Treatise on Poisons by Sir Robert Christison

OF POISONING WITH HYOSCYAMUS, LACTUCA, AND SOLANUM. _Of Poisoning with Hyoscyamus._—Of the narcotic poisons none bears so close a resemblance to opium in its properties as the _hyoscyamus_ or henbane. Several species are poisonous; but the only one that has been examined with care is the _H. niger_, from which the extract of the apothecary is prepared. The hyoscyamus has been analyzed by various chemists, and found to contain a peculiar alkaloid, in which the properties of the plant are concentrated. It is named hyoscyamia. This substance in its pure state, as first obtained by MM. Geiger and Hesse, is a solid body, in fine silky crystals, without odour, of a strong acrid taste like tobacco, partially volatilizable with boiling water, entirely volatilizable alone at a somewhat higher heat, very soluble in alcohol and ether, but sparingly so in water.[1812] Farther, hyoscyamus, like many other narcotic vegetables, stramonium, digitalis, opium, tobacco, and hemlock, has been found by Mr. Morries Stirling to yield by destructive distillation an empyreumatic oil of great activity. Its poisonous properties, however, are not essential to the oil, but reside in a volatile principle which may be detached by weak acetic acid. The relation of this principle to hyoscyamia has not been ascertained; but it is an active poison, small doses producing in rabbits, convulsions, coma, and speedy death.[1813] Runge proposes as evidence of poisoning with hyoscyamus, in common, however, with stramonium and belladonna, to concentrate a solution of the contents of the stomach, and apply it to a cat’s eye to dilate the pupil. Dilatation, he says, was even produced by an extract obtained from the urine of a rabbit which had been fed some time on hyoscyamus.[1814] According to the experiments of Professor Orfila, the juice or extract procured from the leaves, stems, and especially the root, produces in animals a state of sopor much purer than that caused by opium. It is most active when injected into the jugular vein, less so when applied to the cellular tissue, and still less when introduced into the stomach. Except occasional paralysis of the heart, indicated by florid blood in its left cavities, no morbid appearance is to be found in the dead body. Six drachms of the pharmaceutic extract of the leaves killed a dog in two hours and a quarter when swallowed; and three drachms killed another in four hours through a wound in the back. Its action appears to be exerted through the medium of the blood-vessels, and is purely narcotic.[1815] It is probable that the activity of this plant is much affected by season; and the energy of its preparations varies greatly with the manner of obtaining them. The information, however, which is at present possessed on these two points is vague, because the influence of the two circumstances has seldom been viewed carefully apart. The leaves, from which the pharmaceutic preparations of hyoscyamus are obtained, are commonly held to be most active during the inflorescence of the plant in the second summer of its existence. On general principles this appears probable; but there are no satisfactory experiments on the subject, even the late researches of Mr. Houlton having left much still to be determined.[1816] Orfila has made some important remarks as to the effect of season and vegetation on the energy of the root as a poison. The root he maintains is the most active part of the plant; but in the spring it is nearly inert. Thus the juice of three pounds of the root collected near the end of April, when the plant has hardly begun to shoot, killed a dog in somewhat less than two days; while a decoction of an ounce and a half collected on the last day of June, when the plant was in full vegetation, proved fatal in two hours and a half. The extract of the leaves, procured from different shops, was found by Orfila to vary greatly in point of strength, some samples being absolutely inert.[1817] The causes of these differences have been ascertained experimentally by Brandes to be, that the herb loses its active principle in part by decomposition in the process of simple desiccation, and also when long kept; and that the greater part is also similarly decomposed in preparing an extract, unless the process be finished quickly, and at a low heat. The seeds of hyoscyamus are poisonous, as well as the leaves and root. Indeed the whole plant is so. The seeds contain much more hyoscyamia than the leaves. The effects of hyoscyamus on man differ somewhat from those on animals, and vary greatly with the dose. In medicinal doses it commonly induces pleasant sleep. This indeed has been denied by M. Fouquier, who infers from his experiments that it never causes sleep, but always headache, delirium, nausea, vomiting, and feverishness.