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ART. II.-Description of an Instrument for the Subcutaneous Introduction of Fluids in Affections of the Nerves. F. RYND, Surgeon to the Meath Hospital, &c. THE canula (A) screws on the instrument at (B); and when the button (c), which is connected to the needle (F), and acted on by a spring, is pushed up (as in Fig 2), the small catch (D) retains it in its place. The point of the needle then projects a little beyond the canula (Fig. 2). The fluid to be applied is now to be introduced into the canula through the hole (E), either from a common writing-pen or the spoon-shaped extremity of a silver director; a small puncture through the skin is to be made with a lancet, or the point of the instrument itself is to be pressed through the skin, and on to the depth required; light pressure now made on the handle raises the catch (D), the needle is released, and springs backwards, leaving the canula empty, and allowing the fluid to descend. If the instru ment be slowly withdrawn, the parts it passes through, as well as the point to which it has been directed, receive the contained fluid; and still more may be introduced, if deemed expedient.

The subcutaneous introduction of fluids, for the relief of neuralgia, was first practised in this country by me, in the Meath Hospital, in the month of May, 1844. The cases were published in the "Dublin Medical Press" of March 12, 1845. Since then, I have treated very many cases, and used many kinds of fluids and solutions, with variable success. The fluid I have found most beneficial is a solution of morphia in creasote, ten grains of the former to one drachm of the latter; six drops of this solution contain one grain of morphia, and a grain or two, or more, may be introduced in cases of sciatica at one operation, with the very best effects, particularly if they are of long standing; or even in cases of tic in the head and face, with equally beneficial results. The small instrument is for operations on superficial nerves, the larger one for deep-seated nerves; for though it is not necessary to introduce the fluid to the nerve itself to ease pain, still the nearer to the seat of the pain it is conveyed, the more surely relief is given. They were manufactured, and completed entirely to my satisfaction, by the celebrated surgical instrument-maker, Mr. Weiss, of London, and are faithfully represented in the accompanying lithograph, by Foster & Co., of this city.

ART. III. Case of Poisoning by Aconite. By LOMBE ATTHILL, M. D., Fellow of the King and Queen's College of Physicians; Ex-Assistant Physician, Rotunda Lying-in Hospital. THE details of the following case of poisoing by aconite may, perhaps, be deemed of some interest, there being but few wellauthenticated instances on record, those in which recovery took place being still fewer. The accuracy of the details may be relied upon, as I made notes from time to time by the patient's bed-side.

On Friday, the 4th May, 1861, I ordered the following liniment for a gentlemen who was suffering from a painful affection of the hip-joint:-soap liniment, two ounces; tincture of aconite, three drachms. At the same time I prescribed a mixture, of which he was to take one table-spoonful for a dose. He was a weakly, delicate man, and had for several years been subject to fits of epilepsy. On the following morning, having rubbed in the liniment as directed, he proceeded to take the mixture; but, having placed the two bottles together, instead of doing so, he inadvertently poured out and swallowed a table-spoonful of the liniment, which must have contained 48 minims of the tincture of the Pharmacopoeia. This was at 10 minutes to 8 o'clock, A. M. He immediately perceived his mistake, and as quickly as possible sent for me; but though no time was lost, I did not reach him till about 20 minutes to 10 o'clock, for he resided in the country. I found him dressed, sitting on a chair in his bed-room, and supporting his head on a table, with a basin before him. He was sickish, having retched frequently, without discharging the contents of the stomach. He had drunk a good deal of warm water, and to this and the soap liniment he had swallowed we may attribute the inclination to vomit.

His appearance did not indicate anything very unusual. He told me that he had been walking up and down the room till within ten minutes of my arrival, when he was compelled to sit down, feeling himself prostrated and entirely overcome by the effects of the poison. He complained of extreme languor, and a great sense of oppression and weight, with inclination to yawn; but his most distressing symptom was a feeling of dry heat and tightness of the skin over the whole body, accompanied by the sensation of numbness and tingling. This, he stated, commenced in his feet, within a very few minutes of his having swallowed the poison, and spread quickly upwards. There was not at this time any dilatation of the pupils, but they seemed to act sluggishly, nor had he any unpleasant feel

ing about the throat or mouth. His pulse was very feeble, and faltered rather than intermitted; but, within ten minutes of my arrival, it began to intermit in a most marked manner; and the intermissions were more frequent and prolonged, until the pulse ceased to be felt altogether at the wrist.

