Part 28

Herapath noticed that near the smelting furnaces pigs escaped if kept in the pen but suffered if allowed to go at large. This is explained by the presence of lead in the forms of oxide, carbonate and sulphate on the herbage, hay and hedge rows, and in short, on all vegetation.

In post mortem examination the stomach should be carefully searched for lead in the metallic form as sheet lead, bullet spray, etc., for the different forms of paint of which lead forms an ingredient, for the discarded white lead packing of pipes and machinery, and even for solid masses of metallic lead. This is especially necessary in the case of cattle in which the morbid habit of eating non-alimentary matters is so common, and for which the sweet taste of some of the lead compounds seems to offer an attraction. The lead being long retained in the first three stomachs in contact with acetic and other organic acids is especially liable to be dissolved and absorbed in dangerous amount.

In the chronic cases especially, the test by electric current may furnish a valuable pointer. In lead poisoning the muscles respond much less actively to the stimulus than in the normal condition.

In resorting to analysis the following table from Heubel of the amount of lead in the different organs of a dog may offer a guide to the selection of an organ for examination:

Liver .03 to .10 per cent. Kidney .03 to .07 „ „ Brain .02 to .05 „ „ Bones .01 to .04 „ „ Muscles .004 to .008 „ „

Professor George Wilson found the lead very abundant in the spleen, and used it for analysis. He dissolved it in aqua regia over a slow fire, cooled, filtered, evaporated, cleared, and boiled with dilute nitric acid. Then filtered and dried again, dissolved in dilute muriatic acid, and finally applied the color tests. With hydrosulphuric acid it gives a black precipitate, with sulphuric acid, a white, and with potassium iodide or bichromate a bright yellow. Or from the solution of the chloride the lead may be obtained as a metallic deposit on zinc from which it can be fused into a minute globule on charcoal.

In the treatment of lead poisoning the first object is to prevent the further solution of lead in the alimentary canal and to carry it off. To fill the first indication, hydrosulphuric acid or sulphuric acid may be administered to form respectively the insoluble sulphide or sulphate. As a purgative, sulphate of magnesia or soda should be preferred, as favoring at once elimination and the formation of an insoluble precipitate. Large doses are usually desirable, especially in ruminants, because of the bulky contents of the stomach and the torpor of the alimentary canal. If griping is a prominent symptom opium or other antispasmodic must be added.

In chronic cases, after the evacuation of the contents of the alimentary canal small daily doses of potassium iodide will serve to dissolve the lead out of the tissues, while sulphates may be given in small doses to assist in elimination from the bowels and to prevent reabsorption. The treatment by potassium iodide is equally applicable, to assist in the elimination of the lead that has passed into the circulation and tissues. The doses, however, should in any case be small to avoid the sudden solution of a large amount of lead which had been deposited in the tissues in a comparatively insoluble form. The sudden entrance into the circulation of any large amount of such lead would induce a prompt return of the toxic symptoms. A continuous exhibition of small doses is the course of wisdom and safety. The bowels should meanwhile be kept somewhat relaxed by small doses of sodium or magnesium sulphate. As a general tonic a course of bitters may be called for, especially when torpor or emaciation is pronounced.

ALCOHOLIC INTOXICATION.

Beer in pigs, alcohol in dogs, absinthe in horse, alcohol and burnt ales in cows, alcoholized grain in fowls, also fermented raisins. Symptoms, lack of coördination, staggering, flushed mucosæ, full pulse, stertor, sopor, coma, alcoholic breath, chill, muscular twitching, delirium. Treatment: ammonia acetate, or carbonate, apomorphia, pilocarpin, warm water, coffee, stomach pump, electricity.

Poisoning by alcohol is less common in the lower animals than in man, yet the veterinary journals record a considerable number of cases. We have seen pigs suffer from drinking soured beer; the smaller breeds of dogs (English terriers) which are systematically dwarfed by feeding alcohol are often kept for a length of time in a condition of semi-intoxication. Bissauge records the case of a horse inebriated by a glass of absinthe and a pint of white wine, and that of a cow which died intoxicated 24 hours after she had been given three quarts of pure alcohol (Rec. de Med. Vet. 1895). Dundas records intoxication in cows fed on burnt ales. Intoxication of barnyard fowl and wild birds from eating grain soaked in strong alcoholic liquids has been frequently noticed, and Bissauge reports fatal drunkenness among our domestic fowls from eating raisins and other fruits which had undergone fermentation.

The symptoms are too suggestive to require notice in detail. There is a lack of coördination of movement, a staggering gait, a disposition to lie, dilated pupils, dark red flushing of the visible mucous membranes, a full pulse, stertorous respirations, drowsiness, stupor, and finally coma. The breath exhales the odor of alcohol, and the temperature usually falls, especially if the subject has been exposed to cold. It may rise later in connection with inflammation of the stomach or brain. Muscular twitchings and delirium are sometimes found, and may occur paroxysmally.

Treatment. A pint of liquor of the acetate of ammonia to horse or ox may quickly relieve the symptoms, or 1 oz. carbonate of ammonia may be given in solution in a pint of vinegar. If more convenient the hypodermic injection of 1 or 2 grains of apomorphia, or of 5 grains of pilocarpin may be employed. Warm water is of the greatest value in securing elimination. A strong infusion of coffee is very effectual. If the patient is a vomiting animal an emetic may be employed, and in case of coma the stomach pump may be resorted to. Cold applied to the head or galvanism may be used to rouse the patient.

