144

POISONING WITH RED PRECIPITATE.

in eight ounces of lime-water. In a few days he had fetor of t swelling and tenderness of the gums, with salivation. (Brit. M 1878, i. p. 367.)

Analysis. It is known from corrosive sublimate by its inso water, alcohol, and ether. It is known from white precipita insolubility in acids and by its being blackened by alkalies. A sublimate may be obtained from it by heating it with dry sodium Under certain conditions, this compound may be changed into sublimate in the stomach. (Pharm. Jour., Aug. 31, 1878, p. 16 WHITE PRECIPITATE. Ammoniated Mercury.-The sympto this compound produces are violent vomiting, cramps, great thi ing, pain in the stomach and bowels, and convulsions. Tendern gums and salivation have been observed. After death the inflammation of the stomach and bowels are seen. Experiment and rabbits have shown that this is a formidable poison. Th number of recoveries have been probably owing to the substar early ejected by vomiting. Rabbits (which do not vomit) were doses of four and five grains in a few hours. After death, mer found deposited in various organs, but more in the kidneys th other viscera. (For additional facts connected with the actio poison, see Guy's Hosp. Rep., 1860, p. 483.) A trial for atten poison by this substance took place in 1869. (Reg. v. Seaham, M Sum. Ass., 1869.) The compound is white, but, as the result of it gave a yellow color to the gruel in which it was administered. v. Hargreaves (Manchester Lent Ass., 1866), a girl was convict attempt to poison her father by this substance. The poison was milk and medicine. It produced a burning sensation in the th stomach, and thus led to suspicion. About ten grains of white p were detected in some buttermilk. In February, 1873, a boy, æt convicted, at the Central Criminal Court, of administering th feloniously in medicine. The prosecutor experienced a hot sensa like the bitter taste he had before perceived. A white powder w in the medicine, which proved to be white precipitate.

Analysis. White precipitate is a chalky-looking compound co about eighty per cent. of mercury. It is insoluble in water and As sold, it frequently contains, as an impurity, corrosive sublima amount of one or two per cent., separable by ether or alcohol. uble in acids, not blackened by alkalies, and yields a mercurial s when heated with carbonate of sodium. Stannous chloride prod it a black deposit of mercury. If boiled in a solution of potash, it ammonia and yellow oxide of mercury is formed. It may be de organic liquids and solids by boiling them in one part of hyd acid and four parts of water. The mercury may then be separ means of copper (see p. 143). It is not used internally, but it employed by the poorer classes in the treatment of ringworm.

RED PRECIPITATE. Mercuric Oxide. Red Oxide of Mercur substance is poisonous, but instances of poisoning by it are ran case occurred at Guy's Hospital in 1833. The patient recovered days. In another case a woman, æt. 20, swallowed a quantity containing red precipitate. Four hours after she was in a state of with a weak, irregular, scarcely perceptible pulse, dilated pupils, clammy skin, and copious discharge from the mouth. She had once shortly before, and red particles were seen in the ejected fluid. was pain in the abdomen. Under treatment the symptoms aba there was pain in the region of the stomach, a desire to vomit, m

SUGAR OF LEAD-SYMPTOMS.

145

vation, and slight diarrhoea. She gradually recovered. (Brit. Med. Jour., ISTS, i. p. 101.) A case of recovery after the administration of 120 crains has been recorded. (Brit. Med. Jour., 1884, i. p. 56.)

Analysis. By its great density and insolubility in water it may be parated from all liquids. Its red color is characteristic. When heated a a closed tube, it is resolved into oxygen and mercury, the latter being deposited in globules.

Other compounds of mercury, such as the nitrates, the sulphates, the vanide, and the sulphocyanide, have given rise to accidents, and in a few stances have destroyed life, but they very rarely require the notice of a dical practitioner. In February, 1891, two men died from the external plication of nitrate of mercury as a remedy for an eruption of the skin. The sulphide (vermilion), on account of its insolubility, is probably quite

ert.

When heated in a dry state with anhydrous carbonate of sodium, all the compounds of mercury yield sublimates of the metal in globules. All liquid and solid compounds give a dark precipitate of mercury when olled with stannous chloride.

CHAPTER XIII.

PSONING WITH

DEATH.

LEAD.-SUGAR OF LEAD.-SYMPTOMS.-APPEARANCES AFTER CHEMICAL ANALYSIS-LEAD IN ORGANIC MIXTURES.-RED LEAD.-CARBONATE OR WHITE LEAD CHRONIC POISONING.-POISONING WITH COPPER.-BLUE VITRIOL.-SYMPTOMS.APPEARANCES.-CHEMICAL ANALYSIS.-COPPER IN ORGANIC LIQUIDS.

SUGAR OF LEAD.

