temperature similarly accelerates
the effects of those whose action is attended by pyrexia.' It has
been observed that when bromids are given in large doses brom-
ism is more frequent in the colder than in the warmer half of the
year.=
The physiological action, however, of gaseous substances is
markedly influenced by the pressure. Thus oxygen, which,
under the ordinary conditions of dilution and pressure in which
it exists in the atmosphere, is a prime necessary of life, becomes
an active poison under increased pressure, causing death in
tetanic spasms resembling those produced by strychnin.
Conditions of the Poison — Quantity. — E-^^en with the
most active poisons there is a limit of quantity below which the
substance is entirely inert. When the quantity is increased be-
yond this a point is reached where the effects produced are such
as may be desirable under certain conditions and not deleteri-
ous. The quantity then represents a medicinal or therapeutic
dose, and the effects are designated as physiological or medi-
cinal. A further increase in quantity causes effects which
either exceed those desirable therapeutically in degree, or in
their nature are menacing to life or health; when the quantity
taken is a toxic dose. And finally, by further increase a quantity
is reached which, in the absence of antidotal interference, would
extinguish life — a fatal or lethal dose.
The expression "minimum lethal dose" is used in different
senses in works on pharmacodynamics and in legal toxicology.
In the former sense, also referred to as the " co-efficient of tox-
icity," it is applied to the smallest quantity per kilo of body weight
which will certainly cause death. This quantity is known for
many poisons with those animals which are customarily used for
physiological experimentation, but, for obvious reasons, it can-
not be determined with the human subject for any poison.
Nor can it be ascertained for man by calculation from the known
doses for any of the lower animals, because of the great variations
in intensity of action of poisons upon different species of animals.
'Hess and Luchsinger: Pflug. =Fer^: C. rend. Soc. biol., Paris
A.rch., 1884, xxxiv., 184; Zeehuisen: 189,3, 9 s., v., 277. See also Kossa:
^blt. f. inn. Med., 1895, xvi., 1. Arch. f. exp. Path. u. Ph., 1895,
xxxvi., 120.
ACTIONS OF CORROSIVES AND POISONS. 93
Even with animals it is not an absolute, fixed quantity, but varies
within certain limits from variations in the power of resistance
of different individuals of the same species. In the medico-
legal sense the minimum lethal dose may be predicated as a state-
ment of fact or as an expression of opinion. As a statement of
fact, it applies to the smallest quantity of the poison which has
been known to cause the death of an otherwise healthy human
being. With many poisons it is highly probable that this quan-
tity is not the smallest which is capable of causing the death of a
perfectly normal individual, but until some observation is had
of death from a smaller quantity it must remain our best knowl-
edge of fact upon the subject.^ The determination of the true
minimum lethal dose for man is most difficult. The amount
found in the body after death is only a partial indication of the
amount taken, in that the former quantity is an undeterminable
fraction of the latter. In homicidal cases the amount taken is
very rarely known, and is always a subject of contest, and sui-
cides usually take large quantities to insure a fatal action;
therefore, we are practically limited to accidental cases for ob-
servations of deaths from small doses, and in these the conditions
are rarely propitious. The dose must be small and known with
accuracy, it must have proven fatal under conditions which e??-
clude other causes of death, and no part of it can have been re-
moved by vomiting or by treatment. The question: "What is
the lethal dose?" of this or that poison is one which is almost in-
variably asked of medical witnesses in homicidal cases, and it is
usually answered by the quotation of a statement, based upon
opinion only, which has been copied from one text-book to
another, or by an expression of the opinion of the witness as to
what might be the amount, and when so made the answer should
have the weight of opinion only, not that of a statement of fact.
The effective dose of a given poison is that quantity which is
at the time operative upon those blood or tissue cells or fluid
elements upon which it acts. Consequently the stomach must
be considered as a mere intermediate receptacle from which the
'See "Arsenic," p. 434. We literature. In the great majority
deem it necessary in this connection of "small-dose cases" either the
to caution the legal reader against quantity taken is open to question
too ready acceptance of reports of or other and more probable causes
cases of death from very small of death existed in the subject,
doses of poisons recorded in medical
94 TOXICOLOGY — WITTHATJS.
poison may either pass into the blood and tissues, there to be-
come effective, or be removed by vomiting or otherwise and thus
become inoperative. For this reason cases have frequently
occurred in which persons have recovered after having swallowed
very much larger quantities of poisons, particularly of such
as provoke vomiting, than those which have repeatedly caused
death. The relation between the rapidity of entrance into the
blood, by absorption or otherwise, and that of exit therefrom
by elimination also influences the quantity present in the blood,
and therefore capable of action (see p. 108). The effective dose is
therefore greater, and the toxic effect more pronounced and more
prompt, when a toxic dose is injected directly into the veins than
when administered in equal amount hypodermically, or, a for-
tiori, when swallowed. It cannot be doubted that the quantity
of any poison, at one time operative and capable of causing
death under given conditions, has a definite minimum limit.
This is, however, an unknown quantity (see p. 211).
Physical Conditions. — With the corrosives the most im-
portant physical condition in this connection is the degree of
concentration, to which the gravity of the injury is directly
proportionate. With the true poisons the degree of solubility
exerts the greatest influence upon the rapidity and intensity of
action. The dictum corpora non agunt nisi soluta is pre-emi-
nently true of poisons. Both poisons and corrosives act more
energetically when they are warm than when cold.
Age of Poison. — The length of time which has elapsed
since the preparation or solution of the poison may in certain
cases have permitted it to become almost or entirely inert by
decomposition. Thus solution of hydrocyanic acid rapidly de-
teriorates by exposure to light and air, and the dilute acid of
the Pharmacopoeia is rarely met with in pharmacies of the two-
per-cent. strength called for; solutions of morphin form an ex-
cellent culture medium for certain moulds, which convert the
alkaloid into the less active oxydimorphin; and solutions of
aconitin lose their activity rapidly.
Conditions of the Subject — Species and Race. — There
is probably no poison which acts with equal intensity upon
all forms of Hfe. The germicidal activity of mercuric chlorid
is at least five hundred times as great as that of arsenic trioxid,
while the two poisons are fatal to man in about equal doses.
CONDITIONS OF THE SUBJECT. 95
Of the protein substances having poisonous qualities, some
(the toxalbumins) are produced by bacteria, and are poisonous
to animals; while others (the alexins or antitoxins) are produced
physiologically or pathologically in animals, and are poisonous
to bacteria. Ascarides are not poisoned by strychnin, which
destroys their host. Quinin is more poisonous than strychnin
to infusoria and to diatoms, while the reverse is the case with
vertebrates. Neither alkaloid has any considerable influence
upon the bacteria of putrefaction. A rabbit will bear more
atropin or morphin than a man whose weight is fifty times as
great. Goats are not affected by quantities of nicotin or of
lead sufficient to destroy human life. Amygdalin is poisonous
to rabbits, but not to dogs. Frogs are very susceptible to the
action of the digitalis glucosids, which have very little effect
upon toads. While morphin causes complete insensibility and
narcosis in dogs, it causes great excitement in hares, cows, and
cats, and it has no action on goats unless taken in enormous
quantity. Codein is much more poisonous to rabbits than
morphin, while man tolerates from ten to twenty times more
codein than morphin. Instances such as these, which might
be multiplied, indicate that great caution is necessary in drawing
deductions applicable to the human subject from experiments
upon animals. While the result of such experiments are fre-
quently of great value in establishing the identity of certain
poisons (see Physiological Tests) and in studying the method of
action of poisons and medicines under conditions not easily
realized otherwise, they should only be considered as indicating
the action upon the human subject when supported by corrobo-
rative evidence obtained from observations made upon man
either in suicidal or accidental poisonings or by experimentation
within the limits of propriety and safety. In some cases of
homicidal poisoning evidence also has been furnished by the
poisoning of domestic animals that have eaten the remains of the
food in which the poison was administered or the vomit of the
victim, and by examination of their bodies.
Differences in the actions of certain poisons have also been
observed in different races of men. Thus opium, which causes
a sleepy, dreamy condition in Caucasians and Chinese, is said to
affect Malays and Japanese with murderous mania. It is also
96 TOXICOLOGY WITTHAUS.
said that narcotics in general are more active in the inhabitants
of warm chmates than upon northern races. '
Whether these differences are due to varying peculiarities
in organization of the individuals of different races or to other
causes referred to in this section, is not determined.
Age. — The doses of medicinal substances properly adminis-
tered to children are not only absolutely smaller than those
given to adults, but are also less relatively to the weights of the
two, the susceptibility of the child being greater than that of
the adult. The narcotics particularly are much more active
upon young than upon adult subjects. In old age the resistant
power of the individual diminishes, and changes, particularly
in the walls of the arteries, of a character favoring a fatal ac-
tion, are more frequently present. Old persons have in several
instances been killed by doses of drastics and of digitalis which
would have caused only the usual therapeutic actions in persons
of middle age.
Some exceptions to the rule that young individuals are more
susceptible to the action of poisons than those that are full-grown
have been observed. Thus children take calomel without
salivation longer than do adults;^ and new-born puppies with-
stand larger doses of strychnin than full-grown dogs.^
Condition of Health. — It may be said, in general, that
persons in health are better capable of withstanding the action
of poisons than those whose physical condition is impaired by
excesses or by disease. Some poisons also, by similarity of their
effects with those caused by certain diseases, may bring about
the death of a person so affected when taken in small doses.
Thus ordinary medicinal doses of opiates may cause a fatal re-
sult in a person already on the verge of apoplexy. Tartar
emetic or chloroform may suddenly extinguish the life of a per-
son having organic disease of the heart. Persons in a starving
condition have been fatally poisoned by quantities of poisonous
berries and of putrid food which would at most have provoked
vomiting in a person in a well-nourished state. The increased
susceptibility to the action of poisons in general caused by dep-
rivation of food is due, in some measure at least, to the disap-
' Husemann: "Tox.," 29. 'Bert and Demant, ex Loew:
' Id.:, op. cit., 31. "Syst. d. Giftwirk.," 88. Petrone:
Jahresb. f. Thierch., 1901, xxxi., 527.
CONDITIONS OF THE SUBJECT. 97
pearance of glycogen from the liver during starvation, and
consequent diminution of the disintoxicating action of that
organ (p. 101). Persons whose hepatic or renal function is im-
paired by disease of the liver or kidneys are more susceptible
to the action of poisons than are those whose organs are normal.
In such cases a question may well arise as to whether the
disease or the poison was the cause of death. When there is
no question of the administration of the poison, and death has
followed after the manifestation of the symptoms usuallj^ caused
by it and within the usual time in which that poison causes
death, the disease is to be looked upon as a condition, and the
death should be attributed to the poison. But it is possible that
a diseased person may take a poison, manifest the symptoms
attributable to the combined or associated actions of the poison
and disease, and yet die of the disease. Thus, through the
negligence of a physician, a child of about four months of age
was given four drops of deodorized tincture of opium at 9 a. m.
Between noon on that day and the next morning the child
manifested marked symptoms of opium poisoning, for which
it was treated by the usual methods by another physician.
During the two following days the pupils regained their normal
size, the child cried frequently, had a temperature ranging from
103° to 105.5° and died eighty-eight hours after administration
of the opiate, with symptoms of compression of the brain.
The autopsy and the clinical history showed that, while the
child had been dangerously poisoned by opium, it had recov-
ered from the effects of the narcotic and had died of acute
hydrocephalus.
The theory of death from poisoning by improper medication
has also been advanced in homicide cases of death alleged to be
caused by wounds. Thus, in the case of Stokes, it was claimed
by the defense that the death of the deceased was not due to the
pistol-shot wound which he received, but to the action of mor-
phin administered by the surgeons who attended him.^
On the other hand, patients suffering from certain diseases
manifest, apart from habituation, a tolerance for particular
medicines in doses which would be poisonous to a healthy per-
son. Thus large doses of opiates are frequently given to per-
sons suffering from dysentery, tetanus, cholera, or alcoholic
iPeugnet: Papers Med.-Leg. Soc, New York, 1882, 2d ser., 294-333.
IV— 7
98 TOXICOLOGY WITTHAUS.
mania without the production of poisonous effects; syphilitics
bear doses of mercury or of iodin which would cause symptoms
of poisoning in healthy individuals; and strychnin has been ad-
ministered to a hemiplegic to the daily amount of three grains
without injurious consequence. But this immunity has a limit,
and when the quantity of the poison is further increased toxic
effects are produced.
Mental influences may also cause an explosion of symptoms
of poisoning in a person saturated with a drug taken medicin-
ally or habitually. This is frequently observed in attacks of
delirium tremens, and Fere' has reported a case of acute bromic
poisoning in an individual who had been under the drug for
three years, which was clearly due to moral shock.
Continued Action. — The corrosives frequently cause death
by mechanical stricture or closure of the openings of the stom-
ach and by destruction of the gastric follicles, weeks or months
after the primary action has ceased, by the intensity of the in-
flammatory processes set up. Some poisons, also, as arsenic,
may establish a gastro-enteritis of sufficient intensity to destroy
life after the last traces of the poison have been eliminated
from the system.
Cumulative Action. — The action of a poison or medicine
may be cumulative either in the sense that repeated small doses
produce effects different from those which would result from the
administration of a single dose, even much greater in amount;
or in the sense that, during the administration of small doses,
the effects of a single large dose may be produced. In the first
sense all medicines and poisons are certainly "cumulative," and
so-called "chronic" poisonings are the results of such repeated
small doses. The occurrence of poisonings cumulative in the
other sense is most exceptional. It is stated that the glucosids
of digitalis " have the remarkable property that during the con-
tinued administration of small doses the effects of a single large
dose appear. "2 The same is said to be the case with colchicin.'
Carbon .monoxid is distinctly a cumulative poison, and after dea1;h
the blood is frequently found to contain a larger proportion of the
gas than existed in the inspired air (see p. 1123).
' C. rend. Soc. Biol., Par., 1S93, ^ Husemann u. Hilger: "Pflan-
9 s., v., 277. zenstoffe," p. 1240.
'Lewin: "Toxikol.," 7.
CONDITIONS OF THE SUBJECT. 99
Idiosyncrasy-Intolerance. — By idiosyncrasy in the medi-
cal sense, or idiocrasy, is understood a peculiar susceptibility,
causing peculiarities of effect from the ingestion of certain sub-
stances, and from external influences. Idiosyncrasies of odor,
taste, smell, and sound are not of interest here.
Many instances are recorded of persons upon whom ordinary
articles of diet produce most unusual effects. Strawberries have
been known to cause febrile symptoms and convulsions. A case
is reported by Fergus' of a person who on three different occa-
sions experienced severe symptoms on merely tasting a straw-
berry. Once, in less than three minutes, failure of the heart's
action set in and prolonged fainting ensued. Lobsters and
oysters have been frequently known to cause urticaria, and we
have met with a lady in whom the most violent attacks of vom-
iting and sickness always followed the eating of a cooked oyster,
while the raw bivalve could be eaten in moderate quantity
with impunity. Honey has been known to cause severe poison-
ing in several cases. In these, however, the toxic effects are
traceable to the fact of the bees frequenting poisonous plants,
as in the case of the honey of Trebizonde, collected from a spe-
cies of rhododendron, the Azalea pontica.^ Cocoa and beans
have also been known to cause poisoning in some persons.^
Medicinal and toxic agents also act more energetically than
usual upon certain persons, and in some cause symptoms vary-
ing from those usually produced. The wide variations in the
symptomatology of arsenical poisoning may be cited in support
of the latter statement. Instances of intolerance of certain
drugs are frequently met with: rhubarb, manna, and even
mineral waters have been known to produce violent vomiting
and purging in small doses; the balsams and turpentines occa-
sionally produce urticaria; belladonna, even in very small doses,
has caused a scarlatinal rash and toxic symptoms, and even the
application of the ordinary belladonna plaster has produced di-
latation of the pupil and marked dryness of the throat. Idiosyn-
crasies with regard to the action of mercurials, quinin, and Ep-
som salt have also been observed. "* It is particularly with the
'Lancet, 1869, ii., 563. iii., 399. Coleman: New Jersey M.
= Pavy: "Food and Dietetics," Reptr., Burlington, 1S52, vi., 46.
Phila., 1S74, p. 321. See also ^ Kobert: "Intoxikationen," 23.
Bidie: Madras Q. J. M. Sc, 1861, "See MacDonnell: "Wood's Ref-
erence Handb. of the Med. Sci.,"
100 TOXICOLOGY WITTHAUS.
modern synthetic remedies, chloral, chloroform, sulfonal, etc.,
that marked variations in the action upon different individuals,
and even upon the same individual at different times, have been
observed. It is probable, however, that in many of these cases
the amount of the dose actually taken, or the purity of the
product, is questionable, or some other cause of death was also
present.' The following statement of LeydeP concerning the
toxic action of non-synthetic poisons is in the main correct:
"That in adults a peculiar idiosyncracy toward particular poi-
sonous substances exists is not as yet proven. Reference is had,
as a rule, to the different methods of application, which in the
case described causes a more rapid and more powerful action,
than in others in which equally large doses are in question."
Vibert^ has, however, reported an occurrence which shows
that not only may the power of resistance to equal quantities of a
poison be different in different individuals, but also in the same
individual at different times under apparently like conditions:
A man, his wife, and a girl of twenty years each took a glassful of
wine to which aconitin had been added, in the morning, on empty
stomachs. The woman was attacked with aconitic symptoms,
aiid died in about one and one-half hours. The man and girl
only experienced slight and temporary effects. The same evening
the man and girl and another man each took the same quantity
of the same wine under the same conditions as previously. All
were attacked. The first man, practically unaffected in the
morning, died, the girl was slightly affected, and the second man
died. The conditions were as nearly as possible alike in the
several cases.
Habit-Tolerance. — A much more important condition is
the tolerance of certain poisons which is gradually established
by their habitual use. The increasing quantity of morphin or
of the opiates which is taken by those addicted to the opium
habit is well known, and quantities are finally taken by them
which would suffice to destroy several non-habituated persons,
iv., 2 Ascherson: Wchnschr. f. d. ' In this connection see Bora-
ges. Heilk 1837 m., 817. Betan- triiger: Viertljschr. f. ger. Med., n.
court: PhiL Med Times, 1881-82, P., 18S9, Hi., 306-323; 1890, liii.,
xn., 72. Ford: Mich. Med. News, 19-66. ...
1S7S, i 98 Franfois; Gaz. m6d. d. ^ "Leitfaden d. ger. Med.," Berlin,
Strassb., 1863, xxiii., 77. Smith, 1895, 107.
■■• ^i'^?'^;^^"'- •^°"™-' 1876-77, 'Ann. d'hyg., 1899, 3S.,xli.,308.
xxii., 601-603. ' ' '
CONDITIONS OF THE SUBJECT. 101
and would have proved fatal to them if taken at the outset.
Habitual use of alcohol, hashish, cocain, nicotin, arsenic,
chloral, etc., also establishes a tolerance of those poisons. Not
only that, but the poison becomes a necessity, the deprivation of
which causes serious effects, in some instances, as with ar-
senic, resembling those produced in normal individuals by the
ingestion of a poisonous dose of the same poison. It is probable
that a similar habituation may be produced with many poisons
and medicines other than those customarily used by toxicopha-
gists. Thus Kobert' refers to a feast in China at which all the
Europeans were attacked with purging, while all the Chinese
remained unaffected, in consequence of the food having been
broiled ■vC'ith castor oil according to the Chinese custom.
The immunity from the action of poisons established by
habit is, however, never complete, and when the dose taken
surpasses a certain limit the symptoms of poisoning are mani-
fested. Numerous deaths of morphin, cocain, chloroform, and
arsenic habitu6s caused by overdoses have been recorded.
Portier and Richet^ found that dogs treated with glycerol
extracts of the tentacles of actinia are more sensitive to the
action of that venom than dogs not so treated, a condition to
which they give the name "anaphylaxia."'
Action of the Liver upon Poisons. — By an elaborate
series of experiments and observations, Roger* has demonstrated
that the liver acts as a protector of the organism against poi-
soning; that most of the substances carried to it by the portal
vein are arrested,' some are retained, others ehminated, and
others profoundly modified. Many mineral substances, such as
iron, copper, lead, arsenic, etc., accumulate in its parenchyma,
and alkaloids, nicotin, quinin, morphin, cocain, atropin, hy-
oscyamin, strychnin and veratrin, and curare and ammonia
are arrested in their absorption by the liver. Injections of these
poisons into the portal vein act with only half or a third the in-
tensity of similar quantities injected into the jugular. The
peptones, putrid poisons, and the toxic products of intestinal
' "Intoxikationen," p. 23. 'See further with regard to
^C. r. Soc. de biol., 1902, Hv., habituation "Arsenic" p. 513,
548; Richet: Arch, di fisiol., 1903-4, "Morphin" p. 959; Hausmann:
i, 129; C. r. Soc. de biol., 1905,lviii., Ergebn. d. Physiol., 1907, vi., 58.
109, 955; Ann. de I'lnst. Pasteur, * "Action du foie sur les poisons,"
1907, XX., 7. Paris, 1887.
102 TOXICOLOGY WITl'HArS.
fermentations are also arrested by the liver. The normal portal
blood of the dog has double the toxic power of the blood of the
hepatic veins of the same animal when injected into the periph-
eral circulation of rabbits. The protecting influence of the
liver is directly proportionate to the amount of glycogen present.
This accumulation, or deposition of poisons in the liver, which
renders that organ the best situation in the cadaver for the de-
tection of absorbed poison, can only be explained on the suppo-
sition of the conversion of the dissolved poison into a less sol-
uble combination, which is deposited. That such compounds
are formed in the liver and elsewhere has been demonstrated.
The metallic poisons combine with proteins to form sparingly
soluble albuminates, and de I'Arbre' has shown that many
alkaloids form compounds with the biliary acids, which are
for the most part difficultly soluble. Roger^ considers it probable
that the alkaloids may enter into combination in the liver with
glycogen to form sparingly soluble conjugate compounds similar
to the glucosins obtained by Tanret' by the action of glucose and
ammonia upon each other under pressure. Stassano* has shown
that the nucleins of parenchymatous organs, such as the liver,
and of leucocytes combine chemically with silver, arsenic, and
strychnin. It has been demonstrated that the quantity of
glycogen in the liver is rapidly diminished, frequently to the
point of entire disappearance, by the action of many poisons,
such as arsenic, antimony, phosphorus, morphin, strychnin, and
chloroform;^ and that with several poisons, such as chloroform,
carbon monoxid, etc., the disappearance of glycogen is ac-
companied by glycosuria. Kiilz" has found that in rabbits
strychnin causes the disappearance not only of the liver glycogen,
but also the much more resisting muscle glycogen, which he at-
tributes to the muscular activity due to the tetanizing action of
the poison. Ammonium carbamate when injected into the
circulation of dogs in doses of 0.5 gm. per kilo causes violent
poisoning, with epileptiform and tetanic manifestations, and
' " Verbind. einzelner Alkaloide Anat., etc. Berlin, 1865, xxxiv., 79.
mit Gallensauren," Diss., Dorpat., Rosenbaum: Arch. f. exp. Path. u.
18^- . Ph., 1SS2, XV., 450. Demant: Ztsch.
Loc.cit f. physiol. Ch., ISStJ, X., 441. Kim-
" Journ. d. Ph. et de Chim., 1SS5, pel; Sitzber. d. phys.-med. Gesell.
o s., xu., 105. z. Wurzb., 1S03, 135.
^-C.r. Ac. Sc, 1900, cxxxi., 72. » Marb. Festschr., 50iahr. Jubil.
'baikowsky: Archiv t. path. C. Ludwig, p 119
CONDITIONS OF THE SUBJECT. 103
in somewhat larger doses death; but, it may be given in very
much larger amount by the stomach without any ill effects.
In dogs, however, in which, in consequence of Eck's operation,
the blood passes from the portal vein directly into the vena cava,
without traversing the liver, ammonium carbamate is as actively
poisonous when given by the stomach as it is when injected
directly into the circulation.'
The insolubility of any of the compounds whose formation in
the liver is presumed to occur is not absolute, and consequently
the action of the liver is not to prevent, but to mitigate the action
of the poison, to extend the time during which the poisonous
agent passes into the general circulation. Moreover, the alka-
loidal salts of the biliary acids, although difficultly soluble in
water, are readily soluble in the presence of an excess of the so-
dium salts of the same acids which exist in the bile; audit is well
known that not only alkaloidal, but other poisons enter into the
bile and are thus discharged into the intestine to be either ex-
creted with the feeces or reabsorbed gradually and during several
hours later.
Antidotal Actions by the Animal Economy Itself." —
Many poisons, after introduction into the body, are to a greater
or less extent converted by chemical reactions into compounds
whose toxic powers are less marked. These changes are brought
about by several different methods. In some cases it is a mere
neutralization, as when absorbed acids are converted into their
alkaline salts. By oxidation phosphorus is to some extent con-
verted into the phosphates, which are normal constituents of
the body, and the highly poisonous sulfids are oxidized to the
harmless sulfates. By reduction potassium chlorate is con-
verted into the much less poisonous chlorid; and chloral [tri-
chloraldehyde, (C0H,CCl3)] is first reduced to trichloralcohol
(CH20H,CCl3), which is subsequently further modified as de-
scribed below; by synthesis or formation of conjugate deriv-
atives. Thus the poisonous phenols combine with the sulfates
to produce non-poisonous ester-sulfuric acids which appear in
the urine; the camphors, naphthols and chloral, are eliminated in
the form of conjugate derivatives of glucuronic acid (CgHmO,);
' Hahn, Massen, Neucki and ' See also under Cocain, p. 905,
Pawlow: Arch. f. exp.P.andP., 1892, and Strychnin, p. 1053.
xxxii, 161.
104 TOXICOLOGY WITTHAUS.
benzoic and salicylic acids and their congeners form non-poison-
ous glycocol conjugates; and bromobenzene combines with mer-
capturic acid. By decomposition certain poisonous glucosids are
split up into non-poisonous substances.
The seat of these transformations in the body has been de-
termined only imperfectly. Some, such as the conversion of
benzoic into hippuric acid, take place in the kidneys. The liver
is probably an active agent in this respect, and is known to be
the seat of the formation of the glucuronic conjugates. Other
changes, particularly decompositions such as that of the gluco-
sids, occur in the alimentary canal. The spleen appears to exert
a certain degree of disintoxicating action upon certain alkaloids,
including strychnin, morphin and atropin.^
It would appear that certain tissues during life exert a disin-
toxicating action upon certain poisons, notably upon strychnin.
Czylharz and Donath,^ experimenting upon guinea-pigs, found
that when an extremity is tightlj^ ligated, and a certainly lethal
dose of strychnin is injected distally, on removal of the ligature
in one to four hours the animal remains perfectly healthy;
from which they conclude that the subcutaneous cellular tissue,
the muscles, or the blood or lymph has the power to neutralize
strychnin during life. Previously Widal and Nobecourt^ had
found that by trituration with cerebral tissue or liver pulp
shortly after death the toxic power of strychnin, and to less de-
gree of morphin, is notably diminished; and according to Sano,*
the disintoxication is greater with the gray of the motor cortex
than with that of the sensory. Although the method of disin-
toxication is unknown, it seems probable that combination of
strychnin with nucleins, observed to occur by Stassano,^ may
• Nicholas and Beau: C. r. Soc. xxii., 479; Kleine: Ztschr. f. Hyg.,
de bioL, 1900,lii.,881; J.de physiol., 1901, xxxvi., 1; Czylharz: Ztschr. f.
1901, iii., 68, 951. Heilk., 1901, xxii., 156; Pellacani:
^ Ctbl.f.inn. Med., 1900, xxi., 321; Arch. f. exp. P. u. P., 1908, Supbd.
Ztschr. f. Heilk., 1901, xxii., 1. 419.
See also: Meltzer and Longmann: ^ Bull, et m^m. Soc. mcSd. d. hop.
Cbl. f. inn. Med., 1900, xxi., 929: de Paris, 189S, 3 S., xv., 182. See
Med. News, 1900, Ixxvii., 685; J. also: Ottolenghi: Rif. med., 1897,
Med. Res., 1903, N. S., iv., 19; xiii., pt. iv., 2; Arch. ital. de biol.
Thomot and Brouardel: Bull, et 1898, xxix., 336; Brunner: Fortschr.
m6m. Soc. m6d. d. hop. de Paris, d. Med., 1899, xvii 7.
1900, 3 S., xvii., 896; Severi: Jbt. 'i Pflug. Arch., 1908, cxxiv., 369.
u. d. F.d.Thierch., 1900, XXX., 119; = C. r. Ac. sc, 1900, cxxxi., 72.
Baruchello: /ftid., 1901, xxxi., 114; See also: Hatcher: Amer. Ph. J.,
Carrara: Cbl. f. inn. Med., 1901, 1902, Ixxiv., 283.
COMPOUND POISONING. 105
have something to do with it. But Thoinot and Brouardel'
state that a similar disintoxication of strychnin is also produced
by trituration with numerous indifferent substances.
It is clear that with the organic poisons the occurrence of
such transformations in the system is of great forensic interest.
The organic poison found by the chemist in the cadaver in the
form in which it was administered is only the residue which has
escaped modification, and it is quite conceivable that the
transformation may have been complete, so that only the prod-
ucts of the chemism of the system upon the substance introduced
remain. As the exact nature of these products derived from
many organic poisons is as yet unknown, and the possibility of
their formation from other substances than the poisons from
which they are known to be derived is in most instances still
unexcluded, the difficulties in the way of proving the presence
of absorbed organic poisons are great, except with a few which
resist modification or whose changes in the body have been
more carefully studied.
Compound Poisoning. — When two or more poisons are
taken together or in rapid succession, the action of each may be
modified by that of the other or others; but in what znanner and
to what extent cannot be predicted, save in some exceptional
instances. The variations in the combined effects of strychnin
and morphin are well illustrated in the following cases: A
man, twenty-nine years of age, took 0.2 gm. (gr. iij.) of strych-
nin, 3.9 gm. (3i.) of opium, and an unknown quantity of
quinin. Twelve hours after he complained only of "feeling
queer." Later he manifested symptoms of strychnin poisoning
of a mild type; after which he became profoundly narcotized
and died forty hours after taking the poison.^ Marvin^ has
reported a case in which death was caused by 0.65 gm. (gr. x.)
each of morphin and strychnin, and in which the symptoms
of morphin poisoning could hardly be recognized. In Beatty's
case* a woman of twenty-two years took 0.1 gm. of strychnin
(a packet of Battle's vermin killer), and immediately afterward
7.4 CO. (5ij-) of laudanum, and then 2 gm. (3ss.) of red pre-
' Bull, et mim. Soo. m^d. d. hop. ' Chicago Med. Journ., 1860, xviii.
de Paris, 1898, 3 S., xv., 276. See 635.
also Abelous: C. r. Soc. de biol., 'Med. Herald, Louisville, 1879,
1898, 10 S., v., 398. i., 4.
* Lancet, 1871, ii., 907.
106 TOXICOLOGY WITTIL^^rS.
cipitate. In three hours she was found suffering from narcotic
poisoning. She recovered under treatment, and at no time mani-
fested any symptoms of strychnin poisoning. Almost the same
proportion of strychnin and laudanum were taken, with very
different results, in a case reported by Harrison:' A man of
fifty-four years, who had been drinking, took a package of
Battle's vermin killer (0.1 gm. strychnin) and 5.6 c.c. (5iss.)
of laudanum. In an hour he had a spasm, and afterward had .
violent tetanic convulsions, from which he recovered under treat-
ment, without having manifested any symptom of narcotic poi-
soning. A case intermediate in character between these has
been reported by King,^ of a man of seventy years who took
0.26 gm. (gr. iv.) of morphin and "some" strychnin. He
suffered violent tetanic spasms and during the intervals had all
the symptoms of opium poisoning. After a most violent con-
vulsion he went to sleep and slept nine hours, and subsequently
recovered.
A similar variation, although not so marked, has been ob-
served in three cases of poisoning by compound liniment of
belladonna and aconite, in which, clearly, the relative propor-
tion of the two poisons was the same, although the absolute
quantity varied with the dose.^ In Simpson's case the pupils
are said to have been contracted, although both belladonna and
aconite cause dilatation.
When one poison is given before another the effects of that
last administered may be modified. Thus Preyer* has shown
that animals under the influence of atropin are not killed by
doses of hydrocyanic acid sufficient to cause the death of indi-
viduals not so prepared, and Stille= states that double the quan-
tity of hydrocyanic acid necessary to cause death, injected hy-
podermically into a dog under the influence of ether, failed to
produce any evidence of poisoning for three-quarters of an hour
during which ether was being inhaled, but caused the usual
symptoms of poisoning and death on cessation of the etherization.
Or if atropin be administered first and morphin afterward, the
quantities may be so adjusted that the influence of the morphin
' {6*£^:, 1882, i., 780. ISSS, i., 694. Simpson: Ibid., 1SS2,
" Louisville Med. News, 1880, x., i., 774.
^6?„- , , *"Die Blausaure," i., 73.
loo. ''■ '■'^'^""^ Brit. Med. Journ., MVIiarton and StiU^: "Med.
1885, 1., 327. Lipscomb: Ibid., Jur., " 4th ed., ii., 62.
COMPOUND POISONING. 107
upon the pupil will be masked and the clinical history of the
case will record a combination or succession of effects of the
two alkaloids.
If the substances administered differ materially in the rapid-
ity of their action the victim may either succumb to the more
rapidly acting poison or corrosive, without having manifested
the symptoms of that which behaves more slowly, or may re-
cover from the effects first caused and subsequently die from the
action of the slower poison. Thus Ludwig"- cites the case of a
man who died in five hours from the effects of caustic potash
which he had taken along with Paris green and phosphorus.
And Maclaren^ reports the case of a man of twenty-two years,
who took a combination of strychnin and phosphorus, and after
having recovered completely from a violent attack of strychnin
poisoning, died in five days with all of the symptoms caused by
phosphorus. When complex mixtures containing several poi-
sonous ingredients are taken, life may be prolonged for a
longer period than is usual in fatal poisonings by the most active
ingredient, and death may result after an illness the clinical
history of which is rather a combination or succession of the
effects of the different constituents of the mixture than that
of any one. A case illustrating this, in which a woman of
sixty-eight years died in four days from the effects of a dose of
chlorodyne, has been reported by Leighton.^ Much will, how-
ever, depend upon the magnitude of the dose of a given mixture.
Thus while in most cases of chlorodyne poisoning (see Opium)
the clinical history is either of the complex type just referred
to or that of profound narcotism, in Browne's case* of a man
who committed suicide by swallowing three bottles of chloro-
dyne, the patient was found in a dying condition and expired
soon after with manifestations of a distinctly cyanic character.
Sometimes an organism permanently under the influence of a
certain poison is thereby rendered more susceptible to another.
Thus alcoholics are very liable to poisoning by chloroform, and
morphinists to the toxic action of cocain.
1 Med. Jahrb., 1880 (reprint). = New Engl. Med. Mthly., 1882-83,
2 Glasgow Med. Journ., 1881, xv., ii., 270.
320. " Austral. Med. Journ., 1879, n.
s., i., 587.
108 TOXICOLOGY WITTHAUS.
ELIMINATION OF POISONS.
Poisons existing in the blood of living beings are separated
therefrom and discharged from the body, either in the state in
which they were taken or in a more or less modified form, by
all of the excretory organs, and by other channels not physio-
logically excretory. The mere expulsion . of the contents of
the stomach by vomiting shortly after the introduction of the
poison or of the intestinal contents by primary diarrhoea is
not, strictly speaking, elimination, but operates rather to pre-
vent absorption. Later, however, the excretory action of the
stomach and intestines becomes notable with some poisons, such
as arsenic, mercury, and iodin. The latter, when administered
by other channels, is eliminated principally by the gastric
folHcles and vomiting. Morphin and alcohol also, when injected
hypodermically or intravenously, are eliminated in part by the
stomach. According to Stassano,^ mercury, arsenic, strychnin,
and morphin are eliminated by the stomach and upper intestines,
but not by the rectum, the first two named being in combination
with nucleins in a form insoluble in the gastric secretion. Mer-
cury during its elimination by the large intestine produces
characteristic lesions.
As a rule, elimination takes place principally by the urine,
except with gaseous poisons, which are eliminated mainly by
the lungs. The excretory function of the liver also plays an
important part in the elimination of many poisons which pass
into the bile, and are so either separated in the alvine dejections
or reabsorbed in a modified form to be subsequently eliminated by
the kidneys. P^limination also takes place bj- the perspiration,
the serum of vesications and of serous effusions, the saliva, the
pancreatic and intestinal secretions, and the milk. In chronic
arsenical poisoning an important method of elimination is by the
loss of hair, and even of nails, and exfoliation of epidermis which
occur, and in the secretions of the laryngo-branchial epithelium.
The leucocytes not only remove deleterious bacteria by their
phagocytic action, but also aid in the elimination of many poisons.
The duration of elimination and the relation between the
rapidity of absorption and that of elimination are questions of
great forensic and clinical interest. The beginning of elimina-
' C. r. Soc. de biol., 1902, liv., 1 100.
ELIMINATION OF POISONS. 109
tion is probably coincident with or very shortly follows the
beginning of absorption. Potassium iodid may be detected in
the urine ten minutes after its administration; and potassium
ferrocyanid has been found in the same excretion two minutes
after having been swallowed. The rapidity of elimination and
its duration vary with different poisons, and also with the same
poison according to the form and manner in which it is taken,
and variations in the species and physiological conditions of the
subject. As a rule, metallic poisons are eliminated more slowly
than alkaloidal or synthetic poisons. Mineral poisons are also
usually eliminated more slowly when administered in repeated
small doses than when taken in a single dose. Silver may be
deposited in the tissues as metal and remain indefinitely. With
some poisons, such as the copper salts, absorption is rapid and
elimination quite slow. With others the rapidity of elimination
as compared with that of absorption from the intestinal canal is
so great that the substance, although actively poisonous when in-
jected into the circulation, is inert when given by the stomach.
Thus curare is non-poisonous when swallowed by mammals if the
function of the kidneys is unimpaired, but produces the same
symptoms of poisoning as it does when injected into the blood
if administered to an animal in which the renal arteries have
been previously tied. The functional activity of the kidneys
consequently is an important factor in influencing the effects
produced by a given dose of poison, and persons whose kidneys
are diseased may be expected to suffer more serious effects than
those whose kidneys are normal from the same dose of a given
poison, for the same reason that serious disease of the kidney
causes auto-intoxication; i.e., deficient elimination of the poison.
The rapidity of renal elimination is diminished and its dura-
tion is increased with the age of the individual. Brouardel'
administered a gram of salicylic acid during a day to each
of three healthy persons, aged, respectively, twenty, forty-
five, and seventy years. The acid was detectable in the urine
of the first in one hour after breakfast, in that of the second in
the evening, and in that of the third only on the third day.
The elimination was completed in the first the day after the
administration, in the second in four days, and in the third in
nine days.
'Ann. d'hyg., 1894, 3 s., xxxii., 483.
110 TOXICOLOGY WITTHAUS.
The rapidity of absorption and its relation to that of
eUmination for a given poison appears to differ in different
species of animals. Thus Molitoris attributes the immunity of
hens to strychnin to the facts that that poison is very slowly ab-
sorbed from the alimentary canal, and that the organism has the
power of eliminating relatively large quantities in a form which
although bitter is not toxic'
TREATMENT OF POISONING.'
Removal of Cause.
The first indication in a case of true poisoning is the re-
moval from the system of any poison which may yet remain
unabsorbed, or its conversion into some insoluble or inert deriva-
tive or compound. The former end is attained by the adminis-
tration of emetics or purgatives or by physical means; the lat-
ter by the action of the so-called chemical antidotes.
Removal of the Poison from Wounds. — As absorption
from wounds is very rapid, attempts at the removal of poisons
so introduced must be made soon after the introduction to be of
any avail. The means adapted to this end are squeezing or
sucking out the poison, or washing it out, preferably with dilute
hydrogen peroxid if the presence of putrid substances or bacteria
be suspected; the application of tincture of iodin to "post-
mortem" or "dissection" wounds; and the application of the
actual cautery to the poisoned wounds inflicted by venomous
animals. If the wound be in an extremity the intensity of the
poisoning may be diminished if a ligature be placed to com-
press the veins above the injury immediately after its infliction,
and venesection practised below.
Removal of Poison from the Stomach. — This is accom-
plished by the action of emetics or by mechanical means,
which should always be promptlj^ resorted to in cases of
poisoning,^ except it be known that the poison is already
completely removed from the stomach, in which case the admin-
istration of emetics is not only not beneficial but harmful. Cer-
' Verhandl. d. Gesellsch. devit. = It is usually to be avoided when
Naturf. u. Aerzte, 1905-6, Ixxvii., a corrosive has been swallowed.
2 Th., 453. See p. 23'J.
' For treatment of corrosion by
acids and alkalies see pp. 23!), 321.
TREATMENT OF POISONING. Ill
tain poisons, notably morphin and arsenic, pass into the stomach
quite rapidly even when administered hypodermically; therefore,
to prevent reabsorption stomach lavage should be practised, even
when such poisons have been taken otherwise than by the mouth.
The most available emetic is apomorphium chlorid, which
acts within three or four minutes, may be always within the
immediate reach of the physician, and may be administered in
spite of the resistance of the most obstinate suicide. The phy-
sician's pocket case should always contain compressed tablets of
0.007 gm. (gr. 1/10) of the official salt, one or two of which may
be dissolved in about thirty drops of water, and injected hypo-
dermically within a very few minutes. Immediately after the
injection the usual mechanical methods of provoking emesis
should be adopted if possible, such as tickling the fauces with
a feather, bending the body forward and manipulating the
epigastrium from the sides toward the median line, and the ad-
ministration of lukewarm water into which some butter or lard
has been melted. If an emetic is to be given by the mouth, zinc
sulfate should be used in doses of 1.5 to 2 gm. (gr. xx.-xxx.),
or, in cases of phosphorus poisoning, cupric sulfate in doses of
0.2 to 1 gm. (gr. iij.-xv.). Tartar emetic should never be used.
A more prompt and radical method of removing poison from
the stomach is by the use of the stomach pump or, preferably,
the siphon. The latter consists of a rubber tube of about 8 mm.
internal diameter and 2 m. in length, one end of which is closed
and rounded, and has near it a single lateral opening. A stout
hard-rubber ring, through which the soft-rubber tube passes, is
desirable to insert between the teeth in poisoning by strychnin
and other poisons which cause trismus. The rounded end, well
oiled, is introduced into the pharynx and pushed gently down the
oesophagus into the stomach, with the aid, if possible, of an
effort of swallowing on the part of the patient. A funnel is now
placed in the free endof the tube and through it from half a litre
to a litre of lukewarm water, or, preferably in poisoning by the
alkaloids, infusion of tea or coffee, is poured into the stomach,
the tube being compressed to closure near the funnel before the
latter has been completely emptied. The funnel is now removed,
the free end of the tube depressed while still closed, and the pres-
sure released, when the contents of the stomach are siphoned
into a vessel placed for that purpose. More than a litre of liquid
112 TOXICOLOGY — WITTHAUS.
should not be used at one time, and the operation may be re-
peated as many times as may be desirable with fresh liquid.
The pipe should be introduced in adults to a length of 45 to 50
cm. from the teeth. Occasionally the opening of the siphon in
the stomach becomes plugged by solid particles of food or- of the
poison too large to enter it. In that event, the tube should be
withdrawn after a few gentle movements in and out for a short
distance and of rotation, by which vomiting is usually mechani-
cally induced. A siphon may also be extemporized from an
ordinary oesophageal sound having a rubber tube fitted to the
free end. The sound should, however, have but a single lateral
opening, and being of a harder material than the soft-rubber
siphon is not so desirable. The introduction of the pipe is some-
times interfered with by spasms of the oesophagus. When this oc-
curs the end of the pipe may be smeared with an ointment con-
taining cocain, as suggested by Lafosse.^
Removal of Poison from the Intestine. — If the poison
has already passed into the intestine the administration of a
purgative may be desirable, particularly if the substance taken
be known to be one which is slowly absorbed from the intestine.
The purgative used should be one which has no solvent action
upon the poison, and if possible one which tends to render it less
soluble. Thus castor oil should not be given in phosphorus
poisoning, as the oil dissolves that element, and sodium or
magnesium sulfate is to be selected in lead poisoning, with a
view to the formation of the insoluble lead sulfate. A recto-
colonic tube may be used with advantage in some instances, and
the rectum and colon washed out.
Antidotes to Prevent Absorption. — These may act either
physically or chemically. The most generally useful of those
acting physically is animal charcoal in moderately fine powder,
which has the property of absorbing and retaining alkaloidal
and also, to a less degree, mineral poisons. To be of service it
must be freshly burnt or must have been kept in well-closed ves-
sels after having been burnt. Vegetable charcoal possesses the
same property, but in a much less degree. It may be added to
the liquid used in washing out the stomach. Either form of
charcoal is itself non-poisonous and is not contraindicated in any
form of poisoning.
' Bull. g(5n. de th^rap., etc., Paris, 1S8.5, cix., 128.
SYMPTOMATIC TREATMENT. 113
Albumen, in the form of white of egg, is readily obtainable
and is never harmful. Its action is partly mechanical in im-
prisoning the particles of a still undissolved poison and prevent-
ing its adherence to the walls of the stomach, and partly chem-
ical in forming sparingly soluble compounds with many of the
mineral poisons and with some of those of vegetable origin. If
the albumen be not spontaneously vomited after a few moments
it should be followed by an emetic, particularly in poisoning by
corrosive sublimate, to prevent its resolution by the gastric
secretion.
Milk is not so advantageous as albumen, as it is distinctly
contraindicated in poisoning by phosphorus, by reason of the
solvent action of its fat. Moreover, the proteins which it con-
tains do not combine with poisons so readily as do those of
white of egg. Other demulcents, such as mucilage, gelatin,
tragacanth, etc., act only mechanically.
The chemical antidotes are administered with the view of
forming sparingly soluble or insoluble compounds, such as
tannin produces with the alkaloids, glucosids, and antimony
and zinc compounds; ferric hydrate with arsenic; slaked lime
with oxalic acid; common salt with silver nitrate, etc., or of
converting a harmful substance into one which, although soluble,
is comparatively harmless, as magnesia usta forms magnesium
sulfate with sulfuric acid, and vinegar converts caustic potash
into potassium acetate.
Treatment to Favor Elimination. — This is accomplished
by infusion of physiological salt solutions into the veins, with or
without previous venesection. Roger' has shown that the elimi-
nation of foreign substances begins and ends earlier, if saline
solutions have been previously infused.
Symptomatic Treatment.
To combat the effects of absorbed poison the efforts of the
physician should be directed to the counteraction by physical or
antidotal means of individual effects which are menacing to
life, and thus bridging over a critical period until the natural
processes of the economy have either eliminated the poison or
rendered it harmless.
I C. r. Soc. de biol., 1896, 10 S., iii., de Paris, 1905, 2 S., xvii., 28.
976. See also Martin: J. de m^d.
IV— 8
X]^4 TOXICOLOGY WITTHAUS.
The objects to be attained are most frequently to prevent
cessation of respiration or of the heart's action, or to re-establish
one of those functions after a short interruption. The phys-
ical means adapted to these ends are:
Artificial Respiration.— This is one of the most valuable
means of preventing death by all poisons which affect the respi-
ration. It should be resorted to whenever there is threatened
arrest of respiration, and should not be abandoned as useless so
long as the action of the heart is perceptible.
Before proceeding with artificial respiration the freedom of
the upper air passages from obstruction must be assured.
Mucus and fragments of vomited matter are removed from the
pharynx, if present, by the finger covered with a handkerchief.
In syncope and narcosis the tongue falls back, and pressing
upon the epiglottis closes the entrance to the larynx. To free
this opening the operator, facing the patient, places his two
thumbs on the two sides of the upper jaw below the zygoma,
and with the fingers behind the angles of the lower jaw draws
it and the attached soft parts as well forward as possible.' If
the laryngeal opening is closed by oedema which cannot be
overcome by the finger, intubation of the larynx may be prac-
tised or tracheotomy performed. The latter operation is also
sometimes called for when the jaws are fixed by trismus. The
blowing of expired air into a tracheal tube is not desirable, ow-
ing to its large percentage of carbon dioxid. Air from a bag
with properly constructed valves may, however, be used, pro-
vided the apartment be warm and the air be filtered through a
cotton plug. In most cases in which artificial respiration is
called for pure oxygen is to be preferred to atmospheric air.
If an assistant be availal^le, the best method of artificial res-
piration in cases of poisoning is that of Sjdvester, combined
with Heiberg's manipulation. The patient is placed upon his
back; one operator, standing or kneeling astride the hips, leans
forward and, without pressure upon the body, holds the tongue
forward in the manner above described, while the second, kneel-
ing above the patient's head, seizes the arms near the elbows
and draws them above the head, holds them there for two or
three seconds, and then, bending the arms down, presses them
against the sides of the chest to expel the air for the same length
' Ileiberg: Berl. kl. Wochenschr., 1874, xi., 449.
SYMPTOMATIC TREATMENT. 115
of time. The movements are repeated about fifteen times a
minute. The operators should alternate with each other and
will be materially aided by a third or fourth, particularly in
opium poisoning, in which artificial respiration may have to be
continued for a number of hours. A single operator should se-
lect Marshall Hall's method while waiting for further assist-
ance. He kneels beside the patient and with the right fore-
finger maintains the tongue depressed and drawn as far forward
as possible, while with the left hand he rolls the body upon its
face and presses upon the abdomen to expel the air, then rolls it
upon the back to permit entrance of air by the return of the
elastic walls of the chest to their normal position.^
The faradic current is a powerful aid to or substitute for
artificial respiration. The cathode of a faradic battery of mod-
erate power is fitted with a double (bifurcated) electrode, the
two parts of which are applied over the phrenic nerves on each
side of the root of the neck above the clavicles and behind the
sterno-cleido-mastoid muscle, which is pressed somewhat for-
ward; the flat anode is applied to the epigastrium. The cur-
rent is closed for about two seconds at a time, at intervals also of
two seconds. While the current is closed the head, shoulders,
and arms are fixed by an assistant, and pressure is exerted upon
the abdomen in the intervals. From time to time a short pause
is made in the faradization to observe whether and to what ex-
tent natural respiration is established.
When failure of respiration is threatened from paralysis of
the respiratory centres due to insufficient blood supply, as evi-
denced by coma accompanied by a slow, feeble pulse, the action
of gravity may be utilized to favor the blood supply to the brain
by inclining the patient with the head downward. This is the op-
posite to the " ambulatory treatment" adopted in the threatened
coma from cerebral congestion produced by morphin poisoning.
The warmth of the body must be maintained in poisonings
by agents, such as chloral and other hypnotics and narcotics,
which cause diminution of the body temperature as evidenced
by the indications of the thermometer and the coldness of the
nose and extremities. The room in which such patients are
treated should be warm — not less than 70° F. Artificial heat
1 For other methods of artificial Ref. Handb. Med. Sc, " 2d Ed. i.,
respiration see Small: "Wood's 559-561.
116 TOXICOLOGY AAITTHAUS.
should not be applied to the patient too suddenly. The temper-
ature should be gradually raised by simply placing the patient
in bed with sufficient covering, and the application of hot-water
bottles or bags to or near the soles of the feet, or by friction
with warm towels. If a warm bath be used it should not be
resorted to until after the body temperature has approached the
normal. All liquids introduced into the body should be pre-
viously warmed to about 100° F.
The use of the cold douche or ice bags applied to the head
in cases of narcotic poisoning attended with cerebral congestion,
as in opium poisoning, may diminish the sopor and tendency to
coma, but, if incautiously applied, may operate detrimentally
in .further diminishing the already low body temperature. If
they be used the body must be kept warm, either as indicated
above or by immersion in a bath of about 100° F.
Stimulants other than- warmth and electricity are frequently-
indicated — either mild stimulants, such as tea and coffee, or more
powerful agents, such as brandy, ether, acetic ether, or camphor
hypodermically. Inhalation of ammonia serves as an active
respiratory stimulant in syncope, but it must be remembered
that death has been caused by the use of this agent in too con-
centrated a form for this purpose.
Transfusion of Blood is rarely possible, and if practised by the
older methods is of questionable utility and attended with
danger. Crile's method of direct transfusion has, however,
been used successfully in poisoning by illuminating gas.^
Bleeding, followed by infusion of a saline solution such as
Little's^ in double the quantity of the amount of blood removed,
has, however, been found in experiments upon animals to be of
benefit in poisoning by hydrocyanic acid, carbon monoxid,
potassium chlorate, amyl nitrite and nitro-benzol, by removing
a large proportion of the absorbed poison or of permanently
vitiated blood, as well as by accelerating elimination by in-
crease of blood pressure. This method of treatment is referred
to by continental writers as "lavage of the organism" or "blood-
lavage".^
'Seep. 1128. ^Schtvartz: Berl. kl. Wchnschr.,
Sod. chlor., ai.; potass, chlor., 1SS2, xix., 536; Landerer: Virch.
gr. VI.; sod. phosph., gr. iij.; sod. Arch., 1886, ov., 351; Ther. Mtsh..
carb., jr. xx.; alcohol, 5ij.; aq. 1902, xvi., S; Schramm: Wein. med,
dest., oxx. jrb., 1885, 490; Sanquirico: Arch.
SYMPTOMATIC TREATMENT. 117
Physiological Antidotes — Antagonism of Poisons.— The
distinction between " antidotism " and "antagonism" is
that in the former the poison itself is acted upon, as when mor-
phin is oxidized by potassium permanganate; in the latter the
effects of the poison are counteracted, as when the spasms of
strychnin are allayed by chloral hydrate.
The idea that for each poison there is a counter-poison is as
old as the Ayur Vedas, which antedate b. c. 600, and is not yet
eradicated from the popular mind. Yet there are no two poi-
sons whose actions are in all respects opposite or antagonistic.
The nearest approach is with muscarin and atropin, but even
with them the antagonism is not complete, although the admin-
istration of atropin rapidly counteracts the menacing symptoms
caused by muscarin. Physiological antidotes are of value only
when they tend to counteract an effect of the poison which is
dangerous to life, as when chloral or chloroform is given in
strychnin poisoning to prevent or mitigate the tetanic spasms.
On the other hand, there are many cases reported in medical
literature as cases of morphin poisoning which are in truth
poisonings by atropin and morphin, the former alkaloid having
been administered as a physiological antidote.
An ideal physiological antidote would be one which would act
chemically upon the poison in the blood or tissues to form an
inert substance. We know, however, of but one instance of
such "disintoxication": that of sodium thiosulfate toward mal-
onic nitril, in which the poisonous cyanogen group is converted
into the practically inert thiocyanogen, and its toxic action is
arrested even after it has been fully established.'
In poisonings or corrosions attended with great pain it is
not only the part of humanity, but also serves to maintain the
resisting force of the system, to allay the pain by the hypo-
dermic administration of morphin unless its use is directly
contraindicated.
p. le sc. med., 1887, ix., 275; Roger: Masoin: Arch. int. de pharm. et de
C. r. Soc. de biol., 1896, 10 S., tWrap., 1897, iii., 151; Id. ibid., p.
iii., 976; Schuecking: Deut. med. 359, ibid., 1900, vii., 297; Vorbrugge:
Wchnschr., 1899, xxv., 307; Lesn^ ibid., 1898, v., 161; Maurice: ibid.,
& Richet: C. r. Soc. de bioi., 1903-4, 1900, vii., 11 ; Reid Hunt: ibid., 1904,
xii., 331; Martin: J. de m6d. de xii., 447; Morishima: ibid., 1900, vii.,
Paris, 1905, 2 S., xvii., 28. 273; Lang: Arch. f. exp. P. and P.,
' Seep. 815. Also Heymans and 1895, xxxvi., 77.
1 18 TOXICOLOGY WlTTHAUS.
PROGNOSIS OF POISONING.
The action of a poison or corrosive may result in death, in
complete recovery, or in partial recovery.
Death from the primary action of poisons and corrosives
may be due to exhaustion caused by persistent vomiting, vio-
lent convulsions, or severe pain; to cerebral paralysis affecting
the respiratory centres; to cardiac paralysis; to wdema of the
lungs or of the glottis; to internal asphyxia by modification
of the haemoglobin of the blood; to diminished body tempera-
ture; to hemorrhage caused by perforation of blood-vessels
by corrosion; or to more remote effects, such as suppression of
urine, etc.
Complete recovery results in most cases of non-fatal poi-
soning in which the toxic agent is eliminated, and in which
the pathological changes produced are either insignificant in
kind, or of such nature that progressive repair follows the re-
moval of the cause.
Partial recovery is practically recovery from the primary
effects of the deleterious substance, followed by prolonged illness
or death from its secondary effects. Thus death from starva-
tion frequently occurs months after the primary effects of the
mineral acids and alkalies have disappeared; atrophy and de-
generation of various organs follow as secondary effects of
several poisons, of the gastric follicles by arsenic, of the liver
and kidneys by phosphorus, of the extensor muscles by lead,
etc.; necrotic changes are produced in certain organs, as in the
maxillary bones by phosphorus, in the teeth by mercury, and in
the extremities by ergot ; cataract follows ergot poisoning, amaurosis
is caused by wood alcohol; and many poisons cause as secondary
effects great sensitiveness to external influences of certain or-
gans, which persists for months or years.
OF THE EVIDENCE IN OASES OF MURDER BY POISON.'
The proof in a trial for murder by poison is divisible into
three parts:
1. The deceased died from the effects of a certain poison.
'For an excellent article on the more: "Med. Leg. Journ.," New
legal aspect of this subject see Wig- York, 1888, vi., 392-413.
EVIDENCE IN CASE OF MUKDEK BY POISON. 119
2. Said poison was administered to the deceased Vjy the
defendant.
3. Said administration was with a deliberate and premedi-
tated design on the part of the defendant to cause the death of
the deceased.
The evidence upon which a crime of this character is estab-
lished is of necessity circumstantial. It is within the limits of
possibility that a person might, unobserved by the murderer, be
an eye-witness to the administration, knowing the nature of the
substance administered. But in such an event, unless the wit-
ness, while knowing the nature of the substance administered,
was ignorant of its capacity to cause death or was under phys-
ical or moral restraint, he would be an accessory to the crime;
or its consummation, except the poison were one of those acting
with extrenie rapidity, would be seriously jeopardized by
interference with the administration on the part of the wit-
ness or with the effects of the poison on the part of medical as-
sistance summoned by him. And even in a case so improb-
able the question as to whether the substance administered was
actually the cause of death would still remain to be solved by
expert evidence. But the intentional killing by poison is a
crime secret in its essence, and while in many cases there have
been witnesses to the administration of the substance containing
the poison, and in many others an innocent party or the victim
himself has been the agent of administration, the incorporation
of the poison with the vehicle has been an act previously per-
formed in secret by the real criminal — an act which can be
proved only by circumstantial evidence. It is true that direct
evidence of the crime may be furnished by one conspirator
against another; but such evidence is always reluctantly be-
lieved by jurors, and, under the rules of evidence, must be cor-
roborated by other testimony.
With the second and third parts of the above division the
toxicological expert has to do only to the extent of furnishing
evidence with regard to individual facts, which, along with
those developed by the moral evidence, are to be weighed by
the jury in determining these points.
Questions for the toxicologist bearing upon administration
or intent arise in every trial for murder by poison, and always
have an important, sometimes a crucial, influence in determin-
120 TOXICOLOGY — WITTHAXJS.
ing guilt or innocence. In some instances the distinguishing
facts are easily observable and become evident in the course of
the analysis, as when Paris green in substance, or arsenic and
copper in the proportion to constitute that pigment, is found in
the cadaver. Under these circumstances proof of the posses-
sion of Paris green by the deceased and of white arsenic by the
accused would have very different significance from that of evi-
dence tracing Paris green into the hands of the defendant. At
other times the solution of such collateral questions may involve
investigations independent of the main analysis and call for all
the resources of the expert. In a case,. for instance, in which
it was claimed by the defendant that he had administered five
grains of quinin and a sixth of a grain of morphin to the de-
ceased, the absence of quinin became quite as important an ele-
ment as the presence of morphin, and its importance depended
upon the relative delicacy of the tests for the two alkaloids and
the influences of changes produced in them in the body during
life and after death. In the Aff. Canaby^ the claim of the de-
fendant that she had purchased Fowler's solution from several
druggists (upon forged prescriptions) for her own use was con-
troverted by analyses of her own hair and that of the intended
victim, as well as the hairs of several patients under arsenical
treatment. The defendant's hair contained "a quantity of
arsenic very near the physiological or normal," while that of her
husband contained 40 mgm. per kilo, or more than could be ac-
counted for by medicinal administration.
It is chiefly in the endeavor to obtain evidence upon intri-
cate and novel questions that the expert stands in danger of
traveling too far into the domain of theory. The introduction
of scientific evidence of too finely spun a character usually has the
opposite effect to that intended; the expert assumes a position
in his direct evidence which he is unable to maintain in its in-
tegrity in the cross, and, by basing his inferences upon data the
correctness or sufficiency of which is open to question, invites the
submission of opinions at variance with his own by the opposing
party, with the ultimate result of causing the jury to disregard
entirely a mass of conflicting evidence upon points which at best
they can understand but imperfectly.
The question whether the deceased came to his death from
' Dumora: Arch, d'anthrop. crim., 1906, xxi., 716.
EVIDENCE OF POISONIXG FROM THE LIVING BODY. 121
the action of a certain poison depends for its solution entirely
upon expert evidence, to obtain which in the most complete
and satisfactory form possible requires the united services of
the clinician, the pathologist, and the chemist. The evidence of
the cause of death is obtained from:
1. The symptoms manifested during life.
2. The gross and microscopic appearances observed in the
cadaver.
3. The existence of the poison in the body, the vomited
matters, the excreta, or the remains of articles of food, medi-
cine, etc.
EVIDENCE OF POISONING FROM THE LIVING BODY.
From the History of the Attack.
In the great majority of criminal and suicidal poisonings
the dose administered or taken is large, and consequently the
attack is sudden, whether the victim be in condition of health
or of illness, and with most poisons progresses rapidly. But in
several forms of disease and of internal injuries which prove
rapidly fatal the attack is equally sudden,^ as in cerebral hemor-
rhage, organic disease of the heart, the rupture of internal
organs, in certain forms of Bright's disease, etc., most of which,
however, are attended with well-marked pathological changes,
easily recognizable at the autopsy. On the other hand, if
the poison be administered in small and repeated doses, the
onset is more gradual, and the clinical history more closely
resembles that of some natural disease. Thus in the Havre
poisonings by arsenic^ the attacks were so insidious that the
investigation as to their cause originated in a suit brought by
the tenant against his landlord, alleging the unsanitary condition
of the house in which the poisonings occurred.
The relation of time between the taking of a meal, or of
medicine or drink, and the manifestation of symptoms is al-
ways one of high forensic importance, and frequently aids
greatly either to indicate the guilty party or to prove the inno-
' Schuchardt, in Maschka's ^Affaire Pastrd-Beaussier, Brou-
"Handb. d. ger. Med.," ii., 34-42, ardel and Pouehet: Ann. d'hyg.,
reports several cases of sudden death 1889, 3 s., xxii., 137, 356, 460.
from "natural" causes in which
there was suspicion of poisoning.
1 WA.H^W1jWVT a vv xa xjjjujo.
cence of one wrongly suspected. Poisons usually (although by
no means always) act within an hour after their administra-
tion; and for every poison the period of time which elapses be-
tween the administration and the appearance of its effects
varies, according to circumstances, within comparatively nar-
row limits. If, for instance, a person be attacked with symp-
toms of arsenical poisoning about half an hour after having
eaten a meal, the probabiHty that the poison was contained
in some article of food or drink then taken is worthy of serious
consideration; and if on analysis one of these is found to con-
tain arsenic, we have then the demonstrated combination of an
effect and a cause capable of producing such effect.
But if, on the other hand, a person be accused of adminis-
tering arsenic to another in a certain article of food, drink, or
medicine which is found to contain the poison, the accusation is
to be looked upon with grave suspicion if a day or more have
elapsed between the time when the administration was alleged
to have occurred and the manifestation of its effects.
The nature of the symptoms is to be considered in this con-
nection, whether they are those of a poison whose action is al-
ways rapid, or those of one whose effects may be delayed for
several hours.
In poisonings by repeated doses, also, the connection of oppor-
tunity of administration and the occurrence of symptoms is
of importance. Thus in the Havre poisonings mentioned above
the symptoms abated in some of the victims when they went
out of the reach of the accused, and again made their appear-
ance after their return; and in a case reported by Kornfeld,' in
which a woman was convicted of the murder of her husband by
arsenic, the deceased, who worked away from home, suffered an
attack only when he visited his home or his wife visited him.
In multiple poisonings, where poison is mixed with an ar-
ticle of food of which several persons partake, all usually suffer
from its effects in varying degrees of intensity according to the
amount eaten by each and his or her condition of age, etc. If
several persons eating of a particular dish or drinking of a bev-
erage manifest the same symptoms of sudden illness, there is
great probability that the cause of the disorder is a poison
either mixed with or generated in the food or drink taken.
' Friedreich's Bl. f. ger. Med., 1885, xxxvi., 149-160.
EVIDENCE OF POISONING FROM THE SYMPTOMS. 123
But, while it seldom occurs that a number of persons are simul-
taneously attacked with disease suddenly, such instances have
been known, and Taylor^ has recorded several cases.
It is not to be inferred, on the other hand, that because
symptoms of poisoning are observed only in some of those
partaking of a particular article of food or drink and not in
others who have taken as much or more, the symptoms are
due to disease and not to poison. The poison may be one for
which those who escape from the effects have established a
tolerance by habit ;^ or the toxic agent may have been incor-
porated as a sohd in such manner as to accumulate in certain
portions of the dish; or the administration may have been
intentionally limited to one or more of the persons apparently
partaking equally of the same food.^
From the Symptoms.
Can a case of poisoning be diagnosed from the ssmiptoms
alone? The medical witness should not answer this question
without qualification. If among the symptoms we include
the detection of the poison in the excreta, as the existence of
sugar in the urine is included among the symptoms of diabetes,
then the question is answerable in the affirmative in whatever
sense the word " diagnosis" may be used. But if the poison be
one which is not detectable in the excreta with certainty, the
question must be differently answered according to the value
given to the word " diagnosis." In attending a case of poisoning
or of disease the physician, partly from positive indications ex-
hibited by the patient and partly by exclusion, reaches a
"diagnosis" upon the accuracy of which sufficient reliance may
be placed to warrant the adoption of the treatment appropriate
to the form of poisoning or the disease indicated. Such a " work-
ing diagnosis," made by an experienced clinician, is correct in
the great majority of cases, but the symptomatology of poisoning
by the commoner poisons so closely resembles that of some
disease produced by so-called natural causes that a mistaken
'"Poisons," 3d Am. ed., 87-91. found in Taylor, "Poisons," 3d Am.
^ See p. 100. ed., p. 88. Maschka: Friedreich's
' Instances of the cunning with BI. f. ger. Med., 1855, vi., Heft 4,
which one victim may be singled 66-69. Wormley: "Micro-Chem.
out from among many are to be Pois.," 2d ed., 40.
J24 TOXICOLOGl WlTTtlAUB.
diagnosis is a possibility, even with the most careful and expert
physician. While the symptoms, excluding examination of the
excreta, do not afford positive proof of poisoning, they frequently
indicate the strong probability of its existence, and the certainty
that the patient is suffering either from the effects of the par-
ticular poison or poisons to which they point or from one of very
few diseases presenting a closely similar clinical picture.
Although the clinical history is therefore not to be relied
upon alone to prove with absolute certainty that a poisoning has
occurred, it is of the first importance, in conjunction with the
results of the autopsy and of the chemical examination, to estab-
lish that fact to a demonstration, and consequently, whenever it
is practicable, the manifestations during the life of the patient
should be observed with the utmost minuteness and accuracy.
In a case of morphin poisoning it may be claimed that death
was due to cerebral apoplexy, or to uraemic coma consequent
upon Bright's disease. If the patient has during life mani-
fested the symptoms which may be due to one of the three
causes, and if, after death, the anatomical lesions caused by
apoplexy and Bright's disease are found to be absent, and those
due to morphin poisoning (and to other causes also) are found
to be present, and if morphin be found on analysis of the cadaver
or of the vomited matters, the agency of morphin as the cause of
death cannot be questioned as between the three causes men-
tioned. Further, symptoms afford one of the surest means of
answering the question, " Was the poison introduced during
life?" There is no analytical method by which undertaker's
arsenic can now be differentiated from that taken during life,
but it is clear that a history of the symptoms of arsenical poison-
ing during life is strong evidence of ante-mortem administration.
The symptoms of poisoning present no general characters
which permit of a distinction between poisonings and disease —
indeed many diseases are endogenous poisonings. The ques-
tion presented to the clinician in the treatment of poisoning and
in the medico-legal proof of its occurrence is one of differential
diagnosis, which, of course, varies with the poisons producing
different effects. The points of distinction to be observed in a
case of strychnin poisoning are not the same as those which
customarily present themselves when arsenic has been taken.
General considerations upon this important branch of the proof
EVIDENCE OF POISON IN EXCRETA, ETC. 125
of poisoning are idle. The effects of each poison must be con-
sidered in comparison with the symptoms of those diseases
whose symptomatology is similar to that of the form of poison-
ing in question, and therefore we defer consideration of this
branch of the subject to the division on special toxicology.'
From the Detection of the Poison in Excreta, etc
The most direct proof that poison has been administered or
taken during life is its detection in the matters vomited by the
victim, or in the urine or faeces passed during his lifetime.^ In
non-fatal cases these, along with suspected articles of food or
medicines, are the only materials for chemical analysis.^
The vomited matters frequently have easily determinable
qualities which are of great diagnostic value — as, for instance,
their luminous appearance in phosphorus poisoning, their al-
kaline reaction when the alkalies or potassium cyanid have
been taken, their intense acidity in corrosion by the min-
eral acids, their characteristic odor in poisoning by phenol,
prussic acid, or chloroform, etc. If the poison be heavy and
have been taken in the solid form and is not readily soluble, it
may be found deposited in the bottom of the vessel containing
the vomit or washings of the stomach, as has been frequently
observed in arsenical poisoning. As a rule, the quantity of
poison expelled will diminish with each succeeding vomit, yet
Ryan^ has reported an instance in which the stomach pump was
used after three acts of vomiting, and in which the quantity of
arsenic in the material removed by the pump was greater than
in the matters last vomited.
It is quite possible that the poison may be completely re-
moved by vomiting and elimination and yet death result from
its action. In that event, clearly, the poison may be detectable
in the urine and vomit, but not in the cadaver. Such a case is
reported by Taylor' in which a man died seventeen hours after
taking about one ounce of arsenic.
' See also Tardieu, " Empoisonne- any possibility that the poison may
ments," 2eme ed., 25-55. Taylor, have been subsequently added.
"Poisons," 3d Am. ed., 94-117. ^ For a few poisons the blood may
Kobert, " Intoxikationen," 2te be examined with the micro-spec-
Aufl. i, 45-63. troscope.
^ It goes without saying that there * Lancet,' 1851, i., 410.
must be no question as to the iden- * Guy's Hosp. Rep., 1837, ii., 77.
tity of the matters examined, nor
126 TOXICOLOGY — WITTHAUS.
It is, unfortunately, exceptional in homicidal cases that the
vomit is preserved. This defect in the medical conduct of the
case may sometimes be supplied by an examination of the vessel
into which the vomit was received or of the floor, ground, or
fabrics upon which it may have been spilled. The surface of a
board floor may be removed by planing, and portions of the
carpet or other textile fabrics may be cut out. Samples should
be taken for analysis not only from the places where the vomit
was deposited, but also from other portions for comparison.
The detection of the poison in the urine or faeces passed
during the patient's lifetime removes all doubt concerning the
cause of the symptoms observed, provided the analysis is prop-
erly made and the purity of the chemicals used is placed beyond .
question. The negative result of such an examination does not
by any means prove that the symptoms observed are not due to
poison. Even arsenic, whose detection by an experienced ana-
lyst is certain, has been found to be absent from the urine in
cases of undoubted poisoning by the white oxid, either because
the elimination has been completed, or because of an apparent
intermission in the elimination; and instances of failure to de-
tect morphin in the urine of patients who had unquestionably
taken large doses, and even when its presence in the vomited
matters was demonstrated, are numerous.'
The examination of vessels and of articles of food and of
medicine frequently affords evidence of the manner of the ad-
ministration, and may serve to connect a particular person with
the crime. It must be remembered, however, that the detection
of poison in an article of food alleged to have been taken is not of
itself evidence that the poison has been actually taken. Several
cases have occurred in which the symptoms of poisoning have
been feigned and poisoned food has been submitted for ex-
amination to substantiate a false accusation.
The number and variety of articles which, in a case of al-
leged homicide, may be submitted for analysis for the purpose
of tracing administration probably reached the maximum in the
Maybrick case, in which one hundred and seventy-four articles,
other than portions of the body and excreta, were delivered to
the analyst.
'■ See Elimination, p. 108, and also Elimination under Arsenic, Morphin,
Strychnin, etc.
DUTIES OF PHYSICIAN IN SUSPECTED POISONING. 127
DUTIES OF THE PHYSICIAN IN A CASE OF SUSPECTED
CRIMINAL POISONING.
The nature of the physician's relations with his patients and
the course of his daily practice are such that the idea of poison-
ing does not suggest itself unless forced upon his recognition by
the circumstances of the case, and even then is reluctantly en-
tertained. That he should be frequently deceived in attributing
the effects of poison to other causes is natural, .and, be it said,
it is preferable that he should be sometimes misled by the craft
of the poisoner than that he should go into every household in
the double capacity of physician and detective. Yet, as it is the
physician's function to ascertain not only the present condition
of his patient, but also the cause of his ailment, he should, when
called to attend a case of poisoning, recognize or at least sus-
pect its true character. If the case be not plainly one of acci-
dent or suicide, upon him may then devolve a responsibility
more serious than that attending the most desperate case of dis-
ease or of injury — a responsibility not of his own seeking and
entirely beyond the ordinary functions of his profession. He
may be suddenly placed between an intending murderer and his
victim, with the possible intent on the part of the former to
render him an unconscious accessory to his crime; and should
the deed be consummated, upon him the fulfillment or the frus-
tration of the ends of justice -will largely depend. That a re-
sponsibility so onerous, with the subsequent annoyance and in-
terference with regular practice, should be shirked and evaded
by many is to be expected, and we believe that many a poisoner
has escaped punishment through a disinclination on the part of
the attending physician to assume the responsibilities of the po-
sition into which he has been thrust by his attendance upon the
victim, and to incur the risks and discomforts which an accusa-
tion would entail. Three cases in illustration: A physician of
ability greater than the average and of unquestionable integ-
rity, being called in attendance upon a woman, was so thoroughly
convinced that she was being poisoned with arsenic by her hus-
band that he accused him of the attempt and forbade him
visiting the house in which his wife lay ill until she should be
either recovered or dead. Yet upon her death he signed a cer-
128 TOXICOLOGY WITTHAUS.
tificate attributing the death to "malaria and gastritis," and
permitted the only undertaker in the village to fill the cadaver
with arsenic before tardily communicating his suspicions to the
prosecuting officer. Had he had a proper sense of his responsi-
bility, either a murderer would not have escaped the penalty of
his crime through the impossibility of a distinction between
undertaker's and ante-mortem arsenic, or an innocent man
would not have been subjected to a year's imprisonment and
the chances of two trials for his life. In another case a physi-
cian who had a'ttended the husband and one child during their
last illness, refused to attend the second child of a woman who
subsequently confessed to having poisoned all three, and was con-
victed of the murder of the last; his refusal being based upon
suspicion of foul play in the two previous deaths, which he had
certified as being due to "inflammation of the bowels" and "con-
gestion of the bowels." Yet not a word did he breathe of his
suspicions, except to the woman herself, until after her confession.
We have known a prominent surgeon of this city to advise a
nurse who had obtained evidence of the criminal administration
of corrosive sublimate to a patient under her charge to "keep
her knowledge to herself." '
The duties of the practitioner in this connection we appre-
hend to be:
1st. To rescue the patient from the effects of the poison or
corrosive already taken.
To accomplish this a "working diagnosis" of poisoning by
X must be arrived at. To reach this the symptoms will have
been studied to the exclusion of those diseases having similar
symptomatology, and the history of the inception and cause of
the disorder previous to the physician's visit will have been in-
' It is but fair to the medical pro- case, who was out on $250 bail,
fession to state that an equal disin- Her husband had died after a short
clination to assume the responsibil- illness, marked by the symptoms of
ities of a prosecution in cases in arsenical poisoning. Arsenic was
which a prima-facie case seems to present in the unembalmed body,
be clearly established is sometimes and the immoral circumstances of
exhibited by those upon whom this the case indicated the existence of
duty devolves under the law. Upon a strong motive to the commission
one occasion the author, while in of the crime by the wife. Never-
attendance upon a grand-jury hear- theless, neither district attorney
ing in one of the northern counties nor grand jury found sufficient
of this State, had the novel experi- cause for proceeding further, and
ence of being waited upon at the the woman emigrated to a Western
hotel table by the woman in the State with her paramour.
DUTIES OF PHYSICIANS IN SUSPECTED POISONING. 129
quired into. The attendant and possibly the patient will have
been questioned, and from the nature and manner of the an-
swers received the physician may frequently obtain indications
which will govern his future course. Should there be the
slightest doubt in, the mind of the medical attendant that the
case is not one of accidental poisoning, he should take for ex-
amination the urine and vomit and any remains of medicine or
food taken by the patient. Portions of these he should exam-
ine, with all proper precautions, by the simpler tests for the
poison which he believes to have been taken — but by no means
should he use all of the samples taken for this examination, the
purpose of which is solely the verification of his diagnosis for
■the government of his treatment. The chemical knowledge and
manipulative skill in analytical methods of practitioners of
medicine are rarely if ever adequate to the test of cross exami-
nation upon a criminal trial.
2d. To prevent any further administration. From the in-
formation obtained in fixing his diagnosis and fro.m his obser-
vation of the surrounding circumstances the physician may
in most cases determine what means to adopt to accomplish
this end. He may, further, with proper discretion, ascertain
whether any person visiting or in attendance upon the patient
has any reason for enmity. If the attack was traceable to the
taking of a particular meal or dose of medicine, by whom was it
prepared or administered, and in whose care or keeping was it?
He will have to decide, from the degree of his conviction that a
certain person is the author of the poisoning, from the condition
of the patient, and from the nature of the surroundings, whether
and to what extent he should communicate his suspicions to the
patient or to any member of the household. Under no circum-
stances, however, should he give expression to any suspicion
which he may have, or encourage the expression of such sus-
picions by others, as a matter of gossip or public rumor. ■ There
is always the possibility of his being mistaken, and in that
event the injury which may be done to an innocent person is
irreparable, as such rumors travel rapidly, and any subsequent
retraction will probably not reach all who have heard the suspi-
cion originally expressed. In some cases it may be proper for the
medical attendant to insist upon the absence from the sick-room
or from the house of a certain person to whom circumstances
IV— 9
130 TOXICOLOGY— WITTHAUS.
point with sufficient directness as the author of the poisoning.
In other cases, particularly those in which he finds no one ia
the household to whom he deems it wise to communicate his
suspicions, the physician may demand either that the patient
be removed to a hospital, or that a trained nurse of his own selec-
tion shall be called in.
3d. In case of death, to avoid interfering with a proper in-
vestigation by giving a certificate of death or permitting the
undertaker to embalm the body.
As no dead body may be buried without a certificate setting
forth the cause of death from the attending physician or a per-
mit from the coroner or medical examiner, the physician who
still entertains the belief that the deceased may have died from
the effects of poison and signs a death certificate, attributing the
death to " gastritis " or " apoplexy " or some other disease, becomes
morally if not legally an accessory after the fact. According
to the degree of his doubt he has one of two courses to pursue-
either to insist upon a post-mortem by which he may determine
whether any sufficient natural cause of death exists, or to turn
the case over to the proper authorities for investigation. Should
he adopt the former course, which has the advantage that if
the death was really due to disease the expression of an un-
founded suspicion of poisoning has been avoided, the physician
must consider his qualifications for personally making such an
examination. As a rule, the practitioner is not fitted to prop-
erly conduct a medico-legal autopsy, and this may become one,
and it will be much preferable for the proper conduct of the in-
quiry, if one becomes necessary, and for the future comfort of
the physician himself, that he should call in the assistance of
one skilled and experienced in such work. If the services of
the coroner's physician or medical examiner can be obtained
unofficially or semi-officially so much the better, as, not only
should he be expert in such matters, but if the case be one of
poisoning he may then and there take charge of it officially.
As legislatures in this country have been very respectful of
the liberties of the "funeral directors," they are entirely unre-
stricted in all of the States except New York, New Jersey, and
Michigan, and unless expressly forbidden so to do by some one in
authority, it is their custom to inject into every cadaver a more
or less extensive collection of poisons as soon as possible, after
DUTIES OF PHYSICIANS IN SUSPECTED POISONING. 131
death, sometimes within two hours. Poison so introduced can-
not at present be distinguished from that existing in the body
before death, and consequently it is the plain duty of the physi-
cian, when he believes that death has been due to poison, to ex-
pressly state to the relatives and to any undertaker that he may
have reason to believe has or will have charge of the funeral
that the body should not be embalmed, and if necessary to re-
quest of the coroner that he forbid any treatment of the body
before the autopsy.
The statutory regulation of embalming in Michigan is too
narrow, as arsenic only is prohibited. That in New Jersey is
practically inoperative because of indefiniteness. It provides
that " no pei'son shall employ for the purpose of embalming or
preserving any dead human body, any arsenical solution nor any
other poisonous agent, which may by its presence in the viscera
prevent the detection of criminal uses of said poisonous agents
before the death of the individual occurred." In the State of
New York the undertaking fraternity deserves the credit of
having (after prolonged resistance of legislation, be it said)
themselves put in force restrictions to promiscuous embalming
which are precise and comprehensive. Chapter 555 of the Laws
of 1898, asamendedbyChap. 324, Laws of 1899, Chap. 498, 1904,
and Chap. 572, Laws of 1905, establishes a State Board- of Em-
balmers, with power to " make and adopt rules, regulations and
by-laws not inconsistent with law, whereby the transaction of the
business and the practice of embalming shall be regulated and
performed, subject to the approval of the state department of
health." The act also provides for the limitation of the practice
of embalming to licentiates of the board, for the revocation of
licences for violation of its regulations, and for the punishment
of such violations as misdemeanors. Under this law the board
on December 13, 1906, adopted the following regulations, which
were approved by the State Commissioner of Health, December
17, 1906: "From and after October 1, 1907, no embalmer shall
inject into any dead human body, for the purpose of preserving,
disinfecting or embalming the same any fluid that is not a
thorough germicide in the proportions ordinarily used in embalm-
ing, that is eight parts of fluid to one hundred and fifty parts of
body weight, or that contains arsenic, zinc, mercury, copper, lead,
silver, antimony or chloral or any substance or compound that
132 TOXICOLOGY WITTHAUS.
contains either or any of them, or any poisonous alkaloid. Ex-
cept that nothing in this regulation shall apply to the use of the
above named substances in any duly incorporated medical
college or scientific institution by those having in their legal
possession human cadavers intended to be used for the purpose
of medical study or other legitimate purposes." The regulations
also prohibit the sale of embalming liquids containing the
poisons above mentioned, and provide for the bacteriological
examination, chemical analysis and certification of such hquids
by the board.
While in attendance upon a case of poisoning the physician
should bear in mind that every detail of symptoms, treatment,
etc., may become of importance upon a subsequent trial, and
that he may be called upon months or even years afterward to
recite his observations. He should therefore make full and ac-
curate notes of such cases, from which he may subsequently
refresh his memory.
EVIDENCE OF POISONING FROM THE DEAD BODY.
The examination of the body of a person supposed to have
been poisoned is divided into three parts: 1st. The autopsy
proper, at which the appearance of the body and its surroundings
and the existence or non-existence of any departure from the
natural conformation of tissues or organs detectable by the un-
aided eye are observed. 2d. The pathological examination, by
which the presence or absence of minute changes in the tissues,
caused by disease or by the action of poisons, is determined by the
use of methods involving the use of the microscope. 3d. The
analysis, whose object it is to separate and demonstrate the
presence of poison in the cadaver, if such exist.
Evidence prom Position and Surroundings.
Before proceeding to the autopsy proper the coroner or med-
ical examiner should, particularly when the person has been
found dead, make note of the position of the body and its sur-
roundings. Observations then made may frequently be of great
service in differentiating between poisoning and some other
cause of death, or in determining whether the case is one of
suicide, accident, or murder.
THE AUTOPSY. 133
Note should be made of the following points: 1st. The date
and place of the examination. 2d. The names of the persons
present. 3d. The position of the body. 4th. Whether clothed
or not, and the condition of the dress. 5th. Had the deceased
vomited, and if so the relation of stains of vomit to the ca-
daver. 6th. Stains of vomit upon the clothing or other articles,
with the marks placed by the examiner upon such articles for
identification, and the name of the person into whose custody
they are given. 7th. Similarly as to stains of urine and of
faeces if present. 8th. Description of any cup, bottle, or other
vessel, paper or weapon, found near the body, and its position
with regard to the body; with notes for identification as in 6th.
9th. Had stains of vomit, etc., been made while the body was in
the position in which it was found, or had the body been subse-
quently moved, and any appearance which would indicate
whether such movement occurred before or after death? 10th.
The temperature of the room. 11th. In cases of exhumation
also note the position of the grave, the nature of the soil, the
condition of the casket, and transcribe any inscription upon the
cofHn plate.
If the autopsy be made upon an exhumed body the possibility
of fortuitous impregnation with poison should be borne in mind.
The condition of preservation should be accurately noted, as
well as any evidence of the cadaver being or having been mois-
tened by ground water. Samples of the earth from above, be-
low, and each side of the coffin should be taken, and particu-
larly samples of any colored article, such as artificial flowers,
and of any portion of the grave clothes or casket trimmings
which is colored.
THE AUTOPSY.
Direct and positive evidence of death from poisoning is not
to be expected from post-mortem appearances alone. Although
intense inflammation, softening, and corrosion of the oesophagus
and stomach, accompanied by a marked alkalinity of the con-
tents of the latter, may indicate that corrosion by a mineral al-
kali has occurred, there is no true poison whose action produces
characteristic lesions, and many may cause death without leav-
ing any evidence of their effects in structural change of organs
or tissues.
134 TOXICOLOGY WITTHAUS.
Nevertheless, very important evidence in two directions is
obtainable by a post-mortem examination: either as corrobora-
tive of other proof of poisoning directly,, or bearing upon the
possibility of death having been due to other causes.
Certain appearances or conditions observable at the autopsy
may by their existence serve to confirm the theory of poisoning
by a certain agent, or by their absence or the presence of their
opposites may even exclude the possibility of a specific poison
from consideration as a possible cause of death. Thus a con-
gested condition of the cerebral vessels is present after death
caused by the opiates, as well as after death by suffocation from
any mechanical cause; a dark color of the blood is inconsis-
tent with the theory of death from carbon monoxid or illumin-
ating gas; and an acid reaction of the contents of the stomach,
with absence of the odor of peach blossoms, is antagonistic to
the supposition that death was caused by potassium eyanid.
The second purpose served by an autopsy and a pathological
examination is probably the more important in cases of supposed
poisoning. It is the proof of the existence or non-existence of
natural causes of death whose symptomatology resembles the
effects of a given poison more or less closely, but which are
attended with changes in the appearance of organs or in the
structure of tissues which are observable with certainty in a
properly conducted autopsy, aided by a micro-pathological ex-
amination. Thus, in a case of poisoning by morphin, the
pathologist may exclude the possibility that death may have
been due to cerebral hemorrhage or to disease of the kidneys.
The presence of lesions in such cases materially weakens the
proof of poisoning, although it must not be forgotten that kid-
ney lesions, for instance, are quite common, and that a person
suffering from kidney disease, recognized or unrecognized dur-
ing life, may be poisoned by morphin. Indeed, poisoners have
been known to take advantage of an epidemic of Asiatic cholera
to remove their victims by the action of arsenic.
Autopsies — by Whom- and How Conducted.'
The practitioner of medicine, not specially engaged in path-
ological investigations, should avoid assuming the responsibili-
ties of a medico-legal autopsy. Indeed, even coroners' physi-
' See also vol. i., pp. 817-820; 833-864.
THE AUTOPSY. 135
clans are more frequently found ignorant than informed of the
details which should be regarded in an autopsy after death sup-
posed to be due to poison. Whenever it is possible the post-
mortem examination should be conducted by a skilled and ex-
perienced pathologist, and the chemist who is to -make the
analysis should be present.
The autopsy should be made as soon as possible after death,
the earlier the better for the success of both pathological and
chemical examinations. If made after putrefractive changes
have modified the structure of the tissues, microscopic altera-
tions indicative of certain diseased conditions can no longer be
observed, and in a still more advanced condition of decay but
few observations of modifications in gross appearances can be
made, and the autopsy becomes merely the means of securing
material which the chemist may examine for mineral poisons.
The pathologist should, however, not discourage the making of
an autopsy even in a case of supposed death from vegetable or
volatile poison merely because a month or two have elapsed
since the burial. In the Harris case the body was exhumed
fifty-three days after death, and in the Buchanan case forty-
three days after, and both bodies were found in a condition of
preservation sufficient not only to permit of accura-te observa-
tion of gross appearances, but also to a certain extent of the
minute structure of the organs and tissues.
The autopsy, consisting of the external and internal ex-
aminations, should be made with due regard to directions
given in the chapter on medico-legal autopsies;^ and the notes
of the observations made should be written at the time by an
assistant at the dictation of the examiner, should be minute and
accurate in all respects, and should be verified by the examiner
immediately after the completion of the autopsy, while the organs
may be reexamined if necessary.
Under no circumstances should any person upon whom sus-
picion of criminality in the case under examination attaches be
permitted to be present at the autopsy,^ and should any pro-
fessional man be present in the interests of an accused or sus-
' See vol. i., pp. 833-864. was present and made two attempts
^ At the autopsy upon the body of to interfere with the proper re-
Cook, Palmer, who was subse- moval of the stomach for analysis,
quently executed for his murder, "Times Report of Trial," p. 21.
