Volume 3

Twentieth century practice : an international encyclopedia of modern medical science / by leading authorities of Europe and America ; edited by Thomas L. Stedman.

Date:
1895-1903
Catalogue details

Licence: In copyright

Credit: Twentieth century practice : an international encyclopedia of modern medical science / by leading authorities of Europe and America ; edited by Thomas L. Stedman. Source: Wellcome Collection.

    537/658
    The action of colchicine greatly resembles that of veratrum, and cases of poisoning, without a history of the cause, may readily be mistaken for poisoning b}^ veratrum, hellebore, aconite, or even ar- senic, or other gastro-intestinal irritant. It exerts a very severe ir- ritant effect upon the mucous membrane of the stomach and bowels, which is supposed to be not altogether due to its local action, as the same symptoms arise when the alkaloid is administered sub- cutaneously. Upon the medulla and cord it is also depressant, weak- ening the heart and respiration and reducing reflex irritability. Sen- sation is also diminished. It has little or no action upon the brain. Symptoms.—The absorption of the poison is slow and the course of the sj^mptoms is prolonged, extending over several days and per- sisting after the drug is stopped. Eelapses also occur frequently'. The early symptoms are a burning in the throat and stomach, with nausea, vomiting, abdominal pain and tenderness, and diarrhoea. The dejecta are loaded with bile, and may contain blood, mucus, and flakes of lymph. The vomiting and purging may become excessive and be followed by collapse and death. The pulse and respiration become very much enfeebled and circulation fails, but the muscular weakness is not so early nor so severe as in poisoning by the other irritant poisons. Death does not take place for forty-eight hours or later; in numerous cases it has not occurred for a week, and in one case not until the twenty-seventh d&j. Convalescence is slow, the weakness and gastric disturbance continuing for some time. Colchicum poisoning is not very common in this country, but in Europe it is of frequent occurrence from the employment both of the plant and from the drug. Of 55 cases collected (Blyth) 6 proved fatal. The fatal dose varies, as the reliability of the preparations is uncertain. Haines mentions ^ grain of colchicine as the minimum fatal dose. Three-fifths of a grain has caused death. Taylor men- tions a case in Avhich the ingestion of three and a half drachms of the wine, in divided doses, resulted in death on the fourth day. Five convicts, recovering from surgical operations, were given two ounces of wine of colchicum in mistake for Peruvian bark and wine. Two died at the end of eighteen hours, one in twenty, one in twenty- two, and one in twenty-nine hours. No symptoms appeared during the first two hours, except heat at the epigastrium. Then they became raj)- idly ill, with pain in stomach and throat, nausea, vomiting, frequent alvine evacuations, paleness, and coldness of surface, weak i)ulse. In six hours all the symptoms were more severe, particularly the pain in pharynx and the vomiting. The mental faculties remained unim- paired and there was no alteration in motor or sensory ])ower. The treatment consisted in the administration of sulphuric ether and lau- danum, emollient drinks, and enemuta, and the api)li.cution of heat