could not be taken. The doctor prescribed, two hours after, a gummy potion with sixty centigrammes of Camphor and fifteen grammes of the Syrup of Dracodium, frictions with Spirits of Camphor over the thighs and the belly, emollient fomentations over the abdomen, and a gummous tisane. In spite (?) of the employment of these means grave symptoms followed. Horrible sensation of heat in the pelvis, constant desire to urinate followed by the emission of some drops of urine, pulse compressed, frequent; heat of skin sensibly diminished, loud cries at intervals; stiffening of the limbs as in tetanus. Intelligence free. Later, face pinched, speech almost extinguished, pulse thready, skin cold, constant desire to urinate, roughness of the throat ; no pain in the stomach or intestines. It seems to the patient that the bladder is on fire, and that it is molten lead that passes by the urethra. No symptoms of venereal excitation. Intelligence free. Enema with seventy-five centigrammes of Camphor, and mustard plasters applied over the surface of the body. The symptoms calmed little by little, and the patient only complained of a little weakness without any pain in the region of the bladder or intestines. (Bull. de Therap. xxvii, 143).

A Disease from Reeds.—" A curious affection has been occasionally met with in certain parts of France, especially in Provence, among reed-workers, chiefly those who manipulate the stems of Arundo donax. A case at Frontignan (Hérault) has lately been very carefully studied by Mr. Baltus, of Lille. A man, aged 47, and his son, 17, had been at work several hours loading a cart with reeds, which had been cut a year before, and keep in a damp trench. Both were seized with painful irritation of the nose, eyes, and throat, followed by erythematous swelling of the same parts, which extended to the hands, trunk, and genital organs. A number of acuminated pustules occurred in the red swollen areas, the conjunctivæ were injected, the eyes streaming, and there was a slight cough. The next day four other persons-three adults and a child—who had come in contact with the reeds deposited at the farm, presented the same symptoms though in slighter degree. Moreover, four cats and three dogs which had frequented the same reeds presented painful crusts about the nostrils. In every case the disease ran a mild course, and disappeared in a few days, under the influence of wet compresses. An examination of the reeds showed that

they were covered with a mould consisting of the spores and mycelium of a fungus, Sporotrichum dermatodes, which had developed under the prolonged exposure to moisture. The spores had been shaken off as dust during the manipulation of the reeds, and had irritated the exposed parts of the skin on which they had lodged. Although trifling the malady may sometimes assume a severe form, lasting nearly a fortnight, and has been known to cause the death of an old man, 71 years of age. It may apparently be prevented by the simple expedient of washing the reeds before their manipulation." (Lancet, January 27th, 1883).

Value of Experiments on Animals.-In Arch. f. exp. Phys., ii, p. 62, Schmeiberg has a paper on the different results obtained from Caffein on rana temporaria and rana esculenta.

Rana temporaria. 5.22 p.m.-Injection of 20 mgr. Caff. in stomach.

5.45.-Frog rather stiff, when laid on back can only right himself with great difficulty. Reflex irritability rather diminished than increased. On pricking a little he starts scarcely or not at all.

5.48-Cannot right himself when laid on back. Can hop with great difficulty and with widely separated legs. Reflex irritability greatly diminished.

6. When simply touched he does not move; when more strongly irritated he tries to hop, and the stretched-out legs are only gradually bent. Dorsal muscles very stiff.

Rana esculenta. 5.20 p.m.-The same.

5.45.-No trace of stiffness of muscles. Laid on his back he rights himself without effort. Reflex irritability greatly increased, so that when the table is pushed he jerks together and hops about, but does not fall with tetanus.

5.52.-Has a tetanic fit.

6. At every touch, later also when table is pushed there is a short tetanic fit. No muscular stiffness.

Next day, forenoon.-Back quite stiff, bent strongly forwards; posterior extremities single tetanic fit. more mobile than yesterday.

No stiffness of muscles observable. At each touch a

VOL. XLI, NO. CLXV.-JULY, 1883.

T

Reflex irritability above normal so that when table is knocked a weak twitching occurs especially in posterior extremities, which are stretched out when touched more strongly.

Afternoon. -Muscular stiffness increased. The forelegs in consequence of the strong contractions of the pectoralis muscles are crossed. The bending of the body forwards has also become greater. The reflex irritability not increased.

Next day, forenoon.-The flexure of the spine and the contraction of the posteal muscles increased. The reflex irritability is rather weaker.

Perceptible stiffness of pec

toral muscles, so that the forefeet are close to one another. No flexure of trunk. Almost constant tetanus. In the intervals the posterior extremities remain stretched out, the slightest touch of these causes a repetition of the convulsion. The contraction of the pectoral muscles has become greater. Tetanus as yesterday.

This variation in the effects of Caff. on these two animals is always observed, at all seasons and in the same manner.

Poisoning by Citrate of Caffeine (Dr. Chas Routh, Lancet, April 21st, 1883). Man, æt. 63, weakly, sober, of cheerful disposition, no organic disease, took on February 20th, in mistake for granular effervescent Citrate of Caffeine (Bishop's), a whole drachm of the ordinary citrate, pure and simple. Symptoms followed immediately.

