6. Poisoning from arsenic.

Date:
[1820?]
Catalogue details

Licence: Public Domain Mark

Credit: 6. Poisoning from arsenic. Source: Wellcome Collection.

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    Remarks on the Use of Nitric Acid as a substitute for Blisters, by Mr Assistant Surgeon Killett. We hear much of the successful application of firing by the native practitioners; and it is common to hear a farrier say of a horse, “ blister him, and if don't do, fire him, which never fails.*” The cautery is an ancient remedy fallen into disuse, but which nevertheless appeared to possess peculiar virtues. Though, admitting the fact, that firing was more efficacious than cantharides blisters, I had no defined notions in what this superiority lay, but I could not impute it merely to difference in the degree of action, for the blisters used with horses seem often more painful than firing. The substitution of nitric acid for cantharides blisters in cholera has given me opportunities of making some observations on its mode of action, which appear to me elucidatory of the subject. Seeing the quickness of action of the acid in cases of cholera, and that it could be applied under any circumstances of frenzy or unruly conduct, I have been led to employ it in those cases of severe disorder in the stomach and bowels, consequent on excessive drinking, where the promptitude is of vital importance, and where common blisters are altogether useless and inapplica¬ ble ; also in cases of acute and sudden pain from other causes, in hepatitis, and so forth ; wherever the disease depends on spasm, or nervous irritation, the relief is wonderfully sudden; and when it is connected with inflammation, I think it is fully as certain, and more speedy, than after common blisters. The pain, upon the whole, is represented as sharper than that caused by blisters, though some patients say not; but the chief point is, that it reaches its acme in two minutes; it continues severe for three hours, and in three more altogether ceases. It is in this quickness of action that it resembles the actual cautery, and to this therefore I impute the greater efficacy of both, for, it is reasonable to conclude, that the effect will be as the inten¬ sity of the cause ; we may compare it to the shock produced by the sudden affusion of cold water on the surface, which, under a different management, may be altogether avoided. ‘But the acid possesses other advantages. Whoever has felt the tedious progressive pain of a blister, the w'earisomeness and irritation produced, and the agony of motion ; the sickness and disgust of the dressing, and the after sickly smell, itchiness, &c.', will be disposed almost to suffer any pain rather than submit to a repetition ; it is also obvious, that all these circumstances must have their bad effects on the patient. But the action of the acid