The moment I had made a few hurried inquiries, I administered the only emetic at hand, namely, mustard. How much I gave I hardly know, for I shook it into a cup, and mixed it as quickly as possible. Immediately on his taking this, I got him into bed, and placed a hot jar to his feet, which were very cold. Shortly after I administered more mustard, the first dose having failed to act as an emetic. After this he began to retch again, but only brought up mouthfuls of frothy mucus, tinged with the mustard. It was now half-past 10 o'clock (two hours and three-quarters had elapsed since he swallowed the poison), and his condition, which had become rapidly worse, was as follows:

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The whole surface of the body was cold, especially the hands and arms; the feet, however, were kept warm by the jar. He lay on his back, with his shoulders elevated and ported by pillows; his face was livid; the eyes were closed, and, except when roused by attempts at retching, or when spoken to, he seemed to be indifferent to all that passed around him; he did not, however, wander in the least, was perfectly conscious, and expressed himself clearly on several subjects I spoke to him of. The pupil of the eye was very slightly dilated; the pulse could not be felt at the wrist, and even in the temporal artery only with difficulty. The heart's action was feeble, irregular, and intermitting, and was momentarily becoming more and more affected. On examining with the stethoscope, its sounds were distinctly audible, and even preternaturally clear, but its impulse was almost wanting. When asked how he felt, he complained only of the great weight of his head, and the numbness of his legs. I should have mentioned that, shortly after he had taken the second dose of mustard, I had commenced the administration of such stimulants as I could procure, namely, brandy and strong coffee; for I was nearly three miles from any apothecary's shop, and could obtain no others. I had also already applied two mustard sinapisms, one over the heart, and the other to the epigastrium; but, although he complained of the pain they occasioned, they did not seem to produce any beneficial effect; so I now determined to apply one to the nape of the neck. I have already mentioned that this gentleman was subject to fits of epilepsy, for the relief of which he had for several months kept open a

small blister, by means of D'Albespeyrre's plaster, on the back of his neck. Över this the mustard had to be applied; and, although I did not remove the dressing, it almost immediately caused great pain, and stimulated him in a marked degree; so much so, that the pulse was again perceptible at the wrist, though it soon failed again.

At this juncture my friend, Dr. White, of Roundtown, arrived, as I had summoned him to assist me in this distressing and anxious case. He brought with him some aromatic spirits of ammonia, of which we immediately administered half a drachm in brandy and water. Soon after swallowing this he vomited freely, and appeared to be somewhat relieved by doing so, but quickly relapsed into his former condition; and now, for the first time, he complained of drowsiness. Hitherto there had been no symptom of spasm or convulsion; but, at about 11 o'clock, he had a very slight convulsive fit, which, however, passed off almost instantaneously. After it he vomited freely, expectorated large quantities of ropy mucus; the pulse also returned for a moment or two to the wrist. At 15 minutes past 11 o'clock he had a second fit, more severe and better marked than the former, and, though short, it was very decided in its character. During its continuance the head and thorax were slightly drawn back; the hands and arms were flexed; the eyes remained open, and the pupils were considerably dilated; respiration, also, was much impeded; and he must have been unconscious, for, on rallying, he said he had been asleep. His vision, too, seemed impaired, although he saw distinctly when roused. He now complained greatly of a dreadful feeling of numbness all over the surface of the body, more especially on the hands, face, and calves of the legs, with a sensation of tightness of the skin of the face, and tingling of the lips; but there was no distress of any kind experienced in the mouth or throat. There was great restlessness and jactitation.

Again there was another interval, marked as before, first, by a transient rallying of the powers of life, followed by still greater depression. This interval we employed in administering stimulants, and in efforts to keep up the circulation by friction over the thorax and on the extremities. We also applied sinapisms to the calves of the legs and to the back. Among other things, we gave strong green tea, as there was a decided tendency to sleep. About this time the bowels were moved -not, however, involuntarily, for he expressed an inclination to evacuate them, so he was directed to pass it in a sheet under him; and he was in the act of doing so, when he was