wo factors eventually undermined the reputation of zinc chloride as an all-purpose medicament. One was that its disinfectant properties had been overestimated. The second was the disturbing frequency, from the 1850s to the 1870s, of accidental and of self-inflicted poisonings ("Accidental Poisoning," 584). The chemist and physician, H. Letheby, in 1850, expressed surprise that he had not yet come across an acute case of ZnCl2 poisoning. His reaction was understandable. For a number of reasons, consumers were at great risk: zinc chloride fluid was widely available to anyone; its history as a diluted tonic was misleading; the bottles lacked sufficient warning labels, color coding, and unique shape to ensure immediate visual or tactile recognition (“H. Silverlock's”) ; and, since secure cabinets were not easily available, Burnett's Fluid might be stored alongside, and be mistaken for, a potable medicine (“The Storing of Poisons”). Zincane, like Claude-Louis Berthollet’s (1748-1822) Sodium Hypochlorite Bleach (NaClO), was a dangerous corrosive: both compounds destroyed living tissues. The unregulated sale of zincane posed a public-health danger, yet the medical community and manufacturers acted only after zincane accidents and suicides had been publicized.
Where ZnCl2 is mentioned in pharmaceutical texts, the emphasis is on its chemical properties. The pharmacologist, Jonathan Pereira (1803-1853), was an exception. His contribution to the Encyclopedia Materia Medica on ZnCl2 includes a substantial passage on the physiological effects of the chloride. Whereas in minute doses, it had been safely prescribed for scrofula, epilepsy, and chorea, the value of its internal use remained questionable. If the dose was too high, it induced vomiting, anxiety, shortness of breath, cold sweats, rapid pulse, and convulsions; worst of all, it damaged the alimentary system. In 1854, Pereira direfully reported: "several fatal cases of poisoning by chloride of zinc, in the impure state in which it is sold as disinfecting fluid, have already occurred" (The Elements , 272-74). Despite Pereira’s report, in the 1856 edition of Robley Dunglison’s popular, New Remedies with Formulae, the entry for ZnCl2, once again, provides a substantial amount of chemical and physiological information but no warning against accidental ingestion (694). Dunglison described methods of preparing the chemical, incisively surveyed its industrial and medical uses, from Papenguth in 1819 to Burnett and Stratton in 1848, and he outlined its modes of administration as a tonic (5 to 10 drops in water), as a lotion for skin ulcers, as a urological injectable, and as a suppository (694). Its agonizing effect on the digestive system, however, were omitted.
Because the chloride had been advertised widely as an internal remedy, reputedly of benefit in low doses for a variety of disorders, it was routinely kept in medicine cabinets. Its primary use, though, was as a skin disinfectant (Burnett’s formula), comparable to toxic isopropyl alcohol found in most homes today. But the chloride, on the other hand, posed an immediate danger in the household because the public either did not fully understand its toxicity or mistook the bottle for milk of magnesia or a beverage. Most fatalities were traced to mistaken ingestion. A person who accidentally drank the chloride, thinking it was an antacid or laxative, suffered greatly. Dr. Richard Hassall, in an 1853 Lancet article, recounted the case of a man who, in May 1851, had mistaken Burnett’s fluid for gin. Another individual swallowed a draught of zinc chloride, thinking it was "Murray’s fluid magnesia." Upon comparing the Burnett and Murray bottles to each other, Hassall observed, "that their size and shape were closely similar—the resemblance even extended to the labels; and in short the general aspect of the two was so nearly identical as readily to favor a mistake" (Hassall 159). For Hassall, the problem and its solution lay with the glass container and its manufacturers: “Sir James Murray’s fluid magnesia has been in general repute for many years; and it is very much to be regretted that in introducing Sir William Burnett’s fluid care was not taken to adopt some distinctive character for the bottles" (159). Dr. Henry Porter, of Peterborough, recounts a similar case in which a gentleman, reaching into the cupboard for a bottle of Dinneford’s Fluid Magnesia to soothe his stomach, received a terrifying shock (fig. 1); Burnett’s fluid, it seems, "had been placed by the side of the fluid magnesia, resembling it so much in size, shape, and colour of the label, that he at once, put it to his lips, threw his head back, and, taking a full inspiration, swallowed . . . two ounces" (651). Dr. Alfred Swaine Taylor recounts the tragic story of Rev. Thomas Marsh who, while on a sea voyage, was accidentally given Burnett’s fluid instead of mineral water and suffered lethal effects ("Canadian News"; Taylor 492).
