Carbolicum acidum

Volume I — Main text

ACIDUM CARBOLICUM,

Carbolic acid, phenic acid, CH^O. Obtained from coal tar by fractional dti tion and puriBcation,

L ProFuings, — f. Dr. Bacmeister, set. 39, of ncrvous-sanguiy temperament. Feb* 7th, f ive drops of ist on sugar caused sense freedom and expansion in lungs (5 m,) ; coryxa in open air only ( m.) ; frontal headache^ slight (1 h.) ; crampy stitch in J. groin (2 1 lith. Five drops of I2th caused, vtry soon, slight heat in 1, face f forehead, and in 15 m. sense as of fine electric sparks in 1* ala r sternal end of r. clavicle, middle finger of I. hand, and vertex succession. It changed slowly to a pricking itching, with det rub, and relief therefrom* After dinner long-continued hiccoug in e. entire disinclination to study, Twod. after, swelling and f of I. cheek, opposite molars» Throughout and subsequently much free rthanusual, ( Proving — CarMic Acid^ C h i ca go, 1 8 *

1. Dr, HoYNE. Sanguine-bilious j very susceptible t^ Jan, 20th, Took 5 drops of 6th cent. Slight and transient pains, or tingling itchings, were felt in various parts ; but th more persistent burning pain in vertex and r, temple, w flatulence and eructation, and at one time incessant yawnir red blood was blown from nose in e, 30th- Same dose, and itchings, flatulence, yawnings and headache recurred also constant inclination to cough, and :K>rene&s on pressu

of larynx. He was feverish at n. ; and next d his urine was more copious, and had a strong smell. Feb. 4th. Toole 5 drops of 3rd cent. Besides the usual symptoms, he had (15 m.) soreness of throat on empty deglutition, with frequent sharp prickings in it, and (next day) very severe aching pain in r. hip, shifting to L shoulder. From 7th to 1 2th had a vesidei ending in a pustulei on centre of nose*^

1. Miss G. H., set. 11. Jan. 20th. Took a drops of 6th cent, at 4.15 p.m. At 4.20 very dizzy ; things seem moving backwards and forwards J pulse 95 j cannot see across room. 4.30. Nausea; feet feel heavy, 4.40, Pulse 100 ; cannot walk straight ; drowsy and tired in e. I next m. dull pain in r. ankle and I. knee. {Ibid.)

2. Mrs. T, S, H. Jan. 20th^ 4.15 p.m. Took 3 drops of 6th* Burning in stomach, forehead and throat in succession \ heavy pain from forehead to occiput j things seem to move before eyes. In J 4 h. these symptoms had disappeared, but later nausea came on, and continued till noon next day. On 22nd there was a slight vesicular eruption all over body. {Ibid.)

3. J. T. H., aet. 21, Feb. 7th, 8,30 p.m., took 5 drops of 6th* In 5 m. dizziness, headache as in No. 4* In lO m. pulse had risen from 66 to 90, and it subsequently fell only to 80, Face flushed and burning ; itching in various places, belching, and yawning, were frequent during evening. H»d hard headache during night. In morning this continued, and he felt as if a band were round forehead. Woke up in middle of night bathed in perspiration. Pulse at 9 a.m. 100. By noon symptoms had disappeared. On loth a vesicular eruption appeared on hands and all over body, itching excessively ; rubbing relieves itching, but leaves burning pain. This resisted medication, and did not disappear till 28th. {Ibid.)

4. Dr. S. P. Hf DOES. Feb. 5th. Five drops of 6th taken at 1 1 a.m. caused no symptoms that d., but next m. he awoke with a dull, hot, constricted feeling in head, especially '\\ forehead. This lasted all d., becoming an ache at times, and until late at n. Before rising he had also, for 5 or jo m., an acute piercing pain in 1. supra-orbital ridge ; it ceased on rising, but left spot affected sore for more than one day. 27th. Same dose, taken at 3.15 p.m., brought on next m. same headache, but more severe. Pressure relieved, but only at first. Head seemed to swells and felt hot, as if heat radiated from it. Passed much urine. Next d. (as before) felt soreness only» Prover is not subject to headache, and never experienced anything like this. {Ibid*)

5. Dr. E, C. Price, a:t, 43. In perfect health. Aug, 14th. Took two doses of 5 drops of 3rd cent, without effect, 17th, took 10 drops, on i8th 20, and later 50 drops. Had aching soreness in one or other knee under patella, and some transient pains elsewhere. Passed much water. On 19th took 10 drops of 3X at 9 a.m., and 30 drops at 8 p.m. 20th. Had rheumatic pain in right shoulder-joint nearly all day, and regarded it as an attack of rheumatism in the shoulder, having suffered with several attacks during the last 18 years, but they

• ** During this proving" Dr. Hoync notes "an acne^ with which I had been troubled more or less tor three years, disappeared."

never lasted less than three or four davs, while this passed off suddenly in the e., like all the carbolic acid pains, which also come sud* denly. 2ist. Pain for some time inside knee-joint. 23rd. At 8.4S p.m. took 20 drops of 2x. About 10, severe bruised pain beneath left tendo Achillis, as if struck by a club ; in a few minutes it disappeared for a short time, when he had a sharp pain in second joint of left middle finger ; this pain was only momentary, when it went back (not lest intensely) to the leg again. (Amer. Observer^ viii, 148.)

1. Dr. LiLiENTHAL, Set. 52. Sanguine temp. April 14th, at I p.m., took 12 drops of ix in teaspoonful of water, and at 4 12 drops of a 1 to 20 solution. Besides symptoms of local irritation, became sleepy and chilly, with disinclination to mental effort, even reading ; and had dull frontal headache, with feeling as if elastic band were drawn tightly across forehead, worse on 1. side. On iSth, took, at

7 a.m., same dose as last, and at noon 12 drops of a solution of I to 25. In forenoon fulness felt all over head, with pain in forehead and occiput ; there was also a sense of narrowness in chest, as if diaphragm oppressed lungs. Tired sensation in lumbar region, then dull aching there, increased on straightening trunk, and by jolting of driving, which also hurts abdominal parietes. Pain extends down back of thighs. Noon dose increased fulness of head, with which were vertigo, trembling, and tingling of feet ; but all symptoms were relieved by a meal at i p.m., save frontal headache, and this passed off in e. For next 2 d. was irritable, head muddled, with sleepiness, mental and bodily laziness, and easily induced fatigue. On i8th had dull heavy pain in 1. temple during d. On 19th frontal and lumbar pains recurred i could not fix attention ; legs felt heavy as lead. These symptoms, with neuralgic pains in 1. temple, continued till 22nd, and a burning feeling in stomach, which came on in afternoon of 15th, was felt all the while, though appetite and digestion were good. May 3rd. During day took three doses of 12 to 30 drops of 1st. Slight local symptoms, and some trace of left temporal neuralgia, were all that occurred. On 4th took 12 drops of ix, which brought back all the head symptoms, with pronounced heat there ; fresh air only relieved, "cooling heated brain." Reading was impossible, letters looking blurred and fading into one another. Symptoms diminished towar<u e., though he took 12 drops of 1st at 5 p.m. ; but on retiring to bed, after smoking his usual pipe, he felt as if the tobacco had disagreed with him. Next d. head and chest were oppressed ; thighs felt bruised, and back weak and sore ; there was burning at stomach, and weight after food. May 6th. A fresh dose of 12 drops of ist renewed symptoms, and proving was discontinued. {Trans, of N. T. Stat Horn, Soc.y viii, 232.)

