354 THE LESIONS INDUCED BY POISONS. 



stomach contents will not infrequently reveal characteristic crystals of arsenious acid 

 or some of its compounds. The stomach may be contracted and its mucous membrane 

 corrugated. The entire inner surface may be red and inflamed, or there may be patches 

 or streaks of inflammation or deep congestion. The inflamed and congested patches 

 may be thickened and covered with false membrane mixed with larger and smaller 

 particles or masses of the poison. Ulceratiou, perforation, and gangrene are rare. 

 Blood may be extravasated into the mucosa and submucosa, and with the congestion 

 give the mucous membrane a very dark-red or brown appearance. Frequently the 

 mucous membrane is studded with small petechite. Sometimes the arsenic is converted 

 in the stomach into the yellow sulphide. There may be acute gastritis, even when the 

 poison is absorbed by the skin or otherwise and not introduced into the stomach. The 

 epithelium of the gastric glands may undergo granular and fatty degeneration. 



The entire length of the intestine may be congested and inflamed, but the action of 

 the poison does not usually extend beyond the duodenum. In some cases the solitary 

 ' lymph nodules, Peyer's patches, and the mesenteric nodes are swollen. Inflammation of the 

 bladder and peritoneum, and congestion and redema of the brain, have been observed, 

 but are neither frequent nor in any way characteristic. Fatty degeneration of the 

 muscles, liver, kidneys, blood-vessels, and vesicular epithelium of the lungs and chromatoly- 

 sis of the ganglion cells may follow arsenical poisoning. 



Alterations in the spinal cord indicative of acute myelitis have been described by 

 Popon 1 as occurring in dogs poisoned with arsenious acid. 



The walls of the stomach and intestines and other parts of the body may be pre- 

 served from decomposition for a long time after death by arsenical poisoning. 



It should always be borne in mind, in examining cases of suspected arsenical poi- 

 soning, that death may be produced by arsenic and its compounds without any appre- 

 ciable lesions. While in general it may be said that in the cases in which no lesions 

 are discovered death has probably occurred soon after the ingestion of the poison, it 

 should be remembered that death without lesions may exceptionally take place long 

 after the usual time at which inflammatory changes commence. 



Compounds of arsenic, such as the chloride and sulphide, and the arsenite (Scheele's 

 green, Paris green), are sometimes used for suicidal purposes, and produce lesions simi- 

 lar to those of arsenious acid. Paris green is a favorite article in New York, particu- 

 larly among Germans, for suicidal purposes. It is usually taken in considerable quan- 

 tities, and is often found in the stomach after death. 2 



Corrosive Sublimate. 



The mucous membrane of the mouth and throat may be swollen, inflamed, or have 

 a grayish-white appearance. The oesophagus may be swollen and white, or congested, 

 or unaltered. The mucous membrane of the stomach is usually congested or inflamed, 

 or there may be patches of softening, ulceration, or gangrene. Perforation is of rare 

 occurrence. Small ecchymoses in the mucosa are not uncommon. Sometimes there is 

 little or no change in the stomach. Sometimes the mucous membrane of the stomach 

 is slate-colored from the deposition of metallic mercury from the decomposed salt. The 



1 Popon, "Ueber die Veranderungen im Riickenmarke nach Vergiftung mit Arsen," 

 etc., Virch. Arch., Bd. xciii., p. 351. 



4 It is advisable, in cases of suspected arsenic poisoning, particularly if the body 

 has lain for some time, as in exhumations, to preserve not only all of the internal organs 

 entire for the chemist, but also portions of the muscles (back, thigh, arm, and abdo- 

 men), and also one of the long bones, preferably the femur, since arsenious acid and 

 its compounds are quite diffusible, and may be present in proportionately larger quan- 

 tity in other parts than in the gastro-intestinal canal. It is desirable to save the whole 

 of the internal organs, and to weigh the muscle and bones as well as the whole body at 

 the autopsy, in order that the calculations of the chemist, in case arsenic be found, may 

 rest upon a definite basis, and be as little as possible dependent upon estimates, whose 

 value may be questioned by lawyers should the case come into the courts. 



An interesting article on arsenic as a poison, with various collateral data by Pellew, 

 will be found in Hamilton's "System of Legal Medicine," vol. i., p. 349. 



