Fluoricum acidum

Volume I — Main text

Hydrofluoric arid^ HFl. Product of action of Milphuric actd on fyor (fluoride of calcium).

I. Prtvings, — 1. a. Dr. Hering smelt at acid, 5 p.m. It appeared to him to proceed from throat to head. He felt as if he was to be struck with apoplexy, a kind of determination of blood to head and km of consciousness, he could not recollect where he was. There feUowcd sore throat, with diflicult deglutition ; his throat, at fiir as beknr larynx, felt so sore that bread, though masticated venr thorouffUv, could not be swallowed without the greatest pain. This lasted tdl next m. after breakfast, before which there was hawking up of much phlegm, mixed with some blood.

b. Took a traspoonful of 3rd dil. one afternoon. Immediately wiuarioa of warmth on lips and greasy feeling in mouth. In 5 m. headache in upper feiclMad and vertex towards r.; in 10 m. Might feeling of nausea and vcrtm; in isntMudol sensibility of r. upper jaw, reflected, as it were, in lower. 1 h. amr had come onlneM towards r. in occiput ; violent jerking in interior behind and aborc r. eyebrow, ia bone ; some pain in abdomen after a meal of fish and water-melon, which was <|uile unusual ; and burning around first bone of r. middle finger, with itching and itin|pag in skin. From 1 to 1 h. after supervened pain in lar^-nx, as if in cartilage, inducing swallowing ; slight numbness of r. joint of lower jaw, a continual sensation of warmth^ and as if it would begin to pain ; burning pain on outside of r. lower jaw on small spot near ist and ind molar; burning pricking pain in 1. shoulder-blade; and pua in 1. arm above elbow. In e. pain m r. instep, followed by slight numbness of r. thigh, only when crossing lcg> ; painful determination of blood to forehead, like a quick jerk, on first walking after standing, not after sitting; itching, inducing him to scratch, on both upper eyelids ; sensation of fulness in both spermatic oordss creeping and severe itching on r. shoulder, sometimes shifting to 1. ; and genermi heat after little exercise (in n. special warmth in abdomen, with preisure towarda bladder). That e. also, and following m., sensation almost like nuh of blood, but rather as if of nervous seat, somewhat resembling numbness or burning, firvt in Cmv. head, afterwards in upper and lower jaw of same side, in lower part of occiput, in bladder, and various other places.* A cold bath in the mommg was more than ordinarily agreeable. In forenoon of this (ind) d. he had, whilst sitting, a frequent sensation ota general shaking, with a dull pressure and compression in occiput^ particularly towards night, with continual internal sensations of numbness in 1. foremra^ and severe pricking in it whilst stretching it. The 1. hand also felt numb (wm '* asleep ') m m., and remained so the whole fttrenoon. In the course of it came n disposition to anxious ideas, frequently to such a degree that perspiration broke out ; sensation in r. ear as if a singing wrmid commence there ; an almost painftil electric jerk along 1. radius to thumb, which moves involuntarily ; in fleshy part o£ 1. thumb violent burning stitch, often returning and passing out at the end, and beneath the nail painful sensation, as if something was gradually working its way out 'y in the 1. little finger a slowly jerking, repeated burning. During and and 3rd d. there was decidedly less voiding of urine. On 3rd d. no stool; at 10 a.m» on the 4th indefinite {sic) desire, and pappy evacuation. On this and the follow ing d. both hands were constantly led (on 4th d. fiill and warm also, and aa if mottled), and from 10 to it p.m. there was violent pricking-itching on detacbcd spots, mostly on 1. side, particularly on side of chest towards back, and on thigh. In e. this itching affected several cicatrices he had, dating fnim 31 to 1 years backhand all on 1. side ; next m. they were red round their edges, and occupied here and there with itching vesicles. Those of more ancient date had larger vesicles ; the later ones were filled with very small pimples, but only on cicatricial tissue, not on

• This was also experienced after the 6th and 30th dils.