1. Mrs. S. A. F., M.D. May 7th. Two doses of 4 to 5 dropf 1st brought on frontal symptoms as with last prover ; and ano dose next day added frequent micturition. On loth the same taken in dost refracta at intervals; and brought on transient (twice) in left ovary, and oppression of chest, with dull pain in u lobes of lungs. Next day there was a slight pustular eruption on side of face, great heat of body, and physical exhaustion. {Ibid.)

2. Mrs. C. L., M.D* Doses of 1st caused dull frontal headache and total loss of appetite.^ {Ibid,)

3. Dr. C. H. Haeselesl. On 2i5t June took two doses» first of I drop, second of 5 drops, of pure acid in glycerine and water. Next day took 10 drops, and on 23rd 20 drops. Each dose produced to a greater or less degree the features of acute dyspepsia, with head sym* ptoms like those of No. 8, the sharps darting neuralgic pains in the midst of the dull aching being very pronounced. {Hahn, Monthly^ Dec, 1869.)

4. X. Y,, a friend to whom Dr. H. gave 6 drops as an experiment, had similar symptoms. Headache was felt most over right eye ; chest felt oppressed, as after excess in eating \ was drowsy and nervous; and subsequently had pain in back and right side. (Ibid,)

5. Dr. H.'s daughter, ^t. 1 1. Took 4 drops of the acid. Besides local burning and nausea, it caused severe headache, "as if somebody were jogging a sword in and out all around," much aggravated by noise and light. It lasted till evening of next day, at noon of which she was flurried and feverish, with pulse at 90, and pain in r. hypochondrium. On the day yet following she took a teaspoonful of 3X, when same symptoms recurred, headache being fixed over r. eye (as in No. 12) ; but all passed off after a quiet sleep. {Ibid,)

6. J. N. Mitchell, M.D, Three days after application of strong acid to cavity of carious tooth became subject of slight but constant giddiness, followed by a similar dull pressure and pain in back of head and neck. After a week application was renewed daily for lO d. or more, and symptoms then became much worse. There were also added — -r. supra-orbital neuralgia ; constant dark spot before L eye ; severe, band -I ike compression round head (especially felt in temples) ; sense at vertex as if brain were swashing about \ coldness there in spots on stooping, with clammy sweat ; cold sweat on head on least exertion ; and tinnitus aurium, though hearing was unimpaired. Mind was unusually clear, but intellectual exertion increased pressure and pain in head, even to numbness. Giddiness was better while walking in open air. He was constantly heavy for sleep, but sleep was dreamful and unrefreshing. He frequently got into an absent-minded state, with starting and trembling on being spoken to. Appetite and digestion were good, and bowels regular, though sluggish. Abdomen always seemed distended with wind, but none could be passed ; and there was frequent, but ineffectual desire for stool. Sexual organs weakened and rela.xed, but Jiights much haunted with lascivious dreams and emissions.

These symptoms (with great weight on seventh cervical vertebra, which was tender) went on increasing during the use of the acid, but on stopping it, and clearing the cavity, began to diminish in a few h., and in three d. disappeared entirely with some bilious diarrhoea. An incautious renewal of the application some months after caused them to set in again, but they at once disappeared on its removal. {Amtr. Journ, of Horn, Mat, Mid,^ N.S., i, 354.)

• They at the same tiint: relieved tempoi-arily a himbo.sacral aching from which prover was rarely free. On 25th a dose of the joth relieved this pain *Mike magic," and there was no recurrence ot it Co May 14th.

1. N. RoTHE took I grm. in 20 grms. of water, and perceived sharp but cooling taste similar to that of peppermint-oil, warmth in stomach, temporary fulness in head, eructations, and slight eastric catarrh lasting several d. {Die Carbolsdure in der Median^ p. 7.)

2. From dose of i grm. diluted with water, Danion experienced eructations, feeling of warmth at epigastrium, and slight stupefaction, which last, after a dose of 2 grms., lasted for \ h., with roaring in ears and formication in extremities. Four grms., taken in 3 doses, produced cramp in calves, fall in temperature of several tenths, and alkaline dark* brown urine. {Recherches sur F jlcide phenique^ Strassb., 1869.)

3. C. A. Norton, M.D., was exposed for i h. while writing to vapour of a strong solution. In \ h. began to feel faint, especially at stomach. In 10 m. more head felt ^* inflated," the pressure from inside being greatest at temples ; shaking head increased feeling. At end of h. faintness was so general that he desisted writing, and on rising found legs almost too weak for standing. The mind teemed with delightful ideas, but on attempting to express them in writing he found his arms too weak to trace a line. On passing to another room lost all consciousness of a body, but head seemed ten times its proper size. On lying down symptoms abated in order of their oncoming. Entering a meal-room shortly after could smell keenly everything there, however distant or stable, and on a subsequent visit to the watercloset was overpowered with the stench, which was nothing uncommon. Lay down and slept 2^ h., tossing about much while unconscious. Head now felt bruised and sore, and there was a deathly faintness at stomach, so that he could hardly get through undressing for bed. Next m. woke with feeling in head as if he had taken a large dose of opium, and with inclination to diarrhoea, which he found had been indulged involuntarily during n. It came to nothing now , but food seemed to cause nausea. Head and face were extremely sensitive to comb and towel in toilet, and jarring of a carriage in the forenoon was very distressing. On returning from drive bruised, sore feeling began in small of back and extended to hips. There was burning in rectum, and bowels felt as if filled with flatulence. No appetite for food. A tapelike and gluey stool was passed. In e. pain had become concentrated in r. thigh j it kept him awake in n., in m. went to foot, and then passed away. It was 3 d. before sensations in head and abdomen left him. Dr. N. has twice since experienced similar symptoms from carbolic acid vapour. (Publications of Mass, Horn, Socy iv, 285.)

