faintness, and my head felt bruised and sore. I at once began to undress. While doing so I was obliged several times to stop and rest. I thought I should faint before I could get into bed. I was not alarmed, but seemed rather pleased with my peculiar feelings. I attempted to whistle and sing, but had not the strength. Soon after getting into bed I fell asleep in the same position as before, on my back, with my legs drawn up. I did not awake till 6 o'clock next morning, but what was strange with me, I was wide awake in an instant. There was no rubbing the eyes nor stretching, but from sound sleep I passed in an instant to absolute wakefulness. I did not feel as weak as the night before, but had all the symptoms of a bad diarrhoea, with a disagreeable, hot, burning sensation in the rectum. With that I felt as if I had taken a large dose of Opium. Particularly did I feel this Opium symptom in my head. But what was my disgust, when I arose from my bed, to find that I had passed several small stools, involuntarily, during the night. I went to the water-closet, and although I had all the symptoms of a diarrhoea, had no movement of the bowels. I went to my room and took one dose of Arsen. alb. 3d, and then went to breakfast. Had no desire for food. Drank part of a cup of tea (usually drink coffee), and ate a small piece of dry toast. Food seemed to cause nausea. The Opium symptom in the head still continued; was worse when walking; going up or down stairs made me giddy. Cold water caused nausea. Could not wipe my face with a towel, it was so sensitive to touch. It hurt me to comb or brush my hair. I now went out to visit my patients, but the jarring motion of the carriage increased all my bad feelings, so that I was obliged to return to the house. I now began to feel a bruised or sore feeling through the small of the back and bowels. By noon this feeling had gone into the hips, which ached badly. The burning feeling in the rectum was very troublesome, so much so that I took a cold-water injection. My bowels seemed filled with flatulence. Did not go to dinner, had no desire for food, the thought of it was unpleasant. About two o'clock I had a stool, not large, but passed with considerable flatulence. The stool appeared as if composed of thick glue, and mixed with currant seeds, though I had eaten nothing of the kind. It was passed in thin strips, very much like tape. This same peculiarity I noticed in the involuntary stool I passed the night before. Towards night the pain in my hips had passed into the right leg, from the hip to the knee. I did not eat any supper, but retired early, and passed rather a restless night. The pains in my right leg prevented me from sleeping. In the morning the pain had gone from the knee to the foot, and during the day passed off altogether. My bowels, however, continued to be sore, and my head was still troubled with the Opium symptom. All the strange feelings gradually grew less, and in three days were nearly gone. Previous to my exposing myself to the fumes of the acid, my health had been good, and during the unpleasantness I took no remedy except the Arsen. I have twice since experienced similar symptoms when exposed to Carbolic acid vapor,.-[610.] Insensible, retching, the breathing stertorous, the pupils much contracted, and the pulse intermittent; strong smell of acid from the stomach; the mouth, tongue, and fauces presented a white, corroded appearance,".-Insensible; face quite livid, bathed in profuse clammy perspiration; pupils contracted and not responding to light; mouth open, filled with frothy mucus; respiration stertorous; pulse imperceptible; heart-sounds scarcely audible (in five minutes), Totally insensible; pulseless; pupils dilated; face pallid and pinched; respiration of a gasping character; involuntary discharge of

