In the lower animals, salts of copper seem to be uncertain in their effects, at least when given by the mouth. According to Orfila, vomiting is the earliest and most marked symptom, and Drouard found that 12 gr. of sulphate caused fatal gastric inflammation in dogs. On the other hand, Galippi could not poison dogs with pure copper salts, for small doses were tolerated, and large ones were so nauseous that he could not get enough swallowed or retained (Bulletin de Therapeutique, 1875). Ducom and Burq also report that dogs can take from 15 to 60 gr. daily of soluble salts of copper for a varying time without ill-effect on the general condition, with the exception of vomiting at first; long continuance of this medication at length impaired appetite and digestion, and thus led to death from exhaustion (Bulletin de Therapeutique, 1875).

In man, small doses (1/4 gr.) of a soluble salt of copper exert a tonic astringent action, but if continued for a long time impair appetite and digestion, and cause diarrhoea from irritation. The effects of frequently repeated minute doses have lately excited special attention, on account of the adulteration with copper of many preserved vegetables. Thus, in the French preserved green peas, 0.31 to 0.56 gr. has been found in each tin, and by some chemists, and even medical men, this quantity has been pronounced injurious (M. Pasteur and others: British Medical Journal, 1876-77). Vulpian, however, says that any copper compound contained is insoluble and harmless, and that no evidence exists to the contrary; and Galippi, after the crucial test of eating them freely for some time, found no bad result (British Medical Journal, i., 1877). In a 4-lb. loaf of bread .4 to 1.8 gr. has been found, and the latter amount might become serious (Medical Times, i., 1871, p. 509). Doses of 1 to 3 gr. induce a sense of constriction in the gullet, and vomiting occurs in a few minutes without much nausea, and is commonly attended with diarrhoea; 5 to 15 gr. act as a powerful irritant emetic.

Lauder Brunton and West have experimented to ascertain whether cupric salts cause vomiting by irritation of the stomach or of the vomitive centre in the medulla. Into the jugular vein of cats they injected a neutral albuminate of copper (which would not cause coagulation of blood), and retching and vomiting followed. Previous section of the vagi did not prevent the retching, but it did prevent evacuation of the stomach, and after section of the vagi and the splanchnic nerves neither retching nor vomiting occurred: hence they conclude that these symptoms depend upon gastro-intestinal irritation, not upon a direct excitement of the central organs (St. Bartholomew's Hospital Reports, 1876).

Toxic Action

Half an ounce given at one time by the mouth produces severe symptoms of irritant poisoning, including metallic taste, feeling of constriction, thirst, salivation, nausea, vomiting, purging, and severe cramping pain with tenesmus; the abdomen is distended and tender, the evacuations greenish or containing blood; the face may be flushed and swollen, the gums ulcerated, and sometimes jaundice occurs; death may follow from enteritis or exhaustion within a few hours or days. From 1 to 2 oz. of sulphate or acetate may be reckoned a fatal dose, though recovery has occurred after 5 oz., when vomiting has been free (Toussaint and others); in practice a fatal issue is rare.

Blandet asserts that enteritis, though commonly produced by carbonate or acetate of copper, does not occur from the sulphate, and in one case, where 300 gr. were taken, vomiting, suppression of urine, and sub-sultus occurred, yet recovery took place without enteritis (Medical Times, i., 1874); the danger of the drug has doubtless been exaggerated, and Honerkopf gave in seventy-two cases, 5 grammes, and in eighteen cases, nearly 3 grammes without injury, but in other cases enteritis has been caused by it.