4. Smell of acid while preparing solution caused, in Dr. W, M. Williamson, pain over r. eye, going off* in open air ; on later exposure to odour extending to temple, with sense of soreness in r. eyeball. Urine scanty and high-coloured. On another similar occasion same symptoms recurred, with pricking pains through glans penis and in urethra ; straining in passing urine, and uncomfortable sensation for a h. afterwards. Five drops of solution taken subsequently internally caused supra-orbital pain slightly, but urinary disorder severely. ( Trans, of Penns. State Horn, Med, Soc, 1870 — 1, 180.)

5. T. C. Duncan, M.D. Nervo-bilious. Feb. 27th. Inhalation of vapour caused full feeling in frontal lobes of brain, increasing to

severe headache ; great acuteness of sense of smell, and sensitiveness of eyes to Hghc; slight nausea, with prostration ; anorexia; great languor 5 numbness of skin of hands ; symptoms increased in severity for 3 h., when a cup of tea dispersed them. He has repeatedly had this train of symptoms from simply smelling the acid- (As l,)

1. Mrs. E. J, D. About J h. after smelling acid (5 p-m,) complained of severe headache with nausea ; sense of smell exceedingly acute ; no appetite for next meal. A cup of green tea somewhat relieved headache, but did not reduce the olfactory sensibility. The catamenia, which were present^ became more copious, and next ni. were still further increased and darker than usual, with headache and great nervous irritability ; sense of snieJl continuing acute. By c, the symptoms had vanished* {Ibid,)

2. Dkclat {Traiie de i Acide phenlque^ Paris, 1854) observed slight headache after its use, lasting from 5 to 15 m,, spreading over whole head, and returning every time drug was taken \ in some persons most intense in frontal region, in others in occiput. After administration of acid in form of pills, Neumann observed heaviness and fulness of head, weakness of legs, dizziness, appearance of circles before eyes, horripilation, and profuse sweating, (Lewin, Incidental Effects of Drugs ^ New York, 1882.)

II. Poisonings. — 1, When a thin layer of the pure acid is painted on the skin, a pretty severe smarting is felt for about an hour. The epidermis wrinkles, and a white coating spreads over the part touched, and gradually disappears, being succeeded by a congestion which lasts 20 d. This presents all the characters of inflammation, but on tearing the raised epidermis no serosity flows out. The epidermis gradually exfoliates, leaving a brown stain for a long time. The whole exactly ^ resembles a burn in the second degree, which does not go on to suppuration. (Lemairh, di P Acidi phenique^ Paris, 1863.)

1. A curious local action of carbolic acid, to which attention was drawn almost simultaneously by Mr, Erasmus Wilson and by Dr. J. H. Bill, U.S.A., is the property it has when applied in concentrated form of causing very great local anaesthesia. The loss of feeling is not confined to the tissue killed by the drug, but extends some little distance inwards. (H, C. Wood, Therap,^ sub voce.)

3, Where poison comes in contact with mucous membrane, a white scab forms, thickness of which depends on concentration of acid, (BOEHM, Ziemssen's Cyctopttdia^ xvii, 525.)

4, The dark-green, and often almost black, colour of the urine after standing for some time, which often occurs when this poison is absorbed from the surface of a wound, is strikingly characteristic. It is seldom, yet sufHciently often, seen when the poison is taken internally. This symptom clearly depends on the presence in the urine of some product of the decomposition of carbolic acid, the chemical nature of which has not been discovered. E, Salkowsky, in commenting on this striking fact, inclines to the opinion that the decomposition occurs before the absorption of the carbolic acid, as it so rarely occurs from the internal use of this substance. [Ibid,)

1. Miss J., act. 51, had eH>ow-joint excised Dec. 2nd,' 1868, oa

account of disease of c;irtihges. Wound was dressed with weak carbolic acid and water lotion (i to 50), applied on a lint handsge] covered with oiled sillc^ limb l^ing supported by a leather splint. She rallied well after operation, and progressed favourablv for first jz h., when a shivering fit occurred ; the tongue nipidlv fouled^ the pulse rising from 100 to 120, with a weak and fluttering beat^ the skiit becoming very cold and clammy ; at the same time vomiting of m very uncontrollable nature began. Bowels had not acted since the opcr»* tion* Her face became much pinched and anxious, her spirits being] greatly depressed. Nothing came from the wound save a drop or twof of sanious non* purulent discharge, its edges being very dry and glassy* So suspicious were the local and general ?iymptnms that wr 1 to

suspect pyarmia. Still there was no tendency to wandcris. ce,

or sweet breath, cither now or at any other time. Poultices were now , substituted for the lotion, and in the course of 40 hours actual pus ws present in them, and the constitutional irritation was entirely rcmovcii, the sickness being the last to leave* Our patient continued to do well for a week, gradually improving up to Dec. 15th, when the carbolic lodoti^ same strength, was recmployed Within 36 h. vomiting bcganj again, accompanied by the same train of symptoms as on the previous^ occasion* The discharge, which was abundant and purulent on e. of 15th, became scanty and rusty by m, of 17th j the urging, if possible, was worse than before. Now on the 5th d. after the operation Miss J. seemed to be rapidly sinking from the exhaustion caused by the vio« lent and ceaseless urging. Her pulse that day was 130 to 140 per m* and very thready ; the tongue was covered with a thick brown coat | the mental faculties perfectly clear. The bowels acted after an enema ; urine scanty, loaded with lithates, but not dark or carbonaceous looking. That same day (Dec. 7th) the carbultc dressings were changed for linseed-meal poultices, and this had not been done many bouri before a change for the better showed itself. Poultices were again substituted on the 1 8th, when we almost had given up hoping to save the patient's life. She was entirely supported at this time by encmata, her stomach not being able to retain even a little beef tea or brandyand-soda. Two or three d, after the change in the application healthy pus in fair quantity was coming from the elbow j and with the exception of great prostration the evil symptoms had alt abated. Our suspicions were now awakened as to the existence of some undoubted relation between the above symptoms and the nature of the dressing j yet our faith in carbolic acid was so strong that we hardly dared suspect it as the cause. The patient went on very well with the use of ppultices up to Dec. 27th, when, for the last time and with a similar result, the carbolic lotion was resumed. The wound was now nearly healed; two sinuses which had formed we thought to benefit by a bi-daily injection of the foregoing lotion. Fortunately the first appearance of suspicious signs {t.e. slight sickness after food) found us on the alert, and the injections were at once discontinued, the mischief being thereby nipped in the bud. For the next 3 w. warm -water dressing constituted the sole treatment, and the patient left for her home on Jan. iiznd, 1869, quite cured, with an arm which has since'

