Poisonous Effects of Lead.-Dr. Lauder Lindsay, in a paper 'On the Action of Hard Waters upon Lead,' read before the Chemical section of the British Association, Leeds Meeting, September 24th, 1858, arrives at conclusions with reference to the action of waters on lead somewhat different from those which have been hitherto generally held. From observation, experiment, and inquiry he deduces the following results: 1. That certain pure or soft waters do not act upon lead. 2. That certain impure or hard waters, in some cases containing abundance of the very salts which are generally regarded as most protective or preservative, do act upon lead. 3. That the rationale of the action in these anomalous or exceptional cases is very imperfectly understood. 4. That experimentation on the small scale, and for short periods, is most fallacious, and frequently dangerous, in regard to the conclusions thence to be drawn. 5. That water may, under certain circumstances and to certain extents, contain lead without necessarily being possessed of appreciable poisonous action on the human system. 6. That water contaminated with lead may deleteriously affect certain members or individuals only of a community, family, or household. 7. That the use of water so contaminated is the obscure cause of many anomalous colicky and paralytic affections. From this paper we select the following points of interest: "The use of leaden covers to cisterns is fraught with great danger, and fortunately is comparatively seldom resorted to by plumbers. If cisterns are covered at all, probably the safest material is wood. However impure or hard a water is, however saturated with sulphates and carbonates, and however free from plumbeous impregnation, the moisture which results from its evaporation, and which condenses on the leaden cover, is pure or distilled water. Hydrated oxide and carbonate are produced in the ordinary way; these gradually encrust the lead, and by and by scales or fragments fall off and drop into the subnatant water, in which they are partly dissolved, partly held in a state of suspension. "Time is a most important element or condition in the action of water on lead. The mere flowing of water through leaden pipes, and the standing of water for a long period in leaden cisterns, are two very opposite conditions. Accordingly it is found that the same water which will cause no perceptible change on lead from short contact, will produce a copious deposit of oxide and carbonate on standing for some weeks or months. "An equally important element in the action is, perhaps, the extent of surface exposed. It not unfrequently happens that experiments on the small scale give erroneous, and consequently dangerous, results, merely because the surface exposed was too small and the time allowed too short." Dr. Lindsay admits the effect of galvanic action in influencing the corroding power of water on lead, but he thinks too much has been attributed to it by some writers on the subject. He says: "Galvanic action in connexion with the corrosion of lead seems to be a most hopeful field of research. It is generally called into requisition to explain all the anomalous causes of the action of hard waters on lead. But this is making too much of it. I have no doubt that it exerts a powerful influence in many cases, but it has yet to be distinctly shown in what cases, how, and under what circumstances it operates." From an experimental examination of various waters-viz., of well waters decidedly hard (i.e., containing carbonates, sulphates, and chlorides abundant, lime and magnesia also abundant), of spring-waters, mostly hard (presenting similar chemical characters); of surface or drainage water; of river water decidedly soft (containing the same saline impurities but in smaller quantities); and of rain waters, very soft (containing only traces of the above salts), Dr. Lindsay found that they all possessed some action on lead; though only in the cases of the rain waters was this action apparently dangerous in amount or degree. SUMMARY. Poisoning by Hydrochloric Acid.-An instance of poisoning by hydrochloric acid is recorded in the 'Lancet' for July 16th, 1859. The patient was a feeble woman, aged sixtythree. She took half a fluid ounce of concentrated hydrochloric acid for the purpose of suicide. The symptoms as noticed by Dr. Cayley, of King's College, were vomiting, coldness of skin, whitening and abrasion of the mucous surface of the lips, tongue, and fances; rapid and feeble pulse, and burning pain in the throat and stomach. The fauces became swollen, and vomiting of matter containing blood and shreds of membrane was frequent. She retained consciousness to the last. She died eighteen hours after taking the poison. There was great rigor mortis: the lungs were engorged; the heart was healthy, but all its cavities were filled with black clots; the liver was enlarged; the gall bladder distended. The abrasion and distension of mucous surface was confined chiefly to the mouth and fauces. The stomach was comparatively little affected. Abortion produced by Phosphorus.