Note 306 — PART V.—MORE OR LESS VOLATILE POISONOUS SUBSTANCES CAPABLE OF BEING SEPARATED BY DISTILLATION FROM NEUTRAL OR ACID LIQUIDS. (continued 3)

Hauff collected 12 cases, and found a fatty liver in 11.—Würtemb. Med. Corresp. Bl., 1860, No. 34.

[307] Die acute Phosphor-Vergiftung, Berlin, 1865.

[308] This case, from the similarity of the pathological appearances to those produced by yellow atrophy, deserves fuller notice:—“Frances A. Cowley, aged 20, on her own admission, took some rat paste on Tuesday, June 19th. Death ensued eleven days later. The initial symptoms were not very marked. Nausea and vomiting continued with moderate severity for a few days and then ceased. There ensued a feeling of depression. Towards the end insensibility, icterus, and somewhat profuse metrorrhagia supervened. At the necropsy the skin and conjunctivæ were observed of a bright yellow colour. There was no organic disease save of a recent nature, and entirely attributable to the action of the poison ingested. The stomach contained about three-quarters of a pint of dark claret-coloured fluid, consisting largely of blood derived from capillary hæmorrhage from the mucous membrane. There was no solution of continuity of the mucous membrane, which showed traces of recent irritation. The whole surface presented a yellow icteric tint, except the summits of some of the rugæ, which were of a bright pink colour. There was also faint wrinkling of the mucous membrane. The upper part of the small intestine was affected in much the same manner as the stomach. The large intestine contained a quantity of almost colourless fæces. The liver was shrunken, weighing only 26 ozs., and both on its outer and sectional surface exactly resembled the appearances produced by acute yellow atrophy, except that there were greater congestion and interstitial hæmorrhage in patches. The lobules of the liver were in many places unrecognisable; in others they stood in bold relief as brilliant canary-yellow patches, standing in strong contrast to the deep dark-red areas of congestion and extravasation. The gall-bladder contained about 2 drachms of thin greyish fluid, apparently all but devoid of bile. The urinary bladder was empty; the kidneys were enlarged; the cortex was very pale and bile-stained, of greater depth than natural, and of softer consistence. The spleen was not enlarged, nor was it in the least degree softened. In addition to the bleeding from the uterus noticed during life, there was capillary hæmorrhage into the right lung and pleura, into the pericardium, and, as already mentioned, into the stomach. The brain was healthy.”