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PATHOGENETIC RECORD.

AN ARRANGEMENT OF THE

PHYSIOLOGICAL AND TOXICOLOGICAL EFFECTS OF DRUGS. COLLECTED FROM MEDICAL AND GENERAL LITERATURE.

By E. W. BERRIDGE, M.D.

Prefatory note.-As explained in the preface to vol. i, I have no longer time to complete either the "Index to Cases of Poisoning," or the record of the cases themselves. The present and future volumes will therefore contain only those which I have already copied in MS.

Addenda and errata to vol. i (accidently omitted at the close of the volume):

Page 45. Case 48 should be credited to Dr. J. H. Salisbury. Page 51. Case 52 should be credited to Dr. S. W. Williams, and the following added:-" Since the poisoning has not been able to take, nor has had any inclination for, spirits, in which he used to indulge freely. Even the smell of spirits is most disgusting to him."

Page 74. Case 84 belongs to Dr. Ruthnum Moodelly.

Page 146. Case 105 is editorial. Also Case 110, p. 81. Page 161. Case 25 is copied from Quarterly Journal of Calcutta Medical and Physical Society.

Page 222, last line. For boys read girls.

Page 223, line 1. For girl read boy. Line 6, for 5th read 4th. Line 7, for 6th read 5th. Line 10, for 5th read 4th. Line 26 should read " Jan. 5th, at 11 a.m., boy is not now sick or thirsty; vomited throughout last night."

Page 224. Case 119, line 12, for imbibed read inhaled.

Page 225. 4th line from bottom, for Monat read Mouat. Page 325. Case 283, for Annalist read New York Annalist. APPENDIX, B. J. H.

a

FUNGI.

1. Philosophical Transactions, 1844, vol. xliii, p. 51. Paper by Mr. William Watson.

Pliny describes the Boletus which killed the Emperor Claudius.

Reference is made to cases of poisoning recorded in the works of Clusius, John and Casper Bauhin, Ray, Morrison, Tournefort, Vaillant, Dillenius (in his Catalogus Gissensis), and Micheli (in his Nova Plantarum Genera).

John Bauhin says that he rubbed his eyes with a fungus growing in England, called by Caspar Bauhin "Fungus albus acris," and it brought on a violent irritation on his eyelids. Micheli describes a species which caused two persons to be seized in two hours with violent pains in the bowels.

2. Medical and Physical Journal, 1800, vol. iii, p. 41. By Mr. Everard Brande. Poisoning by Agaricus glutinosus (Curtis, in Flora Londinensis); called by Dr. Withering Agaricus semiglobatus. See also No. 19 of Sowerby's English Fungi (published in 1800), and figs. 1, 2, and 3 of Table 248.

A man and his four children ate some of these mushrooms stewed about 8 a.m. About 9 a.m. Edward, æt. 8, was attacked with fits of immoderate laughter. To this succeeded vertigo and a great degree of stupor, from which he was roused by being called or shaken but immediately relapsed. The pupils were at times dilated to nearly the circumference of the cornea, and scarcely contracted at the approach of a strong light; his breathing was quick; his pulse very variable, at times imperceptible, at others too frequent and small to be counted; latterly very languid; his feet were cold, livid, and contracted. He sometimes pressed his hands on different parts of his abdomen, as if in pain, but when roused and interrogated as to it he answered indifferently "Yes" or "No," as he did to every other question, evidently without any relation to what was asked.

About the same time the father, æt. 40, was attacked with vertigo, and complained that everything appeared black, then wholly disappeared. To this succeeded loss of voluntary motion and stupor; pupils dilated; pulse slow, full, and soft; breathing

not affected. In about ten minutes he gradually recovered, but complained of universal numbness and coldness, with great dejection, and a firm persuasion that he was dying. In a few minutes he relapsed, but recovered as before, and had several similar attacks during three or four hours, each succeeding one less violent and with longer intermissions than the former.

Harriet, æt. 12, was attacked also at the same time with slight vertigo. She had two or three attacks of it, with some languor.

Edward had great difficulty in swallowing, and, when relieved by treatment, complained of coldness and insensibility about the stomach. By 4 p.m. every violent symptom had ceased, drowsiness and occasional giddiness only remaining, both of which, with some headache, continued during the following day.

Charlotte, æt. 10, was suddenly attacked about 10.30 a.m. with vertigo and loss of voluntary motion. Pupils very much dilated and sight greatly impaired. These symptoms soon gave place to a degree of delirium, in which she refused to take anything, forcibly striking whatever was offered to her. After treatment had removed these symptoms she was wholly unconscious of anything that had passed since their commencement. Her pulse, which hitherto had not been much affected, was now irregular, and continued so, though in a less degree, during the whole of the day.

