Читать книгу Treatise on Poisons - Robert Sir Christison - Страница 51

The morbid appearances caused by potass, soda, and their carbonates differ with the nature of the case.

In the boy who died in twelve hours Mr. Dewar found the inner membrane of the throat and gullet almost entirely disorganized and reduced to a pulp, with blood extravasated between it and the muscular coat. The inner coat of the stomach was red, in two round patches destroyed, and the patches covered with a clot of blood;—its outer coat, as well as all the other abdominal viscera, was sound.

In the two chronic cases mentioned in the Medical Repository the mischief was much more general, the whole peritonæum being condensed, the omentum dark and turgid, the intestines glued together by lymph, the external coats of the stomach thick, the villous coat almost all destroyed, what remained of it red and near the pylorus ulcerated, and the pyloric orifice of the stomach plugged up with lymph so as barely to admit a small probe.

In Mr. Dewar’s patient who died of stricture of the gullet the intestines were sound, the inner surface of the stomach red especially towards the cardia, the inner and muscular coats of the gullet thickened and firmly incorporated together by effused lymph, the inner coat here and there wanting, the passage of the gullet every where contracted, and to such a degree about two inches above the cardia as hardly to pass a common probe. In Sir C. Bell’s cases the appearances were similar.

Orfila says he is led to conclude from a great number of facts that of all corrosive poisons potass is the one which most frequently perforates the stomach.^[444] This appearance, however, has not been mentioned in any case of poisoning in the human subject.