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lent pains in the abdomen,':-Violent pain in the abdomen, with vomiting and diarrhæa,':-Spasmodic constrictive pain in the abdomen, extending into the lower extremities, after the stools,
Stool.-Involuntary stools, ".-Stools yellowish-white, liquid,».
Pulse.- Pulse rapid, thready,'.—Pulse very small and rapid, ".- Pulse at the wrist not felt in two cases, hut in the carotids it was very weak and rapid,"
Extremities.-Convulsions of the upper extremities,':- Lower extremities bluish,'-Lower extremities cyanotic,'.
Generalities.-First Case. A woman, æt. thirty-three years, ate a quantity of the mushrooms at dinner. At 10 P.M. she was taken with a very severe headache and intense thirst, soon followed by pains in the abdomen, vomiting of black substances, but no stools. At 4 A.M. she had an emetic and a cathartic, which produced profuse vomiting and diarrhæa. The next day she was admitted to the hospital ; the skin was cold and dry, the eyes sunken, the face had the aspect of one suffering from cholera ; the pains in the abdomen were very severe, and forced cries from the patient. The vomiting and biccough continued, and the patient complained excessively of burning heat in the throat, and of violent pains in the articulations, especially of the ankles, aggravated by movement. The abdomen was very sensitive, but not tympanitic. The pulse was small and rapid, the body very cold, but the extremities were not violet. The cutaneous sensibility was decidedly diminished, especially over the chest, abdomen, thighs, and arms. The pupils were irregularly and considerably contracted, the left forming a mere black central point, the right being a little larger; both were insensible to light. She responded slowly to questions, constantly complained of the articular pains, from time to time became much agitated and uttered cries. There were frequently involuntary black stools, without tenesmus. The temperature was 36.6o.
Second Case.—A woman, æt. thirty-three years, ate some of the mushrooms. Eight hours afterwards she noticed weakness of the limbs and intense thirst; about 9 o'clock she was seized with the most intense pains in the abdomen. At 11 o'clock there were vomiting and diarrhea, with tenesmus; the vomiting was incessant, accompanied by very violent pain in the pit of the stomach and throat. Extreme restlessness caused by the pain ; she could not remain in bed. Thirst was intense, but she vomited everything she took. The next day, at 5 P.M., the skin was cold and dry, there was profound prostration, and the stomach and abdomen were painful. There was incessant "hiccough, from time to time, accompanied by regurgitations. Pulse small, rapid. Heart's action very feeble, but not irregular. Diarrhoea very profuse, without odor. There was no urine. Pupils contracted, but mobile. Skin cool, temperature 37.8°. She received syrup of ether, coffee, and digitalis.
Third Case.- A man was brought to the hospital in a state of profound coma; the face was bluish, cyanotic, eyes sunken, devoid of expression, pupils contracted, heart's action very slow, exceedingly feeble. Pulse imperceptible, respiration stertorous. Extremities cold; Dails blue. The patient looked like one suffering from cholera. Complete loss of sensibility. It was stated that after eating the mushrooms he was taken with violent pain in the abdomen, diarrhoea, vomiting, and chilliness, and fell into a state of coma, when the vomiting and diarrhæa ceased. Just before death respiration became feeble, the heart ceased to beat, and the pupils became wildly dilated,“.
Two hours afterwards seized with headache, giddiness, violent pain in the stomach, sickness, ardent thirst, and trembling of all the limbs, and had ultimately fallen into a comatose state. The mother and eldest son, who was an adult, vomited freely, with considerable relief; the others passed the whole night under violent pain in the stomach, great sickness and retching, ischuria, tenesmus, and general convulsions. In the morning all dangerous symptoms had subsided, except in the youngest boy, who had refused to take the emetic, and who was senseless, with general convulsions, trismus, tympanitis, and great dyspnea; his eyes were staring, the countenance flushed, the extremities cold, and the pulse bard and intermitting. Under these symptoms he died, apparently suffocated. The others complained of very violent colic, pains around the navel, and giddiness, and one of the girls was affected with biccough,?:-[110.) Rigid and speechless, ".-Patient extremely weak, '.-Great restlessness, tossing about the bed ; convulsive movements of the extremities,".
Skin.-Skin pale and cold,':-Skin cold,'.
