ing, as, in the practice of medicine, on account of their giving us a very significant warning when we are trying arsenic as a remedy, that we have pushed it to the utmost that any prudent practitioner would venture upon. Where the dose of poison is somewhat greater, but not sufficient to produce death, violent vomiting is commonly the first symptom; although, in some instances, it is preceded by a sense of heat in the tongue and throat; in other cases, these sensations are expressly mentioned as not felt in the whole course of the disease. In these cases, when the vomiting is instant, and the poison has been taken on a full stomach, the patient seems to owe his escape to the poison being discharged before it has time to act. The next symptom which claims our attention is the purging, sometimes of blood; but purging occurs less frequently in this slight degree of poisoning than in the more severe cases. In the region of the stomach and bowels, pain is frequently felt; but it is often rather an insupportable uneasiness and oppression than pain properly so called. The stomach is not described as swelling; and in one case, where there was hiccup, eructation, and difficulty of breathing, it is expressly mentioned, that it was not tense or swelled.

A sensation of coldness, especially in the extremities, and cold sweat, seems to have been almost always present, with general paleness, and paleness of the countenance, in some cases languor, faintishness, and a tendency to sleep. In this degree of poisoning, convulsions are not frequently observed, and the thirst and fever seem to arise from irritation in some persons, as they are seldom expressed. In one case only, is ardor urinae mentioned.

In the second degree of poisoning from arsenic, where the patient lives above a day or two, the first complaints are heat and thirst, or vomiting, or inexpressible distress; the first is less frequently observed than the other two. In one case, of an infant killed by orpiment, the matter vomited is described as viscid and colourless. Purging is not mentioned in any of the cases of this set; but in one a fetid stool was procured by a pessary, and in one gripes are noticed; in two the belly swelled; in one there was great feebleness and lassitude; and in all, convulsions scemed to have taken place, in one case impeding deglutition. In three of the cases, the body is mentioned as having been discoloured, or marked with livid spots; in one even blistered, and one was highly fetid. Two only were examined internally. In one, the intestines were inflated, and the intestines and stomach red with turgid vessels; in the other, the fauces and stomach were yellow, and the heart, spleen, and lungs, dark blue. The cases of this class are too few to afford any accurate inferences; besides, from the length of time, there is greater opportunity for

the cooperation of other causes, whether previously existing disease, or the action of remedies.

In the third degree of poisoning by arsenic, where death takes place in a few hours, the symptoms succeed each other rapidly, or begin at the same time; the fainting and general debility almost precede the vomiting; the vomiting occurred in all the cases but two; purging or gripes in most of the cases; the matter passed by stool is in one case described as green, watery, and viscid. In one case, there was vertigo, also general pains, and loss of speech. Convulsions did not occur often; but there was sometimes hiccup. In a few cases, there was much heat and thirst; even in one, in which (a symptom more frequent than heat) there were complaints of a sensation of intense cold and paralysis of the extremities, with cold sweat. The pulse, in the only case in which it is mentioned, was slow and languid; and death seems to have generally proceeded from exhaustion and rapid sinking of the vital powers. In none of these violent cases, is there any mention of delirium, or affection of the mind, except in one in which the poison was applied externally to the head.

The external appearance of the body after death is not uniform. In some cases, it was swelled or livid; in others, natural. The stomach in almost every instance is inflamed, abraded, or even eroded; sometimes distended, and at others corrugated. Next to the stomach and intestines, the lungs seem most frequently affected; as in almost every case in which the thorax appears to have been opened, they are described as livid, or having livid spots on their surface. In one case, they are inflated; and in another, flaccid. The liver is only mentioned in one case as grey, and the heart in another as flaccid. The blood seems to have differed very considerably; at one time being black and coagulated; at another, black and fluid; and at a third, florid and fluid.

In many of the cases, the remains of the poison are actually found in the stomach, generally adhering to the inflamed points, to which it is probably fixed by coagulating the glairy fluid lining

the stomach.

IV.

Nouvelles Expériences sur les Contre-Poisons de l'Arsenic. Par CASIMIR RENAULT, Médecin, Membre-correspondant des Sociétés Académique des Sciences, Médicale d'Emulation et d'Instruction. A Paris, an IX. pp. 119.

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HIS work, upon another branch of the same subject, has only fallen lately into our hands. It is also worthy of perusal, and is in a great measure founded on actual experiments made by the author.

He commences with some general considerations on counterpoisons. All gastric poisons may be arranged into two classes, into corrosive and narcotic poisons. The action of the latter may be interrupted by a strong reaction of the vital forces; that of the former only by a change in their nature, which cannot be effected on the mineral poisons of this class but by chemical re-agents capable of converting them into innocuous substances. Taking arsenic as an example, M. Renault is of opinion, that only those re-agents can be considered as antidotes to it which fulfil the following conditions.

1. Which may be taken in large doses without any danger. 2. Which are soluble in water and the animal fluids.

3. Which act upon the poison, whether in a fluid or in a solid state, at a temperature inferior to that of the human body. 4. Whose action is speedy.