136 TOXICOLOGY — WITTHAU.S.
pected person, his function should be strictly limited to that of
a spectator.'
External Examination.
The exterior of the cadaver should first be carefully inspected
and note taken of the following points : 1. The sex and apparent
age. 2. The identity. If identified, by whom; if unknown,
any marks, scars, etc., useful for identification should be noted.^
3. The exact time after death when the autopsy is made if
known; if not, the apparent time. 4. The degree of rigidity.
5. The condition of preservation. 6. Whether the hair is loos-
ened or colored at the roots. 7. The condition of dilatation of
the pupils (in early autopsies). 8. The general color of the sur-
face. 9. Any discolorations of the surface, and their exact loca-
tion and appearance. 10. Any wounds, particularly incisions or
punctures, made for embalming, over the carotid, brachial, fem-
oral, or tibial arteries or in the abdominal walls, or evidences of
hypodermic injections. 11. Any particles of foreign matter
found between the teeth or in the mouth should be preserved.
12. If an autopsy has been previously made, note the fact, and
the condition in which the organs are found.
Internal Examination.
In this place it is only necessary to allude to the precautions
which should be taken in the removal of parts for analysis.
These should consist of: 1. The stomach, ligated at both ex-
tremities and unopened. 2. The intestine, from the duodenum
to the lower rectum, also ligated and unopened. 3. The entire
liver. 4. Both kidneys (preserved in separate jars). 5. The
entire brain. 6. The spleen. 7. A large piece of muscular tissue
from the thigh. 8. Any urine which remains in the bladder,
which may be collected before opening the abdomen by passing
a catheter into the bladder and receiving its contents, expelled by
' When a coroner directs a post- to be present; he loses no legal right
mortem exammation, he may, in by being excluded. Crisfield v.
his discretion, determine whether. Ferine, 15 Hun. 200-affd SI N.Y.,
any person shall be present besides 622.
the surgeons And it seems that ^ See "Identity," vol. i., p. 867,
one suspected of the munler of the seq.
person to be examined has no right
THE AUTOPSY. 137
pressure upon the abdomen, into a phial. 9. A portion of the
blood from the heart and great vessels. 10. The fluid which
collects in the thoracic and abdominal cavities during the
autopsy.* 11. The lungs. Before placing the liver, kidneys,
lungs, and brain in their respective jars as described below they
are to be examined as to their gross appearance, and the small
portions required for pathological examination removed and pre-
served in the strongest obtainable alcohol, apart from the re-
mainder of the organs destined for chemical analysis.
It is rare that all the parts of the cadaver mentioned are
subjected to analysis, but at the time of the autopsy, which is
usually made soon after suspicion is first aroused, one cannot tell
in what direction an examination may become necessary in the
light of later developments. A second autopsy is always more
unsatisfactory than a first, because of disturbance of the organs
and post-mortem imbibition, is frequently difficult to obtain, and
may have become impossible by cremation of the cadaver. In
the Patrick-Rice case there was no suspicion of the use of a
volatile poison at the time of the autopsy and, as the cadaver was
reeking with formalin, the author considered it to be unnecessary
to preserve the lungs, a decision which he subsequently had cause
to regret deeply when the case developed into one of chloroform
poisoning.
The whole of each of the viscera mentioned, except such
small portions as are taken by the pathologist, are required
for the analysis, because, the distribution of poisons not being
uniform in them, quantitative determinations can only be made
from properly sampled fractions of the whole comminuted and
thoroughly mixed organ.
Each of the organs mentioned should be placed by itself in
a new glass jar of suitable size, which has been well rinsed out
with water, preferably distilled water, and which is to be closed
with a glass cover^ or stopper, or with a cork tied over with
moistened bladder or parchment paper. Jars having metallic
caps should never be used. The outside of the jar and cover
having been thoroughly dried (in order that sealing-wax may
' This may be removed by a new ^ The so-called "anatomical jars "
sponge which has been previously are the best for the purpose, the
soaked in dilute hydrochloric acid rubber gasket having been replaced
and then washed with water to by one of parchment paper,
neutrality.
138 TOXICOLOGY — WITTHAUS.
adhere to the glass), a cord or tape is to be tied about them and so
fastened to the glass by sealing-wax, bearing a private imprint,
that it is impossible to gain access to the contents without break-
ing the seals or cutting the cords or tapes. If a cork be used it
should not be covered with the wax. No preservative should be
added, unless the parts must be kept for several days at room
temperature before transmission to their destination. Under
these undesirable conditions alcohol or a 2 to 4 per cent, solution
of formalin only should be used, and if used, generous samples
must be separately submitted for analysis. A cold-storage re-
ceptacle should be resorted to if available.
In removing and transmitting the parts destined for analysis
the examiner should exercise the minutest care to prevent the
possibihty of error, contamination, or loss. Each organ as re-
moved, and after examination as to its gross appearance and
removal of such fragments as may be required for microscopic
examination, should be transferred to its jar and immediately
sealed by an assistant, under the observation of the examiner,
and with his private seal. In making the sections of organs
after their detachment they should never be placed upon a table,
nor upon any surface of whose cleanliness the examiner is not
personally assured, but should be supported either by the hand
of the examiner or upon a new and clean dish or plate. Nor
should any part intended for analysis be permitted to pass, even
for a moment, into the hands of any person other than the ex-
aminer or the chemist. After having been properly sealed the
jars containing the viscera should remain in the custody of the
examiner until they are transmitted by him to the chemist, and,
immediately before their transmission, the integrity of the seals
should be verified. If no preservatives have been used, and if
more than forty-eight hours have elapsed since the autopsy,
when the jars containing the viscera are sent to a distance it is
advisable to release the pressure upon the covers sufficiently to
allow any accumulated gas to escape, as sometimes the pressure
so produced has been sufficient to cause the fracture of the jars
when they are subjected to agitation in transit.
The stomach and intestines should not be opened until they
reach the chemist's laboratory, and when they are opened he
should proceed with the analysis for volatile poisons as expe-
ditiously as possible. It is highly desirable that the pathologist
THE AUTOPSY. 139
and chemist should both be present when the stomach and intes-
tines are opened, and that the former should then note the ap-
pearance of the mucous membrane and take sections of the
tissue, and samples of the contents and scrapings from the sur-
face for microscopic examination. If such joint work be not
possible, the chemist should carefully note the condition of the
gastric and intestinal walls, their degree of preservation, whether
thinned or thickened, or softened, the color and appearance of
the gastric and intestinal mucous membranes in detail, locating
any peculiarity in color or texture; and should dehver to the path-
ologist sections cut through all the coats of the stomach and
intestines, taken particularly at any point where ulceration,
thickening, or other unusual appearances are observed.
In exceptional instances the body has been more or less
completely eviscerated and the internal parts removed. Thus
in the Affaire Gloeckler, in 1846,' the internal organs were re-
moved from the cadaver and thrown into a privy, whose con-
tents were subsequently spread upon a field, where the heart,
liver, and one kidney were found. In the Shann case, in New
Jersey in 1893, all the internal organs of the trunk except the
bladder and one kidney were removed.^ In such instances any
' Devergie, "M6d. l^g., " 36me plus a very bad sore throat and an
ed., iii., 563. ulcer in the inside of the mouth,
^ We are indebted to Dr. J. Stock- which almost perforated the cheek
ton Hough, of Trenton, N. J., for before death. In the prescriptions
an opportunity to consult the written for the patient during his
stenographer's minutes in this ex- illness calomel was the only mercurial
traordinary case. Mrs. Mattie C. given, of which the total quantity
Shann, a widow, was tried for the used in the Shann family during
murder of her son, John F. Shann, this period was 2^ grains. A drug-
at the Mercer County (N. J.) Oyer gist, during John's illness, refilled a
and Terminer, August, 1893, and prescription for antiseptic tablets
acquitted, the motive alleged by the containing corrosive sublimate three
State having been to obtain the pay- or four times for the defendant or
ment of insurances upon the life of her seventeen-year-old daughter,
the deceased, which had been written Mabel. There was evidence that
some six months before his death. John had taken other medicine
The deceased, about twenty years than that ordered by Dr. Bergen, the
of age, and residing with his mother nature of which did not appear,
at Princeton, was taken sick about and, it was claimed by the defense,
February 22d, 1893, took to his bed had contracted syphilis during the
March 6th, and died early on the preceding Christmas holidays. The
morning of April 18th, having been body was laid on a cooling board,
attended during his illness by the in a room in which the defendant
family physician. Dr. Bergen. The and her daughter slept, by an
physician diagnosed the case as one undertaker, a cousin of the deceased,
of gastritis, which he assigned as the the following morning. Cloths
cause of death in his certificate. The dipjjed in "Utopia" embalming
symptoms were those of gastritis, liquid were laid 'upon the stomach,
140
TOXICOLOGY — WITTHAUS.
remaining contents of the thorax, abdomen, or pelvis which may
be found should be carefully preserved for analysis, as well as the
brain and large portions of muscular tissue. Diligent search
should be made for the missing organs, and the appearance of
what remains of the cadaver should be minutely noted, as to
how the evisceration was performed, whether by a skilled hand
or otherwise, and whether the body had been embalmed previous
to evisceration.
PosT-MoRTEM Appearances of Toxicological
Significance.
External Appearance. — Rapidly acting poisons do not
modify the general appearance of nutrition of the cadaver.
After death from poisons causing inanition, or whose action is
attended with the loss of notable quantities of fluid, the body is
emaciated, sometimes to complete loss of subcutaneous fat; as
after death from the secondary effects of corrosives, and after
prolonged poisoning by arsenic, mercury, or lead.
hands, and face and about a tea-
spoonful was injected into the sore
upon the face, but the body was not .
embalmed, the defendant desiring
that it should not be done. The
body was last seen in an unmutilated
state by the undertaker at about
10 A. M. on the 19th, and at about
the same time by the local agent of
the life insurance company. From
that time until about 3 A. M. on the
20th, when the body had been
mutilated, it was not seen, so far
as the evidence shows, except by the
defendant and her two daughters.
One of these, Mamie Kelly, alleges
that she saw the body intact at two,
five, and nine o'clock on the 19th,
at five o'clock in the presence of
another person who, however, flatly
contradicts her in his evidence. At
about 5 p. M. on the 18th an agent of
the insurance company asked to see
the body and was refused permis-
sion by the defendant; and at about
eleven o'clock on the evening of
April 19th the defendant was in-
formed that the insurance com-
pany's physician would make an
autopsy on the following morning.
At three o'clock on the morning of
the same night the defendant awak-
ened one of her male lodgers, to
whom she related the particiilars
given below, and who at her request
looked at the body and found blood
stains on the sheet upon which it
lay, and on the canopy which cov-
ered it. At about seven to eight
o'clock the same morning (April
20th) Dr. Bergen examined the
body sufficiently to see that the ab-
domen had been cut open and its
contents removed. The body was
transferred to Trenton by the county
physician that evening and an ex-
amination was made the following
day, April 21st, when it was found
that all the contents of the abdomi-
nal and thoracic cavities had been
removed, with the exception of one
kidney, the bladder, which had been
slit, about three inches of the rec-
tum, and parts of the cesophagus and
trachea. Some of the brain, the
kidney, and some bloody matter
from the abdomen were put into one
iar together, and about two and a
half inches of the rectum in another.
These were analyzed by Professor
Wormley, who found about i grain
of mercury in the contents of the
first jar and about ^ grain in the
piece of rectum. On May 13th the
POST-MORTEM APPEARANCES.
141
Usually there is a slight elevation of the temperature of the
cadaver immediately after death, after which it gradually falls,
reaching that of the surrounding air in from fifteen to twenty
hours. In many forms of poisoning the body temperature falls
notably before death, when the cooling of the cadaver is complete
in a much shorter period. On the other hand, after death from
carbon monoxid the process is much slower, occupying from one
to three days.
Rigor mortis usually begins within six hours after death,
and gives place to flaccidity in from sixteen to twenty-four hours.
But in poisoning by strychnin and other spinal poisons, when
death occurs during a spasm, the muscles remain rigid until rigor
mortis supervenes, and this continues sometimes for several days.
In such cases the cadaver also remains in the characteristic
posture of the spasm. After death from narcotics or from
phosphorus post-mortem rigidity is less pronounced than usual.
After a phosphorus poisoning of not too short duration the
entire surface (and the tissues as well) is icteric. A yellow
body was exhumed and the remain-
der of the brain, the bladder, the
fractions of oesophagus and of
trachea, the larynx, both tonsils,
both parotid glands, an ulcer in the
cheek, the calves of both legs, and a
part of the muscles of the right thigh
were removed, placed in six jars
and submitted to Professor Corn-
well, who found them to contain
mercury. No trace was found of the
viscera removed from the body.
The officers of the insurance com-
pany denied any knowledge of their
removal. The defendant related
that during the night of the eviscer-
ation "three persons dressed in
storm coats, slouch hats, and whose
general appearance (but not with
much particularity) she described,
came to her front door, rang the bell;
she arose, went down, opened the
door, admitted these three men.
That they insisted upon seeing the
body of her son — she refused; they
continued to insist, and in answer to
some questions, she told them where
the body lay. Two of them went
upstairs and entered the room where
the body lay. They came down
after some length of time, she being
meanwhile detained by a third per-
son at the foot of the stairs by vio-
lence, who threw her twice against
the wall when she attempted to go
upstairs; that then they departed
and left. Whether they had any-
thing with them or not she was un-
able to say. During this time the
lamp was on the table in the hall,
which she had brought down, burn-
ing. She says that her condition
of mind under the circumstances
was such that she thought these
persons came from the insurance
company to make some examination
or otherwise, and that she was so
affected by it that she was unable to
make any outcry, or do anything so
as to arouse any of the boarders in
the house, or her daughter,, or Aunt
Eliza who slept in a room about
eight feet from where she stood, de-
tained by one of these three men"
[charge of Judge Abbott]. There
was some collateral evidence in cor-
roboration of minor points of this
testimony, but no dn-ect evidence
in support of it by any of the six
boarders in the house at the time;
and the daughter, Mabel, slept,
without awakening, within a few
feet of the cadaver during the en-
tire period.
142 TOXICOLOGY WITTHAUS.
color of the skin (and internal organs), usually in limited areas,
is also observed in exhumed bodies which have been embalmed
with arsenic. After death from carbon monoxid or illuminating
gas the skin is bright red in color, particularly on the inner sur-
faces of the thighs. A cyanotic appearance is observed after
death from nitro-benzene. The formation of cadaveric lividity
or hypostasis is not of toxicological significance, except as in-
dicating the progress of putrefaction. The formation of stains or
eschars, red, brown, black, yellow, or white, by contact of cor-
rosives, usually about the mouth or upon the chin or breast, or
the presence or cicatrices resulting therefrom, constitute quite
characteristic indications.
The cadaver may exhale the odor of a highly odorous poison,
such as ammonia or hydrocyanic acid.
After phosphorus poisoning the mouth, teeth, and lips may
present a luminous appearance in the dark.
In the Blood. — Manj^ poisons act chemically in or upon
the blood, and produce changes in its appearance observable at
the autopsy. The blood is found to be frothy from the pres-
ence of bubbles of gas, if the autopsy be made soon after death
from hydrogen peroxid, which may cause death by the mechan-
ical action of the gaseous oxygen which it liberates on being
decomposed in the blood. A similar appearance has been ob-
served in animals poisoned by diazobenzene salts, which gener-
ate free nitrogen when decomposed in the blood, and also in
some cases of death from chloroform and ether in the human
subject.
The COLOR of the blood is dark after death from the action
of poisons which interfere with the proper oxygenation of its
coloring matter, as morphin, strychnin, or carbon dioxid, or
which act chemically upon it, with formation of methsemo-
globin, or hsematin, or of sulfhsemoglobin, as potassium chlor-
ate, and hydrogen sulfid. It is bright red after poisoning by
carbon monoxid. (See Physical Examination, p. 149.)
Unusual coagulation of the blood is observed after death
from castor oil beans, jequirity, or the mineral alkalies; while
the blood is fluid when death has been caused by strychnin,
morphin, chloroform, oxalates, carbon monoxid, etc.
Certain poisons cause a more or less complete destruction and
solution of the red blood corpuscles, sometimes so extensive
POST-MORTEM APPEARANCES. 143
that the blood in thin layers appears perfectly transparent and
uniform in consistency, while normal blood obstructs the passage
of light, even when in very thin strata. This solution of cor-
puscles is observed after poisoning by hydrogen arsenid and by
certain fungi.
In the Brain and its Coverings. — The odors of ether, chloro-
form and hydrocyanic acid may sometimes be observed on
opening the cranial cavity, even when they are not detectable in
the abdomen or thorax. Congestion of the cerebral and menin-
geal blood-vessels and effusions of serum into the ventricles and
beneath the arachnoid are usually found after death caused by
acute poisoning by alcohol, morphin, cocain, nicotin, coniin,
strychnin, etc. After late death from carbon monoxid sometimes
areas of hemorrhagic necrosis and softening which are quite
characteristic are observed.
In the Thoracic Organs. — Effusions into the pericardium and
pleura are found after death from many poisons. An unusually
contracted condition of the left heart is sometimes found after
death from digitalin and veratrin; and endocardial ecchymoses
are frequently observed after death from arsenic. The heart
muscle is the seat of fatty degeneration in death from arsenic,
antimony, and phosphorus.
The lungs are congested and sometimes oedematous in poison-
ing by morphin, nicotin, pilocarpin, and certain fungi, and highly
so after death from the inhalation of irritant gases or vapors.
In such cases the odor of the gas or vapor if it have one, may
be observed on opening the thorax.
In the Abdominal Viscera. — It is here chiefly that post-
mortem appearances of toxicological interest are to be found.
On opening the abdomen, the characteristic odor of a given
poison may sometimes be observed; the garlic odor of phos-
phorus, the peach-blossom odor of hydrocyanic acid, the tur-
pentine-like odor of savin, the characteristic odors of phenol,
camphor, alcohol, etc.
The peritoneal surface of the abdominal organs, par-
ticularly the stomach and adjacent parts, is found reddened, in-
flamed, ecohymotic, and the blood-vessels injected after death
from the action of powerful irritants and corrosives. The
peritoneal cavity may contain serous, purulent, or bloody exu-
dations, or even the contents of the stomach, if the walls of
144 TOXICOLOGY WITTHAUS.
that organ have been powerfully attacked or perforated by a
corrosive.
The appearance of the external surface of the stomach and
its degree of distention are to be noted, the organ being held by
its two extremities before a good light. If its size depart from
the normal it is to be measured and its dimensions noted. The
contents are then removed by holding the stomach by its two
extremities over a clean, weighed beaker, and making an in-
cision with a scissors at the most dependent part. The beaker
and contents are weighed and the weight of the latter deter-
mined by subtraction of the weight of the beaker. A mark is
placed on the outside of the beaker at the level of the contents
that their volume may be subsequently determined. The color,
consistency, and odor of the contents are noted and portions of
the solid part removed for microscopic examination (see below).
The reaction is determined. An alkaline reaction may be due
to caustic alkalies, alkaline earths, or potassium cyanid, or to
the administration of alkaline antidotes. An intensely acid re-
action may be due to acids or to acid salts. The contents are
observed in the dark; they are luminous in the presence of phos-
phorus provided alcohol or oil of turpentine be not present.
To examine the mucous surface of the stomach it is divided
from end to end along the greater curvature and spread out,
with the mucous surface upward, upon a new and clean plate or
dish. The characters of adherent particles are first noted carefully
by examination with the unaided eye, then with a hand mag-
nifier of about two diameters and the microscope. In this man-
ner valuable information is sometimes rapidly obtained. Arsenic
trioxid, if taken in substance, is frequently found in the shape of
octahedral crystals, accompanied or not by white amorphous
particles, and sometimes tinged yellow by formation of the
trisulfid during putrefaction. Crystals of white arsenic ac-
companied by black particles of carbon indicate that the poison
was taken as "rough on rats" or some similar combination of
arsenic and soot, in substance. Green, metallic particles may be
found adherent to the walls of the stomach in poisoning by Paris
green, and green scales when death has been caused by canthari-
des. Small fragments of wood with sulfur attached have been
found when match heads have been taken, and fragments of
various seeds and other vegetable tissues after nux vomica,
POST-MORTEM APPEARANCES. 145
stramonium, savin, aconite, tobacco, and other poisonous
vegetable drugs have been taken in substance. Sometimes also
particles of a peculiar food substance, or of one peculiarly
modified, as by the presence of mould, may serve to identify the
vehicle in which the poison was administered.
After any particles adherent to the walls of the stomach have
been examined and collected, the mucous surface is to be washed
with a small quantity of distilled water (which should be pre-
served for examination along with the contents). The appear-
ance of the mucous membrane is to be carefully noted, and any
departures from the normal located. Excoriations, ulcerations,
erosions, and even perforations are found after death from the
immediate effects of corrosives, or marked thickening, ulcera-
tion, absence of epithelium, and contraction of one or both ori-
fices after death from their secondary effects. Irritant poisons,
whether mineral, animal, or vegetable: arsenic, antimony, po-
tassium cyanid, croton oil, savin, many ethereal oils, canthar-
ides, etc., produce more or less intense inflammation, marked
by redness, sometimes diffused over the entire mucous surface
and darker in the depressions between the rugae, sometimes of
a dotted or petechial character; and by more or less injection of
the blood-vessels.
With corrosives and some poisons similar changes are observed
in the oesophagus, pharynx, and mouth. With volatile corrosives
and poisons, such as hydrochloric acid, ammonia, chlorin, etc.,
the larynx and trachea are the seat of intense inflammation;
and may be eroded if a liquid corrosive has been aspirated.
The INTESTINES are to be dissected from the mesentery, di-
vided at the ileo-caecal valve, and the small and large intestines
separately examined in the same manner as the stomach, the
contents being removed either by "stripping" each portion be-
tween the index and middle finger from above downward or
preferably, by the handle of the scalpel after the gut has been
opened by the enterotome. Irritant poisons produce more or
less extensive intestinal inflammation, particularly in the upper
part of the small intestine and in the large intestine. Or the
upper part of the small intestine may be pecuharly colored:
green by Paris green or the salts of copper; brown by iodin,
potassium dichromate, or phosphorus; yellow by picric acid,
lead chromate, or nitric acid; black by silver.
IV— 10
146 TOXICOLOGY WITTHAUS.
The LIVER, HEART, and kidneys are the seat of fatty degen-
eration in poisoning by phosphorus, arsenic, antimony, iodin,
and certain fungi and in "delayed" chloroform poisoning.
The kidneys are the seat of active hyperemia in poisoning
by cantharides, turpentine, iodin, etc. They crackle on section
and contain crystalline deposits of calcium oxalate after death
from oxalic acid or the oxalates, or infarcts of calcium carbonate
in poisoning by the mercurials; and they contain reddish-brown
casts, visible to the unaided eye, after death from mineral acids
or alkalies, potassium chlorate, etc.
In poisoning by the compound ammonias (hydroxylamin, me-
tatoluidin, etc.), the kidneys and spleen are pigmented, and
pigmentary, murifbrm masses are found in the latter organ. ^
EVIDENCE FROM THE PRESENCE OF POISON IN THE
CADAVER.
If post-mortem introduction of poison be excluded, the most
satisfactory evidence of poisoning is from the demonstration of
the presence of the toxic agent in the cadaver.
This may be attained by one of three methods or a combina-
tion of them: The physical examination, by which the poison
is identified, when present in substance, by its appearance,
crystalline form, color, etc., or by spectroscopic or other physical
examination; the chemical analysis, by which the dissolved or
absorbed poison is separated in a form which permits of its
identification by its physical characters and chemical reactions;
and the physiological examination, by which the nature of the
poison is determined by observation of its effects upon animals,
by "life tests." These three methods are used jointly, and to-
gether constitute a toxicological analysis.
CONDITIONS OF A TOXICOLOGICAL ANALYSIS.
The expert selected to perform the analysis must, of neces-.
sity, be a chemist of experience.^ He should also be a graduate
in medicine and familiar with the methods of physiological ex-
'Pilliet: Compt. rend. soc. bioL, a child and swore positively to the
Paris, 1804, 10 S., i., 331. presence of arsenic before the coro-
' As recently as 1861 (Phar. Jour. ner. The jury demanded a further
and Trans., 1860-61, n. s., ii., examination by a chemist, which
614) two medical men in England was made and demonstrated the
analyzed (?) portions of the body of absence of arsenic.
CONDITIONS OF A TOXICOLOGICAL ANALYSIS. 147
perimentation. Indeed, the peculiar experience and training
requisite to enable one properly to conduct an intricate toxi-
cological analysis are such that only most exceptionally can
persons truly competent be found, except among those who in
the larger institutions of medical and pharmaceutical instruc-
tion have devoted themselves specially to this subject.
In some countries, as in France, the analysis is entrusted to
two experts, who conduct the operations jointly. In a circular
of February 6th, 1867, the French Minister of Justice deprecates
the multiplication of experts in the following language : " Under
the pretext of reaching greater certitude and of carrying to the
mind more entire conviction, magistrates show themselves
much too ready to call in at once and without distinction two
and even three experts. This is a regrettable tendency against
which we must contend. In fact, the expert investigation does
not bind either the magistrates or the defense, and the number
(of experts) which always delays the solution of questions in-
volved is no guaranty of the value of the work.
"It seems evident to me, in fact, that expert investigations
draw their force much less from the number of specialists con-
sulted than from the well-known merit, knowledge, and in-
tegrity of the expert. It frequently happens that a report offers
all the more security when it is signed by a single expert, be-
cause the responsibility falls upon him alone, because he has
verified everything himself, and because no opinion is expressed
as a sort of compromise.
" It is therefore, I repeat, by knowing how to choose the ex-
pert to whom a mission is confided, and not in multiplying their
number, that one assures all the importance which it should
have, to this aid to the information which is necessary in many
cases. . . .
"It is hardly necessary that I should add that all the rules
which I have laid down apply to chemical analyses."'
In these views we heartily concur, as we have found that
the collaboration of two experts greatly increases the time nec-
essarily consumed in the analysis and in the exchange of views
concerning the propriety of the steps to be taken, without in any
way rendering the result more reliable than if reached alone
by the more experienced analyst.
1 Dubrac: "Traits de jurispr. med., " etc., Paris, 1893, pp. 193, 194.
148 TOXICOLOGY WITTiL\U,S.
Still more superfluous, and even subversive of accuracy of
the results of so delicate an investigation, is the presence during
the analysis of the purely medical examiner which was required
in Russia.'
No person whose ability or integrity is open to the doubt
implied by the requirement of testimony at the mouth of two
witnesses, or whose perception of color is deficient, should ever
be entrusted with a toxicological analysis, either alone or in con-
junction with another. Purely chemical evidence is of fact rather
than of opinion, and the chemical witness is " expert" only in that
he requires exceptional skill and training that he may ascertain the
facts. His evidence can be traversed only by the testimony of
equally competent witnesses to the effect that the existence of the
facts testified to has been inferred from insufficient data, or by an
attack upon the common veracity of the witness. Although in-
competent persons with a desire for notoriety and for pecuniary
profit may, and frequently do, appear before the courts as toxi-
cological experts, it would appear hardly probable that one such
should resort to bald lying in face of the certainty that the
falsity of such testimony can be demonstrated to the satisfaction
of even a lay jury if it be seriously attacked. Yet the author has
met with two instances in which alleged chemical experts have,
in capital cases, sworn to that which they must have known to be
untrue, and in one of these the falsehoods were given as evidence
for the people, a perjury tantamount to attempted judicial mur-
der. In this case (Peo. vs. Fleming, New York County, 1896)
proof of the falsity of one of the people's experts (?) and of his
general bad character constituted the whole of the defense, and
the defendant was promptly acquitted. In the second case
(State vs. McAllister, Death and Campbell, N. J., 1901) the false
evidence was given in favor of the defense and was considered by
the prosecution to be too fantastic in character to be worthy of
notice in rebuttal. This alleged expert subsequently served a
term in the Massachusetts State Prison for perjury in another
matter.
To insure the physical impossibility of admixture of foreign
substances by mistake or intentional interference, the analysis
should be conducted in a room in which no other work is done
at the same time, in which there are no poisonous substances
1 Dragendorff: " Ermittelung v. Giften," Ite Aufl., 1868, p. 2.
PHYSICAL EXAMINATION. 149
other than those possibly present in the articles under examina-
tion and certain chemicals necessarily used, and which no person
other than the analyst is permitted to enter. The windows
should be sealed, and also the door during the absence of the
analyst, and the integrity of the seals verified each time they
are broken.
The vessels used in each analysis should be new. Each
should bear a distinctive number or letter, and the notes of the
analysis should refer to these in such manner that at no time can
there be any doubt of what may be the contents of each vessel.
No solvent or chemical is to be considered as pure unless
proved to be so by the proper tests, or by purification by the
analyst himself.
When it is possible it is highly desirable that samples of the
poison actually separated from the articles examined shall be
preserved in as many of its distinctive forms as may be.^ This
is always possible if the poison separated by analysis is min-
eral in nature, but with the volatile and vegetable poisons, when
present in small quantity,, it is frequently impossible or un-
desirable. Thus when morphin has been separated in very
minute quantity it is preferable to use all of the material re-
maining after the application of the chemical tests to portions,
in the application of a life test, rather than to reserve a part,
as notable quantities are required to produce the physiological
action, and as evidence of this character is more satisfactory to
the minds of a lay jury than that based upon delicate chemical
reactions.
Finally, we would caution the analyst against undue haste.
No step in the analysis should be taken except after mature re-
flection and appreciation of its possible influence upon the opera-
tions to follow. Nor should the analyst permit himself to be
led into the expression of an opinion as to what poison may be.
present before he is perfectly certain that it is present. All
"tails," such as filtrates, washings, remainders after extraction,
etc., should be preserved until the end of the analysis.
PHYSICAL EXAMINATION.
It sometimes happens, when a poison has been taken in the
sohd form, or is a substance having a characteristic odor, that
' See Forensic Questions, 4, p. 207.
150
TOXICOLOGY — WITTHAUS.
Fig. 1.
-Microscope Super-stage for Ex-
amining Crystals, etc.
portions may remain in the stomach sufficient to permit of
identification or to afford indications of its probable character,
from its crystalline form, botanic character, color, odor, etc.
Such a preliminary physical examination of the contents of
the stomach and of fragments adherent to its walls (see p. 144), or
between the teeth, and of articles of food, medicine, etc., sup-
posed to have been the
vehicle of administration
should never be neglected.
Very frequently the nar
ture of a substance is indi-
cated by its crystalline form,
either in its own form or in
precipitates obtained by
the action of reagents. The
crystals are almost always
small and require the use
of a microscope for the de-
termination of their forms. In some cases also the polarizing
microscope is of service. We have found a super-stage of the
form shown in Fig. 1, very convenient for microscopic examina-
tion of objects in dishes, tubes, etc. For tubes the body of the
microscope is tilted back and the tube placed against the pins aa.
Dishes and other round-bottomed vessels are supported by the
three projecting pieces b, whose points are covered with small
sections of rubber tubing to prevent slipping.^
A spectroscopic examination of blood or urine may in some
cases promptly furnish valuable evidence. Thus after death
from illuminating gas or carbon monoxid the blood presents
the characteristic spectrum of carbon monoxid haemoglobin,*
and in poisoning by sulfonal the urine shows that of hsemato-
porphyrin.^
The action of certain substances upon polarized light may also
be utilized. Thus copaiba, salicylic acid, salol, arbutin, antifebrin,
and chloral render the urine Isevogyrous. Certain crystals are
also brilliantly colored when examined with polarized light.
' See also " Micro-sublimation," p. Vivo: "Atlas de micro-quimica,
180, and Wormley: " Micro-chemis- etc., Barcelona, 1S78. Sedgwick;
try of Poisons," 2d ed., Phila., 1885. St. Andrew's M. Grad. Assoc. Trans.,
Erhard: "Die gittige Alkaloide u. 1867, i., 200-207.
d. Ausmitt. auf mikroskopischem ' See vol. iii., p. 856.
Wege," Passau, 1866. Valenti y ^ See vol.iii.,Pl.ix.,Fig.l4,p.854.
CHEMICAL EXAMINATION. 151
CHEMICAL EXAMINATION.
The purposes of the chemical analysis are: 1. The separa-
tion of the poison from the constituents of the viscera, vomit,
etc., in a condition of purity sufficient to permit of the proper
application of the chemical or physiological tests suitable for its
identification; and 2. The recognition of the identity of the
poison by its physical, chemical, and physiological characters.
It is with the methods of separation only that we have to deal
in this place. The individual reactions of the various poisons
will be considered in the division on Special Toxicology.
The methods adapted to the extraction of poisons from or-
ganic mixtures vary with the nature of the poison. For ana-
lytical purposes, poisons and corrosives may be classified into:
I. Mineral Acids and Alkalies. — These cause extensive de-
struction of tissue, recognizable at the autopsy. With the
possible exception of nitric acid, they are either in their own
form or in other forms of combination normal constituents of
the body, and hence require to be quantitatively determined in
cases of supposed death or injury from their action in which
analytical investigation is desirable.
II. Volatile and Gaseous Poisons are such as are sepa-
rable from acid or alkaline mixtures by mere distillation.
III. Organic Poisons, including all non-volatile substances
which are decomposed by powerful reagents, and which must
consequently be separated by the action of solvents or precipi-
tants not capable of modifying their composition, except in
so far as they may be converted into combinations from which
they may be released without being themselves decomposed.
IV. Mineral Poisons. — Substances of such- stability that
they remain in a more or less modified form of combination
after the action of reagents capable of destroying or removing
the organic material with which they are mixed.
While conditions may exceptionally exist in which it is per-
missible to limit the analysis to the search for a particular poi-
son or group of poisons, in the great majority of cases the work
should be so conducted that the search for a particular poison
shall not render the detection of another impossible. It is de-
sirable also that a portion of materials submitted shall be set
aside, if the quantity be sufficient, in case of accident. For
152 TOXICOLOGY WITTHAFS.
these reasons the objects examined should be divided, except
under the conditions mentioned below. The division, however,
should be so made as to permit of calculations of quantity in an
entire organ from the amount to be found present in a portion
thereof. The material, if solid, should be finely divided by a
hashing machine, mill, or mortar, thoroughly mixed, weighed,
and the portions removed for each analysis also weighed. If
liquid they should be both weighed and measured, and the
weight and volume of portions taken after thorough stirring also
weighed and measured. In some cases the entire organ or sub-
stance must be submitted to analysis, as when a liver is to be
examined for organic poison, or when the stomach contents or
other material are very small in quantity. Under these circum-
stances the chances of detecting the poison are so remote that
they should not be diminished by operating upon any less mater-
ial than the entire quantity available.
If the amount of material available be large, it may be
divided into three portions, one of which is set aside with the
addition of sufficient purified alcohol^ or formalin to prevent
putrefaction, or preferably preserved without addition of any
antiseptic in a cold storage receptacle; the second is examined,
first for volatile poisons by distillation, and the residue for
mineral poisons; and the third directly for organic poisons.
In some analyses, however, it will be found necessary to use
the entire quantity, of some portion submitted at least, for the
detection of both organic and mineral poisons, with or without
the previous removal of a fraction for the search for volatile
poisons. When this is to be done the analysis for organic poi-
sons must necessarily precede that for mineral poisons. All
"tails," i.e., filters, washings, the final aqueous liquid after the
extraction of vegetable poisons by immiscible solvents, and the
residues remaining after the search for vegetable poisons are
to be united with the residue of distillation left after the search
for volatile poisons, and the materials so reunited examined for
mineral poisons.
No reagent is added in the search for volatile or organic
poisons which interferes with the subsequent detection of min-
eral poisons, and in proceeding as above directed there are but
two possible causes of partial loss of material. During the
' See p. 1,'iS, note 1.
EXAMINATION FOR VOLATILE POISONS. 153
heating necessary to distillation certain organic poisons may
suffer partial or complete decomposition, hence only a portion
of the material should be used for this purpose. There is neces-
sarily a slight loss of material in collecting the various "tails,"
distributed in a number of vessels, and consequently an error in
the quantitative determination of mineral poisons. But as
this error is not great, and is in favor of the defense, it may be
disregarded.
Examination foe Volatile Poisons.
The poisons included in this analytical group are: Phos-
phorus, the cyanic poisons, chloroform, chloral, alcohols, ethers,
hydrocarbons, phenol, nitrobenzene, carbon disulfid, camphor
and essential oils, iodin, bromin, and hydrochloric acid.
The following method and apparatus are designed for the
qualitative detection of all volatile poisons, and should be ap-
plied to a portion only of the materials available, which portion
may subsequently serve for the detection of mineral poisons.
When only one specified volatile poison is to be sought for, or
when quantitative results are desired, some modification is
usually required, as will be indicated in the sequel under the
appropriate headings.
The substances to be examined, finely hashed if solid, and
made up to a liquid measure of about 300 c.c, are acidulated
with tartaric acid if not already acid, and placed in the distill-
ing flask a of the apparatus shown in Fig. 2, which is placed in a
water-bath containing a solution of calcium chlorid or paraffin.
The stop-cock h of the carbon dioxid generator c is at first closed.
The distillation is conducted in a dark room and with screens so
placed, if necessary, that after the burner is lit the fractioning
tube d and the upper part of the condenser e are in total ob-
scurity. The heating, which must be moderate and gradually
increased at first to avoid bumping and frothing, ^ is continued
until 250 c.c. of distillate have been collected in separate portions
of 50 c.c. each in five numbered flasks placed at/.
During the distillation the fractioning tube d and the con-
denser e as well as the connecting tube are to be carefully ex-
' Bumping may be prevented by of the flask; and frothing, in some
adding a few. short pieces of capil- measure, by the addition of a frag-
lary glass tube to the cool contents ment of paraffin.
154
TOXICOLOGY WITTHAUS.
amined for the phosphorescence produced by phosphorus (see
Phosphorus) ; the temperature indicated by the thermometer g
is to be noted when the distillate begins to collect and at each
change of the receiving flasks, and the several distillates are to
be examined by the tests for the volatile poisons to be subse-
quently described. The reaction of the distillate is to be noted
Fig. 2. — Distilling Apparatus for Volatile Poisons.
from time to time. If any odor of turpentine be observable
either in the original material or in the distillates, or if any pro-
nounced odor capable of masking that of turpentine be pres-
ent, the distillation must be further conducted for the detec-
tion of phosphorus in the manner directed in the special con-
sideration of that poison. Otherwise the apparatus is allowed
EXAMINATION FOR ALKALOIDS, GLUCOSIDS, ETC. 155
to cool, 100 c.c. of water holding enough magnesia to render
the contents of the flask alkaline are added, and two further dis-
tillates of 50 c.c. each are collected.
In the distillate from the acid liquid alcohols, ethers, chloro-
form, chloral, hydrocarbons, camphors, essential oils, phenols,
nitrobenzene, hydrocyanic acid, iodin, bromin, hydrochloric and
acetic acids are to be searched for; and in the distillate from the
alkaline liquid, chloroform originating from decomposition of
chloral, ammonia, anilin, and volatile bases, including nicotin and
coniin.
Examination foe Alkaloids, Glucosids, etc.
The processes at present in use for the separation of alka-
loidal poisons from complex organic mixtures are either proc-
esses by precipitation or by solution in solvents immiscible
with water. The former, while valuable for pharmaceutical
purposes and for investigation, are not adapted to the needs of
forensic toxicology.
The various methods of extraction by immiscible solvents
are variations of, and improvements upon, the method first used
by Stas in the Bocarme case,' which was founded upon the fol-
lowing facts :
1st. The tartrates (and most other salts) of the alkaloids are
readily soluble in water and in alcohol.
2d. The alkaloids are separated from aqueous solutions of
their salts by ammonia and other powerful bases.
3d. The alkaloids thus liberated pass, more or less completely
and readily, into ether or other liquids immiscible with water,
when these are shaken with aqueous liquids containing the free
alkaloids.
Method of Stas.^ — The material is treated with twice its
weight of strong alcohol and 0.5 to 2 gm. of tartaric acid or
oxalic acid, preferably the former, and warmed to 60°-65°
(104°-149° F.), cooled, filtered, and the filtrate evaporated,
preferably in a vacuum over sulfuric acid or in a current of
air, at a temperature not exceeding 35° (95° F.). The remain-
ing liquid is filtered, and filtrate and washings are evaporated
' Poisonine by nicotin, at Bury in = Bull. Acad. roy. d. m^d. d.
Belgium, in 1851. Belg., Brux., 1851-52, xi., 202-312
(p. 304).
156 TOXICOLOGY WITTHAUS.
in vacuo. The residue is taken up with strong alcohol, and the
alcoholic solution again evaporated spontaneously or in vacuo.
The residue is dissolved in the smallest possible quantity of
water, gradually alkalized with monosodic or monopotassic car-
bonate, and agitated with four or five times its volume of ether,
which is, after separation, decanted and allowed to evaporate
at the ordinary temperature.
The modifications suggested by Julius Otto, and constitut-
ing the Stas-Otto method, properly so called, consisted in
agitating the final aqueous liquid while still acid with ether for
the purpose of removing fats and other substances, other than
alkaloids, soluble in ether, and in adding ammonium chlorid
to the alkaline aqueous liquid after extraction by ether, for the
purpose of causing morphin (which when crystalline is practi-
cally insoluble in ether and soluble in aqueous liquids alkaHzed
with soda) to cr3'stallize.'
Prollius' adopted the method of St as for the extraction
more particularly of strychnin, with the modification that chlo-
roform was used in place of ether.
Method of Uslar and Erdmann.^ — The substances under
examination are digested for one to two hours at 60°-80° (140°-
176° F.) with water faintly acidulated with hydrochloric acid,
and the solution filtered, treated with a slight excess of am-
monium hydroxid, and evaporated to dryness. The residue is
extracted three or four times with hot amyl alcohol (boihng
point 132° C); the filtered amylic solution is shaken with hot
water, acidulated with hydrochloric acid, and the aqueous solu-
tion, after separation, is treated with a slight excess of ammo-
nium hydroxid and again agitated with hot amyl alcohol; the
amylic alcohol layer is then separated and evaporated.
In the later Stas-Otto process,* the use of amyl alcohol for
the extraction of morphin (of which it is one of the best solvents
yet known) is adopted as preferable to the crystallization method
above described.
This method has more recently been modified by Manne','
particularly for the extraction of morphin, by agitating the
' Ann. d. Chem., 1856, c, 44, and ' Ann. d. Chem., 1861, cxx., 121.
Ausmitt. d. Gifte," 3te Aufl., 1SG7, Ztsch. f. an. Chem., 1S02, i., 267.
PP„- 37, 42. 4 3d an(j i^ter editions.
Arch. d. Pharm., 1S57, Ixxxix., =Pharm. Ztg., 1SS3. xxviii., 334.
168
Ztschr. f . an. Chem., 1883, xxii., 6.34.
EXAMINATION FOR ALKALOIDS, GLUCOSIDS, ETC. 157
aqueous liquid, while still acid, with hot amyl alcohol, then
rendering it alkaline with ammonium hydroxid and again
agitating with the same solvent. The purpose of this modifica-
tion is to remove coloring matters and other impurities, and thus
purify the acid solution before extraction of the morphin from
the alkaline solution (see below).
The processes of Husemann' and of Thomas- dififer from
the preceding in that they use acidulated water for the first ex-
traction in place of alcohol, the former acidulating with sulfuric
or hydrochloric acid, the latter with acetic acid. In both
methods the filtered aqueous extract is directly alkalized with
potash or soda, and extracted by agitation with chloroform.
In both also the alkaline, aqueous liquid is subsequently exam-
ined for morphin.
Method of DragendorS. — This process has been gradually
extended by its author from the simple form in which it was
first suggested for the separation of strychnin and brucin, to its
present elaborate form to permit of the separation of a great
number of alkaloids and glucosids.^
The process is conducted as follows: The materials are ex-
tracted at 50° (122° F.) with water acidulated with sulfuric
acid (not more than 5 c.c. of diluted acid 1:5); the extract is
filtered and concentrated to a thin syrup on the water-bath.
The residue is gradually mixed with three to four volumes of
strong alcohol, and filtered cold after standing twenty-four
hours. The alcohol is distilled off. The aqueous liquid remain-
ing, diluted to 50 c.c. and again filtered if necessary, is then,
while still acid, successively agitated with (1) petroleum ether,
(2) benzene (CgHg), (3) chloroform, (4) petroleum ether, each
solvent being separated and evaporated apart, furnishing the
"acid residues" I., II., III., IV. The aqueous hquid is then
rendered alkaline with ammonia, and successively agitated
with (5) petroleum ether, (6) benzene, (7) chloroform, (8) amyl
alcohol, which are in like manner separated and evaporated to
leave the "alkaline residues" V., VI., VII., VIII. Finally the
'"Handb. d.Tox.," Berlin, 1862, 85; 1867, vi., 663. "Ermittelung
p. 202. V. Giften," 4te Aufl., 1895, pp. 149-
2 Chem. News, 1862, 341, 352. 153. See also Nowak: Sitzber.
*Arch. Sudebn. Med., 1865, i. math.-natur. CI. d. k. Ak. d. Wis-
Ztsch. f. an. Chem., 1866, v., 474. sensch.. Wien, 1866, Ixvi., 143.
Pharm. Ztschr. f. Russl., 1866, v..
158
TOXICOLOGY — WITTHAUS.
aqueous liquid is evaporated with powdered glass, and extracted
with chloroform, which on evaporation leaves the final residue
IX. These various residues are then to be examined by the
suitable reagents for those alkaloids or glucosids which are ex-
tracted by each solvent.
We have found that for chemico-legal purposes a process
embodying certain portions of almost all the above is more
advantageous than any one of them. The substances, finely
hashed if solid, are extracted with alcohol' acidulated with tar-
taric acid,^ at about 35° (95° F.),^ and washed with alcohol
until the washings are no longer acid. The alcoholic filtrate
and washings are evaporated spontaneously, either in a current
of warm air or in vacuo, to the consistence of a syrup.* From
three to four volumes of strong alcohol are then gradually stirred
in^ and the solution is strongly cooled and filtered, after having
stood twenty-four hours. The alcoholic filtrate is again evapo-
rated as before, and the residue dissolved in as small a quantity
of water as possible. °
' The alcohol used must be puri-
fied by dissolving in it about 2 gm.
to the litre of tartaric acid, distilling
after twenty-four hours, repeating
the same operation a second time,
and again distilling after twenty-
four hours' contact with potassium
carbonate. In the last distillation
the vapors are passed through a
slightly ascending tube about 60
cm. long filled with fresh, granular
animal charcoal.
^ If the material be strongly acid
it is preferable to extract it first
with alcohol alone until disappear-
ance of the acid reaction and after-
ward with alcohol and tartaric acid,
and then to carry the alcohol and
alcohol and acid extracts through
the subsequent stages of the process
separately. An aqueous solution
of the acid (1:10) must form no
precipitate with CaSOj, Bad,, or
(NHJ.C^O. + NH.HO, and must re-
main unaltered by H,,S even after
addition of NH^HO.
^ This temperature should not be
surpassed at any stage of the proc-
ess, except as subsequently noted in
the evaporation of amylic alcohol.
* If the materials under examina-
tion contain a large amount of fat
they will, according to Focke (Arch.
d. Pharm., ccxxii., 307; Ztsch. f.
an. Ch., 1884, xxiii., 604) retain a
considerable proportion of any
strychnin, and a less proportion of
morphin, should these be present.
To avoid this he suggests that at this
point the residue of evaporation of
the alcohol be mixed with about ten
volumes of water and treated with
baryta water in excess. After stand-
ing several hours dilute sulfuric
acid (1:5) is added in slight excess,
the liquid is stirred and filtered
after an hour, barium chlorid in
slight excess is added to the filtrate,
which is again filtered, evaporated
to a small volume, the residue ex-
tracted with absolute alcohol, the
extract filtered after having stood
for some time and again evaporated.
* If the alcohol be gradually added
during stirring, the precipitate
formed is granular. If it be gummy,
from too rapid addition of alcohol,
it must be subsequently dissolved in
a very small quantity of water and
again precipitated with alcohol.
° Croton oil and nitroglycerol are
to be sought for in the portion here
insoluble in water.
EXAMINATION FOR ALKALOIDS, GLUCOSIDS, ETC.
The aqueous solution is now to be extracted,
first in acid solution, and then, after having been
alkalized, by solvents immiscible with water.
This is best accomplished by the use of a " per-
forator," or extraction apparatus for liquids.'
A very serviceable form of the apparatus for
liquids lighter than water is that of Kumagawa
and Suto, shown in Fig. 3.^ The apparatus
having been disconnected at the two ground
joints, the inner tube is removed and the acid
aqueous solution, prepared as above described,
is poured through a long-beaked funnel into the
body of the extractor, which it and the wash-
water should fill to about the lower level indi-
cated.^ The inner tube is then replaced, 50 c.c.
of the solvent are placed in the flask, which has
been previously dried and weighed, the apparatus
and condenser are connected up and supported
with the flask upon an electric heater or water-
bath. The heating is continued for two hours
after the solvent begins to bubble up through the
aqueous liquid. After this period of extraction
the apparatus is partially cooled, and that por-
tion of the solvent in the extractor above the
aqueous liquid is, if clear, transferred to the flask
by tilting the apparatus, or if cloudy is filtered
thereto through a filter moistened with the
solvent. The flask is then connected with an
ordinary condenser, the solvent is distilled off,
' Extraction by agitation of the aqueous liquid suc-
cessively with the several solvents and their subsequent
separation consumes immeasurably more time, even when
mechanical agitation and centrifugation are resorted to,
and presents no advantage over the method here
recommended.
^ The apparatus should be n?odified from its original
form by having the lower part of the spherical termina-
tion of the inner tube flattened, and its small holes
made in the flattened surface in place of in the sides of
the sphere. The apparatus should have a capacity of
about 50 c.c, and should be provided with two or more
flasks which may replace each other at the lower ground
joint.
^ About 50 c.c.
\
^
Fig. 3.— Per-
forator for
liquids lighter
than water.
160 TOXICOLOGY WITTa.'^.US.
and the extract in the flask is dried by a current of dry air,
cooled, and weighed. Any remaining small portion of the first
solvent having been pipetted of! from above the aqueous liquid,
the second flask, previously weighed and containing 50 c.c. of
the second solvent, is now attached in place of the first, the ap-
paratus is connected up and the second extraction proceeded
with, etc. If extractions by chloroform are omitted in the
following scheme (see p. 161), the entire series can be carried on
successively in the same apparatus. The extracts are removed
from the flasks by suitable solvents, alcohol, ether, dilute hydro-
chloric acid, etc., and transferred to round-bottom glass capsules,
Fig. 1, p. 150, for microscopical and chemical examination.
The first solvent used is petroleum «ther.^ In the residue of
its evaporation (I) the following will be found if present: pi-
perin,^ phenol, picric acid, salicylic acid, benzoic acid, camphors,
essential oils, capsicin, cardol, lobeliin.
The acid aqueous liquid is next extracted with benzene.'
The benzene residue from acid solution (II) may contain,
caffein, cantharidin, anemonin, santonin, caryophyllin, cubebin,
phenol, quinol, catechol, resorcinol, salicylic acid, picric acid,
piperin, colchicin, colchicein, digitalin, gratiolin, cascarillin, elat-
erin, populin, colocynthin, geissospermin, chrysamic acid, absyn-
thin, oils (anemone, ranunculus), quassin, menyanthin, ericolin,
daphnin, cnicin, sabadillin, meconin, antipyrin.
The next step in the complete method is the extraction of the
acid aqueous liquid with chloroform. As, however, the sub-
stances extracted thereby, are, with the exception of acetanilid,
' The true petroleum ether, or ^ rpj^^ commercial " crystallizable
rhi^olene, is neither necessary nor benzol, free from thiophene, " is
desirable. A product of sufficient sometimes sufficiently pure. It
purity, volatility, and solvent power should give no brownish tint with
may be obtained from commercial concentrated sulfuric acid, nor any
gasolene by strongly agitating with blue color when agitated with the
dilute sulfuric acid, then with water, same acid and isatin. To purify
drying by contact with calcium benzene it should be agitated with
chlorid, adding a little lard, and about one-tenth its volume of con-
distilling slowly on the water-bath. centrated sulfuric acid until a sam-
Those portions are collected which pie no longer gives the indophenone
pass below 70° (140° F.). reaction with sulfuric acid and isa-
= The substances whose names are tin. The benzene is afterward
given in italics pass only in traces agitated with water, dried by con-
into this solvent and are more per- tact with calcium chlorid and
fectly extracted by one of those used distilled slowly, that portion being
subsequently. collected which passes at 80°-82°
(17(3°-1S0° F).
EXAMINATION FOR ALKALOIDS, GLTTCOSIDS, ETC.
161
either better extracted by other
solvents, or of little toxicological
importance; and as extractions by
chloroform require a different form
of apparatus, owing to the fact that
chloroform is heavier than water,
this extraction, as well as that by
the same solvent from alkaline
solution, may well be omitted ex-
cept in special cases, and the loss
which necessarily attends repeated
transferrals thereby avoided. If it
be decided to extract with chloro-
form, the acid aqueous liquid may
either be transferred to an ordinary
separator, 1 Fig. 4, and agitated with
chloroform,^ and the solvent drawn
off from below after separation of
the two liquids or, preferably, ex-
tracted in an apparatus such as
that of Osborne,^ shown in Fig. 5.
The condenser being removed, a
few c.c. of chloroform are first
poured in to fill the lower bend of
the siphon, A, and the aqueous
' This form of apparatus is the
most suitable when extraction (with
other solvents as well) by agitation
and separation is resorted to. To
agitate it the glass stopper is re-
placed by a tightly fitting cork, and
the apparatus is fastened upon the
face of a wheel of suitable diameter
which is caused to revolve slowly.
If the agitation be too violent
emulsions are apt to form with
benzene and petroleum ether, which
ire difficult to separate. When this
Dccurs the separator should be
illowed to stand overnight. The
iqueous layer is then drawn off as
'ar as possible from below, and the
separator given a slight shake, and
igain allowed to stand. A portion
jf the solvent will separate and may
De poured off. The emulsion is then
;ransferred to a dry filter in a funnel
IV.— 11
Fig. 4. — Separator.
over a second separator, a drop of
alcohol is added and the emulsion
stirred in the filter with a glass rod.
The liquids will either pass through
the filter and form separate layers
in the separator below, or the
emulsion will contract, and the
solvent separate in a layer in the
filter, which may be removed by a
pipette. Patience is necessary. If
the extract by any of the solvents
be cloudy, it must be filtered through
a small filter moistened with the
same liquid.
^ It should be purified by agitation
with dilute caustic potash solution,
separation, and distillation shortly
before use.
^J. of Physiol., 1901, xxvi., ix.
Other forms of perforator for chloro-
form are described by Gadamer:
Arch. d. Pharm., 1899, ccxxxviii., 68;
162
TOXICOLOGY WITTHAI'S.
liquid is added until the level reaches the opening of the tube
at D. In operation chloroform from the condenser falls through
the solution and collects at the bottom until the level of the
liquid reaches the dotted line, when siphoning
begins through A, B, C, and continues until
the opening, D, is uncovered, when the siphon
is broken by entrance of air. The bulb, H
serves to prevent any passing over of the
aqueous liquid by suction and the floating
thin glass bulb, U, to prevent splashing.'
The residue left by the chloroform from
acid solution (III) may contain: cinchonin,
theobromin, papaverin, narcein, hydrastin,
chelidonin, solanidin, sesculin, gelsemic acid,
picrotoxin, helleborein, populin, quassin,
menyanthin, ericolin, daphnin, cnicin, benzoic
acid, digitalein, digitalin, convallamarin,
saponin, senegin, lycaconitin, myoctonin,
aspidospermin, pereirin, brucin, sanguinarin,
quebrachin, geissospermin, syringin, colchicin,
colocynthin, meconin, anthemin, santonin,
ergotinin, gentiopicrin, veratrin, jervin, an-
tipyrin, acetanilid.
The acid aqueous liquid is then returned
to the apparatus, Fig. 4, and extracted with
ethylic ether. = The residue of evaporation of
the ether (IV) may contain: oxahc acid,
meconic acid, ergotinin, arbutin, gallic acid,
pyrogallol, /5-naphthol, chrysophanic acid,
naphthalin.
The aqueous liquid is next rendered alka-
line by ammonium hydroxid in slight excess,
and extracted with petroleum ether as iaefore. The residue of
evaporation of the ether (V) may contain: strychnin, quinin,
Fig. 5.— Perfora-
tor for liquids
heavier than water.
Pregl: Ztschr. f. anal. Chem., 1901,
xl., 785; Lentz: Pharm. Ztg., 1901
xlvi., 829; Katz: Apoth. Ztg., 1902
xvii., 712.
' The drawing is diagrammatic.
In the apparatus the tubes A, H,
E, B, C do not stand out, but are
placed close against the body of the
main tube, as in the apparatus shown
in Fig. 7, p. 179. The upper bend
of the tube A, B is drawn too low.
^ The ether used should be purified
by agitation with water and redis-
tillation, first from quicklime, then
from tartaric acid, and finally from
metallic sodium.
EXAMINATION FOR ALKALOIDS, GLUCOSIDS, ETC. 163
delphinin, sabadillin, brucin, aspidospermin, pereirin, veratrin,
emetin, gelsemin, quebrachin, oxyacanthin, cocain, coniin, methyl-
coniin, piperidin, amins (methyl-, ethyl-, propyl-, and amyl-),
capsicin, sarracenin, nicotin, lobelin, spartein, quinolin, anilin,
toluidin, picolin, urechitoxin, kairin, thallin.
The alkaline aqueous liquid is then extracted in a similar
manner with benzene. The residue of the evaporation of ben-
zene from the alkaline liquid (VI) may contain:' atropin, hy-
oscyamin, strychnin, ethyl- and methyl-strychnin, quinin, cin-
chonin, quinidin, cocain, narcotin, codein, thebain, sabadillin,
taxin, brucin, physostigmin, pilocarpin, veratrin, sabatrin, del-
phinoidin, lycaconitin, myoctonin, aconitin, antipyrin, thallin.
The aqueous liquid is acidulated with hydrochloric acid,
transferred with chloroform to the apparatus, Fig. 5, rendered
alkaline with ammonia, and extracted with chloroform, in the
residue of whose evaporation (VII) there may be: cinchonin,
cinchonidin, papaverin, narcein, laudanin, berberin, lycaconitin,
muscarin, morphin, pelletierin, antipyrin.
The aqueous liquid is now again acidulated with hydrochloric
acid, returned to the apparatus, Fig. 4, alkalized with ammonia
and immediately extracted with acetic ether. Morphin is to be
sought for in the residue (VIII).^
' This residue frequently contains each case 0.25 gm. of morphin
a crystalline substance which is not hydrochlorid, equivalent to 0.2019
an alkaloid, but whose nature we gm. of crystallized morphin, dis-
have not been able to determine solved in 20 c.c. of water, in the
from lack of material. The crystals separator with mechanical agitation
are brilliant, frequently present acetic ether removed, after alkali-
beautiful pink, green, blue, and zation, only 39.2 per cent, in six
violet iridescence, and often do not agitations, while amylic alcohol
appear until after the residue has under like conditions extracted
stood for twenty-four or forty-eight 93.9 per cent. As each agitation,
hours. They are sometimes plates, with its attendant stratification,
more usually flattened prisms with clearing, and separation, requires at
ends truncated obliquely at angles of least six hours, it is not desirable to
about 86° and 94°. This material is further increase their number, and
not soluble in dilute hydrochloric amylic alcohol is obviously to be
acid and consequently does not re- preferred to acetic ether. In the
main in the residue purified as perforator, on the other hand, acetic
directed below (see p. 164). ether extracted 96 per cent, from a
' One important advantage of the solution of 0.25 gm. morphin hydro-
method here described over that chlorid in 50 c.c, after alkalization,
advised in the first edition is that in two hours, and the ethereal layer
with the perforator acetic ether came off quite clear. Therefore,
may be used for the extraction of acetic ether in the perforator effected
morphin, while the separator almost a more complete extraction in two
compels the use of amylic alcohol. hours than did amylic alcohol in the
In a series of experiments, using in separator in (practically) three days.
164 TOXICOLOGY — WITTHATJS.
Finally the aqueous liquid is evaporated to dryness with
powdered glass in a Hofmeister capsule over the water-bath.
Capsule and contents are then pulverized and extracted with hot
chloroform. The residue of evaporation of the chloroform (X)
may contain curarin and muscarin.
The process may in many cases be greatly abbreviated.
Thus if a sample of urine is to be examined for strychnin alone
it may be acidulated with dilute hydrochloric acid (or tartaric),
filtered, extracted with benzene, then again extracted with the
same solvent after addition of ammonium hydroxid to alkaline
reaction. Strychnin, if present, will be found in the residue of
evaporation of benzene from alkaline solution. For special
methods see under Morphin, Strychnin, etc.
The alkaloid is sometimes present in the residue in a degree
of purity sufficient to permit of its identification directly, but
in most instances a purification is required. This is usually
effected by dissolving the residue in a small quantity of acidu-
lated water, filtering, agitating the acid aqueous solution with
the proper solvent, and then again (to extract the alkaloid) with
the same solvent, after alkalization with ammonium hydroxid
or with magnesia, and repeating the process if necessary. Or
in some cases the alkaloid or the impurity may be removed by
some other solvent. When the residue has been suitably puri-
fied, its quantity may in some cases be approximately deter-
mined at this stage. It is then dissolved in a small quantity of
the proper solvent, and drops of the solution transferred either
to a slip of glass which may be placed upon either a black or
white background, or to small watch-glasses, and the identify-
ing tests applied to the drops themselves or to the residues left
upon their evaporation.
Kippenberger's Process' is based upon the formation of
The extraction must, however, be and important. The lower boiling
made immediately after precipita- point of the other, that of amylic
tion of the morphin from its saline alcohol being 131.4°. The absence
solution, and the acetic ether used of impurities in the ether which
should be one having a b. p. of may either exist in the alcohol or be
76°-77°, containing traces of alcohol produced therein during evaporation
and free acetic acid (the commercial in contact with air. Amylic alcohol
C. P. ether, redistilled), which is is a much better solvent of ptomains
preferable to the pure ester as a than is acetic ether. See further
solvent for morphin. The advan- under " Morphin."
tages of acetic ether over amylic > Ztschr. f. an. Chem., 1895,
alcohol, apart from the solvent xxxiv., 294.
powers of the two liquids, are many
REAGENTS FOR ALKALOIDS AND GLUCOSIDS. 165
soluble alkaloidal compounds and insoluble protein compounds
when the materials are digested with glycerol and tannic acid.
The finely divided substances are digested for two days at 40°
with a mixture of 100 c.c. glycerol, 10 gm. tannic acid, and 1 gm.
tartaric acid, 100 to 150 gm. of the mixture, with or without
addition of water, being taken for 100 gm. of solid material.
The liquid is pressed out and the cake washed several times, with
expression, with water containing glycerol. The united extracts
are heated to 50°, cooled, and immediately filtered, with addition
of water if necessary. The acid liquid is then agitated success-
ively with petroleum ether, b. p. 30°-50°, and chloroform. The
aqueous liquid is then rendered faintly alkaline with NaHO, and
agitated with chloroform, and, after addition of NaHCOg, suc-
cessively with alcohol-chloroform and with ether-chloroform.
For the detection and identification of alkaloids general and
special reagents are used. The former produce precipitates
with a great number of alkaloids and glucosids, varying some-
times in their color and crystalline form with different individuals,
and are consequently more frequently used to determine the
presence of an alkaloid or glucosid than to determine its identity.
The special reactions, on the other hand, are such as are peculiar
to one or to a few alkaloids, and are consequently of greater
value for identification. The special reactions will be described
in the division of special toxicology under each alkaloid or
glucosid.
General Reagents for Alkaloids and Glucosids.
1. De Vry's (Sonnenschein's) Reagent — Phosphomolybdic
Acid.'
This reagent is applied to an acid solution, in which it forms yellow-
ish precipitates with most of the alkaloids. Acolyctin, aconitin,
anagyrin, anthocercin, alpha^homo-chelidonin, arecolin, beta-homo-
^ De Vry: Joiir. de pharm., etc., the precipitate and dissolve it in the
1854, 3 s., xxvi., 220. Sonnen- smallest quantity of sodium hy-
schein: "Ueber ein neues Reagens droxid solution. Evaporate the
auf Alkaloide," Berlin, 1857. Also solution to dryness; ignite the resi-
"Handb. d. ger. Med.," 1869, p. due so long as ammonia is given
317. To prepare the reagent, pre- off; dissolve the residue in water
cipitate a solution of disodic phos- (1:10), and add nitric acid until
phate, acidulated with nitric acid, the precipitate formed is redis-
with a similarly acidulated solution solved. The' yellow solution must
of ammonium molybdate. Wash be protected from ammonia.
166 TOXICOLOGY WITTHAUS.
chelidonin, calamin, eannabin, carpain, ceanothin, cinchonin, coeain,
colchicein, colchicin, curarin, cytisin, ecbolin, emetin, ergotin, ergo-
tinin, laurotetanin, morphin, narcein, nicotin, oxyacanthin, pelletie-
rin, physostigmin, protoveratrin, pseudojervin, sabadillin and saba-
trin, solanin, strychnin, taxin, thebain, thein, veratralbin and veratria
give yellowish-white precipitates. The precipitates with aspidosper-
min, cannabinin, damascenin, scopolin, and spartein are white; those
with ecgonin, hymenodictyonin, hyoscyamin, piliganin, pseudopel-
letierin, and theobromin are yellow; those with atherospermin and
berberin are dirty yellow; that with delphinin is gray-yellow; those
with narcotin, codein, and piperin are brown-yellow; that with brucin
is orange; that with aconin is gray-bluish; that with erythrophloein is
dirty green; that with calcitropin is yellow, turning to blue-green after
twenty-four hours; those with atropin, bebeerin, coniin, and lobeliin
are yellowish and turn blue with ammonia; that with quinin is white
and turns yellow with ammonia. The following alkaloids gWe no
precipitates: arecain, chrysanthemin, eupatorin, lycoctonin, and
papaverin.
The precipitates are not soluble in cold alcohol, ether, or dilute
mineral acids (except phosphoric), but are soluble in concentrated hy-
drochloric acid, hot nitric acid, acetic, oxalic, and tartaric acids, and the
hydroxids, carbonates, borates, and phosphates of the alkali metals.
The precipitates are decomposed, with liberation of the alkaloid, by the
oxids of calcium, barium, lead, and silver and by the hydroxids of po-
tassium and sodium, and some are also decomposed by barium and
sodium carbonates and by magnesia.' Ammonia and many of its de-
rivatives, such as the monamins, anilin, quinolin, give precipitates
resembling those formed by the alkaloids with this reagent, but non-
alkaloidal organic poisons are not as a rule precipitated by it. The fol-
lowing, however, are: euonymin, helleborein, and menyanthin. Aeo-
rin produces a blue color by reduction. Strophanthin gives a pale-
green precipitate if present in quantity, and an emerald solution if
dilute.
2. Scheibler's Reagent— Phosphotungstic Acid.=
This reagent forms precipitates in acid solutions of .salts of the alka-
loids very similar to those produced by phosphomolybdic acid. They
are, however, less permanent and somewhat more soluble.
' See p. 177. ous solution of sodium tungstate; or
' Ber. d. Chem. Gesell., 1872, v., by dissolving 10 gms. sodium tung-
801. Prepared by addition of a 20% state and 6 to 8 gms. sodium phos-
phosphoric acid solution to an aque- phate in 50 cc. water.
REAGENTS FOE ALKALOIDS AND GLUCOSIDS. 167
3. Mayer's Reagent — Mercury -Potassium lodid.'
This reagent, which is also used for quantitative determinations,
gives with acid solutions of most of the alkaloids precipitates which are
for the most part white or yellowish and crystalline, or become crystal-
line after standing for a time, when added to aqueous solutions of their
sulfates or chlorids. According to Dragendorff the precipitates from
dilute solutions of narcotin, thebain, narcein, emetin, aconitin, del-
phinoidin, and bebeerin do not become crystalline; and those with
coniin and nicotin are at first white and amorphous, but afterward be-
come resinous and adherent, and frequently after twenty-four to forty-
eight hours beautifully crystalline. The precipitates with amaryllin,
arecain, arecolin, artarin, aspidospermin, bellamarin, brucin, calcitro-
pin, crysanthemin, corydalin, delphinin, emetin, grandiflorin, lobeliin,
piperin, rhseadin, sabadillin, sebatrin, and veratrin are yellow or yel-
lowish. No precipitates are formed in dilute solutions of caffein, col-
chicin, solanin, and theobromin. The following non-alkaloidal sub-
stances are also precipitated: acorin, euonymin, menyanthin, sikimin,
and sophorin.
The alkaloid may be recovered from the precipitate by suspending
it in water (after washing) and treatment with hydrogen sulfid. The
alkaloid is contained in the filtrate from the mercuric sulfid in the form
of hydriodid, which may be converted into the sulfate by silver sulfate.
4. Manne's Reagent — Cadmium -Potassium lodid.^
This reagent forms precipitates in solutions of the salts of most of
the alkaloids acidulated with dilute sulfuric acid. The precipitates are
nearly all flocculent and white, but some soon become crystalline.
They are soluble in excess of the reagent and in alcohol, insoluble in
ether. The alkaloids may be recovered from the precipitates by decom-
position with alkalies and extraction with the proper solvent. The
reagent does not precipitate with many glucosids and leucomains nor
with ammonia. Caffein forms no precipitate, and solanin and theo-
bromin do so only in concentrated solutions.
' First suggested by Planta-Reich- repeating the process if necessary
enau (Delffs) : Dis., Heidelberg, 1846; (Peset: Ann. d'hyg., 1909, 4 s., xi.,
perfected by Mayer: Ztsch. f. an. 289).
Chem., 1863, ii., 225. Obtained by = Compt. rend. Ac. Sc, Paris,
dissolving 13.546 gm. mercuric 1866, Ixiii., 843. Ztsch. f. an. Chem.,
chlorid and 49.8 gm. potassium iodid 1867, vi., 123. Prepared by saturat-
to the litre of water. The crystal- ing a boiling concentrated solution
line character of these precipitates of potassium iodid with cadmium
may be brought out by bringing iodid and adding an equal volume of
them upon a microscopic slide, dry- cold saturated solution of potassium
ing, covering, running in a drop or iodid. Dilute solutions do not keep,
two of alcohol, warming and cooling;
168 TOXICOLOGY — WITTHAUS.
5. Dragendorff's Reagent— Bismuth -Potassium lodid.'
The reagent is applied to aqueous solutions of the alkaloids, acidu-
lated with sulfuric acid (four drops of concentrated acid to ten cubic
centimetres). The solution must contain no ether nor any trace of
amyl alcohol. The precipitates formed with most of the alkaloids are
orange. Of the glucosids menyanthin gives a yellow precipitate, and
digitalin one in concentrated solution. Kraut^ has studied the com-
pounds formed by this reagent with amins, glycins, piperidin, sulfins,
anilin, and toluidin.
6. Wagner's Reagent — lodin in Potassium lodid.^
Brown precipitates are formed in solutions of -almost all of the alka-
loids, acidulated with sulfuric acid, when the reagent is added in small
amount. The precipitates are for the most part flocculent and amor-
phous, but in many instances become crystalline.
According to De Mattei * precipitates formed by the reagent behave
toward the color reagents like the alkaloid itseK.
7. Tannic Acid.^
Gives white, grayish, or yellowish precipitates with almost all of
the alkaloids, glucosids, and bitter principles. The following are not
precipitated: arginin, aribin, arecolin, chrysanthemin, antiarin, chamae-
lirin, chirettogenin, datiscin, frangulin, angelin, columbin, cascarillin,
capsicin, cornin, marrubin, ononin, and picrotoxin; and the following
only imperfectly: arecain, grandifiorin, theobromin; ericolin and
strophanthin. In most cases the precipitates are soluble in acids, even
in excess of the reagent, although some alkaloids: aconitin, physostig-
min, and veratrin, give precipitates in solutions strongly acidulated
with sulfuric acid, but not in weakly acid solutions. The precipitates
' Pharm. Ztsch. f . Russl., 1866, potassium iodid solution. Wormley
v., 81. Also "Ermitt. v. Giften," (" Mier.-Chem. Pois.," 2d ed., 444)
4te Aufl., 155. Prepared like ]\lar- recommends a stronger solution:
me's reagent, using bismuth in 5 parts potassium iodid and 2 parts
place of cadmium iodid. Cannot iodid in 100 of water. As the
be diluted (Dragendorff) . Dissolve reagent is used in acid solution it is
80 gm. bismuth subnitrate in 200 practically the same as the solution
c.c. nitric acid (sp. gr. 1.18), and of iodin in hydriodic acid used by
272 gm. potassium iodid in a little Selmi and others. Bouchardat
water; add the bismuth solution (Wilder, "Tests," p. 13) uses a
slowly and during agitation to the solution of 10 parts of iodin and 20
iodid solution, cool strongly, sepa- parts of potassium iodid in 500 of
rate from the crystals and dilute to water. See also Hilger: " Verbind.
a litre. Must be kept in the dark d. lod mit d. Pflanzenalkaloiden."
(Kraut). See also Mangini: Gazz. Wilrzb., 1869, and abst. Pharm.
ch.ital., 1882, xii., 115. Jahrb., 1869, 551. Jorgensen:
2 Ann. d. Ch., 1831, ccx., 310. Berichte, Berlin, 1869, ii., 460.
' Dingler's Polyt. J., 1861, clxi., 40; * Rif . med., 1903, xix., 1098.
Ztschr. f. an. Chem., 1862, i. 102; '^ A freshly prepared solution in a
1865, iv., 387. A decinormal solu- mixture of 8 parts water and 1 part
tion: 12.66 gm. iodin to the litre of alcohol.
REAGENTS FOR ALKALOIDS AND GLUCOSIDS. 169
of the tannates of aconitin, berberin, cinchonin, colchicin, narcotin,
papaverin, solanin, and thebain are not dissolved by cold dilute hydro-
chloric acid; and those of aconitin, physostigmin, quinin, solanin, and
veratrin are not dissolved by cold dilute sulfuric acid. Dilute acetic
acid dissolves the tannates of aconitin, brucin, caffein, colchicin, mor-
phin, physostigmin, and veratrin; and the concentrated acid that of
quinin.
8. Platinic Chlorid.
Forms double salts with the chlorids of most of the alkaloids, which
are difficultly soluble and frequently crystalline. The precipitates are
usually yellow; that of the hydrastin compound is yellowish-red; that
of meconidin yellow, changing to red; and those of berbamin, emetin,
papaverin, quinidin, and quinin are white or nearly so. The following
are not precipitated: amaryllin, angelin, arecolin, chrysanthemin,
ecgonin, jurubebin, lycoctonin, pelletierin, picraconitin, piliganin,
protoveratridin, protoveratrin, and trigonellin; and the following only
from concentrated solutions: aconitin, atropin, coniin, cytisin, hyos-
cyamin, narcotin, nicotin, physostigmin, piperin, piturin, pseud-
aconitin, and thein. Morphin gives a precipitate immediately in
solutions of concentration greater than 1 : 100, or in more dilute
solutions (to 1 : 3,000) after twenty-four hours; the deposit becoming
crystalline and being insoluble in cold hydrochloric acid. Aspido-
spermin and acorin, aloin and catechin reduce the platinic salt with
formation of a blue color.
The chloroplatinates of the alkaloids are definite compounds, whose
analysis has been frequently utilized to determine the composition and
molecular weight of the alkaloid.
9. Auric Chlorid.
Forms chloraurates with the alkaloids, which are for the most part
yellow, insoluble or difficultly soluble and crystalline. The precipi-
tates of the chloraurates of aricin, brucin, colloturin, delphinin, ecgonin,
emetin, meconidin, quebrachin, quinicin, quinin, rhaeadin, and strychnin
are amorphous. Eupatorin and pilocarpidin form no precipitates;
codein, narcotin, and nicotin only in concentrated solutions; and
caffein, colchicin, and theobromin only slowly. Reduction of the
gold compound occurs much more frequently than of the platinic, and
is indicated by a purple color, either immediately or after a time.
The following alkaloids cause reduction: aconin, apomorphin, con-
cusconin, conquinamin, eupatorin, geissospermin, hydroquebrachin,
paytamin, pay tin, pelletierin (on warming), physostigmin and quin-
amin; as do many of the glucosids.
The crystalline chloraurates have served the same analytical pur-
poses as the chloroplatinates.
170 TOXICOLOGY WITTHAUS.
10. Hager's Reagent— Picric Acid.^
Added to solutions of most of the alkaloids acidulated with sulfuric
acid it causes precipitates which are in many cases crystalline. Gluco-
sids, with the exception of adonin, euonymin, and limonin, are not pre-
cipitated. Morphin in concentrated solution forms a precipitate which
disappears on dilution. From dilute acid solutions, anilin, caffein,
morphin, pseudomorphin, solanin, and theobromin are not precipitated:
and aconitin and atropin only incompletely even from concentrated
solutions. From strongly acid solutions berberin, the cinchona alka-
loids, colchicin, delphinin, emetin, the opium alkaloids other than
morphin and pseudomorphin, the strychnos alkaloids and veratrin are
completely precipitated.
The alkaloid may be liberated from its picrate by potassium
hydroxid.^
11. Other General Reagents.
Besides various modifications of the above, a number of other gen-
eral reagents have been used, of which the following are the more
prominent:
Bromin,^ in aqueous solution, causes in acid solutions of many
alkaloids yellow precipitates, which sometimes (atropin) assume char-
acteristic forms; and with some, such as brucin, strychnin, narcotin,
and quinin, a rose-pink or red color, either immediately or on being
boiled.
Phospho-antimonic acid* is said to cause white amorphous pre-
cipitates in solutions of the alkaloids in excess of dilute sulfuric acid.
Color reactions are also produced with brucin, narcotin, and piperin.
The delicacy of the reagent is less than that of Sonnenschein's, except
with atropin. Digitalin is also precipitated.
Silicotungstic acid,^ either in aqueous or alcoholic solution, causes
precipitates with almost all of the alkaloids, from which the alkaloid
may be liberated by decomposition with caustic alkalies.
1 Pharm.-Centralhalle, 1869, 131. * Schultze: Ann. Ch. u. Ph., 1859,
Ztschr. an. Ch., 1870, ix., 110. A cix., 177, obtained by dropping an-
saturated aqueous solution. timony pentachlorid into aqueous
^See also Popoff: Ann. d'hyg., phosphoric acid; or by adding one
1891, 3 s., xxvi., 81, and in Brouar- volume antimony pentachlorid to
del and Ogier: "Lab. d. Tox.," four volumes of saturated solution
203. of disodic phosphate.
" Either bromin water, applied to = Godeffrov: Ztschr. f. an. Chem.,
the solution of the alkaloid in dilute 1877, xvi., 244. Prepared by boil-
hydrochloric acid (Bloxam: Chem. ing solutiian of sodium tungstate
News 1883, xlyii., 215); or a solu- with freshly precipitated silicic acid,
tion of bromin in potassium bromid ; precipitating with mercurous nitrate,
or aqueous hydrobromic acid satu- decomposing the washed precipitate,
rated with bromin (Wormley: Pros- with hvdrochloric acid and evapo-
cott, " Orsan. Anal.," p. 47). rating to crvstallization.
REAGENTS FOR ALKALOIDS AND GLUCOSIDS. 171
lodin chlorid^ forms yellow, crystalline precipitates, whicli are
blackened by ammonia, from hydrochloric acid solutions of pyridin
and quinolin and of the alkaloids which are derivatives of those bases.
Potassium plaiinocyanid' forms crystalline deposits with some
alkaloids, notably with morphin, strychnin, and the cinchona alkaloids.
Potassium argentocyanid^ gives amorphous, colorless precipitates
when added in excess to very faintly acid solutions of many of the
alkaloids. Some of the precipitates become crystalline.
Potassium cupro-cyanid,* potassium ferrocyanid, potassium ferri-
cyanid, and potassium thiocyanate^ form precipitates, which are frequently
crystalline, in solutions of some of the alkaloids.
Potassium-zinc iodid" forms in not too dilute solutions of some
of the alkaloids (strychnin, brucin, quinin, codein, papaverin, narcein)
white or yellowish precipitates which are or become crystalline.
Lead acetate, neutral or basic, forms precipitates with only a few of
the alkaloids (acolyctin, aconin, nicotin, spartein, and theobromin),
but does with many glucosids and bitter principles.
Mercuric chlorid also gives white precipitates with many alkaloids,
which are for the most part crystalline or gradually become so. Those
of berberin, brucin (except concentrated), hyoscin, quinidin, and quinin
remain amorphous. The following alkaloids give no precipitates:
arecolin, chrysanthemin, ergotinin, lobeliin, lycoctonin, protoveratrin,
taxin, and trigonellin. Many glucosids also form white precipitates.
Silver nitrate is reduced by some alkaloids: aconin, capsaicin,
cupronin, dibromapophyllin, morphin, and pseudaconin; and precipi-
tates with some others: anthocerin, capsicin (in strong alcoholic solu-
tion), capsicol, lobeliin, oxyacanthin, quinidin, and theobromin. It is
also reduced by several glucosids and bitter principles.
Potassium, dichromate in saturated aqueous solution forms pre-
cipitates which soon become crystalline with solutions of most alka-
loidal salts. The following, however, form no precipitates: aconitin,
amaryllin, and delphinin; the following only in concentrated solu-
tions: cocain, morphin, sabadillin, sabatrin, and thein; ancj narcein
only in acid solution. Alstonin and porphyrin form red solutions.
'Dittmar: Bar. deuf. chem. = Delffs:Chem, Centlbl., 1864, 607.
Gesell., 1885, xviii., 1612. Prepared Van der Burg: Ztschr. f. an. Chem.,
either by agitating iodin chlorid 1865, iv., 296.
with water; by passing chlorin ^ Dragendorff: "Ermitt. v. Ciif-
through water holding iodin in sus- ten," 4te Aufl., 157.
pension; or by mixing together 5 c.c. * Dragendorff : loc. cit.
solution of potassium iodid (1:10) '' Dragendorff: Op. crt., and Worm-
and 18 c.c. solution of potassium ley: "Micro-Chem. Poisons," /lass/m.
nitrite; adding 6.5 c.c. hydrochloric " Dragendorff: Zoc. cii. Preparedin
acid (thirty-three per cent.) and the same manner as Marm^'s
filtering after effervescence has reagent,
ceased.
172 TOXICOLOGY WITTHAUS.
Potassium permanganate is reduced more or less rapidly by many
alkaloids, with precipitation of manganic peroxid. A few alkaloids
behave peculiarly with this reagent : apomorphin gives an intense
green color; morphin forms a white, crystalline precipitate (oxydimor-
phin); cocain forms a stable violet precipitate; and narcein, narcotin,
and papaverin similar, but less stable, precipitates.
Sodium thioaniimonate^ forms yellow, fiocculent precipitates in
solutions, as nearly neutral as possible, of salts of quinin, cinchonin,
quinidin, morphin, codein, narcotin, strychnin, brucin, atropin, and
bebeerin.
Lead chlorid' forms precipitates, usually finely crystalline, in solu-
tions of the chlorids, acetates, or nitrates (not sulfates) of strychnin, ■
quinin, cinchonin, morphin, codein, brucin, and probably of other
alkaloids.
Ammonium diaminchromium thiocyanate^ when added in safr
urated aqueous solution to solutions of the chlorids of the monamins,
anilin, toluidins, pyridin, quinolin, quinin, strychnin, cocain, pilocar-
pin, atropin, and hyoscyamin, produces red or purple crystaUine
precipitates.
Benzoyl chlorid and sodium hydroxid' when agitated with aque-
ous solutions of cadaverin, putrescin, and other diamins causes the for-
mation of insoluble crystalline precipitates of dibenzoyl compounds.
Polyatomic alcohols, including glycerol and the carbohydrates, are
similarly precipitated.
Uranium nitrate^ in aqueous 5 per cent, solution exactly neutralized
with ammonia, forms amorphous precipitates, which become crystalline,
in aqueous or alcoholic solutions of most alkaloids. Caffein, theobromin,
and asparagin do not precipitate. Morphin in not too dilute solution
gives an orange or red color.
Color Tests. — Besides the above reagents, which act as
precipitants, there are numerous substances or mixtures which
produce with the alkaloids and glucosids changes of color more
or less pronounced and characteristic. In applying them it is,
however, essential that the alkaloid shall be separated in as
"Palm: Ztsch. f. an. Ch., 1883, powdered potassium dichromate (40
xxii., 224. gm.) is gradually added, the melt is
^Palm: loc. cit., p. 227. Lead extracted with cold water, the
chlorid dissolved in boiling sodium solution crystallized, and the crystal-
chlorid solution. line residue again extracted with
' Reinecke's salt. Ann. d. Chem., cold water and recrystallized.
cxxvi., 113. Christensen: Jour. pr. * Udransky and Baumann: Be-
Chem. [2], xlv., 213, 356. J. Chem. richte, 1888, xxi., 2745.
Soc, 1S92, Ixii., 798, 1000 [abst.]. = Aloy: Bull. Soc. Chim., 1903,
Ammonium thiocyanate (200 gm.) 3 s., xxix., 610.
is fused in a porcelain crucible,
REAGENTS FOR ALIfALOIDS AND GLUCOSIDS. 173
pure a condition as the circumstances will permit, and shall be
free from other substances capable of causing color changes
which may mask those due to the alkaloid, prevent their forma-
tion, or themselves cause similar colorations.
Some of these reagents produce colors with a great number
of alkaloids and glucosids and may therefore be considered as
general reagents. Such are the following:
Sulfuric acid applied in the concentrated form to the solid alka-
loid causes colors -which are red, purple, or violet with aconitin (only
when impure), apomorphin, beta-homo-chelidonin, boldin, brucin (due
to HNO3 in the HjSOJ, cocain (only when impure), delphinoidin, dita-
min, ecbolin, echitamin, echitmin, fumarin, hydrastin (due to HNO, in
the H2SO4), hypoquebrachin, laudanin, laurotetanin, narcein (if im-
pure), pareirin, porphyrin, protoveratridin, rhaeadin, rubijervin, saba-
dillin, sabadinin, sabatrin, staphisagrin, taxin, thebain; adonin, angelin,
amygdalin, brucamarin, californin, camellin, cascarillin, cerberin,
cnicin, columbin, convallamarin, convolvulin, copalchin, cyclamin,
digitonin, dulcamarin, elaterin, gratiosolin, helixin, helleborein, helle-
boretin, helleborin, hesperidin, hydrocarotin, jalapin, kosin, laserpitin,
limonin, linin, panaquilon, phillygenin, phillyrnin, phloretin, physo-
din, pimpinellin, populin, quinovin (slowly), salicin, saligenin, sapo-
genin (slowly), saponin, sapotin, smilacin, sophorin, tampicin (slowly),
and turpethin (slowly). With the following a red or violet color is
preceded by yellow: atisin, corydalin, grandiflorin, heliotropin, phlori-
zin, sabadin, smilacin, veratralbin, veratrin; assamic acid, ononin,
phlorrhizin, urechitin, and urechitoxin; by brown with menyanthin,
scillitoxin, and vernonin; by green with asiminin, frangulin, and spar-
attospermin ; and by blue with curarin and papaverin (if impure). The
red tinge is succeeded by blue and violet with assamic acid; hy black
with chamselirin; by green, blue, and violet with podophyllotoxin;
and by brown with scillitoxin. The color is yelloio, orange, or brown
with alpha-homo-chelidonin, amaryllin, anthocercin, berberin, caly-
canthin, ceanothin, chelerythrin, cinchonamin, colchicein, colcliicin,
delphinin, delphinoidin, emetin, gelsemin, gnoscopin, hydrocotarnin,
imperialin, javanin, jervin, laudanosin, lobelin, narcein, oxyacanthin,
solanin, veratroidin; andrometoxin, antiarin, capsicin, diosmin, eric-
olin, eupatorin, euphorbin, fraxetin, gentiopicrin, gratiolin, gratioso-
lin, guacin, helixin, helleborein, helleborin, junipicrin, liriodendrin,
mangostin, picrotoxin, prophetin, rosaginin, scillain, scilhn, solanin,
strophanthin, syringopicrin, and villosin. A yellow or brown color is
succeeded by violet and brown-gray with calcitropiu, by green with
chairamidin, concheiramidin, conchairamin, physostigmin, piperin
(slowly), ustilagin, and agoniadin. With gelsemin and euonymin the
174 TOXIC()L()(;Y — WITTHAX'S.
color is yellow, changing to brown. The following give blue or green
colors: aricin, aristin, bebeerin, codamin, concusconin, cryptopin,
cuprin, cuscurin, geissospermin, glaucin, papaverin (if impure), pari-
cin, protoveratrin, pseudomorphin, quebrachamin, rhaeadin, thebaicin,
thebenin, ustilagin; aristolochin, asclepiadin, coniferin, crocetin, cro-
ein, digitalin (?), and syringin. Tylophorin and absinthin are at first
brown, then green, then blue. Strophanthin is fole yellow, then brown,
then green.
Erdmaim's reagent/ Froehde's reagent,^ Buckingham's
reagent,' Selmi's reagent/ Mandelin's reagent/ Brociner's
reagents/ Guy's or Wenzell's reagent/ Luchini's reagent,'
Sonnenschein's reagent/ and Lafon's reagent^" —
Are all solutions of reducible compounds in sulfuric acid which, although
not general reagents, give color reactions with certain alkaloids. (See
Strychnin, Morphin, Atropin.)
Arnold's Reactions/'
(1) Coniin, nicotin, and aconitin give color reactions when heated
five to fifteen minutes with syrupy phosphoric acid. (2) Color reactions
are obtained with brucin, codein, colchicin, delphinin, digitahn, emetin,
morphin, narcein, narcotin, papaverin, solanin, strychnin, and veratrin
when a particle of the alkaloid is moderately warmed with concen-
trated sulfuric acid and a strong (thirty to forty per cent.) aqueous or
alcoholic solution of caustic potash is graduallj^ added. (3) If the alka-
loid be dissolved in concentrated sulfuric acid and a fragment of sodium
nitrite added, and afterward alcoholic or aqueous potash solution, color
reactions are obtained with aconitin, atropin, brucin, codein, colchicin,
' Ann. d. Ch., 1861, cxx., 120. niobate, potassium ruthenate, am-
Six drops of nitric acid (sp. gr. 1.25) monium uranate, and ammonium
added to 100 c.c. water. Of this tellurate in concentrated sulfuric
10 drops are added to 20 grams con- acid,
centrated sulfuric acid. 'Am. J. Ph., 1861, 517; 1870,
2 Ann. d. Ch., 1861, cxx., 188. 385. A solution of 1 part of potas-
0.1 gm. sodium molybdate dissolved sium permanganate in 2,000 of con-
in 10 c.c. concentrated sulfuric acid. centrated sulfuric acid.
