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inspection the mucous membrane of the stomach was found highly inflamed, especially toward the middle of the greater curvature, where for several inches it resembled scarlet cloth. The pylorus and duodenum were of a deep crimson color. The peritoneal surface was reddened, especially over the stomach, the vessels having a vermilion color, as if they had been injected. The heart and lungs were healthy, the blood was fluid, and more florid than natural. The other organs presented no unusual appearances. No analysis was made of the contents of the stomach, but that the nitre was the cause of death no doubt could be entertained, and a verdict was returned accordingly at the coroner's inquest. Another man took an ounce of saltpetre in mistake for Epsom salts. Pain came on immediately, with profuse perspiration. He felt sick, but did not vomit till more than four hours had elapsed. When seen, between six and seven hours after taking the nitre, his pulse was 56 and full. The tongue was white, moist, and tremulous. Micturition was frequent for the first three hours. He recovered. (Brit. Med. Jour., 1882, i. p. 304.) Two cases are recorded of recovery after the administration of two ounces of saltpetre. (Brit. Med. Jour., 1877, ii. p. 520; 1882, i. p. 500.)

Analysis. For the chemical properties and methods of detecting this salt, see pp. 102, 103.

CHLORATE OF POTASSIUM. CHLORATE OF POTASH.

Chlorate of potassium given in large doses acts as a poison, producing severe vomiting, profuse purging, intense difficulty of breathing, lividity of the countenance, and profound depression of the heart's action. After death, the blood is found of a chocolate color, its pigment being destroyed. (Das Chlorsaure Kali, by Von Mering, p. 142.)

SULPHATE OF POTASSIUM. SULPHATE OF POTASH.

Symptoms and Appearances.-The question whether this should be regarded as an irritant poisonous salt or not was much debated among members of the profession, in reference to a case which was tried in 1843: Reg. v. Haynes, C. C. C. The accused had given to the deceased, the night before her death, two ounces of sulphate of potassium dissolved in water; and it was alleged that, a fortnight previously to this, she had taken in divided doses as much as a quarter of a pound of the salt. The woman thought she was pregnant, but this was disproved by an examination of the body; and it was charged that the prisoner had given her the salt with the intention of causing a miscarriage. After the last dose, she was seized with sickness, and died within a very short time. The stomach was found empty, but highly inflamed; and there was blood effused on the brain. One medical witness referred death to the action of the sulphate as an irritant poison; another attributed it to apoplexy as an indirect result of the violent vomiting caused by it. The prisoner was acquitted of the charge of murder, but was subsequently found guilty of administering the substance with intent to procure abortion. Both of the witnesses admitted that, in small doses, the salt was innocent; but that in the dose of two ounces it might produce dangerous effects. Several other fatal cases are recorded. (Ann. d'Hyg., Avril, 1842.)

There is no doubt that the most simple purgative salts may, under certain circumstances, and when given in large doses, destroy life. A case is elsewhere related in which Epsom salts caused death, and gave rise to a criminal charge in this country. (On POISONS, 2d edit. p. 4.) In May,

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1875, a woman, æt. 27, died in a few hours from the effects of two ounces of Epsom salts taken at once. (Pharm. Jour., June 12, 1875, p. 1001.) It is said that sulphate of potassium has in some cases caused vomiting and other serious symptoms, from its containing as impurity sulphate of zinc. This, if present, would be easily discovered by the appropriate tests for zine (see p. 164, post).

Sulphate of potassium may be easily indentified. It is in hard, dry crystals, soluble in water, forming a neutral solution, in which potassium and sulphuric acid may be discovered by the appropriate tests (see pp. 99, 111).

SALTS OF BARIUM.

