CARBON MONOXIDE. 
§46.1 
77 
of the limbs, when the blood in no way attains the Saturation sufficiently 
great to account for such symptoms. Geppert has, through a special 
research, shown that an animal suffocated by withdrawal of oxygen 
increases the number and depth of the respirations ; but when the 
animal is submitted to CO, in which case there is quite as much a with¬ 
drawal of oxygen as in the former case, yet the animal is not in a condition 
to strengthen its respiratory movements; Geppert hence rightly concludes 
that CO must have a primary specific injurious action on the nerve 
centres. I (Robert) am inclined to go a step further, and, on the ground 
of unpublished researches, to maintain that CO not only affects in¬ 
juriously the ganglion cells of the brain, but also the peripheral nerves 
(e.g. the phrenic), as well as divers other tissues, as muscles and glands, 
and that it causes so rapidly such a high degree of degeneration as not 
to be explained through simple slow suffocation ; even gangrene may be 
caused.” 
It is this rapid degeneration which is the cause of the enormous 
increase of the products of the decomposition of albumin, found experi¬ 
mentally in animals. 
§ 46. Post-mortem Appearances. —The face, neck, chest, abdomen are 
frequently covered with patches of irregular form and of clear rose-red 
or bluish-red colour ; these patches are not noticed on the back, and 
thus do not depend upon the gravitation of the blood to the lower or 
most dependent part of the body ; similar red patches have been noticed 
in poisoning by prussic acid ; the cause of this phenomenon is ascribed 
to the paralysis of the small arteries of the skin, which, therefore, 
become injected with the changed blood. The blood throughout is 
generally fluid, and of a fine peculiar red colour, with a bluish tinge. 
The face is mostly calm, pale, and there is seldom any foam about the 
lips. Putrefaction is mostly remarkably retarded. There is nearly 
always a congestion of some of the internal organs ; sometimes, and 
indeed usually, the membranes of the brain are strongly injected ; 
sometimes the congestion is mainly in the lungs, which may be 
oedematous with effusion ; and in a third class of cases the congestion is 
most marked in the abdominal cavity. 
The right heart is commonly filled with blood, and the left side 
contains only a little blood. 
A rabbit that Kionka poisoned twelve times in as many days with 
carbon monoxide, and through artificial respiration restored, was two 
days later killed and examined ; there were haemorrhages in both lungs, 
occlusion of vessels and haemorrhagic infarcti in the intestines, and 
haemorrhages in the liver. In some cases there have been noticed 
small areas of softening in the human brain in cases of CO poisoning : 
these may be explained by the light of the appearances just described 
as caused by small thrombi in the brain vessels. 
