361

blisters. The eruption was associated with the most violent itching and burning, disturbing the sleep, reaching its height in five or six days, and then fading; followed by desquamation; the desquamation was very slow, in large and small scales,35-The whole body became covered with an eruption of small pimples, like miliary rash,369.-General miliary eruption over the whole body, on the sixth day, immediately followed by amelioration of all the symptoms, and re-establishment of the urinary discharge; this eruption lasted five days, after which the body was covered with fine mealy scales,5-Severe eruptions, violent constitutional symptoms, and even death,2-Eruptions chiefly on hands, forearms, scrotum, and thighs, and the suffering proves intense should they have chapped hands at the time,-Numerous petchial spots over the skin of the trunk and thighs,372. -Miliary eruption confined to the forehead, wrists, and feet (third day),271. -[3510.] Pimples or vesicles round mouth (fifth day),270.-Towards the close small spots of purpura on neck,2".-Pimples on the hands, chest, and forehead,-Redness of the hand, with red points extending half way up the forearm,3-Arsenic causes shingles,.-A vesicular eruption over the greater part of right ear, and also of nose; several vesicles have coalesced, forming large patches; they are all surrounded by an inflamed base, 256Vesicular inflammation of the whole face, with acute itching (third day),3 -Vesicles about the mouth (one case),278.-Small white blisters on the inner side of both thumbs, containing a clear watery liquid,374.-Blistering of the feet,[3520.] General erysipelas, with sensation of a devouring fire,370Cutaneous affections of a mixed pustular and scaly character, attacking especially the scrotum, the depression between lower lip and chin, the angles of nose and face, the line along which the hat fits the forehead, in short, every crevice and fold where the Arsenic can accumulate,294.- Various eruptions on the parts most exposed, chiefly arms and legs; sometimes the eruptions resemble eczema, but more frequently they are pustular, and large boils are not uncommon,29.-Obstinate pustular eruptions,.-Eruption of pustules resembling the itching, followed by desquamation,358.—In some of the persons pustules appeared on the forehead,214.-Face covered with pustules,.-On the sixth day eruption of white pustules on the face and upper part of the body, resembling in appearance and progress those of varioloid,.-Eruption of pustules about angles of mouth,. — His hands were contracted, and he was frequently sick during the three months he was at work. At last the Arsenic entered the hand, the skin being broken; his left hand and forearm were swollen; also the left axillary glands; the hand was inflamed; purple patches gradually covered his arm and side. He died,257.—[3530.] Eruption of boils which refused to heal,342. In a case of chorea the Arsenical solution produced a copious crop boils, 30-The workmen are subject to irritations which produce itching, blotches, rawness, and perhaps boils. In one factory where one hundred women are employed in making artificial flowers, hardly any of them. escaped skin diseases. The hands, face, neck, roots of hair, flexure of arms, axilla, and in a most distressing degree the genitals, were affected; the pudendal eruptions being often so severe that they could not bear to sit down,3-Several small superficial ulcers extending along the inner surface of each lip, varying in size from mere specks, the largest being th inch in diameter. The smarting and annoyance were intolerable, and much increased in the evening [when he inhaled much of the poison], when the lips swelled and became so painful that eating or even speaking could

VOL X.-23

of

scarcely be indulged in. He got better, but returned worse than ever; all the old ulcers had reopened, several new ones formed, lips much swollen, with profuse ptyalism,323.-The lips became incrusted, and the skin cracked and peeled,-Inflammation of the skin of the lower part of the abdomen, penis, scrotum, and upper part of thighs; in some places the inflammatory action had gone on to ulceration. The pain was severe and burning. There were signs of considerable constitutional derangement. The evening of the same day on which he washed the sheep he had smarting and pain in the affected region; this increased, and the next morning the parts were red and inflamed. It was more than a fortnight before he was able to resume his work,306.-Subjective. One woman said she had been tormented for the last two days and nights with irritation of skin, which she compared to being in a bagful of fleas (eighth day)."Prickling sensation over the whole skin,367.-Itching over the whole body,374. -Constant itching of eyebrows and forehead,266.-[3540.] Violent itching of the extremities,36.