In 1874, if not earlier, cases of accidental poisoning and suicide by ZnCl2 had increased considerably and were becoming public. D. H. M. Tuckwell, Physician to the Radcliffe Infirmary, Oxford, stated that zinc chloride had become a typically "English poison." Fatalities attributed to the chemical in Burnett’s Disinfecting Fluid, ingested "either with suicidal intent, or accidentally, by mistake for 'fluid magnesia'," followed rapidly, as the lips, the mouth, pharynx, esophagus, and stomach were corroded, patients experiencing indescribable pain. As little as an ounce of Burnett’s fluid containing 200 grains of the salt could cause death; however, due to mitigating factors, a patient was on record as having survived a 600-grain dosage of the solution, "after a very severe and protracted illness," but this was an exception (Tuckwell, 298). Woodman’s and Tidy’s 1877 summation of morbidity and mortality associated with zinc chloride ingestion reveals a grim statistic (224-26). Of 19 cases, reported in The Lancet, the Medical Times & Gazette, and the Edinburgh Medical and Surgical Journal, from 1848 to 1874, 10 or 52% were fatal. Bernhard Naunyn, (1839-1925), German experimental pathologist and pharmacologist, recognized that ZnCl2 had occasionally been used with criminal intent, “but more frequently accidentally” (595). Although, in most cases, temporary improvement occurred over the course of two or three weeks, as late as three or four weeks after the accidental ingestion, in some cases, gastric symptoms unexpectedly returned, as "large ulcers or cicatrices" appeared on the stomach lining (596).
A typical advertisement for medication in a bottle easily confused with one containing zinc chloride. From the 1873 Pharmaceutical Journal and Transactions courtesy of Google Books.
Since Naunyn studied post-mortem pathology, which revealed the corrosive effects of the chloride, he developed a treatment plan based on the fact, established by Dr. François Foy, that the chloride coagulated albumen, water-soluble proteins in blood plasma, serum, muscle, the whites of eggs, milk, and other animal substances. Because the compound reduced tissue to a viscous or thickened mass, Naunyn reasoned that its effects could be assuaged or neutralized by immediately feeding the patient egg whites and milk. He had, in effect, made an antitoxic breakthrough. He therefore recommended the albumen treatment, along with induced vomiting and the administration of carbonates and phosphates, as a way of mitigating the terrible effects of ingested zinc chloride (596).
Distinctive packaging as a practical countermeasure to prevent accidental poisoning by zinc chloride. From the 1873 Pharmaceutical Journal and Transactions courtesy of Google Books.
As the public-health danger manifested itself, practical countermeasures were taken in regard to glass containers. One idea was to give the chloride bottle distinguishing features so that it could be easily identified, both visually and tactilely. Another innovation was the safe, unmistakably identifiable storage box. Pharmaceutical manufacturers responded. The poison, though remaining in domestic settings, could be locked away: "Young’s Patent Poison Cabinet," for example, was advertised, in 1871, as a method "for securing Safety from Accidents" ("The Storing of Poisons," 8). An important innovation was to create projections on poison bottles so they could be identified by touch, especially in the dark by an intoxicated person or by someone visually impaired. "Lynch’s New Poison Bottle" appeared on the market (figure 2). Because it had "conical Projections" on its surface, "it [was] impossible to grasp it without being reminded that contents are of a nature requiring more than ordinary care in their use" ("Lynch’s," 6). Surgeon, Wyndham Cottle, in April 1880, described a system of poison-bottle identification, instituted at the Brookwood Asylum, by Dr. Brushfield. These measures included reshaped bottles that were conical, "tapering from an octagonal base to the neck, which is circular, five-eighths of an inch in internal diameter, and sufficiently long to hold a cork" (569). The glass was color-coded: various sized bottles were uniformly of a deep blue color; and they were affixed with bright yellow, conspicuous labels (569-570). Since the danger of poisoning through accidental or suicidal ingestion had been recognized, the medical community had to reconsider if prescribing the chloride internally outweighed the possibility of unintended overdose in those who self-medicated.
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Last modified 29 January 2017