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A Botanical Arrangement of British Plants in the Midland
Counties, particularly those in the Neighbourhood of Alcester; with occasional Notes and Observations: to which are prefi red, a short Introduction to the Study of Botany, and to the Knowledge of the principal Natural Orders. By T. Purton, Surgeon, Alcester. Embellished with Eight Coloured Engravings, by James SUWERBY, F.L.S. Small 8vo. 2 vols. Longman and Co. This is an elegant and very useful compendium, answering all the purposes stated in the title-page, and admirably suited to the female student, as well as to every amateur who wishes for a knowledge of botany rather as an useful accomplishment than a profound study.
Remarks on Arsenic, considered as a Poison and a Medicine;
to which are added Five Cases of Recovery from the poisonous Effects of Arsenic. Together with the Tests so successfully employed for delecting the White Metallic Oxide; in which those satisfactory Methods peculiar to Mr. Hume were principally adopted, confirmed, and compared with others formerly in usc. By JOHN MARSHALL, Member of the Royal College of Surgeons in London, and Apothecary to his Royal Highness the Duke of Gloucester's Household, &c. &c. 8vo. pp. 163. Callow, 1817.
Our readers will probably recollect, that the late Eliza Fenning, and the family of the Turners in Chancery-Jane, were visited by Mr. Ogilvie, and afterwards by Mr. Marshall, their family apothecary. This has induced the author to offer some useful remarks on the effect of arsenic as a poison, after a practical experience in so many cases, and also to introduce some further accounts of its effects as a medicine admi tered in the manner recommended by Dr. Fowler.
The first chapter relates the history of the Turner family, of which we shall offer a short epitome.-The event of the poisoned dumplings occurred Tuesday the 21st of March.
My attention (says the author) was then directed to Mr. Robert Turner, who appeared to be nearly in articulo mortis ; his face, which had been swollen, having assumed the appearance of the true facies hippocratica, my apprehensions were considerable for bis preservation. Ou examining the contents of the utensils in which he had vomited, a fluid was perceived of a yellowish and greenish colour, and in two of them stercoraceous matter; the pulse was gove, his voice faint and tremulous, and be pointed to the abdomen in great agony. On examination I discovered a very remarkable irregularity of surface, occasioned by the spasmodic contractions of the
muscles of the abdomen, and even of the viscera; this unevenness extended from the epigastric region to the pubis, and to the right and left hypochondrium; and the excruciating pain was relieved for a short time by rubbing the abdomen with a piece of hot flannel and laudanum. From this state of the abdominal surface, there could be no doubt that the arsenic had gone far beyond the limits of the stomach, into the alimentary canal. He complained of extreme faintness, and dreadful sickness. Mr. R. T. had been violently purged; and on examining the alvine secretions, the singularity of their appearance excited great surprise; they were all of a bright homogeneous green colour, like paint, and strongly resembled the green colour produced from a solution of the arsenic by one of Mr. Hume's tests, the ammoniaco sulphate of copper, which will afterwards be more fully described. Each effort of vomiting and purging was preceded and followed by these painful gripings and spas. modic contractions of the abdominal muscles. Mr. R. plained of great heat in the stomach, which the patient compared to a furnace, or red hot irons, which sensation commenced at the tongue, and was felt throughout the course of the esophagus to the cardia, or upper orifice of the stomach ; insatiable thirst, violent head-ach, the eyes impatient of light, but the pupils sensible, and the extremities cold. The patient attempted, in this dreadful state, to get out of bed, to walk to the night table; he was directly seized with vertigo, dimness of sight, and palpitation of the heart; he fell down, and went off into an epileptic fit; he was assisted on the bed, and in a few minutes recovered from the fit.
“ Mrs. Robert Turner had great pain and burning heat in the stomach, head-ach, immoderate thirst, vomiting and purging, with olive green alvine discharges, tension of the abdomen, the face swollen, cold chills alternating with flushings of heat; and light was painful to the eyes. Mrs. R. Turner's peculiar situation made me apprehensive of a miscarriage, in consequence of frequent bearing pains more or less constant in the loins; and, independently of these distressing symptoms, her mind was additionally agitated by the alarming state of her husband, who was lying by her side. If Mrs. R. T. had mişcarried under these dreadfui circumstances, there can be no hesitation in saying, she must have inevitably lost her life.