become fairly useful. (Lightfoot, Brit, Med, Journ,^ 1870, i,

3330

1. LuciCE {Birl* kUn, IVoch.^ 1878, p. 248) observed a nephritis due to action of carbolic add, which disappeared when use of drug was stopped. Edwards (FirchowHIrsch's Jahreshr,^ 1869^ i, 349 )» after introduction into vagina of tampons of cotton medicated with acid, saw singultus, nausea, chilliness, and anasarca, with diminution or suppression of urine, delinum, and, finally, death. He attributes these phenomena to an acute nephritis, with uremia, produced by the drug. E. Wagner {Deutsche Arch, f. kiin, Med.^ 1880, p* 529) studied changes in kidneys with care. Carbolic acid was applied in a case of gangrene of \q^. The next day, urine contained casts of medium width, the majority hyaline, and a few fatty, some studded with red blood-corpuscles or renal epithelium* After death, microscopic examination showed ihat uriniferous tubules were dilated, their epithelia large and very fatty, projecting far into their cavities, which contained numerous masses of protoplasm and jagged shining bodies, (Lewin, op. at,)

2. J, M.) set. 32, swallowed at 10 am, a bottle of carbolic disinfectant. He was seized immediately with nausea, cold sweats, stupor, and loss of consciousness. At 11.30 he was comatose, insensible to all stimuli, breathing panting and tracheal. Death appeared imminent ; but at 5 pni, he still lived, and warmth had returned. There was, however, still coma and entire reflex paralysis; conjunctiva insensible, pupils very contracted. Respirations frequent (48) and stertorous, tracheal rale, mucus from mouth. Pulse very rapid (120) and small 5 heart beat convulsively with some force. No urine since morning. Catheter brought away a glass of hmpid non-ftocculent urine, of yellow colour and violet gleam, with some oily matter floating on it and strong odour of acid. A small bleeding being practised, blood was found black, thick, without shimmer, of peculiar brown colour by transmitted light, and smelling as unne. The clot was soft, without air, diffluent ; had not contracted by next day. Died in asphyxia 2 h. later, P.M.^ — In mouth and throat dryness only. CEsophagus a little red and swollen, as also gastric mucous membrane, but no lesion anywhere. Kidneys very congested. Under capsule patches of sanguineous effusion, On section, htcmorrhagic spots in cortical region. Under niicroscope walls of tubules sound, but epithelium fatty and completely degenerated, as in phosphoric poisoning. (Albu men subsequently ^ouiid in urine drawn off) Lungs, heart, and brain sound, liver congested and blackish. (Rendu, yourn^ di Pharm, it de ChinL^ 1871, p. 456.)

8* In a case of poisoning by the acid occurring in Middlesex Hospital, severe bronchitis ensued, and the patient, aet. 34, was during his recovery extremely restless, and had a vacuous, almost idiotic expression. The reporter states that bronchitis has supervened in several instances of this poisoning admitted into the hospital, and refers to fatal cases of pneumonia induced by the acid, [Lancet^ October i8th, 1884.)

9, A woman J act, 30, swallowed 4 c,c. of carboliscd alcohol (=13

frrammes of pure carbolic acid). Immediately vertigo, followed 10 m. ater by absolute loss of consciousness with cyanosis of face, i { h, after poison was taken there was still coma with relaxed limbs ; no convulsions ; pupils extremely contracted and immoveable ; cold sweat ; respiration slow, irregular, with tracheal rale ; countenance pale and cyanosed ; vomiting. Pulse very quick, regular, but sometimes extinct during inspiration. The stomach was washed out, but she seemed rather worse afterwards. The urine passed i h. after the poisoning was normal, but that passed 15 m. later was the colour of blood. The microscope showed no red corpuscles, but the spectroscope showed the bands of oxyharmoglobin. i j h. after the poisoning temperature in vagina was as low as 34*4° C. The tracheal rale increased, mucus was continually ejected from the mouth and nose ^ the tongue was retracted. She gradually recovered, but 8 h. after the poisoning the temperature was higher than normal, there were pains in throat and stomach, extreme hoarseness, bilious vomiting, urine had to be drawn off, no more haemoglobin, but some albumen, granular casts, some red globules and renal epithelium. The d. after poisoning she had circumscribed pneumonia at base of r. lung. She left the hospital on the 8th d., when the vocal cords were still red and swollen, and the mucous membrane of the larynx injected ; the urine still albuminous, contains granular and hyaline casts. {Rev. dis Sc. Mcd.^ Oct. 15th, 1883.)

1. A man, a:t. 30, given to drink, drank off a glassful of carbolic acid in mistake for whisky. On his mouth and throat burning he gargled with water and went to a public-house. There he felt ill and did not know what happened. Half an h. after the accident he was found stretched unconscious, insensible to all excitations, skin cyanosed, limbs cold, relaxed, pupils contracted and immoveable \ respiration laboured and jerky ; mouth exuding bloody slime \ pulse small, scarcely perceptible. Chest full of large mucous rales. He was bled, sinapisms applied, and friction to the limbs. Cold compresses to chest and benzoic acid internally. After 12 h. consciousness returned. Cyanosis diminished, respiration easy, no rales. Burning pain in mouth, throat, and pit of stomach. Copious vomiting. Urine black as ink. The 3rd d. he still vomits ; skin and mucous membrane of throat and mouth are still livid. The pain of the burning still severe. The 4th d. vomiting ceased ; tissues less deeply coloured, now of a dull brown. Pain in chest, especially on r. side ; rusty expectoration. The 5th d. urine clear. fever, bloody expectoration, violent delirium. Dulness and bronchial breathing on the r. side of back below the angle of the scapula. Died on 6th d. Post-mortem, — Labial and buccal mucous membrane of a grey colour like lead. Pharyngeal mucous membrane bright red, swollen, softened, and covered with patches of exudation. Bright injection of oesophagus, which is eroded in places. Posterior wall of stomach marbled with ecchymoses, but no loss of the substance of the eastric mucous membrane. Intestines normal. Liver large and fatty. Spleen rather big. Right kidney hypertrophied and inflamed. Red hepatisa* tion of middle and lower lobes of right lung. (Ibid.)