Authority. Thos. Stevenson, M.D., Guy's Hosp. Reports, vol. xix,
P. 418, R. M., æt. thirty-nine years, ate about a pint stewed with bacon.
In half an hour he complained of pausea, some oppression in his breathing, and of severe pain across the forehead, with giddiness. His wife now noticed a strangeness in his appearance, and that in attempting to walk he kept his eyes fixed on the ground and guided himself with difficulty. He was, however, quite conscious of everything, and opened a book to see if he could read, but found that he was unable to make out any of the letters. When out of doors he continued to suffer severely from the pain across the forehead, with giddiness, and in addition, experienced a feeling as if something was continually over his head, or as if passing " through an arcade.” He also staggered much. About 11 P.m., after more than three hours, Mr. Hicks was called to see him. He found him sitting down in a semistate of stupor, with pupils dilated and inactive, and the pulse slow and feeble, from 55 to 60. On being roused and made to get up he looked completely bewildered, staggered as if tipsy, and said he could pot recognize the things in the room, nor the roon itself as that which he usually occupied. He now became more restless, threw his arms about, and seemed anxious to be continually moving from place to place. He also appeared to be somewhat convulsed, with twitching of the muscles of the face, and complained of prickings in his hands, and of a feeling as if they were swelling. He suddenly became more excited, and rushed wildly out of the house into the street. He was found in a neighbor's house, considerably prostrated after his exertions, and in a very lethargic state. Twenty grains of Sulphate of zinc were now administered, and in a short time vomiting ensued, much dark fluid with numerous pieces of fungi being brought up. For a short time afterwards he expressed himself as feeling better, and was allowed to be taken to the door of the cottage. Almost immediately afterwards, as if moved by a sudden impulse, he again rushed wildly out, but after going a short distance stopped suddenly, as if bewildered. Emetics were again administered and the stomach-pump used, and in the
AGKISTRODON CONTORTRIX-AGROSTEMA GITHAGO. 281
course of a few hours he gradually recovered, though feeling much prostrated. He said that during the whole time he was quite conscious of what was being done, but that at times he felt drowsy and inclined to sleep. When the convulsive paroxysms came on he felt wild and excited, with an irresistible desire to move about and to run. He had no pain in the stomach or bowels at any time, nor did the feeling of oppression in his breathing continue after the first symptoms.
AGKISTRODON CONTORTRIX. Copperhead snake.
Authorities. 1, Mr. Arnold, Med. Times and Gaz., 1873 (2), p. 461, symptoms produced on John Brown by the bite; 2, Mr. A'Beckett's account of the same case, ibid. ; 3, Mr. Woolridge's account, ibid. ; 4, E. M. Schaeffer, M.D., Field and Forest, vol. i, p. 12, a man, æt. twenty-one years, was bitten on the right hand.
Symptoms of coma (after two hours),': -Semiconscious state (after some hours),-.—Corpea insensible to touch (after six hours),'.—Pupils sluggish and dilated (after some hours),-Pupils possessed only of the minutest power of contraction and considerably dilated (after six hours),'.— Indistinct vision (after two hours),': – Wild appearance of countenance,'.—Countenance rather approaching a livid hue, features swollen (after six hours),': --Considerable swelling about the upper lip (after two hours),'.—[10.] Vomiting (after two hours),':- Breathing rather slow (after six hours),Weak pulse (after two hours), '.—Pulse slow and very weak (after some hours),'.-Pulse of large volume, weak, and about 70 (after six hours),Limbs paralyzed (after six hours),-Pain in the finger,'.-Paralysis of lower extremities (after two hours),:-Stiffness of the legs,': - Complete prostration (after two hours),-[20.) Drowsiness (after two hours),'. Cold perspiration (after two hours),': -Surface of body cold and clammy (after some hours),?. —The wound at once gave him some pain, like the sting of a wasp, as he described it, and in a few minutes he began to vomit. This continued until his stomach was emptied, when he still experienced violent retching. He then became deadly faint, and lay down. Dr. Kleinschmidt described his appearance four hours later as that of a person in the last stage of collapse; skin cold, pulse nearly gone, respiration feeble, and pupils widely dilated, with great dimness of vision. The right hand and arni were fearfully swollen, of a grayish-black color, resembling gangrene. He passed a feverish night, but was much better Sunday. On Monday evening I found him nearly free from pain, though the arm was still swollen to nearly the size of a man's thigh. From this time he progressed rapidly towards recovery, and in less than a week was out, with his arm in a sling,
Dr. Scharling, Cent. Blat., 1850, in Pharm. Journ., vol. x, p. 349 New Eng. Med. Gaz., vol. xi, p. 305), effects of Githargin.
A burning sensation is felt on palate in a short time.
Authority. 15, C. A. L., Pub. of Mass. Hom. Med. Soc., vol. iv, p. 119, a proving
[210.] P., a student of medicine, aged nineteen, in good health. Took 1 drop of 1st cent. dilution every hour from 8 A.M., March 4th.
At 10 A.M. Lancinating pain through both temples, and fine prickling pain in left temple. Burning in, and darting pains through the stomach.
12 m. Tired sensation of lower limbs, chills over the whole body as from water, and sharp pains through both lungs.
