Kalium bichromicum

Volume IV — Appendix

KALI BICHROMICUM.

(See vol. ii, p, 161.)

II. 16. W. W — , St. 47, a furniture dealer's employé, having finished work one night, took up a jug in the shop and drank a hanj draught of the contained liquid, which he imagined to be cold tea, but which afterwards proved to be a solution of bichromate of potash, used for staining wood a mahogany colour. Finding by the bitter taste that he had made a mistake, he immediately started for home, but wa violently sick on the way. The sickness continued with much violence, accompanied by profuse diarrhoea and great pain in the epigastrium. I arrived about an h. after he had taken the liquid, and found him greatly collapsed, with cold sweats, an anxious expression of the face, pu\se a\mo?.v xwv^wte^tvble., pupils dilated, extremities coW, and severe cmmps \u t.\e c^Xncs ^.w^ !c\<^%. \ vccvtwtjivvt.elv wa»hed

out the stomach with warm water by means of a flexible tube and funnel, the liquid first drawn off and the vomited matter consisting of a dark brown liquid with some blood-clots and much mucus. Hot bottles were applied to the extremities and poultices to the epigastrium. Some warm brandy-and«water was left in the stomach, and remained long enough for some absorption to take place. A mixture containing bismuth, magnesia, and chlorodyne was given every 2 h. The first two doses were rejected, but after the third he sank into a good sleep, and next morning was much better, and after being kept for three days on fluid diet was in his usual state of health. The quantity taken was about five ounces of a saturated solution of the salt. (Bullock, Lancet^ Sept. 13, 1890.)

II. 17. a. A young Englishman, Charles B — , aet. 25, committed suicide by taking about 2 oz. of bichromate of potassium in the solid form. From the evidence at the coroner's inquest and from subsequent inquiries it was established that he could not have taken the poison before 11. 15 a.m. A few m. later B — was found lying in the outhouse, vomiting, purging, and in great agony. When seen by the ambulance surgeon of the Montreal General Hospital he was writhing with pain on the floor of the shop, speechless, his mouth, hands and clothes stained with greenish-yellow vomit, surface of body cold, face contorted and of a dusky hue, pupils unequally dilated, pulseless at the wrist, respirations very rapid and shallow, abdomen retracted and painful on pressure, and the knees drawn up to the body. The breath was cold, and the mouth contained a yellow, frothy mucus. The emesis, which had ceased, was brought on again by passing the finger into the back of the mouth. He was taken to the hospital as quickly as possible, a hypodermic injection of ether administered, and an attempt made to use the stomach pump, but without success, the patient dying a few m. after arrival, less than 1 h. from the time of taking the fatal dose. When seen i h. after death, cyanosis was intense over face and neck, and pupils were widely dilated.

b. Autopsy performed 48 h. after death. Intense purplish-blue lividity of face and upper part of neck ; pupils contracted to a pin's point. Post-mortem rigidity present in all joints, and very marked. Bright yellow staining of skin around mouth and nose, and on hands. Anus smeared with vellow faeces. Cerebral sinuses and veins of pia mater, which were distended, contained dark chocolate-brown blood of a syrupy consistency, and without ddt. Brain substance and membranes normal. The peritoneal cavity contained an ounce of dark-brown fluid. The liver was of an intense purplish-blue colour, and hyperaemic on section. The spleen was dark-red and firm. The capsule of the kidneys was non-adherent, and the parenchyma dark purple-red and very hyperaemic. The small intestines were moderately distended, and contained a quantity of olive-green tenacious mucus, with shreddy pieces of a yellowish colour. The mucous membrane showed evidence of irritation, but nowhere was there loss of substance. The large intestine was very firmly contracted, and contained only a little mucus. The stomach contained a considerable quantity of greenish-yellow, ropy mucus, the mucous membrane being stained a. dee^ o\n«-^^ctv

coloar, ind covered in places with a loose membrane which cameawit ia flakes, and under the microscope was found to consist of nuase of cyltodhcil epithelium. No undissolved bichromate was found in the The bladder was hrmlv contracted and quite empty. The