Acetate of Lead-Symptoms.-Acetate or sugar of lead is by no means an active poison. In medical practice it has often been given in considere doses without any serious effects resulting. When from one to two onces have been taken, the following symptoms have been observed: a arning, pricking sensation in the throat, with dryness and thirst, vomit2, and uneasiness at the pit of the stomach, followed by severe colic. The abdomen is tense, and the skin covering it is sometimes drawn in. The pain is intermittent and relieved by pressure. There is generally Constipation of the bowels. If any feces are passed, they are commonly f a dark color, indicative of the conversion of a portion of the lead into hide. The skin is cold, and there is great prostration of strength. The pulse is slow. When the case is protracted, the patient has been observed to suffer from cramp in the calves of the legs, pain in the inside of the thighs, numbness, and sometimes paralysis of the limbs. The action of the nervous system is otherwise indicated by giddiness, torpor, and even coma. A well-marked blue line has been noticed round the margin of the gums, where they join the teeth. (For a remarkable series of cases of poisoning by acetate of lead, see Lancet, 1849, i. p. 478.) In 1882 a woman was convicted (Reg. v. Louisa Jane Taylor, C. c. c., Dec. 1882) of the murder of Mrs. Tregelles, an aged female, by the repeated administration of acetate of lead. The administration extended over several weeks; and the editor found the body largely impregnated with

146

SUGAR OF LEAD-CHEMICAL ANALYSIS.

lead--more especially the stomach. The symptoms were colic, blackening of the teeth, paralysis, and at the last epileptiform con Appearances. In one fatal case of acute poisoning the muc brane of the stomach was destroyed in several places, especially intestinal opening, and the greater part of the intestines were of acute inflammation. In animals, according to Mitscherlich, dose is large the mucous coat of the stomach is attacked and this change appears to be purely chemical, and takes place in th of the body with which the salt of lead comes in contact. If a small dose, it is decomposed by the gastric secretions and corrosive action on the mucous membrane. When acetate of given in a state of albuminate dissolved in acetic acid, death t with great rapidity; but on inspection, the stomach was not f roded. This corrosive action belongs to the neutral salt, and is fested when the dose is small or when the poison is combined acid. Nothing is actually known concerning the fatal dose of stance; but it may be taken in comparatively large quantity wit ducing serious effects. Thirty or forty grains have been given divided doses without injury.

Chemical Analysis. Acetate of Lead as a solid.-1. If a p the powder is heated in a small reduction-tube, it melts, then solid; again melts, acquiring a dark color, and gives off vapor tone and acetic acid, easily recognized by their odor and rea litmus-paper. A black mass is left in the tube, consisting of ca reduced metallic lead. No sublimate is formed. If heated yellow oxide of lead with reduced metal remains. 2. It is ver even in cold water; spring water containing carbonic acid and is turned milky by it. 3. A small portion of the powder droppe solution of iodide of potassium acquires a bright yellow color. dropped into solution of potash it remains white. 5. In sulp hydrogen water or sulphide of ammonium it is turned black, respect it resembles the white salts of some other metals. 6. W powder is boiled in a tube with diluted sulphuric acid, acetic acid by its odor and volatility, escapes. All these properties taken prove that the salt is acetate of lead.

Acetate of Lead in solution.-1. A small quantity, slowly ev on a glass slide, will give slender white prismatic crystals (see

Fig. 15.

which are turned yellow by iodide sium and black by sulphide of am 2. Diluted sulphuric acid prod abundant white precipitate, insol nitric acid, but soluble in hydrochlo and in a large excess of potash. precipitated of a yellow color by i potassium. The yellow iodide of soluble in potash, forming a colorle tion. It is also dissolved by conc hydrochloric acid and by hot wa Sulphide of ammonium, or sulp hydrogen gas, produces a black pre even when less than a 100,000th par salt is dissolved. 5. Place a few d the solution on clean platinum-foil, a with acetic acid, then apply, through the solution, to the surface platinum a thin slip of polished zinc-dark-bluish crystals of

Crystals of Acetate of Lead, magnified 80 diameters.

DETECTION OF LEAD IN THE TISSUES.

147

lead are instantly deposited on the zine; by this method a small quantity of the metal may be detected and separated.

Lead in organic liquids.-Acetate of lead is precipitated by many organic substances, especially by albumen and tannin. Thus we may Lave to analyze either an organic liquid containing lead, or a solid precinitate consisting of mucus or mucous membrane, or albumen combined with lead. The liquid should be filtered and examined by a trial test, i. e. either by adding to a portion sulphuric acid, when sulphate of lead is precipitated, or by exposing filter paper, dipped into the suspected liquid, To a current of sulphuretted hydrogen gas. If the paper is not stained brown, there is not much lead dissolved; if it is stained brown, we dilute the liquid to destroy its viscidity, should this be necessary, and pass into it a current of washed sulphuretted hydrogen gas until a precipitate ceases to form. The black sulphide of lead should be collected on a filter, washed, and dried; then boiled for a quarter of an hour in a mixture of one part of nitric acid diluted with four parts of water. This has the effect of transforming it, at least in part, into soluble nitrate of lead. This liquid, when filtered, may be evaporated to dryness, the crystalline residue disolved in water, and the tests for lead then applied to the solution. If the quantity is too small for the application of all the tests, we may first add sulphuric acid; should a white precipitate be formed, soluble in potash free from lead), and this alkaline solution be again turned black by sulphide of ammonium, this is sufficient evidence of the presence of lead. Should there be no lead dissolved, we must decompose the solid and insoluble matters by boiling them with dilute nitric acid, filter, and test the filtered liquid, previously neutralized; or we may evaporate at once to dryness, destroy the organic matter by heat, and redissolve the residue in nitric acid for testing.

