574 poisons : their effects and detection. [§ 753 . 
distinguishes the above description from that of cholera ; and supposing 
that cholera were epidemic, and no suspicious circumstance apparently 
present, there can be little doubt that a most experienced physician 
might mistake the cause of the malady, unless surrounding circum¬ 
stances give some hint or clue to it. In the acute form diarrhoea may 
be absent, and the patient die, as it were, from “ shock.” This was 
probably the cause of death in a case related by Casper, 1 that of Julius 
Bolle, poisoned by his wife. He took an unknown quantity of arsenic 
in solution at seven in the morning, and in about three-quarters of an 
hour afterwards suffered from pain and vomiting, and died in little more 
than three hours. There were no signs of inflammation in the stomach 
and intestines, but from the contents of the stomach were separated 
•0132 grm. of arsenious acid and -00513 grm. from pieces of the liver, 
spleen, kidneys, lung, and blood. The dose actually taken is supposed 
not to have been less than *388 grm. (6 grains). 
§ 753. The Subacute Form. —The subacute form is that which is 
most common ; it exhibits some variety of phenomena, and individual 
cases vary much in the matter of time. The commencement of 
symptoms is, as in the most acute form, usually within the hour, but 
exceptions to this rule occur. In a case quoted by Taylor, 2 and re¬ 
corded by M. Tonnelier, the poison did not cause any marked illness for 
eight hours ; it was found, on post-mortem examination, that a cyst had 
been formed in the stomach which sheathed the arsenic over, and in 
some degree explained this delay. In another case, again, ten hours 
elapsed, and this is considered to be the maximum period yet observed. 
As with the acute form, there is a feeling of nausea, followed by vomit¬ 
ing, which continues although the stomach is quite empty ; at first the 
ejected matter is a watery fluid, but later it may be streaked with 
blood. The tongue is thickly coated ; there is great thirst, but the 
drinking of any liquid (even of ice-cold water) increases the vomiting. 
Nearly always pain is felt in the epigastrium, spreading all over the 
abdomen, and extending to the loin (which is tense and tender on 
pressure). Deglutition is often painful, and is accompanied by a sort 
of spasmodic constriction of the pharyngeal muscles. Diarrhoea follows 
the vomiting, and has the same characters as that previously described ; 
occasionally, however, this feature is absent. In the case recorded by 
Martineau, 3 a man, aged 25, was seized at 10 a.m. suddenly with vomit¬ 
ing, which persisted all that day and the next, during which time the 
bowels were obstinately confined. On the second day a purgative was 
administered, whereupon diarrhoea set in, and continued until his death, 
which occurred in about two days and sixteen hours from the com- 
1 Case 188 in Casper’s Handbuch. 
Taylor’s Principles and Practice of Jurisprudence, i. 251 ; Flandin, i. 535. 
3 Tardieu, op. cit., Obs. xix. 