surrounding skin. During 4th d, contraction in some jnu«icles of neck on 1, Me and towards shoulder, during forenoon, at rest and whilst rising, which after some renting gradually sub^itded. The pain seemed to i»hift ftxjm one »^ct of rnvKclest to anorher^ but ^as always in more than one. The omohyoideiis was markedly affected. He had also dctp-seated pain in back, below point of shoulder blade, more towards 1,, felt most in sitting posture, particularly whilst riding (al>o felt on 9th d,) ; pricking, burning itching near coccyx, towards r. 5 violent itching on different spots especially backf increasing towards n , on this and the next d. ; on back and 1. hip groups ot hmall red pimples appear. On 5th d., in m., lower incisor teeth have sensation of roughness, as if broken, and tongue feels painful on touching them (this continued several days) ; there was more urination, even twice in night, which h quite unusuat with him, and more (hirst j he had pain in 1. index finger, as if in bone, now and then the whole finger being painful internally, especially in e., when also violent itching occurred, and small vesicles appeared on r. mdex \ at same time, on closing eyes firmly, he observed a large bright ring, which quickly vanished. On 6th cT nothing Irtsh was noted ; but on 7th (and following days) he bad opprrfssion in upper part of chest, not relieved by deep inspiration. On 8th and 9th, there wasj during forenoon j in the room and open air, a headache, a partial fulness, as if something wtre lying on a ^pot in L parietal bone. On 9th d. it seemtd in m. as if his countenance had become all at once wrinkled and old. For the first time he felt,dctire to scraich the head^ without any actual itching; and next m. there was a great falling uff of the hair Deep in the bones, superior and posterior to 1. eye, there was occasional soreness; and behind eye, towards temple, there had previously been in h nostril and forehead a pain, seemingly in bone, as it very deeply in interior something sharp-pointed was moved about. Later same pain occurred in posterior part of r, eye, extending verj' far into upper jaw. There was also diffitulty of breathing, seemingly from an impediment in region of pit of throat and upper chest; at same time aching pimples appeared on the back, and there was pain in chest below point of scapula. On this d. and the following it h noted that the left kg readily went to sleep. On loth d, he had during his walk a very severe itching on throat and chest. Also in both joints of the jaw'^ (worse in .), painful spasmodic contraction (had had same sensation occasionally before) j he often breathed deeply, as it breast within and below was full, in forenoon while sitting and writing j and more itching and fresh pimples came on the back. On this d. and the following, in lower part of entrance to fauces, towards 1. side, was a raw feelings which, though little painful, he apprehended might prove serious. On lath d, violent itching at J. inner canthus of eye, which cau^^ed him to scratch very quickly and forcibly, and itching above the anu^, sudden and most violent, often returning for some days later. In c. itching on r. nipple and around it j the nipple next morning much larger, redder, and the areola darker. A thin brownish crust then formed on the areola. On i^th d. he first noticed several siniall light carminercd round elevated blood-vesicle, resembling little flesh warts; they are very soft and compressible, and by a strong and steady pressure the blood disappears, but immediately returns again. The largest is the size of a hemp-seed, the smaller ones like millet seed^t; some are still smaller, but they are very perceptible as light red enlargements of the capillaries, raiding up the cuticle* They lie below the right nipple and on the opposing surface of the right arm. Three weeks later some of the smaller ones had disappeared. The larger had become darker, somewhat resembling nsevi materni ; some are larger than before. After three months they arc paler. They made their appearance and remained without any itching. On isrh d, is noted aversion to coffee, and on 15th and i6th a very acrid and strong odour of the urine. On latter day a small pimj>lc appeared on the right liidc of the face, and similar ones occurred there 5 weeks afterwards.