In case of gastritis or encephalitis following the attack these must be treated according to indication.

ANILINE POISONING.

Composition. Source. Uses. Toxic action on skin, by inhalation, and by stomach. Symptoms: acute: chronic. Test. Treatment: emesis, purgatives, stimulants, tonics, enemata, bleeding, normal salt solution.

Aniline (Amidobenzene, Phenylamine, C{6}H{7}N) is a product of coal tar produced in the manufacture of benzole and of aniline dyes. Being an object of large production and consumption in the arts, its toxic action is seen not infrequently in man, and less so in animals. As used in confectionery it is so diluted that it is rarely or never injurious. On textile fabrics, however, it often causes cutaneous irritation, and when eaten by animals may be toxic. Workmen in the factories usually suffer from its inhalation.

Turnbull gave ½ dram sulphate of aniline to a dog, inducing vomiting in 2½ hours and purging one hour later. There were accelerated pulse, labored breathing and paraplegia, followed by recovery in five hours. Other objective symptoms are coldness of the surface, and a bluish or purple color of the visible mucosæ, the blood failing to take up oxygen. In chronic aniline poisoning in man the following symptoms have appeared: papular, vesicular or pustular skin eruptions, or ulcers on hands feet and scrotum; an odor of coal tar; anorexia, nausea and vomiting; headache, vertigo, stupor, ringing of the ears, amblyopia, muscular spasms, muscular weakness, anæsthesia and motor paralysis especially of the extremities. The fatal dose is 1½ dr. and upward.

Aniline may be extracted from the tissues by petroleum ether, and on the evaporation of the solution, it is left as an oily yellowish mass which gives the following reactions:—with a few drops of sodic hypochlorite a blue or violet blue; with acids a rose red; with bromine a flesh red.

The treatment must be by elimination by emesis, or purgation, by removal from aniline fumes or mixtures, and by stimulating and tonic agents. In place of emesis a stomach tube and lukewarm water in large amount may be employed to wash out the stomach. For vomiting animals ipecacuan may be employed. Copious enemata may be given, along with purgatives, to clear out the bowels. As stimulants strong coffee, caffein, camphor, or strychnia may be employed. In case of profound stupor, prostration, or paresis it may be desirable to reduce the amount of aniline in the system by free bloodletting, care being taken to inject subcutem, or into a serous cavity, a nearly equivalent amount of normal salt solution.

POISONING BY NITRO-BENZOL.

Composition. Source. Uses. Characters. Toxic qualities. Convulsions: paralysis: cyanosis; weak pulse; bitter almond odor; dark red urine; sopor, giddiness; reduced size of red blood globules; congested brain, stomach, intestines. Treatment: emesis, purgation, stimulants, electricity, derivatives, bleeding, normal salt solution.

Nitro-benzol (Nitro-benzine, C{6}H{5}NO_{2}) is a coal tar product, formed in large quantities in the manufacture of aniline dyes and extensively used as a flavoring agent for soaps, sweet meats, etc. It is formed by the addition of strong nitric acid to benzine, and appears as a yellow fluid with an odor resembling, yet somewhat different from, that of prussic acid or oil of bitter almonds. It may prove deadly to man or dog in a dose of fifteen drops, though most commonly it enters the system by inhalation. In animals the prominent symptoms are convulsions and paralysis, supervening on a period of weak circulation and pulse, and blueness of the visible mucous membranes. The characteristic odor resembling the oil of bitter almonds exhales from the lungs and skin. In man there are dilatation of the pupils, blueness of the lips and nails, pallor of the face, weak pulse, slow breathing (often in the end Cheyne-Stokes respiration), a dark maroon or port wine color of the urine, and amblyopia. In the chronic cases the skin is yellowish, and there are weariness, a dragging walk, headache, morning anorexia, drowsiness, giddiness, numbness of the hands or other parts and emaciation. The blood is chocolate color with red globules reduced in size, in number and in hæmoglobin, but containing an excess of carbon dioxide. The brain is often congested and the gastro-intestinal mucosa like the skin may be yellow (from alleged formation of picric acid). In chronic cases disseminated sclerosis may be seen.

In treatment emesis, purgation, stimulants (ammonia, camphor), galvanism, sinapisms to the chest, and phlebotomy, with injection of normal salt solution, may be resorted to, as in aniline poisoning.

POISONING BY CARBON DISULPHIDE.

Used to kill insects in grain, etc., in barns. Locally anæsthetic, and irritant. Inhaled, toxic, causing excitement, anæsthesia, collapse. Large doses, excitement, reckless movements, incoördination, giddiness, sleep, stertor, paraplegia. Small doses, weakness, emaciation, tremors, paraplegia, polyuria, mellituria; convulsions, death. Distortion and varicosity of axis cylinder, and unequal staining of cytoplasm. Treatment: pure air, good diet; massage, electricity, tonics, phosphorous.

This agent is largely used in vulcanizing and other factories where the employes are liable to suffer, and also in granaries, barns, etc., for the destruction of insects in grain and other objects and where animals are liable to suffer.

Locally it acts like chloroform, when confined to the surface, as under a glass or covering, producing very active irritation with anæsthesia.