POISONING BY ARSENIC USED EXTERNALLY. 
77 
forehead. On the 22d in the evening, an emulsion was pre- 
scribed consisting of Castor oil and manna; to reduce the swell- 
ing of the tongue, four leeches were applied to it. The next 
day the tongue was hot, so intensely red and so swollen that 
deglutition was almost impossible; several half fluid stools oc- 
curring during the day appeared to produce some diminution 
of the constriction and of the symptoms occasioned by the tume- 
faction of the tongue; the extremities regained a little warmth ; 
but very soon after the dyspnoea became extreme, the pulse 
almost imperceptible, the forehead and extremities cold, the 
lips bluish, and the mucous rale announced that death was 
near at hand, when the patient could just state in a feeble 
voice that this alarming change had come on half an hour be- 
fore. She died 96 hours after the application of the arsenical 
paste. 24 hours after death, the bodj^ was cold, bloated, and the 
whole of the posterior portion of the body coloured bluish. 
The friends opposed an autopsy. 
Dr. Kuchler did not doubt that the patient had died from 
poisoning, the symptoms of which are undeniable, from the 
constriction of the heart, the anxiety, the palpitations, the 
dyspnoea, the thirst, the salivation, the swelling of the tongue, 
the difficulty of deglutition, the colic, the tenesmus: he thinks 
that from the softness of the tumor, the exudation from it 
having rendered liquid the arsenical paste, this after having 
acted upon the diseased parts, came in contact with the healthy 
parts, by which it was absorbed, the absorption being favoured 
by the general condition of the patient. 
The author deduces from this case the following practical 
conclusions. 
1. That the use of arsenic is contra-indicated when the part 
is soft and not indurated. 
2. That the least active arsenical preparations are dangerous 
in cases of this kind, and that it is better to use the paste of 
corrosive sublimate, according to the method of Grsefe. 
3. That some hesitation should exist as to the employment 
of arsenic, even in cases of true scirrhous, lardaceous, fibrous, 