Must be freshly prepared. s L'Orosi: 1SS5, viii., 110; Ztsch.
'The sanie as Frohde's except f. an. Ch., 1886, xxv., 565. A solu-
that ammonium molybdate is used. tion of potassium dichromate in
* Berichte, 1878, xi., Ui92. A concentrated sulfuric acid,
saturated solution of iodic acid in « Berl. Id. Wochenschr., 1873, x.,
concentrated sulfuric acid. 310. A solution of cerosocericoxid in,
= Ph. Jahrb., 1S83-S4, 766. A sulfuric acid,
solution of 1 part of ammonium >° C. rend. Ac. Sc, Paris, ISSo.c,
vanadate in 100 parts of concen- 1543. Also da Silva: J. d. ph. et de
trated sulfuric acid. See also Kun- ch. , 1891, xxiv., 102. A solution of 1
drat: Chem. Ztg., xiii., 265; Ztsch. gm. sodium selenite in 20 c.c. con-
f. an. Ch., ISSf), xxviii., 70V). centrated sulfuric acid.
" J. d. ph. et de chim., 1S8S, 5 s., " Arch. d. Pharm., 3 R., xs., 561;
xvm., 204; 18S9, xx., 390; 1890, Ztsch. f. an. Ch., 1S84, xxiii., 22S.
XX., 468. Solutions of ammonium
REAGENTS FOR ALKALOIDS AND GLUCOSIDS. 175
delphinin, digitalin, emetin, morphin, narcein, narcotin, papaverin,
solanin, strychnin, and veratrin. Another reaction, particularly char-
acteristic of narcein, suggested by Arnold,' consists in heating the
alkaloid with sulfuric acid and phenol.
The Furfural Reaction. =
When certain alkaloids (and many other substances) are mixed
with cane sugar and moistened with concentrated sulfuric acid, a purple
red, violet, or blue color is produced, apart from the brown or black
due to the sugar itself. Wender has modified the test by using furfural
and sulfuric acid directly.
Concentrated nitric acid
also causes color reactions with many alkaloids. The following are
colored red, purple, or red-violet: aconitin (if impure), apomorphin,
asiminin, aspidospermin, boldin, brucin, capsaicin, corydalin (slowly),
cotarnin, curarin, damascenin (slowly), geissospermin, grandiflorin,
igasurin, loxopterigin, meconidin, pareirin, paytamin, physostigmin,
porphyrin, pseudomorphin, ratanhin (if impure), thebaicin, tylophorin,
vicin (after evaporation) ; camellin, cascarillin, chicorin, colocynthin,
daphnin, daphnetin, ecbolin, gardenin, laserpitin, sinalbin, and syringin.
With echitamin, purple changing to green; with echitenin red to purple,
to green, to yellow; with fraxetin, dark violet to red, to yellow. The
following give yellow, orange, or brown; aconitin (impure), anthocercin,
bebeerin, berberin, caenothin, cinchonamin, codein, cryptopin (slowly),
cytisin, emetin, gelsemin, hydrastin, imperialin, lanthopin, laudanin,
laurotetanin, morphin, narcein, narcotin, oxyacanthin, papaverin,
physostigmin, piperin, ratanhin, rhseadin, sabadillin, sabatrin, strychnin,
taxin, thebain, veratrin; agoniadin, asamic acid, chamaelirin, digitalin
(?), euonymin, eupatorin, gratiolin, guacin, ononin, and strophanthin.
Colchicin, violet to brow7i, to yellow. Ditamin, yellow to dark green, to
orange-red. Scillain, yellow to green. Scillitoxin, yellowish-red to
orange, to yellowish-green. The following give blue or green colors :
aricin, calycanthin, chairamidin, chairamin, codamin, colchicein,
conchairamidin, conchairamin, concusconin, cusconin, ditamin, para-
buxin, solanin, and adonin. Crocin, blue to brown. Scillain, yellow
to green.
The Euchlorin Reaction.
According to Fraude,' an aqueous solution of perchloric acid, sp.
gr. 1.13-1.14 when heated with the opium or cinchona alkaloids, vera-
trin, caffein, atropin, nicotin, or coniin gives no color, but with aspido-
' Repert. d. an. Ch., 1882, ii., 229. Ibid., 1888, xii., 355, 377. Wender:
' Schneider: Pogg. Ann., 1872, Ph. Jahrb., 1893, 482.
cxlvii., 128; Ztsch. an. Ch., 1873, " Berichte, Berlin, 1879, xu.,
xii., 218. Mylius: Ztsch. f. physiol. 1558.
Ch., 1887, xi., 492. Udransky:
176 TOXICOLOGY — WITTHAUS.
spermin and the strychnos alkaloids produces yellow and red tints,
which are permanent and show absorption spectra. Bloxam' obtained
similar reactions by dissolving the alkaloid in dilute nitric or hydrochloric
acid, heating and adding potassium chlorate. Fraude had previously
used dilute sulfuric acid and potassium chlorate. According to Haens-
serman and Sigel,^ the reaction is not given with pure perchloric acid,
and is due to the presence of free chlorin or of lower chlorin-oxygen
compounds in the commercial acid.
Liebermann's Reaction.*
Most of the alkaloids when cautiously heated to fusion with caustic
potash (purified by alcohol) give no characteristic reaction — aloetin,
chrysophanic acid, the cinchona alkaloids, apomorphin, sabadillin,
thebain, and cocain produce blue or green colors. Ptomains give no
color.
Other color reactions, such as Vitali's, Husemann's, Brouardel and
Boutmy's, the thalleiochin,Chastaing and Barillot's, Gerrard's, Grandeau's,
Pellagri's, Robinet's, Rosenthaler and Turk's, Caro's, Melzer's, Marquis'
and Roussin's, are rather special tests for certain alkaloids than general
reagents, and will be referred to in discussing the alkaloids to which
they particularly apply.
The spectroscopic appearances of alkaloidal color reactions have
been studied by Brasche,* Hartley,' Hock," and Masche.'
Other Methods of Extraction of Alkaloids.
The following processes are here briefly described, because, although
not generally serviceable in toxicological analysis, they may under
exceptional conditions be found of use.
By Dialysis.
This method of separating alkaloidal as well as mineral poisons from
the colloid constituents of organic mixtures is of most limited utility, if
indeed it can be considered as in any way advantageous. It is based
upon the discovery of Graham, that crystalline substances pass through
animal membranes from their solutions into pure water on the other side
of the membrane, while protein and other non-crystalline substances do
so only imperfectly, if at all.
The solution (contents of stomach, etc.) is placed in the inner vessel
of the dialyzer (Fig. 6), which is a ring or glass ^-essel whose bottom
1 Chem. News, 1887, Iv., 155. * Diss., Dorpat, 1891, and Ph.
^ Pharm. Jahresb., 1901, xxxvi., Ztsch. f. Russland, 1891, xxx.
330. ' Cliem. News, 1884, 287.
= Berichte, Berlin, 1878, xi., 1606. " Diss., Bern., 1S82.
See also Lenz: Ztsch. f. an. Ch., ' Chem. Centbl., 1S91, 1091.
1886, XXV., 29.
OTHER METHODS OF EXTRACTION OF ALKALOIDS.
177
Fig. 6. — Dialyzer.
consists of bladder or parchment tightly tied on while moist, in such
manner as to permit of no leakage. Pure water is put into the outer
vessel and the inner is floated upon or suspended in the, water. The
water is renewed from time to time, and, after concentration, is ex-
amined for crystalline
poisons. Or a loop of
tubing made of parch-
ment paper, suspended
with the ends above the
surface of water in a
beaker, may be used as a
dialyzer. Little is gained
by this treatment, how-
ever, as the poison is not
separated in a condition — ^
approaching purity, and
the water from the ex- ■'^:
ternal vessel must be sub- *^
sequently treated by the
usual methods for the
further purification and identification of either mineral or organic poisons.
Graham and Hofmaim's method^
was first adopted for the separation of strychnin from beer, and is
based upon the property of freshly burnt animal charcoal of absorbing
strychnin salts from their aqueous solutions and of giving the same up
to alcohol. Freshly burnt animal charcoal (bone-black) in coarse pow-
der is agitated with the solution to be examined, which is then filtered
off. The charcoal is washed with water and then boiled with alcohol,
which is then filtered off, the alcohol removed by distillation, and the
alkaloid removed from the residue by a suitable solvent.
Precipitation methods
depend upon the formation of insoluble compounds of the alkaloids,
which are subsequently decomposed by suitable agents, and the alkaloid
removed by the proper solvent.
Sonnbnschein's method^ consists in extracting the materials with
water acidulated with hydrochloric acid, concentrating over the water-
bath, again diluting, filtering, and precipitating with phosphomolybdic
solution.^ The precipitate is washed with water containing a little
phosphomolybdate and potassium nitrate, and decomposed by addition
of barium hydroxid to alkaline reaction. The liberated volatile alka-
' Ph. J. and Tr., 1851-52, xi., 504.
^Ann. d. Chem., 1857, civ., 45,
and "Ger. Cham.," p. 320.
IV.— 12
' See p. 165.
178 TOXICOLOGY WITTHAUS.
loids are then separated by distillation, and the fixed alkaloids by treat-
ment with carbon dioxid, evaporation and extraction of the residue
with strong alcohol.
Palm, according to Kobert,' has modified this method in that he
extracts with water slightly acidulated with sulfuric acid, and pre-
cipitates with neutral and with basic lead acetate before precipitating
with molybdic acid.
Brieger's method^ was devised for the extraction of ptomains, and
is also essentially a modification of Sonnenschein's. The materials are
extracted with water acidulated with hydrochloric acid, heated to boil-
ing, filtered, and evaporated to a syrup. This is extracted with alcohol
(ninety-six per cent.) and the filtered extract treated with alcoholic
solution of lead acetate. The filtrate from the precipitate formed is
evaporated to a syrup, again extracted with alcohol, the alcohol evapo-
rated, the residue dissolved in water and freed from lead by hydrogen
sulfid. After addition of a little hydrochloric acid the liquid is again
concentrated to a syrup, which is extracted with alcohol and the solution
precipitated with alcoholic solution of mercuric chlorid. The filtrate
from the precipitate formed is freed from alcohol by evaporation
after the acid has been nearly neutralized with soda, and from
mercury by solution in water and treatment with hydrogen sulfid.
This aqueous solution is concentrated, the residue extracted with
alcohol, the alcohol expelled, the residue dissolved in water, the hydro-
cliloric acid neutralized with soda, the solution acidulated with nitric
acid and precipitated with phosphomolybdic acid.
The alkaloids contained in the mercuric and phosphomolybdic pre-
cipitates are recovered by decomposition of the compounds, and ex-
traction of the liberated alkaloids by suitable solvents.
The precipitation methods, although they have rendered valuable
service for purposes of investigation, are not adapted to forensic
analysis, ^partly by reason of the number of reagents, some of which are
poisonous, which are introduced into the materials under examination,
partly because of the liability to decomposition of glucosids and certain
alkaloids by the reagents used, and partly because they present no
advantage over the extraction methods above described, either in
facility or rapidity of manipulation or of separation of alkaloids from
ptomains.
By Direct Extraction.
The direct extraction of alkaloids and other vegetable poisons by the
action of a solvent, water, dilute acid, dilute alkalies, alcohol, ether,
chloroform, petroleum ether, benzene, etc., upon the dried or semi-
'"Intoxikationen,"p.O.-,. = "Untersuch. u. Ptomaine," 1886,
3 Th., p. 19.
OTHER METHODS OF EXTRACTION OF ALKALOIDS. 179
solid material can rarely be resorted to in forensic analysis. Occasion-
ally, however, this method may be of service in the examination of an
article of food or a medicine, particularly when the search is limited
to one poison. The solvent selected should be that in which the mate-
rials with which the poison sought for is mixed are the least soluble,
and which is yet capable of dis-
solving the substance to be ex-
tracted. With aqueous solvents,
solution and separation are effected
by trituration, agitation, and filtra-
tion. With solvents not miscible
with water the materials must be
previously dried at as low a tem-
perature as possible. The Soxhlet
(Fig. 7) or other form of extraction
apparatus permits of a complete
extraction with a small quantity of
solvent. The dried material is
packed in a paper cylinder or
"thimble" which is placed in the
tube A ; the solvent is put into the
flask B, which is heated on an elec-
tric heater, on or in the water-bath,
or on asbestos gauze. The solvent
is volatilized, passes through E, is
condensed in the condenser C, col-
lects in A until it rises to the
point h, when it flows through the
siphon, D, back into the flask, B, in
which the substances extracted by
it accumulate.
The Method of Hilger and
Kuestee' is a combination of ex-
traction with dilute acids, as in the
Stas and Dragendorff methods, fol-
lowed by dry extraction with solv-
ents. The materials under examina-
tion are extracted with water or alcohol acidulated with tartaric acid.
The extracts are concentrated on the water-bath, made into a paste with
plaster of Paris, sand, or powdered pumice, and completely dried at
100°. The mass is then packed in a thimble and extracted by the
selected solvents in a Soxhlet. After extraction of the acid material
Fig. 7. — Soxhlet's Extraction
Apparatus.
Mitth. a. d. pharm. Inst. z. Erlangen, 1889, ii., 291.
180 TOXICOLOGY WITTHAU.S.
it is removed from the thimble, rendered strongly alkaline with
sodium carbonate solution, dried and again extracted. The
alkaloids are removed by several solvents as in the method
described above, pp. 160-164. This method is more expeditious
than that by agitation, and the extractions are probably more
complete, but in both respects it is excelled by the use of the
perforator.
Micro -sublimation '
consists of applying heat to the substance in a "subliming cell"
in such manner that the change in appearance and the tempera-
ture may be noted, and the sublimate collected and examined
with the microscope. While some of the alkaloids, when exam-
ined in the crystalline form by this method, produce appearances
which may serve to aid in their identification, indications of
value cannot be obtained when the alkaloid is mixed with other
substances.
Quantitative Determination of Alkaloids. — It is rare that
an alkaloidal poison is present in a cadaver in sufficient amount
to permit of quantitative determination. Nevertheless, in
exceptional cases in which enormous doses have been given,
a sufficient amount has remained to permit of determination,
even of such actively toxic alkaloids as atropin^ and aconitin'
and, more frequently, of strychnin.*
In the very exceptional instances in which it is possible, the
most certain method of quantitative determination consists in
the isolation of the alkaloid in crystalline form, finally in a
tared glass dish, and weighing after desiccation. Volatile alka-
loids are converted into chlorids and weighed as such. The
results obtained by this method must, however, always be con-
sidered as only approximately representing the amount originally
present in the materials examined. If the purification of the
extract be not carried to completion there will be plus error,
which may be large, from the presence of impurities and, on the
other hand, complete purification involves a number of opera-
tions in each of which there is some loss of material. Indeed
with small quantities purification may be carried to disappear-
' Helwig: "Das Mikroskop in der Med.," 6th ed., 1888, 398, 463, 509.
Toxikologie," 1865, ii., 8. Guy: Blyth: "Poisons," 1884, 240.
Ph. J. and Tr., 2 s., 1866-67, viii., = See p. 884
719; 1867-68; ix., 10, 58. "Forensic ' See p. 863.
* See p. 1056.
QUANTITATIVE DETERMINATION OF ALKALOIDS. 181
ance. It is best to carry on the purification until a distinctly
crystalline residue is obtained, weigh this, and determine the
amount of alkaloid in it by the alkalimetric method described
below. Owing to inevitable losses in extraction and purification,
the amount found is always a greater or smaller fraction of the
amount originally present.
The several volumetric methods which have been proposed
(other than the alkalimetric as here used) are all unsatisfactory.
The formation of iodhydrargyrates with Mayer's reagent' and
of periodids with Wagner's reagent^ by most alkaloids,, and the
definite composition and very sparing solubility of these com-
pounds, early suggested the use of these reagents for the volu-
metric determination of alkaloidal poisons. The Mayer reagent
is made of such tenure of mercuric chlorid that a given
volume precipitates a definite amount of alkaloid: e.g., for each
c.c. of reagent 0.0167 of strychnin, 0.0145 of atropin, 0.02 of
morphin, etc. The end reaction in this method is too indefinite
to permit of accurate determination even in pure solution, and
particularly in the presence of impurities from which it is very
difficult to free the alkaloid when extracted from cadaveric
material. Kippenberger's iodometric method^ has been shown
by Scholz* to be inaccurately founded, chemically, and to be
useless. Prescott and Gordin's method' based on like principles,
was superseded in Gordin's own estimation by his second method,"
which is based upon the fact that when an alkaloid is precipitated
from an aqueous solution containing a known quantity of acid
by a neutral precipitant such as Mayer's or Wagner's reagents,
each molecule of the alkaloid carries down with it in the pre-
cipitate a molecule of the acid in combination. But Kippenber-
ger' showed it to yield varying results even with aqueous solu-
tions of alkaloids.
To check the results of the gravimetric determination, the
residue is dissolved in a known volume of N/100 hydrochloric
or sulfuric acid. On the other hand, a 250 c.c. flask of alkali-
poor glass is selected, into which 50 c.c. water, enough ether,
' See p. 167. ^ J. Amer. chem. Soc, 1898, xx.,
^ See p. 168. 722.
= Ztschr. f. anal. Chem., 1895, " Berichte, Berlin, 1899, xxxu.,
xxxiv., 317; "Nachw. d. Giftstoffe," 2871.
Berl., 148, 157. ' Ztschr. f. anal. Chem., 1903,
* Arch. d. Pharm., 1899, ccxxxvii., xlii., 101.
71.
182 TOXICOLOGY WITTHAUS.
freshly distilled from sodium, to form a layer about 1 c.c. deep after
agitation, and 5 c.c. of an ethereal solution of iodeosin are placed.
The contents are agitated, and if the aqueous layer have a rose
tint, N/100 acid is added guttatim until, after agitation, the
aqueous layer remains colorless. If now on prolonged agitation
a rose color reappears the flask gives off too much alkah and
must be discarded. N/100 caustic soda is added to the contents
of a satisfactory flask in 0. 1 c.c. until a faint rose color is pro-
duced in the aqueous layer, and then the acid alkaloid solution.
After thp disappearance of the rose color N/100 alkali is added in
c.c. until the aqueous layer remains distinctly rose color after
agitation; then 1 c.c. N/100 acid is added, and finally N/100
alkali in 0. 1 c.c. until a faint rose color remains on agitation.
The residue operated upon must contain the alkaloid entirely in
the free state, and no other basic or acid substance. Each c.c. of
N/100 acid, multiplied by 0.00647 =gm. aconitin, by 0.00289 =
atropin, by 0.00303 = cocain, by 0.00285 =anhydrous morphin,
by 0.00162 =nicotin, and by 0.00334= strychnin.
Purity of Chemicals.
Purity is only a relative idea. The analyst is never justified
in the statement that his chemicals are absolutely pure. But he
can, and should, assure himself that the reagents which he uses
do not contain impurities in nature or quantity sufficient to in-
terfere with their action, or to cast doubt upon his results. He
must himself determine the degree of purity of every chemical
which he uses, by the special methods to'be described hereafter,
not by the pharmacopoeal tests, and if necessary either purify an
impure product or manufacture one himself from pure materials.
The purity of the stock chemicals having been assured, they
should be kept under seal, and their continued purity should be
further ascertained by " blank controls," in which negative results
should be obtained when a given process is carried to completion,
using^ quantities of the several reagents at least equal to those
used in the actual analysis.
Hpdrochloric Acid.— Colorless, "arsenic-free" acid is now purchas-
able of a sufficient degree of purity; although some samples, which have
been purified by Bettendorf's method, are liable to contain tin. It
should be tested for arsenic by one of the two following methods: By
PURITY OF CHEMICALS. 1 S3
Beckurts' process:' To one litre of the acid, which should have a sp. gr.
of 1.19, 20 c.c. of a cold saturated solution of ferrous chlorid are added
and the mixture distilled with acti^•e ebullition and with a well cooled
condenser. The first third of the distillate, after dilution with water,
is tested for arsenic by the Marsh test with zinc (p. 613).
In Otto's method^ at least one litre of the acid is diluted with water
to sp. gr. 1.1; a small quantity of potassium chlorate is added, and the
acid is evaporated in a porcelain capsule on the water-bath with occa-
sional addition of water. The residue is taken up with dilute sulfuric
acid and heated until the hydrochloric acid is expelled, after which the
liquid is diluted and tested with the Marsh, either with zinc or
electrolytically.
The method of Beckurts has the advantage over that of Otto in that
the acid remaining in the distilling flask is not lost, but may be distilled
and used. It also affords a means of purifying an impure acid. The
concentrated acid, sp. gr. 1.19, is placed in a distilling flask along with
20 c.c. of cold saturated solution of ferrous chlorid or sulfate and a
piece of piano wire, and distilled at active ebullition. The first quarter
of the distillate is rejected, the next 50 c.c. are collected separately, and
the distillation then continued, leaving about ten per cent, of the original
quantity in the flask. The 50 c.c. collected separately are tested by the
Marsh test, and should give no stain. The acid thus purified contains
a trace of iron, which is not detrimental for this use.
Thome and Jeffers^ purify hydrochloric acid by application of the
principle of the Reinsch test: The acid is heated and distilled over
bright copper gauze, upon which any arsenic present is deposited.
A sufficiently arsenic-free acid may be obtained by the action of
pure sulfuric acid upon pure fused sodium chlorid, which, is, howe\'cr,
tedious and costly.
Sulfuric Acid. — Zinc. — These are usually tested together for arsenic
and phosphorus. Lead chlorid is added to about 500 c.c. of the con-
centrated acid, which is then distilled. The first portion of the distil-
late, diluted with water, is tested for arsenic by the acid-zinc Marsh
(p. 613). If during one hour's heating no stain is produced in the
reduction tube both acid and zinc are sufficiently arsenic free. Should
they not be so the acid alone is similarly tested in the electrolytic
Marsh (p. 610).
Zinc is tested for phosphorus by spectroscopic examination of the
hydrogen flame in the apparatus figured on p. 676.
Sulfuric acid is tested for metallic impurities, particularly lead, by
dilution with five volumes of water and saturation with hydrogen
'Arch. d. Pharm., 1884, ccxxii., ^Proc.Chem. See, 1902, xviii.,
684. See also p. 593. 118.
' Berichte, Berl., 1886, Ixix., 1903.
184 TOXICOLOGY WITTHAUS.
sulfid. It should remain perfectly colorless and should deposit no
precipitate.
Selenium is a frequently occurring impurity of sulfuric acid, even
that designated as chemically pure. Its presence may be detected by
the formation of a green color in the cold, changing to steel-blue on the
water-bath, when codein is moistened with the acid; or, preferably,
by diluting the acid with three to four volumes of water, and adding
sulfur dioxid, as gas or in solution, when the liquid turns yellow, then
red, and finally deposits red flocks. A still more delicate reagent is
acetylene, which produces a red color in sulfuric acid containing 1 /100,000
of selenium.
Sufficiently pure sulfuric acid is now purchasable. If not obtain-
able, an impure acid may be purified from arsenic by addition of a
few gms. of lead chlorid to a litre of the acid, and distilhng from a
non-tubulated glass retort,' the first 50 c.c. of the distillate being
rejected. Or by Fairley's method^ by distilling after addition of
twenty-five per cent, of potassium bisulfate and a little permanganate or
bichromate, preferably the former; the first two-thirds of the distillate
being collected. It may be purified from selenium by treating with
sulfur dioxid, and careful decantation from the deposited precipitate.
Pure zinc is also purchasable, and we would advise the testing of
different samples of both sulfuric acid and zinc until practically pure
products are found, and then laying in sufficient supplies, rather than
the purification of impure materials. Zinc may, however, be purified
either by L'Hote's method' or by that of Hehner-Mai.* In the former
1.5 per cent, of anhydrous magnesium chlorid are added to the molten
metal, when arsenic volatilizes as the trichlorid, and the zinc is then
granulated. ■ In the latter method a kilo of zinc is fused in a clay
crucible and about 2 gm. of sodium are added, and the mixture well
stirred with a rod of difficultly fusible glass, bent at right angles, the
black scum which forms upon the surface being removed from time to
time until the sodium appears to be oxidized. The treatment with
sodium is repeated once in the same crucible, and a second time in
another heated crucible to which the molten zinc has been transferred.
The zinc is then allowed to cool to near solidification and granulated
by pouring it into very dilute hydrochloric acid. As purified by the
first method, the zinc contains magnesium, which is no disadvantage,
but rather an advantage in the Marsh, as it renders the evolution of
gas more regular than it is with pure zinc.
' The retort should be heated by a ' Zeitschr. f. anal. Chem., 1885,
ring burner and be carefully pro- xxiv., 83.
tected from draughts. « Zeitschr, f . Unt. d. Nahr. u.
' Analyst, 1901, xxvi., 179. Genussmit., 1902, v., 1108; 1903, vi.,
649.
EXAMINATION FOR MINERAL POISONS. 185
Nitric Acid. — The purest nitric acid purchasable still contains 0.03
mgm. to the litre of arsenic. If the Fresenius and von Babo method
be followed, this proportion is negligible in view of the very small
quantity of this acid used, but if one of the acid methods of destruction
of organic material be adopted, in which notable quantities of nitric
acid are added, it must be taken into consideration. The acid is tested
by evaporation of 300 c.c. in a porcelain capsule with addition of 20 gm.
of sulfuric acid in small portions, and the mixture heated until about
15 c.c. of sulfuric acid remain. These are diluted with four volumes of
water, cooled, and tested in the Marsh. The acid may be purified to an
arsenic content of 0.001 mgm. per litre by two distillations in glass with
the addition each time of one-tenth in weight of pure sulfuric acid.
The purity of other chemicals will be considered in the sequel in
connection with their uses.
Examination for Mineral Poisons.
The poisons included in this class are the compounds of
arsenic, antimony, barium, bismuth, chromium, copper, lead,
mercury, silver, tin, and zinc. The salts of other metals, such
as those of cadmium, thallium, and uranium, are also poisons,
but by reason of their rarity have little practical interest, and,
if present, would attract the attention of the analyst in the
course of the investigation.
As quantitative determinations of mineral poisons are
usually possible and always desirable, and as the distribution of
poisons in different parts of the same organ is not uniform, the
entire liver, brain, kidney, etc., must be weighed and then finely
hashed and thoroughly mixed before the samples, which must
also be weighed, are taken for analysis.
The first step in the search for the mineral poisons is the
destruction, as complete as possible, or the removal of the or-
ganic substances of which the tissues and food articles are
largely composed.
The most rapid method of accomplishing this object is by
simple incineration, but it is not available in searching for
arsenic and mercury, which would be lost by volatilization. It
may, however, be occasionally used when only a fixed metal is
to be sought for. The dried and finely divided substance is
gradually heated in a porcelain crucible, at first covered, after-
ward open, until converted into an ash which, after cooling, is
extracted with dilute hydrochloric or nitric acid.
186 TOXICOLOGY WITTHAUS.
A modification of tfie method by incineration which permits
also of the detection of the volatile metals has been suggested
by Verryken/ but is only applicable to the treatment of small
quantities of material. From 5 to 10 gm. of the perfectly dried
material are very gradually heated in a current of oxygen in a
combustion tube whose free end communicates with a Liebig
bulb apparatus containing water, to arrest the volatilized
arsenic or mercury.
Incineration in the ordinary method is facilitated by pre-
viously mixing the dried and powdered material with potassium
nitrate, and adding the mixture in small portions to a red-hot
porcelain crucible. The cooled melt is extracted with hot
water.
The Method of Woehler and von Siebold^ is an improvement
upon the method by incineration, which permits of the detection
of mineral poisons other than mercury, which is lost by volatiliza-
tion. The materials are first partially oxidized by heating with
strong nitric acid, neutralized with caustic potash or potassium
carbonate, and dried at about 120° C. The dried mass, con-
sisting of the partly oxidized organic matter and potassium
nitrate, is then brought in small quantities at a time into a red-
hot porcelain crucible, and the cooled melt is extracted with
boiling water.
The Kjeldahl Method of disintegration of organic substances
may be used, provided no compound of a poisonous metal be in-
troduced as an oxygen carrier. The material is first dried, and
10 gm. of the dried substance, mixed with 60-80 c.c. of sulfuric
acid, to which 10 per cent, of potassium sulfate have been added,
are placed in a Kjeldahl flask, which is then connected by a bent
tube with a Volhard's recipient. The contents of the flask are
heated to near boihng for six to eight hours, until the hquid has
become colorless, which may be accelerated by the cautious ad-
dition of a small quantity of nitric acid. The contents of the
flask are then cautiously diluted with much water, the contents
of the recipient are added, and the mixture is freed from sulfur
dioxid by heating on the water-bath during passage through it
of air containing bromin vapor. ^
' J. de pharm. d'Anvers, 1872, 1847, 494. Also Wohler and v. Sie-
193, 241. Chem. Centlb., 1873, bold: Reprint.
823. 3 See Gras and Gintl: Oesterr.
'^Siebold: "Lehrb. d. ger. Med.," chem. Ztg., 1899, ii., 308.
EXAMINATION FOR MINERAL POISONS.
187
Method of Fresenius and von Babo. — This is the most fre-
quently used and the best process hitherto devised, and effects
the desired end by the oxidizing action of nascent chlorin gen-
erated in a liquid medium.
The substances to be examined are finely hashed if solid,
and freed from alcohol, if it be present, by evaporation on the
water-bath after neutralization of any acid reaction with sodium
carbonate. From 50 to 150 gm. of
the hashed tissue are brought into a
flask and hydrochloric acid and
potassium chlorate added to the ex-
tent of about 25 c.c. of the former
and 2 gm. of latter for every 100 gm.
of solid to be disintegrated. If the
mass be not fluid, a sufficient amount
of water is added. The mixture is
allowed to stand for twenty-four
hours with occasional stirring, after
which it is heated on the water-
bath, with frequent agitation and
the occasional addition of potassium
chlorate, until the contents of the
flask are yellow and fluid, except
for fatty and white granular matter
in suspension, and until the liquid
does not darken on heating for half
an hour without addition of chlorate. f,^^ ^ . „„" , :, ^ .
riG. » ^Apparatus tor use or
If, during the heating, the addition chlorate solution m Fresenius'
of chlorate produces little or no and von Babo's method,
effect, the quantity of hydrochloric acid is deficient, and more
is to be added in the proportion of 10 c.c. to each 100 gm. of
original solid. The quantity of both acid and chlorate used
should, however, be kept at the minimum required to accomplish
the object. The addition of chlorate is best effected by using a
cold saturated aqueous solution in the dropping funnel, c, of the
apparatus shown in Fig. 8. When the disorganization is com-
pleted, the excess of chlorin is expelled by passing a rapid current
of carbon dioxid through the cooled liquid. The solution is then
filtered through a filter moistened with water, and the residue
washed with hot water. Should a large quantity of fat remain.
188 TOXICOLOGY — WITTHAUS.
it is to be heated two or three times with water acidulated with
hydrochloric acid, and the filtered extracts added to the main
solution. The filtered liquid now contains in solution any of the
mineral poisons which may be present except silver and a portion
of the lead, if the latter have been present in large amount;
these will remain in the undissolved residue.' (For the further
examination of solution and residue see below, p. 191.)
The objections to this method are: 1st. That a small and
uncertain proportion of arsenic is lost by volatilization as ar-
senic trichlorid. 2d. That the destruction of organic matter
is not complete, and that a portion of the mineral material, in-
cluding arsenic and other poisons, is retained by the fat which
remains. 3d. The large quantity of chlorate and hydrochloric
acid introduced, and the difficulty of obtaining the latter free
from arsenic.^ On the other hand, this method (or one of its
modifications) is the only one available if mercury is to be taken
into account.
The first objection may be overcome by operating in a retort
or flask connected with a condenser and absorbing apparatus to
retain any arsenic trichlorid which may be formed, or in the
apparatus, Fig. 8, a reflux condenser being substituted for the
tube b. The second objection is only serious so far as the reten-
tion of poisons by the fat is concerned, and, if the amount of
these be large, repeated washings do not effect complete extrac-
tion; yet the percentage retained is very small and only affects
quantitative determinations. The washing is best effected by
strongly agitating the fat with water near the boihng-point,
and then coohng the flask and contents in a refrigerator, when
the aqueous Hquid can readily be poured ofT from below the
sohdified fat cake after perforating of the latter with a stirring rod.
The operation should be repeated four times. The quantities
of acid and chlorate used may be diminished by following
Ogier's modification below described. Pure hydrochloric acid
is now purchasable or may be manufactured or purified by the
analyst himself.
' If mercury be present in the is also only satisfactorily effected
metallic form it is only very slowly if the disintegration is carried so
dissolved and may remain as a far that no granular yellow particles
metallic deposit if the decomposi- of undecomposed material remain.
tion have been rapidly effected. See Ludwig: Ztschr. f. an. Chem.,
noo''°'T?®"°^*'^' Berlin, 1891, xxiv., 1891, xxx., 664. See p. 773.
928. Extraction of mercuric chlorid ^ See p. 182.
EXAMINAI'ION FOR MINERAL POISONS. 189
Ogier's' modification consists in making a mixture of the
finely hashed viscera with one-tenth to one-eighth of their
weight of potassium chlorate and enough water to form a rather
thick liquid, and passing hydrochloric acid gas through the
mixture in a specially constructed apparatus.
Method of Jeserich.^ — This process is also based upon the
decomposing action of nascent chlorin. The finely divided ma-
terial is made into a thin paste with water, to which chloric
acid is then added in small portions; after which the mixture
is slowly and cautiously heated on the water-bath until the mass
has assumed a spongy consistence, when hydrochloric acid is
gradually added in small quantities. The attack is complete in
two to three hours, and yields an almost clear yellowish liquid,
upon which floats a layer of oil. The remaining treatment is
the same as with the method of Fresenius and von Babo.
The following methods are designed more especially for the
detection of arsenic and fixed metallic poisons, and cannot be
used unless the possibility of the presence of mercurial poisons
is excluded.
Method of Gautier.^' — This method depends upon the dis-
integrating action of sulfuric and nitric acid: 100 gm. of the
hashed material are put into a capsule of a capacity of 600 c.c;
30 c.c. of nitric acid are added, and the mixture is heated moder-
ately. The substance liquefies gradually and assumes an orange
tint; when this occurs the capsule is removed from the fire and
5 gm. of sulfuric acid are added, when the mass becomes brown
and is strongly attacked. It is then heated until fumes of sul-
furic acid are given off, when 10 to 12 gm. of nitric acid are
added, drop by drop. The mass again becomes liquid and gives
off abundant nitrous fumes. When all the acid has been added
the mass is heated to beginning carbonization. Finally the car-
bonaceous residue is pulverized and extracted with boiling water.
In tl^is process the oxidation is liable to proceed too violently,
with consequent loss of arsenic. To avoid this Lockemann* has
modified the procedure as follows: 20 gm. of the finely divided
'■ "Le Lab. de Tox.," Paris, 1891, of Orfila (1839): "Tr. de Tox.," 5th
44. ed., i., 494, and of the modification
^ Repert. d. an. Chem., 1882, ii., thereof suggested by Filhol in 1848
369. ("Etudes sur TArsenic," Th., Paris).
^ Bull. Soc. de chim. de Paris, * Ztschr. f. angew. Chem., 1905,
1875, xxiv., 252. This method is a xviii., 421.
combination and perfection of that
190 TOXICOLOGY WITTHAUS.
tissue are placed in a capsule with 5 c.c. of a mixture of ten parts
of fuming nitric acid and one part of concentrated sulfuric acid
and gradually heated on the water-bath until the mass, which at
first froths strongly, forms a thick yellowish fluid. The addition
of the acid mixture is then continued in portions of 1 to 2 c.c. at
a time, to the extent of 20 c.c, a fresh portion being added only
after the evolution of brown fumes has ceased. The mass
finally becomes dark yellow, and, on continued heating, brown.
A concentrated aqueous solution of 30 gm. of a mixture of equal
parts of sodium and potassium nitrates is now added and the
whole evaporated to dryness. The lemon-yellow crystalline
residue is added in small portions to 5 gm. of the mixture of
nitrates in moderate fusion in a platinum crucible, awaiting the
complete oxidation of each portion before adding the next.'
Method of Chittenden and Donaldson.^ — This is practically
the same as the last described, except that the temperatures are
lower and more carefully regulated.
It is claimed for the two methods last described that the ex-
traction of arsenic is more complete than by that of Fresenius
and von Babo; but they are open to the objections that, even
with the most careful handling, the oxidation occasionally pro-
gresses with such rapidity as to cause deflagration and the loss
of a large proportion of the material, and that any mercury
present is lost.
In the Method of Grigorijew' the action of sulfuric acid
is made to precede that of nitric acid. The materials are dried
at 70°-80° and pulverized. They are mixed with ten volumes of
sulfuric acid and gradually heated. After cooHng, 10 c.c. of
fuming nitric acid are added, and the digestion continued, with
further addition of nitric acid, until the froth has subsided.
The mass is then transferred to a Kjeldahl flask, and heated to
boiling, with occasional addition of 10 c.c. of nitric acid, until
brown fumes are no longer given off, and the mass has become
light yellow. The cooled Hquid is diluted with 3-5 volumes of
water, heated to expel nitrous vapors, and, after further dilution
with water, treated with hydrogen sulfid.
The Method of Flandin and Danger/ by carbonization with
'See p. 595. = Vrtljschr. f. ger. Med., 1905, 3F.,
"Am. Ohem. Jour., 1880-81, ii., xxix., 74.
236. ■'Flandin: "Tr. d. Poisons," i.,
618.
EXAMINATION FOR MINERAL POISONS. 191
sulfuric acid, and a small quantity of aqua regia subsequently
added, is attended with loss of arsenic as chlorid.
Method of Pouchet.' — In this process the danger of deflagra-
tion is sought to be avoided by the use of monopotassic sulfate.
The material to be decomposed is placed in a large porcelain dish
with twenty per cent, of its weight of monopotassic sulfate, and
its own weight of fuming nitric acid is added. The reaction,
very violent at first, is subsequently aided by gentle elevation of
temperature. The mass becomes carbonized and porous. It is
moistened with fuming nitric acid, and heated until nitrous
fumes are given off. The carbonized mass is pulverized and ex-
tracted at a boiling temperature with water strongly acidulated
with hydrochloric acid.
The Method of Meillere^ is similar to that of Pouchet, but
a mixture of sulfuric and nitric acids is used in place of nitric
acid alone.
In the Method of Deniges' the oxidation is effected by a
mixture of nitric acid and potassium permanganate, with the
subsequent addition of sulfuric and nitric acids.
The Method of PageP aims to separate arsenic, antimony,
and mercury from fixed metallic poisons by distillation, and is
based upon the decomposing action of chromyl chlorid upon
organic substances. One-hundred gm. of the substance and 30-
40 gm. of a mixture of potassium dichromate and sodium chlorid
(1 : 2) are heated in a tubulated retort, fitted with a dropping
funnel, and connected with a well-cooled condenser, while sul-
furic acid is added guttatim from the funnel, until the evolution
of yellow vapors has ceased. Any arsenic present will be found
in the distillate, as well as the greater part of antimony or
mercury.
The second stage in the analysis for mineral poisons consists
in their separation from the solution or residue obtained by
some one of the foregoing methods. This may be accomplished
by a variety of methods, by electrolytic deposition or by chemical
methods when only one poisonous metal or a small group thereof
' Comp. rend. Ac. Sc, Paris, 1881. ^ Ibid., 1901, [6], xiv., 241.
Legrand du Saulle Berryer, and * Pharm. Post, 1900, xxxiii., 489;
Pouchet: "M6d. L6g.," 1424. Schlagdenhauffen and Paget: Ann.
^ J. de pharm. et de Chim., 1902, d'hyg., 1898, 3 s., xl., 5.
[6], XV., 97.
192
TOXICOLOGY — WITTHAUS.
is to be considered; but when all poisonous mineral compounds
are to be sought for those which exist in the solution are best sep-
arated by hydrogen sulfid.
If the disintegration has been effected by the method of
Fresenius and von Babo, the portion remaining undissolved may
contain silver, lead, or thallium as chlorids, mercury as sulfid
or metal, and barium as sulfate. If the liquid, clear when filtered,
becomes turbid on cooling, the deposit so formed may contain
lead, silver, or thallium as chlorids, or compounds of antimony
or bismuth. The above insoluble portion (I) and any deposit
formed on cooling (II) separated by filtration, are set aside for
subsequent examination.
The clear filtered liquid, freed from chlorin by carbon
dioxid (p. 187), is then treated as follows: Any great excess of
acid is neutralized with sodium carbonate in concentrated solu-
tion to such extent that the reaction still remains distinctly acid,'
and the liquid is then treated with hydrogen sulfid at water-bath
temperature.^
from the generator, dipping into
the hquid, and through the second
a vertical tube, open at both ends
and about one meter long, whose
lower end at the beginning is above
the surface of the liquid, but is
depressed to dip into the liquid after
the air has been displaced. The
gas is produced by the action of
dilute arsenic-free sulfuric acid (1:9)
on fused ferric sulfid in a Dudley's,
Kipp's, or de Koninck's generator,
and purified from possible traces of
arsenic from the ferric sulfid by
Jacobsen's method (Berichte, Berlin,
1SS7, XX., 1999): by passing the gas
first over calcium chlorid, then
through a tube about 40 cm. long
loosely filled with solid iodin, and
finally through a wash-bottle con-
taining a solution of potassium
sulfid. A valve-bottle, permitting
entrance of air but not escape of gas,
should be interposed between the
generator and the calcium chlorid
tube. After the treatment with
hydrogen sulfid has continued three
hours, the water-bath is allowed to
cool and the whole apparatus, with
the cock of the generator open,
left standing overnight, or longer
if the liquid have not cleared in that
' It is recommended to treat the
solution with sulfur dioxid at this
stage for the purpose of reducing
arsenic to arsenous compounds and
thus preventing the deposition of
sulfur subsequently. Usually, when
small quantities of arsenic only are
present, this is unnecessary, but in
analyses of viscera from bodies
embalmed with arsenic it is imper-
ative, not only to avoid the deposi-
tion of large quantities of sulfur
from decomposition of hydrogen
sulfid by arsenic compounds, but
also to avoid loss of mercury at a
later stage if compounds of that
metal be present. When treatment
with sulfur dioxid is required the
liquid should be treated with the
gas, most conveniently obtained
from a siphon of the liquid, until
the odor persists strongly after the
liquid has stood in a closed vessel
for several hours; atid the excess of
sulfur dioxid must be completely
expelled by boiling before the
treatment with hydrogen sulfid.
" The liquid is placed in a flask
fitted with a doubly perforated
stopper, and placed upon a water-
bath. Through one hole of the
stopper passes the delivery tube
EXAMINATION FOR MINERAL POISONS. 193
The treatment with hydrogen sulfid ahnost invariably causes
a precipitation. Sometimes this is abundant and of characteris-
tic color, when the presence of a given poisonous metal may be
suspected; but even in the absence of any poison a precipitate
of sulfur and organic thio-compounds is usually formed, therefore
no positive conclusion can be drawn from the formation of a
precipitate at this stage.
In place of precipitating the metallic sulfids by gaseous
hydrogen sulfid in the manner above described, and, as is usually
done, we have in recent years adopted the thioacetic acid
method of Schiff and Tarugi^ with much satisfaction. This
niethod is much more expeditious than the older one, gives at
least equally reliable results, and with slight modifications is
especially advantageous in certain cases. ^ It offers no ad-
vantage, however, to the comfort of the analyst, as the odor of
the reagent is more disagreeable and persistent than that of
hydrogen sulfid. The reagent is made by dissolving 10 c.c. of
thioacetic acid (CH3.CSOH) in a slight excess of moderately
diluted ammonium hydroxid (with avoidance of heating) and
making the solution up to 30 c.c. It deteriorates in a week Or
ten days. To the cold acid solution of the metallic chlorids, 1.5
to 2 c.c. of the reagent are added and the mixture heated to near
boiling, but not boiled. Arsenic, whether present as arsenate
(as it will be if the Fresenius and von Babo method has been
followed) or arsenite, bismuth, copper, tin, lead, silver, cadmium,
mercury, gold, and platinum are precipitated in the same form as
by hydrogen sulfid, and the remainder of the treatment is the
same as when the gas is used, a portion of the filtrate being
tested with the reagent to be sure that precipitation is complete.
After complete precipitation, the precipitate (III), which
may contain members of two groups of poisons: arsenic, anti-
mony, tin, and traces of copper, whose sulfids are soluble in am-
monium monosulfid (IV), and mercury, silver, lead, copper,
bismuth, and cadmium (V), whose sulfids are insoluble, is sepa-
rated from the liquid which may contain zinc, nickel, cobalt,
thallium, iron, manganese, chromium and aluminium (VI) by
filtration through as small a weighed filter as the bulk of the
time. The initial treatment with of mercury by solution of its sulfid
hydrogen sulfid must be at the in ammonium sulfid later,
temperature indicated to avoid loss 'Bar., Berl., 1894, xxvii , 3437.
= See "Mercury," p. 774.
IV.— 13
194 TOXICOLOGY — WITTHAUS.
precipitate will permit. The filtrate (VI) is set aside for future
examination, and the precipitate on the filter is washed three or
four times with water containing hydrogen sulfid.
To separate IV from V the filter and precipitate are placed in
a small flask, covered with hot yellow ammonium sulfid,' heated
on the water-bath for ten minutes, and brought upon a small
filter, which is then washed, first with hot yellow ammonium
sulfid once, then with water containing a small quantity of the
sulfid, and finally with water containing ammonium hydroxid.'
The members of group I V will be found in the filtrate, those of
group V in the undissolved precipitate.
The filtrate and washings I V are acidulated with hydrochloric
acid, and the reprecipitated sulfids are, after subsidence, collected
on a filter and washed with water containing hydrogen sulfid un-
til a sample of the washings no longer gives any cloudiness when
boiled and treated with nitric acid and silver nitrate. The point
of the filter is then perforated and the precipitate washed into a
porcelain capsule, the last adherent portions being dissolved
with a small quantity of dilute ammonium sulfid solution. The
Contents of the capsule are dried, moistened with fuming nitric
acid, and evaporated to dryness, and then moistened with water
and evaporated to dryness two or three times. The residue is
then subjected to the Meyer fusion. It is treated with a small
quantity of water; sufficient sodium hydroxid (free from car-
bonate) to render the reaction alkaline is added, and then a
mixture of dry sodium carbonate and nitrate (1:2), and the whole
evaporated to dryness after thorough mixing.^ When dry, the
residue is gradually and cautiously heated to fusion and the
heating continued until the mass is colorless or faintly greenish,
or until the only colored portion consists of a heavy black
granular powder (cupric oxid). If, after continued heating, the
'Ammonium monosulfid, (NH.|)„S, ° Any departure from the pro-
is made by saturating ammonium cedure described in the text mil
hydroxid solution (sp. gr. 0.!I6) with entail loss of mercury, if it ^
hydrogen sulfid until it no longer present, by solution of its sulfid at
precipitates with magnesium sulfate, this stage, and its volatilization in
and adding an equal volume of the subsequent treatment of the
ammoniutn hydroxid solution of the filtrate.
same strength. For the use here ^ ^he sodium hydroxid wd
referred to powdered sulfur is should be prepared from metallic
added to this solution, ■>\ hich is sodium (that from other sources is
allowed to stand several days before frequently arsenical), and the nitrate
"se. and carbonate used should be free
from traces of chlorid.
EXAMINATION FOR MINERAL POISONS. 195
fused mass remains gray, the quantity of sodium nitrate is in-
sufRcient and more must be added. During this treatment
arsenic is converted into the soluble sodium arsenate, antimony
into the almost insoluble sodium pyroantimonate, and tin and
copper into insoluble oxids. The fused mass is then extracted
with warm water, carbon dioxid is bubbled through the solution,
an equal volume of alcohol is added, and the liquid is filtered if
not perfectly clear. The insoluble portion (I Va), collected on the
filter, is examined for antimony, tin, and copper in the manner
described iinder "Antimony." The solution (IVb) is evapo-
rated to dryness, and the cold residue is treated with sufficient con-
centrated sulfuric acid and gradually heated until dense white
fumes are given off. The cooled residue, diluted with water
and again cooled, is now ready for the application of the Marsh
test as described under "Arsenic."'
Returning now to the portion of the precipitate insoluble in
ammonium monosulfid (V) upon the weighed filter: this, with
the filter, is dried and weighed. The metallic poisons which may
be present are cadmium, bismuth, mercury, lead, and a portion
of the copper. They are treated with hot dilute nitric acid;
mercury, if present, remains undissolved as the black mercuric
sulfid, which is further examined as directed under "Mercury."
The others, if present, pass into solution. The solution is
filtered from precipitated sulfur, evaporated nearly to dryness,
and diluted with water. A small portion of the solution is
treated with dilute sulfuric acid; a white precipitate is produced
if lead be present. If lead be present, dilute sulfuric acid is
added to the whole of the solution, which is evaporated until
nitric fumes are given off, diluted with water, and filtered im-
mediately from the lead sulfate. The liquid, freed from lead,
is rendered alkaline with ammonium hydroxid; if bismuth be
present, it is precipitated, and is then separated by filtration.
In the presence of copper the filtrate is usually blue, but very
small quantities of copper should be tested for by acidulation
with acetic acid and addition of potassium ferrocyanid. Cad-
mium is detected by the formation of a yellow precipitate in the
solution, freed from coijper and acidulated with hydrochloric
acid, by hydrogen sulfid.
' Experiments made with sodium have thus far proved unsatisfactory
peroxid to efifect these separations in our hands.
196 TOXICOLOGY — WITTHATJS.
The metals not precipitated by hydrogen sulfid from acid
solution (VI) are rarely of forensic interest, but occasionally
zinc, aluminium, iron, chromium, or barium are to be sought
for. The filtrate and washings from the precipitate by hydro-
gen sulfid are concentrated by evaporation, treated with am-
monium hydroxid and ammonium sulfid, and set aside in a
well-corked flask. A more or less colored precipitate is pro-
duced, which may contain besides iron, aluminium, zinc, or
chromium (Via). This is collected on a filter, washed with
water, and examined as below. The filtrate (VIb) will contain
any barium which may have been present.
The precipitate (Via) is dissolved in a small quantity of
hydrochloric acid, diluted with water, the acid reaction nearly
but not quite neutralized with sodium carbonate, and the liquid
left in contact with finely divided barium carbonate for twenty-
four hours. The liquid (Vlaa), which will contain any zinc
present, is filtered off and examined for that metal as described
in the next division. The solid residue, which contains the
oxids of the other metals named, is treated with caustic soda
solution, boiled in a silver basin, and filtered. The filtrate
(Vlab) is examined for aluminium, and the residue' (Viae),
for iron or chromium if necessary.
The material left undissolved after the attack by hydro-
chloric acid and potassium chlorate (I) may still contain silver,
thallium, and lead.' The presence of the last will have been
detected, as above indicated, by the portion which has dissolved.
Thallium is best detected by spectroscopic examination of the
ash; and the method for the detection of silver will be discussed
in the next division.
PHYSIOLOGICAL EXAMINATION— LIFE TEST.
Observations of the effects of poisons upon lower organisms
and upon man may be made for three distinct purposes: 1st.
In the study of pharmacodynamics, with the object of determin-
ing the method of action of the drug or poison, and the nature
of its effects upon the tissues, fluids, and organs of the body.
2d. In the investigations of forensic toxicology, for the pur-
pose of identifying a poison by observation of effects which it is
' See also under Mercury, Analysis.
PHYSIOLOGICAL EXAMINATION LIFE TESTS. 197
known to produce upon living organs, tissues, or fluids. 3d.
In experimental toxicology, for the purpose of investigating such
questions as the rate of absorption and elimination, post-mortem
imbibition, etc.
Experimental observations of the effects of drugs and poi-
sons upon all forms of life, from bacteria to the human subject,
are very numerous and, combined with the observations of the
clinician, constitute in great part the foundation of modern ra-
tional therapeutics, notwithstanding the well-known fact that
a given drug or poison may, and frequently does, act differently
or with varying degrees of intensity upon different forms of
life. Consequently the conclusion can never be directly drawn
that effects observed in a lower form of life will be produced by
the same agent in man, whether taken in proportional dose or
in any other quantity. Very valuable indications of the prob-
able action on man have been, however, obtained by this means,
which should never be omitted as a preliminary to the use of a
newly discovered remedial agent upon the human subject.
Although the investigations of pharmacodynamics are nec-
essarily the antecedents which furnish those data upon which
life tests applied for forensic purposes depend, they do not come
strictly within the limits of a work of this character.'
The application of life tests to the purposes of forensic toxi-
cology is in its simplest form of great antiquity. Articles of
food supposed to contain poison were administered to dogs and
other animals to verify or disprove the suspicion," rulers fearing
poison caused their food and drink to be tasted by another be-
fore partaking of them themselves,^ and instances are recorded
in which suspected poisoners were tried and executed at the
same time by being compelled to take their own preparations.*
The use of physiological reactions in forensic toxicology for
the purpose of identifying a poison, although of the first impor-
tance in a few cases in which such tests afford distinct indica-
' For an extended account of the * Livius: "Hist.," viii., 18. An
methods of experimentation see instance is reported to have occurred
Robert: "Intoxikationen," 2teAufl. in Missouri in 1888, in which a
i., 149-284. Also Hermann: "Ex- negress was forced to drink coffee by
perimental Pharmacology," Phila., which she had poisoned a family
1883. with strychnin, and died in half an
°- See Introduction, p. 6. hour^ (New York Times, June 4th,
'Xenophon: "Cyropajdia," i., 3, "'
T. iii., p. 12, ed. Paris, 1842.
198 TOXICOLOGY WITTHAUS.
tions, is limited. The mineral poisons are separable and csr
pable of positive identification by chemical reactions, even when
present in much less quantity than that required to produce any
visible effects upon a hving organism. It is only to the identi-
fication of certain vegetable poisons, such as strychnin, atro-
pin, digitalis, aconite, and curare, which produce characteristic
symptoms in animals peculiarly sensitive to their action, that
life tests are at present applicable. If the materials under ex-
amination have undergone putrefaction, physiological tests are
only of value when corroborated by chemical reactions, as
ptomains capable of causing mydriasis, tetanic spasms, etc.,
have been found to exist. On the other hand, physiological re-
actions may aid in some cases in differentiating a putrid alkar
loid from one of vegetable origin similar in some other respects.
With some vegetable poisons, such as aconite, physiological
tests are more delicate and reliable than any chemical reactions
at present known.
In applying physiological tests it is essential that the sub-
stance examined shall be previously separated in as pure a form
as possible, and shall be in solution in an inert vehicle as nearly
neutral as may be. Consequently life tests can only be used in
searching for poisons in dead bodies, etc., after extraction by
the chemical methods above described.
Collateral evidence is also sometimes accidentally furnished
by animals, which is particularly valuable in cases of unsuccess-
ful attempts to poison. Thus in the case of Reg. v. Newton,
reported by Taylor,' the intended victim vomited in the back
yard, where some fowls were subsequently observed to be ill
and two died. Arsenic found in the crops of the chickens fur-
nished the only evidence of administration, as the person poi-
soned recovered, and the poisoner had thrown away the re-
mainder of the food supposed to have been poisoned, and had
cleaned out the vessel. In a somewhat similar case, reported
by Maschka,' a woman recovered slowly from poisoning by ar-
senic, of which five grains were found in her vomit and one and
a half grains in the body of a hen that was poisoned by eating
of it. Numerous similar cases are reported.
' "Poisons," 3d Am. ed., 167. " Gutacht. Prag. med. Fak., 1867,
iii., 269-271.
POST-MORTEM IMBIBITION OF POISONS. 199
POST-MORTEM IMBIBITION OF POISONS.
Poisons in a cadaver, whether introduced before or after
death, migrate by diffusion or imbibition from those situations
where they existed, either exclusively or in greatest abundance,
at or soon after death, tending toward a uniform impregnation
of all parts. Such uniformity is, however, probably never
reached, from lacli of time previous to desiccation and the
opposing action of gravity. The rapidity with which diffusion
proceeds and the approximation to uniformity are influenced by
various causes. If the poison have been taken during life and
death have not followed either with extreme rapidity or after
long survival, the poison exists in the cadaver in three conditions:
that in the alimentary canal, either unacted upon or only affected
by the digestive secretions; the "circulating" poison, that in
solution in the blood plasma or in lipoid solution in the blood,
which was in process of absorption or elimination, and that
which has entered into chemical combination with the nucleins
and other tissue constituents. According to their capacity to
form such combinations in the tissues poisons may be classified
into difficultly and easily movable poisons. The vegetable
poisons usually belong to the latter class, the mineral poisons to
the former. And for the same mineral poison the degree of
"fixation" during life is greater when it has been taken in
divided doses than with a single large dose, as is evidenced by the
longer continued elimination under the former conditions.
Time is necessary for the liberation of this combined poison and
its solution by the processes of decay, and aqueous solution is
necessary that diffusion may take place. Experiments with
phosphorus show that it does not migrate. The character of the
putrefactive processes varies also under different conditions.
Sometimes mummification begins early and proceeds rapidly
to desiccation, when diffusion is arrested; or the cadaver may be
in whole or in part converted into adipocere, in which no move-
ment is possible. Under other conditions of the cadaver at
death, or of the circumstances of burial, exposure, temperature,
etc., afterward, a colliquative or moist putrefaction takes place,
which is most favorable to diffusion. The action of gravity is
also operative, as well as that of diffusion, and the tendency of
movement is downward, therefore, after long burial, the lowest
200 TOXICOLOGY WITTHAUS.
lying parts of the cadaver and the materials below it offer the
best objects of analysis. During moist putrefaction the cadaver
exudes a putrescent liquid which collects at the bottom of the
coffin, and into which a notable proportion of the poison passes.
This process becomes one of actual leaching out in cemeteries in
which the surface-water may penetrate the graves. The
quantity of liquid so accumulated may be sufficient to completely
immerse the body. After long burial very little poison may
remain in the cadaver, while it may be found in determinable
quantity in the materials upon which it rests and even in the
earth below, while that above is poison-free. Not only may
poisons pass out of the body in this manner, but they may also
pass into it, and in several cases poisonous pigments have been
thus acquired from artificial flowers, etc.^ The distribution of
the poison in the body, whether ante- or post-mortem in origin,
therefore suffers disturbance after death, by processes which are
entirely different from those which bring about variation in dis-
tribution during life and whose method varies with the condi-
tions. The phenomena of post-mortem migration bear directly
upon the possibility of answering two important forensic ques-
tions: 1. Can the toxicological expert distinguish between ante-
and post-mortem poison from the distribution of the poison found
in the cadaver alone? and, 2. How long after death does a
poison remain detectable in a cadaver? The discussion of the
first question has been chiefly with regard to arsenic, and it will
be considered in the division of special toxicology under that
head.^ The second question will require a different answer with
regard to the several poisons, according as they are more or less
acted upon by putrefactive processes. As a rule, mineral poisons
are less affected than those of organic origin, but even with
arsenic there is loss of a small proportion by the formation of
volatile products.' Physical removal by "leaching" rarely, if
ever, proceeds to completion. Under usual conditions of dry
burial coUiquative putrefaction, if it occur, finally gives place to
desiccation, and when this condition is established and main-
tained there is no reason why arsenic or mercury may not be
detected in the bones and muscles of an Egyptian mummy if
the individual had been poisoned thereby.*
' See p. 569. ^y. Engelin: Ann. Soc. m^d.-Wg.
= See pp. 221, 52!l ct scq., 557 et de Belg., 1908, xix., 206.
seq. "See also: Haberda and Wach-
FORENSIC QUESTIONS. 201
FORENSIC QUESTIONS.
1 . Was the death or disorder caused by poison? This, one of
the three fundamental questions to be passed upon by the jury in
cases of alleged homicide or injury by poison, is the main one to be
answered by expert evidence, and to it all others are subsidiary.
Leaving out of consideration the moral evidence, which does
not concern the expert, the proof of poisoning is complete when
the symptoms known to be caused by the poison have been ob-
served during life; when the post-mortem examination shows
the presence of such lesions as it is capable of producing, and
the absence of other causes of death; and when the toxic agent
is' demonstrated to be present in the cadaver or in the vomit or
dejecta of the person poisoned.
And even when other causes of death exist they do not of
necessity negative the theory of poisoning. If poison be shown
to be present in the cadaver or to have been administered and
marks of violence or evidence of disease sufficient to cause death
be found at the autopsy, it clearty remains to be determined
which of the two or more causes of death known to have ex-
isted was the one finally operative; and it is equally incontest-
able that the existence of any possible cause of death cannot be
invoked as conclusive proof that no other could have existed.^
In such cases it is frequently most difficult to determine which
was the preponderating or final cause of death. Did Mary
Stannard die of the arsenic found in her stomach and tissues
or in consequence of having her he.ad crushed with a stone? Was
Jennie Cramer's death due to the arsenic found in her cadaver
or was she drowned in the water from which it was taken?
Was the finally operative cause of Fisk's death a gunshot wound
or an overdose of morphin? These were vital questions to be
determined in each case to the best of their ability by the jury
in the light of the expert evidence offered.
Indeed, an anatomical lesion which is in itself sufficient ex-
planation of the method of death may have been produced by
holz: Ztschr. f. Med.-Beamte, 1893, » This apparently self-evident
vi., 393; Montalti: cited by Modioa; proposition is stated because we
Modica: Rif. med., 1898-9, xiv., pt. iiave known experts to invoke the
ii., 843, 855; De Domenicis: Giorn. existence of mechanical causes of
di med.-leg., Pavia, 1903, x., 180; death as proof that the results of the
Kratter: Vrtljschr. f. ger. Med., chemical analysis must have been
1907, 3 F., xxxiii., Suph., 119. fallacious.
202 TOXICOLOGY — WITTHAUS.
poison as a cause at least concomitant, as in the case of a man
who fell dead while retching violently — a large clot was found
on the brain and oxalic acid in the stomach. The apoplexy of
which the man died was provoked by the effects of the oxalic
acid taken.'
A discussion of the relative force of the three factors of the
proof would be idle, as no one of them, when taken alone and
unsupported by other evidence, can demonstrate conclusively
that poison was the cause of death. It is quite conceivable,
however, that collateral evidence of fact may exist sufficient to
enable the jury to find that the deceased died from the action of
poison when but one of the factors of expert proof can be ad-
duced. Thus in a case tried in Vermont in 1883 two defendants
were convicted* of murder in the first degree upon moral evi-
dence, supported only by the detection of strychnin in the
cadaver,^ without any history of symptoms or the existence df
characteristic lesions. In such cases, however, the expert
should not be asked to express an opinion as to the cause of
death, as the evidence is insufficient for the formation of a
purely expert opinion, and such medical or chemical evidence as
may be procurable should be simplj' submitted to the jury to
be by them weighed along with the moral evidence.
On the other hand, instances are numerous in which a posi-
tive expert opinion can be formed in the absence of one of the
three factors. The symptomatology and lesions produced by
the mineral acids and alkalies are sufficiently characteristic to
indicate the cause of death without any chemical analysis be-
yond the mere determination of the reaction. The recognition
' Lancet, 1863, i., 47. The defendants were jointly indicted
- State V. Emeline and Almon and the son pleaded guilty to murder
Meeker. This case, exceptional in in the first degree to prevent the in-
many respects, has not been report- troduction of his confession upon
ed. The mother and son were con- the trial. The mother was executed,
victed of poisoning a twelve-year- the son's sentence commuted to life
old girl, the half-sister of the imprisonment. No motive for the
former's husband, by strychnin, crime was suggested by the prosecu-
administered to the ' child while tion during the trial. In A'ew York
driving in a buggy during the night. the motions of the defendants for
The purchase of strychnin and the separate trials would have been
hiring of the buggy by the son were granted as a matter of right, (§ 391,
proved. The child's body was Code Crim.. Proc.) ; and Almon
buried in a swamp. After some Meeker could not have been con-
days the sheriff extorted a confession victed upon his confession alone
from the son, with whom he went to (§ 395).
the swamp and recovered the body.
FORENSIC QUESTIONS. 203
of death by hydrocyanic acid may be reached, partly by exclu-
sion, from the absence of all other causes of sudden death, and
the presence of the poison in the cadaver, even when the body
has been found dead and no symptoms were observed during
life. Many poisons, such as strychnin, leave no physical evi-
dence of their action, and in cases of poisoning by them the
evidence from the autopsy is of negative value only, in exclud-
ing other possible causes of death. And in this connection also
it must not be forgotten that persons in middle age are very
rarely perfectly normal, and that a person suffering from even
serious disease may die of poison.
When the absence of any portion of the facts upon which an
expert opinion of the cause of death might be based is due to
accidental failure, as when a person is found dead or when the
body has been cremated, the failure to present such evidence on
the part of the state should not count for or against the theory
of poisoning. When it is due to interference with the cadaver,
as when the body has been eviscerated and the organs made
away with, or the body has been clandestinely burnt before a
post-mortem could.be made, the detection of poison in the un-
embalmed fragments that may remain is strongly indicative of
criminal poisoning.* But if the circumstances be such that the
lacking evidence should have been obtained if poisoning was
the cause of death, as when a person dies within a short time
and with the symptoms of strychnin poisoning, and a properly
conducted analysis, made shortly after death, fails to show
the presence of the poison, the theory of death from that partic-
ular poison becomes much more difficult of proof, if it be tenable
at all.
It is hardly necessary to state that in the framing of the hy-
pothetical question terminating in " What in your opinion was
the cause of death," which is usually put to medical expert
witnesses, the results of the autopsy, of the pathological exami-
nation, and of the chemical analysis should be included along
with the history of the symptoms.
In non-fatal cases a positive diagnosis can only be reached
by the observation of the symptoms and the proof of the pres-
ence of the poison in the excreta, vomit, or substances known to
■ See the Shann case, previously Pel case, under Arsenic p. 427.
referred to (p. 139, note), and the
204 TOXICOLOGY WITTHAUS.
have been taken or administered. An adequate cause for the
effects observed must be affirmatively proved to exist, either by
lay or by expert evidence.
2. Could the poisoning have been simulated? Every
toxicologist has been annoyed by persons having a fixed delu-
sion that they are in danger of being poisoned. These persons
can hardly be said to simulate poisoning, not only because the
delusion is honestly entertained, but because, although they sub-
mit various articles of food or drink for analysis, and describe
real or fancied symptoms, the analysis always leads to negative
results, and the symiDtoms differ more or less widely from those
of poisoning.
The symptomatology of poisoning very frequently closely re-
sembles that of some so-called natural disease so closely that a
differential diagnosis from the symptoms alone is difficult or
impossible. These resemblances very frequently give rise to
groundless suspicion of poisoning, which, if the person die, may
either be immediately disproved by the discovery at the autopsy
of some lesion adequate to cause the effects observed during life,
or add to the list of "deaths from unknown causes," if neither
lesion nor poison be found.
The possibility of the introduction of poison into a cadaver
for the purpose of supporting a false accusation of criminal poi-
soning was recognized by Orfila as early as 1815.^ Although
the physical possibility of the commission of such a crime can-
not be denied, we know of no instance in which it has been al-
leged in accusation. In some cases a poison has been introduced
into a cadaver to conceal a murder by other means. ^ The non-
criminal post-mortem introduction of poison is of frequent oc-
currence and will be discussed below. ^ The resemblance of the
symptoms of poisoning to those of disease has been taken ad-
vantage of by poisoners to destroy their victims, with less prob-
abihty of detection, during the prevalence of an epidemic.
Several such cases are referred to under Arsenic, and Robert* cites
an instance in which a man was poisoned by tartar emetic during
'"Traits des poisons," Paris, 'See Question 12 and Arsenic,
1814-15, II., ii., 293. " Tr. d. tox.," pp. 557 et seq.
5§me ed.. Pans, 1852, i., 61. * " Intoxikationen," 2teAufl.,i.,
^ Siemens: Ztschr. f. Med.-Beamte 122.
1891, iv., 193. See also cases cited
on p. 1120.
FORENSIC QUESTIONS. 205
an epidemic of cholera, the poisoner thinking that the death
would be attributed to the prevailing disease.
Cases of deliberate false accusations of attempted poisoning,
made by persons still living, have also occurred; and it is quite
conceivable that poison may be mixed with articles of food,
medicine, urine, or even with vomited matters in support of the
charge. Or an innocent person may be placed in serious jeop-
ardy by the suicidal or accidental poisoning of relative, employer,
etc., affected during life with the delusion of poisoning. An in-
stance of this kind, in which the suspected person only escaped
punishment in consequence of the expression by the medical
experts of the opinion that arsenic cannot remain in the body
for eight days without manifesting any of its usual effects and
then cause death, is reported by Boutigny:' A woman accused
her husband of attempting to poison her, and coarsely powdered
arsenic was found in a dish of food alleged by her to have been
prepared by her husband, who was then imprisoned. The
woman at that time and for eight days after was perfectly well.
She then had an attack of mania and died on the ninth day
after the alleged administration by the husband, who had re-
mained in prison. Arsenic in large quantity was found in the
stomach and intestines.
3. Can a poisoning have occurred and the poison either
be or have become undetectable? This question must receive
an affirmative reply as to its first part for many poisons, and as
to its second part for all. There are many vegetable poisons
which leave no characteristic lesions, and whose chemical
reactions and action upon animals, so far as known, are not
sufficiently well-marked to permit of their identification, even
when they are separated in the minute quantities in which
they may remain in the body after death from their action.
And particularly when the body has undergone putrefaction,
even in its earlier stages, their distinction from putrid alkaloids,
which may have been formed is, in the present condition of our
knowledge, impossible. Indeed, the number of alkaloidal poi-
sons which can be distinguished from putrid products by physio-
logical and chemical tests is quite small. ^
' Ann. d'hyg., etc., 1836, xvi., 130; Buchner: Friedreich's Bl. f.
391. See also: p. 12, and Kratter: gar. Med., 1887, xxxviii., 130.
Arch. f. kr. Anthrop., 1903, xiii., = See in this connection Ptoma-
ins, Morphin, Strychnin, Atropin.
206 TOXICOLOGY — WITTHAUS.
And even poisons having distinctive chemical characters
which ordinarily permit of their identification with certainty,
may become undetectable from several causes. The person may
die from secondary effects long after the first action has disap-
peared, as in corrosion by the mineral acids; or life may be pro-
longed for a sufficient length of time to permit the complete
elimination of the poison and death still result from its action,
by exhaustion or by a continuation of morbid processes which it
established. This has been known to occur even with a poison
usually so prompt in its action and of such certainty of detec-
tion as arsenic'
Poisons are removed from the stomach and intestines by
vomiting, purging, and absorption, as well as by washing out
the stomach, if that method of treatment be resorted to; andit
is quite conceivable that even an easily recognizable poison may
have been thus entirely removed from these parts while it still
remains in detectable quantities in the tissues into which it has
passed by absorption and from which it is subsequently removed
by elimination if life continue. The period of time required
for absorption, elimination, etc., is different for different poi-
sons, and varies with each according to the conditions under
which it acts. This subject will be more particularly discussed
in treating of the poisons individually. The possibility of
washing out the stomach after death must also be recognized,
although the probability of its suggesting itself to any other
than a medical poisoner is remote. The operation would of
course leave no traces except the presence, possibly, of an undue
quantity of water, and the absence of all remains of food in the
stomach, which would also tend to aid a simulation of death
from drowning. Of course, poisons such as arsenic would re-
main in the tissue of the organ. "^
When a chemical antidote has been administered during
life, the poison or corrosive M'ill be found in that form of combi-
nation produced liy the reaction, possibly accompanied by ex-
cess of the antidote. Thus the contents of the stomach may be
' See Arsenic — Elimination, pp. is alleged to have occurred in
546 seq. ^ Wisconsin in 1885. Arsenic «
^ An instance in which the stomach found in the tissue {'Sew York
was opened and sponged out in ^ Times, January 9th, 1886).
the interval between two autopsies
FORENSIC QUESTIONS. 207
neutral or even alkaline when acids have been taken and alka-
lies administered.
Poison remaining in the body at death, if it be organic in
nature, or volatile, or oxidizable, may either disappear or be
converted into other products. Thus prussic acid in contact
with the ammonia and hydrogen sulfid produced during putre-
faction may be converted into ammonium thiocyanate, a nor-
mal constituent, in small amount, of the saliva. Prussic acid
and chloroform, even when present in sufficient quantity to be
recognizable by their characteristic odors at the autopsy, are
rapidly dissipated by volatilization if the materials be left ex-
posed to the air. Phosphorus is gradually oxidized, and is
finally converted into phosphates, not distinguishable from those
normally present in the body. Glucosidal poisons are rapidly
decomposed by the bacteria of putrefaction.^
4. What poison produced the injury or death? As
we have said above, the occurrence of symptoms which may be
produced by a certain poison and the satisfactory demonstration
of the fact that the kind of poison capable of producing such
effects was taken by, or administered to, the injured person con-
stitute, in the absence of other causes capable of producing such
results, sufficient evidence that the agent shown to have been
present was the cause of the effects observed. Yet a pernicious
impression exists in the popular mind, and to some extent among
toxicologists, that the poison must be actually isolated and pro-
duced in substance upon the trial. The poison so separated
from the cadaver is even falsely designated as the corpus delicti,
a term which applies to the crime and not to the material agent. ^
A shooting may be satisfactorily proved without the production
upon the trial of either the pistol or the bullet, and a stabbing
without the exhibition to the jury of the cutting instrument with
which the wound was inflicted. Why in a case of poisoning
should the exceptional demand for the actual isolation and pro-
' Prurievitsch: Chem. Ctbl., 1899, crime, and is divided into two
i., 702. component parts, the first of which
' "The corpus delicti in homicide is the death of the person, and the
has two components, namely, death second is that the death was pro-
as the result and the criminal agency duced through criminal agency."
of another as the cause." Peo. v. 160 N. Y., 425, 14 N. Y. Cr., 207.
Bennett, 49 N. Y., 137. In Peo. v. And in Peo. v. Patrick (1905), 1S2
Benham (1899) the Court said: "The N. Y., 140, Gray,, J., defined the
corpus delicti, in a case of murder or term similarly,
manslaughter, means the body of a
208 TOXICOLOGY — WITTHAUS.
duction of the material agent which caused the injury be insisted
upon? That such material proof is desirable, if it can be ob-
tained, is unquestionably true in the one case as it is in the other,
but it is frequently much more difficult to obtain in poisoning
than in homicide by mechanical means, or is not obtainable.
Indeed, it is most exceptional that the poison is recoverable
in the identical form in which it was administered. Phos-
phorus may be separated as such in some cases, and preserved
by sealing in a glass tube, and arsenic trioxid may occasionally
be found in its solid crystalHne form in the stomach; but the
demonstration of the presence of the lower oxids of phosphorus
constitutes quite as satisfactory a factor in the proof of phos-
phorus poisoning as does the isolation of the element itself, and
in the great majority of cases of arsenical poisoning arsenic is
separated in the elementary form, and not as the trioxid or as
Paris green. In a case of tartar emetic poisoning we have
known the defense to lay great stress upon the fact that, of the
carbon, hydrogen, oxygen, potassium, and antimony of which
that poison consists, only the antimony was demonstrated to be
present by the analysis; yet, in view of the further facts of the
purchase of tartar emetic by the defendants and the manifesta-
tion of the symptoms of antimonial poisoning by the deceased,
the jury very properly convicted.^ Similarly, in a case of mor-
phin poisoning in which the defendant was convicted, experts
for the defense maintained that proof of the presence of the alka-
loid was unsatisfactory because it had not been "isolated" in a
state of purity, although its characteristic reactions had been
observed.^ Yet every chemist knows that, in his processes of
analysis, both qualitative and quantitative, it is only excep-
tionally that he "isolates" the elements or compounds whose
presence and quantity he may determine with accuracy.^
The knowledge of the particular form of combination in
which the poison was taken is frequently valuable as bearing
upon collateral points, but is rarely obtainable. Thus if arsenic
be proved to be present as Paris green, either by its separation
in substance or by the presence of copper and arsenic in the
proper proportions, the theory of criminal administration in a
' State V. Fournier and Cox, Chit- = Peo. v. Buchanan, Gen. Sessions,
tenden Co. Crt., Vt., 1894. X. Y., 1893.
= See p. 1-19.
FORENSIC QUESTIONS. 209
colorless liquid is weakened and that of suicide is strengthened
thereby.
5. Was the substance found by the chemist really the
poison? This question may be of importance in two ways:
Either the methods of the analyst may be claimed to be de-
fective or his conclusions unwarranted, or the substance demon-
strated to be present may have found its way into the body by
some means other than by administration in poisonous dose.
The former claim can be successfully advanced by the defense
only when the analyst has been culpably ignorant or negligent, or
worse. The Wharton trial in Maryla,nd in 1872 is an instance
in which the acquittal of the accused was probably due in part
to this cause. The analysis of the stomach was so unsatisfac-
torily performed that the prosecution found a second exhumation
and analysis of other parts to become necessary during the trial,
which was adjourned from Friday noon to Tuesday noon to
allow time for the supplementary analysis. In the case of Peo.
V. Fleming, tried in New York county in 1896, the defense con-
sisted entirely in demonstration of the impossibility of the state-
ments made by one of the two analysts for the people, and proof
that all articles examined by the second had previously been in
the custody of the other. The defendant was acquitted.
In all trials for poisoning by the vegetable alkaloids at the
present time, the defense advances the claim that the reactions
observed were produced by ptomains and not by the vegetable
alkaloid alleged to have caused the death. (See Ptomains, Mor-
phin. Strychnin.)
When the poison, whether mineral or organic, is found only
in minute quantities, the question of its origin may be very
properly raised. It may possibly have been administered med-
icinally, or may have found entrance to the living body as an im-
purity in some medicine or article of food, as arsenic in bismuth
subnitrate, or copper in canned vegetables, or as a constituent
of natural articles of diet, as oxalic acid in rhubarb, or as the
result of addiction to a drug habit, as morphin, chloral, etc.; or
it may have been imbibed by the cadaver, as arsenic from arti-
ficial flowers or from neighboring embalmed bodies in a water-
soaked cemetery. Even when the poison is present in large
amount, "the possibility of post-mortem introduction and, in
some cases, of habituation must be considered. The question
IV.— 14
210 TOXICOLOGY WITTHAUS.
whether the doubt so raised is "reasonable" is for the jury to
determine in the light of such expert evidence bearing upon the
matter as the circumstances of the case permit of.
6. Could the substance administered have caused death?
When the identity of the substance is proven or conceded, the
question whether it is a poison or noxious thing may arise.
(See Definition.) A substance may be administered with intent
to kill, and yet, from its nature or form of administration, be
incapable of causing death. Thus Tardieu' cites the case of a
woman who tried to poison her husband with pure copper
filings; and another of a man who sought to kill his wife by sul-
furic acid administered in wine, in which the mineral acid was
neutralized by the potassium tartrate.
The clinical history of the case may also demonstrate that
the substance administered, although capable of causing death,
could not have done so in the particular case at bar, either be-
cause the time between the administration and the death was
such that no relation of cause and effect could exist, or because
the symptoms observed were not those which the substance ad-
ministered could have produced, or because the patient recovered
from the effects of the poison, to die subsequently of some dis-
ease with which he was at the time afflicted or which intervened.
The question may also be raised on the part of the defense
in cases of mechanical injury capable of causing death, fol-
lowed by improper medical treatment. Thus in the case of
Peo. V. Stokes, a compromise verdict was reached upon the
second trial, in consequence of a grave doubt whether the vic-
tim, risk, died from the effects of a gunshot wound or from
those of morphin administered in excessive doses.-
7. Is a poisonous substance, given in minute quantity, a
poison? This question can only arise in cases in which the
quantity administered is known to be small. It does not apply
when the quantity of the dose is unknown and only minute
quantities have been separated In- analysis (see Question 8).
When the poison or corrosive has been given in such minute
quantity or extreme dilution that it is incapable of causing in-
juiy, it certainly does not come within the medical definition of
poison or corrosive. Whether its administration in such quantity
' "Empoisonnement," 2^me ed., =Peugnet: Papers Med.-Leg.
P- 123. Soc, X. Y., 1S82, 2 s., 294.
FORENSIC QUESTIONS. 211
01' form with criminal intent is punishable is a legal question,
and one which does not concern the expert except in so far as he
may be called upon to fix the limit of quantity or dilution below
which tlie substance will be incapable of causing deleterious
effects.'
8. Was the poison taken in a dose suflficient to cause death?
This is a question a definite answer to which would be highly
desirable were it possible. It is only rarely that it can be an-
swered positively in the affirmative; and the analyst is not war-
ranted in giving a negative answer, if the presence of poison has
been demonstrated.
The answer is necessarily based upon two data: (1st) The
quantity of the poison in question which is capable of causing
death, and (2d) the amount which was taken by the deceased.
The first would be a fixed factor were it Ijnown; the second, one to
be determined in each case if possible. The first has not been
determined within narrow limits, capable of numerical expres-
sion, even in the case of arsenic,^ and varies with the circum-
stances of the case and the nature of the poison. The second can
never be determined by analysis of the cadaver. The quantity
present in certain organs may be ascertained with more or less
accuracy by analysis, but from the results of such determination
only one inference can be drawn, i.e., that the quantity tal^en
was greater than the amount found. How much greater it may
have been may be guessed at, but not determined. The absolute
amount present in the cadaver when it is analyzed could only be
ascertained by one of three methods: 1st. By extracting all of
the poison from the entire body. 2d. By extracting all from a
properly equalized and weighed sample talcen from a mass
obtained by reducing the entire weighed body to a uniform and
homogeneous pulp. 3d. By a similar process as that last
mentioned, except that each organ, the different regions of the
muscular system and included soft parts, and of the skeleton are
treated separately. The first procedute is not possible; the
second is neither possible nor desirable; the third is possible with
mineral poisons, but would involve the entire destruction of the
body and an expenditure of time warrantable only in very ex-
' Two cases in point are cited in ^ See Arsenic — Lethal Dose, p.
Casper-Liman: "Handb. d. ger. 434.
Med.," 8te AuO., ii., 362-367.
212 TOXICOLOGY WITTHAUS.
ceptional cases. With organic poisons the quantity separated
is always a fraction of that actually present, as the methods
available never effect complete extraction. What the magni-
tude of the fraction may be is not calculable. The quantity of
poison separated from the body by the methods at present
followed is therefore only a fraction, more or less large, of that
which exists in the body when it is analyzed, and a still smaller
fraction of that which was swallowed.
In attenipting to calculate the total quantity in the cadaver,
it is never permissible to assume that the amount separated
from a certain fractional part of the body bears the same rela-
tion to the entire amount present that the weight of the fraction
examined bears to that of the body. The distribution of the
poison in the different organs and tissues is uneven under all
circumstances, and the quantity in one part is no indication of
that in any other, except in so far as it is known that certain or-
gans retain a greater quantity than others. And even when
the quantity in a given organ is calculated from the amount
found in a known fraction of that organ, the calculation is only
reliable if the sample is a fair representative of the whole, taken
from the finely divided and thoroughly mixed whole. It is not
safe to assume, for instance, that because a given quantity of
arsenic is found in one lateral half of the brain the entire organ
contains twice that amount. The entire brain should be hashed,
thoroughly mixed, weighed, and a weighed fraction taken for
analysis.
But if the entire quantity present in the cadaver at death
could be separated and weighed, the result so obtained would
have no greater significance. It would simply show that at
least that quantity had been taken, and in all probability more.
How much more will again depend upon the circumstances of
the case and the nature of the poison. How much was expelled
by vomiting and purging? how much was removed by absorp-
tion and ehmination, OY by medical treatment? how much was
transformed by chemical reactions into other compounds? AH
these are questions which must be solved before the main ques-
tion could be answered.
Yet the determination of the quantity of poison in the or-
gans and parts analyzed should be made if possible, and with
the greatest attainable accuracy. The amount thus actually
FORENSIC QUESTIONS. 213
separated may be greater than that which has been known in
accurately observed cases to have been the only cause of death,
in which event, clearly, presuming the poison to have been in
the body during life, the question under discussion may be an-
swered in the affirmative. Or the quantity found may be such
that, although not in itself poisonous, it is sufficient to negative
the theory that the poison was legitimately administered in
medicinal doses, particularly if allowance be made for expulsion
and elimination known to have occurred during life.
In some cases, the statement that a lethal dose was certainly
taken may be warranted, although less than that quantity has
been separated from the cadaver, the conclusion being based
upon known facts of distribution and elimination and minimum
lethal dose for the poison in question. Thus, in a case in which
no mercury was found in the stomach or intestines, but quantities
corresponding to 1.59 grains and 0.44 grains were found in the
kidneys and liver, respectively, it could be concluded with cer-
tainty that a lethal dose had been taken, and had not been taken
recently.
When the quantity of poison separable from the body is
small, all that can be argued from this fact is its mere presence.
The question of its origin must be determined, if it be determin-
able, from the clinical history and from other elements of the
case. But, assuming that the analysis has been properly per-
formed and that the reagents used were pure, the fact of the
presence of the poison in the cadaver must be accepted as proven,
even when the amount must be designated as an unweighable
trace. The reactions by which many of the poisons may be
identified with certainty are of extreme delicacy, and are ca-
pable of certainly detecting the presence of amounts so small as
to be unweighable by the most delicate balance. Thus 0.00001
gm. is practically an unweighable quantity, yet that amount of
strychnin is sufficient to give the color and physiological tests
and the bitter taste of the alkaloid.
In some cases an indication of the amount taken may be ob-
tained from a quantitative analysis of vomited matters, or of
the remains of articles of food or of medicine known to have
been taken or administered.
9. Was the poisoning suicidal, accidental, or homicidal?
Apart from the examination into the mental condition of the
214 TOXICOLOGY WITTHAUS.
deceased or of the accused, the physician as well as the chemist
may sometimes offer expert evidence which will aid in the de-
termination of this important question.
The physical characters of the poison itself or the quantity
in which it is found to be present may raise a presumption in
favor of suicide, or for or against the theory of the prosecution
or of the defense. Presumably a poison which has a marked
color, such as Paris green, or a strong taste, such as strychnin,
would not be unwittingly swallowed by an adult in the full pos-
session of his faculties. This is, however, only a presumption,
and numerous cases of unquestionably homicidal poisoning by
both of these agents have occurred. Moreover, the color and
the taste may be effectually concealed, the former by mixing
with some green vegetable, the latter by enclosing the poison in
a capsule administered to the victim as medicine.'
The finding of a large quantity of arsenic in the stomach
was invoked in the case of Madeleine Smith in support of the
theory of suicide, on the ground that such a quantity could not
be administered without the knowledge of the deceased.^ The
degree of solubility of a poison is frequently a question of inter-
est as bearing upon the form of administration and, indirectly,
upon the question of responsibility.
The theory of accidental poisoning may also be in some eases
set aside by chemical evidence. Thus, in the case of Carlyle
Harris, the defense sought to show that the death might have
been caused accidentally by an error of the druggist in dis-
pensing morphin in place of quinin, although the defendant
had himself supplied the proof that no such mistake had been
made by reserving one of the capsules which, on analysis, was
found to contain the proportions of quinin and morphin called
for by the defendant's prescription.
The method of action of the poison may in some cases throw
light upon this question. Thus, in the case of Jean Humphreys,
referred to by Taylor,^ the theory of suicide was negatived by
the facts that the deceased, who died from the effects of sulfuric
acid, could not voluntarily have swallowed the acid unobserved
during a period of more than twenty minutes before its action
' These capsules are readily open- administered in capsules in homi-
ed, and substitution of poison for cidal cases,
their legitimate contents is easy. - See Arsenic — Solubility, 402.
Aconitin and morphin have been ' "Poisons," 3d Am. ed., p. 85.
FORENSIC QUESTIONS. 215
began, and that sulfuric acid produces the symptoms of corro-
sion immediately.
The presence of the poison in the clothing or in other arti-
cles in the possession of the defendant may also serve as a part
of the proof of administration; thus, in the case just cited, the
night dress of the defendant was stained by sulfuric acid; and
in the Maybrick case arsenic was found in a handkerchief, the
pocket of a dressing gown, and several other articles in the pos-
session of the defendant.
In drawing conclusions from such facts, however, they
should be carefully weighed, and the possibility of their expla-
nation in favor of the defendant fully recognized. Maschka^
reports a case in which the unwarrantable conclusion that sul-
furic acid, from the effects of which a man had died, must have
been administered by another because the deceased had a knowl-
edge of its action, because the burns produced by the acid were
less marked at the lips than in the deeper parts of the mouth,
and because no physician was called during the illness of the
deceased. The first and last reasons do not concern the medical
expert, and the second is insufficient.
The possibility of auto-intoxication or food poisoning must
be held in mind. Auto-intoxications, due to the retention of
poisons produced in the system, are, for the most part, accom-
panied by characteristic post-mortem lesions, such as the struc-
tural changes in the kidneys, which are present in so-called
ursemic poisoning by urinary leucomains. Food poisonings,
caused by eating food which has suffered decomposition result-
ing in the formation of poisonous products, are rarely fatal and
rarely single; usually several persons eat of the same substance
and suffer similar symptoms. An examination of the remains
of the food may show tlie presence of putrid poisons.
10. Could the substance found have been administered as a
medicine? In general terms, irrespective of quantity, and as a
mere question of possibility, this question must be answered in
the affirmative, whatever be the kind of poison used. Of the
poisons known to our predecessors, all have been at some time
used as medicines, and hardly is the poisonous character of a
newly-discovered compound recognized, before its use as a
medicine is suggested. And even quantity, when not excess-
' Viertljschr. f. ger. Med., 1881, n. F., xxxiv., 197.