-The 'Journal de Chimie,' and 'American Medical Monthly' (June, 1859), refer to a communication made by the Abbé Mignot to the effect that pregnant women inhaling the vapour of phosphorus are extremely liable to abort, and that in localities where the manufacture of matches engages a large number of workpeople, the women profit by the circumstance alluded to to rid themselves of the products of conception. The same author states that men working in phosphorus are subject to extreme excitation of the generative functions. Chevallier has the subject now under examination. Symptoms of Poisoning by Potato Berries.—Mr. Morris, of Merford, records, in the 'British Medical Journal' for September 3rd, an instance of death in a young lady of fourteen, from eating the berries of the potato plant. The symptoms are thus described: "She was tossing to and fro in bed; the skin was bedewed with a cold clammy perspiration, and was of a rather livid colour; respiration was hurried; the pulse was exceedingly quick and feeble; the teeth for the most part were closed, and she was constantly spitting through the closed teeth a viscid frothy phlegm. She was speechless. She would, after repeated asking, put out her tongue, which was covered with a dark brown moist fur. She occasionally asked for drink, and begged her mother not to leave her. The eyes for the most part were open, and the pupils were not much dilated. The expression was anxious. She occasionally slumbered for a few minutes, and again was restless." Death took place on the second day. Arsenic, Fallacy of Sources of, in Dead Bodies.-Dr. Lois records the fact of his having made examinations of various specimens of brass. He discovered arsenic in ten specimens of brass, and in some specimens in large quantities. He considers this point as of importance to the medical jurist, inasmuch as various brazen ornaments-such as medals and rosaries, which are laid so frequently in coffins-may by undergoing change in the presence of the products of decomposition, supply to the remains the poison which a chemist may be instructed to search for in the exhumations of persons who have been thought to die from poison.-Oesterr. Zeitschrift. f. pract. Heilk., No. xlix., 1859; and Vierteljahrsschrift f. prakt. Heilk., No. xvi., 1859. Poisoning by Sulphate of Zinc.-Dr. Ogle gives the record of a case of this kind in the 'Lancet' for August 27th, 1859. The poison was taken for the purpose of suicide, and seems to have been swallowed in frequent doses for a week. On the evening before death the patient was very tremulous and apparently delirious, and shortly before going to bed he was violently sick after taking brandy and water. He was found in his bed in the morning with his throat cut, and died whilst being conveyed to St. George's Hospital. The mucous surface from the mouth to the stomach was slightly congested, and its surface was thickened in patches and of a greyish-white colour. The tongue was pale and shrivelled. The stomach was contracted, and contained about an ounce of whey-like fluid; the whole of its inner surface was of a nearly uniform dirty-grey colour, the mucous membrane being very greatly thickened, condensed, and indurated, and altogether having a singular appearance, very similar to that of a piece of tripe. The duodenum had the same appearance in a less degree. The colon and rectum were contracted, but otherwise were healthy. There was general congestion of the visceral organs, and a fluid, dark condition of blood. On analysis, sulphate of zinc was readily detected. II. MISCELLANEA. Case of Rape committed on a Child.-Dr. D. M'Kinlay relates the particulars of a case of rape committed by an adult on the person of a child of less than seven years of age. The injuries produced on the person of the child were remarkably extensive. They are thus described by Dr. M'Kinlay: "At the upper part of the cleft of her buttocks, behind and above the anus, the skin was besmeared with dried blood. In her private parts the vagina was lacerated in various directions. One laceration extended from the lower part of the vagina downwards, dividing the recto-vaginal septum and perineum on the left side of the raphe, down to the verge of the anus, and laying bare the rectum. Another laceration, having divided the upper part of the vagina, passed upwards along the left nympha, and terminated near the root of the clitoris. The vagina was also lacerated laterally, so that for an inch and three-quarters inwards there appeared an open lacerated cavity or pouch rather than the semblance of a continuous canal. "In the cavity produced by the laceration there was some feculent matter. This was found to have come through a lacerated opening in the coats of the rectum. Three-fourths of an inch inwards from the verge of the anus there was a lacerated opening in the rectum of nearly an inch in length, through which the fæces escaped into the lacerated cavity before described. This opening had evidently been produced at the same time with the other parts of the laceration, and was not owing to any subsequent sloughing of the parts." On the clothes of both the accused and the little girl stains were found in which, by the microscope, blood-globules, ephithelial scales, and spermatozoa, were detected. In the course of the treatment of the case it was found necessary to divide that portion of the recto-vaginal septum which extended between the verge of the anus and the laceration. It appears that the child gradually recovered, although for some time the action of the sphincter was not established.