Besides this daily record, it seems that several times during the first days, while considering what might happen, he got into a most ungovernable rage, but only in his thoughts. During first week, he had after 10 a.m. a kind of shaking in the head, particularly in the back part of it, and more towards r, when first sitting, during each quick, short movement, on rising and turning, and during walking; also frequent itching in eyes, making him scratch, dull pains in region of bladder, more easily controlled and gradually diminishing sexual passion, and pain in back, sometimes high up near shoulder-blades, sometimes deeply seated, as it were in region of kidneys. Every (orenocm about 10 to 11 he became sleepy and tired. During fii^t:

tS

two weeks there was heat in face, and desire to bathe it with cold water, which wa* very grateful; and he became sleepy earlier in the evening. In 3rd week he had in €♦ after retiring a jerking^ light betore eyes, crossing itself like lightning. During 4th week he was very irritable towards people, even to the greatest hatred, which he did not hesitate to give vent to in words; btu :is soon as he saw them everything was forgotten, and he had an entirely different opinion of iheni. He aUo had now and then in the evenings of this and the following weeks a pain rcscmbJing a con. tiision in the ends of the -second fingers, an it were In the bones. As far as the 6th week, his urine frequently smelled very offensively; and at this period wheezing during respiration was noticed, rather by others than himself j though while taking his afternoon siesta, he found he had to bend backwards to draw a full breath. StiU during this week vesicles arose, larger and smaller, in groups, with very sensitive itching, on nlnar side of r. thumb and radial side of the neighbouring index, leaving behind them dry scurfy 'spots. Even in 7th week he was reminded of ihc dnig by sensations as of a hair along the back of the L little finger, so that he repeatedly looked to see if one were not there.

The following symptoms also are referred to the ^rd, but without note of time : —Great disposition^ when alone, to repulsive fantastic imaginations, particularly with regard to persons with whom he stands in near relations, or with whom he is connected. Indifferent^ showing no interest in any occupation. Sensation as if dangers menaced him, hut without being afra^l, particularly during the pressure in the occiput, the staggering, the pain in the bladder, Sic, Sudden attacks of coryza, as suddenly disappearing (also after 6th and 30th).

c. The 6th and joth were also proved, in what manner is not stated^ The following symptoms are recorded as observed after the 6th i — In e, he is very discontentedt and looks at ever)'thing in the worst light ; in the morning, after a restless night* his temper is very cheeiful and joyoui^. On making his notes he mistakes right and left, a circumstance that does not easily happen to him — and d. Dulocss and painful tension in head towards nighty and d. In e., after animated conversation, heat in face and headache, like a pressing and forcing deep interiorly towards I. j appearing at times and subsiding again j it then passes to 1, upper jaw, as if teeth ached, even at those places where roots of teeth had been extracted a year ago— md d. In chewing, taste like ink ^ seems to proceed from a lower tooth on 1. side — md d« With diarrhiifa, pain more particularly in region of navel — several h. He feels as if the wind were retained in the anus. Before and after urination, pain in lower part of bladder, there is also patn on pressure— ist and 2nd d. Urmation more frequent — ^several d. A violent, slightly burning, quick nervous pain proceeds from region of bladder down to right thigh, while lying in bed — ist d. Burning, shooting pain, a^ if It were in nerve, from r. hip downwards, piirticularly on inside of knee ; further down less distinctly — and d. Violent itchlngs, and small pimples here and there,

J. From the 30th, the following symptoms had been verified by lower attcnua* tions : — With his usual good appetite, he nevertheless is soon satisfied. The e vacua, tion becomes protracted, insulncient, and lumpy. On awaking, r. upper arm and shoulder feel bruised and benumbed, after lying on L side— several a* (^Matiria Me Sea of A metric an Prtnfings.)

X. Dr. EsRFV, after taking ist, had sickness of stomach from 3 to 4 h i after and, had shooting pain in L forehead, increased lachrymation, soreness of wrists and pain in corns. (Jhrd.)

