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disappeared on the second day, 244, -Shortly afterward became insensible, with rigidity of the body and clenched teeth. Breathing with a loud snoring noise, but without puffing out the cheeks; the skin, lips, and mouth dry; pulse 104; respiration 22 (after two hours and twenty minutes). Contractions and twitchings of both arms, the fingers being clenched by tonic contraction of the muscles, and the elbows rigid (after three hours and twenty minutes). Half unconsciousness began to give way to fussy busy delirium. He constantly muttered, kept picking the bedclothes, and tried to get out of bed. He stared wildly about him, and was very suspicious. He continued delirious, but not violently, all that night and the next day (after ten hours and a half). Became so violent that it was necessary to lay him down in bed. He stared wildly about him, struggled to get out of bed, shouted at the top of his voice, “ Police !” “Murder !” and suffered from various hallucinations, thinking he was in prison, or was about to be murdered. He was very suspicious, refusing to take food, thinking it was poison (after thirty-six hours),272. — [2660.] “ In about five minutes,” to use her own words, she "felt queer about the eyes, then stupid like” in her head; felt she was losing the power of standing on her legs. She became helpless and quite unconscious. ' In less than an hour, when I saw her, she could swallow only a few drops of water, and very soon she became unable to do this. She could not speak, only mumbled incessantly some iparticulate words, which were only audible at times. She was put into bed, and there she sat propped up by pillows, and had a vacant, drunken look; moved her hands about, sorting and catching at imaginary things. Widely-dilated pupils, and a diffused scarlet rash, which was out on the neck and upper part of the chest, and also on the hand and forearm. The rash was not of a long duration ; it soon began to fade, and in four hours was hardly perceptible anywhere. For about twenty-two hours her life was a blank to her. On the morning of the second day, her pupils were widely dilated, and she saw persons and things double, and at times saw imaginary persons and objects about her; her hands felt moist, as did also her feet, and she could not stand. All through there was a good deal of distress about the throat; it was one of the first things experienced, and the discomfort lasted to a certain extent for many days. The patient eventually recovered ; but for several days she felt she was not her ordinary self; could not remember how to do the simplest thing, had forgotten the way; had to ponder over the way an article of clothing should be fastened on, etc.,276— In fifteen or twenty minutes after I had taken it, I felt a very disagreeable sensation in my chest and head, and slightly in my stomach. It seemed to me as if there were an accumlation of wind at the pit of the stomach, which should come up. The vital organs were weary, I wished to draw a long breath every moment, and soon grew worse. My face became flushed. The pupil of my eye was much dilated, covering nearly the entire iris. My head felt full and heavy. Giddiness followed, the room appeared to whirl and the floor to move. There was a sort of constriction in the chest and throat, slightly spasmodic, and a sense of suffocation. This condition rapidly increased in intensity till I felt I was assuredly dying. I could think of no other result. It appeared as if every breath I drew would be the last. I took leave of my family, as I found my voice failing and the sense of vision losing itself in darkness, when I became unconscious. I remained in this position from about 8 o'clock in the morning till after dark in the evening. When I came to myself, so as to know thuse around, the faces of persons look exceedingly large, broad,
and out of proportion. Any little speck or spot on the ceiling over head, or on the wall of the room, as large as a fly, for instance, the head of a nail appeared to my vision precisely like a spider with legs, and the legs constantly in motion. This appearance continued for three or four days, but gradually corrected itself so far as addition to the real object seen went. Still for weeks and months, everything I looked upon, the ground, houses, trees, etc., appeared as if there were a sort of glimmer upon their surface, resembling the wavy motion of heated air arising from the roof or sides of a building. The figures of a carpet seemed to blend as I looked down upon them; indeed, nothing appeared natural to the vision. My stomach and bowels were torpid and inactive. For weeks and months I had no appetite, much of the time