2. A man, act. 37, had daily injections of a 2 per cent, solution of carbolic acid for a fistulous empyema. Though the injections imme-

yj

diately returned, he always complained of sweetish taste on the tongue, sh'ght giddiness, and sometimes headache that lasted several h. Hoping to produce a quicker cure, his wife injected a double quantity of a 3 per cent, solution. Before the operation was at an end the man uttered a cry and tumbled off his chair unconscious, Stertor, agitation, groaning, violent nausea, flaccidity of the limbs except some transient convulsions in the r. arm, pupils dilated and insensible ; respiration irregular, laboured, noisy during inspiration ; pulse not quick, very compressible, and occasionally intermittent; sensibility almost entirely lost, Ac end of 2 h. he recovered consciousness, but remembered nothing of what had passed. He complained of horrible headache, nausea, soon followed by vomiting. The vision of both eyes was entirely lost* The ophthalmoscope shows very indistinct outline of the papillae, especially the r. The following m, the nausea was gone, and the patient perceived the dawn of day. Some h. later was able to see the outline of objects in his room. The 20th d. there was no longer^ any affection of the sight ; r, eye recovered itself more slowly than K^H He had still heaviness of head, and he vomited when he got up. [Ihld*) ^1

1. In a case in which a few grains of the acid in water were injected into rectum of girl of 5^, for thread-worms, with unconscious, ness, slight cyanosis, complete ansesthesia, and general muscular relaxation,strong trismus was present. (Schmidt's y^/rr A., vol. 198, p. 27.)

III. Experiments on animals, — 1. There is a very considerable discrepancy between the action of the poison on animals and in human beings. In the former there occur unmistakcable symptoms of irritation of the medulla oblongata and of the spinal cord, which have as yet never been witnessed in human beings. (Boehm, op. cit.)

1. In Neumann's experiments the general symptoms produced were tolerably constant in the different classes of animals; paralysis commencing in the hinder extremities and gradually spreading upwards, spasms of all the muscles, dilatation of the pupil, oppressed respiration, emaciation, diarrhoea, and death in convulsions, {Veber die JUrkung der CarhQhaure^ ^c^ Wien, 1870.)

2. HusEMANN and Ummethun (Deutsche KUnik^ 1870-1) and E. Salkowsky {PJiuegers Jrchiv^ v, 1872) have carefully investigated the general symptoms of poisoning which follow the absorption of this poison in animals*

a. In frogs, Salkowsky observed, some time after the poisoning, consecutive to a stage of more or less paresis, clonic convulsions in the extremities, gradually increasing in severity, like those in strychnia poisoning, lasting for hours at a time. He also verified analogous affections in rabbits, in which what at first were only general muscular tremors became general convulsions. The occurrence of these spasms in various animals is confirmed by Husemann and Ummethun. Salkowsky refers their origin to the spinal cord, as they still happen when the brain and medulla oblongata are severed from the cord, and also when the arteries conveying blood to the limbs are ligatured. It could not therefore be said that the convulsions were due to asphyxia.

^. The disorders of respiration consist in a verjr considerable

H

{Increase of frecjuency of breathing, and in its becoming very superficial. ' Fatal doses bring on dyspnoea at the last, and manifestly lead to death by paralysis of respiration* The primary acceleration of breathing is not entirely prevented by section of the vagus, although this operation has unmistakeable effect upon it. On the other hand, carbolic acid is able to increase the number of respirations in an animal whose vagi have been previoysly divided, Salkowslcy therefore believes that this poison not only atfects the respiratory nerve-centres, but also excites the pulmonary terminations of the vagus.

c. The organs of circulation are less afFected by carbolic acid» The fret|uency of the beats in the frog's heart gradually diminishes to about half, while the convulsions go on increasing. (Boehm, kc. cit,)

1. a. Dr. Ernest La bee (Arch, Gt'?i., 6e ser., xviii, 451) agrees with Salkowsky in regarding the convulsions as of central origin, but differs as to the particular centres affected. He found that the convulsions did not occur if the cord or medulla had been previously divided, and that destruction of the whole encephalon had a similar result ; but that if only the cerebral hemispheres and the optic lobes were removed, the convulsive phenomena developed in their usual manner. Admitting the truth of these asserted facts, the conclusion is inevitable that the convulsions produced by carbolic acid originate at the base of the brain, and are epileptiform.

The experiments of the two investigators are, with our present light irreconcilable ; but it seems to me that the results of Labee are the most probable. The experiments of Salkowsky are insufficient to carry complete conviction : indeed, he states only that convulsive movements were present to some extent after section of the cord. Further, according to his own researches, the nerves and muscles are not seriously affected by the poisoning i and, this being so, the coincidence of spinal convulsions and of paralysis is apparently inexplicable, and seems to demand the consentaneous existence of an exalted and a depressed state of the spinal ganglia.

if. According to La bee and to Salkowsky, in acute poisoning the heart is found pulsating regularly directly after death, but is finally arrested in diastole ; and in slow poisoning death may be immediately produced by diastolic arrest. Salkowsky asserts that the rapidity of the circulation in a frog's web can with the microscope be seen to be at first increased by the hypodermic injection of the acid. Hoppe-Scyler found that the arterial pressure did not vary much under the action of the poison until the convulsions came on.

r. Post-mortem examinations of animals killed by carbolic acid have yielded varying results. ...JpacfiflfyS^'/^'^ investigations, intense injection of the alimentary g^^^ j^^ places. PjJ^ ^^ observed. Prof. Bruckmuller found the cej^m ^q Jq^^ of the/^^^ys in a state of fatty degeneration. lhis prq^tinesnormaL hjf'^ly w:^^ the counterpart ot

♦ Dr. Wood addsi-^'^^y hypertrophied f^ and purulent mflammation of the bronchial tubcsj with a^r lobes of right h/f pncumuaia/' These phenomena, however, occurred only mj J^^^j dailv ini^o experimiTitcd on, and Lernairc justly infer?, that they mu?,t V fistulous emovt^'^^^ ^^^ ^^^^^"^ heg^n. Another, already emphysematous, had ^ * wjg^gej^t ion ; but the air passages were sound.