49

urine (in two minutes),50.--As soon as the mixture was swallowed, it came foaming out of the mouth, and the patient asked, "What is this you have given me? it burns;" unconscious; pupils contracted and insensible; breathing about 50 per minute; pulse 150, rather small, feeble, and intermittent; surface bathed in clammy perspiration; the mouth and throat, as far as could be seen, were whitened by the action of the Carbolic acid; the pharynx and larynx were filled with mucus, giving rise to tracheal iâles (after ten minutes); countenance indicating a cyanosed condition; superficial veins of head distended,".-Immediately became insensible, falling down suddenly as if in a fit; on his recovery he said he remembered nothing whatever of tasting the liquid. An attack of acute gastritis followed. The urine passed the day after the accident was almost black, but was free from turbidity, and no trace of Carbolic acid, blood, or albumen could be detected in it,.-In about twenty minutes she was found unconscious, collapsed, and blanched. The breathing was stertorous; the pupils were contracted; the pulse was hardly perceptible, not rapid. In about three hours the surface of the body was cold, there were convulsive twitchings of the limbs, and she vomited some blood and oily matter. The next day she continued to vomit a greenish watery matter. The bowels had acted several times, the motions being at first black, afterwards dark brown, and without odor of Carbolic acid. The urine is of a smoky color and aromatic odor. The addition of strong Sulphuric acid to it causes a purple color, changing rapidly to blue; no odor of Carbolic acid is given off. No albumen present. She complains of great burning pain in throat and epigastrium. There is tenderness on pressure over the stomach and cœcum. Fauces reddened and covered with mucous exudation. There is a dark-brown stain on the skin of the upper lip, and running down the left side of the mouth and chin. Pulse rapid; temperature in evening 102°,53.-Unconsciousness was rapidly becoming absolute, the face dusky, the skin was moist and pupils dilated, while the pulse was rapid, irregular, and scarcely perceptible; the breathing remained regular, although the relaxation of the soft palate rendered it noisy. In about an hour after the poisoning coma was complete, the face perfectly livid, the pupils dilated, the skin secreting perspiration in the most extraordinarily profuse manner, the surface of the body warm, as also were the extremities, with the exception of the hands, the pulse at the wrist imperceptible, and the muscles of the soft palate and tongue so entirely relaxed that it was necessary to keep the latter organ extended with catch-forceps to prevent it from falling back upon the glottis. On recovery she was entirely ignorant of what had occurred, and did not know that any mistake had been made. She complained of no pain except in the tongue, but remained in partial prostration for some days, and suffered from an attack of gastric catarrh,.-Immediately after the child swallowed the acid, he began to run around the room crying; on being taken up he instantly became unconscious, turned livid in the face, his eyes staring, breathing slowly and noisily, and foaming at the mouth and nose. Soon after the larynx was full of 1âles. Face pale, cheeks livid, pupils dilated and not responding to light, and there was slight twitchings of the muscles of the extremities. The capillary circulation was very slow. There was a streak of excoriation upon the chin, where some of the acid had run. The next day the uvula was found whitened and shrivelled. He had passed in the morning about a pint of clear urine, of a dark olive-green color, without odor; and had been troubled in the night with a croupy cough,62. -Immediately became unconscious, breathing laboriously; face pale, and