216 TOXICOLOGY — WITTHAUS.
ive, does not permit an absolute negative, as medical literature
is full of instances of the administration of medicines in heroic
doses, which, it must be confessed, have in many instances
caused the death of the patient; and this entirely irrespective
of those cases of so-called accidental poisoning due to criminal
negligence on the part of the prescriber or dispenser of medi-
cines, or of both — unfortunately of much more frequent occur-
rence than they should be — in which either a much larger dose
than was intended in the mind of the physician is given or in
which an actively poisonous drug is substituted for one of
greatly inferior toxic power by "mistake."
So far as the administration of medicines by the attending
physician is concerned, it therefore behooves the prosecution to
show affirmatively, by the evidence of the physician and copies
of his prescriptions, what drugs he actually did prescribe or
order, and by the druggist that the prescriptions were properly
compounded. Without such evidence the question must remain
a doubt, the reasonableness of which it remains for the jury to
determine from all of the evidence; unless, indeed, the quantity
found is so large that it could not have been medicinally given,
or unless proof of some other method of administration is avail-
able, as, for instance, the existence of the same kind of poison
in the remains of an article of food.
It may also be claimed that the poison found, if present in
small quantity, was introduced as an impuritj- in a medicine
legitimately administered, as arsenic in bismuth subnitrate.
A case in which an incomplete analysis permitted the possi-
bility of the presence of arsenic in bismuth subnitrate, admin-
istered to the deceased, to be considered by the court as an abso-
lute bar to a conviction, is reported by Rogers.' Arsenic was
found in the stomach (which was nearly empty) and the intes-
tines in "very decided amount." The liver was not sent for
analysis. During the trial it was shown that bismuth subni-
trate was among the medicines administered during the illness
of the deceased. Ten samples of bismuth subnitrate (not in-
cluding a specimen of that administered) were examined and
eight were found to contain arsenic in quantities not deter-
mined. Upon this condition of facts the trial was cut short
and the defendant discharged, it being held that, in the ab-
' Tr. Coll. Phys., Phila., 1857, n. s., iii., 197.
FORENSIC QUESTIONS. 217
sence of any proof of the absolute amount of arsenic adequate to
destroy life, the mere fact of the discovery of a poisonous adul-
teration of the medicine administered was sufficient to invali-
date the evidence against the prisoner and to justify her imme-
diate discharge. Purchase of arsenic by the accused had been
proved; and it was not shown, nor was it probable, that even if
the subnitrate had been impure, it contained enough arsenic to
cause the vomiting and purging proved to have occurred, much
less a fatal result.
If this extreme view be accepted as correct, it must be ad-
mitted that evidence of the fact that bismuth subnitrate had
been administered in a case of alleged arsenical poisoning
would be adequate ground for the discharge of the jury, what-
ever the quantity of arsenic found. Yet in this case, had the
livei' and other organs been examined and the quantity of ar-
senic determined, it seems probable, from the presence of a
"very decided amount" in the stomach and intestine after the
patient had vomited and purged copiously for several days, that
a distinctly weighable quantity of arsenic would have been
found. If this were more than would have been contained in
all of the bismuth called for by the prescriptions, even if the
drug were in its most impure form, it seems to us clear that
the case would have in nowise differed from one in whii'h only
that quantity of arsenic would have been found which would be
represented by the excess found in this case over that accounted
for as possibly attributable to the bismuth. And if the propor-
tion of arsenic in a sample of the identical drug administered had
been determined (as it might have been had such sample been
available and it actually did contain arsenic), the excess of
arsenic found, if there were such, over that which could by any
possibility have been given with the bismuth, could have been
definitely stated. Yet even under these circumstances it would
seem that under this ruling the prisoner would have been dis-
charged. And as a logical consequence no conviction for arsenical
poisoning could be had or the case even submitted to the jury,
unless more than fifteen grains of arsenic were actually separated
from the cadaver, and the patient had taken no bismuth — condi-
tions which have obtained in only a very few of the large number
of known arsenical poisonings.
On the other hand, if the quantity of arsenic found after
218 TOXICOLOGY WITTHAUS.
death be a mere trace, or less than that which might have been
present in bismuth or other drug or mineral containing arsenic,
the case must be considered as one in which no poison was found,
and should be decided by the jury upon other evidence, including
that showing the administration of drugs containing the poison.
It may also be claimed that the poison found, particularly if
in small amount, was taken as a medicine without the prescrip-
tion of a physician, either by the refilling of an old prescription'
or as a patent or proprietary medicine, by the deceased him-
self or administered without criminal intent by another. Thus,
'in the Maybrick case, it was claimed that the deceased was
in the habit of dosing himself with arsenic. Deaths of chil-
dren from the effects of morphin in "soothing syrups" are
of frequent occurrence; numerous poisonings by tartar emetic
have resulted from the use of "quietness," to remove the effects
of a debauch; and "arsenical wafers" are extensively advertised
and, presumably, largely used. The possibility of such an
origin of a small quantity of poison found must be admitted.
Whether such possibility amounts to a reasonable doubt is for
the jury to determine in the light of all the evidence in the case,
as, even when the symptoms are well-marked, the post-mortem
appearances clearly defined so far as they go, negatively as well
as affirmatively, and the poison is found in quantity which may
be considered large for that particular poison, the possibility
that ah overdose was unintentionally taken still remains. The
question is one of intent, and is not within the province of the
expert evidence, except in so far as that may throw light upon
the matter collaterally as shown in the discussion of these
questions.
Cases also arise in which there is suspicion of homicide by a
poison which is proven to have been previously administered to
the deceased legitimately as a medicine. The question then
arises whether the same poison, found in the cadaver, may not be
an uneliminated residue of the medicine. Every such case must
' Section 1745 of the N. Y. Crim. sale of cocain or of alpha- or beta-
Law makes it a misdemeanor to eucain a felony: but there is no
refill more than once a prescription provision against the refilling of
containing morphin or the prepara- other prescriptions containing poi-
tions of opium in which the dose sons, provided the formalities pre-
exceeds one-fourth of a grain of scribed by Sec. 1743 be observed,
opium or one-twentieth of a grain See pp. 59-62.
of morphin, and Sec. 1746 makes the
FORENSIC QUESTIONS. 219
be determined, if at all, upon its circumstances, the quantity of
poison found, the time which has elapsed since the cessation of
the medication, our knowledge of the rate of elimination of the
poison in question, the nature of the symptoms in the final at-
tack, the revelations of the autopsy, etc. We may cite as an
example the case of a woman who had taken sodium arsenite.
during twenty days, the last twenty-nine days before her death,
and in whose body only traces of arsenic were found, and in
which Scherbatscheff^ very properly gave the opinion that these
traces might have resulted from the medication, but that this
did not exclude arsenical poisoning.
II. When and how was the poison taken? It is highly
desirable in the investigation of criminal poisoning, as in that
of homicide by other means, that the precise time of the in-
fliction of the injury shall be fixed as closely as possible. Ow-
ing to the secrecy^ with which poison is administered when
given with criminal intent, it is but rarely that the time of the
administration can be determined by other than circumstantial
evidence, of which expert opinion may constitute an important
part. The corrosives, which act upon the parts with whicla
they are brought into immediate contact, begin their action at
the instant of contact, consequently if the case has been ob-
served during life or the patient can describe the attack, the
time of administration can be fixed as immediately preceding
the first effects. With the true poisons, however, action does
not begin before the entrance of the toxic into the circulation,
and consequently the interval between administration and the
first effects observed will vary with the conditions which favor
or delay absorption (see p. 80). If the form in which the
poison was taken be unknown, the duration of the interval pre-
ceding the manifestation of symptoms must be considered as
having been between the extreme limits in observed cases, if
these have been sufficiently numerous to afford a basis for com-
parison. Thus in the case of arsenic the duration of this in-
terval has been from "immediately" to nine hours; and with
phosphorus, from "immediately" to two days.
A knowledge of the rapidity of elimination of the poison
may also be of service in fixing the date after which it must
' Vrtljschr. f. ger. Med., 1900, ^ In a few cases the administra-
•3 F., xix., 233. tion was not secret but forcible.
220 TOXICOLOGY WITTHAUS.
have been taken if found to be present, and since which it is
improbable that it was taken if it be not found in a properly
conducted analysis, if it be a poison whose detection by this
means is to be expected.
The clinical history of the case will frequently determine
whether the poison was administered in a single dose or in re-
peated doses.
The question of how the administration was effected may
relate to the channel of entrance or to the vehicle with which
it was mixed. The great majority of criminal poisonings are
by the mouth. It is only exceptionally that poison has been
criminally given by the rectum, by hypodermic injection, by
the vagina, by inhalation, or by the ear, yet such cases have oc-
curred.' If the poison have any local action, as arsenic, or if a
mineral acid have been used, the seat of application will be in-
dicated by the local effects produced.
The vehicle of administration is best determined by analysis
of remains of articles of food, drink, medicine, etc., and some-
times of the bodies of animals who have devoured such remains
when they have been thrown out. Frequently, also, valuable
information can be obtained from analysis of even very minute
quantities of solid or liquid residues remaining in cups, glasses,
bottles, or cooking utensils.
12. Could the substance sepaxated by the chemist have aa
origin other than administration during the life of the deceased?
Admitting the identity of the poison to have been satisfactorily
proven by the results of the analysis, the answer to the first
question discussed above will depend in some measure upon the
exclusion of a possible fortuitous origin of the substance found.
The chemist must be depended upon solely to exclude some of the
possible sources of contamination, as, for instance, by impurity
of chemicals, or introduction into the materials under analysis
during the examination; while the exclusion of others, such as
possible post-mortem imbibition, can at present only be reached
from a consideration of all of the evidence in the case, and some-
times not then.
The purity of the chemicals used must be beyond ques-
tion. This can only be assured by a careful examination of the
■ Sec under Sulfuric Acid, Arsenic, bon Monoxid, and Chloroform, and
Mercury, Phosphorus, Morphin, Cur- p. 66.
FORENSIC QUESTIONS. 221
reagents by the chemist himself, and a purification, if neces-
sary; by the preparatioir of the chemicals in the laboratory from
materials known to be pure; or by a "blank testing." No re-
liance, for toxicological purposes, is to be placed upon the
labels of even the most reputable manufacturers; the chemist
must himself know that he has not unwittingly introduced the
substance which he has found. The methods of testing chem-
icals, their purification or manufacture, have been referred to
previously or will be in the division of special toxicology in
discussing their use.
A "blank testing" consists of a performance of the same
operations as those conducted with the organs examined, and
with the same reagents in equal or greater quantity, upon tissue or
materials known to be free from poison. Its negative result demon-
strates the absence of the poison found from the reagents used.
An unrecognized accidental or intentional addition of
poison to the substances analyzed, at the autopsy or subsequently,
should be rendered a physical impossibility by attention to the
directions already laid down (see pp. 135, 138, and 148).
The occurrence of poisons such as arsenic and copper as
normal constituents of the human body has been, after con-
siderable discussion by the older toxicologists, definitely nega-
tived, except as to minute traces of arsenic in the thyroid gland. ^
It must not be forgotten, however, that both of these poisons,
by constant presence in articles of food or drink and relatively
slow elimination, may be present as quasi-normal constituents
of the bodies of members of certain communities, being taken by
them unknowingly and not in consequence of the contraction of
drug habits. Thus, although we know of no specific observation
of the fact, it would seem probable that if the cadaver of an in-
habitant of the village of Whitbeck (where a stream whose water
is impregnated with arsenic is used as the source of drinking-
water^) were analyzed it would be found to contain small quanti-
ties of arsenic; and owing to the very general use of copper
utensils and of the salts of copper in "greening" canned vege-
tables, pickles, etc., copper in small amount is almost invariably
found, particularly in the liver.
The possibihty of the post-mortem introduction of poison
' See p. 558.
'Ph. J. and Tr., 1860-6*, n. s., ii., 286.
222 TOXICOLOGY WITTHAUS.
into the cadaver has been recognized by toxicologists from the
time of Orfila, and the possibility of distinguishing poison so in-
troduced from that taken during life has been the subject of
much careful study in recent years. The post-mortem in-
troduction of poison into the cadaver may be either (1st) By
mahcious injections; (2d) for the prevention of putrefaction,
in embalming, so-called; (3d) by imbibition from the soil or
from surrounding objects.
It must be admitted as a physical possibility that a properly
selected poison might be introduced into a cadaver in such man-
ner as to lend color to a false accusation of poisoning. But the
success of such a crime would require the fulfillment of condi-
tions which are hardly within the range of possibility; great
toxicological knowledge, combined with diabolical intent on
the part of the perpetrator, and a series of occurrences favorable
to his design and more or less beyond his control, both preced-
ing and succeeding the death of the alleged victim.
The post-mortem impregnation of bodies with poisons for
purposes of preservation and by accidental imbibition is of
much greater practical interest, particularly in the United
States, where the practice of undertakers is regulated by law in
three States only. Although any poison of alleged antiseptic
power may be a constituent of a so-called embalming liquid, and
although many poisons may find their entrance into a cadaver
by imbibition from without if brought in contact with it, it is
chiefly with reference to arsenic that the question is of forensic
interest; and we therefore defer its consideration to the division
of special toxicology under Arsenic.
The addition of poison to articles of food or medicine by a
person still living, for the purpose of procuring false evidence
against another of an attempt to poison, is of by no means
rare occurrence.'
13. Is the flesh of poisoned animals poisonous to man?
Apart from the frequently occurring poisonings by tainted meat,
it must be recognized as possible that, under favorable condi-
tions, a sufficient amount of mineral or vegetable poison may re-
' Kratter: " Beitrage," 1905, p. S. husband with arsenic; the accusation
Sonnenschein: Handb.d.ger.Chem., was disproved, the woman married
1869, 117, relates an instance in another, and was murdered by her
which a man falsely accused his para- accuser,
mour of having poisoned her deceased
FORENSIC QUESTIONS. 223
main in the tissues of an animal wlicise death resulted from its
action to cause poisoning in a human being who may eat of them.
No authenticated case of poisoning by this means is, however,
recorded so far as we know.^
14. Can a case of homicide by poison be made out if the
body has been cremated? If there have been neither autopsy
nor chemical analysis previous to the cremation this question is
practically, Can a case be made out without autopsy or proof of
the presence of poison in the cadaver? because lead and copper
are the only poisons of which traces would remain in the ash^
and these are very rarely used in criminal poisoning, and might
be readily disposed of by substituting other ashes for those of the
cadaver. The answer to the question in its latter form has
already been given in the discussion of the first question.
As the proof of poisoning, difficult in any case, is rendered
well-nigh impossible by cremation, and as in a very large pro-
portion of cases of poisonings which have been proved, the body
has been exhumed after burial, it would seem desirable that the
(Tremation of a body should not be permitted except after an in-
vestigation by the proper medical officer, sufficient to establish
a reasonable certainty that death was due to natural causes.^
The fact that the practice of cremation is by no means general
is no argument against the advisability of this supervision, as
while cremation without an autopsy is possible, it may be re-
sorted to by the criminal to remove the evidences of the crime.
For other "Forensic Questions" bearing particularly upon
individual poisons, the reader is referred to the division of
Special Toxicology
' Taylor: "Poisons," 3d Am. ed., of bone of a cremated body for
170-174, discusses this question at arsenic. His results demonstrated
length. The only case of poisoning the futility of an analysis under
in the human subject, however, these circumstances,
which he cites (from Galtier) was ^ The destruction of the body
more probably one of trichinosis or removes evidences of violent death
of putrid intoxication than one of or injury from other causes as well as
poisoning by copper. See, how- those of poisoning. That the mere
ever, Seeley: Med. Rec, N. Y., certificate of death by the attending
1894, xlv., 14, and Reg. v. Sprague, physician is sufficient is disproved
Ph. J. and Tr., 1865, n. s., vii., 72. by the instances given on p. 127.
^Mai (Ztschr. f.anal.Chem., 1904, §ee also Chapuis: "Precis d. Tox.,"
xliii., 617) examined the fragments 2d ed., 1889, p. 98.
224 TOXICOLOGY WITTHAUS.
CLASSIFICATION OF POISONS.
Poisons and corrosives require classification for two distinct
purposes: 1st. Into analytical groups to facilitate their ex-
traction and identification. 2d. Into natural groups to render
the study of all of their characters more logical and consecutive.
The analytical classification is both possible and neces-
sary, and follows the analytical methods used:
I. Gaseous Poisons: Carbon monoxid, hydrogen sulfid,
sulfur dioxid.
II. Volatile Poisons, which are separable from mixtures
by mere distillation, with or without vapor of water; and from
acid, neutral or alkaline liquids: Alcohol, chloroform, hydro-
cyanic acid, ammonia and its derivatives, phosphorus, etc.
III. Acids, Alkalies, and Salts: Mineral poisons and
corrosives, which are best separated by extraction with water.
Mineral acids and alkalies and certain soluble metallic salts.
IV. Organic Poisons: Substances which do not withstand
the action of powerful reagents, and which are extracted from
the mixtures in which they exist by neutral solvents or by di-
lute acids, either applied directly or in agitation methods with
immiscible solvents — vegetable acids, glucosids, alkaloids, and
bitter principles, and animal poisons.
V. Mineral Poisons: Substances of sufficient stability to
permit of their separation by the decomposition and removal of
the organic substances with which they may be mixed, followed
by the usual methods of mineral analysis, somewhat modified to
meet the requirernents of the case.
A systematic classification is more difficult to arrange
and, in its minuter ramifications, not practicable at present.
Different systems have been suggested, based either upon the
origin of the poisons and corrosives, or upon their method of
action upon the economy. Both arrangements have advantages
and disadvantages, but of the two we believe that based upon
origin to be the preferable one for the present, although the
other would be the more natural and the more useful: because
the origin is determinable in every case, while the method of
action of many poisons is still imperfectly understood.
The earliest classification, suggested by Plenck in 1785,' was
'"Toxikologie," Wien, 1785.
CLASSIFICATION OF POISONS. 225
based upon origin, and consisted of four groups: (I) Animal
poisons; (II) vegetable poisons; (III) mineral poisons; and
(IV) poisonous gases, vapors, and dust.
The first to suggest a classification based upon the method
of action of toxic substances was Fod^re,^ who divided poisons
into six classes: (I) septic poisons; (II) stupefying or narcotic
poisons; (III) narcotico-acrid poisons; (IV) acrid or rubefa-
cient, poisons; (V) corrosives, or escharotic poisons; and (VI)
astringent poisons.
The classifications of writers following Plenck and Fod6re:
Mahon,^ Orfila,^ Christison," Flandin,'^ Casper," Taylor,^ Tar-
dieu^ and others, are merely modifications of these either by
extension or by contraction; if we except the division of An-
glada' into the two classes of solid and liquid, and of gaseous
poisons.
Of the classifications based upon physiological action, prob-
ably the best developed hitherto suggested is that of Rabuteau,'"
who divides poisons into six classes:
I. HEMATIC Poisons. — A. Globular poisons, acting chiefly
on the red corpuscles: Carbon monoxid, hydrocyanic acid,
hydrogen sulfid, and ammonium sulfhydrate, compounds of
selenium and tellurium, phosphorus, arsenic, alcohols.
B. Plasmic poisons, acting on corpuscles and plasma. Ni-
trites and nitrous fumes, salts of silver injected into the veins,
the greater part of the metallic salts, when given in small and
repeated doses.
II. Neurotic Poisons. — A. Paraly so-motor s, which abol-
ish the functions of motor nerves: Curare, calabar bean, acon-
itin, coniin.
B. Spinals, which exaggerate reflex sensibility: Strychnin,
m'boundou, compressed oxygen, cantharides, etc.
C. Cerebro-spinals, which act upon the elements of the
brain and spinal cord: Chloroform, ether, opium.
' Traits de m^decine legale, Paris, <"'Handb. d. ger. Med.," Berlin,
1813, iv., 6. 1857, ii., 383.
""(Euvres posthumes," Paris, An '"Med. Jur.," 3d ed., London,
X. (1801), ii., 320. 1849, p. 7.
^ " Traits des poisons," Paris, 1814, "'Etude s. I'empois.," Pans,
i., 5-14. 1867, p. 167.
* "Treatise on Poisons," Edinb., '"Traits de toxicologie," Brux.,
1829, 81-83. 1837, p. 252.
'^ " Traits des poisons," Paris, 1846, '""Elements de toxicologie,"
i., 225. 2eme ed., Paris, 1887, pp. 29-34.
IV.— 15
226 TOXICOLOGY WITTHAUS.
III. Neuro-muscular Poisons: Solanacese, digitalis, an-
timonials, carbon dioxid.
IV. Muscular Poisons: Strophanthus, veratrin, salts of
potassium and of barium, copper, zinc, cadmium, tin, lead, mer-
cury, etc.
V. Irritants or Corrosives: Sulfuric, nitric, hydrochloric,
hydrofluoric, oxalic acids, potash, soda, ammonia, alkaline'sul-
fids, bromin, chlorin, etc.
The classification which will be followed in this work, after
the primary division into corrosives and poisons, ^ is based upon
origin. Within the classes a further subdivision is desirable,
but, we regret to believe, impracticable at present, consequently
an alphabetical arrangement is as good as any. We wiU divide
toxic agents into:
I. Corrosives: Substances which act chemically upon tis-
sues with which they are brought into immediate contact— min-
eral acids, alkalies, halogens, etc.
II. Poisons: Substances which act after entrance into the
circulation, followed by solution in the blood or chemical action
upon the blood itself.
A. Mineral Poisons: Arsenic, antimony phosphorus, the
salts of copper, lead, mercury, etc.
B. Vegetable Poisons: Vegetable acids, alkaloids, bitter
principles, glucosids, etc.
C. Animal Poisons: Leucomains, ptomains, toxins, toxal-
bumins.
D. Synthetic Poisons: Chloroform, alcohol, chloral, phenol,
antipyrin, etc.^
1 See Definition, p. 51. these classes into hydrocarbons,
' The synthetic poisons may be alcohols, aldehydes, acids, etc. See
classified according to their posi- Witthaus: "Manual of Chemistry,"
tions in the purely chemical classifi- 6th ed., 271, seg., or any modem
cation, first, into open-chain and organic chemistry.
closed-chain derivatives, and within
SPECIAL TOXICOLOGY.
CORROSIVES.
MINERAL ACIDS.
All acids are absorbed and act as true poisons when they are
administered in such dilution that intense local action is avoided,
but yet in sufficient absolute quantity and for a sufficient period
of time to cause diminution of the normal alkalinity of the blood
and other parts.' The symptoms of poisoning — such as somno-
lence, sopor, coma and convulsions, referable to the action
upon the nervous system; and the appearance of albumin, glob-
ulin, blood, and casts in the urine, resulting from the action of
the diminished alkalinity upon the blood and kidneys — and
death occur before the quantity of acid absorbed is sufficient to
entirely neutralize the alkaline reaction. Indeed, the same
effects have been produced in rabbits without the administration
of acids, by withholding food capable of producing alkalies, when
the formation of sulfuric acid resulting from the oxidation of
the sulfur existing in protein substances,^ and of phosphoric acid
similarly produced from the lecithins and other phosphorized
constituents of the body' causes sufficient diminution of al-
kalinity. It has also been shown by Walter* that acid poisoning
is much more rapidly produced in herbivorous animals than in the
carnivora; which is accounted for by the neutralization of ab-
sorbed acid by ammonia to a greater amount in the latter than in
the former.
Instances of such "acidism" or acid poisoning, caused by di-
lute weak acids — such as oxalic and acetic — have been observed
in the human subject (see Oxalic Acid), and are by no means
uncommon after corrosion by the more powerful acids, if life be
sufficiently prolonged. But the powerful mineral acids — sul-
' The gastric juice and urine only Kraus: Arch. f. exper. Path. u.
are acid normally. Pharm., 1890, xxvi., 186.
^ Salkowski: Arch. f. path. Anat. * Arch. f. exper. Path. u. Pharm.,
etc., 1S73, Iviii., 1. 1877, vii., 148.
''Jitta: Diss., Amsterdam, 1885.
227
228
TOXICOLOGY WITTHAtlS.
furic, nitric, and hydrochloric — as well as chromic anhydna,
when taken in concentrated form, act immediately and energeti-
cally upon the tissues with which they come in contact, causing
disintegration and destruction of the part by their chemical ac-
tion, and producing symptoms of such intensity and violence,
due to this corrosion, that the phenomena of true poisoning fall
into the background, or are entirely omitted in rapidly fatal
cases. Moreover, in the frequently recurring instances in which
the patient recovers from the first effects of the acid, from the
acidism as well as from the primary local action, only to die
weeks or months later from interference with the processes of
nutrition, the lesions which are the cause of death are referable
entirely to the corrosive action of the acid and in no way to its
transitory poisonous effects.
Therefore, while the occurrence of acidism is of scientific
and medical interest and while it offers an explanation of the
cause of certain of the symptoms observed in some cases of cor-
rosion by the powerful acids, it is of minor importance in the
forensic toxicology of these substances, which are the most ener-
getic of corrosives.
Statistics and Causation.
Although no statistics serving to indicate the absolute num-
ber of instances in which sulfuric, hydrochloric, and nitric acids
have caused death or injury in the human subject are available,
the following table of cases reported in medical journals accessi-
ble to us will show the relative frequency, mortality, and origin
of corrosions by those acids:
Cases.
Deaths.
Recov-
eries.
Homi-
cides.
Sui-
cides.
Acci-
dents.
Sulfuric acid'
Hydrochloric acid- . .
Nitric acid
3SS
126
8.3
256
89
70
120
106
15
53
6
17
189
57
43
99
40
14
It may be noted that the proportion of recoveries indicated is
certainly too high, as a large number of the cases set down as
having recovered have been reported shortly after their occur-
I ( 'uses of external application ^ Not including English coroners
vitriol-throwing) not included. cases. See note 8, p. 232.
MINERAL ACIDS STATISTICS AND CAUSATION. 229
rence and before sufficient time has elapsed for the development
of the secondary effects which have proved fatal in many
instances.
Of the 76 homicidal cases, 63 were fatal, including all those
by nitric and hydrochloric acids, save two by the latter. Twelve
occurred in Great Britain (1 HCl, 11 HjSOJ; 32 in Germany
(2 HGl, 8 HNO3, 22 HjSOJ; 6 in Finland and Sweden (3 HNO3,
3 H2SO4); 10inAustro-Hungary(2HNO3,8H2SOJ;13inFrance
(4 HNO3, 2 HCl, 7 H2SO,); one in Holland (H^SO,); and one in
Belgium (HCl).
We have been able to find record of but one case of criminal
internal administration of a mineral acid to another in the United
States. In the case of State vs. Frank Dinsmore tried in Ne-
braska in March, 1900, the defendant was convicted of having
destroyed his wife by administration of sulfuric acid. But
these agents have been frequently resorted to by suicides, and the
crime of "vitriol-throwing" is a common one in this country.'
In 45 of the 76 cases the victim was an infant or young child,
to whom the acid was given more or less forcibly. In one in-
stance a father, after conviction for having destroyed his child
shortly after its birth by nitric acid, confessed to having pre-
viously disposed of five others in a similar manner.-
It is difficult to imagine a manner in which a strong mineral
acid could be made the agent of secret poisoning of an adult in
the possession of his faculties. The corrosive action upon the
lips and tongue is immediate upon contact, and so severe that it
would cause the instant expectoration of any small quantity
which might have entered the mouth, before being swallowed.
Indeed, the Appellate Court in a Dutch case held the extreme
opinion that the mixing of sulfuric acid with coffee, a portion
of which was subsequently taken into the mouth of the intended
victim and by him immediately expectorated, was not an at-
tempt at administration of a deleterious thing, because "any
person who did not wish to take it would be prevented by the
repulsive taste from taking a second portion into the mouth, and
would immediately expel that already taken, so that it would
' Beck: "Med. Jur.," 12th ed., ii., [by sulfuric acid]; but he gives no
464, states that: "In 1817 a female particulars.
was tried in this State [New York] ^ Osenbruggen: Allg. deut. Straf-
for poisoning an illegitimate child" rechtsztg., 1865, v., 273, ex Friedr.
Bl. f. ger. Med., 1867, xviii., 75.
230 TOXICOLOGY WITTHAUS.
not be possible for the sulfuric acid to reach the stomach."' In
a somewhat similar case, tried at Cassel in 1853, in which the
injuries were Hmited to the mouth and tongue, beyond which
the acid did not penetrate, the defendant was more properly con-
victed of attempted murder, and sentenced to fourteen years'
imprisonment.^ A case is, however, reported by Mignot,^ of a
man of forty years who died in three months from the secondary
effects of sulfuric acid, which had been adroitly substituted for
brandy which he was in the habit of drinking. The powerful
taste of the acid has also been the means, indirectly, of prevent-
ing the murder of an infant; as in an early case in which the
mother tasted the food prepared by a servant who for revenge
had added sulfuric acid to it. The soup was not given to the
infant, but was sent to the authorities for examination.*
Of the other twenty-eight cases in adults classed as homicidal,
three were declared after investigation to have been more prob-
ably accidental or suicidal than homicidal.* In one fatal case
a woman poured sulfuric acid into the open mouth of her sleeping
husband.' In 1888 (Reg. vs. Lipski) the defendant was con-
victed of the murder of a woman by pouring a mixture of nitric
and sulfuric acids down her throat while in bed.' In another in-
stance, also fatal, a weak-minded woman was induced to swallow
sulfuric acid.^ A woman died from the effects of nitric acid
which her husband poured into her ear while she was intoxicated,
" to correct her," as he alleged.^ In three instances (one each of
sulfuric, hydrochloric, and nitric acid) the corrosive was taken by
a pregnant female upon the advice of her lover, and under the be-
lief, on the part of one or both, that it would cause abortion.'"
In two cases sulfuric acid was given to a pregnant woman with
the same object by a professional abortionist. One of these
'Friedr. Bl. f. ger. Med., 1856, « Christison : Edinb. JI. and S.
vii., Heft 3, p. 73. Jour., 1S31, xxxv., 296.
" Friedr. Bl. f. ger. Med., 1S54, v., ' Taylor: " Manual of Med. Jour.,"
Heft .5, p. 63. 11th Am. ed., lsy2, 373.
^ Bull, et m^m. Soc. med. d. hop. *Fagerlund: ^'ierteljschr. f. ger.
de Paris, 1878, 2 s., xiv., 89. Med., 1894, 3 F., viii., Supplhft. 54.
* Jahrb. d. ges. Staatsarznk., » Arch. g^n. d. M., 1826, xi., 104,
1837, iii., 146. ex Orfila: "Tox.," oeme ed., i., 172.
'Maschka: Vierteljschr. f. ger. '"Van den Broeck: Gaz. mM.
Med., 1881, n. F , xxxiv., 197. Che- Beige, 1847, v., 94 (Affaire Denisty;
vallier and OUivier: Ann. d'hyg., HCl). Buchner: Friedr. Bl. f. gM.
etc., 1845, xxxiii., 179. Maschka: Med., 1866, xvii., 192 (HNOj).
Allg. Wien. med. Ztg., 1880, xxv., Riecker: Zeitschr. f. Staatss -''
31.3. 1S43, 32 Erghft., 284 (H^SO.)
MINERAL ACIDS STATISTICS. 231
died on the third day, after having aborted the previous day.
The other was delivered of a dead immature foetus two months
later and died in three months of pyloric stenosis.^ Among
Hedr6n's^ 1,394 cases of abortion sulfuric and nitric acids were
each used once only. In both cases the woman aborted and
survived.
In an early case nitric acid mixed with wine was poured down
the throat of a woman during a debauch and caused her death.'
A man was induced to take sulfuric acid upon sugar, which was
blackened by the action of the acid, under the representation
that it was a medicine. Although the injuries were severe, the
man recovered.* In 1823 a man in Strasbourg attempted to kill
his wife, first by tartar emetic and afterward by sulfuric acid in
syrup, administered under the pi'etense that they were medicines.^
In two instances concentrated sulfuric acid was administered un-
mixed with other substances to adults in the full possession of
their faculties, they, however, believing that they were about to
receive medicine. Both were successful husband murders. In
one the acid was given in a spoon, which was passed well back
into the mouth before its contents were discharged." In the
other the acid was injected into the rectum.' An unsuccessful
attempt at administration of sulfuric acid to a woman is related
by Taylor:* A woman gave, "while acting as nurse to the wife
of a man with whom she was cohabiting, some oil of vitriol in
a wineglass, representing it to be castor oil. The woman re-
quested that some water might be put in it. This was done,
but the glass became suddenly so hot that the woman could not
hold it. She put it to her lips, which were burnt by it, but she
did not swallow any. The glass was handed back to the ac-
cused, who threw the contents away and washed out the glass.
But for the clear description of the effect of adding water to the
liquid, the nature of the poison would not have been known, as
after the occurrence no oil of vitriol was found. The poisoner
■ Casper-Liman: "Handb. d. ger. ''Bull. Soc. de m^d., Jan., 1830;
Med.," 8te Aufl., ii., 460. Egger: ea; Leconte: These, Strasb., 1855, p.
Friedreich's Bl., 1900, li., 241. 26.
" Vrtljschr. i. ger. Med., 1905, " Hager, in Gross: "Die Straf-
3 F. xxix., Suph. 61. rechtspflege in Deutschland," 1861,
"Tartra: "Traits de I'emp. p. Heft i., p. 181; e.r Maschka: "Handb.
I'ac. nitrique," Paris, An x. (1802), d. ger. M.," ii., 86.
p. 87. ' Leconte: Loc. cit., p. 27.
*Maschka: "Gutacht. Prag. m. » "Poisons," 3d Am. ed., 164. ■
Fak.," 1853, i., 38.
232 TOXICOLOGY WITTHAUS.
was acquitted on the ground that she might have made a mis-
take. She was subsequentl}' convicted and executed for poison-
ing" (Reg. V. Catharine Wilson, 1862). A man died in fourteen
weeks from the secondary effects of sulfuric acid, administered in
beer.' Three other attempts at murder by mineral acids mixed
with beverages proved unsuccessful: One was the Dutch case al-
ready referred to.^ The other two are referred to by Taylor.'
In Reg. V. Hartley (1850) the prisoner, a girl, was charged with
attempting to administer oil of vitriol to her father in coffee.
In Reg. V. Somers (1866) a girl of twelve years was charged with
administering hydrochloric acid to her mistress in beer. Two
instances of attempted wife murder by repeated administration
of small doses of sulfuric acid are recorded. One is an early case
(1701) reported by Valentine,* in which two ounces of the acid
were given in brandy, under the disguise of medicine, during
three weeks, from the effects of which the woman died. The
second, an unsuccessful attempt, was the subject of a criminal
trial at Belfast in 1883.^ The acid was given in port wine, a
sample of which was found on analysis to contain 12.5 per cent,
of the acid. Possibly arsenic was also given. Casper" relates a
case of "murder voluntarily submitted to," a double suicide,
psychologically interesting, in which a twenty-year-old girl died
from sulfuric acid administered by her lover. A woman, into
whose face half a litre of oil of vitriol was thrown, screamed, and
in so doing swallowed some of the acid, from the effects of
which she died the next day.''
Notwithstanding the extreme pain and the sometimes linger-
ing death caused by the mineral acids, suicides apparently
resort to them quite frequently in European countries. In Eng-
land and Wales (1871-80) 17 per cent, of the suicides by poi-
son were caused by mineral acids;* in Vienna (1874-75), 14.17
per cent.; in Prussia (1869) 17.47 per cent. According to
'Mansbach: Munch, med. ' Burgl: Friedreich's Bl. f. ger.
Wehnschr., 1902, xHx., 904. Med., 1902, liii., 447.
^ See p. 229. « The frequent occurrence of
'"Poisons," 3d Am. ed., 163, death by these agents in England at
220. the present time is shown by the
'"Novellae Med.-leg.," Francof., fact that in the single year 1908 the
1711, p. 588, Cas. 29. Pharm. J. reported 46 coroners' cases
' Reg. V. Sorroghan, Ulster Winter by mineral acids, of which 41 ivere
Assizes, 1883, Lancet, 1884, i., 226. by hydrochloric acid, 4 by sulfuric,
» Casper-Liman : Handb. d. ger. and one by nitric.
Med., 8te Aufl., ii., 472.
MINERAL ACIDS STATISTICS. 233
Schmiedel, of 111 poisonings treated at the Charite, in Berlin
(1874-80), 65 were by sulfuric acid.^ Suicides by mineral acids
are also of frequent occurrence in Denmark^ and in Finland.^
In the United States these agents seem to be less frequently re-
sorted to by suicides. Thus only 1.82 per cent, of the suicides
by poison in New York City (1866-80) were by mineral acids.
Sulfuric acid is more frequently taken by women than by men
(men 38.8 per cent., women 61.2 per cent.), while the reverse is
the case with nitric acid (men 60.7 per cent., women 39.3 per
cent.) and hydrochloric acid (men 53.1 per cent., women 46.9
per cent.).
Accidental cases have resulted usually from the careless ex-
posure of the acid within the reach of children or by the acid
being taken in mistake for spirits, beer, medicine, or even water.
In seven cases sulfuric acid was taken by pregnant females to
cause abortion, six times by the mouth* and once by injection into
the vagina.^ In one case hydrochloric acid was poured into the
vagina. It produced atresia, but not abortion. *" Four of the
women aborted, and five of th6m died. Two cases are also re-
ported in which women took nitric acid for the like purpose and
died without aborting.' In four instances sulfuric acid was ad-
ministered in enemata by mistake.' And in an early case the
sanie acid was even given by a medical student as a cure for
toothache. ° Operatives about storage batteries, etc., are sub-
ject to injury from inhalation of the finely sprayed acid which
is given off with the escaping gas. ^°
'Friedreich's Bl. f. ger. Med., ' Schauenburg: Vrtljschr. f. ger.
1882, xxxiii., 121: oxalic acid, 14; Med., etc., 1873, n. F., xvi., 52;
phosphorus, 32. Warren: Am. J. Med. Sc, 1850, July,
^ Trier: "Hosp.-Meddelelser," p. 36. Buchner: Friedreich's Bl.
Kjob., 1851, iv., 1-28; 1852, v. f. ger. Med., 1866, xvii., 192, says
^ Fagerlund: Vrtljschr. f. ger. that nitric acid is frequently used for
Med., 1894, 3 F., viii., Splheft., 48. this purpose; and TomeIIini:Riforma
*Schlegel: Material f. d. Staats- Med., 1906, xxii., 1404, makes the
wissensch., 1800, i., 140; Carus: same statement in Italy.
Gemeins. deut. Ztschr. f.- Geburtsk., ' Jour. d. chim. m^d., etc., 1835,
1828, ii., 37; Ricker: Hencke's 2 s., i., 425. Deutsch: Preuss. med.
Zeitschr. f. d. Staatsarznk., 1843, Ver. Ztg., 1848, No. 13. Hofmann:
32 Erg. H., 284;Fagerlund:Z/oc. c^., "Lehrb. d. ger. M.," 5te Aufl., 648.
54; Hedr^n: Vrtljschr. f. ger. Med., ' Tulpius: "Obs. Med.," L. iii., c.
1905, 3 F., xxix., Suppl. 61. 43, p. 254.
'Lombard: Jour, de chim. m6d., '" Wutzdorff: Arb. a. d. K. Ges.,
etc., 1831, vii., 312. 1898, xv., 1540.
° Beenk: Jhbt. u. d. Fortschr. d.
Geb., 1893, 858.
234 TOXICOLOGY WITTHAUS.
Lethal Dose — Concentration.
The absolute quantity of any of the mineral acids capable of
causing death cannot be stated. The violence of the action de-
pends more upon the degree of concentration, the age and con-
dition of the person affected, and the part most seriously at-
tacked, than upon the absolute quantity taken. Cases are not
wanting, however, in which diluted acids have caused death.
Indeed, the absolute degree of concentration of the acid is stated
in but few cases, and it is probable that, as generally sold by
apothecaries, it is more dilute than that met with in chemical
laboratories and factories. The "oleum," or commercial oil of
vitriol referred to in German cases, is a dilute acid (6:1); and
in that country sulfuric acid sold at retail must be diluted with
five parts of water, the purpose of the regulation being to avoid
accidents.' An instance is reported by Heginbotham^ in which
a man of fifty years died in two and one-half hours after swal-
lowing 22 c.c. (3vi.) of sulfuric acid (specific gravity 1.843),
diluted with 66 c.c. (5xviij.) of water. A woman died in two
months from the effects of two swallows of a mixture of one
volume of sulfuric acid and four volumes of water. ^ Fern-
bacher* refers to the case of a man of nineteen years who died
in eleven days from swallowing 100 c.c. (B3|) of the same acid
diluted with water in the proportion of one to five; and in one
of Mannkopf's cases^ a woman of twenty-four years died in
eight weeks after taking from 15 to 20 c.c. (BJ — |) of the same
acid, also diluted with five volumes of water.
Sulfuric acid has caused the death of adults in doses of 3.7
gm. (oi.) in two instances," and hydrochloric acid in the same
quantity in two cases.'' The smallest quantity of nitric acid
known to have caused the death of an adult was in a case re-
ported by Warren,^ in which a woman of thirty-seven years
• Casper-Liman: "Handb. d. ger. Gaz., 1890-91, x., 299. In the
Med.," 8te Aufl., 461, 467. early case of Consbruch (J. d. pr.
" Med. Times and Gaz., 1863, i., Arznk. u. Wundarznk., 1798, vii.,
183. 2 St., 18) the accuracy of the dose
'Wyss: Arch. d. Heilk., 1869, given (twenty drops) is questionable.
>;-. 1^4. ' Johnson: Brit. Med. Jour., 1871,
' Diss., Miinchen, 1890, p. 8. i., 221, girl, 15 D. in 10 hrs.; Gilbart
" Wien. med. Wochtoschr., 1S62, Smith: Proc. M. Soc. London, 1879-
564. S), v., 225, boy 6i D. in 17 hrs.
°Christison: Am. ed., 131. " Extra. Rec. Bost. Soc. M. Impr.,
Whitton and Turner: .Vustral. M. 1853, i., 78.
MINERAL ACIDS LETHAL DOSE. 235
accidentally took 12 gm. (5iij.)) of which some was spit out,
and died in thirteen days. Children have been destroyed by
less quantities of sulfuric and nitric acids. In a case reported
by Liman' a child of two months died in twenty-eight and one-
half hours after the administration of half a teaspoonful (1.8 c.c.)
of sulfuric acid; and in a case of Maschka's a two-year-old boy
died in seventeen days from the effects of the same quantity of
the same acid.^ Beyerlein^ reports the case of a girl of two and
one-half years who died in eighteen hours from the effects of
3.7 c.c. (oi.) of hydrochloric acid. We find no record of a child
having been destroyed by less than 7.5 c.c. (5ij-) of nitric acid,
which quantity caused the death of a boy of six months in twenty-
four hours in a case reported by Buchner.^ Yet Wunderlich re-
ported the death of a girl of seventeen from half that quantity.^
On the other hand, both adults and children have taken nota-
bly larger quantities of sulfuric acid and have not died within
the period covered by the reports. Brettner^ relates the case of
a young woman who took 250 c.c. (Bviiiss.) of sulfuric acid with
suicidal intent. In seven days she could swallow and retain
liquids. In one of Mendelsohn's cases^ a woman of twenty-
four years attempted suicide by swallowing a cupful (Siv. = 118
c.c.) of sulfuric acid. At the time of the report, eight days after
the injury, she was in a fair way to recovery. In a case re-
ported by Correa de Serra^ a woman took by mistake 75-90 c.c.
(Biiss.-iij.) of the acid on June 5th, and was under observation
to the end of October, after which she was not seen by the re-
porter. In these cases, however, there is no evidence that death
did not occur later from the secondary effects, an event the prob-
ability of which is not remote. Several cases of recovery after
taking 60 c.c. (5ij-) or a "wineglassful") of the acid have been
' Vrtljschr. f. ger. M., 1865, n. an application of the concentrated
F., iii., 89. acid to the mouth, the quantity
^ SammL Gutacht. Prag. med. must have been less tlian this and
Fak., 1858, 2 F., 224. In another very small, yet the oesophagus was
of Maschka's cases a woman stated corroded throughout and there
that she had destroyed her child were eschars in the stomach (Tar-
with two drops of sulfiu-io acid, dieu: "Emp. " 2e. ed., 241).
but the quantity given, although * Arch. d. Heilk., 1863, iv., 183.
small, was certainly greater. " Med. mod., 1890, i., 261.
'Friedreich's Bl. f. ger. Med., 'Charity Ann. (1885-86), 1887,
1890, xli., 31. xii., 183 (Case VII.).
* Friedreich's Bl. f . ger. Med., * Jour. d. chim. m^d., etc., 1826,
1866, xvii., 187. In the case of a ii., 209.
child of fifteen days which died from
236 TOXICOLOGY WITTHAUS.
reported/ in one of which^ a woman of twenty-six years at-
tempted suicide by swallowing a glassful of sulfuric acid. Two
years later she was still living as a nurse at the Maternity, and
although not well nourished, was capable of performing her du-
ties. She had three oesophageal constrictions which were held
in check by daily passage of the sound. Letheby has reported'
an instance in which a boy of nine years swallowed 30 c.c.
(5i.) of sulfuric acid, and, after suffering severely for five days,
gradually recovered. The same author has also- recorded^ the
case of a boy of six years who took 15 c.c. (5ss.) of the acid, al-
though it is believed that not much reached the stomach, and
slowly recovered. Galtier^ cites an observation of Leuret of a
man of eighteen years who recovered after an attempt at suicide
by 60 gm. (Bij.) of commercial nitric acid. We can find rec-
ord of but one case in which a child has recovered from the
effects of nitric acid, and in that the amount of the dose is not
stated;" and but one case in which a child recovered after tak-
ing hydrochloric acid. In this the dose was only "a drop or
two."^ Atkinson* has reported a' recovery of a woman of forty-
five years, from the primary effects of a dose of about 60 c.c.
(5ij.) of hydrochloric acid.
Duration.
The mineral acids may cause death within a few hours by
the intensity of their local action from peritonitis, shock, hem-
orrhage, or suffocation, due to destruction of tissue; or death
may result in several days from a combination of the local ac-
tion, less destructive than in rapidly fatal cases, with true poi-
soning consequent upon the absorption of the acid; or the fatal
result may be delayed for months, and finally result from inani-
tion due to interference with digestion and absorption by the
lesions caused or provoked by the local action of the corrosive.
1 Johnson: Lond. Med. Gaz., 1828- ' Lancet, 1847, i., 43.
29, iii., 253, F. 19. S. Crawford: ■• Med. Times, Lond., 1850, n. s,,
M. T. and Gaz., 1.S67, i., 182, F. 38, i., .58.
S. Desgranges: Rec. per. d. L Soc. d. ' " Toxicologie," i., 154.
m^d., Paris, An. vii., vi., 3, M. ad. " Huber: Ztschr. f. kl. Med., 1888,
A. Tott: Jour. d. pr. Hlk., 1837, xiv., 502, F. 14m, A.
Ixxiv., 1st., 116, F. ad. A. 'Austral. Med. Jour., 1880, ii-,
^ Maurel-Lavall^e, Mausi^re:"Sur 110.
les retr^cissements intrinsiques de ' 8an Francisco Med. Press, 1860,
I'cesophage," Th. Paris, 1865, p. 94. i.', 19.
MINERAL ACIDS DURATION.
237
The relative frequency of different periods of duration of
fatal cases is shown in the following table, computed from cases
reported in medical literature:
u
CO M
il
III
CO
160
6-1
39
16
2
3
60
27
12
35
12
9
18
9
5
22
9
5
9
Hydrochloric acid ....
Nitric acid
5
5
The shortest duration was in a case referred to by Thomson/
in which a child, while attempting to swallow strong sulfuric
acid in mistake for water, died almost immediately, to all ap-
pearances from suffocation due to the action of the acid upon
the glottis. None of the acid had reached the stomach. In a
case of corrosion by nitric acid, a new-born infant died in about
half an hour.^ Sulfuric acid in the quantity of 104 c.c. (Biiiss.)
caused the death of a man of fifty years in three-quarters of an
hour.^ The same acid has caused death in one hour in four
cases: in one a man committed suicide by swallowing about 60
c.c. (5ij.) of the acid;^ in another a woman died in great agony
in one hour after accidentally taking a wineglassful of acid, of
specific gravity 1.833;^ and in still another a man of forty-eight
years died in collapse in an hour after taking an unknown quan-
tity." A woman destroyed her husband in one hour by an in-
jection of sulfuric acid into the rectum.' The shortest duration
of fatal corrosion by hydrochloric acid was two hours in two
cases: both of women who took it with sucidal intent.^ Fauvel
reports the case of a man of thirty years who suicided by taking
about a glassful of a highly acid solution of mercuric nitrate
containing hydrochloric acid, and died in two and three-quar-
ters hours. °
When death results from the primary action of the acid it
' Lancet, 1836-37, ii., 835.
^ Buchner: Friedreich's BI. f. ger.
Med., 1886, xxxvii., 9.
= Rapp: Gaz. m6d. de Paris, 1850,
3 s., v., 926.
* Bell: Canada M. Jour., 1868,
iv., 53.
5 Traill: Monthly J. M. Sc,
Edinb., 1854, xix., 138.
''White: Tr. Path. Soc. Lond.,
1882-83, xxxiv., 96.
' Lefconte: Th^se, Strasb., 1855.
«M. J.: Friedreich's Bl. f. ger.
Med., 1858, ix., 6 Heft, 70. Deutsch:
Med. Ztg., Berlin, 1855, xxiv., 227.
"Tardieu: "Emp.," 2eme ed.,
236.
238 TOXICOLOGY — WITTELAUS.
usually occurs within forty-eight hours after the beginning of
the action. But a longer duration has been observed in some
cases. Thus a man of fifty-six years died suddenly on the
fourth day after having taken a dessertspoonful of sulfuric acid.'
Legg and Ormerod report the case of a man of twenty-one years
who died in great agony five days after taking an unknown
quantity of the same acid.^ Huber gives a case in which death
occurred on the seventh day;^ one in which the patient died in
sixteen days from the primary effects of 60 c.c. (5ij-) of sulfuric
acid occurred in the service of Dr. Jenner;* and Mascarel reports
a case whose duration was twenty-one days.^ In some instance
sulfuric acid has also caused death by pleuro-pneumonia in from
ten to twenty days.^ Cases of death from the primary action of
hydrochloric acid in four and seven days/ and similarly from
nitric acid in eight and thirteen days/ are also reported. When
death is due to starvation from the secondary effects of the ac-
tion of the acid the duration may be much longer. Thus cases
of eleven, fifteen, and eighteen months' duration in which death
was caused by sulfuric acid are recorded. ° In one case of death
from hydrochloric acid the victim survived for more than four
months.^" A man died in four months and twenty-two days
after taking a mouthful of the same acid." A girl of nineteen
suffered from an oesophageal stricture caused by sulfuric acid,
and died in seventeen months/^ and a woman only succumbed
to the effects of nitric acid in two years. It is highly probable
that instances of still longer duration, terminating finally in death
attributable to the action of each of the three acids, have es-
caped observation. ''^
' Guy's Hosp. Rep., 1859, 134. 'Erichsen: St. Pet. m. Ztschr,
= yt. Barth. Hosp. Rep., 1876, 1867, xii., 225. Warren: Extr. Rec.
xii-, 261. Bost. Soc. iM. Impr., 1853, i., 78.
== Ztsch. f. kl. M., 1888, xiv., 490. » Peters: Bull. Soc. d'anat., Paris,
* Med. T. and Gaz., 1S57, xv., 629. 1855, xxx., 153. Kuhn: Diss., Ber-
^ Bull. Soc. d'anat., Paris, 1840, lin, 1838, p. 9. Katz: Diss., Berlin,
XV., 299. 1872, p. 25.
"Smoler: Wien. med. Halle, 1861, "> E^-art: New Zeal. M. Jour,
ii., 434. Maschka:Samml. Gutacht. 1888-89 ii. 241.
Prag. med. Fak., 1858, 2 F., 224. " Gehle: Berl. kl. Wochenschr., i
Barth: Bull. Soc. d'anat., Paris, 1884, xxi. 337. ' i
1853, xxviii., 103. -^ ^^^j,: Diss., Berlin, 1872.
'St. Geo. Hosp. Rep., 1S77-7S, " See case cited by Tardieu (ot
ix., 18. V. Wundschheim: Prag. m. iv.): "Emp.," 2eme ed., 239.
Wchnsohr., 1891, xvi., 605.
mineral acids treatment. 2o9
Treatment.
The treatment indicated is the same whether sulfuric, nitric,
or hydrochloric acid has been taken. As the action of the acid
begins at once and is the most energetic when it first comes in
contact with the tissues, treatment must be as expeditious as
possible, and although cases have occurred in which the patient
has recovered without any treatment, many have died from the
effects of relatively small doses who might have been saved by
the timely administration of antidotes. The immediate indica-
tions are two: viz., to neutralize and to dilute the acid. The
latter object is best attained by giving milk in large quantity,
which also aids in neutralizing the acid by its alkalinity. The
safest, although not the most rapidly acting, agent to fulfill the
former indication is magnesium oxid (magnesia usta) or pref-
erably precipitated magnesium hydroxid (milk of magnesia).
Soap may also be used, and acts by virtue of the alkaline base
which it contains. The carbonates and bicarbonates of sodium,
postassium, calcium (chalk), and magnesium have also been fre-
quently used and are generally recommended. Their introduc-
tion, however, into a stomach whose walls are thinned in places
by corrosion cannot be unattended with the danger that the
sudden generation of a large volume of gaseous carbon dioxid
from the decomposition of the carbonate may cause perforation.
Although we know of no reported case in which the death has
been directly attributed to this cause, there are some in which
perforation of the stomach would seem to have been aided at
least by the exhibition of a carbonate.' It is true that the
carbonates are more prompt in their action than the dry pow-
dered magnesia, and that the latter has been found in the
vomited matters, while these still retained a strongly acid reac-
tion,^ but in Walker's case above cited the contents of the in-
testine were found to be strongly acid although magnesium car-
bonate had been given. Swallowing is frequently difficult or
impossible. When this is the case cocain may control the pain
sufficiently to permit deglutition. The administration of emet-
ics is distinctly contraindicated. The introduction of the stom-
• Thomas: Austral. M. J., 1891, viii., supplhft., 56. Walker: Mthly.
n. s., xiii., 542. Fagerlund: Vier- J. M. S., 1850, x., 538.
teljschr. f. ger. M., 1894, 3 F., ^ Taylor: "Poisons," 3d Am. ed.,
195,
240 TOXICOLOGY WITTHAITS.
ach-tube is always attended with danger of perforation of the
oesophagus or stomach, and in a French case death appears to
have resulted from the introduction of the tube into the larynx m
a violently resisting suicide.' Even when the stomach and ceso-
phagus were not wounded by the tube, death has been caused by
its introduction in a patient having a fatty heart.^ When the
stomach-tube is resorted to, the directions of Kronig^ should be
followed: 20 to 30 c.c. of warm oil are first injected into and
through the oesophagus with a 15 cm. N61aton's catheter.
The well-oiled stomach-tube, which should be as soft and thin of
wall as possible, is then introduced with as little pressure as
may be. Not more than a quarter to a third of a liter of wash
liquid, preferably milk holding magnesia in suspension, is then
passed into the stomach with just sufficient elevation of the outer
end of the tube to carry the liquid in, and in a few minutes re-
moved by slow depression of the tube. The lavage should be
repeated until the washings come away clear and neutral. Cases
in which this method of treatment was successfully followed,
even when a large quantity of the acid had been taken, have been
reported by Mendelsohn,* by Brettner,^ and by Kr6nig.° The
destructive effects of the corrosive are less violent when the acid
has been mixed with food articles or taken into a stomach con-
taining food than when it is taken in its own form into an empty
stomach. The acid is also similarly partly neutrahzed and
diluted when gruel, milk, or other liquid or semi-liquid foods are
given after the corrosive has been swallowed. Gutman^ observed
that a gargle of salicylic acid diminished the pain in the mouth
and throat and caused speedy cicatrization of the wounds there
produced by the acid. He also recommends its internal admin-
istration to the same end. Narcotics are indicated to control the
pain, and ice in fragments for the same purpose as well as to relieve
the intense thirst. In collapse stimulants should be given, and
the body temperature should be raised by the hot pack or by
hot-water bags. When death from suffocation is threatened
tracheotomy should be performed. In a case reported by Pat-
' Davezac and Micheleau: J. de « Charity Ann. (1885-86), 1SS7,
m^d. de Bordeaux, 1903, xxxiii., xii,, 183.
398. s Med. moderne, 1890, i., 261.
= Bundy: N. Y. Med. Rec, 1884, " Loc. cit.
xxvi., 504. » Wien. med. Presse, 1878, xk.,
^Therap. d. Gegenwart, 1899, n. 153.
F. i., 101.
MINERAL ACIDS — TREATMENT.
241
terson' the action of a small quantity of sulfuric acid did not ex-
tend to the stomach, and after the relief of serious interference
with respiration by tracheotomy the case progressed favorably.
Those in whom the secondary effects of the strong acids are
manifested are subjects for surgical treatment, although life may
be maintained for a time by nutritive pancreatized enemata, or,
if the strictures be limited to the oesophagus, by daily dilation
with the sound. The operations of gastrostomy, with or without
retrograde dilatation, for relief of cardiac or oesophageal stricture,
or of gastroenterostomy, pyloroplasty, or resection of the pylorus
for pyloric stricture due to the action of mineral acids have been
made in several cases with a large percentage of successful
results. Mauclaire^ recommends the immediate performance
of "exploratory gastrostomy" in all serious cases of corrosion.^
' Glasg. M. J., 1879, xii., 390.
^ Loc. cit.
^ Oastrostomy . — HjSO^ — Aigre:
France mi5d., 1878, xxv., 577, R.;
Bryant: Lancet, 1881, i., 572, R.;
Schattauer: Centbl. f. Chir., 1884,
xi., 95, R.; Masing: St. Pet. med.
Wchnschr., 1885, n. F., ii., 310, D.;
Caponotto: Cbl. f. Chir., 1885, xii.,
446, R.; Soldani: Lo Sper., 1887,
lix., 243, R.; Hagenbach: Corr.-Bl.
f. schweiz. Aerzte, 1889, xix., 129,
R.; Tietze: Deut. med. Wchnschr.,
1894, XX., 383, R.; HCl— Hadden:
Tr. Path. Soc, London, 1889-90,
xii., 84, D.; Duncan: Lancet, 1890, i.,
797, D.; Mauclaire: Bull. Soc. anat.
de Paris, 1902, Ixxvii., 785, D.;
Lovell-Keays: Brit. M. J., 1902, ii.,
617; Noever: Presse m^d. beige,
1909, Ixi., 10, R.; Geissler: Vrtlj. f.
ger. Med., 1909, 3 F., xxxviii., 74, D.
Resection. — HjSOj — Kohler: Charite
Ann. (1886), 1888, xiii., 538, and
Mendelsohn: ibid., 1887, xii., 183,
D.; Koehler: Deut. med. Wchnschr.,
1890, xvi., 783, D.; v. Eiselberg:
Arch..f. kl. Chir., 1889, xxxix., 802,
R.; Mickulicz: ibid., 1896, Ii., 9, R.;
Monprofit: Arch. prov. de chir.,
1898, vii., 50, R. Pyloroplasty. —
HCl— Bardeleben: Berl. kl. Wchn-
schr., 1888, XXV., 929, R.; Van der
Hoeven: Arch. f. kl. chir., 1889,
xxxviii., 444, R.; Lauenstein: Deut.
med. Wchnschr., 1891, xvii., 1005,
R.; Selenkow: Deut. med. Wchn-
schr., 1893, xix., 1239, R.; Zalaz-
iecki: Wien. med. BL, 1893, xvi.,
291, R.; Canjole: These, Lyon,
1895-6, D.— HjSOi— Postempski:
Rif. med., 1890, vi., 893, R.;
Ortmann: Deut. med. Wchnschr.,
1889., XV., 172, R.; Bardeleben:
Berl. kl. Wchnschr., 1890, xxvii.,
876, D.; Colzi: Lo Sper., 1892, xlvi.,
331, R.; Riegner: Deut. med.
Wchnschr., 1893, xix., 372, D,;
Wanack: St. Pet. med. Wchnschr.,
1893, X., 1239, R.; Kadian, two
cases ref. by Hartmann: X. C'ongres
frang. de chir., 1896, 424, RR.—
HNO3 — Wissinger: Munch, med.
Wchnschr., 1893, xL, 881, R.
Gastroenterostomy. — H 2 S O 4 — M o n-
astyrski, in 1884, ref. by Koellner:
Diss. Gottingen, 1890, D.; Skliff-
ossowski: St. Pet. med. Wchnschr.,
1889, xiv., 373, D.— HCl— Koellner:
loc. cit., R.; Hartmann: loc. cit., R.;
Lejars: Gaz. hebd. de m^d., 1S!)G,
xliii., 601, R.; Poucel: Gaz. d. hop.,
1896, Ixix., 891, R.; Querin and
Petit: Rev. de chir., 1902, xxv., 177,
R. — HNO3 — Robin: Wien. med.
Wchnschr,, 1903, liii,, 1056, R.
Gastropexy. — HCl — White and Lane:
Brit. M. J., 1891, 1., 409, D.
J ejunostomy . — Geissler: loc. cit.,
79, D. See also p. 322.
242 TOXIC()L( )G Y — WITTHAI'S.
SULFURIC ACID.
This, the most powerful of the mineral acids, is used in
some stage of almost e^'ery manufacturing process in which
chemical methods are utilized. It is known popularly as oil 0/
vitriol, and the commercial article is an oily, heavy liquid,
sometimes colorless, but usually having more or less of a brown
color. Sometimes it is almost black. Its chemical formula is
H2SO4, and its molecular weight is 98. When pure it crystal-
lizes at lO.S-^ (50.9° F.) and boils at 338° (640.4° F.). It is odorless.
The specific gravity of the pure acid is 1.848 at 12° (53.6° F.), and
its mixtures with water have, according to-Ure, the following
gravities :
Specific gravity, 1.848 1.S37 1.811.1.767 1.712 1.652 1.597 1.539
Per cent. H,SO„ 100 95 90 85 80 75 70 65
Specific graVity, 1.486 1.436 1.388 1.344 1.299 1.257 1.218 1.179
Per cent. H,S04, 60 55 50 45 40 35 30 25
Specific gravity, 1.141 1.101 1,068 1.033
Per cent. H2SO4, 20 15 10 5
The commercial and C. P. (chemically pure, so-called) acids
usually have a specific gravity of 1.835 to 1.845, and contain
from 92.5 to 98.8 per cent, of the pure acid.
When sulfuric acid is added to water it produces a hissing
sound and a marked elevation of temperature; 100° (212° F.)
is reached Ijy mixing four volumes of the strong acid with one
of water, both ice-cold. This elevation of temperature may
serve to attract attention and thus prevent an accidental or even
homicidal administration if the dilution is made at the time.'
Sulfuric acid absorbs water with great eagerness, and if exposed
to the air rapidly increases in volume and diminishes in concen-
tration by absorption of atmospheric moisture. The action of
the acid upon organic substances, including animal tissues, is
largely due to removal of water or of its elements from the sub-
stance acted upon, which in some cases is thus carbonized.'
Sulfuric acid, in the presence of water, is decomposed by some
metals — such as zinc — with evolution of hydrogen and forma-
tion of the sulfate of the metal. At elevated temperatures it
is decomposed by certain other metals — such as copper— and by
carbon and organic substances, with evolution of sulfur dioxid,
' See case of Catluirine A\'ilson, p. = See "Post-mortem Appear-
•2:v2
ances, p. Zot.
SULFURIC ACID SYMPTOMS. 243
SOj. The salts of sulfuric acid, called sulfates, are soluble in
water, with the exception of those of barium, strontium, cal-
cium (sparingly soluble), and lead. They are not soluble in al-
cohol. When mixed with charcoal and heated to redness the
sulfates are reduced to sulfids.
An acid, known as fuming or Nordhausen sulfuric acid,
is extensively manufactured in Bohemia for use principally as
a solvent of indigo and of alizarin. Such solutions of indigo,
used as blueing in laundry operations, have caused a number of
deaths, suicidal and accidental, from the acid contained in them.
The Nordhausen acid is a mixture or a combination of the ordi-
nary sulfuric acid, H2SO4, and sulfur trioxid, SO3; and is also
known as fyrosidfuric acid, HjSjO, ( = 112804 + 803).
Sulfuric acid produces little alteration in the appearance of
such liquid articles of diet as contain only small quantities of
solid organic materials. Substances rich in protein mate-
rials are modified by coagulation; and those containing sugar
or starch are darkened or blackened.
Free sulfuric acid is not normally present in any part of the
human body, although it has been found in the acrid secretions
of certain gasteropods, notably in that of Dolium galea.^ The
sulfates are, however, constant constituents of most of the tis-
sues and fluids of the body, being partly introduced from without,
but principally produced by oxidation of the sulfur contained
in the proteins. They are absent from the milk, bile, and gastric
juice.
Symptoms.
The symptomatology of corrosion by sulfuric acid may be
divided, if the patient survive for a sufficient time, into two pe-
riods: First, the effects due to the primary action of the corro-
sive, more or less complicated with its action as a poison, some-
times designated as acute phenomena; and, second, secondary
effects resulting from the local action of the acid, improperly
designated as chronic.
Primary Sjrmptoms. — When the acid is taken by mistake
for some other liquid by a person in the possession of his facul-
ties, or when from any cause it is not swallowed, its effects are
I Gorup Besanez: "Physiolog. Chem.," 4te Aufl., 104. Maly: Monatsh.
f. Chem., i., 205.
244 TOXICOLOGY WITTHAUS.
limited to those parts of the lips, mouth, and pharynx with
which alone it comes into contact. Such parts are then cauter-
ized, and covered with a grayish-white coating, resembling an
appUcation of white paint or wet parchment, which subsequently
becomes darker or brown in color. The parts attacked are the
seat of severe pain. The teeth where touched by the acid are of
a chalky whiteness and are deprived of their polish. The acid
may also in such cases, as well as in bungling attempts at ad-
ministration to a child or unconscious adult, be scattered upon
the chin, face, and breast, producing spots or blotches of a whit-
ish or gray color, which subsequently become brown or even
black; and similar stains, linear in character, may be caused by
the acid flowing from the angles of the mouth. Death may oc-
cur rapidly in such cases from penetration of the acid into the
larynx, and consequent cedema of the glottis or suffocation.
These cases are, however, usually light, and terminate in com-
plete recovery, except for the cicatrices which remain.
If the acid be swallowed, the act is attended or immediately
followed by intense burning pain, extending from the lips to the
epigastrium, so severe that the person usually cries out at the
time of taking the acid. Subsequently the pain extends over
the abdomen and chest, and the patient suffers excruciating
agony. The abdomen is extremely sensitive to pressure, and
later becomes distended. A few cases have, however, been re-
ported in which the pain was slight or ceased in a short time.
A man of fifty-six years took by accident a dessertspoonful of
oil of vitriol, after which he walked up-stairs and went to bed;
he vomited shghtly, and. for the two following days seemed de-
pressed, but presented no urgent symptoms. The case was con-
sidered to be a slight one and recovery M'as expected, but he died
suddenly on the fourth day.^ Chowne reports the case of a man
of fifty-two who took 15 c.c. (gss.) of the concentrated acid with
suicidal intent. He felt as if strangled, fell, and suffered burn-
ing pain in the pit of the stomach. The pain, however, sub-
sided in an hour, the abdomen not being sensitive to pressure.
After death, which occurred in forty hours, the stomach and
duodenum were found to be extensively corroded, and the former
thickened in places, although not perforated.^ Scholtz has, de-
scribed the still more exceptional instance of a woman of twenty-
1 Guy's Hosp. Rep., ISaO, 134. = Lancet, 1S47, ii., 35.
SULFURIC ACID — SYMPTOMS. 245
nine years who took about 125 c.c. (Sivss.) of commercial oil of
vitriol, and died in twenty-four hours in collapse. Although
there was excessive burning pain in the throat, the abdomen
was not distended, nor was it sensitive to pressure; yet the
autopsy showed the fundus of the stomach to be corroded, the
pylorus softened, the walls perforated in four places, and the
liver and spleen reduced to a soft paste.'
The case above quoted from Guy's Hospital Reports bears
upon the medico-legal question of whether in a fatal corrosion
by a mineral acid a person is capable of any considerable volun-
tary movement after taking the acid. That this question
must be answered in the affirmative is shown not only by this
case but by others: A man of thirty years, who died from the
effects of 57.3 c.c. (5xvss.) of sulfuric acid of specific gravity
1.842, was able to get out of bed and sit on the night-stool twenty
hours after taking the acid and five hours before his death. ^ A
woman of sixty-seven years, who died in twenty-four hours, walked
some distance to the place where she was found unconscious
two hours later. ^ A man, who died in twenty-four hours from the
effects of 22 c.c. (3vi.) of the acid, called a cab and was driven
home after taking the acid. The only peculiarities observed by
the driver were that the man was very pale and held a handker-
chief to his mouth. ■* A man of fifty-two years took about 90 gm.
(Biij.) of commercial sulfuric acid at nine o'clock, after having
eaten some soup; he remained in bed until noon, when pain
obliged him to call out. At one o'clock he got up, dressed him-
self unaided, and was transferred to the hospital, where he died
five and one-half hours after taking the acid.*
Vomiting follows soon, without, however, bringing relief
from the pain, and continues with more or less violence through-
out the duration of the more active period of primary corrosion.
It has, however, been known to cease early, as in a case reported
by Geoghegan," in which it ceased after three or four hours and
did not recur, the woman dying in thirty-one hours. The vom-
ited matters may be at first thick and slimy, but they are usu-
■ Aerztl. Ber. allg. k. k. Krankh., ' Lond. M. Gaz., 1845, xxxvi., 826.
Wien (1891), 1893, 70. ^Stausky: Gaz. m^d. de Par.,
" Walker: Mthly. Jour. M. Sc, 1837, v., 188.
1850, X., 538. * L'-nd. M. Gaz., 1851, xlviii., 328.
'Schad: Aerztl. Int. Bl., 1885,
xxxii., 388, Case i.
246 TOXICOLOGY WITTHAUS.
ally from the first and always soon become dark-brown or even
black, thick, and grumous in consistence, the so-called "coffee-
ground vomit," whose appearance is due to blood pigment acted
upon by the acid. The vomit is strongly acid in reaction, a
quality which is of great importance in establishing a diagnosis
between corrosion by acids and that by alkalies, the symptoms
of which resemble each other in many respects. But they may
become alkaline from the administration of an excess of alkali
as an antidote. They may also be effervescent when ejected
shortly after administration of a carbonate,' and, if acid, they
effervesce on contact with a carbonate (chalk or a limestone soil
or floor). The vomit contains, besides blood pigment, abund-
ance of epithelial cells and frequently patches or shreds of de-
tached mucous membrane. In several cases of acid corrosion
casts of the oesophagus, brown or black in color, consisting of
the mucous and submucous coats, with portions of the muscu-
laris, and sometimes with parts of the gastric hning attached, have
been discharged on the seventh to tenth day, after progressive
dysphagia." In one case of nitric acid corrosion a cast of the
oesophagus was discharged on the tenth day, and three days
thereafter a complete cast of the stomach.^ The separation of
such casts is due to necrotic (bacterial) changes, and only in-
directly to the direct action of the corrosive. In one case of
nitric acid corrosion orange-colored sloughs were discharged in the
stools.* When the acid vomit is discharged or spattered upon the
clothing or other textile fabrics it produces stains similar to those
caused by the acid (see Stains, below). If "liquid blueing" have
been taken the vomited matters and sometimes the alvine de-
jections are colored by the indigo. There is severe thirst which
is difficult to relieve, owing to the intense pain caused by degluti-
tion, which act is, indeed, frequentlj' impossible, and the intense
vomiting provoked by the entrance of any substance into the
stomach.
'Walker: Mthly. Jour. M. S., xli., 84; Koehler: Deut. med. Wchn-
1850, X., 538. schr., 1890, xvi., 183; Hornefier:
^Puchelt: Med. Ann., Heilbronn, Virch. Arch., 1896, cxliv., 405;
1845, xi., 608; Tardieu: "Empois.," Knauss: Med. Abh. Festschr. d.
2me. ed., 1875, 207, 215; Wvss: Stuttg. aerztl. Ver., 1897, 188. See
Arch.d.Heilk., 1869, x, 184; Laboul- also p. 317.
b^ne: Bull. Ac. de m^d., 1S76, 2 S., 'Thompson and Wilson: Bnt.
v., 1145.; Viscarro: Siglo med., M. J., 1908, ii., 1679.
Madrid, 1878, xxv., 667; Haddcn: 'Harris: Indian M. J., 1885, it.,
Tr. Path. Soc, London, l,SSlt-90, 675.
SULFURIC ACID — SYMPTOMS. 247
There is great difficulty in breathing, caused partly by ojdema
and swelling of the tongue and throat in some cases, and by the
pain caused by contraction of the abdominal muscles in almost
all. Later in the case, if the patient survive, respiration is
further interfered with by pleuropneumonia, developed by the
toxic action of the absorbed acid, or in exceptional cases by per-
foration of the stomach and diaphragm and direct entrance of the
acid into the pleural cavity. The swelling of the tongue and
glottis also causes more or less modification of the voice and
sometimes entire loss of speech. If death do not result
rapidly from oedema of the glottis, it may still occur early and
suddenly from collapse or shock, due to perforation and acute
peritonitis or extensive hemorrhage from corrosion of the walls
of large vessels.
If the patient escape a rapidly fatal conclusion, the epigas-
tric pain persists or increases in intensity and extends over the
abdomen and into the chest. Deglutition is more and more
painful and difficult or continues to be impossible, and every at-
tempt to swallow provokes a violent fit of vomiting. There is
abundant salivation of a ropy character, sometimes tinged with
blood, and sometimes forming a brown or even black froth, dis-
charged from the mouth and nostrils. The breath is often very
fcetid. There is obstinate constipation, and such evacuations as
are passed are dark brown or even black. Exceptionally there
is diarrhoea, the stools containing altered or unaltered blood and
shreds of mucous membrane. A condition of collapse super-
venes, with an almost imperceptible or thready, frequent, and
small pulse, diminished temperature, cold surface, sunken eyes,
an anxious countenance, dilated pupils, and a cold, clammy per-
spiration bathing the skin. This condition may terminate in
death within twenty-four hours, the patient being usually un-
conscious, or sometimes having violent convulsions or a severe
attack of suffocation. In one case death was preceded by furi-
ous delirium.^
After the first day in severe cases the foregoing symptoms
persist or even increase in intensity, the respiration becomes
more seriously affected, and rMes are heard on auscultation.
The parts burnt by the acid become ulcerated and the tempera-
' Kast and Rumpel: "lUustr. Schauenburg: Vrtljschr. f. ger. med ,
Path. Anat.," 1893, Case i. See also 1872, n. F., xvi., 53.
ture rises. The patient may die during this period, in from
three to eleven days, either from exhaustion or in sudden col-
lapse. When the course of the corrosion tends to recovery, the
ulcerated wounds heal more or less rapidly, and sometimes very
slowly, leaving cicatrices, thickening, and vegetations which
are the causes of the secondary or " chronic " phenomena.
The condition of the urine during the course of a corrosion
by sulfuric acid indicates that, in many instances at least, the
acid acts upon the kidneys. The urine is retained from the first,
and must be drawn with the catheter. It is diminished in
quantity, at first of high specific gravity, 1.035-1.045, falling
gradually to 1.015-1.010. It is at first hyperacid. The elimi-
nation of sulfates is relatively high, if the small quantity of
urine passed be considered; but the absolute amount in twenty-
four hours, which affords the only true indication of the elimi-
nation, is rather below than above the normal of 2.5 to 3.5 gm.
(38.6 to 54 grains) in twenty-four hours, except upon the first
day or two. We know of no case in which the saliva, which is
abundantly discharged after the first or second day, has been
analyzed. It seems probable, however, that a part at least of
the elimination is in this secretion and by the stomach, as when
hydrochloric acid has been taken.' In a case of Letheby's, a
boy of nine years during the first four days eliminated sulfates
corresponding to 4.018, 2.592, 1.185, 0.823 gm. (62, 40, 18.3,
12.7 grains).^ At a later period in cases tending to recovery
the absolute elimination of sulfates is diminished. Thus in
the case of a woman of twenty-one years who recovered, reported
by Hoppe-Seyler,^ the total amounts of HjSO^ eliminated on the
sixth to ninth days were: 1.6865, 1.8901, 1.6209, 0.936, 1.1817
gm. (26, 29, 25, 14, 18 grains). On the fifth and sixth days
the amount in the form of sulfo-conjugate compounds was
0.2537 and 0.2583, or 5:1 and 6.3:1. As the normal elimina-'
tion of sulfo-conjugate compounds is on an average 0.25 gm.,
but varies between 0.617 and 0.094, and is in proportion to sim-
ple sulfates as from 6:1 to 15:1,* it appears that the elimina-
tion of sulfo-conjugate compounds remains unaltered, while that
of the simple sulfates is diminished — a result the opposite to that
' See p. 2S 1 . ■> Hammarsten : " Physiol. Chem.,"
^ Lancet, 1847, i., 43. Mandel's transl., p. 363.
' Ztsch. f. kl. Med., 1SS3, vi., 478.
SULFURIC ACID SYMPTOMS. 249
which would be expected if elimination of sulfuric acid contin-
ues to take place by the urine' later than the first two or three
days. In the same case the urine was found to contain acetone
on the fifth to eighth days in progressively diminishing amount,
and during the period of inanition due to the pain incident upon
deglutition. The urine also contains excess of earthy phosphates
and has also been observed to contain excess of calcium oxalate-
and indican.^ The color of the urine is sometimes yellow, more
frequently reddish or reddish-brown. The urine of a boy of
two years who died in seven and one-half hours after swallow-
ing a quantity of liquid blueing was distinctly blue.* Fre-
quently the urine contains albumin, sometimes in large amount.*
But in mild cases, or in the later days of those which progress
favorably, it is absent.^ In a case of suicide, terminating in re-
covery, in which the acid was taken diluted with alcohol, no
urine was passed in thirty-six hours, when 700 c.c. free from
albumin were drawn off.'' The urinary sediment, when albumin
is present, contains casts, hyaline, faintly granular or brown;
and sometimes much granular matter colored with hsematin,^
and occasionally, though rarely, pus and blood. ° The condition
of the urine during a non-fatal case is well shown in one of
Mannkopf's cases,'" a boy of sixteen years who was under ob-
servation for about five weeks; the quantity in twenty-four
hours only exceeded 1,000 c.c. (about Sxxxiv.) on two days, the
twenty-eighth and twenty-ninth. The specific gravity was 1.038
at the outset, slowly fell to 1.015 during the first four weeks,
and then again rose to 1.027. On the first day there was a little
albumin, less until the end of the third week, , when it became
abundant, and again gradually diminished to disappearance.
The quantity of casts kept pace with that of albumin. The
elimination of sulfuric acid during the first three days was 2.51,
1.81, 1.49 gm. In some instances there is diuresis accompanied
by constipation during convalescence.
' See Schuchardt in Maschka's Loc. cit. Wyss: Loc. cit. Mendel-
"Handb. d. ger. Med.," ii., 70. sohn: Charity Ann. (1885-86), 1887,
" Smoler: Wien. med. Halle, 1861, xii., 183, Case ii.
ii., 434. ' Gottschalk: Diss., Berl., 1869,
'Wyss: Arch. d. Hlk., 1869, x., p. 22.
184. * Bamberger: Wien. med. Halle,
^Deslandes: Nouv. bibl. m^d., 1864, v., 301, 309.
1825; ex Galtier: "Tox.," i., 206. » Med. T. and Gaz., 1857, xv., 629.
°Katz:Diss., Berl., 1872, p. 9. "Wien. med. Wchnschr., 1862,
° Smoler: Loc. cit. Hoppe-Seyler: xii., 25, Case iv.
250 TOXICOLOGY WITTHAUS.
The temperature is not similarly affected in all cases. In
one fatal case in which death occurred in twenty-four hours it
was subnormal, 36.2° (97.1° F.);^ while in another, fatal in the
same period, it reached 38.9° (102° F.).^ In one protracted case
in which death occurred in one month, the temperature on the
second day was 37.8° (100° F.), and fell progressively with some
oscillations to 35.9° (96.6° F.) on the day preceding death.' In
another case, in which death occurred in thirty-seven days, the
temperature on admission was 36.5° (97.7° F.), rose the next
day to 37.5° (99.5° F.), and oscillated during the entire time be-
tween 37° (98.6° F.) and 40.5° (104.9° F.), reaching the maxi-
mum shortly before death.'' In a severe case referred to by
Gruhn,' during the fourteen days in which the patient was
under observation, the temperature varied but slightly from
the normal, the extremes having been 36.8° (98.2° F.) and 38°
(100.5° F.)
One of the four instances in which sulfuric acid has been in-
jected into the rectum is quoted by Schuchardt, who comments
that but little of the acid could have been actually injected, as
both patients, mother and child, to whom it was given by mis-
take, recovered in a few days.® Hofmann's two cases, merely
mentioned in a note, are the same as Schuchardt's.' In the two
remaining cases there was immediate intense pain, causing
the person to cry out loudly. A physician gave sulfuric acid
in an enema in mistake for linseed oil; the administration was
made at 11 p. m., the patient passed the night in great agony,
and in the morning a part of the corroded intestine was found
to have been discharged, and the bed clothing to have been burnt
by the discharges.* The other case was one in which a woman
murdered her husband by injecting the acid in place of a medic-
inal enema. The man, who was on his knees, withdrew, and
his back and buttocks and the bed clothing were extensively
burnt by the acid. He died in one hour from acute peritonitis,
'Scholtz: Aerztl. Ber. allg. k. k. "Handb. d. ger. Med.," ii., 67; ex
Krankenh., Wien (1891), 1893, 70. Deutsch: Preuss. Med. Ver. Ztg.,
"Katz: Diss., Berl., 1^72, Case 1848, No. 13.
iv., p. 21. ' "Lehrb. d. ger. M." (Kolisko),
= Graeffner: Diss., Breslau, 1875. 1903, 9te Aufl., 676. Reported by
■' Gruhn: Diss., Berl., 1870, Case Deutsch: Med. Ztg., Berlin, 1848,
iii., p. 19. xvii., 60.
' Loc. cit., Case iv., p. 28. « Jour. d. chim. m^d., etc., 1835,
"Schuchardt, in Maschka's 2 s., i., 425.
SULFURIC ACID — SYMPTOMS. 251
the acid having perforated the gut and entered the peritoneal
cavity.'
In the one case in which sulfuric acid was injected into the
vagina, a woman, the mother of four children, sought to abort
her fifth pregnancy by injecting half a litre of the acid. There
were severe pain and inflammation of the parts, followed by a
bloody, purulent discharge and subsequent cicatrization, which
so constricted the passage that delivery was impossible. A
dead child was removed by Ceesarean section and the woman
died also. The vaginal canal was found to be completely oc-
cluded, and the os uteri also closed by adhesion to the vaginal
wall.^
Secondary Ssnnptoms. — When the violent primary effects
of the acid are withstood, the corroded parts slowly undergo re-
pair, and the patient may be discharged in a few days or weeks
as cured. ^ The internal burns have, however, been so severe that
from destruction of the gastric mucous membrane with its se-
creting glands, from the thickening and contraction due to cica-
trization, from continuation of ulcerative processes, and even
from persistence of effects upon remote organs, the individual
subsequently becomes a subject for medical or surgical treat-
ment, and usually finally succumbs to the remote effects of the
corrosive.
The condition usually met with is one of starvation and in-
anition, caused partly by absence of the normal gastric secre-
tion, and partly by strictures of the oesophagus or stenosis of the
openings of the stomach, which mechanically prevent the pas-
sage of the food or chyme. In cases in which the vomit in the
secondary stage has been analyzed, it has been found to contain
no hydrochloric acid,* and lactic acid is only present when food
has been introduced into the stomach.^ Mendelsohn's Case II.
recovered, however, under prolonged treatment, the quantity of
acid taken having been 7 c.c. (about Sij-), and hydrochloric
' Leconte: ThSse, Strasb., 1855, * Kast u. Rumpel: "111. path.
p. 27. Anat.," 1893, Case ii. Masing: St.
^Lombard: Jour. d. chim. m6d., Pet. med. Wchnschr., 1885, n. F.,
etc., 1831, vii., 312. ii., 310. Mendelsohn: Charite Ann.
= Benjamin: Charity Ann., 1897-8, (1885-86), 1887, xii., 183, Cases ii.,
xxiv., 247, states that at the vii.
Charity victims of corrosives are '^ Mendelsohn: ioc. cii.. Case ii.
never discharged as cured, always
as improved.
252 TOXICOLOGY — WITTHAUS.
acid, absent from the stomach during the previous history of the
case, began to make its appearance about four months after the
first attack, and increased in amount thereafter. Strictures of
the oesophagus are frequently recognized during hfe and ob-
served at the autopsy; and Maurel-Lavall^e has reported the
case of a woman, Hving two years after the primary attack, who
was still throwing out shreds of necrosed tissue from the phar-
ynx, oesophagus, and stomach, while her oesophagus was con-
tracted in three places.' Although oesophageal stenosis is some-
times produced b}' acid corrosion, the pylorus is the position of
predilection for cicatricial stenosis in acid corrosion, as the
oesophagus is in that due to alkalies. It usually requires a
month or longer for the pyloric stricture to close sufficiently to
necessitate an operation. In Bardeleben's case,^ however,
pyloroplasty was performed two weeks after the ingestion of
sulfuric acid. On the other hand, in Dujardin-Beaumetz' case a
woman was admitted to the hospital six years after an acid cor-
rosion, having suffered for six months with almost continuous
vomiting. She died in two weeks, and the autopsy revealed a
dilated stomach with pyloric stenosis. Instances are also re-
ported in which death has been caused after long intervals by
ulceration and perforation. A man, six months after an attempt
at suicide by sulfuric acid, was attacked suddenly with haemar
temesis, and died in a short time. At the autopsy an artery
capable of admitting a crow's quill was found to have been per-
forated, and the stomach was full of black, coagulated blood.'
In another instance a woman died, eleven months after the pri-
mary attack, of peritonitis caused by a perforation of the intestine
at the junction of the caecum and ascending colon. ^ That death
may occur suddenly is shown bj^ a case reported by Lesser,"
of a woman of thirty-five years who fell dead while at the wash-
tub. During the morning her appearance and actions had not
differed from those of the week preceding. At the autopsy a
circular gastric ulcer and total peritonitis were found to exist.
Among the i-emote effects which have been observed in the
1865
Mansiere: These, No. <I4, Paris, * Charcellay: Bull. soc. d'anat
Paris, 1836, xi., 171.
-L alio, J-OOUj -Vl., A ( X.
Berl. kl. Wchnschr., 1S90, ' Peters: Bull. soc. d'anat., Pans,
xxvu., 876. 1S55, xxx., 153.
^ Bull, et m6m. Soc. med. d. hop. " " Atl. d. g;er. M ," i., 16.
de Paris, 18'.)'2, xix., 10.
SULFURIC ACID DIAGNOSIS. 253
course of the secondary action are: Intercostal neuralgia, noted
in one case by Mannkopf;' eruption of red blotches on the skin
of the forearm, also once observed on the twentieth day;= and
frequently coughing, expectoration, pains in the chest, dyspnoea,
and modifications of the normal respiratory sounds and reso-
nance, which are, however, more commonly met with as symp-
toms of protracted primary action.
Diagnosis.
The diagnosis of corrosion by a mineral acid is usually plain
from the character of the violent symptoms, from the history
of the attack, and from the appearance of the stains upon
the skin, lips, and clothing, if such exist. The only question
which remains to be determined is whether the corrosive taken
was a mineral acid or a mineral alkali. The settlement of this
point only requires a testing with litmus of the matters first
vomited, or any remains of the liquid taken, as to its reaction,
which will be strongly acid in one case and strongly alkaline
in the other. It is not necessary to distinguish between free
acids and acid salts for the purposes of treatment in most cases,
but if it be desirable to do so, paper charged with Congo-red or
benzo-purpurin may be used for the purpose.
It is of no clinical significance whether the acid be sulfuric,
nitric, or hydrochloric, as the treatment is the same for the three
acids. But the question is sometimes one of forensic impor-
tance, and may be solved by an examination of the vomited
matters by the method to be described below.
Prognosis.
The prognosis depends upon the amount of the acid taken
and upon whether it has reached the oesophagus or stomach or
not. If the quantity taken have been small, or if it have been
expectorated and none swallowed, recovery is assured after the
danger of death by suffocation has passed, although more or less
deformity from cicatrization may remain. But if the acid have
been swallowed, the prognosis is unfavorable. Of the 388 cases
' Wien. med. Wochenschr., 1862, ^ Q^ltier: "Tox.," i., 176.
xii., 25, Case ii.
254 TOXICOLOGY — WITTHAUS.
referred to on page 228, including those in which the acid was
not swallowed, and light as well as severe cases, the mortality was
66 per cent., of which 8.8 per cent, died in less than three hours;
45.8 per cent., in the first twenty-four hours; 67.8 per cent., within
a week; 82.2 per cent., within a month; and 17.8 per cent., in
periods longer than one month.
Even when the primary effects have been recovered from, if
the acid have penetrated beyond the mouth, the prognosis must
be guarded, as there can be no certainty that strictures will not
be developed in the stomach or oesophagus. In any event com-
plete recovery is most exceptional, as the destruction of gastric
mucous membrane will entail malnutrition, even if the cicatri-
zation be not sufficient to produce dangerous stricture.
External Application — Vitriol Throwing.
Accidental burns of the skin of the face, hands, and even of
parts usually covered by clothing, have occurred in chemical
laboratories and in manufacturing establishments in which the
acid is used;' but it is chiefly in connection with the crime of
vitriol throwing {vitriolage of French authors) that this branch of
the subject is of forensic interest. According to Christison,'this
crime originated in Glasgow during the quarrels in 1820 between
masters and workmen regarding the rate of wages, and became at
last so frequent that it was made a capital offense by a special
enactment. Vitriol throwing was not unknown in Germany at
about the same time, as Bopp^ relates the case of a woman who,
in 1825, attacked another woman and her child with vitriol, and
was convicted of attempt at murder in 1828. The offense is
usually prompted by jealousy, and is one of quite frequent oc-
currence in the United States. The liquid, which is generally
thrown into the face of the victim from a bottle, but sometimes in
mere malice upon the clothing only, is in most cases sulfuric acid.