In the tissues. The organic matter, such as a part of the liver or any other organ, should be dried, and afterwards incinerated in a porcelain vessel. The ash should be heated with a small quantity of dilute nitric acid and evaporated to dryness. The dry residue should be digested in a small quantity of distilled water (free from lead), filtered, and, after it has been slightly acidulated with nitric acid, a current of washed sulphuretted hydrogen gas should be passed into it. The production of a brown elor or a brown precipitate in a slightly acid liquid indicates the presence of lead. The precipitate may be dissolved in nitric acid and further examined. Lead may thus be detected in the dry residue of urine. All Equid and solid organic substances containing lead yield the metal or its oxide by incineration in a porcelain capsule.

Goulard's Extract is a solution of subacetate of lead, containing thirty-five per cent. of the salt; and Goulard Water is a mixture of two drachms of this solution in a pint of water. The effects of these compounds, when swallowed or applied locally, are similar to those produced by the acetate, but are more severe.

RED LEAD. This is a mixture or compound of the protoxide and peroxide of lead, much used in the arts. It has occasionally acted as a fatal poison. Dey relates the case of a woman who died from its effects in . four or five hours, after convulsions. (Lond. Med. Rec., 1882, p. 117.) WHITE LEAD. Subcarbonate of Lead.-This is an insoluble, chalkyLoking compound, which, like other salts of lead, may give rise to the sual symptoms of lead-poisoning. In one instance it appears to have proved fatal. White lead has been used as a cosmetic to give a fair complexion. It is liable to absorption, and to cause the usual symptoms of poisoning. The cosmetic liquid of Madame Rachel consisted of a lead

148

CHRONIC LEAD-POISONING.

compound with fuller's-earth, starch, and hydrochloric acid. Su pound applied to the skin clearly would set up irritation in the be most injurious to health. Most of the cases of poisoning by stance have been of a chronic character, carbonate of lead bein the products of the action of water upon lead. Buchner has also the history of a family poisoned by lead accidentally introduced lead into flour in a mill. (Freidreich's Blätt. f. Gerichtl. Med. 161.)

Chronic Poisoning.-Colica Pictonum, or Painter's Colic, considered as the usual chronic form of poisoning by carbonate The disease is not, however, confined to an affection of the intest (colic), though this is the most common symptom. There is a form of paralysis-lead paralysis, or "wrist-drop;" pains in th often termed "rheumatic;" and a peculiar form of cerebral affec fatal character, the prominent symptoms of which are epileptoid sions simulating ordinary epilepsy and ending in coma. The s of lead-colic are usually well marked. There is at first pain, wit. of sinking commonly in or about the region of the navel (the sea colon). Next to pain there is obstinate constipation, retractio skin of the abdomen, loss of appetite, thirst, a fetid odor of the and general emaciation; with paralysis of a peculiar kind affed extensor muscles, and causing a dropping of the wrist, or showi in a general paralysis of the limbs. The skin acquires a sallo generally well marked in the face; and the patient experiences a s styptic, or astringent taste in the mouth. A symptom of a nature was first pointed out by Burton (Med. Gaz., vol. 25, namely, a blue line on the edge of the gums where these join th of the teeth; the teeth are of a brownish color. The blue line gums may be regarded as a distinguishing sign of lead poisoning owing to the deposition of lead in these structures—a fact proved action of chromic acid on the excised gums. When touched with acquire a yellow color (chromate of lead), and when afterwards with an alkaline sulphide they become black from the form: sulphide of lead. (Lancet, 1878, i. p. 913.)

Lead-palsy usually comes on after several attacks of colic. I itself first, and most prominently, in the extensor muscles of the -the muscles supplied by the musculo-spiral nerve; hence the su longus muscle escapes. The disease, however, is not always to the forearm. The dropped hand, and the inability to raise rise to the term "dropped wrist." Epileptiform convulsions en coma are a late affection, in severe cases, as e. g. among workers in lead factories, and are commonly a fatal affection. The editor with several such cases.

Hair-washes generally contain a salt of lead in solution. The them may lead to all the symptoms of chronic lead-poisoning.

Chronic poisoning with lead often kills the patient, since a great of mischief is usually done before the cause is discovered. The appea found after death have been a contraction of the cavity of the lar small intestines, a considerable thickening of their coats, and degen of the kidneys. The contractions have been especially noticed in th -the seat of colic. The various circumstances under which this f poisoning is liable to occur are elsewhere fully described. (See ON P p. 409.)

One of the most frequent causes of chronic lead-poisoning is the water kept in leaden cisterns or pipes; or the careless employm