5. Which are capable of combining with the arsenious acid in the midst of the juices and contents of the stomach.

6. And which, in acting upon the poison, deprive it of all its deleterious qualities.

We shall pass over our author's chemical critique on Navier's directions for preparing his celebrated martial hepar, and proceed to his own experiments, which were all made upon dogs, with every precaution to render them as little complicated as possible. He had to overcome the difficulty of forcing the dogs to swallow the fluid, and to retain it after it was swallowed. The first object he accomplished satisfactorily, by keeping the dog's mouth open by a piece of stick placed between the grinders, and injecting the fluids through a tube of elastic gum, introduced into the stomach; but the second was only imperfectly effected, by his never leaving the subject of experiment a moment, and forcibly keeping the muzzle closed by strong compression with the hands, as soon as the precursory signs of vomiting appeared.

His first experiments were made to ascertain the powers of sulphuret of potass, which is generally considered as the most powerful antidote of arsenic. Upon mixing solutions of these substances they instantly become turbid, and afterwards deposit a yellow precipitate. This mixture, after diffusing the precipitate through it, he injected into the stomach, and, in one instance, he used the precipitate diffused in water; but neither the sulphuret of potass nor that of lime seemed to retard or diminish the deleterious effects of arsenic. Vomiting, purging, moaning, and prostration of strength, were the almost invariable harbingers of death. On dissection, the stomach was found to be inflamed or livid, generally filled with a glairy fluid like white of egg, often interspersed with flocculi like coagulated albumen, and its surface was sometimes lined with a consistent pseudomembrane of the same nature.

Water impregnated with sulphuretted hydrogen was next employed, and with some success. A single grain of arsenic is sufficient to kill the strongest dog; and yet, in ten instances, our author gave it in solution, in one to the extent of even ten grains without proving fatal, even although the arsenical solution was given some minutes before the hydrosulphuret. It only remained then to try its effect against arsenic in substance; and here it most unfortunately failed completely; as, in almost every instance of poisoning, the arsenic is used in substance.

M. Renault has examined whether arsenic in its metallic state be a poison. Some experiments of Bayen and Sage seemed to prove the negative; but they were not conclusive. As it is almost impossible to reduce arsenic to powder without its becoming oxidized, our author had recourse to its alloys for deciding the question; and he found that mispickel, given to the extent of two drachms, had scarcely any effect; which accords with the conclusion drawn by Bayen in his work on tin, and proves that the arsenic which may be contained in that metal need give no uneasiness, as it is in its metallic state.

The black oxide of arsenic is, however, a deadly poison, and it has the singular property, that when it acts sufficiently, it produces in the stomach an exudation of blood, and infiltration of the same between the coats of that viscus, without any trace of erosion. A dark grey pulverulent substance, sold publicly in France under the names of poudre aux mouches, mort aux mouches, cobalt testacé, is in fact the black oxide of arsenic, and produces exactly the same effects. Our author therefore contends, and properly, that its sale should be subjected to the same restrictions as the white oxide and sulphurets of arsenic.

The native sulphurets, both red and yellow, were given in. large doses to dogs without producing any severe effects; the artificial sulphuret was poisonous even in a small dose. M. Renault thinks that this remarkable difference of effect is owing to the arsenic being oxidized in the latter compound, and in its metallic state in the former.

The salutary effects of vomiting, so often apparent in M. Renault's experiments, have led him into a digression upon the mechanical causes of vomiting, and from thence to some practieal inferences concerning the treatment in cases of poisoning. Having proved the inefficacy of all antidotes, M. Renault places his only hopes in exciting speedy and full vomiting; and as a full stomach has been found by experience to diminish and counteract the effects of poison, and is highly favourable to vomiting, he advises the gorging of it with mucilaginous and gelatinous li quors, such as linseed tea, milk, broths, or even with warm waAs vomiting, however, is certainly the chief means of saving a person who is poisoned, and as it does not always take place immediately, our author has proposed a method of washing out and emptying the stomach mechanically, by means of a large tube of elastic gum and a syringe. We shall give the particulars in his own words.

ter.

"The tube should be long enough to have one of its ends, which should have two orifices, inserted into the lowest part of the stomach, and of a diameter large enough to permit the passage of the half-digested substances which may be in it. At its upper end it should have a brass cup adapted to the extremity of a syringe. The tube is to be introduced through the mouth or nostrils, and the syringe fitted. to it. We are now to throw gently into the stomach a certain quantity of liquid to dilute, suspend, or dissolve the poison. We then draw back the piston, and suck up a certain quantity of the contents of the stomach. By repeating these two operations several times, this viscus will be well washed, and the poison extracted from it without effort, almost without pain, and in a very short time. Provided the poison have not passed the pylorus, the possibility of extracting it in the method I propose, will be evident to all who have any knowledge of mechanical philosophy. When its efficacy shall have been established by trials on the human body, its use may be. come very extended. Until experience shall have decided this, I have made some trials on living animals. I have injected to the extent of eight ounces of water into the stomach of several small dogs, and have been able to pump it entirely out by the procedure I have described. Indeed it could not be otherwise, when we consider with what success similar means are used for emptying the bladder of coagulated blood.”

In the after treatment, our author judiciously recommends bland nutritive fluids as preferable to all reputed antidotes, which