Acute copper-poisoning occurs most often from accidental contamination of food cooked in copper vessels, which, when perfectly clean and pure, are not harmful, but under the influence of air and moisture, vinegar, salt, or hot fats, carbonate, acetate, and oxychlorides of copper are formed, and the admixture of these salts ("verdigris") with the food is exceedingly injurious, causing severe colic, vomiting, headache, and pyrexia; tympanitis is sometimes very marked, and numbness and tremor of the limbs have been noted (Taylor, Armstrong: Medical Times, 1844). Similar symptoms, with scanty urine and excoriations about the mouth, followed the use of water boiled in a copper kettle, and of injections from a brass syringe (Amyot: Medical Times, 1859; Boggs: Lancet, 18G9). An epidemic, much resembling dysentery, occurred on board an Indian emigrant ship from using copper for the cooking of rice with ghee or butter (Moore: Lancet, 1846). If only one portion of the contaminated food has been taken recovery is usually rapid and complete, in proportion to the amount of vomiting; but if more be taken and not rejected, there remains a tendency to colic, vomiting, or diarrhoea, with much debility. Should death follow, there will be found intense redness of the intestinal tract or actual ulceration, according to the stage of the poisoning; perforation is rare (Taylor).

Chronic Copper-Poisoning - "Cuprismus Chronicus." - While by some observers this condition has been described as marked and frequent, by others its existence has been denied, and the symptoms explained by adulteration with lead, etc. The truth lies between extreme views- some amount of copper-poisoning may be traced among workers with the metal, but it is not very serious. Working in pure metallic copper without heat causes no bad symptoms (Hirt, Maisonneuve), but particles of oxide and cupric salts in the air of heated rooms may induce dyspnoea and laryngeal spasm. "Gold-printers," working with brass-alloy in fine powder, sometimes get vomiting, gastric pain, and anaemia; the hair becomes green-colored (Taylor). Dr. G. Harley has described a case of sudden colic with nausea, but neither diarrhoea nor constipation, in a copper-plate printer after cleaning plates coated with verdigris: there was a purple line on the gums (Lancet, 1863). Blandet was the first to describe a more serious chronic cuprismus as existent in Paris workshops, and marked, besides the green coloration, by colic with remissions, fever, lassitude, nausea, bilious vomiting, and diarrhoea, alternating with constipation (Gazette Medicale, 1845). Sir D. Corrigan recorded seven instances in brass-founders and engineers with similar symptoms, also emaciation, cough, and night-sweats; but two of these had organic lung disease, and the cases are not conclusive (Dublin Hospital Gazette, 1854). A band of light or reddish-purple on the gum-margin is described as characteristic, but really indicates an inflammatory condition which may arise from other causes (Bucquoy: Union Medicale, i., 1874). Bailly describes the true copper bluish-green or blue line as on the teeth only, not on the gum, which, however, was commonly inflamed: by analysis he detected copper in the blue line. Perron reported the prevalence of dyspepsia, "enteritis," and phthisis, among Swiss watchmakers working with an alloy of gold and copper; they had green coloration of the teeth, but mal-hygiene was a more likely explanation of their impaired health (Medical Times, 1861). Dr. Clapton brought before the Clinical Society cases of irritative dyspepsia in a flower-girl and a copper-smith, but his inquiries about copper-workers verified the absence of any special disease among them ("Transactions," vol. iii.). Chevallier, after an exhaustive inquiry, concluded Blandet's statement to be exaggerated, and failed to verify a true "copper colic" (Annales de Hygiene, 1859); any severe cases were found complicated by the presence of lead in the material used. Christison and Chomel reached the same conclusion. Hirt, while allowing that verdigris-makers may suffer from intestinal catarrh, and even from some amount of paralysis, blames rather lead, zinc, or arsenic in observed cases of severe "colic." I have known brass-founders get periodic attacks of colic and vomiting followed by rigors - a condition known in the workshops as "brass-founders' ague," and induced when the alloy is melted, and they are much exposed to its vapor - but have connected it rather with zinc or arsenic than copper. Pecholier and Pie-tra Santa, reporting on the health of verdigris-workers, describe local irritation of mucous membranes, but otherwise good health: they note especially the absence of colic and of chlorosis (Medical Times, 1864); and Maisonneuve concluded that though gastro-intestinal disorder may be induced by such work, the symptoms are neither severe nor persistent (Ranking, i., 1865).