“ I next saw Mr. Turner, senior, with symptoms in many respects similar, though not quite so importunate as in the two foregoing cases: Mr. T. had the burning sensation in the stomach, vomiting, inordinate thirst, head-ach, the face swollen, tension of the abdo
; the purgative symptom had been more moderate. Mr. T. did not complain of light affecting the eyes ; and the countenance was flushed, particularly on the upper part of the cheeks.”
“Finding Mr. O. had most judiciously and iboroughly emptied. and washed their stomachs, and as we had every reason to suspect some portion of the arsenic had escaped into the aliinentary canal, especially in the cases of Mr. and Mrs. Robert Turner, and Mr. Gadsden, (Mr. T.'s apprentice,) we resolved to persist in the purgative plan, and gave to each patient another full dose of castor-oil, on NO, 223, si
two table spoonfuls of milk, and every four hours a solution of the magnesiæ sulphas with manna, in mint water; this dose to be alterpated every two hours with the saline draught in the state of effervescence, letting the alkali predominate four grains to each dose, with the intention of neutralizing any possible remains of the arsenic, and relieving the disposition to vomit; and we further determined on persisting in the purgative system, until a more natural colour was effected in the alvine secretion. The patients were allowed to drink frequently, and in small quantities, inilk, soda-water with or without milk, and mutton broth. Mr. T. and Mr. R. Turner wished to have a draught of porter, but we strongly entreated them, also Mrs. R. T. and Mr. Gadsden, to abstain from beer, wine, and all fermented liquors, which they did for a fortnight afterwards, and likewise from animal food. Mr. R. T. once deviated from these directions, on Saturday the 25th, and the effects will be hereafter described, which will satisfactorily demonstrate the propriety of the plan of diet both here and subsequently recommended. "Dr. Orfila, in his admirable Treatise (vide English translation) on Poisons, emphatically confirms this regimen, as in the following extract-- It. must never be forgotten, that the success of the treatment depends in a great measure on the sort of regimen the patient observes during his convalescence, which is commonly long and painful. He ought to be principally nourished by milk, gruel, anù rice creams, and he should be made to take nourishing broths.' The thirst of each patient was so urgent, that they would readily have drank quarts, had they been permitted; and had we yielded to their request, the vomiting would have been at this time unnecessarily excited, and Mr. O. and myself were apprehensive it might tend to increase the inflammation on the villous coat of the stomach, and augment the symptoms of debility. The thirst was sonuewhat allayed by frequently washing the mouth with cold water.
“On the following morning, March 22d, I visited the patients, who had all passed a restless night; the vomiting in each had greatly abated, the pain in the stomach was still violent, which they all compared to a furnace, or hot irons; the alvine discharges were changing to a proper colour, but intermixed with streaks of green, and highly offensive; the skin hot and dry, the pulse quick, varying in each case from 100 to 130, great thirst, and violent headach; their tongues white but moist; Mr. and Mrs. Robert Turver, and Mr. Gadsden, could not endure a strong light.
“The supersaturated saline draught in actu effervescentiæ, with the addition of manna, was ordered to be continued, and the purgative mixture to be onitted.
“ Mrs. R. Turner's polse was 130; this rapid circulation was ac. companied with constant sensations of fainting; but the bearing pains, with the paio in the loins, had somewhat abated.
" Mr. Gadsden appeared this morning to be the most afflicted; he had been seized with four epileptic fits in the course of the night, preceded by a violent palpitation of the heart, accompanied with peculiar tremulous action of the right arm, and lower extremity; a
.considerable degree of symptomatic fever, insatiable thirst, a white but moist tongue, the face flushed, the respiration hurried, pulse 126, irregular and contracted, frequent gripings in the bowels, and spasmodic twitchings in the muscles of the chest and abdomen.
“Mr. Robert Turner, in the early part of the morning had another attack of epilepsy; the symptomatic fever ran high, the pulse 120; he complained of spasmodic twitchings about the chest and abdomen, palpitation of the heart, great languor, accompanied with a constant sensation of fainting, tongue white but not dry, occasional chills, followed by an increase of heat, head-ach, and vertigo. A dose of the purgative mixture was administered, and the same medicine as on the preceding day continued.