Sleep.-Drowsiness, 327 372-Drowsy, but easily roused (after six hours), 26. -Sleepiness, 356-Sleepy shortly before death,20-Somnolence (thirteenth day),5-Somnolence just before death,.-Occasional light sleep, with muttering delirium,307.-Sleeplessness,"

372

282 335

349

362

Fever.-Chilliness. Chilliness,351 354-[3550.] General chilliness, 6. -Chilliness, with cold extremities,236.-Shivering and coldness of surface,266. -Shivering, 35 354-Shivering, recurring when he drank,279.-General sense of coldness,2-Distressing sensation of cold during the whole night,. Cold skin,258 262, etc.-Skin cold and clammy,309 373.-Skin cold and slightly livid (in five hours and a half),.-[3560.] Skin cool and moist,28Trunk and extremities cold,361.-Sensation of cold over whole body (after five hours); increased (after six hours),.-Tip of the nose cold, pinched,. -Sensation as if cold water were poured down back,.-Cold extremities,245 273-Extremities cold, with most violent pain in the abdomen,3 Coldness of the hands and feet,345 350.-Feet a little cold (after five hours),293. -Heat. Fever,248 327 359. -[3570.] General fever, with coldness of the feet, 2-Very violent fever, 2. She had three attacks of intermittent fever; the first in November, 1875, lasting three days; the second in December, 1875, lasting seven days, and the third from 14th to 16th of January, 1876. The symptoms of the attacks were as follows: Between 8.30 and 9 A.M., after getting out of bed, chilly, with chattering of teeth, nails and lips blue, sometimes sickness on waking, bad taste in mouth, desire for much cold drink, pulse feeble, wants to lie down and to be quiet, and wrapped up, breath offensive, tongue brown; this lasts till 1 P.M., then fever comes on. During the fever there is full pulse, frontal pain, not much thirst, especially hot to touch on abdomen, with pain there, feet and hands cold objectively, not subjectively, cannot bear the least draught, breath offensive, tongue brown; this lasts till 4 or 5 P.M.; she then seems well for one or two hours. Then about 6 P.M. she is slightly chilly till about 8 P.M., then there is heat again, cannot sleep, bad dreams, cannot sleep after 3 A.M. She is losing flesh very fast, and getting very weak. The second attack was the most severe, and the third (which occurred after she had been removed to another room) was the slightest,".-In this way can be produced in healthy persons attacks of remittent fever, though not such rigors as those of true fever, but only flushing heats, disappearing and returning, and chiefly felt in præcordial region and forehead. Such acces

sions terminate sometimes in partial or general sweats, and at other times merely in a moist state of skin. This Arsenical fever never acquires any regular type. It is rare for the excitation to be carried to this degree, and there is more usually an increase, more or less considerable, of the heat of the body, which seems to have its source in the stomach and præcordial region, whence it passes to the rest of the body, but is especially felt in forehead and eyebrows. To produce these effects a rather strong dose is required,1. Heat over the whole body, except the hands,355.-Violent heat internally and externally,.-Temperature increased (in the rectum 38.6°),362.-The feeling of heat within did not leave him for a week,239. Heat of skin,239 269 325-Heat and dryness of skin,-[3580.] Alternations of heat and chilliness,.-Sweat. Profuse sweating on the least exertion,295.-Skin moist and temperature good (after five hours); moist and cool (after six hours),293.-Cold clammy sweat, 22-Skin covered with cold clammy sweat,-Clammy perspiration,".-Cold sweat,363.-Whole body, and particularly hands and feet, covered with cold sweat,25.-Cold sweats broke out profusely over surface of body,.-Fetid perspiration on the whole body,-[3590.] Abundant perspiration (after eight days), 59.

ARSENICUM HYDROGENISATUM.

