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Anonymous (1917a)

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Anonymous (1917a) Poisoning from rhubarb leaves. J Am Med Assoc 68(26):847 <<>> At the resumed inquiry held by the Enfield coroner on Tuesday last into the death of a local minister of religion, Dr. B. H. Spilsbury, who made the necropsy, attributed the fatal issue to coma consequent on oxalic acid poisoning, the oxalic acid having been taken in the form of cooked rhubarb leaves. Mr. J. Webster, assistant analyst to the Home Office, stated that he had found oxalic acid in certain organs of the body and no traces of any other poison. Analysis of rhubarb leaves from the same ground as those eaten by the deceased showed the presence of calcium and potassium oxalates in quantity about 10 grains of each to the pound. Dr. Spilsbury characterised this quantity as a borderline amount sufficient to cause serious symptoms in certain people. The smallest recorded fatal dose of oxalic acid is given in text books as of 60 grains, and the soluble acid potassium salt is stated to be equally poisonous. Taken in concentrated form both act as violent irritants and quickly excite vomiting, by which some at least of the poison is expelled. Well diluted or taken with other food gastric irritation may be absent and nervous symptoms dominate the case, due to alteration of the calcium content of the blood. Combined with calcium oxalic acid is entirely inert. The coroner uttered a warning against the use of soda in cooking rhubarb stalks an addition which has been recommended to neutralise the acidity and avoid the necessity of adding sugar inasmuch as a soluble oxalate may to be produced by its action. He might well have given the positive injunction to add a pinch of powdered chalk in the cooking, whereby the same end is attained with perfect safety.

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