Exceptionally nitric or hydrochloric acid or phenol has been used."
Christison'' has recorded the case of Mr. Campbell, upon
whom a large quantity of acid was thrown. The local effects
were severe, involving the loss of one eye, and he died in twelve
' "Poisons," Am. ed., 122. » See Stains, p. 271.
' Ztschr. f. Staatsarznk., 1836, 22 " Edinb. M. and S. Jour., 182a,
Erghft., 2.56. xxxi., 230.
SULFURIC ACID EXTERNAL APPLICATION 255
days, apparently from pleurisy. Another fatal case is reported
by Zwicke.^ The man upon whom the acid was thrown sank
down immediately, overwhelmed with pain. At the hospital he
vomited greenish masses, complained of pain in his chest, but
not in the stomach. The skin of the face was covered with
whitish eschars from the forehead to the throat; the cutis of the
left ear was reduced to a shmy pulp; the mucous membrane of
the nose and lips was corroded; both cornese were opaque; and
there were corroded spots on the tongue and the ulnar side of the
forearm. Pulse 110, respiration normal. Small rales in the
lungs. The urine formed a brick-dust deposit and contained a
large quantity of albumin. The next day he complained ofap-
noea; the respiration 20; the voice hoarse; and the tongue oedem-
atous. Temperature 37.2° (99° F.), pulse 108. At 10 p. m. he
was very uneasy. Respiration 28; pulse 140, small. The respi-
ration was very labored, with tracheal r9,les, but no cyanosis.
The collapse increased, and he died in forty-eight hours after
the injury. The autopsy showed the existence of chronic ca-
tarrhal enteritis, parenchymatous nephritis, multiple fibrinous
pneumonia, multiple pleuritis, myocarditis, and partial- corro-
sion of the posterior wall of the larynx and trachea, besides the
external injuries. Another fatal case, in which the acid had not
only attacked the face, but had also been swallowed and re-
spired, is reported by Liman.^ • A similar case, in which the acid
was inhaled but not swallowed is reported by Lesser.^ The man
died in forty hours, and the autopsy revealed great corrosion of the
skin of the face and of mucous membrane of the mouth, pharynx,
and trachea, and partial corrosion of the bronchi. The oesoph-
agus was intact. Another case in which the acid was also
swallowed, and the woman died next day, is reported by Biirgl.*
In 1894 the secretary of the Danish Legation in London died the
next day after sulfuric acid had been thrown in his face by an un-
known man to facilitate robbery. In December, 1900, at Van
Wirt, Ohio, Mrs. Emma Van Liew was tried for having caused the
death of a woman by throwing vitriol into her face, and pleaded
' Charity Ann., 1882, ix., 367. Burgl: Friedreich's Bl. f. ger. Med.,
"Casper-Liman: "Handb. d. ger. 1902, liii., 447.
Med.," 8te Aufl., ii., 469. Other ' Vrtljschr.f. ger. Med., 1898, 3 F.,
cases are reported by Orfila: "Tox.," xvi., 79.
5^me ed., i., 156. Leconte: These, * Friedreich's Bl. f. ger. Med.,
Strasb., 1855, p. 3. Letheby: Med. 1900, li., 241.
Times, Lond., 1850, n. s., i., 58.
256 TOXICOLOGY WITTHAUS.
guilty to manslaughter. In most instances, although the local
injuries are severe and may involve the loss of one or both eyes
and serious disfigurement, the victim recovers. Patel and
Th^venot^ report the serious injury of a woman by application of
sulfuric acid to the mons veneris.
As the action of sulfuric acid upon the skin is not absolutely
instantaneous, its effects are greatly mitigated if the parts be
immediately washed with a large quantity of water or a weak
alkaline solution, as of sodium bicarbonate.
It is sometimes necessary to determine whether an external
burn was caused by fire or by sulfuric acid. Thus, in a case in-
vestigated by Maschka," a man's assertion that the injuries
upon a child were not produced by acid but by fire was verified.
For the points of distinction, see Vol. I., p. 953,^ and below
under "Examination of Stains," p. 271.*
Post-mortem Appearances.
The appearances observed at the autopsy after death from
sulfuric acid will differ markedly, according as the death was
caused by the primary or by the secondary action of the acid.
Primary. — After death from the primary action of any of
the mineral acids, it is difficult to estimate what portion of the
changes observed were produced during life and how far they
resulted from the continued action of the corrosive after death.
Thus in the case of a person found dead, in which there is no
history of symptoms observed during life, and in which- an un-
known interval has elapsed between the death and the autopsy,
extensive destruction of tissue may have been in great part the
result of post-mortem action.^ Usually, however, the nature of
'Arch, d'anthrop. crim., 1901, 1102. In a case reported by Knauss;
^^V^,^^^-, T, Med. Abhandl., Festschr. d. Stuttg.
^ - Gutacht. Prag. med. Fak., 1S53, aerztl. Ver., 1897, 1S8, in which
^'' 3 T u death occurred in nine days and the
In the case there quoted from autopsy was made in three hours
laylor the acid used was nitric, not thereafter, the stomach was adherent
^""""'^- to the surrounding tissue, so that in
. S'ee also bchuchardt in Masch- removing it a hole was torn in the
lea s Handb. d. ger. Med.," ii., 77, wall through which there protruded
and the experunents of Samuel: a brown-black membrane, which
Arch. t. path. Anat., etc., 1870, li., was subsequently found to be the
■^^j „ . complete necrosed mucous mem-
I'or a case m illustration, see brane, which had been detached and
Gull: Lond. Med. Gaz., 1850, xlv., lay free in the stomach. Evidently
SULFURIC ACID POST-MORTEM APPEARANCES. 257
the symptoms will throw sufScient light upon the question
whether perforation, etc., were ante-mortem or post-mortem.
Putrefaction is frequently delayed, possibly by reason of the
diminished alkalinity. ^ The skin, if the acid have touched it,
is marked with brownish, rust-colored, or black-brown stains,
most frequently seen running linearly from the angles of the
mouth and on the chin. At these points the epidermis is want-
ing, and the derma is parchmentized, the cells of the rete Mal-
pighii have a brown-red color, and in the corium there are trans-
udations from the blood-vessels, causing a diffuse dirty reddish
color. In the lips, mouth, and tongue the appearances noted
during life are observed. The lips may be black; the tongue is
sometimes softened, and has the appearance of having been
boiled. The mucous membrane of the pharynx and tongue are
in some cases gray in color. The oesophagus is corrugated, has
a worm-eaten appearance, is more or less extensively deprived
of mucous membrane, and dark-gray or even black in color.
Where it still exists, the mucous membrane is easily detached
in shreds. Contraction of the oesophagus has also been ob-
served. Thus in a case of death in twenty-four hours there
was extreme narrowing of the oesophagus, whose walls were
greatly thickened and deprived of mucous membrane.^ Du-
j avier and RosenthaP reported a case in which the acid had trav-
ersed the upper passages with scarcely any lesion, and only
superficial burning of the lower half of the oesophagus,
although the stomach was perforated in three places.
The stomach presents the most characteristic lesions. If
the organ be entire, its external surface appears injected, blue-
black, gray, or violet, in places where it feels to the touch thinned
and filled with liquid. The contents consist of a brown, highly
acid liquid, having the appearance of coffee containing a con-
siderable amount of grounds; or are even black. The mucous
surface is pretty evenly brown-black or black in color, very much
thinned in places, sometimes to the verge of perforation, and
this action occurred before death. ger. Med.," 8te Aufi., p. 472, Case
According to the experiments of 193.
Harnack and Hildebrandt: Arch. f. ^ Virchow: Charity Ann., 1879,
exp. P. u. P., 1908, Supplb., 2^6, the iv., 788.
action of corrosives upon the gastric ' Bull. Soc. anat. de Paris, 1897,
mucous membrane is more intense Ixxii., 196. See also: Bigot: ibid.,
after death than during life. 1844, xix., 129.
'See Casper-Liman: "Handb. d.
IV.— 17
258 TOXICOLOGY WITTHAUS.
frequently spotted here and there with islands of less altered or
unaltered patches. ' The black appearance of the stomach and
other parts has been considered as produced by a carbonizing
action of sulfuric acid similar to that which it exerts upon wood,
sugar, etc. But Lesser has shown that it is due to decomposition
of hemoglobin, with formation of haematin.^ The pylorus is
frequently thickened and parchment-like, and sometimes has a
shredded appearance. Partially healed ulcerations are some-
times met with. In an early case in which death occurred in five
hours, Desterne^ found the stomach exteriorly of a brilHant black
color and red in spots. The mucous membrane was converted
into a thick layer, split in all directions, dry, and of a brick-red
color in jjlaces, which contrasted strongly with the brilliant
black of the remainder. If the autopsy be not too long delayed,
sections of the less corroded portions of the gastric mucous mem-
brane show changes in distinct contrast with those produced by
the alkahes,'' but similar to those produced by other mineral
acids. The tissues do not take stains, although there is almost
complete preservation of nearly all the tissue elements, with a
sharply defined appearance of the epithelium, and dilatation of
the blood vessels.^ In about one-third of the eases the stomach is
found perforated. But, unless the autopsy is ' made very early,
it is not possible to determine from the appearances to what ex-
tent the acid has continued to act after death. Perforation from
ulceration, which may occur when the duration of primary
action is sufficiently prolonged, is, of course, produced during life.
The disorganization of the stomach 'in severe and rapidly fatal
cases may even extend to destruction of large areas. Thus, in
the case of a woman of twenty-three years who died in three
hours in a comatose and collapsed condition, the autopsy, made
twenty hours after death, showed the great curvature of the
stomach to have been completely dissolved, and a dark, grumous
liquid discharged upon the intestines and omentum.^
' Good colored plates of post-mor- ^ Arch. f. path. Anat., etc., 1881,
tern appearances after death from Ixxxiii., 19S.
the primary effects of sulfuric acid ^ Bull. soc. d'anat., Paris, 1848,
will be found in Kast and Rumpell: xxiii., 223.
"Illustr. path. Anat.," 189:-!, F., i., 'Seep. 324.
andin Les.ser: "Atl.d. ger. Med.,'* ^ Walbaum: Vrtljschr.f. ger.Med.,
1S,S3, Taf. iii.; iv., Fip;.'^. 1, 2; xv., 19(m, 3 F., xxxii., 63.
Figs. 1, 4, .5. '^Sewell: Canada M. Jour., 1852-
.'">:!, i., 131.
SULFLKK' AtlD POST-MORTEM APPEARANCES. 259
The acid which escapes from the perforated stomach has in
several cases produced disorganization of the surrounding parts.
In a case reported by Otto/ of six hours' duration, the stomach
was found extensively disorganized, the posterior part of the
spleen black and corroded, the left lobe of the liver black-brown,
the duodenum externally and internally gray-black and' corroded,
the left kidney greenish-black and deeply corroded in lines, ami
the mesentery and left side of the peritoneum to the pelvis blue-
black. Scholz- has reported the case of a woman of twenty-nine
years who died in twenty-four hours after taking 125 c.c. (about
5ivss.) of the undiluted acid, and the autopsy was made twelve
hours after death. The stomach, which was blackened and
softened, was perforated in four places, the adjoining peritoneum
was softened, and the omentum in places glued to the abdominal
wall by fibrinous exudation. Between the abdominal wall,
the liver, and lesser omentum was a sero-purulent liquid con-
taining gas; and the liver and spleen were a soft pulp. Or
the diaphragm may even be perforated. In an early case re-
ported bj- Willndovius,^ the suicide died in two hours. The
stomach, in spite of the most careful handling, tore into pieces,
and its coats could not be distinguished; only a few tatters of
the omentum remained; the diaphragm was soft and corroded
in places; the lungs were adherent to the pleuras, and their exte-
rior brown and leathery to the depth of two lines. In another
instance, reported by Moore, ^ in which death occurred in an
hour and a half, the oesophagus and diaphragm were both in-
volved; the oesophagus was saturated with the acid, which had
soaked through and saturated the pericardium and back part of
the heart. At the base of the lung one-eighth of the lung tissue
was hardened. The acid may also attack the blood in the ves-
sels, which it coagulates, hardens, and blackens, producing an
appearance of black arborescence in the smaller vessels, and the
formation of hard black casts, like sticks of licorice, in the
larger vessels. ° The cavities of the heart have also been found
' "Memorabil.," Heilbronn, 1870, See also Lesser: Vrtljschr. f. ger.
XV., 29.5. Med., 1898, 3 F., xvi., 76.
= Aerztl. Ber. allg. k. Krankenh., '^ Haldane: Edinb. M. Jour., 1862,
Wien (1891), 1893, 70. vii., 739. Stausky: Bull. soc.
Uour. d. prakt. Heilk., 1819, d'anat., Paris, 1836, xi., 298. Gri-
xlix., 3 St., 56. zolle: Ihid., 1835, x., 132. Moore:
* Brit. M. Jour., 1879, i., 4.30. Tr. Path. Soc, Lond., 1879, xxx.,
297.
260 TOXICOLOGY WITTHAUS.
distended with dark clots, which were acid in reaction, the post-
mortem having been made thirteen hours after death.'
In most instances the changes do not extend beyond the
stomach, but congestion, ecchymoses, swelhng, and csdema of
the mucous membrane of the duodenum and upper small intes-
tine, and ulcerations of the upper and lower small intestine, as
far as the ileo-csecal valve, are frequently observed. Indeed, in
some cases the duodenum has been blackened and corroded in
the same manner as the stomach,^ while in other instances the
corrosion of the duodenum has advanced to perforation.' In
one case intestinal stricture was observed. Death had followed
the swallowing of the acid in two hours. The mucous coat of
the small intestine was much shrivelled, the valvulse conniventes
standing out like thick cords, so as to entirely obhterate the
canal.*
The larynx and trachea are the seat of serious lesions if the
acid have passed the epiglottis. In Walker's case, above men-
tioned, the larynx and trachea, to within an inch of the bifurca-
tion, were swollen and congested, of a coffee color, and deprived
of mucous membrane. The epiglottis was bleached and shrunken
to half its natural size. In a woman who died in thirty
hours, the larynx and trachea contained a gray, rather abundant
liquid, and a gray adherent membrane which extended into the
larger bronchi. The smaller bronchi contained much thick,
opaque, light-greenish secretion.' A woman was found dead in
her chair, the face black, with a bottle of sulfuric acid in her
hand. She had probably been dead about two hours. The acid
had not reached the stomach, but had corroded the epiglottis,
The rings of the trachea were quite dissected out and the lungs
charred. The acid had escaped into the pleura, had dissolved a
part of the ribs on the right side, and had formed a crust of cal-
cium sulfate on the lungs. The thoracic vessels contained a
sohd magma of decomposed blood, looking hke dried blacking.'
' Walker: Mthly. Jour. M. Sc. Times and Gaz., 1873, ii., "-•
1850, X., 538. Leyden and Munk: Walker: Mthly. Jour. M. Sc, 1850,
Arch. f. path. Anat., etc., 1861, x., 538. Maschka: Yierteljschr. f.
xxii., 237, Case i. ger. Med., 1S81, n. F., xxxiv,, 197.
^ Corfe: M. Times and Gaz., 1S48, •• Willndovius: Loc. cit.
xvii., 258. Leyden and Munk: Loc. = Katz: Diss., Berl., 1872, p. 29.
cit., Case ii. » Letheby: M. Times and Gaz.,
'Prestat: Bull. Soc. anat. de 1850, n. s., i., 58, Case iii.
Paris, 1837, xii., 315. Thomas: M.
SULFURIC ACID POST-MORTEM APPEARANCES. 261
In one case the corrosive action of the acid had estabhshed com-
munication between the oesophagus and the left bronchus.^
Among the remote effects are evidences of pleuro-pneumonia,
emphysema, and hypersemia in the lungs, of parenchymatous
nephritis in the kidneys." Fatty degeneration of the liver, heart,
kidney, and voluntary muscles has been observed even in rapidly
fatal cases. ^
Secondary. — The usual post-mortem appearances after
death from the secondary action of sulfuric acid are in marked
contrast with those found when death has been due to its pri-
mary effects. They more closely resemble those found when the
fatal result has followed the secondary action of the other corro-
sives. The body is greatly emaciated. The subcutaneous pan-
niculus is almost free from fat, which has also in great part dis-
appeared from, or suffered myxomatous degeneration in, internal
parts where it is usually present even in very thin subjects, as
in the omentum and about the kidneys. The eyes appear sunken
from removal of fat from the orbit. This emaciated condition
has also been observed in cases of as comparatively short dura-
tion as five days.* If the local action of the acid upon the skin,
particularly at the angles of the mouth, lips, tongue, and buccal
and pharyngeal mucous membrane have been severe, the places
of its action may be marked by eschars, or by whitish, hardened,
contracted cicatrices. But if the acid have not come in contact
with any one of the parts mentioned, or even if it have there oc-
casioned less severe injuries, no changes in the skin, lips, mouth,
or tongue may be observed, even in cases of comparatively rapid
course.^ On the other hand, such marks cannot be distinguished
macroscopically or microscopically from similar ones produced by
* Nagel: Ungar. Ztschr., 1851, i., Fraenkel u. Reiche: Arch. f. path..
i8. See also: Wagnier: Rev. int. Anat., etc., 1893, cxxxi., 130.
de rhinoL, etc., 1895, v., 65; Bolten- ^ Wagner: "Handb. d. allg. Path.,"
stern: Ther. Mtsh., 1902, xvi., 541. 2te Aufl., 1862, 277 (case fatal in 3
^ For microscopic appearances after hours; Lower: loc. cit. (2 days)
death from primary and secondary Fraenkel and Reiche: Virch. Arch.,
action of sulfuric acid see Fern- 1893, cxxxi., 136 (5 hours),
bacher: "Ein Fall von Schwe- '' Legg and Ormerod: St. Barth.
felsaure-Vergiftung," Diss., Mun- Hosp. Rep., 1876, xii., 261.
chen, 1890. Bamberger: Wien. '^ Casper- Liman: "Handb. d. ger.
med. Halle, 1864, v., 301, 309. L6- Med.," 8te Aufl., ii., 472, Case 193.
wer: Ber. kl. Wchnschr., 1864, i., Niemann: Ztsch. f. Staatsarznk.,
385. Lesser: "Atl. d. ger. Med.," 1862, Ixxxiii., 179.
PI. XV., Figs. 7, 8; PI. xvi.. Fig. 6.
262 T(.)XICOLOGY — WITTHAU.S.
other causes.' The oesophagus is more or less extensively
ulcerated, cicatrized, deprived of mucous membrane, contracted,
and its walls thickened. In a man who died in three months
from the effects of a mouthful of the acid the mucous membrane
of the oesophagus, with the exception of the upper six centime-
tres, was one diffuse ulcer, increasing in depth toward the cardia,
with two small necrotic spots in the upper part. The oesopha-
gus was not contracted, but somewhat dilated throughout its
length.^ The strictures of the oesophagus are sometimes single
and located at the lower part, but more frequently multiple, and
sometimes alternated with dilatations.^. The color of the
oesophageal mucous membrane is gray, dark gray, or red-brown,
but has been found blackened in places in a case of three months'
duration.* The cicatrized appearances due to the action of the
corrosive may also be accompanied by more recent lesions, linear
ecchymoses, or hemorrhages, caused by the too forcible intro-
duction of the sound in attempts at dilatation.^ The oesophagus
has also been found perforated by late ulceration in a child which
died in forty-five days.' The ulcerative processes may also ex-
tend from the oesophagus to surrounding tissues.' The stomach
is contracted, its walls thickened, its mucous membrane either
wanting and replaced by more or less extensive cicatrices, or
the seat of catarrhal inflammation, and of a yellow-buff color.'
Very frequently thickening at the pylorus causes more or less
complete stenosis. ° When this occurs the stomach may be
enormously dilated.'" The stomach has also been found at-
tached to the liver, pancreas, omentum, or abdominal wall by old
'Lesser: Virch. Arch., 1881, Ixxxiii., Lafitte: Bull. Soc. anat. de Paris,
196; Vrtljschr. f. ger. Med., xxxiii., 1890, 5 S., iv., 67.
1882, n. F., xxxvi,, 193. « Niemann: Loc. clt.
^ 2 Kast and Rumpell: "Illustr. 'Lesser: "Atl. d. ger. Med.," i.,
Path. Anat.," Lond., 1893, F. ii. 30.
^Husson: Bull. Soc. anat. de " Husson: Bull. soc. d'anat., Paris,
Paris, 1836, xi., 103; Mascarel: ihid., 1836, xi., 103.
1840, XV., 299; Mazet: *td., 1841, ' Ducastel: Loc. c/i.
xvi., 172; Moutard-Martin: ihid., «For good colored plates see
1845, XX., 42; Peters: ihid., Lesser: "Atl. d. ger. Med.," PL v.
1855, xxx., 153; Luton: -iWd., 1856, Fig. 2; Kast and Rumpell: "m-
xxxi., 497; Wyss: Arch. d. Heilk., Path. Anat.," F. ii.
1860, x., 184. Katz: Diss., Berl., "See p. 252, and cases cited by
1872, p. 28. Ducastel: Bull. Soc. Qu^nu and Petit: Rev. de chir.
anat. de Paris, 1872, 2 S., xvii., 336; 1902, xxv., 51, 176.
Liouville: «6?d., p. 274; Sands: '» Bouilland: Gaz. d. hop., Iwi
N. Y. M. .7., 1S84, xxxix., 535; vii., 496.
SULFURIC ACID ANALYTICAL. 2(i;)
adhesions.' The duodenum and upper small intestine present
changes similar to those observed in the stomach. The duo-
denum has also been found perforated.'
Analytical.
The materials to be analyzed may be either the viscera or
vomit of the victim; the remains of articles of food or other ma-
terial supposed to have been the vehicle of administration; or
stains upon the clothing or elsewhere.
The Contents of the Stomach or Vomit. — These are usu-
ally strongly acid in reaction; but neither does a very distinct
acid reaction indicate conclusively the presence of abnormal free
mineral acid, nor does its absence prove that none has been pres-
ent. Not only is the reaction of the stomach contents normally
acid during life from the presence of free hydrochloric or lactic
acid, or both; but very soon after death the alkaline reaction, ex-
isting in all parts of the body other than the stomach and urine
during life, rapidly gives place to an acid reaction, caused by
the formation of volatile fatty acids, lactic acid, and, exception-
ally, oxybutyric acid, as products of post-mortem decomposition.
As these acids are organic, and as the contents of the stomach
may normally contain the salts of hydrochloric, sulfuric, and
even nitric acid, the first point necessary in the analysis, after
suitable extraction, is the proof of the presence of a free min-
eral acid.
The existence of an alkaline reaction or the absence of acid-
ity, while it is not evidence that corrosion by a mineral acid
has not occurred,^ indicates the impossibility of direct chemical
evidence of the presence of a free acid, and limits the value of
the analysis to such confirmatory proof as is afforded by the
presence of an undue quantity of the salts of the acid or an un-
usual form of its combination. Such a condition may arise
from one of two causes: 1. The administration of antidotes in
excess, in which event the stomach contents or vomit will be
'Ackermann: Deut. m. Wchn- Paris, 1835, x., 315; Legendre: /6id.,
schr., 1894, xx., 835. Masing: St. 1883, 4 s., viii., 200.
Pet. m. Wchnschr., 1885, n. F., ii., 'For cases in illustration see
310. Grajffner: Diss., Breslau, 1875, MasChka: Gutaclit. Prag. med. Fak.,
p. 15. Wyss: hoc. cit. 1867, 3 F., 284. Buchner: Fried-
^Prestat: Bull. Soc. anat. de reich's Bl. f. ger. Med., 1886,
.XXX vii., 9.
264 TOXICOLOGY WITTHAUS.
found to contain a quantity of the combined acid much in excess
of that which can be normally present, particularly if the acid
be nitric or sulfuric, accompanied or not by an excess of the ba-
sic substance (magnesium oxid, etc.) which was given as an an-
tidote. 2. In many cases the corrosive is so completely expelled
by vomiting, even within a few hours, that none remains. In
Schauenburg's case,' in which the child died in about five hours,
during which there was violent and copious vomiting, the analy-
sis failed to give satisfactory evidence of the presence of the
acid.^ Moreover, the acid acts chemically upon the tissues, be-
ing itself thereby modified by combination and dilution, and the
products so formed are rapidly absorbed and as rapidly elimi-
nated. It goes without saying that none of the acid can be
found in the cadavers of those who have died from its secondary
effects.' Indeed, failures to detect the free acid in the stomach
contents after death constitute the rule rather than the exception,
and Buchner's statement that " the chemical detection of a poi-
soning by nitric or sulfuric acid is as a rule impossible"* is quite
true. Nevertheless, an analysis, including a quantitative deter-
mination of sulfates, as well as of free sulfuric acid, should never
be omitted if death have occurred within forty-eight hours after
the acid was taken and the history and post-mortem appearances
(which are generally clearly defined) point to the probability of
sulfuric acid corrosion, as both free acid and excess of sulfates
have been repeatedly detected not only in the vomit, but in the
stomach contents, after death. On the other hand, in the ab-
sence of such indications pointing to the presence of a corrosive,
it is inadvisable to jeopardize the detection of true poisons by a
search for the corrosives. In one instance, 0.031 gm. of free
sulfuric acid was found in 40 gm. (about half a grain in one
and a half ounces) of the stomach, oesophagus, and intestine of
a child thirteen days old, that had died in twenty-four hours
' Vierteljschr. f. ger. Med., 1S72, = Yet Egger (Friedreich's Bl., 1900,
n. F., XVI., 54. _ li., 241) reports a case of death in
'^The analyst in this case, how- three months from pyloric stenosis
ever, seems to have detected traces in which there is said to have been
of the acid, but to have been un- 0.1552 gm. sulfuric acid found in the
willing to recognize them under the stomach and duodenum. No c' ' ""
mistaken idea that "free sulfuric of the analysis are given.
acid can occur in the stomach con- * Neues Repert. f. Pharm., 1866,
tents of normal cadavers," loc. eit., xv 241
p. 60. ; . •
SULFURIC ACID ANALYTICAL. 265
after its mother had poured the acid down its throat.' If,
however, the victim survive more than a few hours (eight to
ten), the probabihties of detection of the free acid are quite re-
mote; although an excess of sulfates may still be found, as in
another case in Casper-Liman,^ also of twenty-four hours'
duration, in which no evidence of free acid was obtained from
the stomach and oesophagus, which, however, yielded 0.0257
gm. (0.4125 "gran") of the acid in combination.
But four analyses made by Bischoff demonstrate the pos-
sibility of the detection of free sulfuric acid not only in the
stomach, but also in the neighboring organs in cases of death
from the primary action of the corrosive, even when the analysis
has been deferred for a comparatively long time. In one of these,
in which a woman had died in six hours, and the analysis was
made sixteen days after death, he obtained 12.478 gms. of free
sulfuric acid (SO3) from the stomach and intestine, and 2.775
gms. from the neighboring organs. In the same case he obtained
from the liver 329, from the kidney 651 and from the spleen 2188
mgms. of total SO3, free and combined, per 100 gms. of tissue, while
the normal SO3 content of these organs is: liver 5.2, kidney 11.5,
and spleen 00 per cent. In another case in which death occurred
in eight and one-half hours, and the analysis was made fifty-one
days later, 18.72 mgms. of free sulfuric acid were found in the
stomach, oesophagus, and upper duodenum. In another of
Lessor's cases, Nitschke found in the brain a proportion of sul-
fates (60.9 mgms. SO3 in 100 gms.) very much above the normal (8.5
to 18.7 mgms.). Knauss* also reported a case of death in twenty-
seven hours, in which 10.7 gms. of free sulfuric acid were found in
the stomach.
As several sulfates (such as those of sodium, magnesium,
quinin, morphin, etc.) are in common use as medicines, and as
many articles of food and nearly all natural waters contain
notable quantities of the sulfates of sodium, potassium, calcium,
and magnesium, the detection of the acid in the stomach or
vomit, in any form other than uncombined, can only be con-
sidered as confirmatory evidence, the weight of which will vary
' Casper- Liman: "Handb. d. ger. 'Lesser: Vrtljschr. f. ger. Med.,
Med.," 8te Aufl., ii., 468. 1898, 3 F., xvi., 76.
' Loc. cit., p. 465. 'Med. Abhand!., Festschrift d.
Stuttg. aerztl. Ver., 1897, 188.
266 TOXK OLOGY WITTHAUS.
with the circumstances of the case. If, for instance, a large
quantity of magnesium sulfate, accompanied by excess of mag-
nesium oxid or hydroxid, be found in the vomit discharged from
the stomach of a person to whom magnesium oxid had been ad-
ministered, the inference that the magnesium sulfate was pro-
duced in the stomach contents by neutralization of the acid by
the base would be strong in the absence of positive evidence of
the administration medicinally of a mixture of magnesium
sulfate and oxid, a combination which, although sometimes used,
is exceptional.
To extract mineral acids from organic mixtures, stomach con-
tents, vomit, etc., these are treated with absolute alcohol in such
quantity that the material is in contact with alcohol of at least
seventy-five per cent. The mixture is warmed to 50°-60° (122°-
140° F.) for about ten hours, filtered, and the insoluble residue
washed with strong alcohol so long as the washings have an acid
reaction. The filtrate and washings are received in a gauged
flask, made up to a known volume, thoroughly mixed, and
aliquot portions taken for qualitative and quantitative ex-
amination. In a portion the presence or absence of free mineral
acid is determined; another part is neutralized exactly with pure
■ caustic potash in alcoholic solution, evaporated to dryness, and
the residue examined qualitatively to determine the nature of
the acid. The material left undissolved by alcohol is to be ex-
tracted in like manner with xvater, and the aqueous extract ex-
amined as to the presence and quantity of soluble salts of such
acid as may have been found. Finally, the material left undis-
solved by alcohol and water is treated with excess of pure di-
sodic carbonate, dried, fused, and the residual mass extracted
with water or dilute hydrochloric or nitric acid. In this solu-
tion the bases and acids present in insoluble combination are
identified and determined quantitatively.'
The presence of a free mineral acid is indicated by the fol-
lowing reactions:
1. A few drops of an alcoholic solution of methyl violet
(1 : 100) colors the liquid blue.
2. An aqueous solution of Congo red forms a blue color or a
blue precipitate. With acetic acid the color is violet.
3. A few drops of the liquid added to three or four drops of
' See alsd pp. 2S7, 2'.)S.
SULFURIC ACID — ANALYTICAL. 2(17
an alcoholic solution of tropaolin 00 (1 : 1,000) and warmed,
produce a violet color.
4. Add to solution of ferric acetate (Liq. ferri acetatis, U. S.
P.), diluted with water until it has only a faint yellow color, a
few drops of a solution of potassium thiocyanate. The solution
remains yellow, but on addition of a trace of a free mineral acid
is colored blood-red.
5. Add to a similarly diluted solution of ferric acetate a little
potassium iodid solution and some starch paste. The blue
starch-iodin reaction appears on the addition of a trace of free
mineral acid.
6. A test-paper, made by dipping ash-free filter-paper into a
freshly prepared solution of 1 gm. phloroglucin and 2 gm. of
vanillin in 30 gm. of alcohol, assumes a red color or a red bor.-
der to the carbonized portion, when dipped into a liquid contain-
ing free mineral acid and heated in a small capsule.
Free sulfuric acid is distinguished from sulfates by the
following tests:
1. Add a few crystals of granulated cane sugar, and evapo-
rate to near dryness; the residue becomes blackened b}- free
sulfuric acid as it approaches dryness.
2. Concentrate the liquid, add some strips of metallic copper,
and heat. In the presence of free sulfuric acid the odor of sul-
fur dioxid (burning sulfur matches) is produced. If the con-
centrated liquid and copper be heated together in a small flask,
fitted with a cork through which passes a tube twice bent at
right angles, whose free end dips into a small quantity of water
in a test-tube, the water will contain sulfurous acid, recogniza-
ble by its odor; or by addition of a crystal of iodic acid and
agitation with chloroform, when the aqueous liquid becomes
yellow and the chloroform violet.
3. A crystal of veratrin, moistened with concentrated sul-
furic acid, is colored slowly yellow, and after a time dissolves,
forming a crimson hquid. The color is not produced by the
dilute acid.
4. By the quantitative method given below.
Test for free sulfuric acid or soluble sulfates. — Solution of
barium chlorid (or nitrate) produces in solutions of sulfuric acid
or of sulfates, acidulated with hydrochloric pr nitric acid, a
white precipitate of barium sulfate. Nitric acid and barium
268 TOXICOLOGY — WITTHAUS.
nitrate are used in place of the corresponding chlorin compounds
in the presence of silver, lead, or mercurous compounds, which
precipitate with hydrochloric acid. The only other mineral
compounds of barium insoluble in acid liquids are the selenate
and silico-fluorid, both of which are compounds rarely met with
and not likely to be present in mixtures examined by the toxico-
logical chemist. Even this remote doubt may be removed by
drying the precipitate of barium sulfate, mixing it with a mix-
ture of sodium carbonate and potassium cyanid, and heating
to redness on the lid of a platinum crucible, by which treatment
the sulfate is reduced to sulfid. The presence of the latter is rec-
ognized by placing a fragment of the cooled melt on a piece of
paper which has been previously moistened with dilute solution
of lead acetate and dried, and adding a drop of dilute hydro-
chloric acid. If a sulfid have been formed, the fcstid odor of
hydrogen sulfid is observed, and the paper is turned brown or
black.
Other reactions common to free sulfuric acid and the sulfates,
but much less delicate than the barium test and by no means as
characteristic, are: 1. Strontium nitrate forms a white precipi-
tate, which is soluble to a slight extent in hydrochloric and nitric
acids. 2. Lead acetate forms an amorphous white precipitate,
which is somewhat soluble in solutions of the caustic alkalies
and of ammoniacal salts.
The quantity of sulfuric acid, whether present as free sul-
furic acid or as sulfate, is estimated, by precipitation as barium
sulfate, with the usual analytical precautions, and weighing the
barium salt after ignition. The weight of barium sulfate found,
multiplied by 0.4201, gives the weight of sulfuric acid (H2SO,)
(and XO. 3429 = 803) in the quantity of liquid examined.
To estimate the quantity of free sulfuric acid in the presence
of sulfates, a measured volume of the solution is evaporated
to as near dryness as is possible on the water-bath, and the resi-
due extracted with a mixture of equal parts of absolute alcohol
and ether. The solution is mixed with water, and warmed on
the water-bath to expel the ether and a portion of the alcohol.
The cooled liquid is made up to a known volume with water,
and in a known fraction the degree of acidity is determined by
titration with one-tenth normal caustic potash solution, using
litmus or methyl orange as an indicator. The remainder of
SULFURIC ACID ANALYTICAL. 269
the solution is evaporated to one-third of its bulk, diluted if
necessary with water, and treated with nitric acid and barium
nitrate solution. The precipitated barium sulfate is collected
and weighed. The filtrate and washings, concentrated if neces-
sary, are treated with nitric acid and ammonium molybdate
solution, and the quantity of phosphoric acid in the yellow pre-
cipitate determined by the usual method' (see below). The
results obtained by this process are not absolutely accurate, but
they are more nearly so than with other processes, such as by
neutralization with barium carbonate; by mixing with alcohol
without evaporation; by extraction with ether alone; by ex-
traction of the residue of evaporation with water, either after
or without ignition; or by calculation from the total quantity
of bases and acids. ^ The sources of error are the following:
There may be more or less action between the dissolved sul-
furic acid and the alcohol, by which the dibasic mineral acid
is converted into the monobasic sulfovinic acid (C2H5.HSO4),
which only requires half the quantity of caustic potash for its
neutralization. This action is the less the smaller the quantity
of sulfuric acid present and the lower the temperature of evap-
oration; hence, if the extract be strongly acid, it should be
diluted with water correspondingly, and during the heating to
expel ether the water in the bath should not be heated to boiling.
Although the sulfates are, as a rule, insoluble in alcohol-ether, the
ferric sulfate is somewhat soluble. If present, however, it colors
the liquid yellow. Free lactic acid is soluble in alcohol-ether, as
well as free sulfuric and phosphoric acids. If it be present, the
total acidity will exceed that accounted for by the sum of the
amounts of sulfuric and phosphoric acids found.
The separation of free from combined sulfuric acid may also be
effected by Roussin's method,^ in which advantage is taken of
the solubility of quinin sulfate in strong alcohol, and the insolu-
bility therein of metallic sulfates. The materials are extracted
with water. The aqueous extract is filtered and mixed with
freshly precipitated and thoroughly washed quinin in slight ex-
cess, and evaporated on the water-bath. The semi-fluid residue
'Presenius: "Quant. Anal.," 6te Ann. d'hyg., etc., 1884, 3 S., xi.,
Aufl., i., 404. 227; andFresenius: "Quant. Anal.,"
^See Beilstein and Grosset: 6te Aufl., i., 399.
Ztschr. f. an. Chem., 1890, xxix., ^Tardieuand Roussin: "Empojs.,"
73. Gamier and Schlagdenhauffen: 2Sme ed., 196.
270 TOXICOLOGY WITTHAUS.
is extracted several times with absolute alcohol, and the alcoholic
solution filtered off and evaporated to dryness. The residue may
be dissolved in hot water, cooled, the quinin precipitated by
ammonia, filtered, acidulated with hydrochloric acid, and the
sulfuric acid determined by barium chlorid.
If a notable quantity of combined sulfuric acid have been
found, the bases present should be quantitatively determined,
notably the sodium and magnesium. '
The significance of the presence of free phosphoric acid was
first recognized by Gamier,- in the case referred to in the note
above, in which the alcohol-ether extract from the alimentary
canal was strongly acid from the presence of a fixed acid, yet
contained no sulfuric acid. The acidity was ascribed to the
presence of free phosphoric acid, liberated from the phosphates
by the stronger sulfuric acid, which had itself combined with
the bases. Consequently, the existence of free phosphoric acid
in viscera (unless it have been medicinally administered) pre-
senting the lesions caused ))v the corrosives, is strong confirma-
tory evidence that sulfuric acid has been present. This view is
supported by the fact that, as Garnier has shown, the other free
acids likelj'' to be present — hydrochloric, butyric, and lactic — are
not competent to liberate phosphoric- acid from the phosphates.
In the case referred to (Affaire de Lichtember|;, Assises de
Saint Michel, 1883) Garnier and Schlagdenhauffen also noted
the presence of minute quantities of arsenic in the cadaver.
The quantity was such as would be accounted for by the inges-
tion of seven to eight grammes, or about a teaspoonful of the
commercial acid, which, notorious^, is always contaminated
with arsenic. The viscera should also be examined for lead, and
its quantity determined if found, as that metal is a frequent im-
purity of commercial oil of vitriol.
Examination of Suspected Materials. — ^This may be limited
to the mere identification and the determination of the degree of
concentration of a sample of commercial oil of vitriol, or it may
extend to an examination of articles of food, drink, or medicine,
not only for sulfuric acid, but for other substances as well.
The acid is readily identified by its giving off dense white
'For methods see Fresenius: -Aim. d'hyg., etc., 18S7, xvii.,
"Quant. .\nal.," 6te Aufl., or John- 14S.
son's translation.
SULFURIC ACID — ANALYTICAL. 271
fumes, and being volatilized, with little or no residue when suffi-
ciently heated; by its blackening sugar; by the development of
heat on dilution with water, and by the barium chlorid test
above given. Its concentration is determined by its specific
gravity, by dilution and titration with standard alkaline solu-
tion, or gravimetrically by precipitation as barium sulfate.
As^an instance of evidence upon collateral points obtainable
from analyses of food articles, we may quote a case from Tay-
lor:' "A girl was charged with attempting 'to administer oil of
vitriol in coffee to her father. The prisoner usually made the
coffee for breakfast, and would then have had an opportunity of
adding it to the hquid. The acid might, however, have been
mixed with the coffee in the cup after it had been poured out;
and in this case other persons would have had the opportunity
of poisoning the coffee. This question was solved by the aid of
chemistiy. I procured the coffee pot, and found that it was old
and rusty. The poisoned coffee was tested, and it contained no
trace of iron; but on warming a small quantity of the acid coffee
in the pot, it was immediately and strongly impregnated with
sulphate of iron. It was therefore clear that the acid had not
been mixed with the coffee in the pot, and that it might have
been afterward put into the cup without the knowledge of the
prisoner." This case also serves to indicate the necessity of
caution in drawing conclusions from the presence of poison in
articles of food, etc., which may have been tampered with by
persons other than the accused.
Examination of Stains. — The identification of sulfuric or
other acid as the cause of stains upon garments, bed clothing,
etc., may afford the most reliable evidence of the nature of the
corrosive administered, and may occasionally aid in pointing
out the person by whom it was administered.
The mineral acids dropped upon earth cause effervescence
from evolution of carbon dioxid. At the same time the acid is
neutralized by conversion in the corresponding salt, and an acid
reaction only remains if the quantity of acid has been greater
than is necessary to decompose all of the carbonates present.
Wood is almost immediately blackened by strong sulfuric aci-d,
is colored yellow by nitric acid, and is hardly modified by hydro-
chloric acid. Iron is attacked by sulfuric and hydrochloric acids,
' "Poisons," 3d Am. ed., 163.
272 TOXICOLOGY WITTHAUS.
with formation of sulfate or chlorid, which is dissolved readily by
water, leaving a roughened appearance of the metal, as if it had
been rusted and cleaned. Nitric acid attacks iron similarly if it
be dilute, but not if concentrated. All of the acids attack the
zinc coating of "galvanized iron." The tin coating of sheet tin
is dissolved by hydrochloric acid, is not attacked by cold sulfuric
acid, and is turned white by nitric acid. Copper is colored green
by cold sulfuric or hydrochloric acid, and blue by nitric acid,
which also evolves ' copious brown fumes. Silver is similarly
acted upon by nitric acid, but cold hydrochloric or sulfuric acid
does not affect it except after long contact. Gold is not acted
upon by any single acid; but is corroded and dissolved by a
mixture of nitric and hydrochloric (aqua regia) .
On cotton, paper, or other white or light-colored vegetable
or animal tissue, sulfuric acid produces a stain which is brown
or black; the tissue is rendered friable, breaks down easily, and
remains moist for a long time. Even by short contact the fab-
ric is perforated if the acid be concentrated. The moistness of
the stain or of the margins of the perforations is the principal
difference in mere appearance between burns in paper or other
fabric produced by sulfuric acid and those produced by heat, the
latter being quite dry. On similar fabrics nitric acid produces
a yellow stain, and at the time of contact brown fumes may be
evolved. Hydrochloric acid does not corrode such tissues.
Stephenson^ relates an exceptional instance (Reg. v. Lipski,
C. C. C.,, July, 1888), in which the cotton night-dress of a woman,
whose life was taken by pouring a mixture of sulfuric and ni-
tric acids down the thr-oat, as well as the deal floor on which the
acids were spilled were partially converted into nitro-cellulose,
which partially exploded when ignited in a closed tube. The
stains produced upon dark-colored fabrics by sulfuric or hydro-
chloric acid are usually red, sometimes green in color, and, if
not too old, disappear permanently when moistened with am-
monium hydroxid solution. Those formed by nitric acid are
dirty yellow or brownish; and, although they may disappear
temporarily when moistened with ammonium hydroxid solution,
they return when the spot dries. The nature of the acid may
also be sometimes ascertained by chemical means, by boiling the
stained fabric for a short time with pure water, filtering the so-
' Taylor: "Manual of Med. Jur.," 11th Am. ed., 1892, 373.
ACID SULFATES ALUM, ETC. 273
lution, and testing the filtrate not only for the free acid, but for
the corresponding salts also, by the methods already described.
Sulfuric acid remains in the tissue for a long time — months or
even years; but nitric and hydrochloric acids, if not decomposed
or neutrahzed, soon disappear by evaporation. The detection
of a small quantity of free sulfuric acid in the margins of a burnt
perforation is not conclusive proof that the burn was caused by
the acid. In a case already referred to, Maschka^ showed that
the margins of burns thus produced by incandescent coals may
contain sulfuric acid, which is produced by the oxidation of the
sulfur which exists in many kinds of coal.
Acid Sulphates — Alum, etc.
Sulfates which have a markedly acid reaction behave both as true
poisons and as mild corrosives, or at least as intense local irritants.
Such are alum (double sulfate of aluminium and ammonium, or potas-
sium, A1,(S0J3, (NHJ 2SO,-l-24 Aq, or A1,(S0,)3, K3SO,+24 Aq), the
monometallic sulfates (sodium or potassium bisulfates, NaHSOi or
KHSOJ, white vitriol (zinc sulfate, ZnSOJ, and blue vitriol (cupric
sulfate, CuSOJ.
Alum.
The salt usually met with is the ammonium compound, which, by
reason of its less cost, has practically displaced the "potash alum"
formerly in use. It is largely used in dyeing and for numerous other
uses in the arts, and is sold without restriction. It has been used by
bakers to whiten bread made from inferior flour, a practice which has
met with the almost unanimous condemnation of hygienists. The
same cannot be said of its use in the preparation of baking powders, if
it be combined with sodium bicarbonate in the proper proportion; for
then, during the raising and baking of the bread, it is completely de-
composed, and the product contains no alum, but aluminium hy-
, droxid or phosphate. Alum is now also added to water in minute
■quantity in certain processes of purification as a preliminary to filtra-
tion. Here also the alum is decomposed and precipitated as alumin-
ium hydroxid.
Up to the present time seven instances of fatal poisoning by alum
have been reported. Taylor^ states that a case of death from alum
I appeared in the registration returns for 1838-39. Van Hasselt^ refers to
an accidental case as having occurred at Hoogeveen, in Holland, in 1851,
' Gutacht. Prag. med. Fak., 1853, ' "Handb. d. Giftlehre," 1862, ii.,
i., 121. 207.
' "Poisons," 3d Am. ed., p. 266.
^ IV.— 18
274 TOXICOLOGY WITTHAUS.
in consequence of the use of burnt alum as a popular remedy for gas-
tric pain. Tardieu' relates the case of a delicate child of three montlis
which died shortly after the administration of 90 gm. of alum by its
mother, and also the ease of a girl who died at Bayonne in 1873 of gan-
grenous angina, as it was supposed, but in whose stomach a large quan-
tity of alum was found. Hicquet^ gives a circumstantial account of
the accidental death in twenty-four hours of a man of fifty-seven
years from the effects of 30 gm. (3i.) of alum. Fagerlund' notes
the case of an infant killed by alum in Finland in 1886. A large but
not accurately determined quantity of alum was found in the ali-
mentary canal. Stevenson* refers to the death of a child of three
years from the effects of a teaspoonful of alum given in syrup as an
emetic. Non-fatal cases are reported by Orfila,* Kramohn," Hedren'
(taken as abortifacient), .Morelli,' and Chiadini."
The SYMPTOMS produced by alum are burning pain in the mouth,
which looks as if tanned, and in the throat and stomach; persistent
vomiting of bloody material;'" accelerated pulse and respiration, dis-
turbances of coordination; clonic spasms of the muscles; diminution
of temperature, and hyperaemia of the intestines and kidneys. The
urine contains blood cells, blood pigment, hyaline casts, and traces of
albumin.
The POST-MORTEM APPEAHANCES are delayed putrefaction, corro-
sion and cedema of the tongue, mouth, and oesophagus. The stomach
contracted, grayish or veh'ety red, its ^•eins filled with almost coagu-
lated blood; the mucous membrane corrugated, loosened, or hardened.
The intestines are inflamed. There are evidences of peritonitis, indud-
ing effusion of red serum into the peritoneal sac, and congestion of the
vessels of the omentum. The li^-er is the seat of fatty degeneration, and
the kidneys are highly injected, with jDarenchymatous degeneration.
Detectiox axd Determination. — In the method of Fresenius and
von Babo any aluminium present will be contained in the solution
designated as Vlab. in the description of the process given in the fiist
section (see page 196). The aluminium is separated as hydroxid by
addition first of hydrochloric acid to acid reaction, and then of ammo-
nium hydroxid to alkaline reaction, and boiling until the liquid is
neutral or only faintly alkaline. This is best done in a platinum
' "Empoisonnements," 2eme ed., ^Pester med.-chir. Presse, 1902,
1875, 21S, 210. xxviii., 241.
2 Bull. See. m6d.-16g., Paris, 1871, ' Vrtljschr. f. ger. Med., 1905,
ii-, 4:28. 3 F., xxix., 62.
^Vrtljschr. f. ger. Med., IS'.U, 3 » Gazz. d. osp„ 1902, xxiii., 956.
F., viii., Supplehft., 74. » Gazz. med. lomb., 1905, bav.,
* Taylor: "Man. Med. Jur.," 11th 495. ,..,
Am. ed., 98. "In Stevenson's case the c»
' "Tr. d. Tox.," .>eme ed., i., :',7(). did not vomit, but died shorti;
after the administration.
ACID SULFATKS — ALUM, KTC. 275
vessel, or, failing that, less well in one of porcelain. Glass vessels
should not be used. The precipitated aluminium hydroxid is washed
with boiling water, first two or three times by decantation and after-
ward in a filter or Gooch crucible with the aid of a filter pump, until
the washings no longer precipitate with silver nitrate. For quantita-
tive estimation the aluminium hydroxid is ignited in a platinum cru-
cible and weighed as aluminium oxid (AI2O3). Of this one part repre-
sents 17.0777 parts of crystallized ammonia alum [Al2(SOj)3, (NHJ2-
SO,-|-24Aq], or 8.6893 of the anhydrous alum [AlsCSOJ,, (NH,)^-
SOJ; or 6.1262 of aluminium sulfate [Al2(SOj3]. After weighing,
the oxid is heated in the platinum crucible with monopotassic sul-
fate (KHSO4) to quiet fusion, and the cooled mass treated with water, in
which it should dissolve completely. If any insoluble residue remain
it is silicic anhydrid, and should be dried, ignited, and weighed, and
its weight subtracted from that of the aluminium oxid found. The
solution will serve for further identification reactions.
Any shorter method of separation of dissolved alum from the vis-
cera is not to be recommended. If the question be whether a given
white solid is or is not alum, it should be dissolved in water, evapo-
rated to crystallization, and the proportions of aluminium and of sul-
furic acid determined in a portion of the crystals. When aluminium
has been found in the viscera a quantitative determination of the sul-
furic acid is desirable, and should be made if any material remain
available.
Aluminium is identified: 1. By its behavior as above described in
the process of separation.
2. Potassium and sodium hydroxids produce voluminous white,
flocculent precipitates of the hydroxid, easily soluble in excess of the
precipitant.
3. Ammonium hydroxid and hydrosulfid also cause similar precipi-
tates, only soluble in a great excess of the hydroxid.
4. Alkaline carbonates produce white, flocculent precipitates of a
basic carbonate, sparingly soluble in excess of the precipitant.
5. Sodium phosphate produces a voluminous white precipitate of
the phosphate, which is easily soluble in soda or potash solution, but
almost insoluble in ammonium hydroxid, particularly in presence of
ammonium chlorid. The precipitate is also soluble in nitric or hydro-
chloric acid, but not in acetic acid. The precipitation is hindered by
the presence of citric acid.
6. If a solid aluminium compound be strongly heated on charcoal
before the blowpipe, moistened with cobalt nitrate solution, and again
heated, a deep sky-blue, unfused mass remains, the color becoming
more pronounced as the mass cools. The reaction is best performed
with the oxid obtained by heating the precipitated hydroxid. A similar
276 TOXICOLOGY WITTHAUS.
blue mass is also formed in the absence of aluminium by the phosphates
of the alkaline earths.
Cupric Sulfate. — See under Copper.
Zinc Sulfate. — See under Zinc.
Acid Potassium Sulfate.
MoNOPOTASsic Sulfate; Potassium Bisulfate, KHSO^.— This is
a salt of strongly acid reaction, which is used in chemical laboratories
for the decomposition of refractory oxids, such as that of aluminium,
the acid sulfate at elevated temperatures being decomposed into the
dimetalhc salt and free sulfuric acid— (2KHSO4 =K2SO^+H2SO,).
Although it would probably act even more energetically than alum if
swallowed, we know of no instance of its having been taken by the
human subject. It may be generated, however, under certain condi-
tions, and give rise to a form of chronic sulfuric poisoning. In the
"plastering" of wine, the added plaster-of -Paris produces free tartaric
acid and neutral potassium tartrate from the cream of tartar naturally
present, and subsequently, particularly in the presence of alcohol,
cream of tartar and acid potassium sulfate are formed. The reactions
are 2(KH.C,0,H,) -|-CaSO, =CaC,0,H, -fK^SO, -|-C,H,0„ and K,SO,
+ C,He0e=KH.C,0eH,+KHS04. The continued use of plastered
wines produces disorders of digestion, and the practice of plastering
is ranked as an adulteration.' According to Kobert,^ acid potas-
sium sulfate is also formed in the economy during starvation and with
extensively albuminous diet.
The NEUTRAL POTASSIUM SULFATE ; Dipotossic Sulfate, KjSO,, when
taken in large dose and in concentrated form behaves as an intense
local irritant and also as a true poison, as do all of the potassium
salts. It has caused death in a few instances, and in two English cases
men were tried for murder for having caused the death of their wives
by this salt given as an abortive with the consent of the deceased.'
HYDROCHLORIC ACID.
Hydrochloric acid is a colorless gas, intensely irritating when
inspired even in a highly diluted form, verj- soluble in water, one
volume of which dissolves four hundred and eighty volumes at
0° (32° F.), acid in taste and in reaction, heavier than air, specific
gravity 1.259. Its molecular weight is 36.5, and its formula is
'See Gaultier: "Sophistication Tr., 1843-44, iii., 243, 256. Reg.f'
des Vins," Paris, 1884, 222. Viard: Gaylor, 1856; ibid., 1856-57, xvi,
"Les Vins," etc., Paris, 1884, 299, 295. See also Bayard: Ann. d'hyg-.
346. Bussy et Buignet: J. d, etc., 1842, xxvii., 397; Bonnasaes;
pharm. at de chim., 1865, 4 s., ii., 1. Gaz. d. hop., 1843; Du Herat et
^"Intoxikationen," p. 211. Delens: Diet. univ. d. mat. mw.,
' Reg. V. Haynes, 1843; Ph. J. and 485.
HYDROCHLORIC ACID.
277
HCl. It exists in volcanic gases, and is produced whenever a
chlorid is decomposed by a stronger acid. The reaction utilized
in its manufacture is the decomposition of sodium chlorid by
sulfuric acid, which takes place according to the equation:
NaCl + H2S04 = NaHS04 + HCl at low temperatures; or 2NaCl +
H2S04 = Na2S04+2HCl under the influence of heat.
The material so extensively used in chemical industries, and
the one which is of toxicological interest, known as hydrochlo-
ric or muriatic acid, spirit of salt, is a solution of this gas in water
of varying degrees of purity and of strength.
The commercial acid is a yellow liquid, containing about
thirty-two per cent. HCl (specific gravity 1.16), and is contami-
nated with ferric salts, to which its color is due, sodium chlorid,
arsenic trichlorid, free chlorin, sulfur dioxid, and occasionally
a minute quantity of thallous chlorid and of selenium.
Acidum hydrochloricum, U. S. P., Br. P., is a colorless liquid,
freed from all but traces of impurities, specific gravity 1.16
( = 31.9 per cent. HCl). The acidum hydrochloricum dilutum
is the above, diluted with water to specific gravity 1.049 ( = ten
per cent. HCl), U. S. P., or specific gravity 1.052 (=10.5 per cent.
HCl), Br. P.
C. P. {chemically -pure) hydrochloric acid is usually the same
as the pharmacopceial acid, and is far from pure. "Absolutely"
or "strictly" C. P. acid more nearly approaches but rarely attains
the degree of purity requisite for toxicological uses.'
The strength of the acid, in the absence of dissolved solids,
is indicated by its specific gravity. There is some divergence
between the older tables of Ure and of Davy.' The following,
by Kolb,^ is probably the most accurate:
to ta IS
i
■3>3
CO Mol
as
•o>3
CO ««
■3-?S
las
Ms
3D,
as
CO M«
A
MS
>— 1
1.007
1.5
1.052
10.4
1.091
18.1
1.134
26,6
1.166
33,0
1.190
37.9
1.014
2,9
1.060
12.0
1.100
19,9
1.143
28,4
1.171
33,9
1.195
390
1.022
4.5
1.067
13,4
1.108
21,5
1.152
30,2
1.175
34,7
1.199
39,8
1.029
5.8
1.075
15,0
1.116
23,1
1,157
31 ,2
1,180
35,7
1 . 205
41.2
1.036
7.3
1,083
16,5
1,125
24 8
1,161
32
1,185
36,8
1,210
42,4
1.044
8.9
1.212
42.9
' See p. 182.
== Bull. Soc. Chim., Paris, 1872,
xvii., 281. =' = 59° F.
za
TOXICOLOGY WITTHAUS.
Hydrochloric acid reacts readily with iron, zinc, and most
of the more distinctly electro-positive metals, except copper,
with formation of a soluble chlorid and evolution of hydrogen,
A few of the chlorids, such as stannic chlorid — SnCl4— and an-
timony pentachlorid — SbClj — are liquid; the remainder are solid,
crystalline, and more or less volatile. The chlorids of the non-
metals are decomposed by water. Those of the metals are solu-
ble in water, except argentic and mercurous chlorids— AgCI
and HgjCla — which are insoluble, cuprous chlorid — CujClj—
which is very sparingly soluble, and lead chlorid — ^PbClj — which
is only sparingly soluble in cold and more readily in hot water.
Hydrochloric acid also dissolves most of the basic oxids and hy-
droxids with formation of chlorids, and decomposes the car-
bonates with evolution of carbon dioxid.
Hydrochloric acid is first referred to in the fifteenth century
by Basil Valentine, who obtained it in solution by distilling
vitriol and common salt. The gas was first collected and stud-
ied by Priestly in 1772. It was not, however, until the early
years of the nineteenth century that the development of the
Leblanc soda industry and the recovery of the enormous vol-
umes of hydrochloric acid which it produced, as an incidental
product, furnished the acid on a commercial scale, and caused
its extensive introduction into the arts. It is at this period also
that its toxicological history begins. Although SproegeP had,
in the middle of the eighteenth century, experimented to deter-
mine the effects produced by hydrochloric acid when injected
into the veins of animals, and similar experiments were made by
Courton, Viborg, and Orfila early in the nineteenth,^ the first
death of a human being following the swallowing of the acid
was in Serres's case in 1805, in which, however, it may be ques-
tioned whether the acid, which was given the patient by the
hospital interne by mistake, was the cause of death or whether
he succumbed to the injuries he had received. Certainly the
dose, 45 gm. (giss.), was sufficient to cause death.' Death
from hydrochloric acid is of exceptional occurrence except in
Great Britain, and but a very small proportion of the cases have
been homicidal. We find mention of but five alleged homicides
I "1
' Experimenta circa varia ve- ^ Wibmer: "Wirkung der Are-
nena," etc., Diss., Gottingen, 1753, neimittel," etc., iii., 97.
pp. 84-86. 3 Orfila: "Tox.," 5#me ed,. i., 19»'
HYDROCHLORIC ACID SYMPTOMS. 279
by this corrosive, in two of which the victims were adults:
Affaire Quenardel, France, 1839;' Affaire Denisty, Belgium,
1846;^ Affaire Poindron, France, 1847;^ Reg: v. Somers, England,
1866;^ and a case in Germany in 1873.^ But deaths from
hydrochloric acid are of more frequent occurrence at the present
time than formerly, particularly in Great Britain.'* Of 126 cases
3 occurred before 1840, 3 in 1840-49, 8 in 1850-59, 10 in 1860-69,
15 in 1870-79, 36 in 1880-89, 28 in 1890-99, and 23 in 1900-1909
(six months, 1909). Hydrochloric acid was introduced into the
vagina of a pregnant girl. She did not abort, but the degree
of atresia vaginse produced necessitated perforation of the child
at term.' A girl in England fell into a vat of hydrochloric acid,
swallowed some, and died.^
In suicidal and accidental cases the acid has been either taken
in its own form or in that of "soldering-liquid," used by tin-
smiths and metal workers, which is a solution of zinc chlorid
containing excess of acid. v. Hofmann" records the death of an
infant suffering from hemateraesis on the third day after adminis-
tration of solution of ferric chlorid containing free hydrochloric
acid.
Acute poisoning by gaseous hydrochloric acid may result
from the anaesthetic use of chloroform by gas-light. '° Chronic
poisoning by the same gas is sometimes met with among op-
eratives in chemical factories, and is characterized by pharyngitis,
laryngitis, bronchitis, conjunctivitis, and coryza.
Symptoms.
The deleterious effects produced by the inhalation of gaseous
hydrochloric acid have at present little forensic interest, although
they may become the subject of discussion in connection with
' Orfila: Loc. cit., i., 216. * Taylor: "Poisons," 3d Am. ed.,
-Orfila: Loc. cit., i., 221. Van 220.
den Broeck: Gaz. m6d. beige, 1847, ^ Zimmermann: Cor.-Bl. d., aerztl.
v., 94, 99, 102, 105, 169, 175. Pier- Ver. d. rhein. Prov., 1873, No.
ard: Ibid., p. 113. Orfila: Ann. xii., 21.
d'hyg., etc., 1848, xl., 137. Flan- " See note 8, p. 232.
din: "Poisons," ii., 491. Tardieu: ' Jhrbt. u. d. Fortschr. d. Geb.,
"Emp.," 26me ed., 246. 1893, p. 858.
= Orfila: "Tox.," 56meed.,i., 224. « Pharm. J., 1908, 4 s., xxvii., 446.
Ann. d'hyg., etc., 1847, 178. Flan- ""Lehrb. d. ger. Med.," 9te
din: "Poisons," ii., 482. Tardieu: Aufl., 680.
"Emp.," 2§me ed., 247. '» See p. 1145.
280 TOXICOLOGY WITTHAUS.
the public health, should the gas be discharged into the air as
it was in the early days of the soda industry.
The liquid acid, when swallowed, produces symptoms very
similar to those caused by sulfuric acid. The main points of
difference are the following: The action upon the skin is mucli
less intense. The hands may be washed in a moderately dilute
acid with perfect impunity; and Lesser^ has demonstrated that
even the most concentrated acid leaves no permanent marks
when apphed to the skin.' White vapors are sometimes ex-
haled from the mouth and nose.' The mucous membrane of the
mouth, lips, and tongue are rarely blackened, but are usually
whitish or ash-gray. The inhalation of the gaseous acid, which
is given off from the solution, produces irritation of the respira-
tory passages, whether the liquid penetrates them or not. Res-
piration is accelerated, there is pain in the throat and behind the
sternum, cyanosis of the face, and almost complete extinc-
tion of the voice, if the acid have been taken in concentrated
solution. Indeed, the action upon the respiratory organs may
be so intense as to mask almost completely the symptoms of
corrosion. This was well marked in a man of fifty-eight years
who swallowed about 200 gm. XBvij.) of the commercial acid.
He immediately experienced severe epigastric pain and a sense of
suffocation. A physician who was called immediately provoked
several acts of vomiting. During the night and the following
day the oppression and suffocation increased. When admitted
to the hospital on the second day there was no vomiting and no
violent epigastric pain, even on pressure; but the oppression and
dyspnoea were intense. The respiratory troubles were so pre-
dominant and the lesions of the stomach so silent, that but for
positive information, the poisoning would have been doubted,
and the case would have been considered as one of acute bron-
cho-pneumonia, developed in a somewhat delirious alcoholic. A
few hours after admission, after having eaten and drank without
difficulty, he died almost suddenly, in full consciousness, without
having vomited once.*
' Arch. f. path. Anat., etc., 1881, ' Viscarro: Siglo med., Madrid,
Ixxxiii., 215. But see p. 283. 1878, xxv., 667.
^An artificial skin gangrene is, * LetuUe and Vaquez: Arch. a.
however, produced by rubbing with phys. norm, et path., Paris, IW
crude hydrochloric acid. Gross: 5 s., i. 101. Vaquez: Bull. Soc.
Deut. .\rch. f. kl. Med., 1904, Ixxv., anat. de Paris, 1888, 5 s., ii., 546.
187; Zieler: Deut. Ztschr. f. Ner-
venhlk., 1005, xxviii., 184.
HYDROCHLORIC ACID SYMPTOMS. 281
The kidneys are but rarely affected, probably only when they
are already diseased. In a careful study of the urine of a man
of twenty-eight years who died in three months from the effects
of 100 c.c. (Siiiss.) of the commercial acid, Bourget' found that
while the acidity was greatly increased during the first day
or two, the urine contained no free hydrochloric acid, but a
great excess of phosphates; and that the quantity of chlorids
eliminated, far from being increased, was notably less than the
normal (about 10 to 15 gm. in twenty-four hours). During the
first few days albumin was present in small and progressively
diminishing amount. The urine of the first six days gave the
following quantitative results:
ist. 2d. 3d. 4th. sth. 6th.
Quantity in 24 hours . . . 1,100 c.c. 1,000 750 400 400 450
Sodium chlorid 6.6 2.75 0.60 0.08 0.08 0.18
PhosphatfiS 9.75 5. 3.24 1.52 1.36 1.70
Reaction^ 6. 1.8 1.4 1. normal.
Albumin small quant. dim. slight, none. none.
The elimination of the acid did not therefore take place by
the kidneys. But the patient on the second day and for several
days thereafter, vomited and regurgitated large quantities of
mucous liquid, which was found on analysis to contain an
average of about ten per thousand of sodium chlorid. Al-
though in this case and in another in which the dose taken was
still larger (200 gm.) the acid was without action on the kid-
neys, other cases have occurred in which the urine contained
albumin, blood corpuscles, and casts, ^ and, according to Demie-
ville,* even medicinal doses of dilute hydrochloric acid may
produce acute nephritis and hsematuria in those having latent
kidney disease.
In rapidly fatal cases, consequent upon the taking of large
doses, the action of the acid upon the central nervous system is
frequently well marked. In such cases death occurs either in
violent convulsions^ or in collapse. ° Instances of cicatricial
pyloric stenosis and of death from inanition due to hydrochloric
acid are by no means exceptional. In eleven of sixty-nine
' Rev. m^d. de la Suisse Rom., * Rev. med. de la Suisse Rom.,
1889, ix., 210. 1889, ix., 214.
^ Acidity in c.c. normal KHO. ^Friedreich's Bl. f. ger. Med.,
' Gehle: Berl. kl. Wchnschr., 1884, 1858, ix., 6 Heft, 70.
xxi., 337. " Bloomfield: Med. Times and
Gaz., 1883, i., 471.
282 TOXICOLOGY WITTHAUS.
cases (15.9 per cent.) death occurred in periods greater than one
month after the ingestion of the acid, from its secondary effects.
In Gehle's case, above referred to, the patient, a man of forty-
four years, died in four months and twenty-two days, having
suffered greatly during the last two months from enormous dila-
tation of the stomach, consequent upon pyloric stenosis. In
another instance a woman of fifty-five years, who died in about
five weeks, became so emaciated that the abdominal aorta could
be felt through the abdominal walls.' Nor is death from per-
foration of the alimentary canal and peritonitis of as rare occur-
rence as has been supposed.^ A girl took 177 c.c. (3vi.) of the
acid in the night. The next morning at eight o'clock vomiting
had ceased and she said she "felt fine, except for the pain,"
which was intense. She died suddenly at 3 p, m. The stomach
was found perforated in three places.^ A woman of thirty years,
about twenty-four hours after taking a glassful of the acid, was in
great pain, the abdomen distended, the vomit greenish, not
bloody, pulse 130, filiform. She died soon after of acute peri-
tonitis, the evidences of which and a perforation of the duodenum
were found at the autopsy.* A man of thirty-five j-ears devel-
oped the symptoms of peritonitis on the fourth day, became
greatly prostrated, and died on the seventh.^ A man of fifty-
four years died in collapse seventeen hours after swallowing
two tablespoonfuls of the acid. Not only was the stomach
found to be perforated, but the oesophagus and the duodenum
as well." Perforations of the stomach or intestine were found
to exist in twelve out of forty-five autopsies after death from
hydrochloric acid (or in, 26.7 per cent, of the cases observed).'
Diagnosis.
The diagnosis between corrosion by hydrochloric acid and
that by sulfuric or nitric acid is not always easy. Fortunately
for purposes of treatment it is not necessary. Occasionally the
white fumes and the odor given off with the expired air or from
' Ber. , . . Rudolph Stiftung, ' Le Gendre: Progres mM., 1883,
Wien, 1865, 153. See also under xi., 1057.
"Post-mortem Appearances." = von Wundscheim: Prag. med.
' vonJakschinNothnagers"Spec. Wchnschr., 1891, xvi., 605.
Path. u. Ther.," 1894, i., 22. « Dyson: Lancet, 1884, i., 65.
^Thomas: Australas. Med. Jour., 'See also "Post-mortem Appear-
1891, n. s., xiii., 542. ances."
HYDROCHLORIC ACID POST-MORTEM APPEARANCES. 283
the vomit may serve to distinguish hydrochloric acid. Positive
reliance is not to be placed upon the existence of yellow stains
upon the mucous membranes as indicating nitric acid, as stains
of that color are sometimes produced by hydrochloric acid and
even by sulfuric acid. The detection of the mere presence of
the acid in the vomit affords no indication as, except under un-
usual circumstances, it is a constituent of the gastric juice. Prob-
ably the only means of positive diagnosis, except when a resi-
due of the liquid taken is available and may be identified,
is by a quantitative determination resulting in the finding of
an amount of hydrochloric acid distinctly greater than that
normally present in the stomach contents; combined with the
existence of the usual symptoms of acid corrosion.'
Prognosis.
According to von Jaksch^ and others the prognosis is more
favorable with hydrochloric acid than with the other mineral
acids. This view is not borne out by the statistics of the 126
cases which we have collected. In these death occurred in 78.6
per cent. Of the 71 cases in which the duration is stated, it was
less than three hours in 2 (2.8 per cent.); during the first twenty-
four hours in 33 (46.5 per cent.) ; during the first week in 47 (66.2
per cent.); during the first month in 57 (80.3 per cent.) and in
periods of from one month to four years in 14 (19.7 per cent.).
Post-mortem Appearances.
Primary.- — The external burns, stains, and scars, which are
so generally observed on the lips and face when sulfuric or
nitric acid has been taken, are almost invariably absent. In-
deed Lesser^ considers the absence of such marks of corrosion
on the skin as a characteristic mark of distinction. The case of
a child of two years which died in a few hours from the effects of
sixty-two per cent, hydrochloric acid is, however, reported,* in
which the skin of both cheeks, as well as of the chin, was in
'See below, under "Analytical." 'Arch. f. path. Anat., etc., 1S81,
"Nothnagel: "Specielle Path.," Ixxxiii., 215.
etc., 1894, i., 22. * Casper-Liman: "Handb. d. ger.
Med.," 8te Aufl., ii., 547.
284 TOXICOLOGY — WITTHAUS.
many places colored light yellow, hardened, and reddened blue
litmus-paper applied to it. Sections through the skin showed a
uniform yellow coloration of its tissue. In the same place an-
other instance is related in which a man of twenty-eight years
drank a quantity of hydrochloric acid and then hanged himself.
The lips at their posterior half were whitish, cloudy, and partly
reddened from loss of epithelium. In a child which died in
nine hours from the effects of hydrochloric acid, the Hps were
brownish-red externally, gray internally, and the gums and
tongue also gray.^ In a girl of two years who died in four hours
from the effects of a 24.7 per cent, acid Lesser^ found the skin of
the face corroded.
The mouth, pharynx, and oesophagus are usually not the
seat of the severe lesions observed after death from sulfuric or
nitric acid. Indeed, even when a large dose had been taken
they have been found to be absolutely intact, save for a slight
reddening of the mucous membrane of the oesophagus near the
cardia.^ More frequently they are whitish or slate-gray in
color. That this is not always the case is evidenced by the fol-
lowing observations: In a child which died in about twenty-
four hours the tongue was found corroded, the oesophagus con-
gested and corroded; the parts about the upper opening of the
larynx were in part hypersemic, in part corroded, the latter of
the color of fat.^ In a man who died in seven hours the inner
surface of both lips were gray-black; the upper part of the epi-
glottis black; the walls of the oesophagus swollen and gray-
black in color.' In a young woman who died in a few hours,
the mucous membrane was black and looked as if burnt.' In a
woman of thirty years, who died in twenty-four hours, the
tongue was greatly congested, the isthmus of the fauces black-
ish, as well as the upper surface of the epiglottis. The oesoph-
agus presented an annular ecchymosis 2 cm. wide, and the re-
mainder of the mucous membrane was of a dark j-ellow-brown.
At about 5 cm. from the cardia the oesophageal mucous mem-
' Zimmermann: Cor.-Bl. d. aerztl. *Hunt: Med. Times and Gaz.,
Ver. d. rhein. Prov., 1873, No. 1883, i., 609.
xii., 21. 'Fagerlund: Vrtljschr. i- f'
' Vrtljschr. f. ger. Med., 1898, Med., 1894, 3 F., viii., Supplhft,
3 F., xvi., 82. 56.
^ LetuUe and Vaquez: Arch. d. '^ Id. ibid.
phys. norm, et path.. Par., 1889, 5
s., i., 102.
HYDROCHLORIC ACID POST-MORTEM APPEARANCES. 285
brane was black; the coloration, which resembled a coating of
pitch, extending over portions of the stomach.^ In a man who
died in twenty-six hours, the bucco-pharyngeal mucous mem-
brane was dead white a,nd the tongue and fauces were moderately
swollen. In front of the lingual V the tongue was whitish, be-
hind distinctly arborescent, with prominent papillae; on both
sides, between the amygdalae and epiglottis, the exposed sub-
mucous tissue was bright red. The oesophagus was brown,
darker above. ^ In a man who died in four and a half hours the
mucous membrane of the CEsophagus was blackish-gray, and the
submucous vessels thrombosed.^ In Leaser's case* there was
almost total corrosion of the epithelium of the mouth, pharynx,
and oesophagus, and partial hemorrhagic gastritis, with loss of
substance.
The oesophagus has been found dilated in two instances,''
and twice perforated. In one case the appearances closely re-
sembled those produced by sulfuric acid. The mucous mem-
brane of the oesophagus was congested in the upper half. In the
lower half it was black, thickened, and contracted; the veins
were filled with black blood. Just above its passage through the
diaphragm it was perforated in the posterior wall, and the tissue
around the opening was black, pulpy, and infiltrated with gru-
mous matter." The second case was that of a woman who died
on the second day after having swallowed 15 gm. of the' acid, and
in whom the oesophagus was also deeply corroded and blackened.'
The stomach is usually of normal size or contracted, al-
though in two instances of death from primary action it was
found distended.* Its mucous membrane is for the greater part
corrugated, hardened, and of a brownish or slate-gray color."
Although in most cases the gastric mucous membrane is much
lighter in color than when corroded by sulfuric acid, several
cases are reported in which it was found blackened in whole or
' Le Gendre: Progres m^d., 1883, " Dyson: Lancet, 1884, i., 65.
xi., 1057. ' Geissler: Vrtlj., f. ger. Med.,
2 Fortunet: Lyon m6d., 1885, xli., 1909, 3 F., xxxvii., 79.
587. * Johnson: Brit. Med. Jour., 1871,
'Legg: St. Barth. Hosp. Rep., i., 221. hegg: Loc. cit.
1874, X., 230. " For colored plate of stomach ma
*Loc.'cit. case of primary hydrochloric acid
* Hadden: Tr. Path. Soc, London, intoxication see LetuUe and Vaquez,
1889-90, xli., 84. Gehle: Berlin, loc. cit.
kl. Wchnschr., 1884, xxi., 337.
2S6 TOXICOLOGY WITTHAUS.
in part.' Among the small number of early cases we find men-
tion of perforation of the stomach as having been met with in
one case only.- Since 1872 it has, however, been observed in
twelve autopsies;^ while in two cases the gastric wall had be-
Cfjme thinned to such a degree that perforation was imminent.'
The rapidity with which deep corrosion results is evidenced by
one of Geissler's cases^ in which a woman swallowed 15 gm, of
concentrated hydrochloric acid at 8 a. m. At 2 p. m. the same
day on proceeding to a gastrostomy the gastric wall was found so
fragile that sutures broke through and a jejunostomy was
necessar}^ A perforation was threatening.
The intestines have been found perforated in two instances,
in both cases near the pylorus. ° When there has been perfora-
tion of the alimentary canal, more or less extensive evidences of
peritonitis are observed. In two instances the escaped acid
liquid had also corroded the liver.' In one of Fagerlund's cases,*
although there was no perforation, there were subserous ecchy-
moses in the stomach, the peritoneal cavitj' contained one and
a half litres of reddish, serous Uquid, and the visceral peritoneum
was dull.
Even in rapidly fatal cases the liver has been found fatty.'
The kidneys are usually normal, or, if abnormal, more prob-
ably so from disease than from the action of the acid.'"
ilarked changes are met with in the respiratory organs.
The larynx and trachea are reddened and congested, occasionally
superficially ulcerated in places, and covered with a grayish-
white friable false membrane. The bronchi also are inflamed,
'Hunt: Loc. cit. Legg: Loc. cit. AVundscheim:Prag. med. Wchnschr.,
Fagerlund: Loc. cit. (2 cases). Le 1891, xvi., 605. Beyerlein: LocA
Gendre: Loc. cit. Thomas: Austral. Bourdet: Lyon m^d., 1895, bnviii.,
Med. Jour., 1891, n. s., xiii., 542. 191. Geissler: ioc. Ci/., p. 82, two
Beyerlein: Friedreich's Bl. f. ger. cases.
Med., 1890, xli., 31. 'Fortunet: Loc. cit. Casper-Li-
- Aff. Poindron, 1847, Ann. d'hyg., man: Loc. cit., case 223.
etc., 1847, xi., 178. In Gu^rard's ^ Loc. cit., p. 79.
account no mention is made of " Dyson: Loc. cit. Le Gendre:
perforation, but the gastric wall Loc. cit.
was softened, a glassful of purulent ' Dyson: Loc. cit. Schad: Aerztl.
fluid was in the peritoneum and Int. BL, 1885, xxxii., 406.
there were adhesions: Ann. d'hyg., "Loc. cit., p. 58.
1S52, xlviii., 415. » Beyerlein: Loc. cit. Legg: iM.
^ Dyson, Loc. cit. Legg: Loc. cit. cit.
Fagerlund: Loc. cit. Thomas: Loc. i" Le Gendre: Loc. cit. Bourget:
cit. Xager: Arch. d. Heilk., 1S72, Rev. m^d. de la Suisse Romj,
iii., 213. Casper-Liman: Lor. cit., 1SS9, ix., 210. Fortunet: hoc A
case 232. Beyerlein: Loc. cit. v, Schad: Loc. cit.
HYDROCHLORIC ACID — ^ANALYTICAL. 287
and evidences of broncho-pneumonia are found in the lungs.'
In other cases, however, the respiratory organs are found en-
tirely normal.
Secondary. — The post-mortem appearances after death
from the secondary effects of hydrochloric acid do not differ
from those observed in similarly fatal cases caused by other
corrosives.
Analytical.^
The chemical detection of abnormal free hydrochloric acid
in the stomach is even more difficult than that of sulfuric or ni-
tric acid, and absolutely requires a determination of quantity.
Not only are the same difficulties met with as have been re-
ferred to in considering sulfuric acid, but two sources of error
peculiar to this acid are to be avoided. The normal gastric se-
cretion contains free hydrochloric acid in the average propor-
tion of about 4.66 in 1,000 parts in the human gastric juice.
The extremes found by Hornborg in gastric juice unmixed with
saliva were 3.65 and 5.66 p. m.^ Moreover, the stomach contents
always contain chlorids in widely varying amount, and these may
be decomposed at elevated temperature even by lactic acid,
which exists in the stomach during the digestion of carbohy-
drates, with liberation of free hydrochloric acid. The mere de-
tection of free hydrochloric acid in the stomach contents or vomit
is, therefore, entirely without significance, and it is only when it
is found present in large amount that the results of a chemical
examination of these materials are of value when taken in con-
junction with the clinical history and the post-mortem appear-
ances. It is only when death occurs quite early, or when the
matters first vomited (before the administration of an antidote)
are available, that any information is to be expected from a
chemical analysis.* In the description of one of Fagerlund's
cases it is said that the highly acid stomach contents gave dis-
tinct reactions for hydrochloric acid, and dissolved a bar of zinc
'Nager: Loc. cit. LetuUe and served rather to befog than to eluci-
Vaquez: Loc. cit. date the case by reason of the un-
^ See also p. 263. tenable ground taken by the ana-
^Jahresb. u. Thier-Chem., 1904, lyst. See Van den Broeck: Gaz.
xxxiii., 547. m^d. Beige, 1847, v., 94, 99, 102,
* In the Aff. Denistx an analysis 105, 169, 175.
288 TOXICOLOGY WITTH.\r.S.
with evolution of gas. ' In a case of death from "a small swallow"
of 24.7 per cent, acid reported by Lesser^ 2.0047 gm. of the free
acid were found in the alimentary canal.
Separation from Stomach Contents, etc.— Several methods
for the separation and determination of free hydrochloric acid in
organic mixtures have been suggested:
1. By simple distillation of the material (after dilution
with water and division of solid particles if necessary) to dry-
ness, and collection of the distillate, in which the acid is identi-
fied and determined by the silver method (see below).
Although this method may yield fairly good results if the
quantity of acid present be very great, it is open to several ob-
jections, and requires the exercise of certain precautions. Dur-
ing the distillation small quantities of sodium chlorid may be
mechanically carried over with the distillate. This may be
avoided by passing the vapor through a wide glass tube, loosely
packed with glass wool and maintained at a temperature of
about 110° (230° F.). The materials may contain ammonium
chlorid (particularly if they have undergone putrefaction),
which also passes over with vapor -of water and is not com-
pletely arrested by the glass wool. The most serious objection
is that organic substances strongly retain hydrochloric acid,
which, even if present in notable quantities, may be entirely ab-
sent in the distillate if the heat be raised only sufficiently to
cause evaporation to dryness. The remainder of the acid is only
driven off by heating the organic matter to carbonization,
when empyreumatic products are given off which interfere
with the subsequent determination.
It must not be forgotten that in this, as well as in all distil-
lation methods, if the materials contain a free fixed acid (sul-
furic, phosphoric, lactic) it will decompose the chlorids pres-
ent and yield free hydrochloric acid. Consequently in all such
methods the presence or absence of these acids must be ascer-
tained, and if present their quantity determined in a separate
portion of the material.
2. ViTALi's method,^ which is one of the best, is a combi-
nation of extraction by alcohol and by water and distillation-
' hoc. cit., p. 57. 3 L'Orosi, 1886, ix., 361 ; "
= Vrtljschr. f. ger. Med., 1898, di Chim. Toss.." 1893, p. 159
3 F., xvi., 82.
HYDROCfiLORIC ACID ^ANALYTICAL. 289
The materials, suitably comminuted if necessary, are macerated
in eight times their weight of absolute alcohol for twenty-four
hours, after which the alcohol (A) is filtered off and the residue
(S) washed with alcohol until a few drops of the washings no
longer become cloudy with silver nitrate.
A, the alcohol extract, is divided, by distillation until the
amount of alcohol added has passed over, into an alcoholic dis-
tillate, Aa, and an aqueous residue, Ab. Aa is fractionally
distilled at very low temperature, using well-cooled condenser
and receivers. Two fractions are collected, the receiver being
changed when the distillate begins to have an acid reaction.
The first fraction is tested for ethyl chlorid (produced by the
action of the acid on the alcohol) as follows: It is placed in a
small flask fitted with a cork carrying two tubes, one of which,
communicating with the air, dips to near the bottom of the
liquid; the other, terminating just below the cork and bent at
right angles, communicating with a calcium chlorid tube, which
in turn communicates with a wider tube 30 cm. long, filled with
purified asbestos and supported in a furnace. The other end of
the asbestos tube is fitted to a Liebig's bulb, filled with silver
nitrate solution, whose other opening is attached to an aspira-
tor. The asbestos tube is first heated to redness when a slow
stream of air is drawn through the apparatus, while the flask
is gently heated on a water-bath. The volatilized ethyl chlo-
rid is decomposed in the hot tube, and the hydrochloric acid re-
generated is precipitated as silver chlorid (see below).
In the second fraction hydrochloric acid is precipitated by
silver nitrate (see below.)
Ab, the aqueous residue of the first distillation, is further dis-
tilled to dryness, the distillation being continued until that
which passes over is no longer acid. A known fraction of the
distillate is removed and used for the application of tests 3, 4,
and 6 (see p. 266) for mineral acids, and of tests (see below)
for the identification of hydrochloric acid. The remainder is
precipitated with silver nitrate and the silver chlorid collected.
Finally the temperature of the distilling vessel is gradually
raised to redness. Any ammonium chlorid present partly dis-
tils and partly sublimes. The distillate and sublimate are
united, treated with acetic acid, evaporated to dryness, and the
residue washed with absolute alcohol and dissolved in water.
IV.— 19
290 TOXICOLOGY WITTHAUS.
In this solution hydrochloric acid is tested for by silver nitrate
and ammonium by platinic chlorid.
B. The material insoluble in alcohol is macerated in water
for twenty-four hours. The solution Ba is filtered from the
undissolved portion {C), which is washed with water until the
washings are no longer acid. The filtrate and washings are
evaporated on the water-bath to a syrup, which is treated with
eight times its weight of absolute alcohol. The precipitate
which forms contains any hydrochloric acid which was present
in the form of an acid albumin soluble in water, but insoluble in
alcohol. It is treated with disodic carbonate (free from chlorid),
evaporated, fused, and the fused mass dissolved in water, and
precipitated with silver nitrate after addition of nitric acid to
acid reaction. The undissolved portion C may stiU contain
acid albumin insoluble in both water and alcohol. This is di-
gested with dilute disodic carbonate solution, filtered, washed,
and the united liquids evaporated to dryness, and the residue
fused and treated as above described.
The quantitative determination of free hydrochloric acid is
made with the acid second fraction above referred to. To an
aliquot part of this nitric acid is added, then silver nitrate solu-
tion in slight excess. The precipitate formed is collected on a
filter after it has been rendered fiocculent by agitation and
slight warming, dissolved off with ammonium hydroxid solu-
tion, reprecipitated with nitric acid in excess, collected upon an
ash-free filter, washed, and dried. The silver chlorid is sepa-
rated from the filter as much as possible, the filter burned in a
small, weighed porcelain crucible, the ash treated with nitric
acid and a few drops of hydrochloric acid, and evaporated to
dryness. The silver chlorid is then added to the contents of the
crucible and cautiously ignited until it just begins to fuse at the
edges, cooled and weighed. The weight obtained by subtract-
ing the weight of the empty crucible from that last obtained,
and multiplying the difference by 0.2543 is that of the hydro-
chloric acid in the quantity of solution operated upon.
3. Rodssin's Method.' — The material, finely hashed and
diluted to a thin paste if necessary, is intimately mixed and di-
vided into two perfectly equal parts. To one of these an excess
of pure disodic carbonate is added. Each half is then sepa-
' Tardieu: "Kmpoisonnement," 2^me ed., 1S7.5, 243.
HYDROCHLORIC ACID — ANALYTICAL. 291
rately treated as follows: They are evaporated to dryness, incin-
erated in porcelain crucibles to complete carbonization, the car-
bonized residues extracted with equal volumes of water, and the
quantity of hydrochloric acid in each is determined by precipi-
tation with silver nitrate as above described. The difference
between the two amounts so found is the quantity of free
hydrochloric acid present in one-half of the material.
A modification of this process, which permits of the deter-
mination of that portion of the acid present as acid albumin,
has been suggested by Winter-Hayem.^ Three equal portions
are taken in place of two: to one (a) excess of disodic carbonate
is added, the liquid evaporated on the water-bath, the residue
moderately ignited, extracted with water containing nitric acid
in excess, boiled, and the total chlorin determined as silver
chlorid (gravimetric ally or volumetrically). The second por-
tion (&) is evaporated, dried, moderately ignited, extracted
with water and nitric acid, and the quantity of chlorin,
existing as chlorids, similarly determined. The third portion
(c) is evaporated to dryness, the residue warmed on the water-
bath for an hour, after which excess of disodic carbonate is
added and the process continued as with a. The free hydro-
chloric acid = a — c; that existing as acid albumin = c — b.
4. CoHN.AND V. Mering's Method.^ — The filtered stomach
contents are distilled until two-thirds of the liquid have gone
over, water is added to the residue, and the distillation con-
tinued. The quantity of volatile acid in the distillate is deter-
mined by titration of a portion. The residue is agitated with
much ether. In the residue of evaporation of the ether the
quantity of lactic acid is determined by titration. The free
hydrochloric acid is determined in the distilled liquid, after
having agitated it with ether, as follows: Excess of freshly
precipitated cinchonin is added, and the mixture digested some
time at a moderate temperature. It is then extracted by several
agitations with chloroform, a further quantity of cinchonin be-
ing added after the third agitation. The residue of evaporation
of the chloroform is dissolved in water containing acetic acid,
' Corr.-Bl. f. Schweiz. Aertze, dieu-Rabuteau method (C.r. Ac. Sc,
1892, 735. Par., 1875, Ixxx., 61), canchonin be-
^Deut. Arch. f. kl. Med., 1887, ing substituted for quinin, as the
233; Ber,, Berl., 1887, xx., c. 226. latter decomposes chlorids.
This is a modification of the Tar-
292 TOXICOLOGY — WITTHAUS.
nitric acid is added, and the hydrochloric acid determined aa
described above as silver chlorid.
5. Sjogvist's Method.' — (v. Jaksch's Modification^).—
Neutral litmus solution is added, and then pure barium carbon-
ate in slight excess until the red color has disappeared. The
mixture is then evaporated to dryness, and the residue moder-
ately ignited. The carbonaceous mass is repeatedly extracted
with water, and the barium contained in the solution deter-
mined by precipitation and weighing as barium sulfate. The
weight of barium sulfate, multiplied by 0.6259, gives the weight
of hydrochloric acid present in the material operated upon.^
Tests for Hydrochloric Acid and Chlorids. — 1. Silver nitrate
produces a white, cheesy precipitate of silver chlorid, which is in-
soluble in nitric acid, soluble in ammonium hydroxid or potas-
sium cyanid solution.