— Eds.

j^ fistulous empyj

n

the changes In phosphorus-poisoning, was always more advanced b the kidneys than in the liver. Neumann states that it was found in a number of autopsies, and is a constant phenomenon j but SaJkowsky was unable to find it in a number of examinations. (H. C. Wood, Therap.^ sub vocej

Volume I — Appendix

Acidum carboUcfuni.t — The following are to he substituted for the corresponding scctiorvs of the pathogenesis at p. 4: —

L— 1« a. Dr. Bacmeister, set. 39, nervous-sanguinc. Feb* 7th, 1869. — At noon, 5 dr* of ist. \n s J^^ while walking out-doors, sense of freedom and expan* sion in lungs, also in nasal passages. In 10 m. smell much more acute ; noon after

• In our expansions, &c., ot the presentation of this and the two folfowing medicines we have been much influenced by the suggestions made by Dr. Berridgc and by the editor in the Homoeopathic tVorUi for 1185. Where they have not been adopted, we beg our colleagues to believe that it has not been for want <»f due consideration, — FiDS

f It was upon this drug that we first tried our ** prcntice-han* ' at condensing (see Af, H. Rev., April, 1883); and in our zial we went ftirther than we have ever gone since. We have therefore given above a Ic^s abbreviated presentation of some of its provings. — Eds*

corvza, only in cold air. In i h. slight aching in 1. forehead ; in 2 h. crampy stitch in 1. groin, while sitting.

b. On nth, at 2.30 p.m., 5 dr. of nth. Soon after slight heat of face and forebead, especially 1., with pressure in 1. temple, seemingly on surface of brain. In 15 m. sense of fine electric sparks in 1. ala nasi, sternal end of r. clavicle, middle finger of 1. hand, and vertex, in succession during about x h. It changed slowly to a pricking itching, with desire to rub, and relief therefrom. After dinner long-continuea hiccup, and in e. entire disinclination to study. Two d. later soreness and swelling of 1. cheek internally, opposite molars ; cheek in the way of teeth when biting ; aching pain to 1. of middle of 1. shin-bone. Throughout proving and subsequently motions more frequent than usual,

1. a. Dr. HoYNE,sanguine.bilious,very susceptible to drugs. Jan. 20th, 2.40 p.m., took 5 dr. of 6th. During next 35 m. aching in r. upper teeth, r. shoulder (when bending forwards), and forehead (transient) ; drawing in 1. arm from shoulder to elbow (transient) and in r. jaw ; burning in 1. eye (transient) and top of head ; tingling or itching in little finger and on scalp, first r., then 1., also on inner thigh and scrotum (here temporarily relieved by scratching) ; pain in r. toe as if pressed upon \ constant tired heavy feeling in 1. arm ; nasty taste in mouth } sense of^ flatulent distension in stomach, better after raising a sweetish-sour fluid. From 3.15 to 3.40 itchings and pains in various parts, once so sharp in centre of cheek he thought he had been bitten. Head pains most seveie, worse on r. side ; most of them seem to affect this side first and then go to 1. Pulse 82 ; head hot, with burning at top and r. temple, beating in r. side j eructations; incessant yawning;. From 3.40 to 5.30 headache worse, disappears when moving about, but eructations become more frequent ; head heavy when leaning forward. By 5.45 all symptoms had disappeared, save burning pain at vertex ; pulse 68, rather low. No appetite for meat. At 7.30, when blowing nose, mucus was tinged with bright red blood. Slept well, dreamine of travelling. Next m. expectoration of much thick whitish mucus ; r. shoulder Tame and sore while walking j nausea most of m. ; neuralgic frontal headache. After dinner felt well. 22nd. — Desire for stool all d., though natural action had occurred in m. ; emission of large quantities of putrid flatus.

b. Repeated dose at 5 p.m. on 30th. During ist h., stomach ached and seemed full of wind, which was often belched up $ tingling in 1. great toe, followed by feeling as if pressed on; pulse, at first 70, in 15 m. rose to 82, whence it fell to 75 (30 m.), and 68 (50 m.) ; pains, itchings, and yawnings as before ; irritation in throat, causing constant hacking cough, 1. side of larynx very sore when pressed on ; constant pains in head, very similar to those of ii., relieved (7.30) by smoking after tea ; slight uneasy pains in r. lung ; emission of foetid flatus ; f^It dull and stupid, back of head sore, pain on swallowing. During e. unusually cheerful, but had rumbling in bowels as if diarrhoea would come on. Slept well, but dreamed of fire, which woke him, when he found himself feverish, though window was open and room cold. In m. woke with hard headache (upper ha^, disappearing after breakfast. Had passed urine with unusual frequency in n., during d. it was increased in quantity, and had very strong smell. Occasional chilly sensations. Next d. only occasional pains in hips and shoulders.*

c. On Feb. 4th, 3 p.m., took 5 drops of 3rd. In 15 m. soreness of throat, and very sharp stitches there, growing worse for a time, passing off by 4.10, save when swallowing and pressing on upper larynx (worse r. side). During xst h, head as before, with transient recurring pressive pain in 1. ear; while writing (3*35) letters seem to run together ; pains, itchings, and belchings as before \ sensation on skin ja^ t below knee as if part was touched with ice. During 2nd h., aching across small of back and in legs ; neck lame and stiff when moving head ; intense burning itching of genitals ; pulse 70 at outset, now. 84 ; headache still, worse on stooping. During 3rd h., burning pain in eyes, worse in 1. \ pulse 86 ; dull aching in whole 1. chest and abdomen. At 9 p.m. beating pain with humming sound in both ears. Next d. only very severe aching in r. hip-joint on walking ; on 6th same, slighter, in 1. shoulderjoint. From 7th to 12th small vesicle, ending in a pustule, on centre of nose.

In I. 7, 1. 4 from bottom of page, after < water' read <* that n/* ; and at end add ** On 24th, while walking, bruised pain in middle of front of 1. thigh, deep seated, and lasting only a few m.**

• It was during this proving that the acne disappeartd.

iu

In L S, , 1, to " i» '' add uoic — '* Probably ise dec. attenuation of solution next mentioned/* L. 14, for ** feet " read ** lower cxtpemiiies.' L, 16, after " c./ read — ** Feet telt bruised whole time/* L. 3 1, after '* hnn/* read " N. restless and dreainhil*'*

In I. I J, for " X. Yr read ' Man, aet. 39/

In I. 13, 1. 6j after • hypochondnum/ insert and both iliac regions, L, S, after ** No, 11)'* Insert '* also some diarrhcea/'

After I. 20, insert following :

' I accidentally inhaled vapour of C ac, hut felt no cifects till next d, ; then experienced soreness of air- passage, with hoarseness^ which increased tip to 4th d,, and remained till nth. On 5th d. cough came on, with (later) expectoration, on appearance of which soreness abated. During 3rd n. passed nearly 3 quarts of pale urine. On 4th d. hard aching pain in r hip^ like sciatica, slowly movmg along cour^ or nerve, till at n, rt reached bend of knee and ceased. On 6th d. awoke with stitching pain in r. neck, which increased up to 8th, when pain recurred cverj' 5 m. for 8 h. | was nearly gone by loth d. Appetite was good all the time. (T, D. PritchaRD, M.D., M r. St. Horn. AM. Soc. Tra/tsacttonJt N. S., i, 156.)*'

After IL 5, insert Following :

^* A baby had carbolic oil (i in lo) applied freely to sore arm after vaccination. In a few d. ne began to seem out of fiorts. The slight sickness he generally had after he was nursed increased to quite an unusual extent. Motions became greenish, and napkins were stained of inky or ^molcy hue at other times. He became exceedingly drowsy, and did not care for food. At n. was feverish, continually groaning, and too drowsy to iity. Drcv^ings were not reapplied from this date. Next m. face flushed, eyes glazed and red, brows contracted; breathing quick and laboured; throat red; dry cough. After a hot bath, free perspiration. Breathing same up to n,^ when it fell, and at 10 p,m. he was cool and sleeping quietly* Frxjm this time he rapidly recov^ered, but greenish colour of motions persisted ^or a time. (Midgley Cash, Horn, fTorid, Aug.. 18S5O"

Volume IV — Appendix

ACIDUM CARBOLICUM.

