Imagens das páginas

surface of contact, the qnioker the absorption in both kinds of cases.—Archil; fur path. Anat. vnd Phys., von K. Virohow, July, 1858.

Further Experiments with Bibron's Antidote for the poison of Reptiles.—Dr. Walker, of Gonzales, Texas, gives the following illustration of the effect of Bibron's antidote. He was called, on the evening of the 30th of June, 1858, to Benjamin Watkins, aged thirty-five, who had been bitten over the metacarpal bones of the third and fourth fingers of the left hand on the Sunday previous, by a black mocassin or cotton mouth of the South, a variety of the trigonocephaly piscivorus. The family being absent, he took a pint bottle of whiskey, and after drinking some of it, started to a neighbouring house, fell to the ground, arose and made another effort to proceed on the way, fell a second and a third time; after which he was unable to rise again. He remained where he last fell, in the sun, without water, from about 11 o'clock A.m., to 6J P.m., when he was found and carried home. He drank about a pint of whiskey during the day; had some nitrate of potass administered on Sunday night. Tuesday, had some tea from the curcle burr, with various kinds of poultices to the hand and arm.

Dr. sWalker found Watkins delirious, with occasional lucid moments; pupils much dilated; bathed in profuse perspiration; pulse 120, and very feeble. The hand very much swollen, with some sloughing, and immense sanious discharge. Forearm and arm swollen, with much purple discoloration, and extensive abrasions along the belly of the "biceps flexor cubiti," with sanious discharge. The muscles of the whole chest, back and front, were much swollen and very tender to the touch, with purple discoloration over the pectoral, deltoid, and scapular muscles of the left side, and dark purple appearance from the clavicle to the ilium of the right side; his breathing deep and laboured. Dr. Walker gave him in $ss. of whiskey, Bibron's antidote gtt. xx.; in thirty minutes he repeated the same dose; immediately after which the patient vomited a quantity of white frothy fluid. In an hour, the same dose was repeated, immediately after which a quarter of a grain of sulphate of morphia was given. The patient continued delirious about an hour, when he went to sleep, waking in about two hours. The delirium had subsided, and the pulse was at 110. The breathing also was somewhat relieved. Dr. Walker left him about sunrise. He ordered sulph. quinine, gr. iii., camphor powder, gr. iii., to be given every six hours, and the sloughing and abraded parts to be dressed with oharcoal poultices, and all the swollen parts to be bathed frequently in salt water. As Dr. Walker had to leave the conntry for a few days, he procured the services of Dr. McKay for the cose, who oontinued the treatment for two days, when finding the patient with a furred tongue, he gave him a mercurial, and substituted iodide of potassium for the quinine and camphor, a stimulating ointment for the poultices to the sloughing parts, and Lugol's solution of iodine in place of the salt bath to the swollen parts.

Dr. Walker resumed attendance on the case on the 7th July. He continued the iodide of potassium, substituted the charcoal poultices with the addition of a solution of creosote for the stimulating ointment, and suspended Lugol's solution. On the 10th July, the abrasions on the arm had healed, the slonghing of the hand had extended all over the third and fourth fingers, over the second, third, and fourth metacarpal and unciform bone on the dorsal aspect of the hand, and all over the palmar surface of tho hand, extending back to the radio-carpal articulation. In connexion with Dr. McKay, amputation of the forearm was determined upon, which they did, performing the double-flap operation in the lower third. On the 18th day after the operation, the patient was riding over the country with the stump entirely healed. Upon examining the wrist-joint after the amputation, they found about a drachm of pus in the synovial sac. Dr. Walker thinks this recovery cannot be attributed to any other agent than the bromine compound of Prof. Bibron.—American Journal of Medical Sciences, Oct., 1858.

