A treatise on therapeutics : comprising materia medica and toxicology with especial reference to the application of the physiological action of drugs to clinical medicine / by H. C. Wood.

  • Wood, H. C., Jr. (Horatio C.), 1841-1920.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on therapeutics : comprising materia medica and toxicology with especial reference to the application of the physiological action of drugs to clinical medicine / by H. C. Wood. Source: Wellcome Collection.

    114/740 (page 110)
    direct evidence of poisoning. Tliis phosphorescence, liowever, very often cannot be detected: according to Vetter ( Virchow's Archiv, Bd. liii. p. 18G) it can be rendered more evident in the vomit, stools, etc., by acidifying with sulphuric acid and warming in a shallow dish. When death ensues during the first week of phosphorus-poisoning, the enlarged liver affords a distinctive proof of poisoning; but when the case is more protracted, the atrophied liver of phosphorus cannot be distingTiished from that of the natural disease. The symptoms during life rarely, if ever, afford sufficient ground for a positive diagnosis. The lull in the symptoms after the first onset of the disease hap- pens more generally in phosphorus-poisoning than in yellow atrophy. Yet the clinical differences between various cases of either affection ai-e greater than those which have been relied upon as separating the two affections. Kbhler has asserted that oxymandelic acid in atrophy of the liver replaces the sarco-lactic acid of phosphorus-poisoning, and stress has been laid upon the asserted facts that in the natural disease leucin and tyrosin are present in abundance in the urine, whilst in the poisoning they are absent. In yellow atrophy, however, tyi-osin is not unfrequently absent from the urine, and leucin present in very small amount, whilst the contrary has already been stated to occur in some cases of phosphorus-poisoning.* In regard to the acids in the urine, very careful chemical analysis would in any case be necessary to deter- mine the presence of either of them, and sufficient evidence is certainly not yet forthcoming to show that either of them is really characteristic. Chemical examination is then absolutely necessary in all medico-legal cases. (For dis- cussions of the diagnosis between yellow atrophy and phosphorus-poisoning, see Kohler, Sydenham Tear-^oo/c, 1870,p. 455 ; Schultzen and Ries, ^/maZcH desBerlin. Krankeiihaitses,Bd.xx., 1869; and especially Dr. I. Ossikovsky, Wien. Medizin. Presse, xiii., 1872, abstracted in Schmidt's Jahrbucher, Bd. cliv. p. 15. For cases m which the question was legally raised, investi- gated, and discussed, see Schmidt's Jahrh., Bd. cxli. p. 167 ; Si/d. Year-Booh, 1832,' p. 430 ; Annales d'Hygihie, Jan. 1869.) According to M. Poulet (Gaz. 3Ied. de Paris, Aug. 1872) phosphorus is eliminated as hypophospboric acid and the poisoning can be recognized by heating the urine with nitric acid to calcination. If hypophospboric acid be present, as dryness is reached the mixture suddenly bursts into a flame like a packet of matches. It has of late years been demonstrated that phosphoras passes mto the blood as phosphorus, and not in the form of phosphoric acid or other com- pound In poisoning-cases in men the breath is said sometimes to be dis- tinctly phosphorescent; and in animals Bamberger has found phosphorus in the blood, and Ilusemann and Mamie in the liver, two or three hours after ts in^esti^n ; W. Dybkowsky (Hoj^pe-Seller s Mediamsch-chennsche Unter- 22nL, Heft i. p 54) has detected it in the blood and liver ten hours after tstStion- and othe observers have demonstrated its presence in almost ro/Hs'sues. I^seems^ro^^ » Case, Schmidt's Jahrb., Bd. 169, p. 127.