(See vol. i, p. 4, 471.)

II. 13. Madame P., xt. 31,

su

ffe

rmg

from stricture of rectum

(probably of syphilitic origin), had linear rectotomy performed by M. Verneuil. To hinder putrid absorption, a catheter was introciuced into the rectum and a sol, of carbolic acid injected, of which only a part returned per anum. An h. later, a second injection was practised. Patient, who had recovered well from the effects of the chloroform given, had now fallen asleep again, and was not roused by the injection, nor subsequently could she be wakened to take food. Seeing that she also grew weaker, the nurse called the house surgeon, who found her pulseless, eyes dull and sunken, and breathing apparently suspended, so that he thought her dying. By artificial respiration and other such means she was brought to herself, and vomited contents of stomach. After 2 h. more, however, she fell again into this syncopal state, and could not be rallied. M. Weiss found her, 2 h. later, in almost complete coma, which was interrupted only by inarticulate cries and some convulsive movements of diaphragm. Face was pale, extremities cold, temp, 35* i'^, pulse hurried and hardly to be felt ; breathing irregular, broken by the diaphragmatic spasms already mentioned. External warmth and subcutaneous ether led to repeated bilious vomitings, and after 2 h, more patient had regained consciousness and began) to reply to questions; temp, becoming 36*2°, and breathing deeper and more regular. Vomiting nevertheless continued during following n., as well as great debility. Urine next d. was found brown. [Gradual improvement now took place ^ n. was good ; and on m. of vot. IV. 30

3rd d. patient complained only of anorexia, a little heaviness of hod and some tinnitus aurium ; she had also a few diarrhccic stools. Urine was chylous (?), but had lost its brown colour. Dunng the folWing days patient gradually convalesced, but a pemphigoid eruption appurcii on hands, face and ears. (Weiss, Prag. mtd. fFocfienschr.., 1878.*)

1. When administered to man in doses of 6 — 8 gr. dissolved in » wineglassful of water, the following phenomena present themselves:

a. Loss of sensibility in mouth and throat, or feeling of numbneia, as when aconite is applied to the lips ; this is followed by a cooling sensation, like that produced by mint.

i. Slight nausea, especially if the stomach is empty ; (his is succec<icd by an uneasy feeling in the abdomen, like that felt before an attick of gravel.

c. Slight vertigo, ringing in ears, and partial deafness, judged by the ticking distance of a watch. This vertigo is so great, if the druf is taken just after rising (and so on an empty stomach), as to compd the resumption of the horizontal position.

</. Loss of heart-beat ; the pulse, according to our repeated observations on different individuals, losing from 4 — 8 beats per m., hHing also in fulness. Temp, under tongue undergoes no noteworthy alteration.

e. Diarrhcra ; this is not invariable, and does not appear till several doses have been taken. If present, it usually disappears on the 3rd or 4th d. of the continued administration of the medicine.

/. After long-continued use of drug, feebleness of heart-beat, mu»— cular debility and loss of flesh occur.

£. On omitting medicine after it has been taken for seven! d. flatulence usually occurs, accompanied with a feeling of depression like that felt after the stimulating effects of morphia have ceaicd— (Bill, /tmer, Journ. of Med. Sc, N.S., Ixxiv, 45.)

1. I was called about I p.m. to attend a farmer. I found hits if violent convulsions with trismus, and blood passing from the mouth il consequence of teeth having wounded the tongue. He was quite coma rose ; face and neck were livid ; breathing stertorous ; extremities an^ surface of body cold ; pulse scarcely perceptible. I had him put iot( a warm bath immediately. In 40 m. convulsions ceased, sensibi partly returned, face and neck assumed their natural hue, brcatl became quieter, extremities and body were warm, and pulse m stronger. He was then removed to bed, and heat applied to body cold to head. I saw him again at 7. He was then perfectly coo scious ; convulsions had not returned ; breathing was calm ; puise 88 He had passed about Oss of urine, which was super-acid. He com--" plained of giddiness, but no pain in head ; he had pain in face and neck, and much gastric irritation. Next m. he was much better and convalesced. He stated that for 3 h. he had been exposed to the fum( of strong carbolic acid, and was then seized with giddiness, which wi followed by the stupor and convulsions in which I found bim-^ (Unthank, Brit. Med, Journ.y 1872, ii, 579.)

2. The acid was applied in too strong solution (15 per cent.) • See a similar case in N. Y. Mtd, Kicordf xv, 378.

phlegmon on the arm. Almost immediately afterwards patient felt olent pains in arm and lost consciouness. She was found throwing ;raelf about in bed, face flushed, pupils contracted, pulse slow ; she cathed with much difficulty. Dressing was immediately removed, id in course of an h. patient recovered consciousness, complaining tijr of fotigue and frontal headache. {Ibid., 1879, ii, 629.)

1. I have lately used carbolic acid injections for ascarides, using j of a i^th or -^h solution. Unpleasant symptoms sometimes follow, sting perhaps an h. ; within 2 m. patient complains of giddiness, aging in ears, clammy skin, and taste of acid in mouth. Pupils are ■affected. There has occasionally been abdominal pain, and in one

two instances confusion of ideas for the next 24 h. Temp, is untaui|ed } pulse, if anything, quickened. (Pbarse, in Iiid.y 1879, i, 852.)