Authorities. (6 to 12, from Berridge's collection in Appendix to Brit. Journ. of Hom.) 6, Dr. John Elliotson, Lancet, 1831 (2), p. 132, a family of eight or more were poisoned by Arsenite of copper, in and about the house, to which water had access; 7, M. Raspail, Med. Times, vol. ix, 1843, p. 15, and vol. xiii, p. 324, Ghelen, poisoned, death in eight days; 8, Raspail inhaled the gas for three days; 9, Vogel, Archiv des Verein (abridged), Dublin Hosp. Gaz., 1854 (1), 157, a man inhaled the gas; 10, Dr. T. Monat, Glasgow Med. Journ., vol. v, 1858, p. 371, Mr. R. inhaled it; 11, M. Piorry, Gaz. des Hop., 1863 (Brit. Med. Journ., 1863 (2), 580), a man, æt. twenty-two years, imbibed a large amount; 12, Dr. Dickinson, Med. Times and Gaz., 1865 (1), p. 659, effects of inhalation; 13, Dr. Valette, Memoire, Lyons, 1870 (Tardieu, Etude Méd. leg. et Clin. sur Empoisonnement, Paris, 1875).

11

Head.-Suddenly seized with vertigo, fainting, and vomiting, and died in eight days,'.—On the third day had vertigo and pains in the stomach, prostration of strength, cerebral congestion, fever, dim sight, indigestion, nausea, and griping,.-Violent pain in the head (in one hour),' Intense headache came on suddenly on the fourth day, followed by very violent pain in the epigastric region and renewed vomiting, with pale tongue and great thirst; the features became for the second time altered, and the sclerotic again became yellow; prostration very great,".-Intense frontal headache (in five hours),".

Eye.-Sclerotic injected with blood of a very yellow color,".-[80.] Sclerotic yellow,13.-Every one had watery eyes,.

13

Face.-Expression like that of a person suffering from cholera," Face and lips pale (in five hours),".

13

Mouth.-The gums became pale, discolored, and bled easily,' Tongue red and foul,.-Blood seemed to ooze from the whole mucous membrane of the mouth, and accumulated on the anterior pillars of the palate, exhaling a nauseous odor,13.

Throat.-Constriction of the throat,13.

Stomach.-Thirst,.-Great thirst,".-[90.] Nausea and vomiting,. Vomiting (in four hours),".-Pain in epigastric region (in four hours),". Feeling of heat of stomach,".

Stool. Bloody stool,13.

Urinary Organs.-Bloody urine,".-On the ninth day the urine. again became suppressed, and vomiting reappeared,13.-Hæmaturia,12 13. Urine deep red, almost black,".-Urine black, bloody, scanty,.-[100.] It caused blackish urine, depending upon altered blood-globules,.—(Arsenic was detected in the urine),13.

Chest.-Constriction on the suprasternal notch,.-Feeling of constriction at base of lung, and breathing was quickened (in five hours),".

Heart and Pulse.-Distress about the heart and stomach, followed by profuse vomiting,.-Pulse small and rapid,".-None had a pulse under 120, and in some it was 160,".-Pulse 90,1%.

13

Back.-Violent pain towards lumbar region (in five hours),".-Feebleness of the limbs continued for a long time,".-[110.] Pains in the limbs,13. -After they apppeared well they had pains in the limbs,.

Generalities.-Blood exuded from the mucous membrane and from the prepuce; the blood was pale; I was scarcely able to call these exudations hæmorrhages, on account of the decolored character of the blood; the patient certainly lost as much as 300 to 400 grams of blood,".-He soon had a sense of burning and constriction in the throat. Next day he was exceedingly ill. He had been suffering for several hours from excessive irritation of stomach, with an intense acrid burning sensation from the pharynx to the lower end of the alimentary canal. The vomited matter consisted at first of the food contained in the stomach, then of the bile which had evidently regurgitated into that organ, and ultimately of dark coffee-groundslooking matter, which was ascertained to consist of broken-down blood corpuscles and the desquamated epithelium of the stomach and lower part of esophagus. The bowels had been obstinately constipated, and there had been severe pains in the loins, accompanied with the discharge of between three and four pints of bloody urine. There was at this time (about sixteen hours after the poison) considerable fever, with a full, hard, frequent pulse, a dry, hot, unperspiring skin, burning pain in the whole course of the alimentary canal, deepseated pain in the lumbar region, intense restlessness, anxiety, and general uneasiness, pale, anxious face, and considerable prostration of the vital powers,10. -Very great restlessness,13.-Walked with difficulty (in five hours),".-Very great prostration,".-Indefinable malaise,13.

