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ELEMENTS OF MATERIA MEDICA.

are, in part, such as might be expected from this violent local disorder:thus the pulse is quick, but at the same time small, feeble, and irregular:there are cold clammy sweats; the action of the heart is irregular,giving rise to palpitation ; the breathing is short, laborious, and oftenpainful; the tongue is dry and furred; and the membrane lining the air-passages feels hot, and oftentimes painful.

Although, in this form of acute arsenical poisoning, the gastro-enteritisis the principal, and in some cases almost the only affection, yet there aregenerally observed some symptoms indicative of disorder of the cerebro-spinal system: sometimes in the form of tremblings or cramps of thelimbs, or delirium, and even, in the last stage, insensibility. Occasion-ally, also, eruptions take place.

In this form of poisoning, death usually occurs in from twenty-fourhours to three days after the administration of arsenic; but Dr. Chris-tison says that Pyl has recorded a case where death occurred in threehours after swallowing the poison.

Form, 2d: Acute poisoning with narcotism , without any remarkablesymptoms of gastro-enteritis. —In some cases of poisoning, in both manand animals, the symptoms are those indicating disorder of the cerebro-spinal and vascular systems: abdominal pain, vomiting, and purging,being either altogether absent or very slight. The symptoms are usuallyfaintness, or perhaps actual syncope, convulsions, or paralysis; and,sometimes, insensibility; at other times, delirium. These symptoms con-stitute the state called narcotism. Of this form of arsenical poisoning(which is somewhat rare) Dr. Christison has given an abstract of twelverecorded cases. In most of them the quantity of arsenious acid takenwas very large; for example, half an ounce, or even an ounce.

Form 3 d: Acute poisoning with symptoms of gastro-enteritis, followedby an affection of the cerebro-spinal system.— In this form of poisoningwe have at first the usual gastro-enteritic symptoms, and which I havealready described under the first form of poisoning. When, from thesmallness of the dose, or from other circumstances, the patient recoversfrom the gastro-enteritis, symptoms of a cerebro-spinal affection some-times make their appearance. The kind of disorder, however, varies con-siderably in different individuals. “ The most formidable,” says Dr.Christison, “ is coma; the slightest, a peculiar imperfect palsy of thearms or legs, resembling what is occasioned by the poison of lead; andbetween these extremes have been observed epileptic fits, or tetanus, oran affection resembling hysteria, or madness.”

In a medico-legal point of view it is important to determine what isthe smallest fatal dose of arsenious acid. It is not easy, however, to givea positive answer to this question. Dr. Christison says, “ the smallestactually fatal dose I have hitherto found recorded is 4£ grains. Thesubject was a child four years old, and death occurred in six hours. Inthis instance, however, the poison was taken in solution.” The powerfuleffects sometimes produced by j, or \ a grain, lead us to suspect that1 grain might produce death ; but we have no recorded case of this.Hahnemann says, 1 or 2 grains may prove fatal in a few days : and Dr.Christison remarks, that this statement cannot be very wide of the truth.

Of course a repetition of much smaller quantities might cause death.However, under certain circumstances, enormous quantities have been ;swallowed with very trivial effects. Some years ago I opened the body iof a man who destroyed himself by taking arsenic, and I was informed i ;