actually loathing the sight and smell of food. One singular sensation I experienced when consciousness was leaving me and immediately on its return, was this: whatever I touched with my hands felt exceedingly cold. The hands and fingers of my wife were as cold to my touch as icicles, and the longer I retained them in my hand, with the thought that they might soon become warm, the more intensely cold did they seem. This feeling was not imaginary, because about the first thing I remembered on coming to myself, when my wife spoke to me and took hold of my hand, was the sensation I have described; but it did not then feel as cold as when I was going into the state of unconsciousness. In four or five days I was able to sit up, and in ten or twelve to go out. But I was weak and trembling, easily excited, quick and hasty in my motions, with a sort of wild and glassy expression about the eye. I felt as if my nervous system was completely shattered. The feelings I have experienced in my brain, at the pit of the stomach, and through my limbs, to which I allude, are difficult to describe. At times when excited or a little weary, and sometimes when there is no apparent cause, even when I feel uncommonly well and bright, I experienced what I call a sort of spism in the brain. The sensation comes quite suddenly. There is a sort of drawing and giving way, again, as if the nerves of the brain were in motion, when all upon which I look appears to move slightly in oue direction, and then back to their former position. If the objects are at a distance, either forests, houses, or mountains, upon which I chance to look at the time, they seem to swing. At these moments I feel as if I should fall to the earth, though I experience no giddiness, but only a strange and alarming sensation at the pit of the stomach, corresponding to the feeling in the brain, and coming at the same moment, as if the two were connected, and the whole on the sympathetic nerves. This sensation was first experienced about two weeks after my prostration. I have since felt it many times, and generally when standing or walking, but seldom when I either stund or sit with my back against something to sustain me. In two months after I was prostrated, I felt those spasins at times so powerfully that it would seem I could not live if they should continue for the space of a minute. They generally pass off in the space of a few seconds, and do not return for some hours, perhaps not for a day or two,265,-Expression vacant, laughing on the slightest provocation. Strong light produced no contraction of the pupils, which were widely dilated. Answered questions when arou-ed, but soon became incoherent; vessels of retina rather enlarged: pulse 114;
† All the symptoms which I have described above, followed in the case of my sister, who took but half the amount I did. She, however, did not become uncona scivus.
quick; extremities cold; mouth and tongue remarkably dry (first day). Delirious and very troublesome throughout the night; limbs feel numbed; objects appear a long way off, and as if double; sees letters dimly, but cannot read (second day),277. —The skin was of the color of a lobster ; pulse 130; respirations rapid, sighing, and shallow; the pupils widely dilated, and the patient much alarmed. She looked as if in the eruptive stage of scarlet fever,279.-Dryness of throat, dilated pupils, and great pain in the passage. Vagina very dry, in great pain of a burning stinging character. Her pulse was quick, the countenance was flushed, tongue dry and parched, 24. -Severe pain in the top of the head, vomiting, dryness of the fauces, spasmodic action of the muscles of the throat and chest, and an indescribable sensation of sinking. Pulse quick and thready; irides very inuch dilated, though contractile; face and eyes suffused, extremities cold, tongue moist, skin dry. Urinated several times with severe scalding and irritation of the bladder,2.8. - Nauseous taste, like copperas, in her mouth, a tingling in the fingers, and stupor, 27. -One hour after swallowing powder, he was attacked with violent headache, especially above the orbits; the eyes became of a red color, which quickly extended over the face, and at last over the body, so that within a few minutes the whole skin exhibited an intense uniform redness, such as is observed in scarlet fever; at the same time the patient felt violent pain and heat in the throat, and along the esophagus, and, on examination, the fauces were found strongly inflanied. These symptoms were accompanied by a very painful irritation of the urinary passages, especially of the neck of the bladder, with constant but fruitless desire of making water,255 —Restless,260—Desire to lie down,247.