13

13

Skin.-Eruption of papules upon the abdomen, face, and loins,13.The eruption on the skin became violet in color,13.

Sleep.-[120.] After about four weeks the patient was attacked with somnolency; the face became of a bronzed hue, and the oozing of blood continued; afterwards the patient had repeated attacks of syncope, and soon after died,13.

13

Fever.-Body cold,".-Skin cold,".-General heat of body,.-Profuse perspiration,.

ARSENICUM IODATUM-ARTEMISIA ABROTANUM. 357

ARSENICUM IODATUM.

Authority. 3, Dr. A. T. Thomson, Lancet, 1838-9 (1), p. 176, experi

ments.

At first appetite is increased, but after taking it for ten or twelve days pain is felt at epigastrium, with thirst, dry state of throat, slight fever, and sometimes diarrhoea and tenesmus; the skin also becomes dry, and the urine is increased in quantity. If it is continued the nervous system becomes extremely irritable, and wakefulness supervenes,3.

ARTEMISIA ABROTANUM.

Authority. 3, A. M. Cushing, M.D., Trans. Mass. Hom. Med. Soc., 1866-70, vol. iii, p. 19, took 6 drops at 10.30 P.M. (first day); 8 drops at 10.35 P.M. (second day); 15 drops at 10.30 P.M. (third day); 15 drops at 10.30 P.M. (fourth day); 20 drops at 11 P.M. (fifth day); 25 drops at 9 P.M. (sixth day); 40 drops at 10 P.M. (seventh day); 25 drops at 12 P.M. (eleventh day); 50 drops at 10.30 P.M. (twelfth day); 100 drops at 9 P.M. (thirteenth day); 500 drops 1st dil. at 10 P.M. (sixteenth day); 1000 drops at 10 P.M. (seventeenth day).

Mind.-Very nervous (eighteenth day),3.

Head.-In five minutes head felt as if squeezed on temporal regions (first day),.-Pain and fulness of the head (seventh day),.-Awoke in the morning with severe pain in the left temporal region, which continued all the forenoon (fourteenth day),.-Headache (sixteenth day),3.

Eye.-Eyes smart in the evening; pain in left eye, could not open it for several seconds (fifteenth day),3.

Ear. Soon after dose, heard a noise like the humming of a bee; walked around the room to find it. When in bed it sounded like persons talking in the distance; on listening intently it disappeared, but would return as he turned his mind from it (eleventh day),.-Wind rushes out of right ear (seventeenth day),.

Nose.-Watery discharge from nose (seventeenth day),3.

Mouth.-Mouth hot and dry, morning, on waking (fourteenth day),'. -Sore tongue and mouth all day (seventeenth day),3.-Mouth dry and sore (twentieth and twenty-first days),-[50.] Mouth quite sore, confined mostly to gums near left upper molars (twenty-second day),.-Sore mouth, with increased saliva, more in the night (twenty-second day),3.-Soreness of mouth increased (twenty-third day),.-Mouth better (twenty-fourth day),3.

Stomach.-Poor appetite (fifteenth, nineteenth, and twenty-second days),-Raises wind tasting of the plants (eighteenth day),.-Evening, belching of large quantities of wind tasting of salt mackerel, though none has been eaten for months; cannot eat it (twenty-sixth day),.-Nausea (thirteenth day),.-Slight nausea, with eructation of large quantities of flatus, tasting strongly of the plant (first day),.-Felt sick all the forenoon, better in the open air (fourteenth day),.-Nausea and sour eructations (seventeenth day),'.-[60.] Nausea, burning, and soreness of the stomach, evening (seventeenth day),.-Stomach very sour (eighteenth day),-Heat in stomach (eighteenth day),.-Heat and pain at epigastrium, at night (twenty-second day),.