longs, wfakh were of a dark blue-black colour extemalij, were crepiant, and contained a little blood, also of a dark chocolate-brown colour. Tiie cot stir^e was dark brown and very frothy. The right auricle 2Dd ventride were moderately dilated, and the left ventrtcle was contnaed. The heart contained three ounces of dark chocolate-brown fluid blood, but no docs. A ciystal of bichromate of potash, about the site of a split pea, was found on the right side of the upper part of oesophagus, and a smaller one on the opposite side at the same lercL The ton^e and the anterior surface of the oesophagus were suined a bright yellow. The skeletal musdes were all very ri^id and o( M; dull red colour. 72 h. after death, when the body was removed foffi burial, rigor mortis was sdU very marked. A chemical cxaminatiai] showed chat the blood everywhere conuined neutral chromatei of sodium and potassium. By ht the largest quantity was obtained the veins of the portal system. The blood in the heart and great. vessels also contained a ver}* considerable amount, and chronur^ could be readily detected in the blood of the brain. The liver, 2s on.' would expect, contained a larger quantity of the poison than anyothc organ ; its tissue was readily stained of a rellow colour by leadacetlC^ and of a red colour by silver nitrate. The kidney also gave cbc^ reactions, but not so readily as the liver. On suspending a porti«n the kidney for a few minutes in a dilute solution of lead acetate, ^ cortex was found to be most deeply stained by the chrome ye^ though all parts of the organ became decidedly tinted. The muc' membrane of the stomach was of a green colour, from the reduced oxide of chromium. The blood was found to be pi altered in colour and consistence, and to have lost its characteri^ alkaline reaction, being quite neutral to litmus. It remained undi posed and homogeneous in loosely corked bottles for nearly two vreer after the autopsy. On spectroscopic examination, the absorpcii bands produced by the blood were found to be identical with tl produced by that form of haemoglobin called methacmoglobi Hoppe-Seyler — that is, the blood presented a three-banded a tion-spectrum in dilute solution, one band being in the red, near th line C in the solar spectrum and between C and D (wave length 632) the two others lying close together between D«and E ; the last tw« formed one black band in more concentrated solutions of the blood^_ The identity was further confirmed by the action of strong redudiu agents. The methsemoglobin could be reduced to hxmoglobin by ammonium sulphide, and again oxidised to oxyhxmoglobin on shaking with air. There being no urine in the bladder, the question of the; excretion of the poison by the kidneys could not be determined. (RuTTAN and Lafleur, Montreal Med. Jeurn.^ Aug., 1888,)

1. Owing to the indefinite nature of the tissue changes de-

scribed as the result of poisoning by bichromates, it seemed to be oT interest to determine, if possible, what, ( any, were the dilfereoocs

°^tween the effects of chromates and bichromates on the system, and ^ tnr to ascribe to each salt its own physiological action.

Two rabbits were poisoned—- one with bichromate of potash, as described before, the dose being about 15 gr., the other with neutral potassium chromate ; the dose given in the latter case was between 20 and 30 gr., the fiital dose, as found by Posner, being about 9 or 10 gr. The rabbit poisoned with bichromate died in f h. with no symptoms of irritant poisoning, no purging or signs of violent pain, the chief symptoms being slowing of the heart, slow and intensely difficult breathing, with blueness of the skin of lips and ears, increasing till death ; there was but one convulsion, and that just before death. The rabbit that had taken the neutral chromate showed symptoms of irritant poisoning from the beginning, the first symptom appearing ^ h. after ; purging, expulsion of urine, convulsions, quick and shallow breathing, were the chief symptoms. The post-mortem examination made immediately after death showed that the rabbit which received the bichromate had the same engorged purple liver and engorged kidneys which characterized the action of the salt ; the lungs were pale and ansmic ; the blood was of chocolate-brown colour, and it gave at once the absorption spectrum of methxmoglobin. Thus the chief differences between the two forms of chromate poisoning seemed to be in their effect on the blood. To confirm this, experiments were made with both salts on a solution of oxyhaemoglobin. The merest trace of the bichromate was sufficient to convert into methsemoglobin almost instantly a test tubeful of diluted oxyhsmoelobin ; a larger quantity precipitated the proteids and destroyed the colouring matters, the blood then yielding the spectrum of acid haematin. Pure neutral chromate had no effect whatever on the oxyhaemoglobin even when added in considerable quantity — /. e. several grains to the test tubeful of dilute blood. (Ruttak and Lafleur, loc. cit.)