Experiments with Bibron's Antidote by Dr. Sabal.—Dr. Sabal, of Ri«eboro', Liberty Oo.i Ga., reports six experiments with Professor Bibron's antidote. In his first experiment, a dog was bitten at the sacro-lumbar articulation. Four minutes after the wound, he staggered and fell; twelve minutes afterwards, he vomited blood freely, when Dr. Sabal administered a dose of Bibron's antidote. This seemed to revive him, but although he made many attempts to rise, he failed in doing so. Fifteen minutes after the first dose was given, Dr. Sabal administered a second dose. The dog again revived, but could not move. In twelve minutes six drops of the mixture were given to him. Ho died in taking it. This dog died in forty-three minutes from the time he was bitten; there was no swelling; his eyes became of a green colour several minutes before his death; the tongue contracted to one half the normal size, and became of a dark purple colour. In the second experiment, the dog was fine, fat, and hearty. He was bitten three times in the flank. Swelling did not commence for fifteen minutes, when he whined, and seemed much distressed. Ten drops of the bromine mixture were administered, and he seemed much better. He was sick fifteen minutes afterwards, and frothed at the mouth. A second dose was given in the same proportions as the first. He revived immediately, and has been well ever since, with the exception of a swollen leg, which disappeared in twenty-four hours. In the third experiment, the dog was very severely bitten on the leg in three places. He vomited the contents of his stomach; inimediiitely subsequently he vomited frothy blood and bled at the nose. Twenty minutes after the wounds were made the antidote was given, and repeated four times at intervals of ten minutes. This dog was sick for six hours, when a fifth dose was given. He made a complete recovery, but the leg remained swollen for two days. In the fourth experiment the dog was thin and old. The medicine was given as described in the preceding cases, but he only lived thirty hours, and unlike any others that died, he was enormously swollen. The fifth experiment was made on a young dog, which was bitten in the neck. This dog lived live hours under the administration of the, medicine, but Dr. Sabal having been called away, the dog was neglected, and died apparently from suffocation. In the sixth experiment, the dog was bitten in the flank, received all attention, but died in an hour and a half.—American Journal of Medical Sciences, Oct., 1858.

Summary.—An instance of wholesale poisoning by lozenges charged with arsenic, occurred at Bradford on the last days of October and the 1st of November, 1868. Mr. Neale, a confectioner, sent to Mr. Hodgson, a druggist, at Shipley, for what is technically called "daff," but which is really sulphate of lime. The "daff" this time supplied, was, by a careless accident, arsenious acid; lozenges were made with it, and Hardaker, a stallman, sold them. There were more than twenty deaths as the result, while a hundred were made sufferers. Excepting one fact, of the mode in which the accident occurred, this case has but little interest now to the medical jurist; since no medical scientific record has been made which can be considered as throwing any light on toxioological studies.

Poisoning by HyoscyamusScarlatinal Eruption.—The 'Montreal Chronicle' records a case by Dr. R. Craik, of Montreal, in which a child was poisoned by swallowing a portion of some plants of hyoscyamus niger, growing in the yard of the Montreal General Hospital. The plant eaten was not quite ripe, and nearly an ounce of capsule and seeds had been swallowed. The symptoms induced were flushing of countenance, restless and violent tossing, momentary listening to imaginary sounds, and eager clutching at visionary phantasms; the eye was brilliant, the pupil widely dilated, the pulse hurried, and the respiration laboured. The most curious symptom was this: the whole surface of the skin was of scarlet redness, exactly as occurs from the rash of scarlet fever; the mncous membrane partook, to some extent, of the same appenrance as in scarlatina. Emetics of sulphate of zinc and mustard removed the hyoscyamus seeds and capsules from the stomach, and recovery took place; but the acute symptoms did not entirely cease for twenty-four hours; the pupil remained dilated for several days. On the fourth day varicellar eruption appeared, followed by extensive desquamation of the skin.

Deathfrom eating Roily Berries.—The' Gardener's Chronicle' and' Pharmaceutical Journal,' for,March, 1859, contain record of the following case: A little boy, named Fuller, at Northiam, was allowed by his parents to eat from twenty to thirty of the red berries from the holly. He was ill and vomited through the night. In the morning Mr. Harris was called in, but was summoned too late for his attendance to be of any avail. The jury returned a verdict that death occurred from some "vegetable irritant." The dangerous properties of red holly berries have been pointed out by some botanical writers, as De Candolle and Lindley. The latter author states, "the berries are purgative and emetic, six or eight will occasion violent vomiting." A fatal case of poisoning from them does not, however, seem to have been before noted, and -Christison, Orfila, and Pereira are silent on this poison. It is well, therefore, to make known, that the berries with which our churches and bouses are decorated at Christmas, are to be ranked amongst the vegetable irritant poisons.