[1818] I have certainly seen it sometimes have these effects; but much more generally it has acted as a pleasant hypnotic and anodyne. Its effect in large doses have been well described by M. Choquet as they occurred in two soldiers who ate by mistake the young shoots dressed with olive oil. They presently became giddy and stupid, lost their speech, and had a dull, haggard look. The pupils were excessively dilated, and the eyes so insensible that the eyelids did not wink when the cornea was touched. The pulse was small and intermitting, the breathing difficult, the jaw locked, and the mouth distorted by _risus sardonicus_. Sensibility was extinct, the limbs were cold and palsied, the arms convulsed, and there was that singular union of delirium and coma which is usually termed typhomania. One of the men soon vomited freely under the influence of emetics, and in a short time got quite well. The other vomited little. As the palsy and somnolency abated, the delirium became extravagant, and the patient quite unmanageable till the evening of the subsequent day, when the operation of brisk purgatives restored him to his senses. In two days both were fit for duty.[1819] In a treatise on vegetable poisons, Mr. Wilmer has related the history of six persons in a family, who were poisoned by eating at dinner the roots of the hyoscyamus by mistake instead of parsneps. Several were delirious and danced about the room like maniacs, one appeared as if he had got drunk, and a woman became profoundly and irrecoverably comatose. Emetics could not be introduced into the stomach, stimulant clysters had no effect, external stimuli of every kind failed to rouse her, and she expired next morning at six.[1820] The roots in this instance were gathered in the winter time,—a fact, which does not quite coincide with the conclusions of Orfila, that the plant must be in full vegetation before the energy of the root is considerable. From these and other cases, the abstracts of which are to be seen in Orfila’s Toxicology, or in Wibmer’s Treatise on the Operation of Medicines and Poisons, it follows that hyoscyamus in a poisonous dose causes loss of speech, dilatation of the pupil, coma, and delirium, commonly of the unmanageable, sometimes of the furious kind. In general a stage of delirium precedes coma; and sometimes as the coma passes off, delirium returns for a time. It has been known to act powerfully in the form of clyster.[1821] It has also been known to act with considerable energy even through the sound skin, as appears from a case which occurred to Wibmer. He was called to a lady affected with great stupor, dilated pupils, flushed face, loss of speech, full hard pulse, and swelling of the abdomen; and he found that these symptoms were owing to several ounces of henbane leaves having been applied to the belly in a poultice, on account of strangury and tympanitis. She was still capable of being roused by speaking loudly close to her ear; and under proper treatment she recovered.[1822] Henbane seldom causes any distinct symptoms of irritant poisoning. In several, however, of the cases related by the older modern authors some pain in the belly, a little vomiting, and more rarely diarrhœa, appear to have occurred.[1823] Plenck quotes, from a Swedish authority, an instance of its having produced burning in the stomach, intense thirst, watching, delirium, depraved vision, and next day a crowded eruption of dark spots and vesicles, which disappeared on the supervention of a profuse diarrhœa.[1824] The same author alludes to cases where it proved fatal; but this event is rare in the present day, obviously because the precursory stage of delirium gives an opportunity of removing the poison, before the stage of coma is formed. A fatal case, which occurred to Mr. Wibmer, has been mentioned above; and another has been related in Pyl’s Magazin. Two boys a few minutes after eating the seeds were attacked with convulsions and heat in the throat; and one of them, who could not be made to vomit, died in the course of the ensuing night.[1825] The accidents it has occasioned have commonly arisen from the individuals confounding the root with that of the wild chicory or with the parsnep, the latter of which it somewhat resembles. Of the other species of the hyoscyamus, the _H. albus_ has been known to cause symptoms precisely the same with those above described. Professor Foderé has given a good example of its effects on man, as they occurred in the crew of a French corvette in the Archipelago. The plant was boiled and distributed among the whole ship’s company, as several of the sailors said they knew it to be eatable and salubrious. But in no long time they were all seized with giddiness, vomiting, convulsions, colic, purging, and delirium of the active kind. They were all soon relieved by emetics and purgatives.[1826] Dr. Archibald Hamilton has described a case of the same nature, which was caused by the seeds of this plant. A young medical student, who took about twenty-five grains of the seeds, was seized in half an hour with lassitude and somnolency, and successively with dryness of the throat, impeding deglutition, convulsive movements of the arms, incoherency, total insensibility of the skin, and loss of recollection. These symptoms continued about twelve hours, and then slowly receded.