1. A woman, aet. ^o, swallowed 4 c.c. of carbolised alcohol (= I grm. of pure carbolic acid). Immediately vertigo, followed 10 m. ter by absolute loss of consciousness with cyanosis of ^ce. 1 ^ h. after ig^tion there was still coma with relaxed limbs, no convulsions ; pupils Ktremely contracted and immovable ; cold sweat ; respirations slow, Tegular, with tracheal rale } countenance pale and cyanosed ; vomiting; •ulse very quick, regular, sometimes extinct during inspiration. Stomach ras washed out, but she seemed rather worse afterwards. Urine passed tn h. after poisoning was normal, but that passed 15 m. later was of ^lour of blood ; microscope showed no red corpuscles, but spectroscope revealed bands of oxyhaemoglobin. Temp, in vagina was as low as 34'4° C. The tracheal rale mcreased } mucus was continually ejected from mouth and nose ; tongue was retracted. She gradually recovered ; put 8 h. after the poisoning temp, was above normal, there were pains 11^ throat and stomach, extreme hoarseness, and bilious vomiting ; 'rioe had to be drawn ofF, no more haemoglobin, but some albumen ^ granular casts, some red globules and renal epithelium. The d. ^ she had circumscribed pneumonia at r. base. She left hospital on '~ d., when vocal cords were still red and swollen and m.m. of larynx V^cted } and urine was still albuminous, containing granules and Nine casts. {Rnnu des Sc. MSd., Oct. 15, 1883.)

'9. A man, aet. 37, had daily injections of a 2 per cent, solution for a '''"Ous empyema. Though the injections immediately returned, he **ys complained of sweetish taste on tongue, slight giddiness, and "'^times headache that lasted several h. Hoping to produce a quicker "^ his wife injected a double quantity of a 3 per cent. sol. Before * ^>peration was at an end the man uttered a cry and fell oft his chair ^conscious. There was stertor, agitation, groaning, violent nausea, *^(lity of limbs save for some transient convulsions in 1. arm, 'P^U dilated and insensible ; respiration irregular, laboured, noisy iintig inspiration ; pulse not quick, very compressible, and occasionally 'Permitting ; sensibility almost entirely lost. After 2 h. he recovered i^iitciousness, but remembered nothing of what had passed. He coml^ined of horrible headache, and of nausea, soon followed by vomiting. **ion of both eyes was entirely lost ; ophthalmoscope shows vtry 'distinct outline of papillae, especially r. Next m. nausea was gone, ^d patient perceived dawn of day. Some h. later he was able to see

be

Jca ici

outline of objects in room. The 4th d. there was no longer tjon of sight. R. eye recovered itself more slowly than 1. had heaviness of head» and vomited when he got up. (Ibid.) 20. a. A man, act. 30, given to drink, drank off a glassful in mistake for whiskey. As his mouth and throat burned, h with water, and went to a public-house. There he felt ill, an know what happened. Half an h. after he was found : __ unconscious, insensible to all excitations, skin cyanosed, limbs relaxed, pupils contracted and immovable ; resp. was labc^ v jerky, mouth exuding bloody slime, pulse small and scarce! tible, chest full of large mucous rales. He was bled, employed and friction to limbs, cold compresses to chest; bcn.^,^ internally. After 12 h. consciousness returned; cyanosis dim ^'1 resp. easy, no rales; burning pain in mouth, throat, an</ stomach ; copious Vomiting ; urine black as ink. The 3rd d. vomits ; skin and m.m. of throat and mouth still livid. On Jm!!t vomiting ceased ; tissues less deeply coloured, now of a dull l^^^fpain in chest, especially r. side; rusty expectoration. On 5th rf^^l clear; fever, bloody expectoration, violent delirium; dulnes*^^ bronchial breathing at r. base posteriorly. Died 6th d.

b, P.M. — Labia] and buccal m.m. of grey colour like pharyngeal m.m. bright-red, swollen, softened, and covered with pa j of exudation ; bright injection of oesophagus, which is ertid^^"^ places. Posterior wall of stomach marbled with ecchymoscs, bu^ loss of substance of gastric m.m. Intestines normal. Liver large ^ fatty ; spleen rather large ; r. kidney hypertrophicd and infiai*' Red hepatisation of both lower lobes of r, lung. {Ibid.)

in. 5. a. Dr. KosTER injected 7^ grm. of a 5 per cent, solutf** into the r. femoral vein of a dog weighing 10,480 grm. After a Z*^ seconds there was slight muscular trembling; after 10 grm. of s***" solution he became restless and whined ; after 15 grm, strong tremtlifj of all muscles, numbness of sensorium, apathy ; after 35 grm. fcfc^ rigor, the breathing occasionally changed to spasmodic, jerking eP^ tractions of single or of all muscles ; the lower jaw chattered ai *^ rigor ; the reflex irritability was considerably exalted ; every noise, every time the table was struck, produced spasmodic twitchi The pupils would not react, moderately large, latterly slightly di After 5 m. the trembling abated, then 70 grm. were injected, every new dose the convulsions became stronger; the pupils dilated their maximum, but soon became more contracted to moderate si lastly the dog lay with his limbs twitching, breathing weak, a quantity of saliva flowed from his mouth, the temperature fell co. ally, after 35 m. to 37'5°, i.e. 2° less than at the commencci The vein was now ligatured and the dog let loose ; the reflex irrital seemed nearly extinct, the animal appeared to be moribund, the spiration very superficial, the pulse scarcely perceptible. After | A the symptoms diminished in intensity ; after 15 m. more the d , his head and tried to get up on his fore legs, but always ft\ powerless. At last he got up, his hind legs dragged somewhat, h« was staggering. After i h. more he appeared quite lively only n

after 3 h. temp, was 39'4°, after 6 h. 39*6". The following m. te well except rather weak.

no grm. of same solution were injected into 1. femoral vein of n 20 m. The effects were similar to those observed in the first Sensorium dulled ; he barked loudly, had violent muscular ng and convulsions, which gradually declined and the barking d to a kind of barking whining. The temp, continued tu sink th ensued. Before this occurred, the barking and trembling ting, the pupils became insensible. After a few h. he somescovered, during the night had liquid stools. Death ensued &h.

r25 grm. was injected into connective tissue of back of a dog. limal became very restless, the temp, before the operation was 15 m. afterwards 418'. After 10 m. he became quiet but lay nZ) the temp, fell to 397°. Trembling increased and in e. temp. 5 and towards m. fell again. The following d. the dog was ill, hing, but next d. was lively. After seven d. he died owing to an that developed itself where the injection had been made. \ smaller dog had 3*37 grm. injected below skin of back. The irhich was at first 39 "1° rose at first to 39'5° and then fell below t degree. After 10 m. trembling which lasted 15 m. pretty r; much saliva. Lastly he became unsteady on his limb«, fell Next morning was living, but after some d. he died from in the back. (iV. Ztitsch.f. horn. Kl.^ xxiv, 29.)