Detection of Phosphorus.—The 'American Medical Monthly,' for September, 1858, contains a note on a new mode of detecting phosphorus, discovered by Professor E. Delarue. In examining a body supposed to have been poisoned by phosphorus, the ordinary tests failed. It then occurred to him to test for some metallic substance. He therefore submitted a very small portion of the stomach to combustion by means of sulphuric acid, when suddenly, to his surprise, the carbonaceous mass was covered with brilliant sparks, which burned at the side of the capsule with all the characteristics shown by phosphorus when burning in air. In another case, the intestines of a child, four years old, were examined for phosphorus, but without success. Professor Delarue, for the sake of experiment, mixed with a portion of the stomach the material derived from twenty matches, and submitted tho structure to combustion with sulphuric acid, when all the phenomena of phosphorus combustion were again markedly developed.

In the 'Glasgow Medical Journal,' for October, Professor Easton continues his very able paper on the Elimination, Catalysis, and Counteraction of Poisons. In the 'American Journal of the Medical Sciences,' for October, 1858, Dr. Buel gives instances of two men who were poisoned by Seidlitz powders. One man died within a few minutes with symptoms of the tetanic type; the other had similar symptoms, but recovered under the use of emetics. The evidence at first was in favour of the view, thut the powders were charged with strychnine; the remaining powders from the same parcel were submitted to a strict chemical analysis by the Professor of Chemistry in the Brown University, but the inquiry threw no light on the subject.

Since our last report, four deaths at least have occurred from chloroform. Three of these are recorded in full. One occurred at the Opthalmic Hospital, Moorfields, in a child eight years of age; the others in Paris, in subjects young and apparently healthy. In all the cases the chloroform was given on a handkerchief or from lint.

IL Miscellanea.

Extra- Uterine Pregnancy and Death.—The subject of this report was a free negress, who had buen twice married, had borne two children at the full period, and had suffered two abortions. The periods of pregnancy at which the abortions had ocourred, were not ascertained. The history of the last attack commenced on the 9th of December, 1857. About nine in the morning the patient felt sudden abdominal pain, and soon after became so faint that she would have fallen, but for the support of her husband. She was laid upon a bed and partly recovered from her fainting condition. The pain, however, continued and increased in intensity. Dr. Metcalfe, who reports the case, found the woman with all the symptoms of haemorrhage. She had menstruated five or six weeks previous to this time. He ordered stimulants and anodynes, under which she seemed at first to rally; but on his return, after a short absence, she was hopelessly sinking; she died about fourteen hours after the sudden expression of pain in the morning. On the following morning, on making a post-mortem examination in this interesting case, which in this country would have given rise to strict judicial inquiry, Dr. Metcalfe found that hemorrhage had taken place into the abdominal cavity, and that the cause of the hramorrhage was a rupture in the light Fallopian tube, near its connexion with the uterus. The rupture was about one-fourth of an inch in extent, and on increasing the opening a cavity was found as large as a chesnut, involving both the tube and proper tissue of the uterus. In this cavity the mouths of several small vessels were found to terminate, and near the opening was found a displaced ovum. The uterus was lined with decidua,— Semi-Monthly Medical News, Jan. 1st, 1859, Louisville, Kentucky.

Detection of Blood and Blood-stains.—Dr. Heller, in an elaborate paper on Haematin and its Detection, supplies some notes of a test for this colouring matter, from which we make one or two short extracts. After describing various colouring substances which may give a red or inky coloured water, he explains that in all cases the water must be tested for albumen, the absence of which excludes hieraatin. If albumen be present and be separated by boiling, the coagulum containing the hromatin is not white, but of a red or rusty-brown colour, and the whole red colour of the water is lost, and the clear fluid becomes first of a light and then of a darker yellow tone. The colleoted dried albumen coagulum will assume, if a very little haematin bo present, a brownish-black colour, whilst, if no albumen be present, the coagulum will be yellow.