2. Mercurous nitrate produces a white precipitate of mer-
curous chlorid, which turns black on addition of ammonium
hydroxid.
3. Lead acetate produces a white precipitate in solutions
which are not too dilute. The precipitate dissolves in hot
water, from which it crystallizes on cooling.
4. Free hydrochloric acid, when warmed with manganese
dioxid or with lead peroxid, evolves chlorin, which may be rec-
ognized by its odor, color, and bleaching action on moist vege-
table pigments, if the quantity be sufficient. Bonis* applies this
reaction to organic mixtures as follows: The material is acidu-
lated with pure acetic acid, filtered through muslin under pres-
sure, and then through paper, a few fragments of potassium
chlorate and some gold leaf are added, and the mixture is
' Ztschr. f. physiol. Chem., 1889, 1325. Rosenheim: /6id., 1892, xviii,
xiii., 1. 280,309. Wittmann: Jahresb.f.Kit-
"Monatsheft f. Chem., 1889, x., derhlk., 1892, xxxiv., 1. Marinoand
464. Dotto: Deut. med. Wchnschr., 1892,
^ For other methods see Bidder u. xviii., 126. Wagner: Ctbl.f.d.m.^ is-
Schmidt: "Die Verdauungssafte," sensch., 1892, xxx., 196. v.Pfungen;
Leipzig, 1852. Leo: Ctbl. f. d. med" Ibid., 262. Dmochowski: Deut. m.
Wissensch., 1889, xxvii., 481. F. A. Ztg., 1892, 388. Maurice: J. »■
Hoffmann: Ctbl. f. klin. Med., pliarm. et de chim., 1892, 6 s., v.,
1890, xi., 521. Salkowsld: Jahres- 350,450. Kossler: Ztschr. f. ptj"
ber, d. Pliarm., 1891, 220. Jolles u. siol. Chem., 1893, xvii., 91. Fried;
Wallenstein: Pharm. Post, 1891, lander: Apoth. Ztg., 1S92, 66o.
445. Graff enberger: Pharm. Ztc;., Martins u. Luttke: Ctbl. f. d. m.
1X91, 392. Katz: Wien.med. Wissensch., 1893, xxxi., 218.
Wchnschr., 1890, xl., 2193. Luttke: ^ Ann. d'hyg., etc., 1874,2 s,
Deut. med. Wchnschr., 1891, xvii., xli., 457.
NITRIC ACID.
293
warmed for an hour or two on the water-bath. If the liquid be
very dilute it is concentrated by evaporation on the water-bath.
The liquid is then decanted and the dissolved gold tested for by
stannous chlorid solution, which produces a purple-red or vio-
let precipitate. Chlorids do not produce this reaction except
in the presence of free sulfuric acid.
Chlorids.
We have already referred' to a case of death caused by the physical
action of sodium chlorid (common salt). Zahorski' has reported the
case of a child in which vomiting for five hours and collapse were caused
by two sodium chlorid enemata. Frohner^ reports several cases of
poisoning by sodium chlorid in horses and cattle.
Solutions of certain chlorids, acid in reaction or containing notable
excess of hydrochloric acid, exert an action upon the economy which
is a combination of the corrosive effects due to the acid and the truly
poisonous action of the metal. The most important of these are anti-
mony trichlorid, which will be considered along with the toxicology of
the other antimonials; zinc chlorid, which has already been referred to
as the "soldering liquid" used by tinsmiths, and which will be further
discussed among the zinc compounds, and mercuric chlorid, or "corro-
sive sublimate," which will be treated of under "Mercury."
NITRIC ACID.
Pure nitric acid is a colorless liquid, which boils at 86°
(186.8° F.) and solidifies at —40° (-40° F.), gives off white
fumes when exposed to air, and is strongly acid in reaction.
The specific gravity of the concentrated acid is 1.522. The spe-
cific gravity and boiling-point of the diluted acid vary with the
concentration:
go
i) .
■Ma
■*-i
C "
go
CO M
is
■Sa
1-
St
So
1.522
100.0
86°
1.315
50.00
113°
1.207
33.33
108°
1.155
25.00
104°
1.486
88.75
99°
1.297
46.67
1.197
31.82
1.138
23.00
1.452
77.78
115°
1.277
43.75
1.188
30.44
1.120
20.00
1.420
70.00
120°
1.260
41.18
1.180
29.17
1.101
17.44
1.390
63.64
119°
1.245
38.89
1.173
28.00
1.089
15.00
1.361
58.33
117°
1.232
36.84
1.166
26.92
1.068
11.43
1.338
53.84
1.219
35.00
1.160
25.93
1.022
4.00
' See p. 91.
" Inn. Cor .-hi., 1904, p. 480.
2 Tox. f. Thierarzte, p. 77.
294 TOXICOLOGY — WITTHAUS.
If a strong acid be distilled, the boiling-point gradually rises
from 86° until it reaches 120° (248° F.), when it remains con-
stant, the specific gravity of both distillate and distilled being
1.42. If a weak acid be distilled the boiling-point rises until
it becomes stationary at the same temperature.
The formula of nitric acid is HNOg, and its molecular weight
63.05. When exposed to air or to light, or when heated, it is
decomposed into nitrogen tetroxid, NOj, water, and oxygen.
Hence it is useful as an oxidizing agent. Most of the metals
dissolve in nitric acid as nitrates, a portion of the acid being at
the same time decomposed into nitrogen dioxid (NO) and water.
Gold and platinum are not attacked by nitric acid. The salts
of nitric acid (nitrates) are for the most part colorless and, with
the exception of a few "basic salts," soluble in water. When
fused they act as powerful oxidants. They are decomposed by
sulfuric acid at more or less elevated temperatures, with libera-
tion of the acid.
The commercial acid, aqua fortis, is a yellow liquid, met
with in two degrees of concentration : single aqua fortis, specific
gravity about 1.25 = thirty-nine per cent. HNO3; and douhk
aqua fortis, specific gravity about 1.4 = sixty-four per cent.
HNO3. It contains as impurities the oxids of nitrogen, sulfuric
acid, iron, fixed salts, and sometimes chlorin and iodin.
Acidum nitricum, U. S., Br., is a colorless acid, free from
the impurities above mentioned, and of specific gravity, 1.403=
sixty-eight per cent. HNO3. Like the C. P. acid, specific gravity
1.522 = one hundred per cent. HNO3, used in chemical labora-
tories, it must be kept in bottles completely filled and protected
from light. The dilute acid of the U. S. P. is of specific gravity
1.059, and contains ten per cent. HNO3.
Fuming nitric acid is a yellow liquid, fuming when exposed to
the air, made by saturating strong nitric acid with nitrogen
tetroxid. A similar acid, though more dilute, is known as
nitroso-nitric acid.
Although nitric acid was known certainly in the thirteenth
century, probably to the Arabians of the eighth century, and
possibly to the ancient Egyptians, we know of no earlier refer-
ence to its toxic action than that of Bruno Seidel, who relates
the case of a girl who was killed by drinking the acid.' ^^-
' " De morbis incurabilis," Francof., 1.303, p. 13.
NITRIC ACID. 295
ing the seventeenth and eighteenth centuries deaths from nitric
acid occurred occasionally, and Tartra, whose thesis^ was for
that period an exhaustive treatise upon the toxicology of the
mineral acids, relates 55 cases, 29 of which were first described
in this thesis. Of these, 26 died — 19 from the primary action,
and 7 from the secondary effects of the corrosive. Considering
the much more extended use of nitric acid at the present time,
the frequency of intoxications by it has not materially increased
since the time of Tartra. We find reference to 85 cases since
1802, distributed as follows: 1802-9, 1; 1810-19, 3; 1820-29,
6; 1830-39, 9; 1840-49, 5; 1850-59, 9; 1860-69, 17; 1870-79,
9; 1880-89, 15; 1890-99, 9; 1900-1909, 3. At the present time
nitric acid is apparently less frequently the cause of death directly
than either hydrochloric or sulfuric acid.
We find mention of fourteen criminal administrations of ni-
tric acid, all of which occurred on the continent of Europe.^
The earliest was one of Tartra's cases.'' In 1801 a woman of
thirty-five died, it was alleged, from the effects of nitric acid
mixed with white wine which was poured down her throat while
she was intoxicated. Two other French cases are reported.
One that of a woman who died from the effects of nitric acid
poured into her ear by her husband while she was intoxicated,
"to punish her";* the other the case of a woman who killed her
infant shortly after its birth by pouring nitric acid down its
throat.' Eight cases are reported in German literature. One
was in an adult female who took the acid under the advice of
her lover in the belief that it would provoke abortion;* the others
were in infants or young children.' One case, also in an infant,
' "Essai sur I'empoisonnement, ° Taylor: "Poisons," 3d Am. ed.
par I'acide nitrique," Paris, An x. 210, from Cazauvieilh: "Du suicide
[1802]. de I'ali^nation mentale," etc., Paris,
' Gribble and Hehir ("Med. Jurispr. 1840.
for India," 3d ed., 1892, p. 435) " Buchner: Friedreich's Bl. f.
state, on the authority of Dr. Rog- ger. Med., 1866, xvii., 192. Accord-
ers, that two cases of intoxication ing to Schauenburg (Vrtljschr. f.
occurred in India during 1883, ger. Med., 1872, n. F., xvi., 54), the
in which nitric acid was found mixed German name of this acid, "Scheide-
with coffee. wasser, "is applied to it from the
A man was convicted of murder prevalence of its use to separate the
by a mixture of sulfuric and nitric fcetus from the mother,
acids in 1889. (See Mixed Acids.) ' Osenbruggen: Friedreich's Bl.
'Tartra: Loc. cit. Orfila: "Tr. f. ger. Med., 1867, xviii., 75. Buch-
de tox.," 56me ed., i., 166. ner: Loc. cit. (2 cases). Casper-
*Morisson: Arch. gfo. de. m^d., Liman: " Handb. d. ger. Med.," 8te
1826, xi., 104. Orfila; Op. ci^., 172. Aufl., ii., 549; and Lesser: "Atlas
296 TOXICOLOGY WITTHAUS.
is reported from Hungary/ and two cases in young children from
Finland.^
Symptoms and Diagnosis.
The effects and manifestations produced by nitric acid are
similar to those caused by sulfuric or hydrochloric acid. The
principal point of difference is in the color of the stains formed
upon those portions of the skin and visible mucous membrane
touched by the acid. Owing to the xanthoproteic reaction pro-
duced by nitric acid upon the proteins, these are colored a
bright yellow, which turns to orange on the addition of am-
monia. Consequently the stains produced by nitric acid are
usually distinctly yellow, and subsequently become dirty light-
brown, and the superficial layer readily peels off in a short time.
Yellow stains are, however, neither constantly present nor cer-
tainly characteristic. The acid may be taken from a spoon or
other vessel passed well back into the mouth, when no visible
stains are formed, as in a case reported by Berselh.^ The lips
and skin of the chin have been seen to be excoriated, and the
tongue and buccal mucous membrane white or red in place of
yellow,* even when they have been corroded by nitric acid; but
such cases are unusual and exceptional. If the patient be seen
some time after the acid has been taken, the yellow stain may
be concealed by an eschar — as in a man who was seen on the
day after taking a teaspoonful of the acid. The lips and tongue
were covered with a thick brown scab, which peeled off the next
day, exposing the brightly yellow stained mouth and tongue.^
On the other hand, yellow stains may be produced by picric acid
or by any one of a number of other yellow dyes, and have even
been met with in corrosion by sulfuric acid."
If the patient be seen during the first twenty-four hours the
d. ger. Med.,"Pl. i., Fig. 2; Buchner: ^Duckworth: Tr. Clin. Soc,
Loc. cit., 1886, xxxvii., 9 and 14. London, 1886, xix., 53. Richar-
Lesser: Vrtljschr. f. ger. Med., 18118, diere: Ann. d'hyg., etc., 1886, 3 s.,
3 F., xvi., 83. XV., 88. St. Geo. Hosp. Rep., 1877-
' Masclilia:Samml. Gutacht.Prag. 78, ix., 18. Dougall: Glasgow M.
m. Fak., 1867, 3 F., 284. J., 1872, n. s., iv., 338.
= Fagerlund: Vrtljschr. f. ger. ' Guy's Hosp. Rep., 1859, 3 s., v.,
Med., 1894, 3 F., viii., Supplhft., 140.
59. See also "Statistics," p. 228, "Taylor: Guy's Hosp. Rep., 1846,
' Gaz. med. ital. Prov. Venet.,
■I860, iii., 201.
2 s., iv., 396.
NITRIC ACID PROGNOSIS. 297
most certain means of establishing a diagnosis in doubtful cases
is by the detection of nitric acid in the urine, which, moreover,
is red or dark in color. ^
Prognosis.
The prognosis in nitric acid intoxication is even more un-
favorable than in that by hydrochloric acid. Of 76 persons
affected 64, or 84.2 per cent., died, and 12, or 15.8 percent., re-
covered from the primary effects. Of 54 fatal cases in which
the duration is reported death occurred in less than three hours
in5 (9.2 per cent.), during the first twenty-four hours in 5 -1-16 = 21
(61.1 per cent.), during the first week in 21+12=33 (61.1 per
cent.), within a month in 33+7 = 40 (74 per cent.), and in periods
longer than a month in 14 (26 per cent.). The extremes of dura-
tion were "in a few minutes" in a new-born infant,^ and in three
hours in a woman of fifty-five years,^ as minima; and as maxima,
two years in one case and "several years" in another.*
Post-mortem Appearances.
These are very similar to those observed after death from sul-
furic acid, and under like conditions the destruction of tissue is
quite as extensive. In place, however, of the blackening of the
gastric mucous membrane so frequently met with after death by
sulfuric acid, the stomach, as well as the oesophagus, pharynx
and tongue, are usually yellow in color. The color varies from
a bright yellow to a dirty olive yellow, and frequently alter-
nates with black or red.^ While the yellow color is very rarely
absent in the oesophagus and stomach after death from the
primary action of nitric acid except when the acid has not been
' Richardifere : Loc. cif. ; Schulzen: three-quarter hours, quoted by Tay-
Arch. f. Anat., Phys., etc. 1864, lor from Sobernheim ("Handb. d.
500. Ipsen: Vrtljschr. f. ger. Med., pract. Tox.," Berhn, 183S, 402) it
1893, 3 F., vi., 11. Lassar (Zts. f. is not stated whether the decreased
physiol. Ch., 1877, i., 165) and was a child or an adult.
Spiegel (Diss., Wilrzburg, 1894), ■'Tardieu: "Empoisonnement,"
however, failed to find nitrates in 26me ed., 1875, 238, 239, quoted
the \irine. from Moutard-Martin and Vernois.
^ Taylor: "Poisons," 3d Am. ed., ^ Colored plates are to be found in
210. Lesser's "Atl. der ger. Med.," PI.
"Ipsen: Vrtjsehr. f. ger. Med., ii.. Fig. 2, and in Vrtljschr. f. ger.
1893, 3 F., vi., 11. In the notice Med., 1893, 3 F., vi., T. 1 and 2
of Bernt's case, of death in one and (Ipsen).
298 TOXICOLOGY — WITTHAUS.
swallowed, ' in some instances the color has been slate-gray^ and in
one case is described as green.^ A yellow color may be due to
causes other than nitric acid. Not only is the gastric mucous
membrane frequently tinged yellow by biliary pigment and by
the formation of arsenic trisulfid, but in a few instances a more or
less extensive yellow coloration has been observed after death
caused by sulfuric* or hydrochloric' acid, or by the mineral
alkalies." In one case the stomach was perforated.'
Analytical.*
If the acid have been swallowed in notable quantity and have
caused death within a short time, nitric acid, both free and in
combination, should be found not only in the stomach contents,
but in other tissues as well. In the body of a suicide who died
in three hours from the effects of a large but undetermined dose
of nitric acid, Ipsen' found free nitric acid in the stomach,
oesophagus, left pleural cavity, duodenum, pancreas, liver, and
spleen, and nitrates in the urine, 50 c.c. of which contained
1.1497 gm. HNOj,'" as well as in the brain, and in the blood
from the heart and lungs. As in fatal cases of acidism, the
circulating liquids and the tissues do not become acid before
death, although the degree of their alkalinity is diminished, the
presence of free nitric acid outside of the alimentary canal was
due to post-mortem diffusion of the acid through the non-per-
forated wall of the alimentary canal, although only nineteen
hours elapsed between the death and the autopsy. That such
diffusion takes place rapidly was shown by Ipsen by experiment
upon a cadaver. Bischoff" obtained 197 mgm. of the free acid
' Buchner: Friedreich's Bl. f. ger. « See p. 322.
Med., 1866, xvii., 187; 1886, xxxvii., 'Jacquemart:MarseiIlem^d.,1895,
9. xxxii., 208.
2 ToUemer: Bull. Soc. anat. de * See also p. 263.
Paris, 1891, 5 S., v., 670. » Vrtljschr. f. ger. Med., 1893, sr,
=> Harris: Indian M. J., 1885, iv., vi., 11.
675. 10 Nitric acid was also detected id
'Habershon: Med. Times and the urine in Schultzen's case of
Gaz., 1855, n. s., xi., 470. Jenner: aqua regia poisoning: -^ch. f. Aa,
Ihid., 1857, XV., 629. Falk: Viertel- Phys. u. w. Med., 1864, 500, and
jschr. f. ger. Med., 1875, n. P., one of Benjamin's cases: Chanle
xxiii., 14. Maschka: Ihid., ISSl, Ann., 1807-8, xxiv., 244.
xxxiv., 197. 11 Vrtljschr. f. ger. Med., 18»i
*> Kryspen: Arch. d. Pharm., lS(il, 3 P., xvi., 83.
clvii., 23. V. AVunschheim: Prag.
med. Wchnshr., Isill, x\-i., 605.
NITRIC ACID A\A LEXICAL. 299
(30 per cent.) from the alimentary canal of a child two days old,
whose death had been due to nitric acid poured into its mouth
and strangulation.
For the separation of nitric acid and of nitrates from por-
tions of the body, the process already described (see p. 266) is
to be followed. The extraction with alcohol should, however,
be made at the ordinary temperature, and should not be undulj^
prolonged, because of the tendency of the acid to act upon the
alcohol.
Or Vitali's modification of the Tardieu-Rabuteau sulfuric
acid method^ may be followed for the extraction of free nitric
acid.. The liquid part of the material, or an aqueous extract,
filtered and expressed, is treated with alcohol, filtered, and evap-
orated to expulsion of the alcohol. Freshly precipitated quinidin
is added and the mixture warmed slightly, after which it is
filtered and concentrated. To three volumes of this liquid
two volumes of chloroform are added and enough absolute alco-
hol to dissolve the chloroform in the aqueous liquid and to hold
it in solution; and, finally, without agitation, half the original
volume of water. In this way the chloroform, holding in solu-
tion the alcohol and quinidin nitrate, is separated, while alka-
line nitrates remain in the aqueous alcoholic layer. The chlo-
roform stratum is drawn off and evaporated to dryness; the
residue is extracted with a mixture of absolute alcohol and
anhydrous chloroform; and the extract is filtered through a
double or triple filter, and again evaporated to dryness. The
nitric acid in the residue is converted into potassium nitrate
by the action of dipotassic carbonate, and known fractions
of the solution are used for identification and quantitative
determination.
Tests for Nitric Acid and Nitrates. — 1. The free acid when
warmed in contact with copper filings is reduced and gives off
brown fumes, which, if present in small amount, are best seen by
looking into the mouth of the test-tube. With nitrates only in
presence of free sulfuric acid.
2. If a solution of a nitrate or of nitric acid be mixed with
an equal volume of concentrated pure sulfuric acid, cooled, and
a concentrated solution of ferrous sulfate be floated on the mix-
ture, a red-brown band is found at the junction of the two strata.
' "Man. di Chim. Toss.," Milano, 1893, p. 239.
300 TOXICOLOGY WITTHAUS.
A similar reaction is produced by selenious acid, but if the layers
be mixed and allowed to stand selenium separates as a red
deposit.
3. Add to some hydrochloric acid in a test-tube enough
indigo-carmine solution to give it a pale blue color, and boil;
the blue color should remain. If, now, a nitrate or nitric acid be
added and the liquid boiled, the color is discharged. A like
effect is produced by chlorin and by other oxidizing agents.
4. A crystal of brucin dissolves in pure sulfuric acid, form-
ing a colorless solution. If to this a nitrate or nitric acid be
added, a brilliant red-orange color is developed, which gradu-
ally fades to yellow. Chloric acid and its salts act like nitric
acid, but with sulfuric acid alone they produce a yellow or orange
color, and evolve a greenish, suffocating gas. This reaction is
only exceeded in delicacy by No. 7 (Berthemont).
5. Narcotin is dissolved by pure concentrated sulfuric acid,
forming a light yellow solution, which turns purphsh when
heated. But if nitric acid or a nitrate be present, the cold
solution is reddish-brown and turns dark red when warmed
(Wormley).
6. If to a few drops of a solution of paratoluidin sulfate (or
a sulfuric acid solution of commercial anilin oil) a solution of a
nitrate be added, and then an equal volume of concentrated sul-
furic acid in such manner that the liquids do not mix, a red
zone, gradually changing to dark yellow, is formed at the junc-
tion of the liquids. Nitrites produce a yellowish or brownish
color, which only becomes red after a time. Chlorates give the
same reaction as nitrates (Braun, Longi).
7. A drop of a freshly prepared solution of 0.01 gm. di-
phenylamin in 100 c.c. of pure concentrated sulfuric acid is
placed in a porcelain dish, and a minute drop of a solution of a
nitrate or of nitric acid brought into it with a pointed glass rod;
a fine blue zone is formed around the lesser drop, which becomes
more intense as the two liquids mix, gradually assumes a green
tinge, and finally fades out. Although this is the most delicate
of the nitric acid reactions, it is not so characteristic as some of
the others; a blue color is also produced by nitrites, chlorates,
hypochlorites, bromates, iodates, vanadates, chromates, perman-
ganates, molybdates, salts of iron, barium peroxid, and hydro-
gen peroxid (Kopp, Laar).
NITRIC ACID NITROUS FUMES. 301
8. One part of phenol is dissolved in four parts of concen-
trated sulfuric acid, and two parts of water are added. If a
drop or two of this reagent be added to a solid nitrate, a reddish-
brown color is produced, which, on addition of a drop or two of
strong ammonium hydroxid solution, turns yellow or greenish
(Sprengel) .
Quantitative Determination. — The quantity of nitric acid
is best determined by v. Dumreicher's method:^ To the solution
containing nitric acid or nitrate contained in a flask a freshly
prepared solution of stannous chlorid^ is added, and the mixture
boiled for an hour, after which it is transferred to a porcelain
capsule and evaporated on the water-bath to the formation of a
crystalline crust. The capsule is left on the water-bath for
another half-hour and then allowed to cool. By this treatment
nitric acid is converted into ammonia, which is retained by the
acid. The cooled solution is distilled with caustic potash, and
the distillate collected in normal acid solution. The quantity of
ammonia is determined by titration. The quantity of am-
monia (NHj) found, multiplied by 3.683, gives the quantity of
nitric acid (HNO3) present.
Nitrous Fumes.
Nitric acid has in several instances been indirectly the cause of
death. When the acid is exposed to the air or, more rapidly, when it
is in contact with organic matter or with metals, it is partly volatilized
and partly decomposed with formation of the oxids of nitrogen, par-
ticularly of nitrogen tetroxid, NOj. The fumes or vapors thus given
off are brown in color and are actively poisonous, being particularly
dangerous because of the comparatively slight discomfort which they
produce at once when inhaled. As small a proportion as one per cent,
renders an atmosphere irrespirable, and produces severe irritation of
the respiratory organs, as well as genersri systemic effects.
We have met with the records of 89 cases^ of poisoning by the
inhalations of such fumes, of which 38 caused deaths, in from five*
' Sitzber. d. k. Acad. d. Wissensch. three cases by Picht: Ztschr. f.
z. Wien, 1880, Ixxxii., 2, p. 583. Med.-Beamte, 1902, xv., Sonderh.,
^ Made by dissolving 16 gm. of 1; nor that of Bley in Jbt. U. d.
pure granulated tin, in 60 gm. of Fortschr. d. Pharm., 1878, 571. See
forty-per-cent. pure hydrochloric also Montagn^: These, Paris, 1907-
acid, and used in such amount 8. Coullaud: Ann. d'hyg., 1909,
that the above quantity is present 4 s., xii., 490.
for each gramme of nitric acid. * Manouvriez : Bull. Ac. de med.,
^ We have not seen the report of 1897, 3 s., xxxvii., 306.
302 TOXICOLOGY WITTHAUS.
to forty' hours in 36 cases, while two died in 22 days and 1 month.'
A few cases have occurred in workmen engaged in operations involving
the action of nitric acid on metals.' In one case a morocco worker was
exposed to the fumes;* in three other cases, chemists;^ in another an
operative in anilin works;" in four operatives in a nitro-eellulose
factory, three of whom died;' in three instances workmen were overcome
while cleaning the lead chambers or Glover's towers of sulfuric acid
works.' A man suffered severely from carrying a large open pot
containing the fuming acid a short distance," and a girl was similarly
affected by inhaling the fumes given off by the strong acid which she was
carrying in a tin box(!).'" In preparing a fertilizer containing super-
phosphate (probably containing an excess of sulphuric acid) and Chili
saltpetre among its ingredients, the mass took fire and evolved thick
clouds of orange-colored vapors. Some thirtj^ persons were poisoned,
of whom two died." Another poisoning of four persons, with two
deaths, occurred in France from the same cause. '^ But most of the
cases have resulted from the spilling of notable quantities of the acid,"
or fracture of vessels containing it," and attempts to protect property
from injury thereby. At a fire so caused at the Bayer factory at
Elberfeld thirteen persons were severely poisoned and two died;"
and at a similar fire at Albany, N. Y., four firemen were overcome,
and one died. '" The throwing of sawdust upon the spilled acid not only
increases the volume of the fumes generated, but also activates the oxi-
'Pott: Deut. med. Wchnschr., 665. Lesser: Vrtljschr. f. ger. Med.,
1884, X., 451. . 1898, 3 F., xvi., 83.
= Hall and Cooper: J. Am. Med. « Becker: Aertz. Schv. Ztg., 1899,
Ass., 1905, xlv., 396. v., 277.
^Tandler: Arch. d. Heilk., 1878, '" Schmitz: loc. cit.
xix., 551. Chevallier and Boys de " Pott: Zoc. cj'i.
Loury: Ann. d'hyg., 1847, xxxviii., "Manouvriez: he. cit.
323. Souquet: cited by Chevalier >' Temple: Boston M. and S. J.,
and Bois de Loury. 1884, ex., 496, five cases, two
* Tardieu and Roussin: Ann. d'- deaths,
hyg., 1875, 2 S., xUv., 345. Wharton " Chem. News, 1863, 132 (caseot •
and Still^: "Med. Jur.," 4th ed., Mr. Stewart and assistant). Des-
ii-i 529. granges: J. de m4d.,etc.. An. xii.
^Schmitz: Berl. Id. Wchnscfer., (1804), viii., 4S7. Charrier: Bull.
1884, xxi., 428. Kockel: Vrtljschr. f. Soc. mM. d'emul., 1823, quoted by
ger. Med., 1898, 3 F., xv., 1. Wood Orfila: "Tox..," 5e., ed., ii., 189.
and Stephen: Australas. M. Gaz., Lancet, 1854, i., 430, and Temple:
1909, xxvih., 25. loc. cit. (case of Mr. Haywood).
Bauer: Virch.-Hirsch Jbt., 1895, Wood and Stephen: loc. cit. Kockel:
!•> 460. loc. cit. Schmieden: Centbl. f. inn.
'Holtzmann: Ztschr. f. Gew.- Med., 1892, xiii., 209. Biirgl: Fried-
Hyg., 1908, XV., 565. See also: reich's BI. f. ger. Med., 1899, 1., 204.
Vogt: Vrtljschr. f. off. Ges., 1898, '^^ Kunne: Deut. med. Wchnsclir.,
XXX., 566. 1S97. xxiii., 414.
'Eulenberg: Vrtljschr. f. ger. "Pearson: Albany M. Annals,
Med., 1S76, n. F., xxv., 209, Paul: 1899, xx,, 28,
Wien. kl. Wchnschr., 1S95, viii.,
NITRIC ACID NITROUS FUMES. 303
dation to such an extent that fire results.' At a fire caused in this
manner in Milwaukee four firemen were killed by nitrous fumes, and
five others were almost fatally poisoned.- At a similar fire in Denver,
eighteen firemen and two employees were severely poisoned, and four
of the former died.^ Products of oxidation of nitrogen are formed
during the combustion of illuminating gas, and are detrimental to
health.''
Ssrmptoms.
No effects, save a trifling irritation of the air passages, are felt for
from two to four hours after the inhalation, if we except the temporary
sense of suffocation sometimes experienced at the time, when the
vapors are inhaled in a condition but slightly diluted with air. There
is then a sense of uneasiness and loss of muscular power, accompanied
by sense of constriction of the chest, pain on inspiration, and coughing.
The face is pale, the lips cyanosed, the forehead bathed in cold per-
spiration, the extremities cold, and the pulse weak. The respiratory
organs are the seat of very acute hypersemic inflammation of the bron-
chial mucous membrane, which at first is limited to the larger tubes,
but rapidly extends to the finest bronchi. The sputa are lemon-yellow
to dirty gray in color, tenacious, adherent to glass, alkaline in reac-
tion,' and contain a few pavement and columnar epithelial cells,
innumerable nuclei, large numbers of red and white blood corpuscles,
and groups of yellow non-refracting pigment globules, which exhibit a
lively Brownian movement. Vomiting occurs but rarely, and pain,
which is in some cases intense, is not epigastric but thoracic. The
; urine is normal. In fatal cases the dyspnoea increases, sometimes after
marked remissions, coarse rales are heard all over the chest, and death
occurs with all the signs of acute pulmonary cedema. Recovery is
slow, and occupies one to two weeks in the less severe cases. In one-
third of Hall and Cooper's cases" relapses occurred, generally on the
third week, and averaging 15 days in duration. The symptoms were
^ those of the original attack, but less intense usually. The average
duration from exposure to practical recovery in eight cases was 113
days, five were not well in nine months, and two died. The two who
,died had been affected at first like the others, but more severely, had
.progressed favorably, and were comparatively well, when the relapse
was brought on suddenly by exposure to cold. Both were unconscious
several hours before death, and both died with all the symptoms of a
! desperate broncho-pneumonia.
'Schneider, Kockel, Schmieden: *v. Bibra: Arch. f. Hyg., 1892,
.'■oc. cit. XV., 216.
^Harrington: Wisconsin J. of * Pott: Deutsch. m. Wchnschr.,
,,VI., 1903, i., 177. 1884, x., 451.
' ^ Hall and Cooper: loc. cil. " Loc. cit.
304 TOXICOLOGY WITTHAUS.
Treatment.
Heroin in 1 /12-grain doses controls the cough, but has no effect upon
the dehrium. Strychnin, digitahn, and nitroglycerin in heroic doses
have a gratifying influence upon the heart. Champagne may be given
freely. Restlessness is partly controlled by chloralamid. Inhalationof
oxygen should be resorted to as early as possible, and constitutes tlie
main reliance of the treatment, along with the application of the
pneumonia jacket or poultices to the chest.
Post-mortem Appearances.
The most marked changes are found in the thoracic organs. The
pleurae are adherent over more or less of their extent. The lungs are
extremely hypersemic, and their tissue is extensively disorganized, satu-
rated with black, fluid blood, presenting a spleen-like appearance on
section, and non-crepitant except in a few places. The, cavities of the
heart, particularly those of the right side, are distended with black
blood, partly fluid and partly imperfectly coagulated, and a similar
material fills the great vessels.' The mucous membrane of the trachea
and bronchi is more or less reddened. The stomach is distended with
gas, contains a small quantity of fluid, which may be strongly acid in
reaction, and its mucous membrane is inflamed, thickened, and stained
yellow in places. The veins of the pia mater and the arteries at the
base of the brain are distended with dark colored, tarry, or fluid blood.'
Nitrates and Nitrites.
Nitrates which are used in solution containing excess of acid or
which are readily reduced by contact with organic substances produce
effects which are similar to those of nitric acid itself, more or less com-
plicated by the toxic effects of the metallic element. Examples of such
nitrates are the acid mercuric nitrate and silver nitrate.
Acid Mercuric Nitrate. — See Mercury.
Silver Nitrate — Lunar Caustic, Lapis infernalis.
Acute intoxications by this substance are of very rare occurrence.
Of eight cases reported five were the results of accident in children, but
one of which died, a child of fifteen months, into whose throat a stick of
lunar caustic slipped during its medical application. Death occurred
in six hours in violent convulsions.^ Of the three cases in adults, one
was that of a woman of fifty-one years who died in three days fwm
the effects of a six-ounce mixture containing fifty grains of silver ni-
'In Eulenberg's case (Zoc. cit.) => Lassar: Ztschr. f . physiol. Chein.,
in which the gas inhaled contained 1S77, i., 165.
other ingredients than nitrous fumes, ' Scattergood: Brit. Med. Joi^'i
the heart and great vessels were 1871, i., 527.
found empty.
NITRIC ACID NITRATES AND NITRITES. 305
trate, taken in divided doses;' another was an attempted suicide, wlio
recovered after swallowing about 30 gm. (one ounce) of silver nitrate;^
the third was that of a paranoiac who died eight days after having swal-
lowed three sticks of lunar caustic' Hippie* reports the case of a soldier
who applied lunar caustic to his cornea to evade military duty.
The symptoms are those of intense gastro-enteritis.
The antidote indicated is common salt, followed by an emetic. Sil-
ver chlorid and sodium nitrate are produced. The former, although
insoluble in water, is soluble to some extent in sodium chlorid solution,
and also forms with albuminous substances a compound which is
soluble in sodium chlorid solution and in the digestive liquids.
Potassium Nitrate, KNO3, saltpetre, nitre, and sodium
nitrate, NaNOg, Chili saltpetre, cubic nitre, are used in the arts as
oxidizing agents, the former also as a component of black gun-
powder, and the latter in fertilizers and as a source of nitric acid.
They are true poisons, not corrosives, the former being much
more active than the latter, because of the toxic action of the
potassium. We find no record of a human poisoning bj^ the so-
dium salt, although several poisonings of horses and cattle have
been reported.^ It is possible that it, as vpell as the potassium
salt, might cause nitrite poisoaing by reduction. * We have seen
the reports of 33 cases^ of saltpetre poisoning, of which 3 were
accidental, one a suicide,* and in one it was successfully taken to
cause abortion. ° The accidental cases have for the most part
resulted from mistaking nitre for Epsom or Glauber's salts. One
was the fatal poisoning of a soldier by gunpowder, taken in
brandy for gonorrhoea.'" Fifty per cent, of the cases termi-
nated in death. The smallest quantity which has caused the death
of an adult was one ounce (31 gm.)." Eight gm. (124 gr.) ad-
ministered in enema is said in an early case to have caused death. '^
'Taylor: "Poisons," 3d Am. ed., 'Six other cases are reported in
475. journals inaccessible to us.
^Orfila: "Tox.," 56me ed., ii., 22. 'Souville: quoted by Orfila:
'Edel: Vrtlijschr. f. ger. Med., "Tox.," 5e ed., i., 354.
1901, 3 F., xxii., 39. " Alexander: ibid., p. 356.
*Berl. kl. Wchnschr., 1891,xxviii., "Robert: Rec. de m6m. de med.
466. . . . mil., 1869, 3 S., xxii., 275.
= Barth: Diss., Bonn, 1879. Froh- " Oberstadt: Wchnschr. f. d. ges.
ner: "Lehrb. d. Tox.," 1890, 78. Hlk., 1841, 297. Fuller: quoted by
Tereg and Arnold: "Thieriirztl., Taylor: "Poisons," 3d Am. ed.,
Arzneib.," Berlin, 1892, iii., 383. 263. Chevalier, de Luynes and
"Barth: Loc. cil. Binz: Arch. f. Devergie: Ann. d'hyg., 1861, 2 S.,
exp. P. u. P., 1881, xiii., 133. See xvii., 400.
also "Nitrites," p. 306, and "Bis- '^ Meyer: St. Pet. verm. Abh. d.
muth," p. 687. Hlk., 1823, ii., 88.
IV.— 20
306 TOXICOLOGY— WITTHAUS.
One man recovered after having taken four ounces (125 gm.),'
In the most rapidly fatal case death occurred in 45 minutes/
and the longest survival was 60 hours.^ The average of eleven
fatal cases in which the duration is stated was thirteen hours.
The symptoms begin very soon with nausea, burning epigas-
trie pain, and vomiting, followed by abdominal pain and purging.
The vomit and stools sometimes contain blood, and in Butler's
case"* pure blood was vomited. In Bailey's case'^ the pulse was
full and bounding, the eyes congested, the face red and hot, and
the patient became wildly delirious, afterward falling into a con-
dition of collapse, which was followed by a second period of ex-
citement. In Robert's case (gunpowder)" there were no ill
effects upon the first day, but upon the second there was a condi-
tion of violent excitement, resembling drunkenness. In Wilson's
case,' on the other hand, the pulse was weak, small, and thready,
and the man was stupid, but rational. In this case also there
were neither abdominal pain nor purging, although epigastric
pain was experienced and vomiting occurred. In Thompson's
case* the pain was principally abdominal and only began three
hours after the ingestion, and on the third day there were severe
lumbar pain and haematuria. In Mouton's case' the action o(
potassium was prominent, great anxiety, lumbar pain, spasmodic
muscular contractions, aphonia, convulsions, coma, and death in
about six hours. Recovery from large doses is slow, and general
weakness, parasthesias, and gastro-intestinal disturbances per-
sist for tAVO to three months.
At the autopsy evidences of hemorrhagic gastritis are found,
and in Souville's case^" there was a small perforation at the
fundus. In Lesser's case" Bischoff on analysis detected nitrates
in the stomach contents, liver, kidneys, and spleen.
The nitrites, sodium nitrite and amyl nitrite, are used medic-
cinally, the former per os and the latter by inhalation of its
vapor, and are poisonous, although not corrosive. Non-fatal
poisonings by sodium nitrite, taken through pharmacists' errore
' Bailey: Phila. M. and S. Rptr., ^ Loc. cit.
1872, xxvi., 7.3. ' London M. Gaz., 1848, n. b.,
^ Chevalier, de Luynes and De- vi., 856.
vergie: Loc. cit. « Brit. M. J., 1878, i., 402.
■' Souville; Loc. cit. ' Union med., 1873, xv., 472.
*Edinb. M. and S. J., ISKS, xiv., '"Loc. cit. „„,
34. >■ Vtljschr. f. ger. Med., »
■' Lor. cit. 3 F., xvi., 93.
MIXED ACIDS. ;j()7
in mistake for a nitrate, are reported by Collischonn' and by
Bloch;- and Shoemaker^ reported a non-fatal poisoning by
swallowing amyl nitrite. Cadwallader'' reports the death of a
physician in sixteen days from the inhalation of a comparatively
.small, but unknown quantity of the vapor. Cases of nitrite
.poisoning have also resulted from reduction of bismuth subnitrate
,i,n the alimentary canal.' When taken internally the nitrites
;xert a local irritant action upon the alimentary canal. How-
!ver absorbed, they are stimulant to the central nervous system,
md produce spasms when taken in overdose: and they reduce
isemoglobin to methsemoglobin, the blood giving the spectrum
)f the latter substance and being chocolate-brown in color."
\ccording to the experiments of Harnack' sodium nitrite kills
lecause of its reduction in the system, the products of the re-
luction probably participating in the action. Nitrites exist in
mall quantities in the saliva and in several of the tissues of the
')ody, and are produced by bacterial action in the alimentary
:anal, either by reduction of the nitrates or by oxidation of
immonia.* Gibson and Douglas® report a case of autointoxica-
'ion of three years' standing, with symptoms of methsemoglobin-
3mia, the presence of nitrites in the saliva and blood, and of
-nethaemoglobin in the latter. Nitrites of bacterial origin fre-
•{uently occur in impure natural waters.
s Mixed Acids.
Mixtures of mineral acids are used in the laboratory and in
he arts, and have been swallowed by man in a few instances,
iroducing effects similar to, but even more intense than, those
' aused by either acid alone.
*• A mixture of nitric and hydrochloric acid, in the proportion
f one molecule of the former to three of the latter (one part
!^
'Deut. med. Wchnschr., 1889, 253. Binz: Arch. f. exp. P. u. P.,
v., 844, two cases. 1881, xiii., 133.
■ 2 Ibid., 1899, XXV., 322. Ph. J. ' Berl. kl. Wchnschr., 1893, xxx.,
s., 1904, xviii., 839; 1907, xxiv., 1139. Arch. int. de pharmacod.,
39, two deaths from NaNO,,. 1903-4, xii., 185.
(^ Med. News, 1893, Ixii., 54'4. « Sartissow: Diss. Dorpat., 1866.
*'Med. Rec, 1896, i., 816. Petrone: Berl. kl. Wchnschr., 1893,
,. ^ See p. 687. xxx., 918. Stepanow: Arch. f. exp.
'' =Gamgee: Phil. Trans., London, P. u. P., 1902, xlvii., 411. Ville and
!69,olviii., 589. Brunton:Arh. a. d. Mestrezat: Bull. Soc. Chim., 1908,
aysiol. Anst. zu Leipzig, 1870, iv. 4 s., iii., 711.
■ernheim: Pflug. Arch., 1874, viii., « Lancet: 1906, ii., 72.
308 TOXICOLOGY — WITTHATJS.
by weight HNO3, specific gravity 1.42, to four parts HCi, spe-
cific gravity 1.16), is used as a solvent for gold and platinum
under the names aqua regia and nitromuriatic acid, and in a
diluted form as a medicine, acidum nitrohydrochloricum diu-
tum, U. S. P. In the concentrated form it is a colorless liquid
when first prepared, but soon becomes orange-yellow, whicli
when warmed is decomposed, with liberation of chlorin and
formation of water and compounds of chlorin, nitrogen and
oxygen, NOCl and NOjCl. Its solvent action upon gold and
platinum is due to the nascent chlorin which unites with the
metals to form auric or platinic chlorid.
We find but three references to intoxication by aqua regia in
the human subject: two fatal cases of suicide in jewelers, wto
used the acid in their trade. One reported by Gontier,' the
other by Liouville." The third case was a non-fatal one of a man
who took four or five swallows of the dilute acid, and in whose
urine nitric acid was detected on analysis.^
A mixture of sulfuric and nitric acids is extensively used in
the preparation of dynamite, gun-cotton, and other nitro-deriv-
atives. In 1889 a man was convicted in England of the murder
of a woman by pouring such a mixture of acids down her throat
while she was in bed.* Lesser^ has reported a fatal poisoning by
this mixture; and Fagerlund^ the case of a woman suicide who
swallowed first sulfuric, then nitric acid.
OTHER MINERAL ACIDS.
Hydrofluoric Acid— HF, 20.01.
This intensely acid gas is usually produced by the action of sulfunc
acid upon calcium fluorid (fluorspar), and is used principally for etching
upon glass, which is attacked by it whether in the gaseous form or in
solution. In this industry the sand-blast has to a great extent, althoiigl
not entirely, replaced the use of the acid. In dilute solution it has also
been used to a limited extent as a germicide.
Its action upon the animal economy is most intense, yet but lew
deaths have been caused by it, owing to its limited uses.
There is some difference in opinion as to the effects of i
■ Bull. See. anat. de Paris, 1840, ' Reg. v. Lipski: C.C.C, M,
XV., 156. 1888. Taylor: "Med. Jur./ H"
2 Bull. Soc. anat., Paris, 1S72, 2 Am. ed., 102. „.,
s., xvii., 274. =Vrtljschr. f. ger. Med., ISSI^
'Schultzen: Arch. f. An., Phys.u. 3 F., xvi., 79. , ,,
med. Wiss., 1SG4, 500. » Ibid., 1894, 3 F., 1894,SpMt.,»
OTHER MINERAL ACIDS. 309
gaseous hydrofluoric acid. Most writers upon professional hygiene
assert that those exposed to an atmosphere contaminated with the gas
suffer from ulcerations of the conjunctiva, nose, mouth, and gums, and
from severe laryngitis and bronchitis. According to Kobert,' Bergeron
makes the astounding statement that 400 gm. of hydrofluoric acid may
be inhaled daily. The inhalation of so powerfully acid a gas cannot but
be deleterious. Indeed, the deaths of two chemists were due in whole
or in part to inhalation of this gas: Nickles, of Nancy, who died in 1869,
and whose death was considered as accelerated by exposure to the
fumes of phosphorus and fluorin compounds ;^ and the Belgian chemist,
Louyet, whose death resulted from the inhalation of hydrofluoric acid
during his endeavors to isolate the element.'
"We know of but three cases of death from swallowing the acid in
solution, all suicides. The earliest case is that reported by King:^ A
man of forty-six years of intemperate habits, swallowed 15 c.c. (Sss.)
of the solution, was immediately seized with severe pain and vomiting,
and died in thirty-five minutes from cardiac paralysis, the respiration
continuing for some time after disappearance of the radial pulse and
heart beat. The buccal mucous membrane was white, the tongue,
gums, epiglottis, and cESophagus denuded of epithelium; the mucous
membrane of the stomach softened, corroded in places, black on the
prominences of the rugae, and intensely red and ecchymosed in the de-
pressions. The duodenal mucous membrane was somewhat injected.
In the opening of the glottis was a small quantity of dark brown mucus,
' insufficient, however, to account for the death, which was more probably
' due to true poisoning following absorption of the acid.
In 1885 a manufacturer of glass signs died in the Chambers Street
Hospital, New York, in about two hours after swallowing about a gill
(118 c.c.) of the acid used in his trade. Another man, engaged in the
same trade in England, died in about an hour from swallowing about a
tablespoonful of nine per cent, acid, diluted with water.'
Solutions of the acid in contact with the skin produce severe and
■painful burns which heal very slowly."
The toxic effects of the fluorids have been studied experimentally
by Rabuteau,' Miiller,* Tappeiner," Schulz,'" Hewelke," Siegfried,'^ and
'"Intoxikationen,"lteAufl.,377. ''See Blodgett: Boston M. and
In the second edition, p. 201, the S. J., 1881, cv., 401.
amount is omitted. ' Thfese de Paris, 1867 ; " Toxicolo-
' Jour. d. ph. et de chim., 1869, gie," 2Sme ed., 709.
4 s., ix., 446. « Diss., Greifswald, 1889.
^Rabuteau: "Toxicologie," 26me "Arch. f. exp. Path. u. Ph.,
ed., 710. 1889, xxv., 203; 1890, xxvii., 108.
' Tr. Path. Soc, London, 1873, "> Ibid., 1889, xxv., 326.
xxiv., 98. " Deut. med. Wchnschr., 1890,
* Stevenson: Brit. M. J., 1899, xxii., 477.
ji., 1145, 1376. '2 Arch. int. de pharmacod., 1901,
ix., 225.
310 TOXICOLOGY — WITTHAUS.
Schwyzer.' Notwithstanding its toxicity, sodium fluorid has been
used as a preservative of food articles.
For the detection of fluorin in organic mixtures, these may be
incinerated with the addition of a httle soda, and the ash warmed with
concentrated sulfuric acid in a platinum crucible covered with a watch
glass partly coated with wax or paraffin. The uncoated parts of glass
are roughened. This method is not available if the materials contain
silica, in which case the non-etching silicon fluorid is formed. Tam-
mann's method^ avoids this source of error: the substance, intimately
mixed with quartz powder, is placed in a flask provided with a cork
having three holes; sulfuric acid is added through a funnel tube, and
the flask heated ; a stream of dry air is caused to carry the sihcon fluorid
formed into a narrow vessel containing water, where it is decomposed
with separation of gelatinous silicic acid.
The mere detection of traces of fluorin in organic mixtures is not
evidence that a toxic fluorin compound has been taken, as fluorin is a
normal constituent of many animal tissues. It is most abundant in
the enamel of the teeth, which contains three to four per cent., calcu-
lated as calcium fluorid, and in bones, whose ash contains about the
same percentage. It has also been found in less amount in the blood,
milk, brain, and in hen's eggs.
Silicon fluorid — SiF^,
is another gaseous fluorin compound, possessed of poisonous qualities
which were recognized by Eulenberg from experiments upon animals,'
and observed in the human subject in two fatal cases by Cameron.'
This gas is produced by the action of suKuric acid upon calcium fluorid
in the presence of silicic acid or a silicate, and is decomposed by contact
with moisture, with formation of gelatinous silicic acid and of hydro-
fluoric acid. In Cameron's cases the victims were operatives in a
fertilizer works in which phosphates containing notable quantities of
fluorid and silicate were treated with sulfuric acid. They complained
of a sense of suffocation, and expectorated frothy material. Death fol-
lowed in a few hours, after increased dyspnoea, and in full consciousness.
Cameron considers that on contact with the moist bronchial mucom
membrane the gas is decomposed, the gelatinous silicic acid forming a
varnish-like coating upon the bronchi to their most minute ramifications,
and the irritating hydrofluoric acid causing reflex spasmodic contrac-
tion. From the lungs of one man 0.75 gm. (11.6 grains) of silicic acid
were obtained.
' New York M. J., 1901, Ixxiv., 1; ' "Schadlichen und giftigen Gas-
J. Med. Res., 1903, x., 301. en," Braunschweig, 1865, p. 465.
^ Ztschr. f. physiol. Chem., 1888, * Dublin Jour. M. Sc, 1SS7, 3 s.,
xii., 322, and Ztschr. f. anal. Chem., Ixxxiii., 20.
1885, xxiv., 32S.
OTHER MINERAL ACIDS. 311
Boric Acid — Boracic Acid — H3BO3 — 63.03.
Is a crystalline solid, unctuous to the touch, slightly bitter, odor-
ess, soluble in twenty-five parts of water at 10° (50° F.), which is used
as an antiseptic. In recent medical literature several cases have been
recorded in which more or less severe symptoms followed its use either
in the form of powder dusted on abraded surfaces or in aqueous solution
for washing out cavities in surgical practice.'
The question of the permissibility of the use of boric acid and borax
for the preservation of articles of food has been much discussed and
has been the subject of much experimentation since it was first agitated
in connection with the alleged supply of "embalmed beef" to the
American army and navy during the Spanish war. The subject is
rather hygienic than toxicological. The weight of evidence appears
to be adverse to the use of these substances for this purpose.^
The symptoms consist of loss of appetite, nausea and persistent
vomiting, hiccough, marked cardiac weakness, emaciation, diarrhoea,
great depression, coryza, conjunctivitis, bronchitis and pharyngitis,
and a papular eruption on the skin near the seat of application and on
the neck, arms, and chest. The urine is suppressed or diminished in
amount. In Bruzelius' case,* in which enemata of 1,400 to 1,500 c.c. of
tepid saturated aqueous solution of boric acid were given twice a day
for five days, and once a day for three days thereafter for chronic
diarrhoea, the urine was tested from the start and found to contain
boric acid, which disappeared with the cessation of the treatment.
Seven fatal cases have been reported: two by Molodenkow,* one
that of a man of twenty-five years who died in four days after his
pleural cavity had been washed out with a large quantity of the solution,
the other that of a boy of sixteen years who died in three days after a
lumbar abscess had been opened and washed out. In Brose's case,'
in which the powdered acid had been applied to an open wound, there
was found a large clot in the right ventricle, partly ante-mortem.
The stomach was congested and there were several spots of erosion of
the mucous membrane. The intestines were greatly congested and in-
flamed. The liver was enlarged, and the right lobe congested and
softened. The spleen was enlarged and much inflamed. Schwyzer"
'Spencer: Northwestern Lancet, and Wharton and Stills : Med. Jur.,
1888, viii., 22. Brose: M. News, 5th ed., ii., 797; and for bibliography
Phila., 1883, xliii., 199. Huse: Ind. Cat. Libr. of Surg. Gen. U. S.
Ibid., 1882, xl., 704. Welch: Med. Army; and Kobert: "Intoxica-
Rec, New York, 1888, xxxiv., tionen," 2te Aufl., ii., 64, 1242.
531 (3 cases). Bruzelius: Hygiea, ' Hygieia: 1882, xliv., 548.
1882, xliv., 548. Lemoine: Gaz. ■" Med. News, Phila., 1882, xl., 571.
m^d. d. Par., 1890, xviii., 205 ^Ibid., 1883, xliii., 199.
(3 cases). " New Yorker med. Monatschr.,
" See circular 15, U. S. -Dept. of 1895, viii., 264.
Agriculture, Bureau of Chemistry,
312 TOXICOLOGY — WITTHAUS.
reported the death of a man of sixty years, caused by 1.5 gm. of boric
acid.
Branthomme' relates two cases, one fatal, resulting from the use
of boric acid in dressing surgical wounds.
Best^ reported the case of a man of thirty-six years, who died from the
effects of the treatment of the wound after a surgical operation by
powdered boric acid.
Dopfer^ reported a death caused by the treatment of a burn by
boric acid ointment.
Methods for the detection of boric acid or of borates in organic mix-
tures are not very satisfactory, owing to their volatility with vapor of
water or when heated, and the sparing solubility of even the least
soluble borates. Probably the best method consists in drying the ma-
terial, fusing the residue with sodium carbonate and nitrate, and testing
the residue for borates: 1. By adding alcohol and sulfuric acid, and
igniting the alcohol ; the flame is colored green, and shows four lines in
the spectrum, in the yellow, green, and blue {X, 581, 548, 544, 519:
Boisbaudran). 2. A solution in dilute hydrochloric acid, when dried
upon turmeric paper, stains it red-brown, and the color is changed to
black-blue by caustic potash. The following reagents cause precipitates
in solutions of borates: 3. Calcium chlorid, white, soluble in am-
monium chlorid. 4. Ferric chlorid, yellow. 5. Silver nitrate, white.
6. Solutions of barium chlorid, magnesium chlorid, and lead nitrate
also form white precipitates in solutions which are not too dilute.'
Chromic Anhydrid — Chromic Acid — CrOj — 100.1.
Crystallizes in brilliant crimson prisms, very soluble in water and
in alcohol, forming yellow or orange solutions. It is produced by the
action of sulfuric acid upon potassium diehromate solution, and conse-
quently exists in "battery fluids" such as "electropoion." It is a
powerful escharotic, for which purpose it is used medicinally.
Intwo^ of the twenty-eight reported cases the patient swallowed some
of the solution which was being applied to the tonsils with a brush.
A child of five months died in nine days from an application of chromic
acid.* Ten cases' of which five were fatal, were in females to
' France M6d., 1896, xliii., 99. ' White: Univ. M. Mag.,
= Tr. Chicago Path. Soc, 1903-4, ii., 54 (D.). Mosetig, Falck: "Toxi-
vi., 161. kologie," p. 144 (D.). Bruck: W
^ Munch, med. Wchnschr., 1905, Jacob: Aerztl. Int. Bl., 1878., BV,
Hi., 763. 95 (2 cases). N. Schmidt's Jahrb.,
*See also Villiers and Fayolle: 1884, cci., 129 (D.). Sticker: Miinch
Ann. d'hyg., etc., 1895, 3 s., xxxiv., med. Wchnschr., 1895, xlii., Mi
272. Mucha: Vrtljschr. f. ger. Med.,
= Fowler: Brit. M. Jour., 1889, i., 1906, 3 F., xxxi., Suplh., 35. Roffi-
1113. Tisn6: J. d. m^d. de Paris, seau: These, Paris, 1878, p. »
1887, xiii., 61. JIund6: Am. J. Obst., 1881, »v.,
"Ztschr. f. Med.-Beamte, 1906, 121. Betz: Memor. Heilbronn,
xix., 2te Beil., 227. 1895, xxxix., 157.
OTHER MINERAL ACIDS. 313
the anhydrid or its solution was medicinally applied. In one instance
a man made an unsuccessful attempt at suicide by taking 1 gm. (15
grains) of the acid in aqueous solution/ another man killed himself by
swallowing 750 c.c. of a 50 per cent, solution/ still another man was
accidentally poisoned by swallowing a tablespoonful of a .50 per cent.
solution/ and in the remaining cases a battery fluid was swallowed with
suicidal intent in two instances/ and with fatal results in five.'
In Fowler's case there were severe epigastric pain, agonizing vomit-
ing of green ropy matter, collapse, scarcely preceptible pulse, fear of
impending death, contracted pupils, deafness, purging, and copious
urination, with recovery in three hours. In Tisne's case there were
severe gastritis and vomiting, great pain in the back of the neck, and
vertigo. After four hours the symptoms abated, but there remained
constipation and suppression of urine. The urine of the next day
gave no reaction with silver nitrate. In von Limbeck's case the symp-
toms caused by chromic acid were complicated with those due to
sulfuric acid. In White's case the intellect remained clear until death.
In V. Baeyer's case the autopsy showed the existence of stomato-
pharyngitis, oesophagitis, gastroenteritis, with haemorrhagic erosions of
the duodenum and extravasations in the stomach and duodenum ; acute
parenchymatous nephritis, and subpericardial ecchymoses in the heart.
In White's case chromium, probably in the form of sodium chro-
mate, was found by analysis in the kidneys a.nd liver, but none in the
rectus muscle. In von Limbeck's case chromium was found to be
present in the urine, vomit, and faeces.
For the detection of chromium in the urine, faces, and vomit these
are dried, ignited with potassium nitrate, and the residue is dissolved in
water. In this solution: 1. Silver nitrate forms a dark brownish-red
precipitate, readily soluble in nitric acid or in ammonium hydroxid.
2. When heated with dilute hydrochloric acid and alcohol or with the
same dilute acid and stannous chlorid or metallic zinc, the yellow or
orange color changes to green. 3. Lead acetate forms a yellow pre-
cipitate, insoluble in ammonium hydroxid, soluble in caustic potash or
soda, and insoluble in acetic acid."
See also "Chromates" p. 70L
'Wardner: M. and S. Reptr., nasconi: Th&se, Lyon, 1883 (2 D.).
Phila., 1869, XX., 362. Whitney: "Sei-i-Kwai," Tokyo,
^Rossle: Deut. Arch. f. kl. Med., 1887, vi., 227. Baeyer: Diss. Miin-
1902-3, Ixxv., 569. chen, 1901, and Munch, med. Wchn-
'Burghart: Charite Ann., 1896-7, schr., 1901, xlviii., 1245; Kron-
xxiii., 196. heimer: Ibid., 1902, xlix., 903.
*v. Limbeck: Prag. med. Wch. Kossa: Pfliig. Arch., 1901, Ixxxvm.,
nchr., 11187, xv./ 25. Lohr: 627. Mucha.: Loc. cit.
Berl. kl. Wohnschr., 1904, xli., « See also ante, p. 196; and
749. Fresenius: " Qual. Anal.," 16te Aufi.,
'v.
Limbeck: Loc. cit. Ber- 1895, 263, 484, 507, 508.
314 TOXICOLOGY — WITTHAUS.
FIXED MINERAL ALKALIES.
The most important of these are the hydroxids and dimetallic
carbonates of the alkaline metals.
Potassium hydroxid — caustic potash, potassa, potash — KHO—
and sodium hydroxid — caustic soda, soda — NaHO — these are
hard, white, amorphous solids, usually met with in irregular
masses or in cyhndrical sticks, very soluble in water, and forming
intensely alkaline and corrosive solutions. They are used in
medicine in the solid form as escharotics, either alone or com-
bined with quicklime, or in solution in the proportion of
five per cent., as liquor potassii hydroxidi and liquor sodii
hydroxidi U. S. P. In the arts and in the household they
are used in soap-making and in cleansing and bleaching.
Soap lye, caustic lye, soap lees, laugenstein, laugenessenz, consist
of sodium or potassium hydroxid with varying quantities
of the carbonate, formed by absorption of atmospheric carbon
dioxid.
Dipotassic carbonate — carbonate of potash, pearlash, salt of
tartar, potassii carbonas, U. S. P. — E2GO3 or KjCOj+SAq, and
disodic carbonate — carbonate of soda, washing soda, sal soda,
soda crystals — NajCOj or Na2CO3+10Aq— are amorphous pow-
ders or crystalline solids, soluble in water, forming solutions
which are strongly alkaline, although less so than those of the
hydroxids.
Sodium peroxid — NajOj — is a yellowish powder, recently
introduced in chemical technology, and possessed of even more
energetic powers than the hydroxid. Its violent reaction with
water will probably prevent its becoming of practical toxicolog-
ic al interest.
The monometallic alkaline carbonates — monosodic car-
bonate — bicarbonate of soda, cooking soda, salaratus, sodii bicar-
bonas, U. S. P.^NaHCOg — and monopotassic carbonate-
bicarbonate of potash, sal aeratus, potassii bicarbonas, U. S. P-
EHCO3 — exert but little corrosive action, owing to their slight
alkalinity.
Calcium monoxid — quicklime, calx, U. S. P.— OaO— would,
were it swallowed dry, produce violent symptoms, not only
from its water-absorbing and caustic action, but also by the heat
which it develops on contact with moisture. If brought in
FIXED MINERAL ALKALIES. 315
contact with water it becomes "slaked," and converted into
the comparatively harmless calcium hydroxid, CaH^O.,. The
corresponding barium compounds are of more interest as true
poisons than as corrosives.
Piazza' has reported the only instance of which we find
record of the toxic action of quicklime: that of a boy of five
years who swallowed some of the solid and died in 7 or 8 hours
from the effects.
Statistics — Causation.
Corrosions by the fixed alkalies occur less frequently than
those by mineral acids, except in certain European countries
where at certain periods many accidental and suicidal cases
have resulted from the insufficiently regulated use of liquid
wash-lyes in households, where they are accessible to all, and
frequently kept in beer bottles. Thus Johannesson- states that
140 cases of accidental poisoning by wash-lye occurred in
Christiania, Sweden, during the five years 1893-1898; v.
Hacker^ collected 333 cases in three hospitals in Vienna during
the ten years 1876-1885; v. Torday* in Buda-Pest met with 208
cases during the twenty years 1880-1899; and Kramoztyk*" had 32
cases of lye corrosion in 50 cases of poisoning in the^ Jewish
Children's Hospital at Warsaw, in the years 1898-1899. We
have found further record of 167 cases, of which twenty-two were
by impure sodium hydroxid, three by disodic carbonate, forty-
four by potassium hydroxid, eight by dipotassic carbonate, two
by a mixture of potassium hydroxid and carbonate, and eighty-
seven by "lye" etc. Seventy-one of the cases were in adults;
twice both adults and children were affected, and in the remainder
the victims were young children. In most of the accidental
cases the alkali was taken by children or adults in mistake for
beer, medicine, etc. ; in one case by aspiration through a pipette,
in another it was given by a nurse to a hospital patient in mistake
for magnesia.* A man died in fifteen minutes after the sub-
cutaneous infusion of 220 c.c. of caustic potash solution, used in
■ Gazz. d. osp., 1907, xxviii., 498. Teleky: Ztschr. f. Heilk.,.1904, xxv.,
Uhrb. f. Kinderhlk., 1900, li., Chir. Abt., 1.
153. "Jhrb. f. Kinderhlk., 1901, Hii.,
'"U. d. n. Veratz. entst. Speise- 272.
rohrvereng.," Wien, 1889. See also = Ibid., 1902, Iv., 580.
» Brit. M. J., 1904, ii., 1547.
316 TOXICOLOGY WITTHAUS.
mistake for salt.' A man died from inhalation of the dust of a
highly alkaline fertilizer." In two instances death resulted
from external application; once by immersion in a vat containing
sodium hydroxid solution;' in the other case* from application of
disodic carbonate to an infected wound. Opacity of the cornea
was caused by application of solid potassium hydroxid to it.'
A man of fifty-three died of chronic poisoning by monosodic car-
bonate, having taken daily doses of two ounces for sixteen
years." Two lunatics died after eating soap, which did not
contain an excess of alkali.' Twenty six cases were suicidal, of
which twenty were successful, and two were combined with
homicide.* One each by disodic and dipotassic carbonate,
three by sodic hydroxid, nine by potassium hydroxid, and
twelve by " lye." One was awoman, five months pregnant, whose
intent may have been to cause abortion.' We find no other
case with this intent. In only seven cases was there allegation of
homicide. Of these two were Austrian cases in which women
destroyed their children and themselves.'" Two occurred in
Germany: In one, reported by Casper," a woman attempted
to murder her three-year-old illegitimate child. In the
other, reported by Liman,'" the victim was also a child (five
months old), which died in eighteen days. Two other cases are
referred to by Taylor,'^ and appear to have been the result of
negligence rather than of intentional poisoning. The poisoning of
a ten-months infant left in charge of a servant for a few minutes
appears to have been homicidal."
Symptoms — Duration — Diagnosis — Prognosis.
When the alkali comes in contact with the lips or mouth the
patient experiences an intense soapy taste and sensation, imme-
I Hof acker: Ztschr. f. Med.-Be- "Schall: Beitr. i. path. Anat.
amte, 1894, vii., 379. (Ziegler), 1908, xliv., 482.
^ Borntrager: Aerztl. Schverst. " Hofmann: "Lehrb.d.ger.Med.,
Ztg., 1904, X., 50. 6te Aufl., Wien, 1891, 655.
= Sands: New York M. J., 1884, ""Handb. d. ger. Med.," 3te
xxxix., 534. Aufl., ii., 475.
* Hancock: Lancet, 1854, ii., 435. " lUA., 8te Aufl., ii., 530.
= Dobrowolsky: Ifl. Mtschr. f. " "Med. Jur.," 11th Am.ed.,m
Augenhlk., 1881, xix., 161. and (Reg. v. Boothman, 1860
"Tunstall: Med. Times, 1850, "Princ. and Pract. Med. Jur.,' «
n. s., i 564. ed., i., 234. , ,
'Liebetrau:Med.Klin., 1906, 1228. " Filiatraut: Union mM a''
«v. Hofmann: "Lchrb. d. ger. Canada, 1882, xi., 511.
Med.," 9te Aufl., 681.
FIXKD MINERAL ALKALIES SYMPTOMS. 317
diately followed or accompanied by violent burning pain.
Even if the lye be immediately expelled, as is frequently the
case, even with suicides, the short contact has been sufficient
to cause corrosion of the parts touched, which are colored at
first white, afterward becoming red or dark brown, are more or
less eroded, and subsequently become greatly swollen. The
symptoms referable to the local action upon the parts touched
by the alkali follow, as in corrosion by the mineral acids, with
the following differences: The vomited matters are alkaline in
place of being strongly acid, are at first thick and slimy, and
only become tinged with blood or dark in color later. The
vomited matters contain shreds of necrosed tissue from the
oesophagus and stomach. In one case, a week after an attempt
at suicide, a portion of a cast of the oesophagus was found pro-
truding from the mouth. Having been carefully withdrawn,
it was found to consist of the mucous, submucous, and part of
the muscular coats of the entire oesophagus, including the low-
est part of the pharynx and a part of the necrosed epiglottis.^
Whether the alkali taken was a hydroxid or a carbonate, the
vomit, if alkaline, effervesces on addition of an acid. This is
partly due to the carbonate which almost invariably exists in
the hydroxid, and partly to that formed by the carbon dioxid of
the expired air. The urine rapidly becomes strongly alkaline,
and may continue to be alkaline or subacid for several days.
It is cloudy, and deposits amorphous phosphates and crystals
of ammonio-magnesian phosphate. In some cases the urine is
retained, causing painful distention of the bladder.
The symptoms of perforation, shock, and peritonitis, so com-
monly observed as effects of the primary action of the mineral acids,
have not, so far as we know, been caused by the mineral alkalies.
Indeed, death is rarely a primary result of the action of fixed
alkalies. Of seventy-one fatal cases in which the duration is
stated, death occurred in less than twenty-four hours in seven-
teen; in from one to seven days in nine; in from one to four weeks
in thirteen; in from one to four months in twelve; in from four
' Hadden: Tr. Path. Soc, London, Buffalo M. and S. J., 1897-8, xxxvii.,
1889-90, xli., 86. Similar cases 103 (nature of corrosive unknown) ;
have been reported by Troquart: J. Bornikoel: Berl. kl. Wchnschr.,
de mM. de Bordeaux, 1895, xxv., 1901, xxxviii., 177; Mangour: Gaz.
157; Bussenius: Charity Ann., 1897, hebd. d. sc. m^d. de Bordeaux,
xxii., 242; Benjamin: iUd., 1899, 1905, xxvi., 236. See also p. 246.
xxiv., 248 (same case); Brown:
318 TOXICOLOGY — WITTHAUS.
months to one year in fourteen; and in periods longer than a
year in six. The shortest alleged duration is in a mere men-
tion by Taylor' of the case of a boy who is said to have died in
three hours. Excluding this case as insufficiently reported, and
another case reported by Little/ in which a four-year-old child
died in seven hours from the combined effects of caustic potash
and white arsenic (practically Fowler's solution with excess of
arsenic), the most rapidly fatal case on record is Dewar's case,
quoted by Christison,^ of a boy who died in twelve hours after
taking three ounces of a strong solution of potassium carbonate.
"Here," it is said, "death was owing to the general system or
some vital organ being affected through sympathy by the injury
sustained by the alimentary canal." In a suicidal case reported
by Liman* a woman died in thirteen hours; but, although the al-
kali swallowed was the cause of death, the fatal termination was
probably accelerated by severe injuries to the head, not, however,
involving fracture of the skull, which she had inflicted upon her-
self. The most rapidly fatal uncomplicated case reported in
the more modern literature is that of a boy of four years who
died in collapse in fifteen hours. The stomach, although seriously
attacked, was not perforated.' A somewhat similar case, in
which a girl of nineteen years died suddenly in collapse in
eighteen hours, is reported by Kiemann, but in this instance
the autopsy showed that the alkali had entered the lungs by
inspiration.* In two rapidly fatal cases death was due to suffo-
cation caused by the action of the alkali upon the upper air passages.
In one of these a child of two years died in twenty-two hours;'
in the other a child of three years died in twenty-four hours.'
Another child of three years died in twenty-four hours without
coma or convulsions and with only slight difficulty in breathing,
with some moist rattles in the throat, the sensorium remaining clear
' Excluding Hof acker's case of sub- * Casper-Liman: " Handb. d. ger.
cutaneous injection in which death Med.," 8te Aufl., ii., 532. ^^
occurred in 15 minutes (Ztschr. f. 'Lesser: "Atlas d. ger. Med.,
Med.-Beamte, 1894, vii., 379). i., 9. See also "Post-mortem Ap-
Taylor does not give this as his own pearances."
observation, and quotes it without ^ Ber. . . . Rudolph-Stift., Wien,
reference. We find no mention of 1881, 305.
it in Christison or elsewhere anterior ' Nager: Arch. d. Heilk., 1872,
to Taylor. xiii., 221.
^Colorado M. J., 1898, iv., 326. « Cox: Lancet, n. s., xvi., 66U.
='Edinb. M.- and S. Jour., 1828, So cited by Beck: "Med. Jur.,
XXX., 309. Christison: "Poisons," 12th ed., ii., 519.
Am. ed., l.S,'),
FIXED MINERAL ALKALIES — DURATION. 319
to the end.^ Still another child of two and a half years died in
about twenty-four hours, apparently iii collapse, and the ap-
pearances observed at the autopsy were very similar to those
described by Lesser.' Liman' mentions two cases of deaths of
young children in twenty and twenty-four hours, respectively.
Although we find no record of perforation as a primary effect
of the caustic alkalies, late deaths from perforation and peri-
tonitis have been reported. The perforation is either spon-
taneous — as in the case of a man of forty-nine years who died
over two months after an attempt at suicide with caustic lye*
— or it may be produced by attempts to dilate an oesophageal
stricture by means of bougies, as in the case of a child of two
years which died in thirty-six days;'' and- in the case of a girl
of twenty years whose death — eight months after she had taken
two spoonfuls of caustic potash solution — was caused by pulmon-
ary disorder which had resulted from the passage of a bougie
through the oesophageal walls. ^
In the majoi'ity of fatal cases, death is the result of inanition,
caused by cardiac or oesophageal, less frequently pyloric, steno-
sis, or after unsuccessful attempts at surgical relief of such con-
ditions. Usually the stenosis develops gradually until, in from
three weeks to a few months, interference with deglutition be-
comes sufficiently serious to call for operative interference.'
But the final result from this cause may be delayed for a long
period. Barham* has reported the case of a woman of twenty-
two years who died from inanition two years and three months
• after swallowing a quantity of soap lees by mistake. Wein-
lechner' describes the case of a boy of seventeen years who died
in thirty hours after an operation for gastrostomy, performed
to relieve CEsophageal stricture, which was caused by " laugen-
essenz" with which he had attempted suicide two and a half years
previously. . Sir Charles Bell'" describes the stenosed oesophagus
of a woman who died literally from starvation, having taken
' Brannock: Nashville J. M. and genvergiftung," Diss., Munchen,
S., 1857, xii., 361. 1888.
^Voss: "Ueber Laugenvergif- "Weinlechner: Ber. . . . Rudolph-
tuDg," Diss., Berlin, 1892, p. 26. Stift., Wien, 1879, 398.
'Casper-Liman: "Handb. d. ger. 'Arch. f. kl. Chir., 1893, xlv.,
Med.," 8te Aufl., ii., 529, 632. 605.
* Ber. . . . Rudolph-Stift., Wien, » Lancet, 1850, i., 275.
(1875), 1876, 373. » Loc. cit., p. 396.
= Schuberg: "Bin Fall von Lau- ""Surgical Observations," 1816,
Ft. i., p. 82.
320 TOXICOLOGY — WITTHAXJS.
soap lees twenty yeai's previously; and Teleky' refers to the case
of a woman in whom an oesophageal stricture returned eighteen
years after the primary injury.
That oesophageal stricture may result from the action of a
very small quantity of alkali is evidenced by a case reported by
Brug.^ A man drank from a bottle of caustic potash by mis-
take, but discovered his error in time to prevent much of the
liquid passing into the oesophagus, and rinsed out his mouth
with water. He did not consult a physician at the time, but
two months later noticed a difficulty in swallowing. Examina-
tion showed a stricture near the cardia, which was dilated, and
the patient taught to pass the sound himself. He was read-
mitted later, the stricture having narrowed until permeable only
to the smallest catheter with great difficulty, while above the sten-
osis was a sac-like dilation of the oesophagus. The third day
after readmission the stenosis became impassable. He died
twenty-four hours after an operation for gastrostomy.
Sometimes there is a single constriction, more usually two or
three, at or near the upper and lower extremities of the cesophagus
and at the point where it crosses the bifurcation of the trachea.'
Although the oesophagus is usually the seat of strictures pro-
duced by alkalies, Hadenfeldt* has reported a case in which
total stenosis of the pylorus also occurred, and was relieved by
gastroenterostomy.
The physiological action of the potassium compounds differs
notably from that of the sodium compounds, in that, while the
neutral salts of latter metal are practically inert unless taken in
enormous quantity, those of the former exert a distinctly toxic
action upon the heart, causing at first increase and subsequently
diminution of blood pressure, and diminution and even arrest
of the heart's action. This is, however, of little interest when
the caustic alkalies are taken, as the pulse and heart's action
'Ztschr. f. Heilk., 1904, xxv., (Hft. 47). Benjamin: Berl. kl.
Chir. Abt., 46. Wchnschr., 1898, xxxv.. 725; M
= Bost. M. and S. Jour., 1876, Charity Ann., 1899, xxiv., 246.
xcv., 481. Teleky: Loc. cit. Kramsztyk: Jahrb.
= See also: v. Hacker: "U. d. n. f. Kinderhlk., 1902, Iv., 580. Johan-
Veratz. entstandene Speiserohren- nessen: /bid., 1900, li., 153. Torday;
verengungen," Wien, 18S9; Id. Arch. Ihid., 1901, liii., 272. ,„„.
f. kl. Chir., 1893, xlv., 605. Keller: ' Munch, mad. Wchnschr., IW
Oesterr. Ztschr. f. prakt. Heilk., xlvii., 216.
1862, viii., 857, 903 (Hft. 46), 902
FIXED MINERAL ALKALIES TREATMENT. 321
are similarly affected in the exhaustion and collapse caused by
either alkali.
Among exceptional cases we may note the following: A
woman of forty-five years died on the third day after an appli-
cation of monosodic carbonate to a wounded surface.^ A man
of fifty-three years died suddenly while upon a journey. The
remote cause of death was in the condition of his alimentary canal
and general nutrition, caused by his having taken two ounces of
sodium bicarbonate daily for a period of sixteen years. ^
The prognosis is far from favorable. In 56 out of 77 cases
(72.7 per cent.) death is known to have resulted, and in 21 (27.3
per cent.) the patients did not die while under observation. Of
477 cases of oesophageal corrosion observed by v. Hacker'
69.8 per cent, were caused by alkalies. Of these' one-third died
from the primary effects, and of the survivors more than one-half
had more or less severe strictures, of which at least one-third
died. Very few escaped without strictures.
Treatment.
As in acid corrosion, if the case be seen very early, the in-
dications are to dilute and neutralize the corrosive as expedi-
tiously as possible. All that has been said regarding the treat-
ment of acid corrosion* applies here, save that the neutrahzing
agent must be an acid and not a base. The most available acids
for the purpose are acetic (vinegar), citric (lemon juice), and
tartaric. Usually, however, corrosion is quite advanced when
the patient is first seen, in which event it is better to avoid the
administration of acids, as neutralization of the alkali does
not restore destroyed tissue, and the acid only aggravates the
already severe pain. If the stomach-tube have been successfully
introduced,^ the washing should be continued until the washings
are neutral. Fragments of ice, or^ small quantities of ice cream
should be given internally, and cold applied to the abdomen.
Narcotics are indicated to control the pain. Oils, mucilaginous
drinks or white of egg may be given later, more with the view of
' Hancock: Lancet, 1854, ii., 435. * See p. 239.
^Tunstall: Med. Times, London, "With the precautions described
1850, 564. See Post-mortem, p. 322. on p. 240.
• ■ => Arch, f . klin. Chir., 1893, xlv.,
605.
IV.— 21
322 TOXICOLOGY WITTHAUS.
coating the raw surfaces than with the hope of neutralizing the
alkah with the formation of soaps. Avoid overfilling the stom-
ach. Later, when the mouth has returned to the normal and the
gastric symptoms have abated, oesophageal strictures should be
sought for and, if found, dilated with bougies if possible. In
most cases, however, gastrostomy, with or without retrograde
dilatation, or cesophagotomy must be resorted to. Rectal
feeding may be necessary at times.
Post-mortem Appearances.
We find but few observations of the post-mortem appear-
ances after early death from fixed alkalies. The most complete
are those of Lesser, ' Voss," and Nager,* from the first men-
tioned of which the following description is taken:
Stains of a dirty yellow color upon the skin of the chin;*
outer portion of lips cyanotic and deprived of epithelium; the
visible mucous membrane of a dirty red-brownish to greenish
color; tongue swollen; epithelium where present opaque, whit-
ish, or greenish-gray; where denuded, subepithelial tissue uni-
formly intensely red. Gums and pharj-nx injected and swol-
len, most markedly so at the opening of the larynx, which is
markedly narrowed, and where there is considerable submu-
cous cedema. Brown, linear, opaque stains on anterior surface
of the uvula and on the soft palate. CEsophagus corroded in
its upper part; lower part normal in consistence. Stomach of
medium size; peritoneal surface pale; only the large vessels of
the subserous tissue moderately injected with dark fluid blood.
It contains about 80 c.c. (5iij-) of cloudy, thick fluid tinged
with bile, and acid^ in odor and in reaction. On the inner
surface the cardia, the lesser curvature in its left two-thiids,
and the neighboring parts of the anterior and posterior sur-
faces are in marked contrast with the remainder. They form
an irregular triangle, whose apex is directed toward the py-
lorus, about 10X12 cm. (4x4f inches), with sharply defined
'"Atlas d. ger. Med.," i., 9, 13, See also Casper-Liman:
PI. ii., Fig. 1, 5 (good colored d. ger. Med.," 8te Aufl., 529, o32.
plates); Vrtljschr. f. ger. Med., * In one of Liman's cases yello"
1898, 3 F., xvi., 84. stains similar in character were o^
" "Ueber Laugenvergiftung," served in a child that had survivefl
Diss., Berlin, 1892, p. 26. for eighteen days.
= Arch. d. Heilk., 1872, xiii., 221. * See p. 325.
FIXED MINERAL ALKALIES POST-MORTEM. 323
borders, brown-red in color, uneven, and nodulated and leath-
ery in consistence. The remaining mucous membrane is ca-
tarrhal, flat, and pale reddish-yellow or greenish, with a few
small spots, altered as in the principal lesion. A section through
the eschar shows tha,t it penetrates the entire mucous layer, but
the submucous and part of the muscular layers only in the im-
mediate vicinity of the cardia. In other parts of the stomach
wall adjacent to the eschar there is only a considerable cedema-
tous and cellular infiltration. The section of the eschar is
thicker than normal. The entire small intestine is catarrhal, less
so toward the ileo-csecal valve, and in its upper part also colored
by biliary imbibition. The abdominal glands are normal but
pale. Heart normal; the blood contained in it partly coagu-
lated. The mucous membrane of the larynx, trachea, and
bronchi bright-red; in the bronchi a notable quantity of viscid,
purulent mucus. In the posterior part of the lower lobes of the
lungs are numerous, circumscribed, brown-red, pneumonic spots,
of the size of peas, caused by inhalation of ingesta.
The appearances in Voss' case were similar, but the stomach
contained coagulated blood, and its contents were neutral in
reaction.
In Kiemann's case of death in eighteen hours, the mucous
membrane of mouth, pharynx, larynx, trachea, large bronchi,
oesophagus, stomach, and duodenum was brown-yellow and
corroded. There was much blood in the small intestine. In
places in the lungs there was gray-red hepatization, due to in-
spiration of caustic potash.
In Nager's case of death in twenty-two hours the stomach
was perfectly normal, the fauces were ulcerated, the follicular
gland tissue protruding in the form of yellow ridges. The in-
testines were normal. The lungs were affected with acute
cedema, and to the right below with lobular pneumonia. The
cortex of the kidneys was hypersemic, black-red; the pyramids
anaemic, pale yellow. Nager gives a description of the micro-
, scopic changes, with illustrations, for which we refer to the
original.
Walbaum' in experiments upon animals found that alkalies
produce changes in the minute structure of the gastric mucous
' Vrtljschr. f. ger. Med., 1906, Beitr. z. path. Anat. (Ziegler), 1908,
3 F., xxxii., 63. See also: Schall: xliv., 458.
324 TOXICOLOGY WITTHAUS.
membrane quite distinct from those produced by the mineral
acids.' The sections stain easily, the blood vessels are con-
tracted, the red corpuscles have disappeared, the outlines of the
cells are dimmed, the protoplasm clear and the nuclei distorted;
all the connective tissues are homogenized.
Autopsies after death from the secondary effects of alkalies
have been made much more frequently. The most marked
changes are found in the oesophagus, stomach, and lungs. If
death have resulted from inanition, great emaciation and other
evidences of starvation are observed. The oesophagus is af-
fected in most cases, being deprived of epithelium, thickened,
and cicatrized, and thereby diminished in calibre, most fre-
quently toward the middle or lower part, frequently to the ex-
tent of complete or almost complete closure. Sometimes it is
greatly dilated above the stenosed portion.^ Or the oesophageal
wall may be softened in places, as in one of Weinlechner's cases,'
in which, two months after the injury, the lower third of the
oesophagus was found inflamed, purulent, of a punk-like con-
sistence, and distended above the cardia to a pocket, the wall
of which had been perforated by the sound, causing purulent
peritonitis. The stomach is frequently contracted, pale, buff
color, more or less deprived of epithelium, and cicatrized, with
thickened walls. The pylorus is often stenosed by cicatrization,
but less frequently than the oesophagus or cardia. When it is
affected, the cardia or oesophagus is also contracted, and the
stomach more or less cicatrized. In one case, however, the car-
diac opening of the stomach hardly admitted a director, while
at the pylorus there was an extensive cicatrix, involving the
valve, and completely shutting off the duodenum. Yet the
stomach intervening between the pylorus and cardia was healthy.*
Evidences of pneumonia or of tuberculosis or of oedema are
frequently found in the lungs. In one case the fatal termination
was caused by secondary empyema.^ Frisch* has reported a case
in which the oesophagus and the trachea in the region of the
' See p. 258. ■• Barclay: Med. Times and Gaz.,
' Barham: Lancet, 1850, i., 275. 1S53, vii., 553.
Lesser: " Atl. d. ger. Med.," PL v., 'Shuberg: "Ein Fall von Lau-
Fig. 3. genvergiftung," Diss., Munchen,
' Ber. . . . Rudolph-Stift., Wien, ISSS.
1875 (1876), 373. » Jahrb. d. Wien. K. K. Kranken-
Anstalt (1893), 1894, i., 819.
FIXED MINERAL ALKALIES — ^ANALYTICAL. 325
bifurcation were perforated and in which there had been acute
pulmonary oedema.
In Tunstall's case of death from long-continued doses of the
bicarbonate, the tissues were very pale, the stomach twice its
natural size, its peritoneal surface covered with reticulated
blood-vessels, with a bright brick-red blush spreading from the
cardia over one-third of its surface; the entire mucous mem-
brane was disintegrated, pulpy, with numerous ulcers from the
size of a pea to that of a bean. The stomach had the appearance
of polished tortoise shell. It contained half a pint of strongly
acid liquid.^ The small intestines were in the same condition as
the stomach. There was no fat in the omentum, and the liver
and spleen were small and consolidated.
Analytical.
Very little is to be expected of the chemist in cases of alka-
Hne intoxication. Although the identification and quantita-
tive determination of potassium and sodium present no difhcul-
ties, salts of these metals are normal constituents in quite
notable quantity of animal tissues and fluids. Hence to argue
the presence of the hydroxid or carbonate it must be detected in
its own form. This, so far as we are aware, has never been ac-
complished in portions of the cadaver, nor is it probable that it
will be, as during the survival of the victim it will be expelled
by vomiting or converted into other forms of combination.
Indeed, we know of but one instance in which the stomach con-
tents have been found to be alkaline.^ It is to be regretted that
Liman, in his description of the exceptional instance of death in
thirteen hours,' does not state what the reaction of the 500 c.c. of
liquid found in the stomach was. If the matters first vomited
have been preserved, it may be possible to detect and determine
the amount of alkali in them, but it must not be forgotten that a
considerable quantity of alkali may be neutralized by the acid
gastric contents. The materials should be dried and extracted
with warm absolute alcohol, which dissolves the hydroxids but
' He had taken several doses of - Lesser: Vrtljschr. f. ger. Med.,
sodium bicarbonate during the day, 1898, 3 F., xvi., 85. See p. 322 and
and about a pound was found in his above.
pockets. ^ Casper- Liman: "Handb. d. ger.
Med.," 8te Aufl., ii., 532.
326 TOXICOLOGY WITTHAUS.
not the carbonates. A quantitative analysis of all the bases and
acids present is also desirable. Usually the function of the
chemist will be limited to a determination of the nature and
quantitative composition of a sample of the substance which
caused the intoxication. The urine should be carefully ana-
lyzed, particularly as to the degree of its alkalinity or acidity,
If stains upon clothing, etc., have been produced by the alkah,
they will be white, and will contain the carbonate whether the
substance taken was carbonate or hydroxid. Confirmatory evi-
dence may be obtained from the presence or absence of arsenic
in small quantity in the cadaver, as it is an almost constant
impurity of commercial caustic soda.*
AMMONIUM HYDROXID AND CARBONATE.
Ammonia — NH3 — is a colorless, pungent, intensely suffo-
cating and irritating gas, lighter than air (specific gravity 0.589
A), which is formed during decomposition of organic nitrogen-
ous matter either spontaneously or by destructive distillation,
Is is most readily obtained by decomposing the ordinary aqua
ammoniaB by heat, or an ammonium compound by a stronger
base. The gas is extremely soluble in water (1,050 volumes in
1 at 0°), to which it communicates an intensely alkaline reac-
tion. When subjected to a pressure of about seven atmospheres
it is reduced to a colorless liquid, which boils at — 33.7° (—28.6°
F.). In many forms of ice machines this liquid is produced
along with a certain amount of frozen water by pressure, and the
lowering of temperature is attained by its volatilization.
Ammonia is not only irrespirable, but causes immediate
suffocation when it is inhaled, even if largely diluted with air.
The detrimental effects of inhaled ammonia gas are due entirely
to its local irritating action upon the respiratory organs. Under
these conditions it can have no truly poisonous action as Magnus^
and Sihle' have shown that the lungs are impervious to this gas
M'hich is neither absorbed into the blood nor eliminated there-
' See p. 270. In one of Liman's nothing is said of the presence ot
cases ("Handb.," ii., 532) the pres- arsenic in the body, nor is its ag-
ence of arsenic in the liquid which nificance there recognized,
caused the intoxication, and the - Arch. f. exp. P. u. P., IW
existence of a large quantity of so- xlviii., 100.
dium compounds in the "contents " Zentbl. f, Physiol., 1903-4, xWi
of the cadaver" are noticed, but 238.
AMMONIUM HYDROXID AND CARBONATE. 327
from in the lungs. Death from inhalation of ammonia has oc-
curred either from the injudicious use of aqua ammonise or am-
monium carbonate as a remedy or by its escape from ice ma-
chines. Falck^ refers to two cases of ammonia intoxication by the
careless administration of the fumes of aqua ammonise to epilep-
tics/ one caused by a similar use of the same substance as an an-
tidote for hydrocyanic acid poisoning, one from the breaking
of a bottle containing strong aqua ammonise,' and one in which
a workman employed about a Carre ice machine almost perished.
