mend, through the substance of the latter. In a few rare instances, the placenta has actually been expelled by the natural efforts before the child, and the patient has recovered without having incurred any danger.-La Lançette Française.

POISONING BY ARSENIC SUCCESSFULLY TREATED WITH THE TRITOXIDE OF

IRON.

A young lady, who had been long drooping from severe chagrin, attempted suicide by swallowing a quantity of arsenic. About an hour after the commission of the deed, she was seized with violent vomiting; and, as fortunately she had taken food not long before the poison was swallowed, it is probable that a considerable portion of the latter was rejected from the stomach. The excruciating pain and sense of burning in the abdomen, accompanied with cramps of the limbs, however increased; and the parents, becoming now more alarmed, called in the assistance of Dr. Deville.

From the nature of the symptoms, he at once suspected that his patient was suffering from the effects of a poison. The girl confessed the truth, and directed him to a drawer wherein the cup, from which she had drank the poison, was to be found.

After administering a quantity of milk, and having a large linseed poultice applied over the whole of the abdomen, Dr. Deville sent off to procure some of the hydrated peroxide of iron—a preparation which, within the last two years, has been strongly recommended as an antidote to the effects of arsenic. After several laboratories had been applied to in vain, a small jugful was fortunately obtained from M. Caventon. It was now upwards of five hours since the arsenic had been swallowed. A spoonful (nearly an ounce) of the peroxide was given every quarter of an hour, until nearly half a pound of it had been taken.

The alarming symptoms began to abate; and, as the pulse had risen and the pain of the abdomen was extremely severe, twenty-five leeches were applied to it, and the hot poultices were ordered to be persevered with.

It is unnecessary to pursue the particulars of the case further, as the patient ultimately recovered, after suffering for several days from most intense head-ache.

Dr. Deville, in his remarks upon the case, states that he is led to believe that very nearly a drachm of arsenic had been swallowed. True; a portion, perhaps a large one, of it had been rejected along with food by vomiting; but, as we know that even a few grains are sufficient to cause death, there is strong ground to infer that the peroxide of iron must have acted as a direct antidote, or neutralising substance.

Dr. Bunsen of Gottingen, who discovered this property of the peroxide, states that three or four drachms of it-recently prepared and suspended in water-to which sixteen drops of ammonia have been added, are sufficient to neutralise six or eight grains of arsenious acid: an insoluble and inert Arsenite of iron being formed.

M. Lesneur, while he admits the counter-acting operation of the tritoxide, says that a much larger quantity is necessary for the neutralization of the arsenic, than that stated by M. Bunsen.

But the subsequent researches of MM. Bouley, Soubeiran, and Miquel,-all able and experienced chemists-have shewn that about twelve parts of the fresh tritoxide are sufficient to neutralise one part of the arsenious acid. The sooner that it can be administered after the injection of the poison, the more prompt and effectual will be the counteraction. M. Bouley says that if it be taken along with the poison, it annuls the effects of the latter altogether.—Revue Medicale.

REMARKS ON PARALYSIS OF THE EYElids.

Although this affection is not unfrequently connected with, and is a mere outward sign and concomitant of, disease in some part of the nervous centre, it is nevertheless, very often quite a local weakness, and may be relieved by local applications,

The following four cases of blepharoplegia (in all, the upper eyelids were affected), are related by M. Carron du Villards, in a recent number of the Bulletin General de Therapeutique.

Case 1.-Madame Lenoir has long been subject to most troublesome attacks of coryza. The eyes are always more or less affected, and the lids are swollen and oedematous. After a recent attack, the right upper eyelid was found to be quite motionless; the patient had lost all power over it. The medical man in attendance had ineffectually tried various means; and the patient applied to M. Carron. He recommended frictions with concentrated acetic æther to be used three times a day.

By the third day the paralysis had quite disappeared.

In the second case, the falling of the upper eyelids followed an attack of erysipelas of the face, and had lasted for three weeks, when the patient applied to Mr. Carron. He recommended him to keep the eyelids continually wetted with a warm infusion of four drachms of the ergot of rye in boiling port wine (quatre gros de seigle ergoté dans du vin rouge bouillant). In two days, the eyelids had recovered their mobility.

In the third case, the affection of the eyelids supervened upon a partial asphyxia, induced by the power of charcoal. Fomentations, with an aqueous infusion of ergot of rye, were ordered to be kept constantly applied to the affected eyelids: in eight days the paralysis had vanished.

The fourth case was not quite so simple. A lady, thirty-two years of age, had been long subject to intense headaches; and latterly a complete blepharoptosis of the right side had come on. She had been under treatment for some time before applying to Dr. Carron. He ordered her to be bled in the foot; to be cupped over the nape of the neck; and to take small doses of the tartrate of antimony. The use of strychnine, both internally and externally, was now resorted to; but without advantage. A liniment, sharpened with some Croton oil, was then rubbed upon the affected eyelid and brow: this brought out a miliary eruption, and the patient began to recover speedily power over the movements of the lid.-Bulletin General.