"Burning in the throat and gullet, followed by giddiness, faintness, nausea, numbness, and tremors of extremities; pain and tenderness of bowels and stomach; great thirst; dry tongue. At 4.45 he was violently sick, with vomiting of digested matter and also violent purging. Much urine was also passed. This sickness and vomiting recurred at 5.45. On leaving the closet he could hardly walk and had to be assisted. These vomited matters consisted also of digested matters.

At 6 p.m.

he was collapsed; pulse hardly perceptible, irregular, 120; skin cold and clammy, but all his senses perfectly intact, not even headache; sensibility of skin nowhere impaired, a symptom not presented throughout."

Thus far we have the pure effects of the drug. Ipecacuanha wine was now administered, then a tumbler of luke-warm water, then Animal Charcoal and Nitrite of Amyl. He vomited largely. The following effects are, obviously, not to be regarded as pure :

"7.30.-Condition as before; hands and feet icy cold; muscular tremor in hands and feet; cardiac oppression; sense of impending death. Pupils equally dilated, indeed, rather contracted. Some lumbar pain and tenderness, some aching about the masseter muscles."

He was now ordered sinapism to heart: feet to be put in hot water; Ammonia, Alcohol, and Nitro-glycerine.

"10 p.m.-Debility and depression of spirits as before; pulse rather firmer; hands and feet warm; lumbar pain worse; no urine passed. Taking greasy mutton broth at frequent intervals, and half an ounce of brandy every four hours. Throat fee's very sore, and has a burning sensation down the oesophagus. Organs of sense have been throughout unaffected, and the head is free from pain. To continue one drop of Nitro-glycerine every two hours. The patient continued to improve till 1.30 a.m."

Later on in the morning he was seen again, and the Nitroglycerine had by that time asserted itself.

"He complained still of feeling very ill, but he was certainly not so weak; his pulse was stronger, but the top of his head was very painful; had vomited freely. The right orbital region was also very painful. Nitro-glycerine was continued; no sickness; took milk and soda-water freely. Cold to head to relieve pain. As he complained of a burning sensation in the mouth, I ordered ice, but this producing intense abdominal pain it was stopped. The diluent drinks with raw-beef juice were taken freely. Later the headache increased and the pains in the back, both of which were relieved by mustard poultices. Later I substituted Digitalis" (the proper homoeopathic antidote), "I gave up the Nitro-glycerine. From this time he improved. The prostration gave way, and he complained mainly of the back.”

February 24th, pulse 80, not over-strong; urine 1025 sp. gr., no albumen, doubtfully a trace of sugar. Lumbar pain relieved by pressure, very muscular; no headache. Food mainly bread and bread-and-milk, with brandy and soda-water.

We have here a valuable proving of the Citrate of Caffeine. The analogy between the action of this drug and that of Digitalis

is sufficiently apparent; and the speedy improvement in the patient's condition after the administration of Digitalis is noteworthy. The symptoms recorded after the administration of the various drugs given by way of antidotes must, of course, be received with caution. The action of the Nitro-glycerine on the head can hardly be mistaken. The strength of the preparation given is not mentioned.

Acute Phosphorus Poisoning (Dyer, Lancet, June 16th, 1883). A. F, a healthy, well-nourished girl, æt. 18, admitted to hospital (Middlesex) 15th April at 3 p.m. Said had taken on 14th two penny bottles of phosphorus paste. She had previously had chorea; father died in a lunatic asylum, two cousins had committed suicide.

State on Admission.-Temp. 101°, pulse 68, weak and compressible, but regular. Is well nourished and muscular. Complains of great pain over epigastric region, vomiting (the matter vomited first was luminous in dark), and great prostration. Skin harsh and dry, slightly jaundiced, conjunctivæ distinctly jaundiced; no extravasation below skin. Percussion notes and heart sounds everywhere normal. Cardiac dulness normal, sounds at base and apex clear but feebly heard. Hepatic dulness slightly increased, extending downwards just below costal margin, edge cannot be felt. Spleen normal. Bowels open normally; no diarrhoea, no blood with motions. Tongue thickly coated with white fur, dry. April 17th.-Temp. 98.6°; pulse 80, regular, but feeble. Urine contains no albumen, but is bile stained. Pain over epigastrium continues. Evening temp. 100.2°.

18th.-Temp. 99.4°, pulse 56. Conjunctivæ and skin more jaundiced. Evening temp. 101.6°.

19th.-Temp. 99.2°. Bowels open twice, no blood with stools. Pulse 116, very feeble, easily compressible. Cardiac sounds very feebly heard. Evening temp. 102.2°.

20th.-Temp. 101-4°. Heart's action and breathing very rapid. Radial pulse scarcely perceptible. Diarrhoea with bloody stools has set in. Is very drowsy. Twitching of several muscles set in. She lay comatose for two hours, when she died.

Post mortem.-Body well nourished and well developed. Muscles pale and granular looking. Rigidity present. Peritoneal cavity normal. Intestines distended. Numerous small hæmorrhages seen in the intermuscular planes. On removing the