covered with a cold clammy sweat, with convulsive twitching of the facial muscles, and trembling of the limbs; the jaws were firmly compressed, while the pulse was small, and almost imperceptible. He recovered in about three hours, but there remained some soreness and reddening of the mouth and gullet, with a burning pain at the epigastrium. The urine, which was passed voluntarily, showed traces of albumen, and assumed a dark-green color, which again disappeared in the course of the following day. Simultaneously all symptoms of cystitis disappeared, and the patient made a good recovery,63.-On the removal of the syringe the patient said something "became numb and commenced to jerk." The respiration was 30 in the minute, and superficial; the pulse was 168 at first, but in the course of the next two hours it fell to 120,61.-One evening it was observed that after the solution had been thus injected, little or none of it flowed away, and at the same instant the patient uttered an exclamation, and suddenly became unconscious, with tremor of limbs, pallor of skin, clammy sweat, and intermittent laborious respiration, imperceptible pulse, etc. The next day she wholly recovered from the above symptoms. There existed, however, for some days, an irritative vesical catarrh, caused doubtless by the rapid elimination of a considerable quantity of the poison. The urine, which for the first twenty-four hours, showed the usual dark-greenish color, now became acid and albuminous, depositing a thick sediment of pus,“.[620.] Great debility; violent burning sensation from the fauces down to and into the stomach; pulse full, slow, regular, and strong; semicomatose condition; she could only with difficulty be made to understand any question; she could scarcely move her limbs, and when raised they dropped like those of one dead drunk, as indeed she was,58.-Insensible (after a few seconds); skin pale, with cold sweat; features livid; breathing labored; mucous râles, almost to suffocation; pulse 110, small and hard; pupils partially dilated (after twenty-five minutes); convulsions in fifteen minutes after insensibility, that returned every few minutes,".-Immediately slight convulsions set in, followed by unconsciousness, cold sweat, pulse hardly to be felt; the convulsions lasted for an hour, when consciousness returned. Breath smells of Carbolic acid. Lips, gums, pharynx coated with a white membrane. White membranes were ejected by the mouth. Other membranes were thrown off the next day. Stool and urine pass involuntarily; the latter gives the linen the color of red wine,.-Almost immediately afterward she was seized with convulsions, and there was a complete loss of consciousness, cold perspiration, imperceptible pulse, strong odor of Carbolic acid in breath; lips, tongue, gums, and pharynx covered with a white slough. The convulsive attacks continued for an hour, but were not severe. Consciousness returned in an hour; there was great pain in the neck and stomach, and difficulty in swallowing even small quantities of milk; the mouth was filled with a thick saliva. There was vomiting, the vomitus being a white, creamy substance, smelling of Carbolic acid; involuntary fecal discharges, not at all abnormal in appearance; but the urine, which was also voided involuntarily, left a stain on the linen resembling that made by dark-red wine,56.-Face of a leaden hue, and bathed with cold sweat; eyes fixed, and the pupils slightly dilated; extremities cold and completely insensible; breathing stertorous; slight convulsions,".-In five minutes in a state of collapse, pale, and cold, with clammy perspiration on the forehead. The radial pulse was about 112, and scarcely distinguishable; the conjunctiva was insensible to touch, and the pupils were dilated and immovable; respiratory movements almost imperceptible, about 56

per minute; froth exuded from the nostrils. The breath smelt strongly of Carbolic acid, and marks of erosion were seen on either side of the upper lip,.—Chill, attended with great nervousness and distress, although profusely warm; unsteady, weak, and irregular pulse; great giddiness and impending convulsions. He recovered from this "chill," but continued exceedingly dizzy for three days longer,66.

CARBONEUM CHLORATUM.

Authority. 3, J. Y. Simpson, M.D., Pharm. Journ., vol. vii, 1848, p. 516. When the vapor is inhaled it causes so great irritation of the throat, that few can persevere in breathing it for such a length of time as to induce anaesthesia. I have latterly, however, seen it inhaled perseveringly until this state, with all its usual phenomena, followed; and without excitement of the pulse or subsequent headache. When I myself attempted to inhale the Chloride of hydrocarbon, it produced an extreme degree of acrid irritation in the throat, which did not disappear entirely for many hours afterwards,3.

CARBONEUM OXYGENISATUM.

Authorities. 33 and 34, S. Plymptom, Bost. Med. and Surg. Journ., vol. xix, 1838, p. 325, Goodwin, aged twenty years, and Denvir, aged twenty-six years, put an irou kettle containing charcoal into their sleepingroom; 35, Dr. B. E. Cotting, ibid., vol. liv, 1856, p. 142, F. J., aged twentythree years, slept in a closed room with a coal fire; (36 to 41, from Dr. J. Ch. Herpin, L'Acide Carbonique, Paris, 1864); 36, effects of a bath; 37, M. Rotureau, effects of a bath; 38, Dr. Sequin, Annal. de Chem., vol. lxxxix, 1792, experimented on himself by inhaling the gas; 39, Pilatre de Rozier, descended by a cord attached to the shoulders into the gas caused by the fermentation of beer; 40, Attumonelli, breathed the air of a grotto laden with Carbonic acid gas; 41, Herpen, general effects; (42 to 54, from Friedberg, Die Vergiftung Durch Kohlendunst, Berlin, 1866); 42, case of poisoning; 43, a family were poisoned by sleeping in a room with a coal fire; 44, poisoning of a man; 45 to 54, other cases; 55, Dr. McD., New York Journ. of Hom., vol. i, 1873, p. 566, effects on himself of sleeping in the room with a Franklin stove, the draft being shut off; 56, effects on Mrs. McD.; 57, Dr. Quincke, Archiv. für Exper. Path. und Pharm., vol. vii, p. 101, the action of carbonated water.