Martha, æt. 18, was attacked about 11 p.m. with symptoms exactly the same as those of Harriet.

3. Medical and Physical Journal, 1808, vol. xxi, p. 14.

By Dr. Royston.

Wild, but not furious, delirium, slow and feeble pulse, tremors, subsultus tendinum, and a singularly expressive character of intoxication, were the symptoms which indicated the action of the poisonous Agaric; and by those who recovered an interesting account was given of the recollected intellectual derangement. The Agaricus muscarius is used as an agent of intoxication. Soon after swallowing it the persons are described as being seized with convulsions in all their limbs, then with furious delirium; a thousand phantoms, gay or gloomy, are presented to their imaginations; some dance, others are seized with unspeakable horrors. Sometimes the poison impels them to suicide, murder, or other dreadful crimes.

4. Medical and Physical Journal, 1804, vol. xii, pp. 385 and 512. By Dr. Samuel Argent Bardsley. Case of poisoning, apparently by the Agaricus bulbosus of Sowerby (Plate 130).

The following is the description of the fungus :

Stalk central, solid, bulbous at the base, gradually attenuated upwards, curved, ascending; brownish buff. Length from 3 to 4 inches, diameter at base from to inch.

or wanting; no wrapper.

Ring cobweb-like,

Pileus brown-buff, darker in the centre; somewhat convex, slightly bossed, margin turned in. Diameter from 1 to 4 inches.

Gills buff, somewhat decurrent, giving a scored appearance to the stalk, as low as the ring or remains of the curtain; very numerous, four in each series; two of the loose gills very small, the middle one extending more than half way to the stalk.

A boy, æt. 5, ate some of the above. In about two hours he was led home in a state of alarming illness. He seemed to stagger like a person intoxicated, and with odd gesticulations laboured to express his sufferings, but was unable to articulate a single syllable. When I first saw him, about two hours after his first seizure, he appeared partially delirious, and uttered faint and indistinct screams. Pulse was slow, small, and somewhat irregular. Pupils much dilated and vision imperfect. He seemed very averse to lying down, and his restlessness and impatience led him to make frequent attempts to walk about the room, but without any fixed object or design. His gait and gestures were those of a person inebriated. He was unable to answer questions or to express his feelings by words. Slight convulsive motions might be perceived in the legs and arms, which gradually extended to the muscles of the trunk and produced irregular distortions of the whole body. The upper extremities began to swell, and assumed a livid colour, and the abdomen felt hard and rather tumid. After treatment (which caused purging, sweating, and vomiting of an offensive greenish fluid) he improved, and seemed like a person just roused from a long and deep sleep, unconscious of anything that had happened to him. Next day he was well except some languor and debility.

5. Medical and Physical Journal, 1809, vol. xxii, p. 503. From the Moniteur, November 9th, 1809.

Three people ate a mixture of the fungi known as Pinodossa,

which grows at the foot of fir trees, and those called in France Catalans. At midnight all three had nausea, pains in bowels and debility, One, an old woman, had acute pains in kidneys and bowels, and a great debility.

6. Medical and Physical Journal, 1810, vol. xxiii, p. 68. Review of "A Treatise on Champignons," by M. Paulet, M.D. This work contains some cases of poisoning, and should be examined.

7. Medical and Physical Journal, 1806, vol. xv, p. 247. By John Whitlam. Poisoning by Agaricus campestris. A lady, æt. 36, ate some mushrooms.

September 26th.-Had pain in throat and considerable difficulty in swallowing; the fauces were dark red, no ulceration, and not much swelling. Stomach seemed distended and loaded; the stomach had been thus for some days, with frequent and disagreeable eructations. Ordered an emetic, liniment and gargle.

27th.-Throat not quite so red; great difficulty in swallowing, which she described as proceeding from an enlargement of the root of the tongue. Tongue moist at edges, but the rest of it covered with a light-coloured fur. Ordered a blister from ear to ear, and a purgative.

28th.-Tongue so much enlarged that she could not speak intelligibly; it was covered, as far as could be seen, with a very thick, dark-coloured substance. Ordered liniment of borax and purgative.

29th. Swelling much less; she was better in every respect.

October 3rd.-Tongue nearly natural in size and quite clean. About this time the right submaxillary glands became enlarged; the swelling extended down the greatest part of the neck, and there was great soreness about the thyroid cartilage. Ordered a liniment and poultice.

6th.-Soreness nearly gone; swelling of glands and neck increased and very painful.

9th.-A large blister was applied to the swelling, and as the sense of weight and distension of stomach had returned, an emetic was given. The blister discharged a fluid like pus, which seemed to proceed from every part where the cuticle had been

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