To obtain a reaction of haematin, Heller recommends the following. The coloured water, whether it contains much or little albumen, is boiled in au open eprouvette, and solution of caustic potassa is added. In the presence of haematin, as the potash solution is added, a faint bottle-green colour appears. The solution is warmed for a short time and shaken, upon which the earthy phosphates subside by reason of the ammonia which is being produced. The haematin escapes, and after a time appears partly above, partly at the lower part of the vessel, at one time ot brownish-red, again of a beautiful blood-red. The eprouvette is now allowed to stand aside for a time quietly, so that the earthy phosphates which have been coloured of a blood-red by the haematin settle at the bottom. Under the microscope this sediment presents yellow amorphous masses. The red earthy phosphates, after two days, again become discoloured by the further action of the potassa. If the solution contains very little earthy phosphate, or if it consists of any fluid, such as vomited matter, which has to be tested for Laematin, then an equal volume of pure water must be added to the fluid to be tested, in order to obtain a sufficient quantity of earthy phosphate.

This reaction is specially recommendable in coses where the blood-colouring stuff has undergone partial decomposition and lost its red character, orwhere it is hidden, as by biliphein, or where fluids exist which from their exterior appearance would not be suspected to contain blood, as in the fluid of an abscess and in the contents of cysts. Dr. Heller gives special precautions on the detection of blooil-stains, pointing ont that success or failure depends principally on fonr points—viz., the quantity of blood found, the age of the blood-stain, the place in which the corpora delicti have been preserved, and lastly, the means which may have been used for removing traces of blood. His haematin test given above affords a fnrther contribution to the analytical method of ascertaining the fact of blood—Zeitschrift der Kaiserl. Konigl. Gesellschaft der Aerzte zu Wien, November 22nd, 1858.

Detection of Blood-stains.—Dr. Andrew Fleming, of Pittsbnrg, Pa., has also a paper of valne on blood-stains. The paper is rather useful as a comprehensive review of the whole subject, than as offering original material. He considers the " chemical characters of blood-stains" and the "microscopical examination." His note on the method of procuring blood-crystals may be of use. The method of obtaining crystals is to put a drop of blood on a glass slide, add a small quantity of alcohol, water, or ether, and then allow evaporation to take place slightly, covering the fclood with a glass slip, and first interposing a hair between the glasses, to afford room for the crystallization; carmine-red crystals of different sizes will appear in from half an hour to a few hours or several days, according to the kind of blood and the situation in which it has been placed. The crystals are more rapidly obtained by exposure to sunlight, and more easily from defibrinated blood. The blood from which it is desired to make crystals does not require to be taken immediately from the vessels, but they are with less trouble procured when it has stood from twelve to twenty-four hours, which is a great advantage in lecal cases. From blood that has been dried in clots for several months, the haematin crystals may sometimes be obtained. Dr. Fleming is of opinion that in the microscopy of blood corpuscles great difficulties arise in the recognition of the corpuscles special to the blood of special animals. [We can ourselves fnlly attest to these difficulties, and add that they are insurmountable.]—American Journal of Medical Sciences, January, 1859.

III. Hy-iene.

Life and Labour.—The 'Sanitary Review' for January has an article on the influence of various common occupations on health and life. The effects of sand-paper making are illustrated as giving rise in the young to a modified phthisis, which is sometimes rapidly fatal. sWalking-stick making and hemp and flax dressing are described as exciting bronchitis and bronchorrhoea. The Neapolitan hemp has also the peculiar property of producing a spasmodic paroxysmal attack like that produced by drying hay and by ipecacnan. Trimming manufacturers' work leads to bronchial mischief. Fur dyeing, by exposing the artisans to the fumes of nitrons acid and to the dust arising from dried sulphate of copper, specially leads to a number of serious evils, affecting the teeth, the digestion, and worst of all, the organs of respiration. Cigar and snuff-making, in the first instance, give rise to the peculiar toxical effects of tobacco, and afterwards to chest disorder, ending in chronic bronchial flux and inanition. The writer of this paper suggests that a Parliamentary committee of inquiry should be organized to inquire into the subject of occupations and health. He concludes as follows:

"When we look at diseases as a whole, we stand amazed at the varieties of type which they assume. When we classify them into groups according to their causes, we stand equally amazed at finding to how very few groups all diseases may be reduced. We find all the disease causes out of the body and clothed in externals. Resolving the causes, there stand out some dozen poisons of communicable and reproductive power, improper dietary, variations of atmosphere, and occupations. Of all these, the last stands most invitingly for mquiry. The inquiry is of a kind to which the most rigid rules are applicable. Its results might be demonstrations, its suggested remedies simple certainties."—Sanitary Bmiew, January, 1859.