Chloride of Barium.—Symptoms.-A woman, æt. 22, took by mistake for Epsom salts, less than a teaspoonful (100 grains) of the chloride. In half an hour there was a feeling of deadly sickness, with sharp burning pains in the stomach and bowels. Vomiting and purging set in violently, the purging being attended with straining. An hour and a half after she had taken the poison the following symptoms were observed: The face was pale and anxious, the eyes deeply sunk, the surface cold, the heart's action feeble, the pulse scarcely perceptible, the tongue natural and warm, loss of muscular power, sensation and intelligence unaffected, the pupils natural. Fluids taken were instantly rejected, together with a ropy mucus. There was pain in the stomach, ringing in the ears, twitching of the face, and twisting of the legs and arms. In eight hours and a half the symptoms had abated, but in about fourteen hours the purging had returned, and the symptoms were much worse. There was a loss of voluntary muscular power. The breathing was slow and labored, and indicated effusion in the bronchial tubes, but the woman was sensible. In fifteen hours she was convulsed, and these convulsions continued in paroxysms for two hours, when she died, seventeen hours after taking the poison. During the fits she had several watery evacuations, and consciousness was lost. There was no post-mortem examination. (Lancet, 1859, 1, p. 211.)

Another instance of death from chloride of barium is reported (Pharm. Jour., Aug. 10, 1872, p. 117); but no account is given of the dose taken, or of the symptoms and appearances. Kennedy states that, in using this compound as a medicine, he has found that few persons are able to bear the eighth of a grain; that it is analogous to corrosive sublimate; and that an overdose will produce similar effects. He has used it for many years, and he finds the proper dose is from the twelfth to the sixteenth part of a grain; but he cites no instance of its acting as a poison in a dose of one or two grains. (Lancet, 1873, ii. p. 28.)

Chevallier met with a case in which acetate of barium had been supplied in a medicine in place of sulphovinate of sodium. It caused the death of the patient, and produced serious symptoms in the druggist, who had swallowed a portion of the medicine, in order to show that there had been no mistake in its preparation. (Ann. d'Hyg., 1873, 1, p. 395.) Nitrate of barium acts like the chloride. The chlorate, used in pyrotechny, bas acted as a poison.

Carbonate of barium is said to have destroyed life in two cases, in each of which only sixty grains were taken; but the following cases show that this compound is not so poisonous as the chloride: A young woman swallowed half a teacupful of the powdered carbonate, mixed with water, at a time when she bad been fasting twenty-four hours. There was no particular taste. In two hours she experienced dimness of sight, double

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POISONING WITH PHOSPHORUS.

vision, ringing in the ears, pain in the head and throbbing in the temples, with a sensation of distention and weight at the pit of the stomach. There was also palpitation of the heart. After a time she complained of pain in the legs and knees, and cramps in the calves. She twice vomited a fluid like chalk and water. The skin was hot and dry, the pulse frequent, full, and hard. These symptoms gradually abated, and she recovered, although the pain in the head and stomach continued for a long time. (Med. Gaz., xiv. p. 448.) A woman took a mixture of the carbonate and sugar in repeated doses, but in unknown quantity. She died on the second day, having suffered from vomiting, purging, pain, and other symptoms of irritation. On inspection, the mucous membrane of the stomach and intestines was inflamed. The carbonate was found in the stomach. (Brit. Med. Jour., 1877, i. p. 888.) This salt is used as a poison for rats and mice.

Analysis.-Chloride of barium crystallizes in plates, and is soluble in water. 1. The solution yields a white precipitate with sulphuric acid or an alkaline sulphate. This precipitate is insoluble in nitric acid. 2. The powdered salt, burnt on platinum wire in a smokeless flame, imparts to it a greenish-yellow color. 3. Chlorine may be detected in it by a solution of nitrate of silver. Nitrate of barium reacts like the chloride with sulphuric acid, and imparts a similar green color to a flame. It also yields the reactions of a nitric (see nitric acid, p. 103, ante).

Carbonate of barium is a white insoluble powder, entirely dissolved with effervescence (carbonic acid) by diluted hydrochloric acid. On evaporation, this solution yields crystalline plates of chloride of barium, which may be tested by the processes above described.

CHAPTER X.

