692 POISONS : THEIR EFFECTS AND DETECTION. [§ 885 . 
doses of zinc phosphide seem to have done good in mercurial tremors. 
Potassic iodide is also supposed to assist the elimination of mercury. 
§ 885. Post-mortem Appearances. — The pathological effects seen 
after chronic poisoning are too various to be distinctive. In the museum 
of the Royal College of Surgeons there is (No. 2559) a portion of a 
colon derived from a lady aged 74. 1 This lady had been accustomed 
for forty-three years to take a grain of calomel every night ; for many 
years she did not suffer in health, but ultimately she became emaciated 
and cachectic, with anasarca and albuminuria. The kidneys were found 
to be granular, and the mucous membrane of a great part of the in¬ 
testine of a remarkable black colour, mottled with patches of a lighter 
hue, presenting somewhat the appearance of a toad’s back. From the 
portion of colon preserved, mercury was readily obtained by means of 
Reinsch’s test. The black deposit is in the submucosa, and it is, 
without doubt, mercurial, and probably mercury sulphide. In acute 
poisoning (especially by the corrosive salts), the changes are great and 
striking. After rapid death from corrosive sublimate, the escharotic 
whitening of the mouth, throat, and gullet, already described, will be 
seen. The mucous membrane right throughout, from mouth to anus, 
is more or less affected and destroyed, according to the dose and con¬ 
centration of the poison. The usual appearances in the stomach are 
those of intense congestion, with ecchymoses, and portions of it may be 
destroyed. Sometimes the coats are very much blackened ; this is 
probably due to a coating of sulphide of mercury. 
In St George’s Hospital Museum (Ser. ix. 43, y. 337) there is a stomach, rather 
large, with thickened mucous coats, and having on the mucous surface a series of 
parallel black or black-brown lines of deposit; it was derived from a patient who 
died from taking corrosive sublimate. With the severe changes mentioned, per¬ 
foration is rare . 1 2 In the intestines there are found hypersemia, extravasations, 
loosening of the mucous membrane, and other changes. The action is particularly 
intense about the csecum and sigmoid flexure ; in one case, indeed , 3 there was little 
inflammatory redness of the stomach or of the greater portion of the intestine, but 
the whole surface of the csecum was of a deep black-red colour, and there were 
patches of sloughing in the coats. The kidneys are often swollen, congested, or 
inflamed ; changes in the respiratory organs are not constantly seen, but in the majority 
of the cases there have been redness and swelling of the larynx, trachea, and bronchi, 
and sometimes hepatisation of smaller or larger portions of the lung. 
In St George’s Hospital Museum there are (from a patient dying in the hospital) 
preparations which well illustrate what pathological changes may be expected in any 
case surviving for a few days. The patient was Francis L-, aged 45, admitted 
to the hospital February 27, 1842. He took a quantity of corrosive sublimate spread 
on bread and butter, was immediately sick, and was unable to take as much as he 
had intended. The stomach-pump and other remedies were used. On the following 
day his mouth was sore, and on March 1 his vision was dim ; his mouth was drawn 
over to the right side, and he lost power over the left eyelid, but he had no pain ; 
he passed some blood from the bowel. On the 2nd he passed much blood, and 
1 Path. Soc. Trans., xviii. 111 . 
2 There is only one case of perforation on record. 
3 Lancet, 1845, p. 700. 