Skin.-Scarlet redness over the whole body,252. —[2670.] Scarlet redness over the whole body, with pain and heat in the throat, desire to urinate, and painful discharge of bloody urine, 24-Her body and limbs were covered all over with a beautiful scarlet rash, resembling the rash of scarlativa, but this disappeared in a few hours (after sixteen hours),248 — Transient redness over the whole body, especially on the chest and neck, "SI. Face, neck, and upper part of the chest reddened and congested (after pine hours and half ),478 — In about one and a half hours the face of the child was covered with spots the size of a silver quarter, and larger. These spots were of a bright red color, and a little elevated and puffy, similar tu nettlerash. These gradually coalesced, and in about two hours covered the face and front of the neck. Around the spots was a white border ; also around the mouth,275.—Scrotum blistered,478.
Sleep.-Fast asleep (after three hours); sleeping quietly without stertor (after six hours and a half); after the application of cold to the scrotum and spine, tickling and pivching the feet and legs, the patient became partially aroused at 3.30 A.M. (after sleeping nine hours and a half); he then slept quietly till morning, when he woke of his own accord,278 — Wakeful,261
Fever.-Skin cold (after four hours),250 — The lower limbs were inclined to be very cold, and it was with considerable difficulty that they were kept partially warm,975. — [2680.] Skin hot (after two bours and a quarter),286. –Profuse perspiration,248 249.
Authorities. 12, Dr. Mackenzie, Med. Times and Gaz., 1862, p. 239, a boy sucked some through a siphon; 13, E. Nicholson, Lancet, 1862 (1), p. 135, a student took a soap perfumed with nitrobenzol into a bath ; 14, Alfred S. Taylor, Guy's Hosp. Rep., vol. x, 1861, Mr. Fotherby communicated to me a case, a woman, æt. thirty years, swallowed not more than a drop, and spilled a tablespoonful, and did not immediately wipe it up; 15, Ein Fall von Nitrobenzolvergiftung, Inaug. Diss., Dr. Hermann Pagenstecker, Würzburg, 1867, case of poisoning ; 16, Dr. Swederus, Hygea, 35, 1873, S. J., 170, p. 232 ; 17, Ewald, Centralblatt für die Med. Wissenschaften, 1873, Lond. Med. Rec., vol. iii, 1875, p. 75, a young woman, æt. twenty-two years, took about a drachm of commercial bitter almond oil; another, æt. eighteen years, took about 2 drachms; 18, Ewald, general symptoms; 19, Dr. Bruglocher, Ærz. Intell. Blatt, Jan. 5, 1875 (Lond. Med. Rec., vol. iii, p. 74), a soapboiler, æt. 'forty years, took five or six drachms, with about twenty times its bulk of spiric; he took part at 2 A.M., the rest at 7 P.M.; 20, Dr. Stephenson, New Remedies, 1876, p. 268, a man, æt. thirty years, for pain in the chest and cough, took of the following prescription, Benzol, rect., 3ij., Ol. Menth. Pıp. Zss., Ol. Olivæ, 3x, three doses of thirty drops (first and second days), one dose at 9 A.M. (third day); 21, Bruglocher (Bayr. Arztl. Intell. Blatt, 1875), S. J., 168, 128, poisoning by a small quantity; 22, From the Swedish, S. J., 170, 232, a man took some by mistake for castor oil.
Mind.-Stupor,s: -First felt only a little sleepy, finally the stupor increased, and it was impossible to rouse bim, and he died twelve hours after,'?.–Both recovered after about five and twelve hours' insensibility, and a further period of partial coma," --Soon became unconscious, tossed about, with inarticulate, confused speech,"4.-Complete loss of consciousness,':.-Extreme coma,
Head.—[110.) Headache,18.—Slight headaches,"?.
Eye.-Rolling of eyeballs," - Constant slow movement of the eyeballs, from left to right, under the closed lids, 5 — Eyes partly closed, Pupils dilated,16 18. — Pupils contracted,'".
Face.-Edema of lace,'': --- Face intensely pale, bluish,:: - Face bluish gray, covered with cold sweat,'-120.] Jaws spasmodically closed, 16.
Mouth.-Tenacious saliva flowed from the mouth,''.