PHOSPHORUS.-RED PHOSPHORUS.-SYMPTOMS AND APPEARANCES.-CHRONIC POISONING.— CHEMICAL ANALYSIS.

POISONING with phosphorus is not uncommon in this country, as the result of accident and suicide; but homicidal poisoning by it is rare. The ordinary yellow or soluble phosphorus is alone poisonous; the red, amorphous, or insoluble variety has been clearly proved not to be poisonous. It is usually given either in the form of vermin-killer or ratpaste a mixture of yellow phosphorus, fat, flour, and sugar or as tips of lucifer matches infused in some liquid. The smell of yellow phosphorus, its taste, the fumes which it gives off, and its luminosity in the dark, commonly reveal its presence. At the Norwich Aut. Ass., 1871 (Reg. v. Fisher), a girl of 18 was convicted of an attempt to poison a family. She put a vermin-compound containing phosphorus into a teapot with the tea. When hot water was poured on it, the smell produced at once led to suspicion. Phosphorus was found in the tea, taken from a pot carelessly left about the house. The girl was convicted. Casper described a case in which the luminous appearance of the poisoned food led to a suspicion of poisoning with phosphorus, and this was subsequently proved. A woman put a preparation of phosphorus into some soup, and gave it to her husband.

He ate it in a dark room in the presence of some friends, and they

PHOSPHORUS-SYMPTOMS.

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noticed that the liquid, as he stirred it, was luminous. (Vierteljahrsschr. f. Gerichtl. Med., July, 1864.) In this way a person may be warned and a life saved. (See Ann. d'Hyg., 1870, 2, p. 203.)

Symptoms-Phosphorus acts as an irritant poison, and also specifically. The symptoms of irritation may manifest themselves in a few minutes after the ingestion of the poison. In general, however, there is a longer interval of some hours. In the first instance, the patient experiences a disagreeable taste, resembling that of garlic, which is peculiar to this poison. An alliaceous or garlic-like odor may be perceived in the breath. There is pain and oppression in the region of the stomach, malaise, eructation of phosphoric vapors having a garlicky odor; and these may be luminous in the dark. Vomiting is sometimes frequent and violent; in other cases quiet and at longer intervals. The abdomen is distended. Purging is not common. The vomited matters are coffee-colored, or yellow and bilious, and may be iuminous. There is intense thirst. The symptoms may increase in severity, ending in death from collapse in the course of a few hours-four to eight in the worst cases.

Nevertheless, in the majority of cases the progress to a fatal termination, though no less sure, is slower and more insidious. The irritant symptoms in a great measure subside; and, though the pulse is feeble and there is a certain amount of malaise, the patient may, to a casual observer, appear to be in an almost normal state of health. But after the lapse of three or four days, jaundice sets in and rapidly increases; there is great prostration of strength; the abdomen becomes distended; the liver is observed to be greatly enlarged, and vomiting of altered blood may come on, with intense thirst; the skin is cold; the pulse feeble, rapid, and perhaps imperceptible at the wrist; the urine is scanty and high-colored, and contains casts from the kidneys. The feces, previously suppressed, are now more abundant and contain blood. Coma sets in, with jactitation of the limbs, or muscular twitchings; and the patient succumbs, generally five or six days after the administration of the poison.

A female, æt. 20, took several doses of phosphorus-paste; the first on the evening of January 11, 1877. The dose was repeated twice on the 12th. The quantity of paste taken was of the size of a large cobnut, containing about two grains of phosphorus. On the morning of the 13th she retched, and at midday her appetite failed at dinner, and in the evening she vomited. At 10 P.M. on the 14th she was first seen by Tyson, about seventy-two hours after the first, and forty-eight hours after the last dose was taken. She had then an excited aspect, and her breath had a phosphoric odor. There was tenderness over the region of the stomach. On the 15th there was faint yellowness of the conjunctive of the eyes, slight pain in the stomach, and nausea, but no vomiting. The urine was highcolored and turbid. On the 16th there was decided jaundice, great thirst, and prostration. There was still a slight garlicky odor of the breath; but the urine and feces showed no luminosity. There was no obvious enlargement of either the liver or the spleen. On the 17th the liver was enlarged; only a very little dark-colored urine was passed; and there was much epigastric pain and tenderness. In the evening there was slight delirium. From this time she gradually sank, and died on the 18th, nearly a week after the administration of the first dose of the poison. On post-mortem examination the liver was found to be of the usual size, but it had undergone extensive fatty degeneration, as had the heart also. There was no marked appearance in the stomach, which was almost filled with a blackish syrupy liquid. (Guy's Hosp. Rep., 1877, xxii. p. 452.) In 1876 a woman, and her daughter æt. 5, each drank some phosphorus