1. Dr, Freitag took 30th, followed by 6th. From latter attenuation ire reported — Headache in forehead and lemplcti. Behind r. ear a pain which moves upward in head j at same time in r. heel. Pain in r. ear^4th d. Pain in r. side of neck. Pressing pain in 1. arm, just above elbow, and numb pain down forearms to hands. Acute needle-pricks in fingeri^. Severe pain^ in all L toes save ist, after 8th dose J aUo pains, ot short duration, in L leg, arm and hand. Pressure and sensation of lameness, particularly in hand, arm to elbow, and foot. After ^oth occurred (confirmed by Hering's experiment with 3rd) pimples on abdomen, but principally on thighs and legs, points of which soon formed a crust, and scaled off 17 d. after commencing proving, {Ihut)

2. Dr. HusEMANN took -jolh and rst. From latter only symptom reported is — • In c, of and d., after retiring, on closing eyes red sparkling* cioss each other In all

pwsTble directions; this gradually rca^s, and there remain* a red flaming trembling for a few m., which disappears after opening ryes. Symptoms trom 30th are mostly trivial, and the few noteworthy are unconfirmed, (JhiJ,)

5, Dr. Walter Williamson took at 5 p,m. 20 drops of 5th, Immediately felt stunning sensation in head, mo^t in fronts and stiffness and sorenes* in nucha. At 10 took teaspoonful of i to 100 solution : in i 5 m. following symptoms appeared in succession,— com pre.^Mng pain in r. frontal eminence, dislocative pain in first joint of r. little finger, drawing round L eye, pain in r. outer ankle, heat in sole of r. foot, decpj^atcd pain below r. knee, with pain on inside, Article ing under ribs to L of cnsiform cartilage, trembling in r, biceps. On 9th heavy pain in 1. half of head silking coronal sutures. Took another teaspoon ftiL Excessive languor^ decidedly uncomfortable sensation in stomach. P.m» — Profuse sour offensive perspiration* free rvacuarion of bowels twice. On loth, soreness in muscles of thighs, aching tn r, elbow.joint^ lamene&s in L hip. On i ith, soreness and pain on motion in K hip, particularly felt on getting in and nut of bed ; elevated round and red blotches over eyebrows, most on 1., but longer-lasting on r. ; in eyebrows some pityriasis^ with pricking sensation. On nth eruptions continued through day, but other symptoms were ab^nt till c,, when he had pricking sensation in ends of index fingftrs, most ia 1., and in r* thumb 1 penetrating pain in K side of L knee; aching in 1. elbow; crawling in st>le of r. foot; copious urine of pungent and strong odour; pain in r. frontal eminence j aching in L index ; dryness of 1. half of palate and roof of mouth. At n. swcettsh taste in throat, and deep-seated pain tn 1. lumbar region.

6, Dr, Je ANEs took 5 drops of 3rd. Immediately after, acid taste and greasy feeling in mouth. In 5 m, confusion and pain ih rough head. In 8 m. pain in inner condyle of L femur ; In 45 m. in r, hip. In 2 h* burning feeling in sole of r» foot. In 3 h. pain about r, wrist and finger-join ts, in first joints of toes of r. foot» in r. instep (with burning). There was, after talcing doae, prickling of tongue and increase of saliva for some h., with afterwards smarting feeling of palate, as if something very acid had been gargled ; feeling of tenderness and irritability in larynx ; coughing to clear throat causes feeling of soreness, which shows an unusual degree of sensibility. (I^id,)

7, Dr. N£IDHARD took, at 9.30 a.m., 30 drops of 2nd. In a few m, uneasiness about heart, in 15 m. aching there; after i h. soreness and jerking, which in another h> became painful. With cardiac uneasiness began determination of blood to head, with heat in forehead, gradually increasing to frontal headache. Very soon eructation of wind and sickness at stomach i latter increasing up to 2 h., with general heat, heaviness, and lameness. In 15 m. slight lameness in r. arm, and burnmg in eyes. Very soon, aching pain in sacrum, and during ISC and 2nd h. jerking there. In 1 h. rheumatic pain in bones of I. arm, from elbow to shoulder, with lameness. In 2—3 h. pyrosis with nausea, heaviness above eyes and sick headache. In 3 — 4 h. violent burning pain in all the toes, so that he can hardly walk i soreness in chest. In 4 h. pressive headache in both temples; toothache, drawing in 1. lower jaw ; still some sickness of stomach, with vertigo and headache ; occasionally stitches and drawing through L testicle to abdominal ring and spermatic cord ; oppression with pain in chest ; small stitches in side ; pain in r. knee-joint with some in bones of r. forearm. After dinner some bitter eructations. In e, headache in r. forehead and itching in r. internal canthus of eye; inclination to diarrhoea, two stools. Next day, afternoon, frequent acid eructations, with pyrosis

and passage of flatulence ; pain in r. upper arm in bone towards elbow, passing over to 1. ; two hard stools. {Ibid,) 8. Mr. E. Smith proved ist and 2nd.

