CHAPTER XVI. ANTIMONIAL COMPOUNDS.

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In its metallic state antimony is not regarded as poisonous. Two of its preparations, however, claim attention; namely, tartar emetic, and chloride of antimony.

Tartar Emetic (Tartrated or Tartarised Antimony, Potassio-Tartrate of Antimony, Tartar Emetic).—Since the trials of Palmer, Dove, Smethurst, and Pritchard, poisoning by this compound has attracted much attention. In large doses it has been administered without any serious result, a circumstance which may be accounted for by the promptitude with which it excites vomiting and purging. Given in small doses, frequently repeated, the effects of tartar emetic may be made to simulate, in some degree, those due to natural disease.

Three quarters of a grain killed a child; and a dose of two grains has destroyed an adult, under circumstances which favored its action. Dr. Taylor says that from ten to twenty grains taken at once might prove fatal to an adult; while in divided doses a smaller quantity might suffice. It is plain, therefore, that the quantity necessary to cause death must vary with the condition of the patient.

Symptoms.—In acute poisoning by this agent there is a metallic taste, nausea, and violent vomiting, burning heat with pain in the stomach, and purging. Difficulty in swallowing, thirst, cramps, cold perspiration, and great debility soon set in. Should the case terminate fatally, death may be preceded by giddiness, insensibility, difficult respiration, utter prostration, with violent spasms, tonic or clonic; but even when matters appear to be most critical, symptoms of improvement are often manifested, and recovery gradually follows.

The effects of chronic poisoning are, constant nausea, frequent attacks of vomiting and purging, a loathing for food, a weak frequent pulse, loss of muscular power, cold clammy sweats and fatal exhaustion. The symptoms are of course aggravated after each administration of the poison, whether given in food or medicine.

Tartar emetic ointment applied to the skin produces a pustular eruption like that of smallpox; while, if much be absorbed, there will be nausea, sickness, &c. Sometimes this same eruption appears in the throat and on the skin after swallowing a large dose.

Post-mortem Appearances.—The most common are inflammation of the throat, stomach, and intestines. Sometimes the mucous membrane of the stomach is softened and infiltrated with blood. The cÆcum and large intestine are also inflamed, especially if life has been prolonged after the dose, as in chronic poisoning. The brain and lungs have been found congested.

Treatment.—Vomiting should be encouraged by warm greasy water, milk, &c. Liquids containing tannin, as tea without milk or sugar, decoction of oak bark, &c., must be freely given. Cinchona bark in tincture or powder may be advantageously prescribed. Afterwards opiates may be administered.

Tests.—Tartar emetic is soluble in water but not in alcohol.

In solution tartar emetic may be thus detected:

1. A drop evaporated on a glass slide leaves microscopic crystals, either tetrahedra or cubes, with the edges bevelled off.

2. The solution may further be proved to contain antimony by passing through it sulphuretted hydrogen or adding to it sulphide of ammonium, either of which throws down an orange-red precipitate of sulphide of antimony. This precipitate is soluble in strong hydrochloric acid, which being diluted, throws down a white precipitate.

3. The three dilute mineral acids (nitric is best) throw down a white precipitate with tartar emetic, which is soluble in excess of the acid used or in tartaric acid.

The metal may be separated from organic substances by Marsh’s or Reinsch’s process.

Chloride of Antimony (Terchloride or Butter of Antimony) is a powerfully corrosive liquid. It produces violent inflammation and corrosion of the whole intestinal canal; occasionally also drowsiness, as from the use of a narcotic.

Dr. Taylor has collected the histories of four cases of poisoning by butter of antimony, three of which recovered. The fourth, in which a gentleman took from two to three ounces, proved fatal in ten hours and a half, after producing great prostration, nausea, violent griping pain, and tenesmus, followed by a tendency to sleep. On inspection, the whole of the inside of the alimentary canal was blackened, as if it had been charred; there was but little mucous membrane remaining, and the parts were much softened.

Treatment.—Magnesia must be administered in milk, together with the remedies recommended in poisoning by tartar emetic.


                                                                                                                                                                                                                                                                                                           

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