CASES OF GLANDERS IN THE HUMAN SUBJECT-DISCUSSION AT THE ROYAL ACADEMY ON.

M. Husson read the report of a case which occurred very recently at the Hôtel Dieu.

An ostler had charge of eleven horses affected with glanders: in some the disease was acute, in others it was chronic. Several of these animals were killed by order of the public authorities. The man slept in the stable along with the glandered horses.

The first symptoms of sickness in him were headache, and a profuse discharge of mucus from the nostrils. This discharge became successively sanguineous and sero-purulent. To these symptoms were soon added a violent fever and

a severe pain in the right shoulder, which was considerably swollen and very tender on pressure.

Bleeding, general as well as local, was had recourse to the blood drawn from the arm was strongly buffy. The swelling of the shoulder extended down along the whole arm. At one point was observed a gangrenous spot. Several pustules made their appearance on the body, neck, and arms; and a hard tumor was felt over the right lower ribs. The pustules became covered with eschars; delirium and coma supervened; the pulse was filiform and sometimes almost imperceptible; and death soon followed. The disease had lasted for eight days. Dissection. There was observed to be a generally diffused eruption of pustules and of gangrenous spots. The pustules were large on the face especially, and on the neck and scalp. At various parts of the body there were large subcutaneous tumors, of a livid aspect on their surface. The largest of these was situated over the right shoulder, and was more than an inch in diameter. These tumors were found, on being cut into, to contain a sanguineous purulent matter. The one on the shoulder was found to communicate with another large one over the right rib by a chain of little knotty swellings. The contents of the thoracic one had made their escape into the cavity of the pleura. In many parts of the limbs, numerous abscesses were found between the muscles and the skin. Many of the lymphatic glands in the neck and elsewhere were much enlarged, and also softened.

The mucous lining of the nostrils exhibited patches of erosion and ulceration, as well as numerous pustules scattered over its surface. The septum nariam was perforated at one point for the extent of half an inch or so, and it was covered with pustules and minute ulcerations.

The pleura were red; and the lungs presented the traces of suppurative lobular pneumonia.

An abscess existed in the right pleural cavity, and communicated with the swelling on the outside of the thorax.

The arteries, veins, brain, and other viscera appeared to be normal.

The pathological phenomena, which we have now enumerated as having been found in this patient, are the usual post-mortem appearances discovered in horses which have laboured under acute glanders.

Case 2nd, occurred recently in the practice of M. Breschet.

A robust healthy man, 34 years of age, had been employed to attend to some glandered horses, and had slept for some months in the stables where they were kept. The earliest symptom of disease in him was an attack of intense pain in the left knee; this was accompanied with swelling and redness of the part, and exhibited much of the appearance of phlegmonous erysipelas.

When taken to the Hôtel Dieu, the knee was tumefied, and covered with numerous phlyctenæ. A discharge-at first mucous, then bloody, and at last sero-purulent, and very similar to the nasal flux in glandered horses-from the nostrils came on; and, nearly about the same time, an eruption of pustules and of phlyctena within the nostrils, and on the fauces, neck, trunk, and arms made its appearance. The pustules were not unlike those seen in Frambesia: their bases were hard, and surrounded with livid areolæ, and their apices were covered with eschars. Some of these pustules resembled small carbuncles: the cellular substance surrounding them was traversed with tracts of purulent matter. The phlyctenæ were filled with an opaque sanious matter. On examining the nasal passages, they were observed to be coated with a yellowish-coloured matter, which was readily made, by slight compression, to exsude down upon the lip. The external characters of this case may therefore be classed under four heads: 1. Pustules (like those seen in varicella and in frambræsia) and phlyctenæ ; 2. Erysipelatous swelling of the affected joint; 3. Gangrenous or carbuncular spots on the surface; and 4. Suppurations, more or less extensive, in the subdermic cellular substance.

After the eruption had made its appearance, the patient became somnolent and oppressed with stupor; there was a general abattement of all the corporeal energies; the urine was discharged involuntarily; the breathing was laborious and noisy from the snuffling in the nostrils; the patient was troubled with a cough; he became delirious, and died.

Dissection. The livid areola round the pustules had disappeared, and the pustules themselves were affaissées; their contents were a yellowish pus: the subjacent skin was excoriated. The subdermic cellular tissue was infiltrated at various points, and principally beneath the eschars, with purulent matter; and this was found also between the neighbouring tendons, and even in the substance of the muscles. The veins did not seem to be inflamed; but their contents were, in several places, found coagulated and mixed with pus. There was a sanguineous infiltration in the cellular tissue of the right arm.