Urinary Organis.-Diuresis towards the latter part of the case was greatly increased, -Urine drawn by the catheter brownish red,''.— The first urine passed in case No. I was about 9 ounces, brownish red, slightly turbid, free from albumen, sp. gr. 1020, and smelling strongly of bitter almonds. It held a large quantity of cupric sulphate and potash iu solution, but did not reduce the copper [? glycogen, glycocoll, or inosite]. The urine in the second case was twice drawn off by catheter (six and eight hours afterwards), and a third sample passed spontaneously was also examined. The first samples equalled about halt a pint together, sp. gr. 1017. The next was similar. The quantity is not stated. It partially reduced, but did not decolorize, Trommer's solution, and failed to show appreciable amount of sugar by the polarizing apparatus,
Respiratory Oryans. - Accelerated respiration, s. — Respiration
18 and 22,"?- Respiration irregular, scarcely 10 to the minute, 15-130.] Respiration irregular, snoring,'6.-On every deep inspiration the wings of the nose dilated, the lower lip was somewhat drawn inward, and the epigastrium was much raised; with the respiration there was vesicular pharyngeal stertor,
Pulse.-Rapidity of pulse,': -Pulse 12+ and 108,97.—Pulse tense, irregular, intermittent, at times slow, sometimes rapid, about 96,5 - Pulse weak, regular, 6. — The pulse became very slow and weak,6.
Generalities.-The blood taken by cupping was brownish in color, but gave no special spectrum bands," : — Powerful odor of bitter almond,'s
-There was an intense smell of the poison in the breath, vomit, etc., for three days. Even the urine smelled of it,': – 149.] Violent trembling followed by transient spasms, with drawing of the head backward, and to the left side, 16 -Convulsions, 's - The burning taste in the mouth was immeiliately followed by a sensation of numbness and tingling in the tongue and lips, and a strange feeling for the next hour. In an hour and threequarters after the occurrence her aspect was quite typical of prussic acid poisoning; the eyes were bright and glassy; the features pale and ghastly; the lips and nails purple, as if stained by blackberries; the skin was clammy, and the pulse feeble. She was able to swallow a mustard emetic, afier which she became rapidly worse ; lost her consciousness; the teeth became set, the hands clenched and blue, the muscles rigid and convulsed. She vomited freely a pale fluid matter, which had the peculiar odor of nitrobenzole. The breathing became much reduced, and the pulse could scarcely be felt. In about eleven hours there was reaction, consciousness returneil, and she was able to swallow. At the end of seventeen hours she was much better; but she then complained of distorted vision, with flashes of light and strange colors before her eyes. For some weeks she contin. ued weak. There is no doubt these severe symptoms were chiefly due to the breathing of the vapor in a concentrated form. A fellow-servant in the room at the time the nitrobenzole was spilled also feli sick from the inhalation of the vapor,".-Loquacity was followed by drowsiness, which was soon merged into complete insensibility. He was found quite unconscicus at 7.30 P.M. At 8.30, when brought to the infirmary, all his limbs were paralyzed, as in deep chloroform narcosis; the jaw was clenched tightly, and was opened with great difficulty. The skin was cyanotic; the lips were of a violet-blue. He foamed at the mouth. His breathing was stertorous and superficial. The pulse was scarcely to be felt. The heart's impulse and sounds were extremely weak. The surface was cold. The pupils were moderately dilated, insensible to light. The urine and faces were passed in voluntarily. He smelt strongly of bitter almonds,'.-On the afternoon of the second day he was observed to look pale and weak, but he was not conscious of feeling ill until after taking the dose at 9 A.M., on the third day. All the morning he suffered from headache. He left the office shortly after 2 P.M., but had not walked more than forty yards when he fell. He was just sensible enough to state where his office was situated, but speedily became quite unconscious. When seen at 3.5 P.m. he appeared to be dead. The surface was bluish purple and cold. No pulse could be felt at the wrist. The lower jaw was rigidly closed, but the lower limbs were flaccid and dropped powerless when raised. The heart could, however, be heard beating faintly and irregularly. No breathing could be perceived until twenty minutes later, 70:- He fell to the ground unconscious, the extremities paralyzed, as in deep chloroform sleep, eyes closed by