a, 5 m. after taking 40 drops of 2nd, there commenced an increased flow of saliva, which caused him to spit constantly for about lO m., when he began to feel a pain in head, a sensation as if head were too heavy, and would drop down from one side to the other, also a pressing outward from within ; after this pin had commenced the flow of saliva began to diminish, and in about an h. ceased entirely. The feeling of heaviness in head continued xn a diminished degree until going to bed : he awoke with it in m., but it ceased at 9 a.m. On bending the head (stooping) on previous e. a dull, quick throbbing pain came in r. temple, lasting only a short time.

b. Soon after taking ist, at 6 p.m. 10 d. later, there commenced the same salivation, with a dull heavy pain in whole head, slight fever heat under eyes, sickness of stomach with desire to vomit, heat in gums, later in pharynx. These feelings passed away in an hour. At 7.30 a dull heavy pain in upper part of forehead, passing sometimes to upper part of both temples, more particularly in 1. This pain is increased on stoopino;. Shooting pain in bowels, as if from wind, sometimes very acute. Next m. there was rumbling there, with wandering pains. Dead feeling in r. knee-joint. At 10.30 (other pains having ceased, save in head and knee), a sore pain 1. side of the chest, as if beneath skin, felt only on moving, and a similar pain in 1. scapula. He awoke in m. with a slight pain in forehead, which soon passed away. On getting up, pain in 1. chest, as yesterday. After breakfast, no pains save on quickly moving head, which caused aching all day. (Ibid.)

II. Poisonings, — 1 he local effects of the acid are those of a powerful corrosive caustic. This is seen in the case of fatnl poisoning reported by King (Trans, of Path. Soc.j xxiv, 98), where half an ounce caused violent vomiting, speedily followed by collapse, and death in 35 h. ; in the instance given by U ruber (Oest. Med. IP'ochenschrift^ N,5., ii, 2, 242), where a minute's exposure of the hand to the vapour set up violent pain, inflammation, vesication, and suppuration, with fever ; and in the experiments of Kreiner, who took solutions of various strength, which excited the objective and subjective symptoms of inflammation in mouth and throat, with vomiting, followed by nausea, eructations, and lassitude. (Ibid,)

Volume I — Appendix

Acidum fiuorioum* — In I. 6, I, 4, the pain about r. wrist and finger-joinci ' occurred 1 h, instead of 3 h. after dose

After II. I, insert

"III. Expffimmts on ammab. — 1. M. Maumene gave, for a period of 5 months^ fluoride of potassium to a dogi at end of which time a swelling similar to goitre appeared in the neck. The dog then made Its escape, but 3 years later was again discovered with a swelling which appeared to M. Maumené to have all the characters of goitre, {Med, Times and Gaz.^ May 5, if 66*)"

Volume IV — Appendix

ACIDUM FLUORICUM*

(See vol. i, p. 16.}

II. 2. A young lady, in attempting to remove with fluor. ac, some taint from china, spilled some of the acid on her palms and forearms. Ibe at once washed it off with running water, and applied turpentine

0 the palms. Next d., a few spots on one hand which the turpentine lad not reached gave her great pain, which she described as intensely Nilsating, like the beat of the heart. The pulsation involved the tip >f the thumb particularly ; but this had not been touched by the kcid, nor was it red and inflamed like those spots which had been, but t was sore to touch, and when pressed there was sensation as if a iplinter were under the nail and in the cellular tissue. The whole )and was swollen and hot, and the cold open air felt grateful to it. The throbbing and heat in the thumb continued for about 4 d., and padually subsided under treatment. (T. F. AtlEN, N. A. J. 0/ H.y ^rch, 1886, p. 288.)