The lymphatic vessels were injected, swollen, and inflamed: the glands were enlarged in the neighbourhood of the pustules. The joints were sound, with the exception of the elbow-joint, which contained a large quantity of sanguineous synovia. The mucous membrane of the nasal passages was swollen, and coated with a thick layer of glanderous matter. When this was carefully washed away, the membrane was found to be highly vascular and injected; here and there it exhibited small elevations formed by the concreted matter, at other points little crypts, such as we see on the mucous membrane of the intestines after fatal typhus fever; and mixed with these were pustules and ulcerated erosions. The submucous tissue was infiltrated with pus. The lining membrane of the maxillary and other sinuses, and that of the fauces, palate, pharynx, and even of the larynx, exhibited somewhat similar appearances. There was an abscess in the cellular tissue of the pharynx. The mucous membrane of the bronchi was highly injected, and its follicles were much enlarged. The lungs presented traces of lobular pneumonia. The other viscera seemed to be normal.

After the reports of these two cases had been read to the Academy, M. Barthelemy rose to express his dissent from the opinion of M. Breschet, that his case was one of genuine glanders, communicated to the patient from the horses which he had been tending. He stated that he had gone himself to the stables, where the man had been employed, and that he examined the animals very carefully; and that it was quite true that there were some glandered horses in them; but that the disease in all of them was of the chronic and not of the acute form (la morve chronique et non la morve aiguë). Now the chronic disease was, every one admitted, essentially different from the acute form, and was certainly not contagious.* It would seem however, from M. Barthelemy's own admission, that there had been, a fortnight before the patient's employment at the stables, a horse labouring under the acute or genuine glanders.

He urged several other objections to the idea that the disease in M. Breschet's case was real glanders.

M. Rochoux seems to have taken the same view as M. Barthelemy, as he expressed his disbelief in the communicability of the morve from the horse to the human species.

M. Bouley was surprised that, in the present day, any one could question the occurrence of genuine glanders in the human subject. Whether, indeed, the disease is ever of spontaneous origin, or whether in all cases it is the result of contagion from the horse, is a question which is perhaps not yet definitively settled. The latter view is the more probable; as every instance of the glanders hitherto observed in the human subject, has occurred in ostlers and other persons who have had to do with horses.

* We believe that the chronic morve is the Farcy of English veterinarians, and the acute morve is the genuine Glanders. It is unfortunate to apply the same term to two diseases, if they are different.

M. Bouley then canvassed the question, whether the disease is strictly contagious among horses themselves. He alluded to the results of various experi. ments, which had been made on this subject by a committee appointed not long ago by government, to ascertain this very point. It would seem that these experiments were considered to authorize the conclusion, that the chronic morve is not contagious; and even that the acute form is not always, but only occasionally, so. In very many cases it was found, when healthy horses were brought into contact or at least contiguity with glandered horses, there was no communication of the disease. M. Bouley seems to lean to the idea, that the disease, such as appeared in M. Breschet's case, and which, of late years, has been by many decided to be glanders communicated from diseased horses, may possibly be of spontaneous origin in the human constitution.

M. Rayer replied to the preceding speakers. He adduced various arguments to prove that the glanders in the human subject* is a disease sui generis, and distinct from any other in the nosological catalogue; and that it is strictly analogous in its essential phenomena-the leading symptoms during life, and the pathological appearances discoverable on dissection-to the same disease in horses. In both, there is a morbid state of the nasal passages; in both there is an eruption of pustules and gangrenous spots on the skin; in both, there is frequently a lobular pneumonia; and in both, there is the rheumatic affection, and also the appearance of purulent tumors in different parts of the body.

The lungs, the nasal passages, and the skin, are the organs which are most generally and most seriously diseased in glanders. The immediate cause of death may usually be traced to the purulent alterations of the lungs. The proposal, therefore, to perform tracheotomy in such cases is founded on an erroneous presumption.

M. Rayer dwelt very forcibly on the acknowledged fact that all the recorded cases of glanders in the human subject have occurred in persons who have had to deal with horses. He then proceeded to discuss the assertion, made by M. Bouley and others, that the chronic form of the disease is not contagious. His experience and researches are directly opposed to the truth of this opinion. The one form is frequently observed to be convertible into the other: if this be the case, are we not bound to admit that they are strictly of the same nature?

The conclusions, which M. Bouley had drawn from the experiments recently made by the French Committee, are, in M. Rayer's opinion, quite erroneous. In the last place, the learned speaker alluded to several experiments, narrated on most trust-worthy authority, which shew that, on the one hand, the inoculation of the matter-(it is not stated whether it be the nasal discharge, or the contents of the pustules on the skin)-from the human subject is capable of producing genuine glanders in the horse; and, on the other hand, the too frequent occurence of veterinary surgeons, and others, accidentally catching the disease from glandered horses, sufficiently proves the converse of the position.

MM. Velpeau and Blandin followed M. Rayer, supporting the same view of the question, and expressing their decided belief that the disease in the two cases reported above was genuine glanders, and was caught by infection from diseased horses.-Memoires de l'Academie de Medicine.

* Dr. Elliotson, we believe, has proposed to designate the disease Equinia, ta tally with Vaccinia. It seems to be a very good appellation.