An accident, fatal to three men, is reported by Fairbrother.*
While some workmen were employed in the construction of a
freezing-machine the floor gave way. A tank containing an-
hydrous ammonia was broken open, and four men were exposed
to the fumes during three minutes. The body of one was
drenched with the liquid, the exposed portions of the skin were
severely blistered, and the tongue and pharynx denuded of epi-
thelium. He died comatose in fifteen minutes. A second was
found in a condition resembling chloroform delirium, and re-
mained in the same state for two hours, when he suddenly ex-
pired. The third was conscious and able to walk, but com-
plained of occasional difficulty in breathing. He swallowed
and conversed readily. In about five hours the dyspnoea sud-
denly increased, and he died after a few gasps. The fourth
man sustained a compound fracture of the leg, which was am-
putated. For three months he suffered from bronchial irrita-
tion and constant haemoptysis, but recovered, except for partial
paralysis of the right side. Monro and Workman^ reported the
deaths of one man, found dead, and of two others, who died in
about two days, from inhalation of ammonia escaping from a
broken pipe in a cold-storage plant. In May, 1907, five men were
killed and twelve others seriously injured by the explosion of an
ammonia tank in a refrigerating plant in Chicago. A man of
fifty-five died in June, 1899, having been seriously injured in an
'"Lehrb. d. Tox.,"Stuttg., 1880, man died on the third day. A
p. 107. similar case is reported in Edinb. M.
^In one of these (Gaz. de sant6, andS.,J., 1818, xiv., 642.
May 21st, 1816), about two drachms ^ Souchard: Ann. d'hyg., 1841,
of the liquid ran into the mouth and xxv., 219.
nose. In the other (Nysten: Bull. "St. Louis M. and S. Jour., 1887,
de la soc. de m^d., 1815, iv., 352); lii., 272.
a handkerchief saturated with aqua ^ Glasgow M. J., 1898, i., 343.
ammoniae was held to the nose. The
328 TOXICOLOGY — WITTHAUS.
ice-machine explosion in Juh^ 1891, and expert opinion favored
the widow's claim for damages.' A man died in four days from
inhalation of ammonia in cleaning a machine in a chemical
factory.^ A photographer was seriously affected by the gas es-
caping from a suddenly opened bottle of aqua amnionic. ^
We find mention in medical literature of 89 cases of intoxi-
cation caused by swallowing aqua ammonise — spirits of harts-
horn, volatile alkali — ammonium hydroxid solution — NH^HO —
or anin\onium carbonate — or some preparation containing one or
the other, such as "household ammonia," ammonia liniment,
aromatic spirts of ammonia, eau sedative, Preston salts. Of the
83 cases in which the causation is given, 49 were accidental, 27
suicidal, 5 homicidal, and 2 to procure abortion.
It is difficult to imagine how a substance possessed of so
pungent an odor could be taken accidentally and unknowingly
by a person in the full possession of his faculties, yet in only 14
of the "accidental" cases were the victims young children.
Seven of the 35 accidental (?) cases in adults were caused by drug-
gists' errors, and 17 by errors of the patients themselves or their
attendants in taking or administering medicine; in 3 cases aqua
ammonise was taken in mistake for spirits, in 2 for water, in the
dark, in 1 for beer, in 1 instance while the man was drunk, once by
a lunatic, once by a soldier to evade duty, and in 2 cases " by
mistake."
Of the five homicidal (?) cases, one is referred to by Huse-
mann^ as reported bj^ Souchard, of a girl of six years who in-
tentionally poured aqua ammonise into the mouth of her younger
sister. Two others are mentioned by Taylor: One, the death of
an infant of four and a half days from the effects of an ammoniacal
embrocation mixed with its food, as it would seem either by the
mother or by a two-year-old child ;^ the other (Reg. v. Haydon,
1845) in which a man was tried for the murder of a child by ad-
ministering to it spirits of hartshorn. ° In a case reported by
Barclay' a girl of nineteen "was made to swallow" aqua am-
'Edel: Aerztl. Schverst. Ztg., = Guy's Hosp. Kept., 1864,3 s.,
1900, vi., 153. X., 190; "Poisons," 3d Am. ed., 255.
' Lewin: Berl. kl. Wchnschr., " In the table of criminal poison-
1908, xlv., 1873. ings in France, 1851-63, given by
'Harris: Indian M. Ciaz.. 1885, Tardieu (p. 164) are included four
iv., 673. by ammonia.
«"Toxikologie," i., 948. 'Med. Times and Gaz., 1853, ii.,
554.
AMMONIUM HYDROXID AND CARBONATE. 329
moniEe. In a recent German case a nurse girl of sixteen was
convicted of an attempt to destroy a six-months infant by aqua
ammoniae in milk.^
One case is reported of the mahcious external application of
ammonia. A liniment containing a strong solution of ammonia
was thrown by a man into a woman's face, with intent to in-
jure her. A portion reached the eyes. She recovered.-
In one of the cases of abortion a woman swallowed 90 gm.
of aqua ammonise, was delivered of a dead foetus on the second
day, and died on the eighth.^ In the other, ammonia was in-
jected into the vagina, causing atresia.^
Prognosis. — The prognosis when aqua ammoniae has been
swallowed appears to be more favorable than when the fixed
alkalies or mineral acids are similarly taken. Of 89 cases, 52
(58.4 per cent.) died, and 37 (41.6 per cent.) recovered. Nor
is death from secondary effects to be anticipated. It has only
occurred once among the cases of which we find record.'
Duration. — The lethal action of volatile alkali is, as a rule,
more rapid than that of the fixed alkalies. Of 43 cases in
which the duration is given, 25 died within thirty-six hours.
The most rapidly fatal case is one reported by Stevenson," in
which a man, a hard drinker, took a teaspoonful of liquor am-
moniae of specific gravity 0.88. After complaining of some
pain in the abdomen, he turned over on his side, turned blue
in the face, and expired at once without any struggle for breath.
A male suicide died in fifteen minutes after taking a large dose of
aqua ammonia.' A man of sixty-eight years, having defective
sense of smell, swallowed 60 gm. (about Bij.) of aqua ammoniae
in two doses, and died of suffocation three and one-quarter hours
later. ^ A man of seventy years took two mouthfuls of aqua am-
monise while drunk, and died in convulsions in four hours.'
'Feisenberger: Arch. f. krim. xvii., 225. Other early cases of
Anthrop., 1905, xxi., 278. short duration are mentioned by
'^ Reg. ». Gavan, 1873, Stevenson, Plenck: "Tox.," 1785, 4 min.
Taylor: "Med.Jur.," 11th Am.ed., 111. Paget: Lond. M. Gaz., 1837, child
^Franjais: Ann. d'hyg., 1877, 2 yrs., 1 min. after injection into a
2 s., xlvii., 556. nsevus. J. de chim. m^d., 1845, 531,
* Neugebauer: " Verwachs. u. man, 1 J teaspoonful, "soon."
Vereng. d. Scheide," Berlin, 1895. 'Taylor: "Poisons," 3d Am.
= Barclay: Med. Times and Gaz., Ed., 252.
1853, ii., 554. Mann: "Forensic * Christen: J. d. chim. m6d., etc.,
Med.," p. 421, reports a non-fatal 1869, 5 s., v., 309.
case of oesophageal stricture. "Kern: Med. Corr.-Bl. Wiirt.
"Guy's Hosp. Repts., 1871, 3 s., Aerztl. Ver., 1868, xxxviii., 304.
330 TOXICOLOGY WITTHAUS.
The most prolonged case in which death resulted from the
primary action of the alkali of which we find record is that of a
woman suicide who died in forty-five days from the effects of
45 gm. of aqua ammonise.' A man of forty years died of
laryngismus stridulus in nineteen days after swallowing one
ounce of liquor ammonia. ^ A man died in ten days after taking
100 gm. (Biij-) of liquor ammonise;^ another in a like period from
the effects of an equal quantity;'' another in eight days from the
effects of 250 gm. (gviij.) of eau sedative;^ and a woman ex-
pired eight days after taking 90 gm.° In the single case of death
from the secondary effects of volatile alkali above referred to,
death occurred in three months. In two other cases death oc-
curred in eight' and in ten^ days.
Lethal Dose. — In very few cases is the quantity and concen-
tration of the preparation swallowed accurately determined.
The smallest quantity which we can find record of having caused
the death of an adult was 15 gm. (4 dm.) of an ammonia of
unstated strength, which killed a man suicide in three and one-
eighth hours.' In Kanders' case'" a woman of sixty-five years
took "two swallows," estimated at 20 c.c. (about 5^ dm.),
of 10 per cent, ammonia and died the same day. In Matterson's
case," through a pharmacist's error, a man of fortj'-four years
swallowed about 20 c.c. of ammonia of unknown strength, and
died in thirty-six hours. Lesser'^ reported the death of a child of
two years in fourteen and three-fourths hours from 1.5 gm.
(24 minims) of ammonia of 10.2 per cent, strength. Doses of
30 gm. (1 oz.) have been recovered from in four instances.'*
Under exceptional circumstances, a pregnant woman suicide of
twenty-two years was rescued from the effects of 140 gm.
(about 4-T oz.), which she swallowed while holding her nose.
Having done so she immediately jumped into the river, from
' Robin, quoted byTardieu: ° Geneuil, quoted by Tardieu
"Emp." 2eed., 322. "Emp." 2e ed., 317.
2 Patterson: Edinb. M. J., 1857, '" Wien. med, Bl., 1881, iv., 513.
iii., 236. " Lancet, 1876, i., 280.
3 Potain: Union m6d., 1862, xiii., >2 yi-^jgchr. f. ger. Med., 1898,
119. 3F., xvi., 89.
* Gaz. d. hop., 1862, xxxv., 39. "Trotter: Lancet, 1S52, i., 261,
'Rulie: Union m^d., 1S57, viii., M. 36. Fonsagrives: J.dechim.m^d.
522. 1859, 4 s., v., 13, M. 56. Page:
"Fran^ais: Ann. d'hyg., etc., Mich. M. News, 1881, iv., 27, M. 35.
1877, 2 s., xlvii., 556. BelUni: Lo Sperim., 1876, xxxviii.,
' Francai.s: Loc. ell. 177, F. 19.
«Gaz. d.h6p.,lS62, xxxv., 39.
AMMONIUM HYDROXID AND CARBONATE. 331
which she was promptly extracted, whereupon vomiting of the
swallowed water effected thorough lavage of the stomach, and
she recovered.'
S3anptoms. — Immediately on swallowing the alkali the
person experiences a sensation as if he were being mechanically
suffocated, he gasps for breath, sometimes utters a low cry, and
sometimes falls back insensible. Burning pain in the lips,
mouth, and fauces practically accompanies the act of swallow-
ing or is complained of immediately the patient regains con-
sciousness. The pain soon extends to the stomach, and later
the abdomen becomes distended, tympanitic, and tender to the
touch. Retching and vomiting also soon follow the ingestion,
the vomited matters having the odor of ammonia, and contain-
ing blood, frequently in large amount. The lips, tongue, and
mucous membrane of the mouth and pharynx are white or
bright red, with the epithelium peeling off in shreds, and be-
come greatly swollen and cedematous. The oedema may in-
volve the glottis, and thus cause death suddenly.^ Respiration
is interfered with; deglutition is difficult or impossible; there
are severe thirst and dryness of the mouth and pharynx, and the
voice is husky, reduced to a whisper, or extinguished. The
breath smells of ammonia. The lachrymal and salivary secre-
tions are greatly augmented, the saliva is frequently streaked
with blood, and bloody or purulent sputa are discharged from
the air passages. The urine is scanty, high colored or dark,
subacid or alkaline, and contains albumin, casts, and blood cor-
puscles. The bowels in some cases remain constipated during
the entire attack; in others there are copious evacuations, con-
taining blood or consisting entirely of blood and clots. Death
most frequently occurs suddenly from suffocation. Others have
died from exhaustion, comatose, or in convulsions. In non-fatal
cases aphonia may continue for weeks or months.
Frank^ has reported the case of a man who swallowed 10-20
gm. of aqua ammonise upon a full stomach and vomited in
' Bianchi: Gazz. d. osp., 1882, iii., cock: Med. Chron., Manchester,
418. 1891, xiv., 107. Benn: Pac. M. and
2 Tracheotomy has been per- S. J., 1867-68, n.s. i., 13. Scharpff:
formed for the relief of this condition Diss., Kiel, 1903).
four times, once successfully (Dick- ^Corr.-Bl. d. Wurtemb. aerztl.
inson: Lancet, 1890, ii., 1214), and Ver., 1903, Ixxiii., 434.
three times unsuccessfully (Han-
332 TOXICOLOGY — WITTHAUS.
eight to ten minutes. He had no gastric pain, coughing, hoarse-
ness, or dyspnoea.
Treatment. — The indications for neutralization are the same
as when the fixed alkahes have been taken. Impending death
from suffocation may be averted by inhalation of oxygen,
tracheotomy, or artificial respiration; anodynes for the pain;
ice pills.
Post-mortem Appearances. — The mucous membrane of
the mouth and pharynx is deprived of epithelium, red, glazed,
much inflamed, or in parts softened or destroyed. The oesopha-
geal mucous membrane has been found detached in shreds at its
upper part or intensely inflamed at its lower part. In one in-
stance, in which death occurred in thirty-six hours, the oesopha-
geal mucous membrane was yellow, thickened, partly destroyed,
with almost complete stenosis in some places.^ The stomach
contains dark, altered blood, which has the odor of ammonia,
and may also be distended with gas. In a woman who died the
same day from the effects of 20 c.c. (§ivss.) of ten per cent,
aqua ammonise, the stomach was found to contain 500 c.c.
(about a pint) of tenacious, mucous, acid fluid.^ Its mucous
membrane is thinned or destroyed, particularly at the points
where the ammonia would first come in contact. The erosion has
been observed to extend into the muscular coat, but we find only
one case in which it has proceeded to perforation.^ The re-
mainder of the gastric mucous surface is intensely injected,
thickened, and reddened, or white and covered with mucus.
The duodenum and jejunum have been found intensely injected
or filled with blood, but in other instances the intestines were
normal. The epiglottis is eroded and swollen. The submucous
tissue of the glottis and larynx are highly oedematous, some-
times to almost complete closure of the opening of the glottis.
The oedema has been found to cease at the vocal cords, the
trachea and lungs being normal, but usually the trachea and
lungs are also oedematous or congested. The lungs have even
been found affected with pneumonic consolidation.^ The blood
is fluid and bright red, or if dark becomes light on exposure to
air. The kidneys in some cases are unaffected, in others con-
' Gillam: Med. Times and Gaz., » Taylor (Hilton): "Poisons," 3d
1878, ii., 706. Am. ed., 255.
^ Kanders: Loc. cij. ■'Dyson: Med. Times and Gaz.,
1878, i., 35.
AMMONIITM HYDROXID AND CARBONATE. 333
gested and affected with glomerulo-nephritis and fatty degener-
ation. The Kver is usually healthy, but may be the seat of fatty
degeneration.
In Barclay's case of secondary death after three months^
the oesophagus was healthy, the cardiac orifice of the stomach
contracted, and the pyloric opening reduced to the size of a
crow, quill.
Anal3^ical. — The detection of an alkaline ammoniacal com-
pound in the stomach contents is only possible or significant
if the case has been of short duration, and if the examination be
made soon after death. Ammonia and ammonium hydroxid
and carbonate are very rapidly diffusible, and the two former
gaseous or extremely volatile; hence they are not only rapidly
absorbed, but soon escape from the living or dead body. Under
favorable conditions, however, the stomach contents may have
a marked odor of ammonia, be alkaline in reaction, and yield
ammonia on analysis; but it must be remembered that am-
monia is formed during putrefaction, and therefore its detection
is of no significance if that process is at all advanced.^ Prob-
ably the best method of separation is that proposed by Vitali:^
The viscera are treated with absolute alcohol, ether is added, and
the mixture distilled at a temperature not exceeding 40° (104°F.).
Free ammonia (or that present as hydroxid) passes over with
the ether, but ammoniacal salts are not decomposed at that
temperature. The ammonia is extracted from the ether by
agitation with dilute sulfuric acid. If a decinormal acid be
used the quantity of ammonia may be determined from the loss
of acidity of the acid solution. To extract ammonium carbon-
ate the viscera are mixed with alcohol and distilled, and the
carbonate in the distillate precipitated with lime-water or bar-
ium chlorid.
Ammonia may be recovered from the solution of the sulfate
obtained as above by evaporation to dryness, washing with ab-
solute alcohol, dissolving in water, and distilling the solution
with caustic soda in a small retort connected with a bulb tube
' Med. Times and Gaz., 1853, ii., mined in the stomach and viscera,
554. but he states that undoubtedly it
2 Lesser: Vrtljschr. f. ger. Med., was a product of putrefaction, and
1898, 3 F., xvi., 89, reports two cases was not a remainder of the dose
of death from ingestion of ammonia talcen in either case.
in which that substance was not only ^ " Manuale d. Chim. toss.,"
found, but quantitatively deter- Milano, 1893, p. 165.
334 TOXICOLOGY — WITTHAUS.
charged with water and cooled by ice. The presence of ammo-
nia in the distillate is recognized by: (1) The odor; (2) the
formation of white fumes when a glass rod moistened with
moderately concentrated hydrochloric acid is approached to it;
(3) freshly made hsematoxylin paper is colored blue- violet by
the vapor; (4) phenolphthalein paper is colored red; (5) rosolic
acid paper is colored purple; (6) Nessler's reagent colors the
liquid yellow or brown; (7) a solution of mercuric chlorid forms a
white precipitate; (8) a solution of mercurous nitrate forms a
black precipitate; (9) neutralized with slight excess of hydro-
chloric acid, the solution treated with excess of platinic chlorid
solution, evaporated to dryness and extracted with alcohol-
ether, leaves a yellow residue consisting of microscopic octa-
hedral crystals of ammonium-chloroplatinate — (NH4)2PtCle.
The formation of this compound may be utilized to determine the
quantity of ammonia. To that end it is dried at about 100°
and weighed; 100 parts correspond to 7.61 parts of ammonia
(NH3).
If caustic alkalies be present in the objects examined along
with ammoniacal salts, the latter are decomposed at slightly
elevated temperatures, and ammonia is liberated.
The detection of ammonia (as carbonate) in the urine is of
no toxicological significance, as it is normally present therein
and is greatly increased in amount from decomposition of urea,
on exposure to air, and frequently in the bladder.
THE HALOGENS.
ChLORIN BhOMIN lODIN.
The halogens (a\s = salt, •ycvca = birth) are the four elements fluorin,
chlorin, bromin, and iodin, which exist in compounds more or less
closely resembling sea salt, sodium chlorid. Fluorin, although prob-
ably a most intense corrosive, has no practical toxicological interest,
owing to the exceptional conditions necessary for its liberation.
Chlorin.
Chlorin is liberated by the action of manganese dioxid, MnOj, upon
hydrochloric acid, either alone or in the presence of sulfuric acid, or
upon a mixture of sulfuric acid and common salt; or electrolytically
by the decomposition of a chlorid. It is also given off when a hypo-
THE HALOGEXS — CHLORIN. 335
chlorite (bleaching powder, etc.) is exposed to the air or decomposed
by an acid.
It is a yellowish-green gas; has a verj' penetrating, pungent odor;
is very soluble in water ; and is reduced to a liquid under a pressure of
eight and a half atmospheres at 12° (53.6° F.). Liquid chlorin, in steel
cylinders, is now an article of commerce. Its chief use is as a bleach-
ing and disinfecting agent.
We find reference in medical literature to seven cases of accidental
acute poisoning by inhalation of chlorin among operatives in facto-
ries where the gas is used, or from generation of the gas from chloride
of lime.' A quasi criminal, fatal poisoning by chlorin occurred in
New York State in 1894, in which an aged negress lost her life through
the pranks of some college students.
Probably the most accurate description of the symptoms is that
given by Sury-Bienz : The man had inhaled a small quantity of the pure
gas. He immediately experienced an inclination to cough, dyspnoea,
and a stabbing pain in the chest. He was seen by the physician the
morning after the accident (which had occurred during the night) suf-
fering from severe dyspnoea and coughing constantly. In the evening
he was worse, and was transferred to the hospital. The next morning
the dyspnoea was intense, and coughing, with little expectoration, was
almost uninterrupted. The patient was greatly excited, and spoke
with great difficulty. The heart impulse was not detectable, but the
heart sounds were clear. Sibilant rales were heard, particularly to
the right and above. The liver dullness was normal. The urine was
brown-yellow, clear, and without albumin. The face was cyanosed.
The sputum was frothy and bloodless. There was nothing abnormal
in the pharynx, and the voice was clear and loud. Toward evening
the dyspnoea increased markedly; every respiratory muscle was called
into play; the movements of respiration were short, particularly the ex-
piration. There was slight cyanosis and the pulse was very frequent
and small. At 10 p. m. the patient slept quietly. At 10.30 he awoke
and threw himself about; the pulse became imperceptible; there were
r^les in the throat; and he died at 11 p. m., about forty-eight hours after
the inhalation.
The prominent post-mortem appearances noted in the above case
were: rather intense inflammation of the mucous membrane of the
upper as well as the more minute air passages; marked oedema of the
' Kastner: Arch. d. Apoth. Ver., Soc. m6d. Suisse Rom., 1876, x.,
1826, xviii., 101. A. B.: Lancet, 177. Med. Pr. and Circ, Dublin,
1839, ii., 194. Meissner: Ztschr. f. 1880, n. s., xxix., 245. Sury-Bienz:
Med. Chir. u. Gebh., 1862 n. F. i., Vrtljschr. f. ger. Med., etc., 1888,
347. Cameron: [Dublin Q. J. M. n. F., xlix., 345.
Sc, 1870, xlix., 116. Baylon: Bull.
336 TOXICOLOGY WITTHAUS.
lungs; slight catarrh of the right kidney; severe, acute catarrh of the
stomach and of part of the duodenum. There were also found (of an-
terior origin) marked emphysema, enlargement of the heart, with some
thickening of the valves of the right side, complete destruction of the
right kidney, and chronic catarrh of the bladder. The death was
ascribed to cardiac paralysis.
In Cameron's case, on cutting into the ventricles of the brain, a very
strong, unmistakable odor of chlorin was observed.
Hypochlorites. — Mixtures and solutions containing hypochlorites
are extensively used in bleaching and laundrying. Those most fre-
quently met with are: Bleaching fowd'eii= chloride of lime, a white,
rather moist powder, made by treating slaked lime with chlorin, and
containing calcium hypochlorite, Ca(C10)2, with some calcium chlorid
and excess of slaked lime. Labaeeaque's 80'lvtio'!<I'= liquor sodce
chlorinatcB, U. S. P. — a faintly greenish liquid, having the odor of
chlorin, made, by adding a strong solution of disodic carbonate to bleach-
ing powder suspended in water. It contains sodium hypochlorite,
NaClO. Sodium hypochlorite may also be produced from the chlorid
by electrolysis, if the temperature be not allowed to rise. Eau de
Javelle =Javelle water, is properly the potassium compound, corre-
sponding to that of sodium contained in Labarraque's solution. Usually,
however, the two are practically identical.
A few cases of intoxication caused by swallowing JaA-elle water
have been reported in France,' one a homicide in which a child of six
months was destroyed by eau de Javelle forcibly administered by its
father.^ The toxic power of these solutions is largely due to the excess
' of alkali which they contain, and the symptoms and lesions which they
cause resemble those produced by the fixed alkalies.
A girl made an unsuccessful attempt to poison a familj' by chloride
of lime in Kings County, N. Y., in 1888. Kob^ reported the mm-der of
a new-born illegitimate infant by its mother by a mixture of chloride of
lime and potash.
Bromin.
Bromin is a dark reddish-brown liquid, volatile at all temperatures,
gi^'ing off brown-red vapors, which have an odor similar to that of
chlorin, and a like effect upon the air passages. It is soluble in water
to the extent of 3 . 2 parts in one hundred at the ordinary temperature,
the solution being known as "bromin water." It is more soluble in
'Tardieu: "Empoisonnement," 249. Carles: Ann. d'hyg., etc.,
2eme ed., 1875, 285-292 (cases iv., 1876, 2 s., xlv., 550.
v., vi.). Barbet and Brulatour: J. ^ Case vi., Tardieu.
d. chim. m6d., etc., 1844, 2 s., x., ' ■\'rtljschr. f. ger. Med., 1904,
3 F., xxvii., 85.
THE HALOGENS BROMIN. 337
alcohol and ether. Its chemical characters are similar to those of the
chlorin, but in general somewhat less energetic.
We find in medical literature but five instances of bromin intoxi-
cation. Two of these were suicidal: one that of a man of twenty-four
years, a daguerreotyper, who swallowed an ounce of undiluted bromin,
and died in seven and one-half hours;' the other that of a teacher, who
was found dead under circumstances which left no doubt that he had
swallowed bromin.^ The third case was either accidental or homicidal.
It was that of a child of one and three-quarter years, which died in six
days from the inhalation of bromin vapor. The question whether the
accused, a photographer, had intentionally caused the inhalation was
not determined, as he died in prison during the inquiry.' The fourth
case was the result of ignorance of chemistry on the part of a shoe-
maker in practising medicine. A child of ten years received three
doses at two hours interval of a mixture containing potassium bromid
and chlorin water in such quantities that the child, which died in 15
hours, must have received 0.203 gm. of free bromin.^ Another case of
severe though non-fatal intoxication of a young man of nineteen years
by inhalation of bromin vapors is reported by Bruck.'
In Snell's case there were immediate spasms of the pharyngeal and
laryngeal muscles and difficult respiration, and soon afterward great
anxiety, restlessness, pain in the stomach, and tremors of the hands.
The respiration was hurried and the pulse tense and corded. The
symptoms increased in intensity; the extremities became cold, the
pulse failed, and death followed. In Kornfeld's case the skin below
the mouth was inflamed and yellow-brown. The voice became husky
an hour after the inhalation, and remained so until death. Respiration
was difficult and abdominal. Three days later there were gastric pain
and painful deglutition; and in the evening transitory gnashing of the
teeth and slight contractions of the fingers. On the sixth day a severe
attack of dyspnoea occurred and was repeated in the evening, accom-
panied by cardiac palpitation. During the night spasms and general
convulsions were followed by death in complete unconsciousness.
In Snell's case, in which the autopsy was made seventeen hours
after death, the external surface of the stomach was found vividly in-
jected, most markedly so at the lesser curvature; near the middle a
soft ecchymosed spot and several smaller ones posteriorly. The stom-
ach contents consisted of 120 c.c. (5iv.) of a port- wine colored fluid, hav-
ing a faint odor of bromin. The mucous surface was covered with
' Snell: N. Y. M. Jour., 1850, v., ^ Kornfeld:Friedr. Bl. f. ger. Med.,
179. Schapps: Ihid., p. 340. etc., 1883, xxxiv., 228.
^Sehmalfuss: Vrtljschr. f. ger. * Hering: Ztschr. f. Med.-Beamte,
Med., etc., 1889, n. F., 1., Supplh., 1889, ii., 217.
37. 5 Apoth. Ztg., 1895, No. 96, p. 839.
IV.— 22
338 TOXICOLOGY AVITTHAtTS.
a thick black layer, resembling coarse tanned leather, or a mixture of
lampblack and gum arable. The submucous tissue was intensely in-
jected. The duodenum was vividly injected. Those organs nearest
the stomach were stained j'ellow. In Schmalfuss' case, in which from
ninety to one hundred hours intervened between the death and the au-
topsy, the odor of bromin was perceptible on opening the abdomen.
The external surface of the intestines and peritoneum were coated
with a brown-black, smeary mass. The posterior wall of the stomach
was entirely absent, only shreds of the pylorus remained, and what
was left of the stomach and contents appeared as if burnt. The con-
tents of the small intestine were yellow or orange, and had a distinct
odor of bromin. The small intestine had the appearance of having
been cooked. At about a half metre from the pylorus the intestine was
perforated, and near the opening in the peritoneum was a yellowish
mass weighing about 50 gm. and smelling strongly of bromin. As
the case was clearly one of suicide no analysis was ordered, but bromin
was obtained from the contents of the intestine by distillation.
The analytical method which should be followed for the detection of
bromin is the same as that recommended for iodin.' Free bromin may
be recognized by (1) its odor; {2j its color and appearance; (3) the
orange and yellow color of its solution in chloroform or carbon bisul-
fid; (4) the brown color of its vapor; (5) it colors starch pa.'^te yellow
or orange; (6) with phenol it forms a crystalline precipitate of tri-
bromophenol, insoluble in water.
Bromids give the following reactions: 1. Silver nitrate produces
a faintly yellowish-white precipitate of silver bromid, which is insolu-
ble in nitric acid, sparingly soluble in ammonium hydroxid solution,
and almost insoluble in boiling solution of ammonium sesciuicarbonate.^
2. Solution of palladious nitrate (but not that of the chlorid) forms
in concentrated solutions a red-brown precipitate of palladious bromid
(PdBrj). 3. If chlorin water be added to a solution of a bromid,
the bromin is liberated and colors the liquid darker yellow or orange.
If it be then shaken with carbon bisulfid or chloroform, these dissolve
the bromin, forming reddish-yellow solutions. 4. Bromin similarly
liberated by chlorin water from bromids responds to the other tests
for free bromin given above.
lODIN.
lodin is a blue-gray solid, forming crystalline scales which have
something of a metallic lustre. Specific gravity 4.94S. It is volatile at
all temperatures, and if heated gives off a dark violet-colored vapor
whose odor somewhat resembles that of bromin. It is but sparingly
' See p. 343. -See p. 343, note 3.
THE HALOGENS lODIX. 339
soluble in water, but water standing upon excess of iodin continues to
dissolve it by formation of hydriodic acid. Its solubility in water is
greatly increased by the presence of hydriodic acid or of certain salts,
notably potassium iodid. It dissolves readily in alcohol or ether, form-
ing brown solutions ; or in chloroform or carbon bisulfid, forming violet-
colored solutions. Its chemical characters are similar to those of chlorin
and bromin, but less pronounced. Its atomic weight is 126.97.
Elementary iodin is used medicinally in solution as Tinctura iodi,
U. S. P., an alcoholic solution containing eight parts of iodin in one
hundred parts; and as Liquor iodi corny., U. S. P., or Lugol's solu-
tion, an aqueous solution containing five parts of iodin and ten of po-
tassium iodid in one hundred parts. The so-called "colorless tincture
of iodin" contains no free iodin, but triethylamin, ethyl iodid, and
ammonium iodid, along with alcohol and some free ammonia. Iodin
in combination is also extensively used in medicine: in metallic com-
bination in the iodids of the alkalies, and of zinc, iron, and mercury,
and in more recent times as iodin trichlorid and tribromid, and sulfur
iodid; and in organic combination as iodoform, CHI3, iodol (tetri-
odopyrrole, CjIjNH), iodal (monoiodaldehyde, C2H3IO), diiodoform
(ethylene periodid, carbon tetriodid, CI4), iodoglycerol, iodalbuminate,
and iodocasein, in all of which the therapeutic action depends largely
if not entirely upon the iodin present. Iodin exists in minute quantity
in the tissues of all plants and vegetables inhabiting the sea. A stable
compound containing iodin, called thyroiodin, also exists in a globulin,
thyreoglobulin, in animal bodies, principally in the thyroid gland, but
also in lesser proportion in the liver, kidneys, ovaries and epidermic
tissues. This substance appears to exert a protective function in
preventing the toxic effects, tetanus, myxoedema, cretinism, which are
manifested after total extirpation of the thyroid.
Acute iodin intoxication caused by free iodin or its solutions is of
comparatively rare occurrence. We have met with 31 cases in med-
ical literature. Of these the majority, 20, were accidental; 5 were chil-
dren who drank from carelessly exposed bottles of the tincture; 2
were adults who took the tincture in mistake for internal remedies;
and the remaining 11 were cases of medical poisoning by solutions
of iodin, either given internally, applied to the surface, or injected into
cavities, abscesses, or tumors. Nine were attempts at suicide, 5 of
which were successful. Two were unsuccessful attempts at homi-
cide. One of these is mentioned by Taylor:' an attempt by a woman
to poison a fellow servant by tincture of iodin added to food in a plate.
The deep blue color produced by the iodin with the farinaceous food
attracted attention and frustrated the attempt. The other was an at-
I "Poisons," 3d Amer. ed., 2S.5.
340 TOXICOLOGY — WITTHAUS.
tempt by a girl to destroy her illegitimate child by administration of the
tincture.'
The action of elementary iodin is rather that of a true poison than
that of a corrosive, although it combines with albuminous substances,
and thus acts locally upon tissues with which it is brought in
contact. The gastric symptoms which it produces appear to be due
quite as much to its action through the blood as to its action from the
stomach directly. Rose^ found in a woman who received 10 gm. of
iodin (5iiss.) daily, injected into an ovarian cyst in the form of Lugol's
solution, that during the first days about 4 gm. ( 5 '•) '^^'as daily ex-
pelled in the vomit, which contained free iodin, while at no time did
the urine contain iodin, except in combination. Iodin also exerts a
marked influence upon the circulation and upon the blood. Pellacani'
has shown that iodin acts upon the blood corpuscles and enters into
combination with the liberated haemoglobin.
On contact with the skin iodin produces a brown stain, and, if the
action be more intense, a sluggish dermatitis which may become puru-
lent. Death has been caused by the systemic disturbance resulting from
too extensive an application of the tincture to the skin in at least two in-
stances: one a boy of eleven years,* the other a boy of seventeen years. °
As an example of the symptoms in a fatal case of acute poisoning by
iodin we may cite the suicidal case reported by Hermann' of a man
of thirty-eight years, who died in thirty-three hours from the effects
of 60 gm. (5ij.) of tincture of iodin. He immediately experienced
burning pain in the gullet, which extended downward and became
most severe in the stomach. He vomited and had liquid stools. In
two and a half hours he was admitted into the hospital: face pale,
pupils moderately dilated, sensitive to light, surface cool; severe ab-
dominal pain, not increased by pressure; mouth pale and drj^; lips not
cyanosed; posterior wall of pharynx dry, slightly reddened; expired
air had strong odor of iodin, particularly during and after vomiting.
He was perfectly conscious ; no stupor, no loss of perception, no inco-
herence of ideas, no sensory disturbance, except buzzing in the ears and
a sense of heaviness in the head. Complained only of great praecordial
anxiety, which caused him to change his position constantly. Collapse
and prostration, but not to the extent of fainting. Respiration some-
what accelerated. Radial artery seemed like a hard, thin cord without
' Laennec: Ann. d'hyg., etc., 1S83, '"Sulla tossicologia del iodio," Mi-
3 s., ix., 534. In Tardieu's table lano, 1884.
of criminal poisonings in France * Culpepper: Therap. Gaz., De-
during 1851-71 one by tincture of troit, 1888, 3 s., iv., 225.
iodin is included. No particulars. " Gillespie: Med. Times and Gaz.,
2 Arch. f. path. Anat., etc., 1866, 1864, ii., 488.
xxxv., 12. «at. Petersb. med. Wchnschr.,
1868, XV., 336.
THE HALOGENS — lODIN. 341
pulsation; carotid pulse weak, small, 120; heart's action irregular and
tempestuous. In first few hours quick vomiting, preceded by retching
every ten to fifteen minutes; later at long intervals. Vomit at first
dark; after administration of starch and magnesia faintly blue, rather
white, thin and fluid. Vomiting provoked by drinking or by slight
movement. Stools after colic and straining thin and brownish, : smell-
ing of iodin. After a sleepless night, the prsecordial anxiety and de-
rangement of respiration had increased; radial pulse very small, 132;
marked collapse; speech stuttering and voice hoarse; thirst intense;
deglutition difficult; epigastric pain severe, and extended to the dis-
tended abdomen, back, and oesophagus. Vomiting less frequent, but
vomit contained considerable pure blood, as did the faeces. Of urine,
barely three tablespoonfuls in twenty-four hours, dark red-brown, had
strong odor of iodin, and resembled tincture of iodin in appearance.
Patient very uneasy but conscious, and died almost without a struggle.
The presence of free iodin in the urine in this case (verified by
analysis of that from the cadaver) is a condition different from that
observed in Rose's case, in which the urine, while containing iodids,
was free from elementary iodin.
In more prolonged cases death is the result of changes caused by
the truly poisonous action, resulting in part from the destruction of
gastric follicles as a result of their eliminatory action and the disturbance ,
of the circulation. Thus in a woman who took thirty drops of tincture
of iodin three times daily (in all 60 gm. of the tincture) and who became
greatly emaciated, large furuncles appeared on the breast and shoulder
blades, with great inflammation in their neighborhood. Warm com-
presses caused separation of the furuncles as hard, nodular bodies;
leaving deep, painless, but non-granulating ulcers. Soon after gan-
grenous inflammation began at one great toe and extended upward
rapidly, whereof she died.'
The smallest dose taken internally which has been known to cause
the death of an adult was one drachm (3.9 gm.) ;^ and a child of four
years died from the effects of twenty grains (1.3 gm.).^ Probably less
quantities might prove fatal.
When a solution of iodin has been swallowed, solution of sodium
thiosulfate should be given and the stomach washed out with water
containing albumin and starch paste, or water holding sodium thio-
sulfate in solution. In one instance threatened death from oedema of
the glottis was averted by tracheotomy.*
'Lewin: "Neb enwirkung der ^Jackson: Prov. M. J., 1847, p.
Arzneimittel," 2te Aufll., 1893, p. 356.
383, which also contains an exten- ^ Gairdner: "Essay on the Effects
give account of the varied symptoms of Iodin," 1824, p. 20.
observed in toxic but non-fatal *Kobert: "Intoxikationen," 375.
cases.
342 TOXICOLOGY — WITTHAUS.
After death from iodin, the skin and mucous membranes which have
been touched by the solution may be stained brown. In Hermann's
case, however, there were only orange-yellow spots on the tonsils, con-
sisting of a detachable membrane which extended to the pharynx and
oesophagus. The tracheal mucous membrane is eroded, and the sub-
mucous tissue red and (Edematous, the bronchi to the finest capillaries
are inflamed and filled with thick mucus; intense emphysema is present;
the parenchyma of the lungs is bloodless. The oesophagus throughout
is covered with orange-yellow, mucoid liquid. The stomach contains
an orange-colored mucoid liquid; its mucous membrane is of the same
color, finely punctate and swollen. The same appearance presents in
the duodenum. The liver is large, cirrhotic, and icteric. Kidneys
large; substance of parenchyma hard, hypersemic. Bladder contracted,
contains a small quantity of liquid having the color and odor of iodin.
When free iodin has been absorbed it may be detected, either free or
in combination, in the contents of the stomach and intestines, in small
quantity in the faeces, in all secretions, urine, perspiration, tears, saliva,
etc., in pathological exudations if present, and in the expired air.
The bile only contains iodin in detectable quantity when it has entered
the circulation in large amount at one time.' Its excretion does not
take place with great rapidity, probably because iodin is eliminated by
the gastric mucous membrane and again absorbed from the intestine,
very little being contained in the faeces. The duration of its sojourn in
the body has been found to be from forty-five to one hundred and
forty-nine hours. ^
Iodin has been detected and determined in several cases of poisoning
in the human subject. In Hermann's case* (death thirty-three hours
after two ounces of tincture of iodin) 91.3 gm. of stomach contents
yielded 0.0182 gm. iodin, and a like quantity of blood from the liver,
0.0209 gm. The large intestine contained about as much as the stomach
contents; the small intestine a decidedly smaller quantity; the urine
gave a distinct iodin reaction. The quantity could not be determined
in the small amount of urine from the cadaver, and that passed during
life was lost. The bile contained no trace of iodin. The urine passed
by a woman on the second day of poisoning by tincture of iodin was
found by Huber^ to contain 0.2781 gm. of iodin in 500 c.c, while
1.300 c.c. of vomit contained 0.013 gm. In a woman who attempted
suicide with tincture of iodin, the breath had the odor of iodin in half
an hour. Iodin was detected in the vomit, and in the urine of the sec-
ond day, but none in the urine of the third day. There was no trace of
iodin in the fajces passed on the fourth day. The ciuantity taken was
'Rozsahegyi: Ph. Jahrbr., 1878 ' hoc. cU.
.^(iS. Hermann: Loc. C(«. ■" Ztschr. f. kl. Med., ISSS, xiv.,
' Rozsahegyi: Loc. cit. 471.
THE HALOGENS — lODIN. 343
about 1 gm. of iodin.' In Rose's case, already referred to, iodin was
never found free in the urine, but was found in the vomit of tlie first
few days. The urine passed by a child while suffering from the effects
of an overdose of tincture of iodin was found by Stewart and Gulliver-
to contain iodin in combination, but not free. It also contained indican,
a large excess of urea, and a large quantity of mucin, but no albumin.
Its reaction was strongly acid.
If present in notable amount, iodin may be directly recognized in
the urine or other liquid by agitation with chloroform, or preferably,
with carbon bisulfid, which is colored violet by free iodin, but not by
iodids. The color is only produced by the latter if the liquid be agitated
with chloroform or bisulfid after addition of yellow nitric acid or of
chlorin water.
The materials are to be distilled with water, the receiver being cooled
with ice. If iodin be present in sufficient amount the vapor may have
a violet color, and a paper moistened with cold starch paste and exposed
to the vapor will be colored blue. After distillation of the free iodin
the materials are to be dried with potassium hydroxid and sodium
nitrate in a silver crucible, and incinerated at as low a temperature as
possible. The ash is extracted with alcohol, the solution evaporated, the
residue dissolved in water, the solution acidulated strongly with sul-
furic acid, and potassium dichromate or manganese dioxid added, and
the mixture again distilled. Iodin which existed in metallic combina-
tion (iodids) will pass over in this distillate.
Free iodin may be recognized by: (1) its odor; (2) the violet color
of its vapor; (3) the violet color of its solution in carbon bisulfid or
chloroform; (4) it colors cold starch paste dark blue, the color disap-
pearing on the application of heat and reappearing on cooling; (5) if
present in sufficient amount it separates in the distillate in its character-
istic solid form. If too large a quantity of chlorin has been generated
in the second stage of the process above described, iodin trichlorid will
be produced, which does not give the above reactions. In that event
enough caustic potash is to be added to the distillate to decolorize it,
the liquid evaporated, the residue ignited, and dissolved in water, and
the solution tested for iodids.
The iodids are recognized by 1. Silver nitrate produces a flocculent,
yellowish-white precipitate of silver iodid (Agl), insoluble in nitric
acid, very sparingly soluble in ammonium hydroxid, and insoluble in
a boiling solution of ammonium sesquicarbonate.' 2. A solution of
' Malmsten: Hygiea, Stockh., solving one part of transparent com-
1885, xlvii., 119. mercial ammonium carbonate in
^Ord: Brit. M. Jour., 1877, i., nine parts of water at the ordinary
671 . temperature, and adding five drops of
' This solution, which dissolves ammonium hydroxid solution of sp.
silver chlorid, is prepared by dis- gr. 0.96 to each 10 c.c. of the liquid.
344 TOXICOLOGY WITTHAUS.
palladious chlorid or nitrate produces a brown precipitate of palladious
iodid (PdlJ, which is sparingly soluble in solutions of chlorids, but
almost insoluble in cold dilute hydrochloric or nitric acid. 3. A solu-
tion of one part of cupric sulfate and one and a half parts of ferrous
sulfate produces a dirty white precipitate of cuprous iodid (CujIJ in
neutral, watery solutions. 4. Add to the liquid a little dilute starch
paste and a few drops of dilute sulfuric acid and a little yellow nitric
acid; the liberated iodin colors the liquid blue or black, the color dis-
appearing on the application of heat. 5. Add a little sulfuric acid and
some yellow nitric acid and agitate with carbon bisulfid, the latter is
colored violet.
The quantity of iodin may be determined from that of the palladious
iodid. This is collected on a weighed filter after standing twenty-four
hours, washed in succession with water, alcohol, and ether, dried at a
temperature of 80° (187° F.), and weighed. Afterward the filter is
burnt in a porcelain crucible, ignited, and the remaining palladium
weighed: one hundred parts of palladious iodid correspond to 68.67
parts of iodin, and one hundred parts of palladium to 259 parts of iodin.
Or the iodin or iodid may be determined volumetrically by the methods
of Harnack,' Hilger,^ Rose,' or Jaworowski.^
1 Ztschr. f. physiol. Chem., 1884, 298; Ann. d. Ch. u. Ph., 1874.
viii., 158; Berlin, kl. Wchnschr., clxxi., 212.
1882, xix., 788. 'Arch. f. path. Anat., etc., 1866,
2 N. Rep. of Ph., 1874, xxiii., xxxv., 12.
"Ph. Ztschr. f. Russl., 1893, 819.
MINERAL POISONS.
ANTIMONIALS.
The native black sulfid of antimony was known to the an-
cients, and was used by them as a cosmetic for staining the
eyebrows and eyelashes, and also in the form of ointment for
external application. Its Latin name stibium is derived from
the Greek o-Tt/i,/Ai or a-rifii.^ In the latter part of the sixteenth
century the first description of elementary antimony and of
many of its preparations, including the trioxid and oxychlorid,
was published in a work attributed to Basil Valentine, in which,
however, the element is constantly referred to as a substance
long known. ^ Tartar emetic was discovered and first used as a
medicine by Adrian van Mynsicht in 1631.
The internal administration of antimonials by physicians
dates from the latter part of the sixteenth century. It was
chiefly to the medical use of antimony and mercury that the
acrid discussions between the iatrochemists and Galenists of
that time related. The former adopted the view of Paracelsus,
that a poison might be beneficially used as a medicine, while
the latter insisted that a poisonous substance was such under all
circumstances, and inadmissible in medical practice. In many
European countries for over a century antimonials were only
administered in violation of laws.^
■ Ezekiel xxiii. 40. Dioscorides: following a decree of the medical
"Materia medica," v. 99; Ed. faculty, passed an enactment de-
Frankof., 1598, p. 361. Pliny: daring antimony to be a poison and
"Hist, nat.," xxxiii., 33, 34; xxix., forbidding its use. This remained
37. Dioscorides also designates it in force until 1666, and a half-cen-
TrXarvbipBaXiMv and yvvaiKuov. tury later, in 1719, the French Gov-
^ "Triumph Wagen Antimonii," ernment paid a goodly gum to de la
Fratris BasiHi Valentini, Benedicter Ligerie for the secret of the prepara-
Ordens, Ed. Johan Tholden, Leipzig, tion of Kermes (a preparation of
1624, pp. 116-136, 172, et ■passim. antimony) that it might be used as
For a discussion concerning the a medicine. From 1580 to 1655
authorship of this work see Kopp: every graduate in medicine at Hei-
" Beitr. z. Gesch. d. Chem.," iii., delberg took oath that he would not
110-129. administer antimony or mercury.
' The parliament of Paris in 1566,
346 TOXICOLOGY — WITTHAUS.
Although Grevin in 1568 wrote that "there is no poison by
which one might more secretly poison a man,"^ he cites no case.
The first investigation of a death supposed to have been caused
by antimony is given by Zacchias,^ who, however, declares
that antimony, borax, oleander, and savin, administered by the
accused to produce abortion, are not poisons. The earliest re-
cordecl case of death from tartar emetic was that of an epileptic
child in 1682.^
If we exclude poisonings by antimony among operatives ex-
posed to inhalation of antimonial fumes,* all modern instances
of antimonial poisoning of which we have knowledge, save two,
have been caused either by the trichlorid or by tartar emetic.^
The exception referred to is the non-fatal poisoning of a young
girl and two children, reported by Page,* caused by lozenges
purchased of an itinerant confectioner, and found on analysis to
contain 0.015 gm. (half grain) of antimony trioxid each. The
antimony appears to have been present as trioxid and not as
tartar emetic. In what manner it got- into the lozenges is un-
known. Lesser^ records the case of a boy of twelve and one-
half years who died in about twenty-eight hours after eating a
piece weighing 1.75 gm. of a salt composed of antimony and
sodium fluorids, containing 40.48 per cent, of antimony and used
as a substitute for tartar emetic in dyeing.
Chemical and Pharmaceutical.
Antimony — Sb — atomic weight, 120.193 — specific gravity, 6.175
—fuses at 450° (842° F.).
Elementary antimony is a bluish-gray, brittle solid, having a me-
tallic lustre, readily crystallizable, tasteless and odorless; volatilizes
at a red heat, and may be distilled in an atmosphere of hydrogen.
When deposited from decomposition of its hydrogen compound, as in
the Marsh test, antimony is amorphous and has a dull sih'ery lustre.
^ "Deux livres des Venins," An- (glass of antimony). Zacchias:
vers, 1568, p. 322. "Qusest. Med.-lcg.," ed. Venet.,
= "Quaest. med.-leg.," ed. Venet., 1737, iii., 19, 28 (native sulfid).
1737, iii., 19. Hasenest: " Medicin. Richter," 1755,
'"Zodiacus med.-gall.," Genevan p. 151 (glass of antimony), and
(1682), 1685, iv., 40-42, others. See Wibmer: " Wirkung d.
* See Lohmeier: Wchnschr. f. d. Arznm.," v., 200, 202, 208.
ges. Heilk., 1840, 265, 286. « Lancet, 1879, i., 699.
* Early poisonings by other anti- ' Vrtljschr. f. ger. Med., 1898,
menials are mentioned by Wepfer: 3 F., xvi, 93.
"Hist. Cicut. Aquat.," 1716, p. 254
ANTIMONIALS — CHEMICAL AND PHARMACEUTICAL. 347
Antimony is not altered in dry or moist air at the ordinary' tem-
perature. When sufficiently heated in air it burns, with formation of
the trioxid. It unites with hydrogen under the same conditions as
arsenic does. Cold, dilute sulfuric acid does not affect it, but the hot,
concentrated acid forms with it antimonyl sulfate (SbO)2S04, and sulfur
dioxid. Hot concentrated hydrochloric acid dissolves it very slowly
when it is finely divided. Nitric acid oxidizes it with formation of an
oxid or of antimonic acid. It dissolves readily in aqua regia, as the
trichlorid or pentachlorid. It is not affected by solutions of the alkaline
hydroxids, but is dissolved by solutions of potassium or sodium sulfid.
Elementary antimony enters into the composition of type metal
(twenty to twenty-five per cent.), Britannia metal (ten to sixteen per
cent.) ; pewter (seven per cent.) ; anti-friction alloys (ten to nineteen
and a half per, cent.), and in small amount in brass, bell-metal, and
speculum metal.
Hydrogen Antimonid — stihin, antimoniuretted hydrogen, sti-
bamin, stibonia — SbHj — 123.2.
Is produced (along with hydrogen) when a compound of antimony
is in presence of nascent hydrogen, under the same conditions as the
corresponding compound of arsenic is formed ; and may be obtained
in larger quantity by acting upon an alloy of four hundred parts of two
per cent, sodium amalgam and eight parts of freshly reduced and dried
antimony with water in a current of carbon dioxid.
It is a colorless, odorless, tasteless, combustible gas, subject to the
same decompositions as hydrogen arsenid, from which it differs in
being by no means so poisonous,' in not possessing the garlic odor of
the arsenical gas, and in its action upon silver nitrate solution. Hy-
drogen antimonid, arsenid, phosphid, and sulfid, all color dry siher
nitrate yellow, from the formation of double compounds of silver nitrate
with silver antimonid, ars.enid, phosphid, or sulfid. All of these com-
pounds are decomposed and turned black by water, those containing
arsenic or phosphorus instantly, those of sulfur and antimony slowly.
These gases also cause the formation of black deposits in solution of
silver nitrate. In the case of the arsenical gas all of the arsenic remains
in the solution in the form of silver arsenite, which may be precipitated
by neutralizing with ammonium hydroxid, and the deposit consists of
metallic silver; while with the other gases the antimony, phosphorus, or
sulfur is entirely contained in combination with silver in the deposit.
(See Analysis, p. 376, and Arsenic, pp. 613, 618.)
Antimony Trioxid— SbjOa— 288.4.
It is an insoluble, tasteless, odorless powder; white at ordinary tem-
I See Hanon: Gaz. d. hop., Paris, f. exp. Path. u. Ph., 1890, xxvii.,
1860, xxxiii., 46. Kubeler: Arch. 451.
348 TOXICOLOGY — WITTHAUS.
peratures, yellow when heated. Crystallizes in rhombic prisms, trans-
parent and having a pearly lustre, and sometimes in octahedra. It is
therefore isodimorphous with arsenic trioxid (see Reinsch test, p. 601) ;
specific gravity, 5.2 to 5.778. At a dull-red heat it fuses to a yellowish
liquid, which, on cooling, forms a crystalline mass having a silky lustre.
At a higher temperature it volatilizes and condenses, in the absence of
air, in prismatic needles.
Antimony Tetroxid — intermediate oxid of antimony — anti-
mony antimonate — Sb204— ^304.24.
Is formed when the oxids or hydroxids of antimony are strongly
heated, or when the lower oxid or the sulfids are oxidized with nitric
acid or by fusion with sodium nitrate. It is a white powder, very
sparingly soluble in water, with which it forms a solution acid in
reaction.
Antimony Acids.
The normal antimonous acid, HjSbOj, is unknown, but the series
of antimonic acids: ortho- HjSbO^, pyro- H^SbjO,, and meta- HSbOj,
is complete, either in the form of salts or in that of the free acids.
There also exists, in its sodium salt, a derivation of the lacking anti-
monous acid: metantimonous acid, HSbOj. The insolubility of monosodic
pyroantimonate NasHjSbjO,, 6 Aq., is also taken advantage of in
Meyer's method for the separation of antimony and arsenic (see p. 372).
Antimony Trichlorid — protochlorid of antimony — butter of
antimony — SbClj — 226.55.
Is obtained by passing dry chlorin over excess of antimony trisulfid ;
by dissolving antimony trisulfid in hydrochloric acid, or by distilling
mixtures, either of antimony trisulfid or of antimony with mercuric
chlorid, or of antimonyl pyrosulfate and sodium chlorid.
At low temperatures it is a solid, crystalline body; at the ordinary-
temperature a yellow, semi-solid mass, resembling butter; at 73°. 2
(164° F.) it fuses to a yellow, oily Hquid, which boils at 223° (433.4° F.),
forming a colorless vapor. It absorbs moisture from the air, and is
soluble in a small quantity of water. With a larger quantity of water
it is decomposed, with precipitation of a white powder, powder of
Algaroth, whose composition is SbOCl if cold water be used, and SbjOsClj
if the water be boihng. In water containing fifteen per cent, or more
of hydrochloric acid, antimony trichlorid is soluble without decom-
position.
Antimony Trisulfid — sesquisulfid of antimony — black anti-
mony — SbjSs — 336.48.
Is the chief ore of antimony, and is formed when hydrogen sulfid
is passed through a solution of tartar emetic. The native sulfid is steel-
gray; the artificial product, an orange-red or brownish-red amorphous
ANTIMONIALS CHEMICAL AND PHAEMACET-TICAL. 349
powder. The precipitate obtained when hydrogen sulfid acts upon a
solution of an antimonial compound is, according to circumstances, the
trisulfid or pentasulfid, mixed with free sulfur. Hydrochloric acid
decomposes antimony trisulfid, with formation of hydrogen sulfid.
Potassium -Antimonyl Tartrate — tartarated antimony — Tar-
tar Emetic — Antimonii et Potassii Tartras(U. S. Ph.) — ^An-
timonium Tartaratum (Br. Ph.)— K(SbO)C4H,Oe— 323..35.
Is prepared by boiling a mixture of three parts antimony trioxid and
four parts cream of tartar in water for an hour, filtering and crystalliz-
ing. When required pure it must be made from pure materials.
It crystallizes in right rhombic octahedra, containing one-half Aq.,
which turn white and lose a part of the Aq. in air, the remaining Aq.
being expelled entirely at 100° (212° F.). It is soluble in about two
parts of boiling water and in about fifteen parts of cold water. Its
solutions are acid in reaction, have a nauseating, metallic taste, are
laevogyrous, [ajo = — 156°. 2, are precipitated by alcohol, and decompose
rapidly from the development of algae, when exposed to the air. It is
decomposed by the alkalies, alkaline earths, and alkaline carbonates,
with precipitation of antimony trioxid. The precipitate is redissolved
by excess of soda or potash or by tartaric acid. Hydrochloric, sul-
furic, and nitric acids precipitate corresponding antimonyl (SbO) com-
pounds from solutions of tartar emetic. It converts mercuric into
merourous chlorid. It forms double tartrates with the tartrates of the
alkaloids. Of the many antimonials formerly official in the U. S.
Pharmacopoeia, this is the only one retained in the revision of 1900.
Non-official medicines said to contain antimony:
Ayer's cherry pectoral (Hoffmann): 93.3 syrup, prun. virgin., 11.7
vin. ipecac, 11.7 vin. antim., 7.8 Tr. sanguinar., 0.2 morph. hydrochlor.
Balsam of wild cherry (H. & H. 169') — contains 1 fl. § extr. prun.
virgin., 2 fl. 5 extr. ipecac, 2 fl. 5 extr. scillse, l3 Tr. opii, 1.0 tartar
emetic, 3 drops ol. anisi, 1 § alcohol, i 5 syrup, i 5 Tinct. persionis
comp., water to 85- Brechzucker (Richter) lozenges, each of which
contains about 0.2 gm. tartar emetic. Chemisches Praparat des Buch-
halters J. D. Molfeuter in Ulm (Hager) is said by the manufacturer to be
antimony chlorid. It is in fact commercial fuming muriatic acid.
Coxe's hive syrup (H. & H. 801) — an infusion of 10 pts. each of
serpentaria and squills in 100 pts. water, made up to a syrup with 50 pts.
each of sugar and honey, in which 0.025 pt. of tartar emetic is dissolved.
Cuff's cattle medicine (veterinary) (Geissler) — contains potassium iodid,
tartar emetic, arsenic trioxid, and arsenic trisulfid. Derby's condition
powders (veterinary) (Schadler) — 2.0 tartar emetic, 20.0 antimony
trisulfid (black), 10.0 sulfur, 10.0 saltpetre, 40.0 fenugreek seeds, 20.0
' Hahn und Holfert: "Specialitaten und Geheimmittel," Berlin, 1893.
350 TOXICOLOGY — AVITTHAVS.
juniper berries. Diaphoretic antimony — is potassium metantimonate.
Dixon's pills (Blyth) — each pill contains comp. extr. colocynth 0.1296
gm., rhubarb 0.0648, tartar emetic 0.0038. Dr. J. Johnson's pills
(Blyth) — each pill contains: comp. extr. colocynth 0.162 gm., calomel
0.039, tartar emetic 0.002, oil of cassia 0.007. Elixir tonique anti-
glaireux de Guille (H. & H. 483), a complex elixir containing 1 gm.
of tartar emetic in 11 litres. Ethiops of Antimony = is a mixture of
antimony trisulfid 3 pts. and mercuric sulfid 2 pts. Flechten^ pulver
aus St. Lubes (Wittstein) — contains saltpetre 10 pts., antimony tri-
chlorid 1 pt., antimony trioxid 20 pts. Flowers of antimony — is an
impure oxysulfid, with varying quantities of the trioxid and trisulfid.
Glass of antimony — is a mixture of antimony trioxid and trisulfid.
Hind's sweating ball (veterinary) (Blyth), 3.888 gm. each of tartar
emetic and asafcetida made into a ball with liquorice powder and syrup.
James' powder — antimony trioxid, 33, precipitated calcium phosphate,
67. James' pills (Wittstein) — consist principally of mercuric oxid 1 pt.,
James' powder 30 pts. Kermes mineral, antimony trisulfid and trioxid,
and an alkaline thioantimonite, was formerly official under the name
Antimonii oxysulphuretum, U. S. Ph. Liver of antimony — is a mixture
of antimony trioxid and trisulfid, potassium sulfid and potassium
carbonate; used in veterinary practice. MitcheU's pills (Blyth) — each
pill contains: aloes 0.070 gm., rhubarb 0.103, calomel 0.01, tartar
emetic 0.003. Poudre merveilleuse de Vivier (H. Btirchner) consists
of iodin 48 pts., arsenic 8 pts., tartar emetic 8 pts., phosphorus 1 pt.
Poudre unique de Godemaux, for epilepsy, is precipitated calomel
(Braconnot). Gray oxid of antimony (Alcyon). Calomel and metallic
mercury (Planche). Quietness is tartar emetic, used in England as a
popular cure for dipsomania. Rotzkrankheit^ Mittel (veterinary)
(Btirchner) — 1. Each bolus weighs about 35 gm. and contains about
1 gm. of golden sulfuret of antimony and 7 gm. of liver of antimony
(see above). 2. Each contains 7 gm. of antimony trisulfid (black).
Schnellmast pulver von R. Hiibner (veterinary; condition powder)
(Karmrodt), contains 15.56 per cent, of antimony trisulfid. Schweine
pulver von Dr. Gustav Swoboda (veterinary) (Hager) contains about
34 per cent, of antimony trisulfid. Sel desopilant d' Audin-Rouviere
(H. & H. 1539) contains 0.2 per cent, of tartar emetic. Trunk-
svchtsmitteP von Karrer-Gallati (Karlsr. Ortsges.-Rath) consists of two
liquids, one an alcoholic extract of gentian, the other a 2.6-per-cent.
solution of tartar emetic. Trunksuchtsmittel von J. H. Rungel (E.
Harms) is a 3.5-per-ccnt. aqueous solution of tartar emetic. Trunk-
snvhtsmiUfi von Fr. Schumacher (H. & H. 1705) is a solution of tartar
' Flechte = herpes. ' Trunksucht = dipsomania.
^ Glanders.
AXTIMOX"!' 'I'KICHLOEID. 3.51
emetic. Vomi-purgatif de Leroy (H. & H. 1770) contains 0.8 per cent,
of tartar emetic. Ward's red pill (Blyth) — glass of antimony and
dragon's blood. Washed saffron of antimony is liver of antimony (se(^
above) from which the potassium sulfid and carbonate have been
removed. Weikard's Hauspilleii (H. & H. 761) contain 7.2 per cent,
of "golden sulfuret of antimony," and also about 15 per cent, of calomel.
Antimonials used in the Arts.
Alloys of antimony, see p. 347. Antimony cinnabar, or vermilion
is an oxysulfid. Antimony yellow is a~ mixture of lead antimonate
and basic lead chlorid. Naples yellow is basic lead antimonate. Anti-
mony trisulfid is used in the native, crystalline form in the friction tube
used in firing cannon, in percussion caps, in red and blue fires, and in
the heads of Swedish matches; and in the amorphous, orange form in
the vulcanization of caoutchouc, which it colors red-brown. Glass
of antimony is used to color glass and porcelain yellow. Liquid butter
of antimony is a concentrated solution of the trichlorid, specific gravit}-
1.35, used to color iron and steel brown (gun barrels). SchUppe's
salt, sodium thioantimonate, SbS^Naj + 9Aq., is used in photography.
ANTIMONY TRICHLORID.
Of the ten intoxications by antimony trichlorid of which
. we find record' four were accidental, four suicidal, and in two
it was "taken by" the patient. Five cases were fatal and four
recovered. In two of the non-fatal cases the dose taken was
one ounce (31 gm.). In all of the fatal cases the dose was two
ounces (62 gm.) or more. The shortest duration was in Cooke's
(R. B.) case,^ in which a woman of forty years died in less than
two hours; and the most prolonged in Crisp's case^ in which a
girl of nineteen years died in twenty-four hours. In Middleton's
case^ a child of sixteen months recovered after having swallowed
two teaspoonfuls of " butter of antimony" used by her father as a
dressing for sheep having "foot-rot."
Symptoms. — Antimony trichlorid acts mainly as a corro-
sive, and the symptoms observed are those of intoxication l)y
the mineral acids (q. v.). The violent symptoms may, how-
ever, be slightly pronounced and the case present a narcotic
' Cooke (W.): Lancet, 1848, i.,230. 23d. Cooke (R. B.): Lancet, 1883,
Houghton: Lancet, 1841, i., 324. i., 860. Middleton: Lancet, 1908,
Crisp: Tr. Path. Soc, London, 1865, ii., 1013. Pharm. J., 1907,4 s., xxiv.,
xvi., 125. Taylor: "Poisons," 3d 341.
Am. ed., 456-458. Banks: Prov. ' Loc. cit.
M. and S. Jour., 1846, December
352 TOXICOLOGY WITTHAUS.
type, as in one of Taylor's cases (attributed to Mann)/ in which
a man swallowed from two to three ounces (62-93 gm.). When
seen about an hour later there was entire prostration of strength,
with coldness of the skin, and incessant attempts to vomit.
Severe griping pains were felt in the abdomen, and there was a
frequent desire to evacuate the bowels, but nothing was passed.
In the course of a few hours reaction took place, the pain sub-
sided, and the pulse rose to 120. There was now a strong dis-
position to sleep, so that he appeared as if laboring under the
effects of a narcotic poison. In this state he continued until he
died, ten and a half hours after he had swallowed the poison.
In Crisp's case there was no urine passed.
Post-mortem Appearances. — The most noteworthy ap-
pearance is a blackening and apparent charring of those parts
with which the corrosive liquid has come into contact, similar
to that produced by sulfuric acid. The lips and mouth may be
black and excoriated, also the oesophagus, stomach, and upper
intestine. In Crisp's case the stomach appeared as if uniformly
coated with the antimonial. When this coating was removed
the surface appeared blade and charred. In Evans' case (re-
ported by Taylor) the stomach was vivid-red in places, in others
blackened. In Cooke's (R. B.) case the mucous membrane of
the stomach was intensely congested and of a bluish-black color.
In this case, as well as in Evans', corrosion and blackening of the
lips, mouth, and oesophagus were not observed. Perforation of
the oesophagus, stomach, or intestine was not met with in any of
the cases. From the intensity of the corrosive action, however,
it is quite, probable that it might occur.
Analysis. — In Evans' case antimony was found in the
putty-like masses of altered mucous membrane, etc., from the
stomach. In Cooke's (R. B.) case the stomach was found to
contain compounds of antimony and of arsenic to the amount
of eight grains (0.5 gm.) of the former, and 0.1 grain (0.0065
gm.) of the latter. (For methods see under Tartar Emetic and
Arsenic.)
TARTAR EMETIC.
St.^tistics and Administration.
Of 124 cases of tartar emetic poisoning of which we find
record, 89 were "accidental," 6 suicidal, and 20 homicidal.
I Loc. cit.
TARTAR EMETIC — STATISTICS AXD ADMINISTRATION. 353
In comparing tartar emetic poisonings with those by other
poisons, except arsenic, the very small proportion of suicidal
cases (4.8 per cent.), and the large proportion of homicides (16.9
per cent.)* are noteworthy.
Of the homicidal cases two occurred in the eighteenth
century,^ the remainder since 1850. The following are the hom-
icidal cases since 1850 of which we have knowledge:
1854. Case of Ann Palmer. — The symptoms of her last illness
were those of antimonial poisoning. The body was exhumed one year
after death and found to contain antimony. Her son, suspected of
having poisoned her with repeated doses of tartar emetic, was executed
for another poisoning by strychnin.^
1856. Reg. v. McMullen. — Woman gave her husband "quietness"
(a mixture of cream of tartar and tartar emetic) to counteract the effects
of a debauch, whereof he died. Convicted of manslaughter.''
1857. Reg. v. Freeman. — Mentioned by Taylor. No particulars.^
1857. Reg. v. Hardmann.- — Mentioned by Taylor. Tried for the
murder of his wife by repeated administration of small doses of tartar
emetic."
1858. Affaire Ramier. — Conspiracy by R., his mistress (Z^lie), and
Porel to poison the wife of R. First attempt with phosphorus, second
with tartar emetic. Both unsuccessful. Porel confessed; Ramier con-
victed; Z^Me acquitted.'
1859. Reg. v. Smethurst. — Surgeon, indicted for the murder of his
mistress by repeated small doses of antimony and arsenic. Tried twice.
Convicted on second trial. Subsequently pardoned."
1860. Reg. v. Winslorv. — Defendant charged with murder of Ann
James by aggravating a disease of the csecum from which she was suffer-
ing by the repeated administration of small doses of antimony. Anti-
mony was found in the body of the deceased. Prisoner acquitted."
' If we add seven cases of gross * "Poisons," 3d Am. ed., 145.
negligence the percentage is in- " /6id., 2d Engl, ed., 97.
creased to 21.8. 'J. d. chim. m6d., etc., 1S58,
^Zacchias: "Quaest. Med.-leg.," 4 s., iv., 32.
Consil. iii., 12-14, ed. Venet., 1737, * Browne and Stewart: Op. cil.,
iii., 19-24. Zittmann: "Med. pp. 397, 448-479; Sessions Papers,
For.," 1706, p. 1455. Central Crim. Crt., 1859. Stephen:
' iSrowne and Stewart :" Trials for "Hist, of the Crim. Law of Eng-
MurderbyPoison,"pp.87,88. Tay- land," iii., 438, 465; Brit. M. Jour.,
lor: "Poisons," 3d Am. ed., 96, 1859, ii., 707-711. Taylor: "Princ.
121; Guy's Hosp. Reps., 1857, 3 s., and Pr. of Med. Jur.," 3d ed., 1883,
iii., 369-481. 196.
*Ph. J. and Tr., 1856-57, xvi., » Browne and Stewart: Op. cit.,
147, 197. Taylor: hoc. cit., 58, 479-489. Taylor: "Poisons," 3d
121; and "Med. Jur.," 11th Engl. Am. ed., 121.
ed., 47; Lancet, 1856, ii., 259.
IV.— 23
354 TOXICOLOGY WITTHAUS.
1865. Reg. v. Pritchard. — Tried at Edinburgh. Defendant was a
physician. Poisoned his wife with repeated doses of tartar emetic, and
his mother-in-law with antimony and aconite. Convicted. Confessed
before execution.'
1866. Reg, v. Bellemey, alias Barnett. — An apothecary was tried at
Melbourne, AustraUa, for the murder of his paramour by repeated
doses of antimony. Acquitted.^
1871. State v. Eliz. G. Wharton. — Tried at Annapolis, Md., Decem-
ber, 1871, and January, 1872. Defendant was accused of the murder of
Gen. W. S. Ketchum by tartar emetic. Another visitor at defendant's
house, Mr. Eugene Van Ness, suffered violent symptoms of antimonial
poisoning. Acquitted.'
1871. A woman was held for trial in England (Staffordshire Assizes).
Antimony had been found in the cadavers of three of her children.
She had buried ten out of twelve children at different times, some
having manifested symptoms of antimonial poisoning. We are unable
to find further reference to this case.*
1876. The Balham Mystery, or Bravo Case. — Bravo, a barrister,
probably died from the effects of antimony and laudanum. The cor-
oner's jury found a verdict of willful murder by some unknown person.
Subsequently it was shown that the deceased had purchased a large
number of quack powders, advertised for the cure of dipsomania, which
contained tartar emetic* (Classified above as suicide.)
1878. Prof. H. Ranke reports the case of a man who was supposed to
have died from tartar emetic administered by a barber-surgeon (bader)."
1878. State v. Vosburgh. — A preacher tried in Hudson County
(N. J.), for an attempt to murder his wife by tartar emetic. Case
unpublished.
' Browne and Stewart: Op. cit., Law Rev., Boston, 1874, 647-668;
397-448. Reports of trial: William also in his "Famous Trials," 274-
Kay, Edinb., 1865; Edinb. M. and 309. Reese: Am. J. M. Sc, Phila.,
S. Jour., 1865, xi., 163-200; Wien. 1872, n. s., Ixiii., 329-355. Will-
m^d. Wchnschr., 1865, xv., 1072, iams: Richm. and Louisv. M. Jour.,
1105. Felizet: Arch. gte. d. m^d., 1873, xv., 721-747; Med. and Surg.
Paris, 1865, ii., 267-277. Roughead: Reptr., Phila., 1872, xxvi.,-475,
"Trial of Dr. Pritchard," London, 503, 523. Wood, H. C, Jr.: Med.
1906. Rec, N. Y., 1873, viii., 169. Tay-
^ Ph. J. and Tr., 1868-69, 2 s., X., lor: "Med. Jur.," 11th Am. ed.
325. (Bell), 23.
^Report of trial. Baltimore Ga- "Ph. J. and Tr., London, 1871-
zette. Bait., 1872. Aiken: "A Re- 72, 3 s., ii., 397, 458, 516.
view of Professor Reese's Review of '^Taylor: "Med. Jur.," 11th ed.,
the Wharton Trial," N. Y., 1873; 136. Johnson, Payne, and Red-
also, on "Some Supposed Fallacies," wood: Lancet, 1876, 1., 755. Wade:
etc., Richmond and Louisville M. Brit. M. Jour., 1876, ii., 264.
Jour., 1873, XV., 7-13. Chew: /6?f/., "Friedreich's Bl. f. ger. Med.,
1872, xiv., 93-116; Med. Rec, N.Y., 1879, xxx., 241. See also ScheUe:
1873, viii., 332-338. Morse: Am. Ibid., 1882, xxxiii., 8.
TARTAR EMETIC — STATISTICS AND ADMINISTRATION. 355
1887. Reg. v. Th. Hall. — New Zealand. A man of seventy years,
poisoned, as alleged, by his son-in-law.'
1893. Peo. V. Henry Meyer, etc. Defendant tried twice for the mur-
der of one Baum or Brandt, to obtain an insurance upon his life.
Convicted of murder in the second degree.^
1894. State v. Effi,e Cox, alias Whalen, and Rose Fournier. — Tried
in Chittenden County Court, Vermont, 1894. Defendants indicted for
the murder of Fournier by repeated administration of tartar emetic;
convicted of manslaughter, first degree. "Reasonable doubt" that
the purpose of the administration was to correct an alcoholic habit.
Case not published.
1903. Rex vs. Klowsowski, alias Cha'pman. — The defendant had
spent several years as a hospital attendant. Having deserted his wife
he lived successively with three other women who died, and in whose
cadavers antimony was found on analysis. Two of the bodies were
exhumed after one and five years' burial.''
Suicide by tartar emetic is of most exceptional occurrence.
Excluding the Bravo case above mentioned (which was to some
extent at least an opium poisoning, and possibly accidental),
there are but five cases, all anterior to 1860. Of these three were
in females, of which one was fatal.* Of the two men one died.^
(See Lethal Dose, below.)
Of the accidental cases 29 were in children less than ten
years of age (for the most part medicinal poisonings); and 56
in persons over ten years of age, who took the poison either
medicinally in overdose or in mistake for other drugs^i.e.,
Glauber's salt, nitre, cream of tartar, bicarbonate of soda,
Epsom salt, potassium acetate, oxid of antimony, sugar, or as
an external application.
The use of tartar emetic as a medicine is now much less
general than it formerly was, and consequently accidental poi-
sonings by it are now very infrequent. During the past thirty-
five years but 23 tartar-emetic poisonings have been reported.
Of these 9 were homicidal, 12 due to negligence or mistake, 1
to absorption from a fabric, and 1 medicinal.
' Brit. Med. Journ., 1887, i., 853. Bost. M. and S. Jour., 1856-57, Iv.
^ Doremus: J. Am. Ch. Soc, 400). The other two are reported
1895, xvii., 667. in Lancet, 1844, i., 444 (Lefevre) ;
'Stevenson: Br. M. J., 1903, i., and Galtier: "Toxicologie," i., 505
873; Waldo: Med. Press and Circ, (in 1835).
1904, n. s., Ixxviii., 193. '' R^camier's case. See Galtier:
* A trance medium who appar- Op. cit., 507. The non-fatal case is
ently poisoned herself to verify her reported by Serres. See Galtier: Op.
own prediction of her death (Ellis: cit., 506.
356 TOXICOLOGY — WITTHAUS.
Accidental poisonings have resulted from the administration of
repeated small doses of tartar emetic, called "quietness" in some parts
of England, for the cure of the drink habit; and in some alleged homi-
cidal cases the defense has claimed this to have been the motive for
administration." Usually such treatment is resorted to without the
knowledge or consent of the "patient," but Harnack^ has reported the
case of a man who dosed himself with tartar emetic for this purpose,
at the suggestion of his wife, from June 18th to 22d, and died on
the 23d.
The administration in all but eight cases was by the mouth.
In four instances it was by external application, either as powder
or ointment;^ in two cases in enemata;* in one case by absorption
from a fabric mordaliced with tartar emetic,'^ and in one case in
the milk of the mother."
In 29 instances tartar emetic was taken in aqueous solution;
in 25 as a powder; in five as antimonial wine, in one as "horse
medicine," and in one as a patent medicine.
Lethal Dose.
It is only under exceptional conditions that a single dose,
however large, of tartar emetic may cause the death of an adult.
An analysis of the 40 deaths of adults attributed to tartar
emetic shows that 16 were cases of alleged homicide, in most,
if not all, of which the theory of the prosecution implied re-
peated administrations; seven were accidental poisonings caused
by more than one dose, five were cases in which antimonial poi-
soning was probably not the proximate cause of death; in five the
method of administration is doubtful, and in one it was by ex-
ternal application. The six remaining cases may be summarized
as follows:
1. Hoffmann, 1760.' — A mere statement that a person (a woman)
died in a short time after an improper administration of tartar emetic.
2. Orjila.' — An incidental statement that a woman of eighty-two
' Reg. I). MoMuUen, p. 353; State * Charier: J. d. chim. m6d.,
V. Effie Cox and Rose Fournier, p. 1847, 3 s., iii., 472.
355. Both cases resulted in convic- ^ Gillet: Ann. d. 1. See. m^'d.-chir.
tion for manslaughter. d. Li^ge, 1886, xxv., 83.
^Vrtljschr. f. ger. Med., 1901, 3 « Wibmer: "Wirkung d. Arznei-
F., xxi., 267. mitt.," v., 179.
' Lancet, 1838, i., 250 (two cases); ' "Op. omn.," v. i., pt. ii., ch. v.,
Beitr. z. prk. Heilk., 1834, i., 670 ed. Genev., 1760, i., 213.
(two cases). • s "Tox. g6n.," 5eme ed., i., 620.
TARTAR EMETIC — LETHAL DOSE. 357
years died in fifteen hours after having talcen 0.5 gm. of tartar emetic,
which caused some purging but no vomiting.
3. Skae, 1844.' — In this case a man of forty-five years certainly tooli
one dose of about fifty-five grains of tartar emetic, while suffering from
delirium tremens, and vomited in ten minutes. About sixteen hours
later he got out of bed and in so doing fell insensible and died.
4. Beale, 1854.^ — A girl of sixteen years took a quantity of tartar
emetic estimated at forty to sixty grains at one time. In fifteen minutes
she vomited, and continued to vomit and purge continuously for about
three hours. The next morning she did not seem ill, but in the after-
noon she felt as if dying. A physician was then called, who found her
continually throwing the head back and screaming, with dilated pu-
pils, knees drawn up, and a thin pulse. She was delirious for six
hours before death, which occurred thirty-six hours after she had taken
the poison. The autopsy revealed the existence of extensive incipient
ovarian disease.
5. Gabb, 1866.' — A man of forty-three years took about two drachms
of tartar emetic at one time by mistake, and very shortly thereafter "a
draft of vinegar." He walked a mile to a physician's office, where he
appeared so well, so free from any of the symptoms of having taken
tartar emetic, that it was believed that he was mistaken. Soon after he
vomited for the first time, about an hour after having taken the emetic.
After a severe attack of vomiting, purging, cramps, etc., he passed a
comfortable night and the next day was much better. Early the fol-
lowing morning he was pulseless and in a condition of collapse resem-
bling that of cholera. After administration of brandy his condition
was much impro^'ed, but, sitting up in bed contrary to advice, he had
an attack of syncope, from which he rallied a little, but sank again and
died about forty hours after the accident, retaining his consciousness
nearly to the last moment.
6. Dobie, 1887.* — A boy of fifteen years took forty grains of tartar
emetic in mistake for Epsom salt. He vomited in ten minutes and
suffered the usual symptoms of antimonial poisoning, from which he
seemed to be recovering on the third day. On the same day he became
delirious and died comatose on the sixth day. In the short report of
this case the duration is stated in one place as six days and four lines
below as twelve days.
Cases 1, 2, and 6 are incompletely reported. In Case 3
acute alcoholism was at least a contributing cause of death.
In Case 5 the long delay of the emetic action of the poison (caused
■ North. J. Med., Edinb., 1844, ' Med. Times and Gaz., 1866, ii.,
i., 289. 379.
2 Lancet, 1S.54, i., 68. * Lancet, 1887, i., 773.
358 TOXICOLOGY WITTHAUS.
possibly by the vinegar taken) favored absorption, prevented
that prompt removal of the poison which is the chief factor of
safety when single doses are taken, and established very much
the same conditions as obtain in cases of repeated administra-
tion. Beale's case may therefore be said to be the only un-
complicated fatal poisoning of an adult by a single dose of tartar
emetic. And in this the history is by no means sufficiently ex-
plicit (the reporter having only seen the case on the second day,
and the hearsay evidence having been given in a case which was
the subject of a coroner's inquiry) to fully prove the method of
administration and the absence of other causes of death.
Of the five cases above referred to as instances in which the
causative relation of antimonial poisoning to the fatal result is
questionable, two were clearly deaths solely from other causes.
These are: (7) Deutsch's case, cited by Wharton and Stille,' of a
woman who is alleged to have died "in the course of a year" from the
effects of a single dose of a scruple (1.3 gm.) of tartar emetic. The
other (8) is Wakeley's case, cited by Taylor,^ of a man said to have
been fatally poisoned by three grains, and concerning which Taylor
says that "death could not be reasonably attributed to the medicine."
In the other three cases tartar emetic administered to persons
already seriously ill can be considered at the most only as a con-
tributary cause of death.
9. Recamier.^ — ^A man of about forty years took with suicidal intent
2 gm. (thirty-one grains) of tartar emetic. After exhibiting the usual
antimonial symptoms he became furiously delirious and died in convul-
sions on the fourth day. At the autopsy excessive cerebral lesions were
discovered. In commenting upon this case Galtier^ remarks that death
should be attributed to the recent lesions of the brain and meninges, of
which the emetic, or rather the inflammation of the intestinal canal and
the efforts of vomiting, were only the provoking cause.
10. Constant, 1831.* — The case of a medical student under treatment
by Professor Andral for "gastric trouble due to insufficient nutrition and
overstudy," received two grains of tartar emetic in three half -glasses of
water, which immediately provoked vomiting, and severe pain, which
1 "Med. Jur.," 4 ed., ii., 193, ex quoted by most authors from Orfila
Canstatt's Jahresb., 1851, iv., 270. down.
2 "Poisons," 3d Am. ed., 448. * "Toxicologie," i., 508.
^Magendie: "D© I'influence de '^ Arch. g^n. de m^d., 1831 1 s.
I'c^m^tique," etc., Paris, 1813, and xxiv., 262. ' ''
TARTAR EMETIC — LETHAL DOSE. 359
persisted the remainder of the day, with abundant diarrhcEa. He died
on the second day.'
11. An extremely feeble woman of fifty-five years, suffering from
broncho-pneumonia, was bled 500 gm. and was given 0.15 gm. (about
gr. iiss.) of tartar emetic. In the following night, and without any
symptoms referable to the alimentary canal, she was suddenly attacked
with copious and continued intestinal hemorrhages which caused
her death. ^
In several instances persons have taken quantities much
greater than that which is probably the lethal dose of tartar
emetic and, although rendered severely ill thereby, have recov-
ered. Thus Taylor^ quotes a case of Couling's, of a man who
took two hundred grains (13 gm.) in mistake for carbonate of
soda. McCreery* reported that of a man who took half an ounce
(15.6 gm.) in mistake for Glauber's salt, and Gleaves' that
of a man who took a tablespoonful (about an ounce, 31 gm.).
Orfila' also quotes Lebreton's observation of a young woman
who recovered from the effects of 24 gm. of tartar emetic.
Very much smaller quantities have been known to cause death
when taken by adults in more than one dose. That even two
administrations upon two consecutive days of as small a total
quantity as 0.2 gm. (three grains) may cause death when the
first dose fails to provoke emesis is proved by the fatal poisoning
of a woman who died in thirty-six hours after taking the first
dose.^ In Laveran's case, reported by Tardieu,* a man suffer-
ing from erysipelas of the face was given 0.4 gm.. (6.17 grains)
of tartar emetic in doses of 0.1 gm. (one and one-half grains)
during four days. He was attacked with nausea, vomiting,
epigastric pain; passed liquid stools, and died in collapse in
nine days. Antimony was found in the liver.
The susceptibility of young children to the poisonous action
• This is the case referred to by ' "Poisons," 3d Am. ed., 443.
Wharton and Stills ("Med. Jur.,' * Am. Jour. M. Sc, 1853, n. s.,
4th ed., ii., 193), in the,brief state-' xxv., 131.
ment: "Two grains have proved '^ West. J. M. and S., 1848, 3 s., i.,
fatal to an adult." It is also men- 23.
tioned by Taylor ("Poisons," 3d « "Tox. g^n.," 5^me ed., i., 620.
Am. ed., 448), who, however, adds: ' Beau: Bull. g^n. de th^rap.,
" But in this case there were circum- 1856, li., 231.
stances which favored the fatal op- ' " Empoissonement." 2eme ed.,
eration of the poison." 744.
^Piorry: Gaz. d. hop., 1853,
xxvi., 147.
360 TOXICOLOGY — WITTHAUS.
of tartar emetic is such as to render its administration to them
as a medicine dangerous. Beck' has collected a number of ob-
servations of serious and fatal poisoning in young children by
tartar emetic. Among these are two by Charier^ of children
recovering from the measles who were rapidly destroyed by
0.05 gm. (three-quarters grain) given in enemata.
Duration axd Prognosis.
In children the duration of fatal tartar-emetic poisoning is
shorter than in adults. The average of 8 cases in children less
than ten years of age, in which the duration is definitely stated,
was 15.9 hours, the extremes being 1 and 48. In adults the aver-
age of 18 cases was 88.9 hours, or, if 5 exceptionally protracted
cases are omitted, 37.4 hours, with 6 and 96 as the extremes.
The most rapidly fatal poisoning was in a child to which, af-
ter an attack of benignant measles, 0.05 gm. (three-quarters
grain) of tartar emetic was given in an enema, which
caused his death within an hour.' One of Wilton's* cases
was that of a child a year old whose mother gave it repeated
small doses of antimonial wine for a cold. Yery suddenly there-
after it had slight but frequent convulsions, with sickness and
severe diarrhcea, and died in about two hours. Hartley" has
reported the cases of two children of five and three j"ears which
died in eight and twelve hours, respectively, from the effects of ten
grains (0.65 gm.) of tartar emetic. A more recent and somewhat
more reliable case is that published by Chabon,^ in which a
vigorous child of two and a quarter years received two doses of
0.05 gm. (three-quarters grain) each, ten minutes apart, and died
of syncope eight hours later. The most protracted duration of a
fatal case in a young child of which we find notice is that merely
mentioned by Sigmond' of a child of two years which died forty-
eight hours after an external application of tartar emetic to the
spine. Two fatal cases of twenty-four hours' duration are re-
ported, in one^ of which, however, the child most probably died
'"Infant Therapeutics," 2d ed., ' Lancet, 1S46. i., 460.
N. Y., 18.5.5, 30-47. « Union m^d. d. 1. Seine inf., 1881,
^ J. d. cliim. m(5d., etc., 1S47, xx., 114.
3 s., iii., 472. " I aneet, 1S3S, i., 250.
H'harier: loc.cil. * Taylor: "Poisons," 3d Am. ed.,
"Prov. M. and S. ,J., ly44, 204. 447.
TARTAR EMETIC DURATION AND PROGNOSIS. 361
from disease; while in the other/ in which tartar-emetic ointment
was applied to a child of three years, which died in eclampsia, the
patient was suffering from whooping-cough.
In adults only the duration of poisonings in which more
than one dose was certainly or probably administered can be
given. The shortest duration was in a case involving an accu-
sation of criminal negligence, in which a man of twenty-eight
years died six hours after he had received 1 gm. (15.4 grains)
of tartar emetic in two doses, half an hour apart. It is question-
able whether in this case the antimonial was more than a con-
tributorj'^ cause of death. ^ The fatal termination followed
the last administration in ten hours in two instances — a trance
medium, aged twenty-one, who appea,rs to have taken an un-
known quantity, after having predicted her own death. She
had had a similar attack previously.^ A man of thirty years
died in ten hours after the outbreak of symptoms supposed to
have been caused by tartar emetic which he had had several
weeks in his possession.'' In four instances the duration has
exceeded a week. A woman of eighty-three years, a patient in
the Salpetriere, received 4 gm. (6 If grains) of tartar emetic
during three days, and having exhibited the symptoms of anti-
monial poisoning, died upon the seventh day.^ A man received
0.4 gm. (6.2 grains) of tartar emetic during four days. He suf-
fered from nausea, vomiting, and epigastric pains, passed liquid
stools, and died in collapse nine days after taking the last dose."
A man of thirty-four years is reported to have died in twelve
days after a "treatment" at the hands of an empiric, which is
said to have consisted in part in the administration of daily
doses of twenty to thirty grains (1.3 to 2 gm.) of tartarized an-
timony almost continuously for three weeks.'
In all of the homicidal cases of which we find published
accounts the poisoning extended over several days. In the Ann
' Krebs: Beitr. z. prkt. Heilk., "^ Laveran, cited by Tardieu:
1834, i., 670. "Empois.," 2Sme ed., 744.
2 Ranke: Friedreich's Bl. f. ger. ' Le Boutillier: N.-West. M. and
Med., 1879, xxx., 241. Schelle: S. J., Chicago, 1855, xii., 353.
/bid, 1882, xxxiii., 8. , Beck ("Infant Therap.," 2d ed.,
^ Ellis: Bost. M. and S. Jour., 141) makes a mere mention of the
1856-57, Iv., 400. death of a woman of twenty-six
* Pollock: London M. Gaz., 1850, years, twelve days after she had
xlv., 801. taken oss. of tartar emetic. See
^ Durand-Fardel: Bull. g6n. d. also Dobie's case above referred to.
therap., 1843, xxv., 370.
362 TOXICOLOGY WITTHAUS.
Palmer, McMullen, and Hardman cases death occurred after
symptoms referable to the administration of repeated doses. In
the Wharton case the deceased, a healthy man of about sixty
years, was first attacked on June 24th, and died on the 28th,
having had two distinct outbreaks of symptoms. Another gen-
tleman who spent some days at the defendant's house had a
violent attack of symptoms such as are produced by antimony,
from which he recovered; and some days afterward the accused
offered him a glass of beer, which was analyzed, and found to
contain fifteen grains (1 gm.) of tartar emetic. In the Pritch-
ard case one of the victims (Mrs. Pritchard) was first taken ill
about January 1st, 1865, and died March 18th, having had
several attacks, each probably succeeding an administration,
while the other victim (Mrs. Taylor) had two distinct attacks,
February 13th and 22d, of the last of which she died February
24th. In Smethurst's case the first SYmptoms were observed
March 29th, and the woman died May 3d. In the Winslow
case the poisoning began early in February, and death only oc-
curred June 24th. In the Cox-Fournier case there were re-
peated administrations, the last illness lasted four days, and the
last dose was administered six hours before death. In the
Meyer, Bellemey, and Hall cases there was also allegation of
repeated administration on the part of the prosecution.