-Glasgow Medical Journal, July, 1859, p. 135. Blood Crystals, and their Judicial Medical Importance.-Büchner and Simon, in a valuable paper on blood-crystals, give as characteristic of these the subjoined particulars. They usually form rhomboidal tables, but seldom rhomboidal columns. When somewhat imperfect, they take the form of a shuttle. Their colour changes from yellow to black, but most frequently they are of dirty red-brown. Their size is various; they generally lie in groups together, and often lie crossways, form the x figure, or they take the stellate form. Forms of needles, rods, or grains are of little value in a forensic point of view. The crystals are insoluble in water, alcohol, acetic acid, phosphoric acid, and hydrochloric acid. They dissolve with lifficulty in ammonia, in dilute sulphuric acid, and in dilute nitric acid; but are easily soluble in potash water, English sulphuric acid, and in the vapour of nitric acid. In chlorine water they lose their colour, and look as if corroded. For the demonstration of the crystals, a very small quantity of blood, or of fluids tinged with blood, is required, but an excess of concentrated acetic acid is necessary. The character, age, or impurity of blood, in no way hinders the crystallization. To obtain crystals, a drop of fluid blood is to be mixed with a small excess of concentrated acetic acid, and evaporation is slowly made over a spirit lamp; in the dried matter remaining the crystals will be recognised by the microscope. In cases where the blood which has to be examined has been robbed of its salts by washing, rain, or moisture, as may happen, crystallization will not occur by the simple process given above. Under these conditions it is necessary to add a few grains of common salt, when the capability of crystallization is restored. It is, perhaps, after all, best in forensic inquiries to use the salt on every occasion. A source of fallacy may enter inquiries of this nature, for it has been found that madder, red ink, dragon's blood, and some other substances, will also form crystals. Crystals thus formed may be distinguished by their want of colour, irregular form, solubility in water, and different chemical reactions. Murexide offers the greatest difficulty in determination, since it forms crystals similar to the hæmatin crystals, both in colour and form. Solution of murexide gives, however, with acetic acid, a residue after evaporation of a clear brick-red colour. This residue, covered with water, dissolves, giving a purple-red colour. Addition of hydrochloric acid destroys the colour, and potash causes dissolution with a blue colour. Blood-crystals, on the other hand, are insoluble in the first, and are dissolved in potash with a green colour. Professor Bryk, of Cracow, has also an original article on the same subject, in which is supplied information similar to that embodied in the paper of Büchner and Simon. In some minor points he differs from those authors; in other points he is more elaborate, and he introduces certain new facts of value. He recommends the acetic acid plan as the best for producing the crystals, but thinks the addition of salt superfluous, and that the presence of salt crystals is apt to deceive. In cases where blood cannot be scraped off an object-i.e., where the blood is imbedded in a soft substance, the spots, as Bryk directs, should be steeped in distilled water; the blood-colouring stuff sinks in streaks and flakes, and gives to the fluid a brown-red or brown-greenish colouring. The maceration is perfected in from ten to twentyfour hours. The solution, protected from the air by a glass cover, is evaporated to dryness in the sand-bath, great care being taken that the mass does not become carbonized. When quite dry the blood is treated with acetic acid for crystallization. This author states that spots of blood left by fleas and bugs yield no crystals, and that if purulent matter be mixed with blood there is a granular pigment formed, but no characteristic crystalline substance. Blood spots left on wood are retained differently. If the wood be smooth and hard, the blood retains its power of crystallization; if the wood be soft and the blood soak deeply into it, one can obtain for the first six or eight days, by maceration, a solution of blood-colouring stuff which will yield the crystals. After six to eight weeks, especially in soft kinds of wood, the crystal formation no longer is possible, owing probably to the formation of a tannin albuminate, which is insoluble. On iron without rust, dried blood retains its capability of crystallization; it loses it, however, if rust form at the same spot. Blood left on clay or chalk retains also the power of crystallization, unless it is thinly laid on and has been long exposed to the influences of the weather. In instances where linen substances spotted with blood have long macerated in water, so that the blood-colouring stuff is in a great measure extracted, Bryk recommends that the linen be dried and then moistened with acetic acid; on adding further a solution of potassa, a green colour is given to the threads of the fabric.