Urinary Organs.-In a general way it produces a sensation of warmth and tension in the stomach, it excites the peristaltic action of the stomach and intestines, promotes the appetite and digestion, increases the secretions of the stomach, accelerates the respiration and pulse, and according to some authors, causes slowness of the pulse, and diminishes the temperature. The whole organism becomes freshened and energetic, and mental activity is increased. Large quantities cause vertigo and congestion of the brain. The secretion of urine is increased; carbonated waters are the best diuretics. The object of the present paper is to show the diuretic action of carbonated drinks by a series of observations. The subjects experimented on, healthy, with good and regular appetite; the hours for meals were fixed, and the food and drink were carefully estimated; the carbonated water was always taken in the morning fasting, after the blad

der had been emptied; subsequently the urine was gathered every hour or half hour; the specific gravity noticed, etc. The first experiment was made in October and November, the drink used was distilled water artificially impregnated with Carbonic acid gas. 500 cc. were drunk at one time. The amount of urine in the different experiments on average showed an increase of 14.4 per cent. on the days in which the experiments were made. The specific gravity showed a corresponding diminution. The second experiment was made on a healthy person, somewhat chlorotic, æt. twenty-six years, appetite good and regular. He drank, in the morning fasting, a glass of artificial Pyrmont water in two portions, with an interval of ten minutes. Three times during the experiment he drank springwater. The general average showed an excretion of 665 ce. of urine while taking the carbonated agent, 539 cc. when not taking it. A third experiment was made on a man with Pyrmont water, for eleven days, showing during the first three hours after taking the water an average increase of 36 cc. of urine, while the amount secreted during the first hour after the drink was diminished on average 25 cc. The fourth experiment was made on a man in the same way for sixteen days. The urine showed an average increase in the first three hours after the drink 34 cc. In all the experiments the result was the same, increased secretion of urine after the Carbonic acid,"

Extremities.-Loss of motion and sensation in the right arm, followed by atrophy. The right leg was cold, somewhat heavy; the arm recovered under galvanism, after many months,".-Incomplete paralysis of the left lower extremity, with serous infiltration of the foot, which was painful, not red; and along the dorsal surface of the metatarsus there developed numerous blisters, with brownish-red spots as large as a half dollar, 52.

Generalities.-Paralysis of the right arm; involuntary evacuations; anasarca of the right arm; over the body various spots, which looked as though they had been burnt, where blisters developed, followed by suppurating ulcers; the whole right arm from the shoulder to the fingers was very much swollen, painful on pressure and motion; the whole right thigh was swollen, especially on the outer side, the skin seemed infiltrated; skin of the right side swollen, not painful; large suppurating sores formed in the right axilla; gangrenous spots on the back of the right hand; sores on the outer side of the right thigh, and on the inner side of both knees, becoming gangrenous,.-Loss of consciousness for a long time; paralysis of the bladder; paralysis of the lower extremities; bed-sores over the sacrum; diabetes; abscess in the breast; violent convulsions,-[380.] Found in deep coma, followed by bronchitis, herpes of the lips, and sugar in the urine for three days after the poisoning,".-Found in a comatose condition; afterwards pleuro-pneumonia of long duration, and transient diabetes,".Paralysis of the rectum and bladder; persistent idiocy,".-Stertorous respiration, paralysis of the limbs, paralysis of the bladder, trismus, convulsions, pneumonia on the right side,".-Paralysis of speech; hæmoptysis; recovery only after many months,".-Loss of consciousness. Surface of the body cold. Stertorous respiration. Frothing from the mouth. After being aroused he complained of headache, difficulty of swallowing, dryness and scraping in the throat, causing cough; nausea; painful pressure in the epigastric region; confusion of the head; coma; chilliness; numbness of the hands and feet. On the third day, the feeling of paralysis had almost entirely disappeared, the pulse was 120, temperature 39.1°. The