The prognosis is probably more favorable than is indicated
by the cases reported. Of 118 such 56 (47.4 per cent.) died, and
62 (52.6 per cent.) recovered.
Symptoms and Elimination.
The taste of tartar emetic, which is metallic in character, al-
though not very pronounced, may be noticed at the time of
swallowing it; but more frequently it escapes observation.
The interval preceding the manifestation of the symptoms
proper is usually from a quarter to half an hour. In one in-
stance vomiting is said to have immediately followed the taking
of forty grains (2.6 gm.) of powdered tartar emetic. ^ In an-
other case in which 7.8 gm. (5ij.) were taken in aqueous solu-
tion, nausea, trembhng, and cold sweat followed in seven min-
utes.^ In three instances the duration of the interval was ten
' Durrant: Prov. M. and S. Jour., - Ornellas: Gac. med. d." Lima,
1850, 369. LS5G, i., Xo. 10.
TARTAR EMETIC SYMPTOMS AND ELIMINATION. 363
minutes.' In three instances no symptoms appeared for an
hour.^
Soon there is nausea, which is followed by vomiting, which
is frequently repeated, sometimes as often as every three or four
minutes, and after a time without nausea. The vomited mat-
ters at first consist of the stomach contents, and later become
fluid and tinged with bile or blood. At the same time there is
a burning sensation in the mouth and cesophagus, with a sense
of constriction at the base of the throat. Deglutition is difficult
and thirst severe. The lips and buccal mucous membrane some-
times become swollen, and there is salivation in some cases.
The acts of vomiting are early accompanied by violent epigastric
and abdominal pain and by purging, the stools being watery or
"rice water" in character, and suddenly and involuntarily ex-
pelled. The pulse is at first accelerated, but the arterial tension
is rapidly lowered, and the pulse and respiration shik. There
are cramps in the extremities, sometimes accompanied by spas-
modic contraction, which may even become general and dis-
tinctly tetanic in character.' The skin is cold and moist, there
are attacks of vertigo and syncope, and finally loss of conscious-
ness, collapse, and death from heart failure.
In some instances violent delirium has preceded death,*
while in other cases the patient has become drowsy or comatose.^
Death has also been known to occur suddenly during a muscular
effort on the part of the patient.®
' Galtier: "Toxicologie," i., 504. later attacks, during one of which
Dobie: Lancet, 1887, i., 773. Skae: he died, were as markedly those of
North. J. of M., Edinb., 1844, i., 289. strychnin. Although, as in EUiot-
^ Freer: Lancet, 1847, i., 535. son's cases, the spasms due to anti-
Gabb: Med. Times and Gaz., 1866, mony may be distinct and severe,
ii., 379. Mason: Brit. M. Jour., they have not been known to be
1877, i., 674. sufficiently severe and prolonged to
^ The occurrence of tetanus as an cause death by asphyxia during the
effect of tartar emetic was a point spasm, as strychnin frequently does,
of great interest in the Palmer case and as was the case with Cook. The
(see Times Report of Trial, London, theory of the crown that Cook was
1856, and Elliotson: M. Times and fil-st dosed with antimony and after-
Gaz., 1856, n. s., xiii.j 6-8). Anti- ward killed by strychnin is most
mony had been found m the cadaver probably correct, notwithstanding
of the deceased as well as in that of the partial failure of the analysis.
Palmer's mother, which had been * Beale: Lancet, 1854, i., 68.
exhumed, but the analysis had Beck: "Med. Jur., " 7th ed., 897.
failed to show the presence of ^ Mason: Brit. M. J., 1877, i.,
strychnin. Yet, although the symp- 674. Dobie: Lancet, 1887, i., 773.
toms in Cook's case were at first "Skae: Northern J. of Med.,
distinctly those of antimony, the Edinb., 1844, i., 2S9.
364 TOXICOLOGY WITTHAUS.
Some one or more of the prominent symptoms may also re-
main absent. Thus in one instance (not fatal), although there
were incessant nausea and great prostration, there was no purg-
ing. The dose, it is true, was small (fifteen minims of antimo-
nial wine to an adult) and the patient recovered.* In two in-
stances the patient did not vomit,^ in two not during the first
hour,' and in one only under the influence of an emetic* In
Gabb's case pain was also absent. In another case, although the
other symptoms were pronounced, there was neither difficulty in
swallowing nor sense of heat or constriction in the throat.^ In
one instance the urine was suppressed.* In two instances a pecu-
liar metallic taste is noted, not as the first but as a rather later
manifestation.' A pustular eruption similar to that produced by
inunction was observed in one case of internal administration.*
The external application of tartar emetic causes local and
systemic effects. A pustular eruption, resembling that of vari-
ola in appearance (ecthyma antimonale), attended with pain,
fever and oedema, is produced upon the skin. The pustules
first resemble little knots at the openings of the skin follicles,
soon increase in size, become inflamed and purulent, and form
deep crater-like ulcers, which readily become gangrenous, and
sometimes involve exfoliation of bone. The action upon the
skin is not limited to the surface of appUcation, but may make
its appearance at points far distant, as upon the genitals and in-
ternal surface of the thighs, after inunction to the breast or
shoulders. The usual systemic symptoms — naused, vomiting,
purging, great prostration, and frequent fainting — also follow
absorption from external apphcation; and complete suppression
of urine has been observed. Death has been caused by applica-
tion of tartar emetic to the uninjured skin,' as well as by its ap-
plication 1^0 wounded surfaces. '^
' Richardson: Lancet, 1856, i., Jour., Detroit, 1859-60, ii., 717.
400. Hulot: Arch. g6n. d. m^d., 1S53,
" Beck: "Med. Jur.," 7th ed., 897 5 s., i., 475.
(Serres). Orfila: "Tosicologie," * Gleaves: Loc. rif.
5eine ed., i., 625. " Krebs: Beitr. z. prkt. Heilk.,
'Gabb: Med. Times and Gaz., 1834, i., 670. Sigmund: Lancet,
1866, ii., 379. Cleaves: West. J. 1838, i., 250. Lewin: " Nebenwirk.
M. and S., Louisv., 1S4S, 3 s., i., 23. d. Arzneimittel," 2d ed., 1893, 681.
'Orfila: Op. cj(., 621. See also Gillet: Ann. See. m6d.-
' Procter: Assoc. M. J., 1853, 513. chir., Li^ge, 1SS6, xxv., S3.
"Taylor: "Poisons," 3d Am. ed., "Sigmund: Loc. cit. Tardieu and
443 (Carling). Roussin: "Empoisonnement, 2feme
'Rynd: Penins. and Ind. Med. cd., 1866, p. 610.
TARTAR EMETIC — SYMPTOMS AND ELIMINATION. 365
The administration of repeated doses causes nausea, vomit-
ing, purging, great prostration and weakness, pains in the stom-
ach and bowels, heat and uneasiness about the throat and
mouth, constant thirst, and a foul tongue. The person becomes
emaciated; the eyes are sunken and watery, but clear and intel-
ligent; the features are sharp and flushed; the skin is moist and
cool. The pulse is weak, contracted, and very rapid. There
are local spasms, as of the wrist, early in the poisoning. The
person becomes weaker and weaker; the cheeks become more
hollow, sharp, and pinched looking, though still flushed; the eyes
red and sunken, with a peculiar wild expression; the pulse very
weak and rapid, and the tongue more foul. Death finally results
from exhaustion. During such a case more violent acute symp-
toms may occur, following upon a renewed administration of
the poison, and the patient may die during one of these.
The method of action of antimony when injected intrave-
nously or hypodermically as sodium tartar emetic is very similar
to that of arsenic. It causes continuous diminution of the blood
pressure in consequence of dilatation of the vessels, of direct
action upon the heart, and of disorders in the central nervous
system; and also gastro-intestinal symptoms due to congestion
and changes in the mucous membranes of the stomach and intes-
tines. In experiments upon animals Falck found a notable
diminution in the body temperature in acute antimonial poison-
ing, from 4.4° to 6.2° C. (7.9° to 11.2° F.).' The local irritating
effect of tartar emetic when taken by the mouth is, however,
more intense and more prompt than that caused by the
arsenicals.
Distribution— Elimination.— By the copious and persist-
ent vomiting and purging which it provokes itself, tartar emetic
is in large part expelled soon after having been swallowed.
Not only is tartar emetic taken by the mouth expelled by vomit-
ing and purging, but even when it enters the circulation by
other channels it is, like arsenic, eliminated by the gastric and
intestinal mucous membranes. Brinton^ found antimony in the
stomach contents of a dog fifteen minutes after its injection into
the femoral artery. The gastro-intestinal symptoms observed
' "Lehrb. d. pr. Toxikol.," 104. f. exp. Path. u. Ph., 1880, xii., 438.
See also Nobiling: Zeitsch. f. Biol., Kobert: Ibid., 1882, xv., 22.
1868, iv., 40. Soloweitschyk: Arch. ^ Lancet, 1853, ii., 599.
366 TOXICOLOGY — WITTHAUS.
after external applications of tartar emetic are no doubt ac-
companiments of its elimination, as they are with arsenic.
Owing to this action of the gastric mucous membrane we would
expect that the tissue, at least, of that organ would contain an-
timony in cases in which death had followed the ingestion of a
single poisonous dose within the average period of duration,
even though there had been copious emesis. Yet in Ranke's
case, in which the patient died in six hours, and in which the
accused confessed to having administered 1 gm. (15.4 grains) of
tartar emetic. Professor Buchner failed to find antimony in
either the stomach or intestines or their contents.^ With such
results we should be disposed, in the absence of chemical exam-
ination of other portions of the body, rather to question the
accuracy of the confession than to conclude with Buchner that
a large dose had been taken. In two early cases, in one of
which death followed an ingestion of tartar emetic in about
ten hours, while in the other life was prolonged for more than two
days, antimony was found in the stomach.^ Unfortunately, as
bearing upon this and other questions of elimination and dis-
tribution of antimony, we have no investigation by modern
methods made in cases of accident or suicide; while to draw
inferences from homicidal cases, in which the conditions of ad-
ministration are not known but sought to be proved, is to argue
in a circle. In the cases of Mrs. Pritchard and Mrs. Taylor, in
which the autopsies were made three and thirty-three days,
respectively, after death, Maclagan^ found the following quantities
of antimony, calculated as tartar emetic: contents of stomach
and 18.1 mgm.; liver, 254.56 and 74.58; and in the former case
14.13 mgm. were obtained from the urine and 7.84 mgm. from
the bile. In three cases of homicidal poisoning in which the
analyses were made soon after death and after one and five years'
burial, respectively, Stevenson* found the following quantities of
antimony, calculated as tartar emetic: In the stomach and con-
tents, 41.47, 20.74, and 5.18 mgm.; intestinal contents 1078.27,
1518.26, and 74.52; liver, 128.30, 294.84, and 156.8; kidneys, 25.27,
51.14, and 11.66. In the first case 30.46 mgm. were obtained
•Friedreich's Bl. f. ger. Med., ' Roughead: "Trial of Dr. Pritch-
1879, XXX., 241. ard," 1906, pp. 164, 168.
' Ellis: Boston M. and S. Jour., ' Brit. Med. J., 1903, i., 873.
1856-57, Iv., 400. Beale: Lancet,
1854, i., 68.
TARTAR EMETIC SYMPTOMS AND ELIMINATION. 367
from the brain, and a part of the antimony contained in the
cadaver was still in a soluble form. In the Cox-Fournier case
the author found 586.3 mgm. in the stomach and contents and
366.5 in the intestines, these being the only parts available for
analysis.
That antimony is eliminated by the urine (which is usually
increased in quantity) was shown by observations upon the hu-
man subject by Orfila,' and by Millon and Laveran.^ The elim-
ination begins very shortly after the ingestion. Wormley^ men-
tions an instance in which antimony was found in the urine five
minutes after "0.01 gm. of antimony in solution" had been
taken. Millon and Laveran also noticed that there were inter-
missions in the elimination, during which the urine did not
contain antimony, and that antimony was present in the urine
in several cases sixteen, seventeen, eighteen, nineteen, twenty,
and twenty-four days after the last administration. One of the
two twenty-four-day patients died of phthisis, and antimony was
found in the liver. That antimony may be detectable in the
liver at longer periods after administration is shown by ex-
periments upon animals; but for what period it may remain de-
tectable in the human subject, whether after single or repeated
administrations, is, so far as we know, not determined by ob-
servation. The statements of Chapuis that " if the doses of the
poison have been repeated, it may still be characterized (in the
cadaver) three months after death;"* and of Kobert, that "the
metal (antimony) may remain stored up in the liver for several
months,"^ while valuable as opinions, do not, so far as we know,
rest upon actual observation in the human subject.
We cannot agree with Chapuis in the opinion that the
liver will not contain antimony if death have resulted rapidly
from a single dose.° Antimony acts only after absorption,
and absorption from the alimentary canal involves passage
through the Hver. While localization in the Uver tissue may
continue, and the maximum of saturation be only reached later,
the poison, in its passage from the alimentary canal, must reach
the liver within a few minutes of its ingestion, and probably
' "Toxicologie," 56me ed., i., 619. * "Precis de toxicologie," 2eme
^ Ann. d'hyg., Paris, 1846, xxxvi., ed., 189.
221. ^ "Intoxikationen," 266.
^" Micro-chemistry of Poisons," " See p. 356.
2d ed., 238.
368 TOXICOLOGY — WITTHAUS.
remains present in that organ so long as any of it is in the body,
excepting that portion retained in the bones, or at all events until
shortly before the last traces are in course of elimination by the
kidneys.
Antimony also passes into the milk; not, however, in suffi-
cient quantity to render the milk of cows, to which one of many
antimoni&l preparations used in veterinary medicine is adminis-
tered, dangerous to adults or even to children. '
Experiments on Animals. — Orfila in 1840,^ experimenting with
dogs, found that, after death from single large doses of tartar emetic
given by the stomach, antimony was found in large amount in the
liver and particularly in the kidneys, and only in small quantity in the
spleen, lungs, and heart; and that antimony is also found in the liver
and urine after endermic application.
Millon and Laveran' in 1846 administered three grains of tartar
emetic in repeated doses during ten days to each of five dogs. In one,
which died in six days, antimony was found in the liver, muscle, in-
testines, lungs, and brain. In another which died in three daj-s the
brain contained a larger proportion than the other organs. In another
which died in six weeks from another cause, antimony was found in
notable quantity in the liver and fat, but particularly in the bones.
The fourth was killed in three and one-half months, and, while the
liver, bones, and other organs contained antimonj^, 50 gm. of the fat
contained as much as 500 gm. of the other tissues. In the fifth, four
months after the administration, antimony had accumulated in the
bones. The liver contained a large quantity, the other organs but little.
In 1856 Richardson* found antimony in the blood, vomit, rectum,
lungs, liver, stomach, bladder, kidneys, and small intestines, in propor-
tion diminishing in the order named, of a dog which died in one and
two-thirds hours after the injection of oi- of tartar emetic in solution
into the cellular tissue; while in another dog, killed in seven days by
the daily application of tartar-emetic ointment to a wound, no antimony
was found in the brain, but it was found in larger amount in the liver
and spleen than in other organs.
Nevins in 1856* administered dry tartar emetic in doses of gr. ss.,
gr. i., and gr. ij., respectively, four times a day to each of twelve rabbits,
which were killed from day to day until they began to die from the
effects. Antimony was always present in the liver after gr. v. had
been given, and it appeared in that organ before its presence was clearly
' Baum: " Ber. u. d. Verterinar- ^ hoc. cit.
wesen in Sachsen," 1892, 156. * Lancet, 1856, i., 400, 508.
^Tox. g^n., .5i>me ed., i., 618. » Liverp. Med.-Chir. J., 1S57, i.
TARTAR EMETIC SYMPTOMS AND ELIMINATION.
369
proved elsewhere; it next appeared in the kidney, and after fifteen
days was present in the bones. Its presence was also easily proved in
the blood, lungs, urine, and fseces. In the brain it was never clearly
present, and its evidence in the muscles was very slight. Antimony
was constantly passing off in the urine and fseces, and it was abundant
in both in some rabbits which had survived twenty-one days after the
last dose had been given ; and in the fseces it was slightly present thirty
days after the last dose. It disappeared from the liver before the
fifteenth day, and from the kidneys somewhat later than this, while it
was found abundantly in the bones thirty-one days after the last dose
had been given.
The results of the experiments of Chittenden and Blake,' in which
more perfect analytical methods were used, may be thus tabulated :
Mgm. in 100 gm.
I.
II.
III.
IVa.
IVfe.
Va.
Yb.
Via. iVIfe.
Liver
Brain
Heart 1
Lungs J
Stomach and intestine
Muscle
Kidney
12.21
2.18
2.18
1.08
0.90
1.25
2.38
4.03
2.40
2.22
3.63
1.47
1.93
2.04
0.92
0.66
0.45
5.21
1.72
6.34
2.96
4.4
l{
15.3
1.11
1.92
5.855.24
9.6
2.28
1.5l'o.5
0.66
0.36
0.70
1.28
|2.22
1.06b. 45 0.91
0.9
2.15
0.12
7.4
I. Cat: 0.12 gm. tartar emetic, under the skin, died in two hours.
II. Rabbit: 0.083 gm. tartar emetic, hypodermic in three doses, died
in twenty-two hours after first. III. Cat: 0.15 gm. tartar emetic,
hypodermic, died in four and one-half hours. IV. Two rabbits: a.,
0.8 gm. tartar emetic, hypodermic, in four hours ten minutes 0.8 gm.
more, died twenty minutes later. 6., 0.08 gm. tartar emetic, in solution
into rectum, in four hours five minutes 0.16 more by rectum. First
injection, 11:45 a.m., died during night. V. Two dogs: a., 0.762 gm.
tartar emetic fed during seventeen days, two to three doses daily, no
vomiting, killed by chloroform six hours after last dose. 6., 2.073
gm. antimony trioxid fed during seventeen days. Killed by chloroform
eight hours after last dose. VI. Two rabbits: a., 2.34 gm. tartar emetic
fed in gradually increasing doses; died in seventeen days, b., anti-
' Studies Lab. Sheffield So. Sch.,
Yale, 1887, ii., 68.
IV.— 24
* ^ Stomach and small intestines;
the rectum and adjoining intestine
contained 3.05.
370 TOXICOLOGY — WITTHAUS.
mony trioxid, containing the same amount of antimony (1.08 gm.) fed
during seventeen days ; Icilled by chloroform.
The principal conclusions drawn by the authors from these experi-
ments are that the brain has a decided tendency to absorb and retain
antimony, even when administered as antimony trioxid, which is less
completely absorbed than tartar emetic; that under the conditions in
experiment II., the distribution is more even when death occurs more
rapidly, as in experiment I.; that the elimination of absorbed antimony
proceeds somewhat rapidly, the proportion in the liver diminishing
and that in the kidneys increasing relatively; and that the epithelial
cells of the stomach and small intestines have a special absorpti\-e
action for antimony.
The same observers in another series of experiments with a dog,'
from the results of which they conclude that the administration of
small repeated doses of antimony trioxid has no influence upon protein
metabolism, found that with daily doses of one to two grains during
thirteen days, or 16 grains (1.037) gm. in all, there were eliminated in
the twenty-four hours' urine of the seventh day 13.5 mgm. of metallic
antimony, and on the thirteenth day 22.4 mgm. — amounts correspond-
ing to 17 and 25 per cent, of the daily doses. On the first and third
days after cessation of the administration the urine contained 17.6
and 15.1 mgm. of antimony, respectively. The amounts in the faeces
were not determined.
Pouchet,' experimenting with rabbits by repeated administrations
extending over fifty to two hundred and fifteen days, only found anti-
mony in notable quantity in the alimentary canal. The bones, kidneys,
liver, skin, hair, and muscles contained only traces, and the brain none.
In experiments on dogs with antimony and arsenic, he found that the
brain, cord, muscles, and liver contained arsenic, but no antimony;
and the alimentary canal contained small quantities of arsenic and
large quantities of antimony. It appears that the ilarsh method was
used, by which the totaUty of the antimony is not recovered.'
Cieohanowski,* in experiments with rabbits in acute poisoning by
tartar emetic, found the greatest amount in the intestine and contents.
The quantity in the liver was the greater with longer survival, the
amount in the kidneys relatively greater than that in the liver; and
only small quantities in nervous tissues.
Tre.\tment.
The best antidote is tannin, either in aqueous solution or in
aqueous extracts of oak barl^, cinchona, coffee, or tincture of
' Loc. cit., p. So. 3 ggg p 3--
' C. r. Ac. Sc, 1901, cxxxiii., 526. * Ann. d'hyg., 1898, 3 s., xl., 125.
TARTAR EMETIC POST-MORTEM APPEARANCES. 371
cinchona, or other tinctures containing tannin. The purpose is
the formation of the insoluble tannate. As this is, however,
soluble in solutions of tartaric acid, that acid or substances con-
taining it are to be avoided. The stomach should be washed
out. Oils, mucilage, milk, albumin, are of some value, but only
mechanically. Pain is to be controlled by opiates, and heart
failure to be combated by caffein, alcohol, ether, atropin, cam-
phor, etc.
In chronic cases elimination is promoted by administration
of iodids.
Post-mortem Appearances.
The lesions caused by antimony closely resemble those due to
arsenic. In two cases of exhumation, after one and five years'
burial, the bodies were exceptionally well preserved, although
the conditions in the longer burial favored putrefaction.'
A scarlatinal or vesico-pustular eruption is sometimes ob-
served upon the skin in places, both in cases of short and of pro-
longed duration. Pustules and aphthse are also found in the
mouth, oesophagus, and stomach. Or the mouth and tongue
are not sensibly altered, except that the former contains much
viscid mucus, while the pharynx and oesophagus are coated with
a dense, yellowish-white pseudo-membranous deposit, forming
a hollow tube and filled with a reddish frothy mucus. ^ The
mucous membrane of the stomach is marked with the pustules
already mentioned, which appear to be the most characteristic
lesion, although they may be absent and the stomach appear
normal, as in a suicidal death which followed an ingestion of
the poison in ten hours, ^ and in which no lesions were found
above the lower part of the small intestines; and in an accidental
death after 0.15 gm. (2.3 grains) were taken.* Perforations
of the stomach are never observed as the result of the action of
tartar emetic, and ulcerations only exceptionally.^ The stomach
' Stevenson: Brit. M. J., 1903, i., involved in the small intestine; the
873. gastric mucous membrane inflamed,
" Durand-Fardel: Bull. g^n. d. disorganized at the larger curva-
th6r., 1843, XXV., 370. ture, and, at the pylorus, suppura-
^ Ellis: Boston M. and S. J., 1856- tion of the follicles. And in one
57, Iv., 400. of Hartley's cases (Lancet, 1846, i.,
* Gaz. d. hop., Paris, 1853, xxvi., 460) there were two or three white
147. spots in the gastric mucous mem-
'" In Le Boutillier's case {loc. cit.) brane of the size of split peas which
the intestines are described as ulcer- under a magnifying glass appeared
ated, the muscular coat being deeply to be beginning of ulceration.
372 TOXICOLOGY — WITTHAUS.
may be empty, but usually contains considerable thick, grumous,
or gruel-like reddish liquid. In both of Stevenson's cases of
exhumation' extensive patches of cinnabar-red or orange-
colored material containing antimony trisulfid were found in the
stomach and intestines.
Fatty degeneration of the liver, kidneys, heart, muscular
tissue of the diaphragm and gastric follicles, first noted by Sai-
kowski^ in the chronic form, is a constant effect of the pro-
longed action of tartar emetic, and probably also exists in some
degree in all cases. If sHght in degree it is only recognized
on microscopic examination.
The lungs are usually dark in color and are the seat of in-
flammation and hepatization; although this is not constant, as
in Laveran's^ case they were healthy, and rather anaemic than
congested. As secondary appearances congestion of the dura
mater, effusions into the arachnoid and ventricles, and conges-
tion of the cerebral vessels may be noted.
ANALYSIS.
The detection of antimony- is a comparatively simple matter.
The method followed is the same as that used in the search for
arsenic (to the description of which in this volume we refer),
except in certain points, some of which will be discussed here,
others under "Arsenic."
The separation of antimony from arsenic and from tin
is an essential step in the process. The distinction between an-
timony and arsenic is easy; their complete separation, when both
are present, by no means so easy.
The method most generally used for their separation is by
the Meyer fusiox, based upon the extremely sparing solubility
of sodium pyroantimonate and the ready solubility of sodium
arsenate in water and in alkaline liquids, which effects not only
a complete destruction of any remaining organic material, but
also serves to afford one point of distinction between antimony
and arsenic, and to separate them almost completely from one
another, if not completely. The precipitated sulfids soluble in
ammonium sulfid freed from chlorids (TV.) (see p. 194) are first
' Loc. cit. 'Tardieu: " Empoisoimement,"
2 Arch. f. path. Anat., etc., Isti5, 2enie ed. 1S66, ti27,
xxiv., 73,
ANTIMONY ANALYSIS. 373
oxidized partially by fuming, chlorin-free nitric acid, first at the
ordinary temperature, and then on the water-bath, the nitric
acid being then removed in great part by moistening the residue
with water and drying it on the water-bath several times. The
residue is then treated with water and a small quantity of caustic
soda (free from carbonate) to alkaline reaction; a suitable
quantity of a mixture of one part of disodic carbonate and two
parts of sodium nitrate (both free from chlorid and pulverized) is
added, and the mass dried in a capsule. The completely dried
residue is transferred in small portions to a heated porcelain
crucible, each portion being heated to quiet fusion before addition
of another. Under this treatment it turns brown or black at first
and subsequently colorless or faintly greenish. Should it remain
dark after continued fusion a further quantity of sodium nitrate
is to be added and the fusion continued until the color is completely
discharged, unless, indeed, the color be in a heavy black powder
which readily settles to the bottom and which consists of cupric
oxid. Any antimony present will now exist as sodium pyroanti-
monate, any arsenic as sodium arsenate, and any tin as stannic oxid.
The cooled residue is then treated with a small quantity of water,
with which it is warmed, and, if necessary, with further quan-
tities of water, until the cake is completely dissolved, except
possibly a small quantity of white, powdery material and some
heavy black powder. The solution, whether clear or cloudy, is,
after having cooled completely, treated with carbon dioxid for
a few minutes to convert any sodium hydroxid possibly present
into the carbonate, and thus precipitate a small quantity of stan-
nic oxid which may have dissolved in the caustic alkali. The
solution is separated from that which remains undissolved by
filtration through a very small filter, and the undissolved resi-
due is washed first with water and then with dilute alcohol.
Arsenic passes into the solution, antimony and tin and possibly
copper remain in the residue. To separate antimony from tin,
should the latter be present, the dried filter and its contents are
heated in a weighed porcelain crucible until the paper is reduced
to ash; small quantities of dry powdered potassium cyanidare
added, and the heating continued to fusion of the cyanid and in-
cipient redness. The material turns dark, and a gray powder
or metallic globules, or both, consisting of antimony or tin liber-
ated by reduction of their compounds by the cyanid, separate.
374 TOXICOLOGY — WITTHAUS.
Should copper be present it will appear with its characteristic
color. The cooled, fused mass is extracted with water and
transferred to a weighed capsule, in which it is washed by de-
cantation — first with water, then with alcohol, and finally with
ether — dried and weighed.' A portion sometimes adheres te-
naciously to the crucible, the weight of which may be deter-
mined. The washings when decanted are passed through a
small filter, which with proper manipulation should remain per-
fectly clean. To detect the presence of tin a portion of the
metal-like powder is treated with hydrochloric acid and warmed;
tin is dissolved as stannous chlorid, antimony remains. The
liquid is tested for tin by addition of a few drops to a small
quantity of a dilute solution of mercuric chlorid. A white
cloud or precipitate indicates the presence of tin. The residue,
free from tin, is next warmed with concentrated nitric acid,
evaporated to dryness, and the residue treated with water. The
water separated from the undissolved material, which is now
white, is tested for copper.^ The remaining antimonial com-
pounds are dissolved in a mixture of hydrochloric and nitric
acids; the excess of nitric acid is expelled by warming over the
water-bath, and the remainder is diluted with water. If a
cloudiness be produced on dilution hydrochloric acid is added,
and aliquot parts of the solution so obtained are used for the ap-
plication of the other tests for antimony and for quantitative
determination.
Although the language of Otto would seem to indicate that
by this method a complete separation of antimony and arsenic
is attained,^ such is not the case absolutely. Sodium pyroanti-
monate is not insoluble, but only extremely sparingly soluble,
even in alkaline solutions; and as W. Fresenius has said,* small
quantities of antimony pass into the aqueous solution. The
quantity dissolved is, however, extremely small if the amounts
of solvent and wash liquid are kept within proper limits; and
of the processes hitherto suggested for the separation of anti-
mony and arsenic, this yields the best results. Moreover, this
' The washing, drying, and weigh- ^ " Ausmittelung der Gifte," 6te
ing should be performed as rapidly Aufl., 1884, 164. The latter part of
as possible. the note modifies the statement in
^ In the liver copper is almost in- the text somewhat,
variably present, and is here washed * Ztsch. f. an. Chem., 1881, xx.,
out and quantitatively determined 536.
in part.
ANTIMONY — ANALYSIS. 375
method affords one important safeguard against the possilDility
for mistaking antimony for arsenic in the Marsh test, for if an-
timony be not present in quantity sufficient to leave an insoluble
residue at this stage, it will also not be present in sufficient
amount to respond to the Marsh.
Methods for the separation of antimony, arsenic, and tin,
based upon the same fundamental facts as to solubilities as the
Meyer method, in which, however, oxidation is effected at the
ordinary temperature by hydrogen peroxid or by sodium per-
oxid, have been suggested. Trials of these, however, with va-
rious modifications have convinced us that they are in any form
yet devised less manageable and less reliable than the Meyer
method.
In Rose's method,' which is more applicable to analyses
of alloys, antimony and arsenic are brought into the same
forms of combination as in Meyer's method by fusion with
caustic soda in a silver crucible. The resulting mass is treated
with hot water until that which is insoluble appears finely
granular; a little water is added and enough alcohol of 0.83
specific gravity to make the proportion of alcohol to water 1 : 3.
After standing twenty-four hours, with frequent stirring, the
liquid is filtered off and the residue washed with alcohol of in-
creasing strength, first 1 : 3, then 1 : 2, then 1 : 1, then 3:1,
the washing being continued until a sample is not colored when
acidulated with hydrochloric acid and treated with hydrogen
sulfid. Antimony remains in the residue, arsenic and tin pass
into the solution.
Bunsen's method,^ based upon the precipitation of anti-
mony and tin from a solution of the three sulfids in potassium
sulfid solution by sulfurous acid, while the arsenic remains in
solution; and Clark's method,^ based upon the different solu-
bilities of the sulfids in oxalic acid solution and the different ac-
tions of hydrogen sulfid upon the solutions of those dissolved, are
not so satisfactory or reliable as those above mentioned.
Or the separation may be effected by the magnesia method.
The sulfids are oxidized by nitric acid or otherwise; tartaric acid
'"Anal, quantit.," Paris, 1862, also Nilson: Ztschr. f. an. Chem.,
.557; andFresenius: "Quant. AnaL," 1877, xvi., 417; 1879, xvii., 165, 264.'
6te Aufl., i., 634. 3 chem. News, 1870, xxi., 124.
^ Ann. d. Chem. u. Ph., cvi., 3. Fresenius: Loc. cit.
Fresenius: Op. cit., ii., 636. See
376 TOXICOLOGY WITTHAUS.
and a considerable quantity of ammonium chlorid are added, and
then an excess of ammonium hydroxid. If a cloudiness be formed
at this point the quantity of tartaric acid or of ammonium
chlorid is insufficient. Magnesia mixture' is then added in
sufficient quantity and the mixture allowed to stand forty-eight
hours, when the precipitate is collected on a filter (using the
liquid itself until all the solid is on the filter) and washed with a
mixture of three parts of water and one of ammonium hydroxid,
until the washings do not precipitate with nitric acid and silver
nitrate. The filtrate and washings contain the antimony, the
precipitate the arsenic.
This method is sometimes available in toxicological investi-
gations, although more cumbrous than the Meyer method, and
generally not to be preferred to it.
Davy's^ or Naquet's^ method and Thiele's* method aim at
the separation of arsenic and antimony when existing in their
gaseous hydrogen compounds. In the former the action of
silver nitrate is taken advantage of. The arsenical compound,
when decomposed by the silver solution through which it is
passed, deposits elementary silver as a dark powder, while
all of the arsenic remains in the solution as silver arsenite; but
when the antimonial gas is similarly decomposed, all of the anti-
mony combines with the liberated silver, and is precipitated as
silv-er antimonid. The separation of antimony from arsenic
may then be effected by simple filtration and washing.
Thiele's method is based upon the fact that hydrogen anti-
monid is decomposed at a lower temperature than hydrogen ar-
senid. The mixed gases are passed through a coil of tubing
heated to 208°-210° (406.5°^10° F.), beyond which antimony
is deposited, while the arsenic is only separated in a second tube
heated to redness.
While these methods may effect a complete separation of the
two elements in a mixture of gases (and the first mentioned cer-
tainly does), neither these nor any other method based upon the
formation of the hydrogen compounds by nascent hydrogen are
' Eleven parts of MgCl, and ^ Chem. News, 1876, xxxiii., 58.
twenty-eight parts NH^Cl, dissolved ^ " Legal Chemistry," Battershall's
'in one hundred and thirty parts HjO transl., 2d ed., 34.
and seventy parts dilute NH^HO * Ann. d. Ch., 1891, cclxiii., 361.
added, and filtered after two days. Baumert: "Lehrb. d. ger. Chem.,"
212.
ANTIMONY — ANALYSIS. 377
applicable, as pointed out by Fresenius, ' to the separation of ar-
senic from antimony in solutions, for the reason that "portions
of the arsenic and antimony are not given off as hydrogen
arsenid or antimonid, but remain in the generating vessel."
So far as arsenic is concerned this objection is groundless, as it
has been shown by Gautier,^ and by Chittenden and Donaldson,*
and repeatedly verified by others, that with proper precautions
(see "Arsenic," Marsh Test) the totality of the arsenic intro-
duced into the generator is evolved as hydrogen arsenid. But
with antimony, in repeated experiments under the most va-
ried conditions, we have never succeeded in regaining all of
the antimony introduced, and in some instances the loss was
as great as that observed by Reichardt,* of one-third of the
amount introduced.^
For the methods of Schneider and Fype, Fresenius and
VON Babo, Piloty and Stock, Marsh, and Reinsch, see under
" Arsenic."
Reactions of Antimony. — 1. Water in sufficient amount
produces in solutions of antimony trichlorid (solutions produced
by the action of hydrochloric acid, either alone or in connection
with potassium chlorate, or of nitric acid upon antimony or any
of its compounds capable of solution) a white precipitate of anti-
mony oxychlorid (powder of Algaroth). The precipitate redis-
solves readily in tartaric acid, and if this acid be added to the
hydrochloric acid solution before dilution, the precipitate is not
produced.
2. Hydrogen sulfld forms in acid solutions, if the quantity
of free mineral acid be not excessive, an orange-colored precipi-
tate, which usually consists of antimony trisulfid, SbjSj;' which
' Op. cit., i., 641. portion of antimony deposited in the
^ Bull. Soc. chim., Paris, 1875, mirror varied from 19.5 to 48.3 per
xxiv., 258. cent. He proposes to use the
' Amer. Chem. Jour., 1880-81, ii., Marsh to determine the quantity of
238. antimony by conversion of both that
■•Otto: "Ausmitt. d. Gifte," 6te portion deposited in the mirror and
Aufl., 198. Sanger and Gibsen that remaining in the generator after
(Chem. Abst., 1908, ii., 518) found complete disappearance of the zinc
that the loss of antimony in the into the trisulfid.
Marsh diminishes with the dilution ^ The precipitate from solution of
of the solution introduced, and pro- antimonic acid in hydrochloric acid
pose the use of that method for is a mixture of the trisulfid and
quantitative determination. pentasulfid (SbjS;^) along with free
^ Ciechanowsky: Ann. d'hyg., sulfur. This precipitate is readily
1898, 3 s., xl., 125. Usually the pro- soluble in ammonium hydroxid.
378 TOXICOLOGY — WITTHAUS.
is not formed in alkaline solutions, and only to a slight extent in
those which are neutral.^ This precipitate dissolves readily in
solutions of potassium or sodium hydroxid, in solutions of the
alkaline sulfids and hydrosulfids, in cold concentrated hydro-
chloric acid (specific gravity 1.18), and in the same acid still
more dilute if hot. It is very sparingly soluble in ammonium
hydroxid, and still less soluble in ammonium carbonate in the
absence of antimony pentasulfid. It does not dissolve in dilute
mineral acids nor in monopotassic sulfate solution.
The dried precipitate, when heated with sodium nitrate,
yields sodium sulfate and sodium pyroantimonate, the latter al-
most insoluble in water. The pyroantimonate is also formed
when the precipitate is fused with a mixture of sodium carbon-
ate and nitrate. If the precipitate be heated in a current of
chlorin or ignited with a mixture of five parts of ammonium
chlorid and one part of ammonium nitrate, it is completely vol-
atilized. If the dried precipitate be heated with potassium cy-
anid to fusion, elementary antimony is produced as a gray pow-
der or in metal-like globules, and potassium thiocyanate is
formed. If the fusion be conducted in air or in a current of
carbon dioxid, none of the antimony is volatilized; but if it be
done in a current of hydrogen a metal-like mirror of antimony
is formed in the tube near where the heat was applied.
3. Ammonium sulfids in small amount form precipitates
of antimony trisulfid, which dissolve in excess of the precipitants.
4. Metallic zinc (or tin or magnesium) in the absence of ni-
tric acid deposits elementary antimony as a gray powder. The
solution should be so far concentrated that the greater part of
the excess of acid is expelled, transferred to a platinum crucible
cover, and a pointed piece of zinc or tin is brought in contact
with the platinum surface through the liquid. The platinum
surface moistened by the liquid is colored brown or black with
small quantities of antimony, the stain disappearing- when
moistened with cold nitric acid. With cold hydrochloric acid
(specific gravity 1.12) the stain soon disappears if it be faint,
but if thick it only disappears slowly when heated. In this test
hydrogen is generated and a portion of the antimony escapes
as hydrogen antimonid. Tin is deposited from its solutions
• The presence of nitric acid or of other oxidizing agents is to be
avoided.
ANTIMONY ANALYSIS. 379
when they are subjected to this test, but it does not attach itself
to the platinum.
5. Metallic iron, when added to a solution containing anti-
mony and free hydrochloric acid and the liquid warmed, causes
the separation of the antimony as a heavy, black, flocculent de-
posit. Tin is not similarly deposited.
6. If a solution containing antimony be added to one of so-
dium thiosulfate to which a solution of sulfurous acid has been
added, and the mixture boiled, it becomes cloudy from the sep-
aration of sulfur; afterward the red antimony pentasulfid
(SbjSs) is deposited.
7. Potassium hydroxid, sodium hydroxid, ammonium hydroxid,
disodic or ammonium carbonate form voluminous, white precipi-
tates much more slowly and incompletely from solutions of
tartar emetic or similar compounds than from solutions of the
chlorid. The precipitate dissolves quite readily in excess of
sodium or potassium hydroxid, and in disodic carbonate only
when warmed, but is almost insoluble in ammonium hydroxid.
8. Denigds' reagent, made by dissolving 1 gm. potassium
iodid and 3 gm. cesium chlorid in 10 c.c. water to which one
drop of dilute ammonium hydroxid (1:10) has been added. In
hydrochloric or sulfuric solutions containing less than 2 mgm. of
antimony in 1 c.c. this reagent forms a red precipitate of
cesium-antimony iodid; or, in sulfuric solutions, red hexagonal
crystals.
9. For the action of antimonials with the Marsh and Reinsch
tests, see under "Arsenic."
Quantitative Determination. — The determination of the
quantity of antimony present is best attained by weighing the
metallic antimony separated by reduction of the pyroantimonate
by fusion with potassium cyanid as above described (see p. 373),
or by electrolytic deposition.
Should tin or copper be also present, their quantity is to be
determined. To this end the alloy (or an aliquot part) is finely
powdered, placed in a bulb tube through which a gentle stream
of perfectly dry chlorin may be passed, and which is in connec-
tion with two U tubes of sufficient capacity, containing a solu-
tion of tartaric and hydrochloric acids in water. The bulb
tube is heated, at first moderately, afterward to slight redness.
The copper remains as chlorid in the bulb, the antimony and
380 TOXICOLOGY WITTHAUS.
tin' volatilize as chlorids, which pass into the tube beyond the
bulb and into the hquid in the U tubes. The bulb tube is cut
near the bulb and between it and the U tubes, and any subli-
mate contained in it added to the liquid from the latter.
The cupric chlorid is dissolved in a small quantity of dilute
hydrochloric acid, the solution transferred to a weighed plati-
num dish, a fragment of metallic zinc (known to be soluble in
hydrochloric acid without residue) is added, and the dish cov-
ered with a watch glass, which is afterward washed into the
dish. The proportion of acid should be sufficient to cause gen-
eration of hydrogen, but not too rapidly. With the quantities
of copper usually present, the metal attaches itself firmly to the
platinum, and may be washed, dried, and weighed, after the
deposition is complete. If the quantity of copper be large, it
may separate partly as a non-adherent spongy mass. When
this is the case, having made sure that no zinc remains, the de-
posit is rapidly washed by decantation with boiling water
until the washings are free from chlorin, dried, and weighed.
Tin is only exceptionally present. Should it be, the quantity
of antimony is determined in the liquid from the U tubes. To
an aliquot portion hydrochloric acid is added to strongly acid
reaction and a bar of tin, and the whole warmed for some time;
the precipitated antimony is separated from the tin bar, col-
lected on a weighed filter, washed in succession with dilute hy-
drochloric acid, alcohol, and ether, dried at 100° (212° F.), and
weighed. -
If the plant be available, the most satisfactory results are
obtained by Classen's electrolytic method.^ An aliquot part of
the solution obtained as directed on page 374 is evaporated to
dryness in a porcelain capsule, and the residue treated with about
80 c.c. of sodium sulfid solution,* saturated at the room tem-
'A minute trace of tin remains sulfid (see note 2, p. 192) till the
with the copper. volume ceases to increase. When
^ There is a slight loss of antimony, completely saturated the solution
which is not absolutely insoluble in is filtered from the precipitate
dilute hydrochloric acid. formed, and mixed with the other
' Classen- Boltwood : Quant. Chem. half of the sodium hydroxid solution.
Anal, by Electrol., p. 269. Hydrogen sulfid is again passed
* Made by dissolving sodium hy- through the solution, with exclusion
droxid, purified by alcohol, in water of air, and it is filtered again. The
to a solution of sp.gr. 1.35. The nearly colorless filtrate is evaporated
solution is divided into two equal in a capacious porcelain or platinum
parts, and one half, with exclusion dish containing a platinum spiral
of air, saturated with pure hydrogen over a strong free fire as rapidly as
ARSENICAL POISONS. 381
perature (sp. gr. 1.22-1.225) and enough concentrated solution
of pure sodium hydroxid to leave an excess of 1-2 gm. sodium
hydroxid. If solution does not take place at once, it is hastened
by warming over a low flame. The solution is then transferred
to a platinum dish whose inner surface has been roughened.
The dish is made the cathode, and the electrolysis is conducted at
a temperature of 50° to 60°, with a difference of potential between
the electrodes of not more than 0.7 volt, and a current density of
NDi9o = 0.5 ampere. The deposition is complete in two hours,
when the disengagement of gas ceases and the solution becomes
clear. During the electrolysis the dish is covered with a watch-
glass, whose under surface is washed into the dish with a drop or
two of water at the end of the process. The deposited aritimony
is washed in the dish, first with water, and then with pure ab-
solute alcohol, without interrupting the current, and the dish and
contents dried for a short time in the air-bath at 80° to 90°, and
weighed. The deposited antimony is gray and metallic in ap-
pearance. Tin if present is not deposited.'
ARSENICAL POISONS.
The toxicology of the arsenicals, and particularly of the tri-
oxid and of Paris green, overshadows in forensic importance
that of any other class of poisons. The facility with which
white arsenic, Paris green, and arsenical vermin poisons can be
obtained, and the acquaintance of even the most ignorant with
their destructive powers, sufficiently account for the frequent
murderous administration of the former and for the favor in
which the latter appears to be held by suicides in the larger
cities in the United States.
Elementary arsenic, as well as such of its compounds, min-
eral or organic, as are either soluble in water or are rendered
soluble by the action of the hquids of the body, are capable of
possible. As soon as a thin crystal- of metallic mercury, which is not
line pellicle forms on the surface, the permissible in a toxicological labo-
solution is poured while hot into ratory. If antimony is to be deter-
small bottles with well ground mined electrolytically in presence
stoppers which must be filled nearly of small .quantities of copper, Hol-
fuU and completely filled by pouring lard's method, using mixed solutions
melted paraffin upon the surface. of sodium sulfid and potassium
I Vortmann's modification (Ber., cyanid (Analyst, 1903, xxviii., 228),
Berl., 1891, xxiv., 2762) is open to may be followed,
the objection that it requires the use
382 TOXICOLOGY WITTHAUS.
causing arsenical intoxication when introduced by any channel
into the human body.
ELEMENTARY ARSENIC.
The element (symbol = As; atomic weight = 74.9) occurs
in small quantity in nature, and is usually met with as a dull
black or dark-brown amorphous material. When freshly iso-
lated it constitutes a brittle, crystalline, steel-gray soUd, having
a metallic lustre, which it soon loses on exposure to air. When
deposited upon and viewed through a glass tube, as in the re-
duction and Marsh tests, it forms a briUiant black "mirror."
It is tasteless and odorless. Its specific gravity is 5.7 to 5.9.
When heated in an atmosphere of an indifferent gas at the or-
dinary pressure, it volatilizes without fusion at 180° (356° F.).
When heated under strong pressure it fuses at a dull red heat.
It burns in air with a bluish-white flame, giving off a dense,
heavy, white cloud of arsenic trioxid. It also ignites sponta-
neously and burns in chlorin with formation of the trichlorid.
It is insoluble in water and in other neutral solvents if oxidation
be prevented. It is dissolved by nitric acid with formation of
arsenic acid, and in hydrochloric acid with formation of arsenic
trichlorid.
Although elementary arsenic, so long as it remains such, is
insoluble and therefore incapable of absorption from the ahmen-
tary canal, there is abundant evidence of its poisonous character
after exposure to the air. The early experiments of Bayen and
of Renault' showed that while dogs suffered no iU-effects from
taking from 4 to 8 gm. of metallic arsenic, or of mispickel (sulfid
of iron and arsenic), they were fatally poisoned by 0.2 to 0.3
gm. of arsenic which had been exposed to the air. The poison-
ous character of arsenic under these conditions is further es-
tablished by numerous experiments upon animals (Sprogel,
Hilefeld, Monro, Schroff), and by cases of poisoning in the
human subject. Arsenic when exposed to moist air loses its
metallic lustre and is converted into a dull brown powder {mort
aux mouches, cobalt) by a limited oxidation.
The experiments of Schroff^ seemed to prove that unoxidized,
> Orfila: "Toxicologie," 56me ed., ^ Zeitsch. d.k.k. Gesell. d. Aerzte
i., pp. 377, 611. z. Wien, 1858, xiv., 3; 1859, xv., 689.
ELEMENTARY ARSENIC. 383
elementary arsenic is poisonous to rabbits, probably by undergo-
ing oxidation in the alimentary canal, causing death in twenty-
eight to forty-two hours, in doses of 0.6 to 1 gm. Schmidt and
Bretschneider,' however, from experiments made at about the
same period, consider the element as innocuous, and question
the purity of the arsenic used by Schroff.
The more recent experiments of Paschkis and Obermayer,^
made with great care to insure the prevention of atmospheric
oxidation, show conclusively that elementary arsenic may be
absorbed by the skin; that it undergoes oxidation in the body;
that it produces gastro-enteritis, nephritis, great thirst, and ec-
zema; and that it is ehminated in solution in the urine.
The "fly poison," "fly stone," "cobalt," and "fly paper,"
(mart aux mouches, poudre aux mouches, fliegenstein, cobaltum
minerale), formerly used, owed its efficacy to elementary arsenic,
partially oxidized by the action of air and moisture.
Of twenty-four cases of poisoning by fly poisons certainly
containing elementary arsenic, seven were homicidal, two sui-
cidal, eight accidental, and seven uncertain. The accidental and
uncertain cases occurred in four instances in children,^ and in
the others in consequence of the poison having been accidentally
mixed with articles of food or taken in mistake for medicine.
In three instances the cause of the poisoning of several individ-
uals was found in the existence of elementary arsenic in bottles
from which wine or spirits had been taken. It is possible that
in some of these the arsenic may have been originally put into
the bottles as a constituent of the shot used in cleaning them
(see below). In one case all the persons in the house of a priest
suffered from arsenical poisoning, and upon investigation " mort
aux mouches" was found in the bottom of a bottle of brandy
from which they had drunk.* In a second case* six persons were
severely poisoned and one died. Elementary arsenic was found
in the bottle from which they had drunk wine. In another
case* five persons were similarly poisoned with wine, which had
' Moleschott: "Untersuch. zur Schobbens: Ann. Soc. de m^d.
Naturlehre," 1858, vi., 146-147. d'Anvers, 1846, 224.
" Med. Jahrb., Wien, 1888, n. F., * Galtier: "Tox.," i., 446.
iii., 117-124. =Rapp: Tr. Soc. d'^muL, Rouen,
'Leger: Lancet, 1835, i., 516- An vii.
518. Evans: Nelson's Amer. Lane, " Batillat: J. d. chim. m^d., etc.,
1853, vii., 180. Hurd: Boston M. 1840, 2 s., vi., 33.
and S. Jour., 1845, xxxi., 316.
384 TOXICOLOGY WITTHAUS.
been eight months in a bottle in the bottom of which elementary-
arsenic was found. An experiment in this instance showed that
wine was capable of dissolving elementary arsenic to the extent
of about 1.5 parts in 1,000 of white arsenic during a contact of
twenty-four hours.
A man drank beer in which there were the bodies of flies
killed by "cobalt." In two hours he was attacked with cohc,
nausea, and vomiting, and later with diarrhoea, headache, in-
somnia, and prostration; but recovered slowly after the admin-
istration of an emetic* No other instance of serious poisoning
from this cause has been found. Payen^ fed three hundred
flies, poisoned by solution of white arsenic, mixed with bread
crumbs to a spaniel, which was not at all incommoded. An
equal number of poisoned flies similarly fed to a hen provoked
no symptoms of poisoning. He therefore considered that it
would be impossible for a human being to involuntarily take a
sufficient number of poisoned flies to cause poisoning.
The use of elementary arsenic to kill insects has also caused
serious poisoning in the human subject in consequence of the
false impression that it is only fatal to insect life. The mem-
bers of two families suffered from severe arsenical poisoning,
but ultimately recovered, in consequence of eating cheese in the
manufacture of which " mort aux mouches" had been used to
prevent the appearance of "skippers."*
Bucholtz relates an instance in which a family of six adults
and a child were seized with nausea, pain, vomiting, and other
symptoms of arsenical poisoning within an hour after partaking
of a soup in which "cobalt" had been cooked.* He does not
state whether the addition was intentional or accidental. Gal-
tier* cites the case of a woman who was seized with vomiting
and died in ten hours. The stomach contained about 180 gm.
of a sanguinolent Hquid and 15 gm. of "black oxid of arsenic"
(elementary arsenic). He also mentions another instance in
which three persons died in a few hours after violent pain and
vomiting from taking "cobalt mineral arsenical." The stom-
achs were highly inflamed and contained a sanguinolent hquid.
> Grimm: "Misc. Ac. nat. cur.," 'Collier: J. d. chim. m^d., 1844,
Lips., 1699-1700, Dec. iii., Ann. 7-8, 2 s., x., .571.
P- 292. 4 J. fi, pr. Arzneik. ii. Wissensch.,
^ J. de chim. m^d., Paris, lS2.j, Jena, 1797-98, v., 37.5.
i-. 196. s " Toxicologie," i., 446, 447.
ELEMENTARY ARSENIC. 385
Schobbens' relates the case of a man who died after exhibiting
the usual symptoms of arsenical poisoning, in consequence of
having taken "fly poison" by mistake for a purgative. The
"fly poison" taken in the two cases reported by Schobbens (see
above) was the powdered "Tunaberg ore," which is a compound
of cobalt, arsenic, iron, and sulfur. Deri^ has reported the
cases of two men, father and son, who each took about a tea-
spoonful of fly stone in mistake for aloes. The elder had devel-
oped a most pronounced poisoning of the cerebro-spinal type
in two hours and died in 35 hours. The son manifested no effects
for four hours and recovered.
The earliest case of homicidal poisoning by elementary ar-
senic of which we find record occurred in 1740.^ A girl poi-
soned her father and three sisters by serving to them dried pears
boiled with water and 24 gm. of "cobalt." The deaths of the
father and two sisters occurred in thirteen, nine, and eighteen
hours; that of the other sister, who ate but little of the poisoned
pears, on the sixth day. The stomachs were highly inflamed,
and in two cases contained extravasated blood.
Hahnemann* relates the case of a wood-cutter who was poi-
soned by his wife in 1784 by several grains of fly stone. He
suffered from vomiting, burning pains in the stomach, and tear-
ing pains in the bowels, but recovered. Orfila, Chevalier and
Barruel,'' in examining the stomach in a case of supposed homi-
cide, found about 5 gm. of a powder, consisting of elementary
arsenic, oxid of iron, quartz sand, and flakes of mica; but state
that the contents of the stomach contained no trace of arsenious
acid. Briand, Chaudd and Bouis" state that a case of supposed
homicide by "mort aux mouches" was tried in France in 1844,
but give no particulars. Aguilhon'' reports a case of homicidal
poisoning by fly poison which terminated fatally, after the
symptoms usual in arsenical poisoning, on the sixth day. Worm-
ley' cites a case of criminal poisoning by fly powder in which
death took place in thirty-six hours, and in which a quantity
^ Loc. cit. 'J. d. chim. m^d., Paris, 1839,
2 Pest, med.-chir. Presse, 1898, 2 s., v., 3-16.
xxxiv., 985. ""M^d.Ug.," lOeme ed., Paris,
'"Misc. Ac. nat. cur.," Lips., v., 1880, i., 666.
obs. 102, p. 355. 'Ann. d'hyg., Paris, 1851, xlv.,
■* "Die Arsenvergiftung," Leipzig, 159-181.
1786, p. 57, note. *" Micro-Chemistry of Poisons,"
IV.— 25
1st ed., p. 239.
386 TOXICOLOGY WITTHAUS.
of arsenic equivalent to forty-two grains (2.7 gm.) of arseni-
ous acid remained in the stomach at the time of death, although
there had been almost incessant vomiting for over thirty hours.
The classic case of homicidal poisoning by elementary arsenic is
that of Dombrowsky, reported by Schiitte.^ The accused was
convicted of the murder of his wife by the repeated administra-
tion of fly stone. The stomach contained at death nearly twenty-
four grains (1.5 gm.) of arsenic, partly in the form of elementary
arsenic, partly in that of the trioxid. The mucous membrane of
the stomach" was softened, reddened in streaks, excoriated near
the cardia, where there were also a few spots of extravasated
blood. Attached to the walls of the stomach were small black
bodies, some possessed of a metallic lustre, which were found to
consist of finely powdered elementary arsenic. A similar pow-
der was also found in the pockets of a night-dress worn by the
prisoner. The deceased survived for six days after the date of
the first alleged administration, during which she suffered from
the usual symptoms of arsenical poisoning.
A suicidal case is reported by Patissier:^ that of a girl of
nineteen years who died in sixteen hours after taking an un-
known dose of "fly poison." Jager^ relates the case of an adult
female who poisoned herself with water which had stood in
contact with " black oxid of arsenic" (elementary arsenic). She
suffered no pain and remained conscious till near her death.
Pluskal* reported two cases in which wounds caused by small
shot provoked symptoms not accountable for by the mechanical
injury, and which he attributed to the poisonous action of the
arsenic contained in shot. Shot metal consists of lead to which
about two per cent, (forty pounds to the ton) of arsenic are added.
Each ounce of shot therefore contains about nine grains of arsenic.
Tin is frequently contaminated with arsenic in small amount.
In St. Petersburg several persons suffered from gastro-intestinal
disturbances, accompanied by fever, nausea, vomiting, lassi-
tude, prostration, and emaciation, from the use of food prepared
in vessels tinned with an English tin containing 0.05 to 0.1 per
cent, of arsenic and only one per cent, of lead.^
' Vrtljschr. f . ger. Med., 1854, vi., * Oest. med. Wchnschr., etc.,
230-293. 1843, iii., 505, 507.
= Bibl. m(4d., 1S27, ii., p. 59. = Ann. d'hyg., etc., 1890, 3 s.,
'"Diss, de effectibus arsenici," xxiv., 113.
etc., Tub., 1S08.
HYDROGEN ARSENID. 387
HYDROGEN ARSENID.
This substance, also known under the names arseniuretted
or arsenetted hydrogen, arsonia, arsenamin, and arsin, has the
formula AsH,. It is produced: 1. By the action of water
upon an alloy obtained by fusing together native sulfid of anti-
mony 2 parts, cream of tartar 2 parts, and arsenic trioxid 1
part. 2. By the action of dilute hydrochloric or sulfuric acid
upon the arsenids of zinc and tin. 3. Whenever a reducible
compound of arsenic is in presence of nascent hydrogen (see
Marsh test). 4. By the action of water upon the arsenids of
the alkali metals. 5. By the action of hot solution of potash
and powdered zinc upon reducible compounds of arsenic.
It is a colorless gas, having a strong odor of garlic; soluble
in five volumes of water free from air; neutral in reaction. It
is partially and slowly oxidized by air and moisture, with depo-
sition of elementary arsenic. It is decomposed into hydrogen
and arsenic when in contact with a red-hot surface, and by the
passage through it of luminous electric discharges (see Marsh
test). Its mixtures with air or oxygen are explosive. It burns
in air with a greenish flame from which a white cloud of ar-
senic trioxid arises. A cold surface held above this flame be-
comes coated with a white, crystalline deposit of the trioxid.
If the flame be cooled by the introduction of a cold surface into
it, the hydrogen alone is oxidized and the arsenic is deposited
upon the cold surface. Chlorin decomposes hydrogen arsenid
explosively, with formation of hydrochloric acid and arsenic
trioxid. Bromin and chlorin behave similarly, but with less
violence. Active oxidizing agents convert it into water and ar-
senic acid; less powerful oxidants into water and arsenic trioxid.
Solid potassium hydrate decomposes it partially, and becomes
coated with a dark deposit, which seems to be elementary
arsenic. Solutions of the alkahne hydroxids absorb and decom-
pose it, hydrogen being given off and an alkaline arsenite remain-
ing in solution. It is reduced by solution of silver nitrate, metal-
lic silver being deposited, and silver arsenite remaining in the
solution. Hydrogen arsenid and hydrogen sulfid do not mu-
tually decompose each other in the absence of air. The presence
of traces of hydrogen arsenid may be detected in air by passing
a large volume, first through a solution of cuprous chlorid to
388 TOXICOLOGY — WITTHAUS.
remove hydrogen sulfid, antimonid and phosphid, and then
over paper moistened with mercuric chlorid, which is colored
yellow; 0.02 c.c. per litre giving a distinct reaction.
Hydrogen arsenid is the most violently poisonous of the
mineral compounds of arsenic, partly by reason of the large
proportion of arsenic which it contains (about ninety-six per
cent.), and partly because its absorption by the pulmonary sur-
faces is more rapid than that of dissolved arsenicals by the ali-
mentary canal. Van Hasselt* and other toxicologists have
considered hydrogen arsenid apart from the other arsenicals as
a poison sui generis, because of its much greater activity in
minute doses and because of certain differences between its
symptomatology and that of other compounds of arsenic. Its
solubility in water is not sufficiently great to account for its ab-
sorption, and it probably enters into combination with some
constituent of the blood, as it causes extensive cytolysis. Joly
and Nabias^ found that in dogs poisoned by hydrogen arsenid
the solution of haemoglobin is so extensive that one-half of the
total amount is in the serum, from which it passes into the serous
fluids and urine, being converted into methaemoglobin. The
amount of arsenic capable ' of causing death when absorbed as
hydrogen arsenid is much less than that required in the other
forms of combination. According to Brandes, the quantity
inhaled by Gehlen (see below) could not have exceeded one one-
hundredth grain. In the case reported by Schindler^ the amount
inhaled was greater, although it probably did not exceed one-
eighth grain of arsenic. Hebert and Heim,* in experiments upon
animals, found that 3.5 c.c. per litre of air is rapidly fatal to
mammals, and 0.09 c.c. per litre to birds; and that in concen-
trations below 0.05 c.c. per litre with mammals, and 0.02 c.c. per
litre with birds it is without distinctly detrimental results.
All of the reported cases have been accidental,^ and, with
» "Allg. Giftlehre," 1862, 390. * BuU. Soc. chim. de France, 1907,
2 C. r. Ac. Sc, 1S'.)0, ex., 666. For 4 s., ii., 571, 573.
other experiments on animals see 'The B os trom-Becker case
Stadelmann: Arch. f. exp. P. u. P., (Becker: Di^;s. Giessen, ISSS) may
1883, xvi., 221. Minkowski and have been one of suicide. It was
Naunyn: ibid., 1886, xxi., 14. Ep- that of a student in a chemical
pinger: Beitr. z. path. An., etc. laboratory who, being in a despond-
(Ziegler), 1903, xxxiii., 127. ent frame of mind, prepared a
^ Rept. f. d. Pharm., 1S40, Ixix., quantity of hydrogen from arsenical
271. ■ zinc and acid, and inhaled a quantity
from a gas-bag.
HYDROGEN ARSENID. 389-
very few exceptions, caused by the inhalation of hydrogen gener-
ated from materials containing arsenic as an impurity, under
which conditions the arsenic is converted into hydrogen arsenid.
As commercial sulfuric acid is also contaminated with selenium,
hydrogen in whose preparation it is used also contains hydro-
gen selenid. This gas is capable of causing death even in the
dilution of .62 per cent.,' its action being chiefly that of a power-
ful local irritant to the respiratory organs, an action resulting
from its decomposition by moisture, with deposition of sel-
enium. But this gas has not the destructive action of hydrogen
arsenid upon the erythrocytes, and in the dilution in which it
exists in impure hydrogen its effects may be disregarded.
We have collected the reports of 84 cases of poisoning by
hydrogen arsenid.^ Of these 10, of which 6 were fatal, were those
of chemists who inhaled the gas, more or less diluted with hydro-
gen, in the course of chemical experiments. Indeed, the earliest
recognized case was that of the chemist Gehlen, who met his
death while experimenting upon the action of hot concentrated
caustic potash solution upon arsenic trioxid.^ Five cases,
with two deaths, resulted from the performance of Tyndall's
experiment with impure hydrogen.* Thirty-eight cases, with
fifteen deaths, occurred in operatives in chemical or mechanico-
' Eulenberg: "Schadliche . . . Rundschau, 1886, xvii., 325 (case
Gase," 1865, p. 454; Chevalier and of Dr. S., died). The case discussed
Chaignot: "Intox. p. 1. gaz d. bal- at length by Becker: Diss. Giessen, "
Ions," 1904, p. 65. 1888, is evidently the same as
' We have not seen the Diss, of Bostrom's: Binz, in Penzoldt and
Geigy, Basel, 1890, in which another Stintzing: "Handb. d. spec. Ther.,"
case is said to be reported. ii., 5 (case of Prof. Schultz, died).
^ At Munich in 1815: Schweigger's OUivier: Gaz. d. hop., 1863, xxxvi.,
Jrn., 1815, xv., 501; Ann. de. phys. 509; C.r. Soc. de bioL, 1863, 3 s., v.,
et de chim., 1815, xcv., 110. The 77 (case of Barboret, died) . Schick-
other cases are reported by Muller: hardt: Mtinch. med. Wchnschr.,
Ann. d. Staatsarznk., 1837, ii., 422 1891, xxxviii., 26 (case of Dr. X.,
(Prof. Emmert, died 1819). Taylor: recovered). Schmidtmann: " Handb.
"Poisons," 3d. Am. ed., 350, also d. ger. Med.," 1905, i, 906, refers to
Boston M. and S. J., 1837, xvi., 99 the case of Von Arten in Amster-
(case of BuUocke, 1836, died). dam, but gives no particulars.
Schindler: J. f. Chir. u. Augenhlk., * When the lungs are filled with
1838, xxvi., 364; Kept. f. d. Pharm., hydrogen the voice is weakened, hol-
1840, Ixix., 271; Mag. f. Phys. u. kl. low and hoarse (Tyndall: "Sound,"
Arznw. u. Tox., 1846, i., 364 (case 1867,p.9). O'Reilly: Dublin J.Med,
of Schindler, 1836, recovered). Sc, 1841-42, xx., 442 (Dr. Brittain,
Mouat: Indian Ann. Med. Sc, died). Ferr^: "Arsenicisme prof.,"
1856-57, iv., 657 (case of Prof. 1882, 24 (Bietani, died). Eitner: Berl.
Robertson, rec). Vogel: Arch. d. kl. Wchnschr., 1880, xvii., 256 (Prof.
Ver. f. gem. Arb., 1854, i., 209, X and two pupils, recovered),
recovered. Bostrom: Med.-Chir.
390
TOXICOLOGY WITTIIAUS.
chemical industries in which commercial acids, etc., contami-
nated with arsenic, were used, or in which hydrogen containing
hydrogen arsenid was otherwise produced.^ Ten cases, with
three deaths, occurred in persons engaged in filhng toy balloons
with impure hydrogen.^ Twenty-one cases, with nine deaths,
have occurred in balloonists.^ Most of these were mass poison-
ings in which several soldiers detailed to balloon duty were
more or less severely affected.
Numerous instances have been recorded of chronic, or even
acute, arsenical poisoning in persons inhabiting rooms whose
walls are either painted or covered with paper colored with
arsenical pigments. Under these conditions a volatile com-
pound of arsenic is produced, which has been supposed to be
hydrogen arsenid, but more recent investigations have shown
it to be diethylarsin.*
The symptomatology of poisoning by hydrogen arsenid
differs in several essential respects from that of the solid arseni-
cal poisons. The duration of the poisoning, whether it ter-
minate in recovery or in death, is materially longer. The short-
1904 (etchiBg on metals with im-
pure acids, recovered). Jones: J.
Am. M. Assoc, 1907, xlviii., 1099
(Mac Arther-Forest cyanid process,
five cases, three deaths). Dahm:
Deut. med. Ztg., 1907, xxviii., 604
(dilute sulfuric acid in a galvanized
iron pail in a confined space). Pharm.
J., 1907, 4 s., xxiv., 537 (cleaning
vitriol tank, death).
^ Waechter: Vrtljschr. f . ger. Med.,
1864, n. F., xxviii., 251 (four cases,
one death). Dutting: Diss., Freiburg,
1S88 (six cases, two deaths).
'Oulmont: M^d. mod., 1S90, i.,
933 (two deaths). Schumberg: Vrtl-
jschr. f. ger. Med., 1893, 3 F., v.,
291 (two deaths). Storch: Therap.
Monatsh., 1892, vi., 310 (recovery).
Crone: Deut. militariirztl. Ztschr.,
1900, xxix., 139 (two deaths).
Maljean: Arch, de m6d. et de pharm.
mil., 1900, XXXV., 82 (five recoveries).
Chevalier and Chaignot: "Intox.
p. le gaz d. ballons, " 1904 (seven
cases, two deaths). Belin and
Lecornu; Bull, et m^m. Soc. m6d. d.
hop. de Paris, 1903, 3 s., xx., 1380
(recovery). Bari^ and Brissy: ibid.,
1904, 3s., xxi., 1059 (death).
■' See p. 582.
' Miiller: Ann. d. Staatsarznk.,
1837, ii., 418 (tin salt, recovered).
Barker: St. Louis M. and S. J.,
1864, n. s., i., 29 (cleaning castings
with impure sulfuric acid, recovered) .
Valette: Lyon med., 1870, iv., 440
(anilin, one death, one recovery).
Trost: Vrtljschr. f. ger. Med., 1873,
n. F., xviii., 269; Transl. Wharton
and Stille: Med. Jur., 5th. ed., ii.,
716 (arsenic and hydrochloric acid, 9
cases, 3 deaths). Sury-Bienz:
Vrtljschr. f. ger. Med., 1888, n. F.,
xlix., 349 (zinc chlorid, died). Id.
ibid., p. 353 (anilin, five cases, re-
covered). Coester: Berlin kl. Wchn-
schr., 1884, xxxi., 119; 1886, xxxiii.,
209 (anilin, two cases, one death).
Public Health: 1891-2, iv., 317
(metallurgic experiment, died).
Martin: Med. Chronicle, 1893-94,
xix., 108 (zinc chlorid, death).
Mann and Clegg: Med. Chronicle,
1895, i., 462 (zinc chlorid, five cases,
two deaths). Lesser: Vrtljschr. f.
ger. Med., 1897, 3 F., xiv., 296, 309
(zinc, hydrochloric acid and arsenic,
death). Gulevitsch: Ztschr. f.
physiol. Chem., 1898, xxiv., 511
(zinc in mixture of acids and arsenic,
recovered). Driesen: Diss. Mvinchen.,
HYDROGEN ARSENID. 391
est period of complete recovery was in Valette's case, eight days;
while in many cases several weeks or months elapsed before the
patient was discharged. The shortest time in which death oc-
curred was twenty-three hours, in one of Chevalier and Chaig-
not's cases. In one of Jones' cases death occurred in sixty
hours, and in three days in two of Trost's cases, in one of Crone's
and in one of Diiting's cases. The longest survival in a fatal
case was twenty-eight days in Valette's second case. The aver-
age duration of twenty-five fatal cases was four days and four and
one-half hours. About one-half of the deaths from poisoning
by white arsenic occur within the first twenty-four hours, and
cases in which the duration of the poisoning is prolonged for
two or three days are exceptional.
The onset of a poisoning by white arsenic is, in the great
majority of cases, sudden, beginning with a violent attack of
vomiting and abdominal pain, and occurs within one hour. In
poisoning by hydrogen arsenid abdominal pain and vomiting
are either absent or occur later in the history of the case. In
most cases the attack begins with a feeling of faintness and gid-
diness, particularly on going upstairs, pain in the head, chills
more or less severe, and pain in the kidneys. Occasionally, as
in one of Valette's cases, nausea and voniiting are early symp-
toms. In this case the workman experienced nausea at the time
of the exposure, and going out to vomit, urinated, and was
struck by the dark red color of his urine. In Bostrom's case
the attack is described as apparently one of renal colic, but the
urine was dark brown, almost black, in color, and the skin was
copper-colored.
The three prominent symptoms of poisoning by hydrogen
arsenid, which are not observed in poisoning by the other ar-
senicals, are lumbar pain, hsemoglobinuria, and icterus.
Lumbar pains occur early and are severe in most cases, al-
though in some instances they were not observed, as in four of
Trost's nine cases and in Eitner's case. Almost pure hsemoglo-
binuria occurs in all cases. The urine passed is bright red,
dark brown, or black in color, coagulates almost solid by heat,
and on standing deposits a very sparing sediment, which con-
tains no blood corpuscles, but sometimes granular matter,
the product of their disintegration. The quantity of urine
passed is usually normal or somewhat increased at first, while
392 TOXICOLOGY WITTHAUS.
afterward there is marked diminution or complete suppression.
In Coester's first case, which terminated in death in nine days,
the elimination was 1,500 c.c. (50f fiuidounces) on the first
day; while in the succeeding five days the total elimination
was only 24 c.c. (6^ fluidrachms), or 5 c.c. (H fluidrachms) in
twenty-four hours; and on the sixth day 4 c.c. (1 fluidrachm).
Or the suppression may begin at the outset. Thus in O'Reilly's
case, on the first day the patient passed 60 c.c. (2 fluidounces)
of blood, on the second 15 c.c. (4 fluidrachms) of blood, and on
the fifth, sixth, and last days no urine was obtained by the
catheter, and the breath was strongly ammoniacal. In cases
which terminate in recovery the blood pigment gradually dis-
appears from the urine, which resumes its natural color and in-
creases in quantity. In Coester's second case the elimination
during the nine days was 2,000 c.c. (67J fluidounces), 2,500
c.c. (84 J fluidounces), 2,500 c.c, 3,500 c.c. (118 fluidounces),
3,000 c.c. (lOli fluidounces), 2,800 c.c. (94^ fluidounces), 2,900
c.c. (98J fluidounces), 4,500 c.c. (152 fluidounces), and 4,500
c.c. The urine contains methsemoglobin, oxyhsemoglobin, in
solution and in flakes, and albumin, the last sometimes in such
amount that the urine solidifies to a Jelly when heated.* Bile
pigments are sometimes present in traces, but more frequently
absent. In some cases other manifestations of extensive dis-
organization of the blood are observed. In ^'alette's second
case, which terminated in death in twenty-eight days, there
was almost complete suppression of urine, a very small amount
of black urine only being passed during the first twenty days,
when there were sanguinolent diarrhceal stools, hemorrhages
from the gums, buccal mucous membrane, glans penis, and
prepuce, the blood being pale and escaping rather by leaking
than by bleeding. At the same time the skin was covered with
an extensive papular eruption. On the tM^enty-first day the
urine was abundant and clear. On the twenty-eighth day
the patient vomited half a glassful of black blood, had two
attacks of syncope, and died quietly in the afternoon. The
number or red corpuscles in the blood is very much diminished.
In Barrie and Brissy's case, fatal on the fourth day, the blood
count showed 1,147,000 erythrocytes per cubic mm. on the third
day, and 868,000 on the fourth. In Belin's case of recovery,
'■ Storch: loc. cit.
HYDROGEN ARSENID. 393
the count was 2,400,000 on the sixth day; and in Driesen's case,
also of recovery, it was 5,700,000 on tlie day of the intoxication,
2,200,000 on the fourth day, and 3,810,000 on the eighth day.
Mann and Clegg made blood counts in two of their cases and
found a destruction of from forty-six to sixty-four per cent, of
the red corpuscles. Examination of smears shows the erythro-
cytes to be paler than normal, at first punctated, and later nu-
cleated (Driesen); and also the presence of much detritus of
disintegrated corpuscles (v. Sury-Bienz, Becker). The quan-
tity of hsemoglobin in the blood is also notably diminished.' In
Driesen's case the proportion was fifty per cent, on the first day;
forty per cent, on the fifth; sixty per cent, on the seventeenth;
seventy per cent, on the twenty-ninth; eighty-five per cent, on
the thirty-eighth; and ninety per cent, on the fifty-seventh day.
Storch estimates that in his non-fatal case 125 gm. of hsemo-
globin were discharged in the urine.
Jaundice is an unfaihng symptom. The only case whose
symptoms have been described in which it is not mentioned is
that recorded by Miiller (1837), in which there was general sub-
cutaneous emphysema. The face was pale, bluish, livid; the
left arm and left leg were particularly swollen and covered with
innumerable large and small petechial spots. In some cases
the conjunctivEB and skin become yellow on the second day, the
color of the skin deepening to a bronze or copper, which gradu-
ally diminishes toward the fifth or sixth day, and the conjunc-
tivse become brownish-red from a combination of icterus and
injection. In other cases jaundice is among the first symptoms
to appear. Thus in Trost's cases the workmen noticed the yel-
low color of each other while at work, and in Valette's two
cases the sclerotic was observed to be yellow one hour after the
exposure. The alvine discharges are dark brown-black, liquid,
and in some cases consist of almost pure bile.
The experiments of Stadelmann^ have demonstrated that the
icterus of hydrogen arsenid is hepatogenous, and is due to the
production by the liver of a bile so modified in composition that
it is peculiarly fitted for absorption. He considers, however,
that the fundamental cause of the icterus is in the disorganiza-
tion of the blood.
'Arch. f. exp. Path. u. Pharm., Ponfick: Verh. d. Congr. f. inn. Med.,
1883, xvi., 221-255. See also 2te Congr., 1883, 205.
394 TOXICOLOGY \MTTHAUS.
The post-mortem appearances after death from hydro-
gen arsenid differ also in some respects from those caused by
white arsenic. The surface is dirty yellow or bronzed in color,
and all the tissues are more or less yellow. The liver is normal
in size or somewhat enlarged; in some cases of a deep indigo
color and congested; in others yellow, gray, or slate-colored, and
usually neither congested nor anaemic; but in Crone's cases the
livers were fatty, and all of the internal organs were markedly
anaemic. The gall-bladder always contains much bile and is
sometimes greatly distended. The kidneys are highly congested,
dark brown-red or indigo in color, the surface sometimes almost
black, and enlarged. The mucous membrane of the stomach is
yellow or slate-colored, and evidences of inflammation were ab-
sent in all cases except in that reported by O'Reilly, in which
death occurred in six days three and one-half hours, and in
which there were two distinct inflammatory patches at the
greater curvature.
Analyses of the viscera have been made in but few fatal cases.
Dr. O'Reilly detected arsenic by the Marsh test in 10 ounces of
fluid effused in the chest in the case of Brittain. Fresenius
found undetermined traces in the liver in Coester's case. In
Crone's cases distinct mirrors of arsenic were obtained from the
stomach, heart, kidneys, and blood, those from the solid organs
being more intense than that from the stomach. In Lesser's
case the analj-sis, made by Bischoff, showed the following
amounts in mg. of arsenic trioxid in 100 gm. of tissue: in the
liver, 1.308; kidneys, 0.127; spleen, 0.617; heart, traces; blood
from the heart, 0.54; lungs, 0.05; brain, 0.054; bile, 0.714;
muscles, 0.076; diaphragm, 1.11; stomach, none; intestine and
contents, 0.065. The man had died eleven days after the in-
halation. In Mann and Clegg's two fatal cases, in which death
occurred in six days, arsenic was found in the liver, Iddnej^s, bile,
urine, and blood, and in one case in the pericardial and pleural
fluids as well.
Arsenic Trioxid, or White Arsenic.
Physical and Chemical Properties.
This substance, the common arsenic of the shops, is also
known under the names arscnious acid and arsenious anhy-
ARSENIC TRIOXID — PROPERTIES. 395
drid. Its formula is As^Oj (molecular weight = 197.68);' one
hundred parts therefore contain As 75.78 and O 24.22, and one
part of elementary arsenic represents 1.32 AS2O3. It is obtained
industrially by roasting the native suMd of arsenic and iron
(arsenopyrites, mispickel) in a current of air.
It exists in three forms: vitreous, porcelainous, and crystal-
line. It is odorless, whether in the form of solid or vapor.
Aqueous solutions of arsenic trioxid are acid in reaction, and
probably contain the true arsenious acid — H3ASO3. They are
neutralized by the alkalies and by alkaline carbonates, as well
as by bases in general, with the formation of salts called arsenites.
Consequently solutions of white arsenic in solutions of potassium
or sodium carbonate do not contain "arsenious acid," but potas-
sium or sodium arsenite.
Arsenic trioxid is readily reduced, with separation of ele-
mentary arsenic, when heated with hydrogen, carbon, potas-
sium cyanid, or other reducing agents. Oxidizing agents, such
as nitric acid, the hydrates of chlorin, and chromic acid, convert
it into arsenic pentoxid, AsjOj, or arsenic acid, HgAsO^. Its
solution, acidulated with hydrochloric acid and boiled in
presence of copper, dep,osits on the metal a gray film, com-
posed of an alloy of copper and arsenic consisting of As 32, Cu
68 in 100.
Crystalline Form. — When white arsenic is fused and allowed
to solidify, it forms translucent or transparent, yellowish,
vitreous masses, having no visible crystalline structure. When
it is sublimed in moderate quantity it deposits in the warmer part
of the condenser, first in small, brilliant octahedral crystals
which gradually increase in size, and as the temperature rises fuse
together and finally form a colorless, liquid film, which on solidi-
fication has precisely the appearance of glass. This vitreous
arsenic shrinks and cracks on cooling, and in a short time, in air
containing the merest trace of moisture, becomes granular and
milky, beginning at the edges, with formation of crystals. This
change, which progresses gradually throughout the mass, results
in the transformation of the vitreous material into a milk-white,
'The correct formula is more xii., 1116), at 1560° (13.78 A. = 198.93
probably AsjOf,, as the specific grav- H.), nearly corresponds with the
ity of its vapor, determined by Mit- molecular weight (395 . 36) repre-
scherlich, at 571° (13.85 A.), and sented by that formula (198.93X2
later by V. and C. Meyer (Ber., 1879, =397.86).
396 TOXICOLOGY WITTHAUS.
rather friable, opaque substance, having the appearance of porce-
lain, and hence known as the porcelainous variety. '
The cakes or lumps of arsenic met with in commerce consist
externally of porcelainous arsenic, usually with more or less of
the remaining vitreous modification in the centre of the mass,
diminishing in amount with the age of the product.
When arsenic trioxid is sublimed or when it is produced by
heating the element in a current of air or oxygen, it is deposited
in briUiant isometric octahedra (Figs. 9, 10), which are larger
Fig. 9. — Crystals of Arsenic Trioxid. Sublimed. Transmitted light. X 75.
and more perfectly formed the nearer the temperature of the con-
densing surface is to 180° (356° F.). If the condensing surface
be cold the crystals are formed rapidly and are consequently
smaller; while if it be too hot the edges of the crystals are partly
rounded by volatilization, or they fuse together to form the vit-
reous variety. If the temperature varies, aggregated or dis-
torted forms are produced, or small crystals are deposited on
the facets of larger ones.
The flowers of arsenic, or powdered white arsenic of the shops,
is a more or less crystalline powder, obtained by grinding either
' I. Sickels: "Arsenic Trioxid: a Study of Some of its Forms." Re-
searches Loomis Lab., 1S92, ii., 121.
ARSENIC TRIOXID PROPERTIES.
397
the vitreous arsenic or a more or less crystalline raw product, or
by rapid condensation of the vapor in suitable chambers. If
prepared by the last-named method, without subsequent grind-
ing, it consists entirely of octahedral crystals. If obtained by
grinding the vitreous variety, which is rarely the case, it consists
of a powder whose particles exhibit no crystalhne structure
when examined microscopically. By far the greater proportion
of commercial white arsenic is obtained by grinding a product
consisting partly of crystallized and partly of fused arsenic, and
Fig. 10. — Same specimen as in Fig. 9. Reflected light, x 75
consequently consists of a mixture of microscopic octahedral
crystals and amorphous particles of varying size.
A microscopical examination of the crystals of white arsenic
may be of value under certain conditions for the purpose of dis-
tinguishing between two samples. Such a differentiation was
of importance, and was the subject of extended inquiry in the
trial of State v. H. H. Hayden, for the murder of Mary Stannard,
in Connecticut in 1880.
In this case the body of the deceased was found in the woods with
the throat cut and a hole in the head, into which a blood-stained stone
found near by accurately fitted. An analysis revealed the presence of
nearly ninety grains of arsenic in the stomacli and liver. The death
398 TOXICOLOGY WITTHAUS.
was abundantly accounted for by the mechanical injuries, and the
poison found was considered of importance by the prosecution mainly
for the purpose of fixing the crime upon the defendant. It was proved
and admitted by the prisoner that, two days before the murder, he had
purchased an ounce of arsenic, "to kill rats," which he claimed to have
secreted in his barn to prevent the children getting it. A tin box con-
taining one ounce 38.4 grains of arsenic was found in the barn. The
prosecution sought to show that the arsenic found in the barn could
not have come from the source claimed by the defense, and that the
arsenic found in the stomach was similar to that purchased by the de-
fendant. The theory being that the arsenic found in the barn had
been placed there either before or afterward, that the accused had ad-
ministered the poison proved to have been purchased by him to the
deceased, that he was with her at her death, and that it was his hand
that wielded the knife and the jagged stone. To effect this distinction
and identification, Prof. E. S. Dana was sent to England to study the
processes of manufacture of arsenic, and upon the trial nearly five days
were consumed by the State in taking the testimony of Professors
Dana, Brewer, and Wormley, who affirmed that the "barn" arsenic
could be readily distinguished from samples obtained from the stock
of which the defendant had purchased, and that the latter closely re-
sembled the arsenic found in the stomach of the dead girl. The char-
acters upon comparison of which this opinion was based were: 1. The
number of crystals as compared with the number of irregular frag-
ments. 2. The size of the crystals. 3. The degree of lustre or dul-
ness of the crystals. 4. The proportion of large fragments to dust-
like particles.
The distinction between the "sample" and "barn" arsenics was
certainly established by the following differences in characters: 1.
About one-third of the "sample" consisted of well-defined crystals, in
some mountings only one-fourth, never one-half: while fully nine-
tenths of the " barn " was in regular crystals. 2. More than four-fifths
of the "sample" crystals measured yj-^o to -g-^-j- of an inch in their
greatest diameter, while the crystals of the "barn" arsenic measured
raVo to To^nr, except about one per cent, measuring gi^j to sio. 3.
The crystals of the "sample" were dull-surfaced, while those of the
"barn" were smooth and lustrous. 4. In the "sample" some of the
irregular fragments were larger than the crystals, and they constituted
more than one-half of the mass, while in the "barn" they did not ex-
ceed from one-tenth to one-fourth. The distinction, however, became
of little or no import when it was shown that the "sample" arsenic
had been taken one month later from the almost empty jar, and con-
sisted of the scrapings of a vessel which had been in use for many years
ARSENIC TRIOXID — PROPERTIES. 399
and from which many pounds of arsenic, obtained from different whole-
salers, had been dispensed by the druggist, who was consequently
unable to state whether the scraping "sample" was from the same
wholesale lot as that from which the defendant had purchased or was
the remains of another lot put into the jar ten years before.
The investigations of Professor Dana have therefore shown
that under favorable circumstances it is possible by microscopic
examination to disprove the common origin of two samples of
arsenic. But the result of the Hayden trial has also shown that
caution is necessary in the use of such evidence. The attempt
in this trial to show similarity between the "sample" arsenic
and that obtained from the stomach of the dead girl failed; nor
does it seem probable that under similar conditions such an at-
tempt would prove successful, for the reason that the solvent ac-
tion of the gastic secretions produces an undetermined modifi-
cation of each of the characters used for differentiation.
In the case of Com. v. Goersen (Philad. Oy. and T., May, 1883)
Professor Leffman found the arsenic adherent to the m.ucous
membrane to be in crj'"stals, which they could not have been had
the substance been administered in a homeopathic trituration.
He also observed some difference between the regularity of the
crystals found in the stomachs of the two victims.*
In England, where arsenic when sold in small quantity must
be mixed with one-sixteenth its weight of soot, or one-thirty-
second its weight of powdered indigo, that it may not be mis-
taken for one of the many white powders used in the household
(14 Vic, c. 13, s. 3), it may be possible to establish the cer-
tainty of dissimilarity or the probability of similarity between
arsenic found in the stomach or vomit and that of the particu-
lar preparation alleged to have been administered, by the detec-
tion or non-detection of these insoluble colored materials. This
point was the subject of inquiry on the trial of Madeleine Smith
(1857), in which it was shown that of two samples of arsenic
purchased by the accused one was colored with soot and the
other with waste indigo. Neither pigment was found in the
stomach or intestines.^
Arsenic trioxid is dimorphous and isodimorphous with anti-
' Paper-book of plaintiff in error, Browne and Stewart: "Trials for
pp. 19, 70. Murder by Poison," pp. 311-312,
^ Morison's Report, pp. 33, 35, 38. 316-317.
400
TOXICOLOGY WITTHAUS.
mony trioxid, and under certain conditions forms crystals which
are modifications of the right rhombic prism. Thus when the
trioxid is subhmed in a test-tube that portion of the subhmate
nearest to the heat contains long prisms among the octahedra,
their number being increased by slight pressure and by using a
temperature of about 400° (752° F.)' (Fig. 11). The circum-
stances, however, under which prismatic crystals are produced
are not such as obtain in the appHcation of the Marsh or Reinsch
test as directed below. ^
Fig. 11. — Prismatic Crystal of Arsenic Trioxid, among Octahedra.
By Sublimation in Sulfur Dioxid. X 250.
Taste. — Although the taste of white arsenic has been de-
scribed as hot, acrid, sweetish, metallic, and rough, it is under
the most favorable circumstances faint. Taken in small quan-
tity in the soHd form it is, as might be expected from its sparing
solubility, tasteless, and in very few of the many instances in
which it has been taken in large quantity mixed with articles
of food is any reference made to an impression of taste: in 15
' Sickels: Loc. cit.
^ Occasionally crystals are met
with among the octahetlra in a sub-
limate which have the appearance
of being ])risms with oblique ends.
These, however, arc thin, flat deriv-
atives of octahedra so placed that
they present their narrow faces.
Their true character becomes evi-
dent on changing the focus and ren-
dering the illumination somewhat
oblique.
AKSEXIC TRIOXID PROPERTIKS. 401
cases out of 1000. In these the taste was referred to as " bitter"
in 6 cases. This, if correctly observed, was certainly not due to
arsenic. In one instance' a " nauseous " taste was noticed, but as
it escaped the notice of 14 other persons who ate of the same
poisoned pudding, it was probably more imaginary than real.
Of a family of 8 persons poisoned by arsenic in their food all are
said to have experienced a harsh metallic taste. ^ This and
another^ are the only cases among 1000 in which this quality of
taste is referred to.
The aqueous solutions of arsenic, although not acrid in any
degree, have a very faint though distinct taste, which is at first
sweetish, somewhat nauseous, and later slightly metallic in
character. It is probable that this taste is observable when the
substance is taken in large quantity and unmixed with articles of
food. Indeed, Liman^ states that rescued suicides who have
taken it under these circumstances describe the taste as harsh and
somewhat salty. Taylor,^ however, reports an instance in which
three persons were severely poisoned by drinking port wine
"saturated with arsenic," yet "not the least taste was perceived
by any of the parties."
The sensation described as a "rough taste" is more a me-
chanical irritation, ca 
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