- Vierteljahrsschrift f. d. prakt. Heilk., Jahrgang 1859; Virchow's Archiv, Band xv.; and Wien Wochenschrift, 1858, Nos. 42, 45. The Smethurst, Case.-The necessary limitation of space prevents us from noticing in the briefest terms upwards of forty other cases of forensic interest which have appeared since our last report in the British and Foreign Journals. We must, however, for the sake of our Continental readers, say a word respecting the famous Smethurst case, which in this country has for some months been the leading medical topic. This case was one in which poison was suspected; but as there was no evidence of poisoning as the cause of death, save in the imagination of men who have gifts in that direction, we could not logically put the case in our toxicological section. The essence of the case is that a woman, forty-three years of age, and having premonitory indications of abdominal disease, became pregnant. That upon the pregnancy there resulted vomiting, an aggravation of the intestinal disturbance and dysentery. In great measure from starvation (owing to the inability of the stomach to retain food), to which must be added the exhaustion produced by the dysenteric disease, death was the result. Facilis descensus averni: the medical philosophers who attended the case, not appreciating the meaning of the previous history of the woman, ignoring altogether the fact of pregnancy, and mistaking the symptoms which peculiarly mark starvation, came to the hypothesis that the case was one of slow irritant poisoning, Nevertheless, they took no pains for many days-not indeed until death was at the door either to remove the poisoner, to look for poison, or to give an antidote. On the contrary, they prescribed for the case as one of ordinary disease almost to the end. When, granting that the case had been a case of poison, it was too late to do anything, the supposed poisoner was arrested, the antidote was supplied, and the poison was searched for. Suffice it to add, that no poison was found in the possession of the prisoner; none satisfactorily in the body of the patient after her death; that the post-mortem appearances were admitted to be dysentery; and that the fact of the existence of pregnancy was revealed by the knife. In spite of all, the vague hypothesis was adhered to. A man was tried for his life, and a jury, overpowered by the dogmatic, and, we may add, stereotyped statement of the scientific witnesses for the prosecution; to wit, that death could only be attributed to irritant poisoning-condemned the prisoner to the scaffold. Since, the condemnation the country has risen up against it, and the Secretary of State for the Home Department, than whom a more logical mind is not in this realm, has granted a reprieve from death. The nation is thus happily relieved from a national sin, and English science rescued from indelible disgrace. Another remarkable case of suspected poisoning by arsenic, antimony, or both, has happened in Germany. A woman died, as it was supposed from poison. Portions of her body were examined by two chemists, who found, or thought they found, arsenic, but no antimony. Other portions were examined by two other chemists, who found, or thought they found, antimony, but no arsenic. The whole evidence was then submitted to the distinguished Fresenius, who in an elaborate report, conspicuous for its clearness and science, showed that there was no chemical evidence whatever of death from poison. III. HYGIENE. Building of Hospitals.-Dr. Mackenna, in a paper on the Hygienic Requirements of Hospitals, gives the following advice to his fellow-colonists: "As it is not likely that we shall in this colony require another large hospital, I shall pass on to enumerate the advantages that smaller ones ought to secure. For a population of eight or even ten thousand, I think one of fifty beds should answer. The site, aspect, and drainage should be the best it is possible to procure; the ventilation should be, as it could easily be, made perfect; the wards should hold six or eight beds; the ceilings should be eighteen or twenty feet in height--as I am convinced that the higher a ward is the better, and that no extension in other directions can compensate for it. The impure air should be drawn gradually off by two or more of Dr. Chowne's syphon tubes of large size, the exterior opening of which should be controlled by a cover and vane to prevent downward drafts in hot winds. The ventilation carried on by the aid of louvres and other permanent openings in the roof is liable to the objection that the hot winds force their way downwards, and instantly expel the cooler air, to the great danger of delicate patients. This can be remedied by changing them to a common tube controlled as above. A cold