306 poisons : their effects and detection. [§ 366 . 
as a remedy, administered to himself three times his accustomed dose. 
Very shortly there was contraction of the left arm, disturbance of vision, 
pain in the stomach, faintness, inability to speak, and unconsciousness 
which lasted half an hour. Intermittent convulsions now set in, and 
pains in the limbs. There was neither somnolence nor delirium, but 
great agitation ; repeated vomiting and diarrhoea followed. After five 
hours these symptoms ceased ; but he was excessively prostrate. 1 There 
was complete recovery. 
One may hazard a surmise that, in such a case, tolerance has been 
established for morphine, but not for other morphine alkaloids in the 
same degree, and that the marked nervous symptoms were in no small 
degree the effect of some of the homologous alkaloids, which, in such an 
enormous dose, would be taken in sufficient quantity to have a physio¬ 
logical action. 
There are several instances of a relapsing or remittent form of 
poisoning—a form in which the patient more or less completely recovers 
consciousness, and then sinks back into a fatal slumber. One of the 
best known is the case of the Hon. Mrs Anson (January 1859), who 
swallowed an ounce and a half of laudanum by mistake. After 
remaining in a comatose condition for more than nine hours, she 
revived. The face became natural, the pulse steady. She was able to 
recognise her daughter, and in a thick voice to give an account of the 
mistake. But this lasted only ten minutes, when she again became 
comatose, and died in fourteen hours. 2 
In a Swedish case quoted by Maschka, 3 a girl, 9 years old, in weak 
health and suffering from slight bronchitis, had been given a non- 
official acetate of morphia lozenge, which was supposed to contain 5 
mgrms. (-075 grain) of morphine acetate. She took the lozenge at 
8 in the evening ; soon slept, woke at 10, got out of bed, laughed, talked, 
and joked with the nurse, again got into bed, and very quickly fell 
asleep. At 4 a.m. the nurse came and found her breathing with a 
rattling sound, and the physician, who arrived an hour later, found the 
girl in a state of coma, with contracted pupils, breathing stertorously, 
and the pulse scarcely to be felt. Despite all attempts to rouse the 
patient, she died at 8 in the morning, twelve hours after taking the 
lozenge. 
The post-mortem examination showed some hypersemia of the brain 
and serous effusion in the ventricles, and there was also tubercle in the 
pleura. Three lozenges similar to the one taken by the patient were 
1 Demontporcollet, De V Usage quoiidien de VOpium, Paris, 1874. 
2 Taylor, op. cit. 
3 Maschka’s Handbuch, ii. 438 ; also Svenska, Lak-Sdllsk. Forhandl., Apr. 1, 
p. 90 ; Apr. 8 , p. 160, 1873. For other cases see Nasmyth, Edin. Med. Journ., 
Dec. 1878 ; Kirby, Dub. Med. Press, Dec. 24, 1845 ; W. Boyd Muschet, Med. Times 
and Gaz., Mar. 20, 1858. 