1 P.M. After dinner, sinking feeling in stomach.
March 5th, 10 A.M. Aching in left lung. Discharge of bright-red blood from the nose, which was swollen.
11 A.M. Severe nausea, as from fat meat.
March 9th, 9 A.m. Bleeding from the nose aud sharp pains through both lungs; worse when taking a long breath.
12 m. Mouth very sore, and feels raw and burning, as if from the presence of acid.
1.30 P.m. Lancinating pains in both temples, and deathly faintness of the stomach after dinner, lasting an hour and a half.
4 P.M. Sensation as from a blow in right ear.
March 10th, 8 A.M. Mouth sore and raw, and oozing of blood from the denuded surface. Faint feeling, with nausea. Sharp pains in both lungs, and in the stomach, as from pins.
12 m. Ringing in right ear.
5 P.M. Mouth very sore and painful, discharge of blood from the swollen gums.
March 12th, 8 A.M. Dryness of the mouth, and bleeding from the roof and sides. Nausea in the abdomen.
10 A.M. Sharp pain through the right temple, with nausea.
3 P.M. Pricking pain through left lung. Trembling of the legs. Ringing in the ears, like music.
March 15th, 8 A.M.. Mouth continues very sore, with discharge of blood and stringy mucus. Teeth feel as if he had taken acid in the mouth.
10 A.M. Pains in lungs return, and trembling of the legs and bruised sensation of right forearm. Constriction of the throat, with sensation of a foreign body there for about ten minutes after every dose of the medicine. Took same doses up to the 25th, with no new symptoms,..
William A. Hammond, M.D., Amer. Journ. of Med. Sci., October, 1856,
First Experiment.— The action of Alcohol where a uniform weight of the body was preserved. Took 12 drachms of Alcohol daily for five days.
My weight increased from an average of 226.40 pounds to an average of 226.85 pounds, being .45 of a pound difference. The carbonic acid and vapor of water in the expired air had respectively decreased 1324.50 and 196.51 grains, the fæces 1.22 ounces, the urine 3.43 ounces, the urea 87.19 grains, the chlorine 37.59 grains, the phosphoric acid 24.47 grains, and the sulphuric acid 13.40 grains. The free acid and uric acid (especially the former) were so slightly affected as to render it probable that the Alcohol bad exercised no influence upon them.
During these experiments, my general health was somewhat disturbed. My pulse was increased to an average of 90 per minute, and was fuller and stronger than previously; there was headache and increased heat of the skin, and my mental faculties were certainly not so clear as on the days when no Alcohol was taken. There was general lassitude, and indisposition to exertion of any kind. My appetite was variable. The amount of flatus discharged from the intestines was sensibly diminished.
Second Experiment.—The action of Alcohol when the body lost weight from a deficiency of food. Took 12 drachms daily for five days.
During the experiments immediately preceding these, my weight decreased an average of .28 of a pound daily, falling from 226.73 pounds to 225.34. In the present series, under the same conditions, except the use of the Alcohol, this decrease has not only been overcome, but there is an actual average daily increase of .03 of a pound, the weight rising from 225.34 to a mean of 225.50 pounds. The mean weight of the body is less than the mean of the last series, owing to the fact that the average daily gain is not so great as the previous average daily loss. The carbonic acid decreased on an average of 129.08 grains, the aqueous vapor 312.06 grains, the fæces .19 of an ounce, the quantity of urine 1.37 ounces, the urea 54.51 grains, the chlorine 10.08 grains, the phosphoric acid 8.70 grains, and the sulphuric acid 6.11 grains. The free acid of the urine, and the uric acid, were apparently slightly increased. The general condition of the system was never better.
Third Experiment. The effects of Alcohol when the body gained weight from an excess of food. Took daily, for five days, 12 drachms of Alcohol.
During the series of experiments immediately preceding the present, the average daily increase of weight was .22 of a pound. By the action of the amount of Alcohol, the average increase was raised to .31 of a pound per day. The average amount of carbonic acid excreted, compared with the mean of the last series, was reduced to 581.99 grains, the aqueous vapor 266.21 grains, the fæces 2.34 ounces, the urine 4.15 ounces, the urea 93.27 grains, the chlorine 26.92 grains, the phosphoric acid 8.29 grains, and the sulphuric acid 14.87 grains. The free acid and uric acid were but slightly affected. The perspiration was sensibly diminished. The healthy action of my system was very much disturbed. Headache was constant, sleep was disturbed, the skin was hot, pulse full and bounding, averaging 98 per minute, and there was on two occasions after eating, slight palpitation of the heart. My appetite was capricious. Sometimes disgust was created by the mere sight of food, at other times I ate with a good relish.