[1827] Three other species, the _H. aureus_, _physaloides_ and _scopolia_ are represented by Orfila to be equally deleterious. The alkaloid hyoscyamus possesses in an intense degree the active properties of the plant. It has not been hitherto examined in this respect with much care. But extremely minute quantities produce excessive enlargement of the pupil, when put within the eyelids in the form of neutral salt. _Treatment._—The treatment of poisoning with hyoscyamus consists in removing the poison, diminishing cerebral congestion, and restoring sensibility. It is therefore substantially the same as in poisoning with opium, except that general or local evacuation of blood is more frequently required, in consequence of the greater tendency of hyoscyamus to induce determination of blood towards the head and congestion there. It has been lately alleged by an Italian author that a large dose of lemon-juice is an immediate antidote for the effects of too large a medicinal dose, even when the poison was administered in the form of injection.[1828] This does not seem probable. _Of Poisoning with Lactuca._ Allied in its effects, but greatly inferior in power to opium and hyoscyamus, is the _Lactuca virosa_, together with the _Lettuce-opium_, or inspissated juice of _L. sativa_, and _L. virosa_. Orfila found that three drachms of the extract of _L. virosa_ introduced into the stomach of a dog killed it in two days, without causing any remarkable symptom; that two drachms applied to a wound in the back induced giddiness, slight sopor, and death in three days; and that thirty-six grains injected in a state of solution into the jugular vein caused dulness, weakness, slight convulsions, and death in eighteen minutes.[1829] This poison, therefore, like other narcotics, acts through absorption. But it is far from being energetic. The extract is very uncertain in strength,—as may indeed be inferred from the variable nature of the processes by which it is prepared. Lactucarium, the inspissated juice, especially that obtained from _L. virosa_, is obviously a more active preparation than the extract. Doses of no great magnitude kill small animals. But there is a want of good observations on its effects and energy as a poison. _Of Poisoning with Solanum._ Different species of _solanum_, a genus of the same natural order with the hyoscyamus, have been considered by Orfila to possess the same properties, though in a much feebler degree. The _S. dulcamara_ or bittersweet has been erroneously believed by some to possess distinct narcotic properties.[1830] M. Dunal found that a dog might take 180 of the berries or four ounces of the extract without any inconvenience, and quotes an experiment on the human subject where thirty-two drachms of extract were taken in two doses also without injury.[1831] If it has any power at all, therefore, it must possess too little to be entitled to the name of a poison. Chevallier says he knew an instance of a druggist’s apprentice being attacked with deep somnolency for ten hours after carrying a large bundle of it on his head;[1832] but some other cause may be justly suspected to have here been in operation. The _S. nigrum_ or common nightshade has been made the subject of experiment by Orfila, who found its extract to possess nearly the power and energy of lettuce-opium.[1833] The following seems a genuine case of poisoning with the berries of this species. Three children near Nantes in France were seized with severe headache, giddiness, colic, nausea, and vomiting. One of them then had excessive dilatation of the pupils, sweating and urgent thirst; loss of voice, stertorous breathing, and tetanic spasms ensued; and in twelve hours he died. Another had swelling of the face, alternate contraction and dilatation of the pupils, repeated vomiting, and eventually coma; but he recovered. The third was similarly, but more slightly affected, and also recovered. The children who recovered pointed out the berries they had eaten; which were found to be those of _S. nigrum_.[1834] The _S. fuscatum_ is rather more active, fifteen berries having caused hurried breathing and vomiting.[1835] The _S. mammosum_ is also probably an active species, the capsule of the berries having been known to excite vomiting, giddiness, and confusion of mind.[1836] In the _S. nigrum_ and _dulcamara_, M. Desfosses discovered in 1821 a peculiar alkaloid, which induces somnolency in animals, but is not a very active poison.[1837] It has been supposed by some that the tubers of _Solanum tuberosum_, the common potato, may acquire in certain circumstances poisonous qualities of no mean energy. Dr. Kabler of Prague has described the cases of four individuals in a family who were seized with alarming narcotic symptoms after eating potatoes which had begun to germinate and shrivel. The father of the family, who had eaten least of them all, appeared as if tipsy, and soon became insensible. The mother and two children became comatose and convulsed. All had vomited before becoming insensible. They recovered under the use of ether, frictions, and coffee; and in two hours were out of danger.[1838] An alkaloid has been indicated by several chemists in various species of solanum. The most recent account, that of Otto, represents it to be a pearly, white, pulverulent substance, alkaline in reaction, and capable of uniting with acids. One grain of sulphate of solania killed a rabbit in six hours, and three grains a stronger rabbit in nine hours,—the symptoms being those of narcotic poisoning.[1839] Violent effects have often been assigned to the genus Solanum, in consequence of its similarity to a powerful poison, the _Atropa belladonna_; which indeed is described by the older authors under the name of _Solanum furiosum_. It will be noticed among the Narcotico-acrid Poisons.