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at the accuracy of the references. Some idea of the completeness of this index may be conveyed by mentioning that the list of works and articles on the subject of Asiatic cholera occupies 148 of the large pages of the work, printed in double column and very small type. The homoeopathic literature of cholera alone takes up 2\ columns. If only there were such a catalogue in the library of the Royal College of Surgeons, what an assistance that would be to the student. 195
Poisoning by Arsenious acid.
On the 13th of June last Dr. Chappuis was called, at 12.30 p.m., to attend Mdlle. X.—, whom he found in bed in the following condition :—Pace red and animated; eyes moist; eyelids injected and half shut; a little headache, intellect clear; tongue, cavity of mouth, and pharynx normal, without a trace of any poisonous substance whatsoever; thirst, and bad taste in the mouth—metallic taste; painful spitting; no constriction of the throat. Before the doctor's arrival there had been two vomitings, of which the matter was not saved. Abdominal region but little sensitive even to pressure; pulse a little frequent, strong, and perfectly regular; respirations easy; nothing peculiar on the skin, of which the colour was a little heightened. Although the patient stated that she had a sudden illness of which she did not know the cause, M. Chappuis judged from the totality of the symptomH that it was self inflicted, and by much pressure brought her to confess that in consequence of keen disappointment she had swallowed at 10.30, in a glass of water, a tablespoonful of a powder, of which the remainder was found hidden between the mattresses. A pinch of this powder thrown into the flame of a candle gave out the characteristic odour of garlic. Beyond doubt, this young person had taken an enormous quantity of Arseniom acid, which could be roughly estimated at twenty grammes. Although the patient did not present the violent symptoms we usually see in such cases, M. Chappuis judged the case to be very grave and called in M. Lecanu. Meanwhile he caused the patient to swallow 1 decagramme of Tartaric emetic dissolved in 200 grammes of water to make her vomit, and gave her an emollient enema of 100 grammes of Olive oil; a minute after vomiting of greenish liquid matters took place, with a little blood, from which he drew some filaments with whitish particles, which a little latter M. Lecanu pronounced positively to be Arsenious acid. On the arrival of M. Lecanu with another confrere, the Peroxide of Iron was at once administered, in a dose at first of 125 grammes, suspended in water at the ordinary temperature. Considerable vomiting. The use of Iron salt solution was continued for two hours and a half, and the quantity of it certainly exceeded a kilogramme. At each glassful fresh vomitings occurred, which were repeated every five minutes. From the unfavourable surroundings of her abode, the patient was taken to the Maison Royale de Sante. There she had a violent rigor, the face became dull, the pulse quickened. Continuation of the Iron, which was always followed by vomiting, demulcent tisane, with two grammes of Nitrate of Potash. Half an hour after, very abundant emission of a notable quantity of urine. 9 p.m.— Amelioration, vomiting less frequent, tendency to sleep, disgust for drinks. 3 a.m.—Slight faintings, which recurred five or sis times before the following morning. Enema containing Peroxide of Iron suspended in it; demulcent tisane; in the evening a purgative enema. From this moment improvement was pronounced, and continued the following eight days without accident. The patient was quite convalescent and walked about in the garden.
M. Lecanu analysed the urine of the first, second, and fifth days, and found in the specimens a notable quantity of Arsenic.— Bull, de Tkerap., xxv, 229.
Poisoning by Phosphorus.
On the 27th of last April the Prussian Government ordered experiments to be made for a year with Phosphorus paste in place of Arsenic for the destruction of rats, and recommended the authorities of the different provinces to collect the results obtained in order to made it clear whether it would be well to make the exclusive use of this substance for the purpose compulsory by ordinance.
In the ministerial instructions we read that if Phosphorus offers scarcely less danger as a poison than is found in the use of Arsenic, it has, at least, the advantage over the latter of losing its toxic properties in the course of a few days by oxidation alone. The following case, contributed by Dr. Grabenschiitz, shows to demonstration how far this opinion is from the truth:
A married couple named H— lived with the mother and brother of the wife in a little house which had been sold to them on condition of their accommodating in it the daughter of the former proprietor till her death. Tired of the last condition, and desirous of ridding themselves promptly of the young woman, after several futile attempts at poisoning, the brother of the woman H—, went to meet her in a wood and killed her with blows of a hatchet on March 14th. Five days after the body was found, and suspicion falling on the mother and brother of the woman H— these two were arrested. From the moment of his going to prison the young man urged his sister to bring him regularly the food he required, threatening if she failed to declare her complicity and that of her husband. On the other hand, the mother had said to one of their neighbours that her son was accompanied by his sister when they returned from the wood. Trembling with fear of seeing herself compromised, the woman H— conceived the idea of ensuring herself against the danger by poisoning at once both the mother and brother. Accordingly, on the 20th of March, she brought them porridge and milk in which she had mixed about a half of the Phosphorus paste previously purchased by her husband. The young man, repelled by the bad taste, only took a little, but the mother, impelled by hunger, ate nearly all of it. An hour after the meal the two prisoners felt ill. The mother complained of great distension of the abdomen, of anxiety, and later of heat and colic pains in the bowels ; at the same time she was tormented by a burning thirst, and desire to vomit, and soon she was taken with abundant diarrhoea which lasted the night of the 20th and 21st, and even during the latter day. The intestinal pains felt by the young man were acute enough, but nevertheless they subsided after several diarrhoeic evacuations. The next day the mother's facial expression had a miserable decomposed appearance, she could hardly keep herself upon her legs, answered questions incoherently. She fell soon into quiet delirium, interrupted by lucid moments; but on the 22nd, after the middle of the day, she recognised nobody, anxiety and restlessness increased, and death took place on the night of the 22nd and 23rd.
The autopsy was made on the 27th of March, and presented the following features:—Anterior surface of body (especially of chest and abdomen) covered with blood-red stains, a little raised, of the size of a hemp-seed, and of a clear red tint, containing clear red liquid blood, effused between the epidermis and the cutis. Peritoneum and epiploon of a red inflammatory colour. Stomach externally coloured a dirty grey; it contained about a grain of a pale thick liquid of a greyish-green colour; on tha posterior wall, a little distance from the pyloric orifice, were two gangrenous ulcers; on the great curvature a third gangrenous ulcer; villous membrane softened, veins of the stomach like thick cords. The author calls attention to the fact that the development of petechia? in phosphorus poisoning had not been noted hitherto, and he remarks in addition that in this instance, the stains were of a clear red, whilst those which occurred in subjects of arsenious poisoning were of a dark blue.—Bull, de Therap., xxv.
Poisoning by Belladonna Pilules.
The following case is reported by GK H. Brown, L.R.C.P.E., of Brynmawr, in the 'Lancet,' of March 17th, 1883:
"A few days ago I was summoned in great haste by a man to see his nephew, a child aged three years, who had been suffering from whooping-cough, and to whom, an hour and a half previously, he had given three homoeopathic pilules of belladonna. On my arrival, a few minutes afterwards, I found the child comatose, pupils widely dilated—in fact, the iris was a mere circle—pulse scarcely perceptible, gasping respiration, and skin bathed in perspiration. I applied mustard over the heart, used the stomachpump, first to wash out the cavity of the stomach, then pumped in a little brandy-and-water. I then administered a hypodermic injection of x\nd of a grain of morphia, and rubbed brandy over the abdomen, which was tympanitic. In about half an hour the little patient recovered so as to be able to swallow a little beeftea with port wine. A few minutes after swallowing it I observed