“Mr. Turner, senior, appeared much better; the pulse 90, skin temperate, tongue moist and cleaner; the vomiting had subsider, but the stomach was in great pain; he complained of extreme lassitude; the face was flushed, and he had slept about four hours.
* The faces of all the four patients were swoilen, with a fixed redness, more or less, under the eyes and on the cheek-bones; they had vomited two or three times in the course of the night, by drinking too copious a draught of the diluents recommended over night, and each complained of the tongue and lips being sore and swollen."
Those who wish for minute information, will consult the work; we shall only in general remark, that Mr. Turner and the apprentice had a repetition of epileptic fits, and Mrs. R. Turner was delivered of a healthy child." Mr. Ti's recovery was also retarded by too early a return to a free diet. Mr. Gadsden's epileptic fits have continued to the present time and rendered him unfit for his occupation. The remedies used for the relief of this symptom are slightly mentioned.
The succeeding chapter contains reflexions on the natural and artificial causes which contributed to the recovery of the patients, with practical observations, and some remarks on the treatment of epilepsy. The last, containing a continuation of Mr. Gadsden's case, we shall transcribe.
“Since giving the above description of the state of the constitution and symptoms of Mr. Gadsden, he has returned from Cheltenham, greatly improved in his general health, and was fully able to resume his situation in Mr. Turner's office; the epileptic fits had left him about three weeks; but I have to regret the necessity of stating, that he has experienced a relapse, with increased violence and frequency, as the fits now* return every twelve, or at least three or four times in forty-eight, hours. For some minutes his sensations and distress of countenance generally indicate their approach; and since the short time the epilepsy has returned, the patient's health and strength have suffered materially.
“ In epilepsy, phlebotomy is almost generally recommended;
“* About three months subsequent to the coinmencemeot of the attack."
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perhaps perhaps it may be of use in some plethoric cases, wherein the blood is liable to determine towards the vessels of the head, and in those patients who are more advanced in years or verging upon a state of apoplexy, or when attributable to the sudden supă pression of a customary discharge, especially the catamenia. But in the course of my practice I have never witnessed any material advantage derived from bleeding in this disease. After the second relapse of the epileptic fits, Mr. G. was bled by the advice of Dr. Babington, but without the slightest mitigation of the violence or frequency of the attack; he was, therefore, again recommended to change the air, from which he derived considerable benefit. Two years have now elapsed since Mr. G. became thus afflicted by the arsenic, and he is still subject to frequent and severe recurrences of this frightful disease."
Some remarks follow on the use of ol. terebinth, in epi. lepsy, with the authority of Drs. Penderleath and Young, and of Drs. Merriman and Latham in worms, which the author considers a frequent cause of epilepsy,
In, considering arsenic as a medicine, particularly in the form of Fowler's solution, the author informs us of ill effects which, after a very extensive practice, have never occurred to us.
We much suspect sufficient care was not taken, that this powerful medicine should never be applied to the naked stomach. As a remedy, Mr. Marshall recommends magnesia. We are not prepared to say what the effects of this substance may be in cases in which arsenic has proved dele. terious; but, from the facility with which we have for many years exhibited Fowler's solution, we should be unwilling to introduce any other, or to render that more complicated.
Having given this gentleman's account of these cases, and of the author's and our own opinion of arsenic as a remedy, we shall conclude with remarks on the test by which it is to be discovered when swallowed.
Of all the tests discovered for proving the existence of arsenic, our author gives a decided preference to those peculiar to Mr. Hume, and, amongst these, he quotes that which first appeared in our Journal, (Medical and Physical Journal, 1810). "This consists in converting the white arsenic into arseniate of potash, and may be adopted either pri. marily to detect the poison, or subsequently to the silvertest, to substantiate the truth where there is any doubt.
The results of some experiments on decoction of onions are detailed, and these seem to invalidate the opinions of some medical men, on a late trial in Cornwall, who affirmed, that this decoction
be confounded with a solution of arsenic. Besides the author's own testimony, we have that of Dr. Plenderleath and Mr. Hume, all agreeing that there is no similarity between these fluids to warrant such assertions, or to