148 POISONS : THEIR EFFECTS AND DETECTION. [§§ 167 , l 68 . 
approximation to the truth, it is evident that, for any child below 10 
or 12, quantities of from 28-3 to 56-6 c.c. (1-2 ozs.) of absolute alcohol 
contained in brandy, gin, etc., would be a highly dangerous and probably 
fatal dose ; while the toxic dose for adults is somewhere between 
71-8-141-7 c.c. (2-5-5 ozs.). 
§ 167. Symptoms. —In the cases of rapid poisoning by a large dose 
of alcohol, which alone concern us, the preliminary and too familiar 
excitement of the drunkard may be hardly observable ; but the second 
stage, that of depression, rapidly sets in ; the unhappy victim sinks 
down to the ground helpless, the face pale, the eyes injected and staring, 
the pupils dilated, acting sluggishly to light, and the skin remarkably 
cold. Frantzel 1 found, in a case in which the patient survived, a 
temperature of only 24-6° in the rectum, and in that of another person 
who died, a temperature of 23-8°. The mucous membranes are of a 
peculiar dusky blue ; the pulse, which at first is quick, soon becomes 
slow and small; the respiration is also slowed, intermittent, and 
stertorous ; there is complete loss of consciousness and motion ; the 
breath smells strongly of the alcoholic drink, and if the coma continues 
there may be vomiting and involuntary passing of excreta. Death 
ultimately occurs through paralysis of the respiratory centres. Con¬ 
vulsions in adults are rare, in children frequent. Death has more than 
once been immediately caused, not by the poison, but by accidents de¬ 
pendent upon loss of consciousness. Thus food has been sucked into 
the air-tubes, or the person has fallen, so that the face was buried in 
water, ordure, or mud ; here suffocation has been induced by mechanical 
causes. 
A remarkable course not known with any other narcotic is that in 
which the symptoms remit, the person wakes up, as it were, moves about 
and does one or more rational acts, and then suddenly dies. In this 
case also, the death is not directly due to alcohol, but indirectly—the 
alcohol having developed oedema, pneumonia, or other affection of the 
lungs, which causes the sudden termination when the first effect of the 
poison has gone off. The time that may elapse from the commence¬ 
ment of coma till death varies from a few minutes to days ; death has 
occurred after a quarter of an hour, half an hour, and an hour. It 
has also been prolonged to three, four, and six days, during the wdiole 
of which the coma has continued. The average period may, however, 
be put at from six to ten hours. 
§ 168. Post-mortem Appearances. —Cadaveric rigidity lasts toler¬ 
ably long. Casper has seen it still existing nine days after death, and 
Seidel 2 seven days (in February). Putrefaction is retarded in those 
cases in which a very large dose has been taken, but this is not a very 
; “ Temperaturemiedrigung durch Alcoholintoxication,” Charite Annalen, i. 371. 
2 Seidel, Maschka’s Handbuch, Bd. ii. p. 380. 