Mortality of England in 1856.—Of 890,506 deaths in the year, the causes were not specified at all in 4666 cases, and 8474 are simply tabulated as sadden deaths, all inquiries having failed to elicit further definite information; 94,407 of the whole number of deaths were those of infante under one year old.

The causes of death are arranged in a few classes with numerous subdivisions. 78,047 of the deaths are classified as zymotic diseases: typhus (15,898), scarlatina (14,160), and diarrhoea (13,815), proving fatal in 43,873 instances, or considerably more than one-half of the whole number due to this class. Hooping-cough, measles, and croup stand next in order. Small-pox, formerly so fatal, was the cause of death in 2277 cases.

Of the class of diseases denominated "constitutional," 82,85G persons died. Phthisis (consumption) stands sadly pre-eminent in this list, its victims numbering 48,950 persons, by far the greater proportion of whom were young women. "How many of the thousands of deaths are to be ascribed severally to the fatal stays and to the in-door life of women, &c., it is not easy to calculate. Air is the pabulum of life, and the effects of a tight cord round the neck, and of tight lacing round the waist, differ only in degree in the time of their manifestation and in some of their symptoms; for the strangulations are both fatal. To wear tight-laced stays is, in many cases, to wither, to waste, and to die, and is perhaps the natural chastisement of the folly which inflicts this Chinese deformity, natural only to wasps and other insects, on the hnman figure." The tubercular diseases carried offin all 63,832 persons.

The "local diseases," as inflammations, the allied pathological phenomena or their results, and functional diseases of particular organs, proved fatal to 149,911 persons. 50,535 of these died of diseases of the brain and nervous system, including also 23,946 deaths by convulsions. 13,672 deaths were referred to diseases of the organs of circulation. Diseases of the respiratory organs proved fatal to 52,908 persons, 21,528 of whom died from bronchitis and 22,653 by pneumonia. These diseases, and all others of the class, were less fatal than in the previous year. 22,620 persons died from diseases of the digestive organs. The1 other causes of death under this heading are numerous, but the cases are few in each.—Condensed from the Registrar-General's Annual Report for 1856.

Effects of Sewer Emanations.—Dr. S. J. Radoliff, of Baltimore, reports a case in which a .man was exposed for two hours to the gases arising from a privy sink. The man, a strong athletic German employed in the night business, was engaged with two others in cleansing a sink which was eight feet deep. About 950 gallons of the fluid had been removed, when the man attempted to descend into the sink to complete the work, the contents being then only two feet and a half deep. He was overcome by the noxious gases, and precipitated to the bottom. Every means was used to extricate him, but for some time to no purpose. He was kept alive by continued douches of cold water; and finally, after a lapse of two hours, finding that he was too exhausted to grasp a rope, a ladder of sufficient length was procured, and at the risk of their own lives, several men descended, and succeeded in rescuing him. The •symptoms exhibited by the man on coming to the air were those of partial asphyxia, with coldness of the body and shivering. The fresh air revived him, and reaction soon set in. After a time he complained only of nausea, and thought he could taste and smell nothing but .the disgusting effluvia. In two days, without any peculiar symptom, and with no indications whatever of typhoid, the man was fairly convalescent. He made a perfect recovery.— American Journal of Medical Sciences, Oct 1858.

By Edward H. Severing, M.D.

Fellow of the Royal College of Physicians, Physician to, and Lecturer on
Materia Medlca at, St Mary's Tjospital.

I. On "Ataxie I.ocomotrice Progressive." By Dr. Ducheitnr (de Boulogne). (Archives Generales de Me"decine, Deoembre, 1858.

UtnwB the above title, for which we are as yet unable to suggest a suitable English version, Dr. Duchenne describes what he regards as a new disease. He states that for six years past his researches have induced him to believe in its existence, and that once having satisfied himself of "the fact, he bad no difficulty in discovering many instances of the disorder. "Without making a minute search, he states that in a brief space of time he collected twenty oases. The characteristic features are: progressive abolition of the co-ordination of movements and apparent paralysis, contrasting with the persistent integrity of the muscular forces.

The loss of power of co-ordinating the movements which is manifested in the lower extremities, consists in a difficulty of maintaining an erect position without trembling or without support, or of performing certain movements in progression, such as lateral or gyratory movements. The patients commonly at such time feel giddy, and as if about to

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