chamber could, and indeed should, be made in the underground, which by a simple arrangement of evaporating surfaces would procure for one or two, or more chambers above, a supply of air several degrees colder and moister than the outside temperature by which many an otherwise fatal disease might be effectually checked. No kitchen or other office which could in the slightest degree tend by its ascending odours to taint the air of the wards or passages, should be tolerated, and every care should be taken to keep this story thoroughly ventilated. The passages and wards should be flagged with glazed tiles set in cement, which do not retain the moisture after being washed, nor imbibe impurities, and the walls and ceil ings should be coated with a glaze of silicated paint. A permanent verandah should face those aspects much exposed to the sun, and the windows should be protected by kuskus tatties. No hospital should have more than a ground and upper story, or be without a pair of wards apart from the house for noisy or unruly patients. Lifts and Arnott stoves (for occasional use in winter) are indispensable in every hospital, and the wards should communicate with each other and with the offices by speaking-tubes. Every mechanical improvement in baths, water-closets, and especially those for the removal of patients before and after operations, accidents, &c. &c., should be provided." Effects of Swill Milk.--A report on milk, by Dr. Percy, read at the Academy of Medicine, New York, introduces us to what is called swill milk, or milk yielded by cows fed on swill, the said cows consuming in the daily swill potations not less than a gallon of vinegar per day. The milk yielded has a strong acid reaction, is deficient in butter and sugar, and, according to the observation of Dr. Percy, is quite insufficient for the purposes of life. It is also said to be wanting in a peculiar phosphoric organic compound which has been found in butter, and is described by Gobley, Treacy, and others. The effect of this milk on children fed with it is thus described: "It is not found that this milk, as given to children, actually in all or many cases sickens them at the time it is given; but the child, though inordinately voracious, is starved and poisoned by slow degrees. The nervous system becomes irritated beyond endurance, the vitality is undermined, and the child dies of inarasmus, bowel complaints, cholera morbus, dropsy upon the brain, or kindred diseases.". QUARTERLY REPORT ON PATHOLOGY AND MEDICINE. By EDWARD H. SIEVEKING, M.D. Fellow of the Royal College of Physicians, Physician to and Lecturer on Materia Medica at St. Mary's Hospital. I. Some Remarks on the Epidemic of Diphtheria (angine couenneuse) of 1857 and 1858. By THE author's paper is based upon an observation of 73 cases of diphtheria, 51 of which were cured, 22 having been fatal. His general conclusions are, that we are still far from being acquainted with the real nature of the disease. He entirely differs from the views of Bretonneau, who considers that under all circumstances the diphtheritic germ is sown locally, like that of syphilis, forgetting, as the author justly observes, that wherever the virus may be deposited, at least with very rare exceptions, the throat, the tonsils, or the nasal fossæ are the parts in which the diphtheria is first manifested. Dr. Bouillon-Lagrange admits the possibility of contagion, but denies the necessity of this element in the propagation of the disease. He holds that we are nearer the truth in regarding the disease as one primarily constitutional, manifesting itself on the mucous membrane, in the same way as the eruptive fevers are characterized by a rash. This view, he adds, may be less attractive than the one accounting for the propagation by local contact, because it deprives us of the excuse for employing heroic remedies. Pathological anatomy, chemistry, the microscope, have not, according to our author, thrown much light upon the study of diphtheria; the first has only confirmed what clinical observation had previously taught regarding the state of internal organs; it has also demonstrated the liquid state of the blood and the internal congestions which result from this condition, and the asphyxia produced mechanically by the false membranes in the air-passages. Dr. Bouillon-Lagrange urges the propriety of paying more attention to the lymphatic system, which he believes to play an important part in the disease. He concludes by calling upon chemists and microscopists to study the state of the blood at different stages of diphtheria, which "may be the sole means of obtaining a knowledge of the morbid state which certainly precedes the primary modification of this fluid, before the profound alteration unavoidably entailed by the enormous deposition of fibrine upon the mucous membranes." II. Diphtheritis: the Epidemic Malignant Sore-throat prevailing in Albany, New York. (American Medical Monthly, December, 1858.) It appears that our American confrères are also surprised by the appearance of diphtherite, an epidemic of which prevailed in Albany, a town about one hundred and fifty miles north |