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PHOSPHORUS-CHRONIC POISONING.

paste in warm water. The woman was seen four days later, apparently in her usual health. Subsequently she sickened, became jaundiced, and died, a week after the poison was swallowed. The child exhibited no symptoms till 7 A. M. on the day after taking the poison. She then vomited some slimy material, and her breath had a garlicky odor. In a few hours she was in a state of semi-collapse. Next day she became drowsy, then thirsty, restless, and vomited constantly. There was no jaundice. She died fifty-nine hours after the administration of the poison. On post-mortem examination, the heart was found to have undergone fatty degeneration, and it and the aorta exhibited ecchymosed patches. The stomach was considerably injected, and its surface was thickly coated with tenacious mucus. The small intestine was much congested at its commencement, and to a less degree lower down. The liver weighed twenty-six ounces, was yellow, anæmic, and showed extreme fatty degeneration, except in isolated patches. In neither of these cases could the dose of phosphorus taken be ascertained. (Guy's Hosp. Rep., 1877, xxii. p. 449.)

Chronic poisoning.-Phosphorus-vapor.-Chronic poisoning by phosphorus is accompanied by nauseous eructations, frequent vomiting, a sense of heat in the stomach, purging, straining, pains in the joints, wasting, hectic fever, and disease of the stomach, under which the patient slowly sinks. Some interest is attached to the chronic form of poisoning with phosphorus from the researches of Strohl and others on the effects of the vapor upon persons engaged in the manufacture of phosphorus or lucifer matches. It has been remarked that such persons have suffered from necrosis of the jaw, carious teeth, and abscesses. There has been also great irritation of the respiratory organs, and bronchitis has frequently shown itself among them. (See ON POISONS, 2d edit. p. 345.) Cases of chronic phosphorus-poisoning are now of great rarity, owing to the precautions adopted among workers in phosphorus to prevent the introduction of the poison into the system. The fumes of phosphorus pills may cause necrosis.

The

Appearances.-Among the appearances produced by phosphorus are marks of irritation and inflammation in the stomach and intestines. stomach has been found much contracted, and its mucous membrane inflamed, occasionally softened, and presenting purple or violet-colored spots. In one fatal case the body was found in a state of great muscular rigidity. The membranes of the brain were congested, and there was serous effusion between them. The heart was flaccid and nearly empty. The mucous membrane of the stomach, gullet, and small intestines was very red, and there were patches in which the membrane was destroyed. When the stomach was opened, a white vapor escaped, accompanied by a strong smell of phosphorus. This organ contained a tablespoonful of a viscid greenish matter, from which particles of phosphorus with some Prussian blue (used as a coloring for the phosphorus-paste) subsided on standing. (Lancet, 1857, i. p. 600.) The mucous membrane has been found raised in small bladders or vesications, but this appearance was probably owing to putrefaction, as the body was not examined until twenty-three days after death. Schuchardt describes the blood as dark and fluid, and it does not become red on exposure to the air. Ecchymoses are sometimes found on the skin, on the surfaces of various organs, and on the lining membrane of the aorta. (Brit. and For. Med. Rev., 1857, vol. 19, p. 506; Jour. de Chim. Méd., 1857, p. 84.) The most remarkable appearance met with in the acute form of poisoning is fatty degeneration of the voluntary muscles and other organs.