Carboneum sulphuratum

Volume II — Main text

CARBONEUM SULPHURATUM.

Bisulphide of carbon, carbonic disulphide, CS₂. (Formerly known as " alcohol sulphuris " and " liquor Lampadii ") . I. Provings.-1. Косн.-а. 3 dr. of 7x, April 28th, 1850, at 11 p.m., on sugar. N. rather restless. 29th.-Same dose in m. fasting. Immediately after ingestion compressive feeling in muscles under jaw, particularly alongside larynx. Breakfast caused pressure in stomach, relieved by eructations; tickling in forefront of urethra, and sensation as though something was about to run out of it. Severe pain in r. parietal bone, as though violently pressed on with a hard body. At noon, tongue coated; eyes sunken, with strongly marked grey rings around them; feeling as though heavy weight lay across shoulders and weighed him down, so that head sank forward (while walking). Glass of beer 5-6 p.m. had not its usual taste, and caused pressure at stomach and eructations. At 10 p.m. 3 dr. Pressure at stomach immediately; tickling at back of throat, causing hard dry cough, soon after lying down in bed. N. good, but woke early, and had many dreams. Next d. a welldeveloped status gastricus-headache, discomfort, coated tongue, indisposition to exertion, and general feeling of illness ; diarrheic stool after breakfast ; 1. testicle and epididymis somewhat swollen ; sore headache in forehead; transitory pressing sticking pains in scrobiculus, setting from a single point towards cardiac region, afterwards frequent noisy eructations with relief (as in neuralgia cæliaca). From any food or drink, even beer or sugar, pressure in stomach, region of which is painful and tender almost all d. At 10 p.m. 3 dr. Piercing pains in 1. * It is well to mention that nearly 50 healthy persons, in addition to the above, took part in the re-proving of the drug ; but neither from the 1st, 2nd, or 3rd trituration could get any symptoms whatever.-EDS .

metacarpus and tibia when in bed; testicle more swollen, hard and painful ;* n. as last. May 1st, I h. after breakfast, 10 dr. Well during forenoon ; in afternoon very severe pressure at stomach, and portentous eructations, with very fetid flatus. In e. tensive frontal headache ; feeling in bowels as if about to have diarrhea ; great and painful lassitude in ankles and soles. 2nd.-Pressure and eructations, &c., as before. Red, somewhat raised eruption on both cheeks and across nose from 2 p.m. after shaving till n., with burning of nose and lips ; was asked if he had herpes of face. At 7 p.m., chills ; at 8, pappy stool, followed by weak and tremulous feeling, headache, and cramp-like sticking in both ears ; pulse 80; violent burning and itching in anterior commissura ani, which is sore to touch. Headache increased towards n., and he was once awakened from sleep by violent stitches in l. ear. 3rd. All teeth ached after being washed with cold water this m.; eruption still slightly visible ; face bloated ; whole head confused and painful tillnoon,when perspiration from exercise relieved it. 4th.-Violent rheumatic pain in r. arm and shoulder; stitches in 1. ear; face scaling where eruption was . 5th.-Itching and stinging of hands, especially between fingers, where he found little vesicles. Wandering rheumatic pains all d. 6th.-Severe pains in joints offoot in m. in bed, walking very troublesome at first, but easier afterwards ; muscular pains in thigh and leg all d., hindering movement. 7th.-Nothing now but slight pressure at stomach after dinner. b. On 8th, took 3 dr. of 2nd cent. in m. and e. Return of pressure, flatulence, stitching in 1. ear, and frontal headache, with addition of prickling feeling in various parts of skin and dislocated pain in loins. 9th.-6 dr. m. and e. L. ear still some. what painful, and as if stopped; violent rheumatic pain in l. upper arm in e.; n. very restless. roth.-Violent pulsating pains in temple at 6 a.m. on waking, so that he could not lie quiet, continuing till breakfast at 7.30; whole head confused and painful thereafter. At 8 a.m. 6dr., whereupon temporal pain returned, with pressure in stomach and abdomen, belching of disgusting fluid, and rheumatic pains in all parts of trunk and limbs, lasting all d. Repeated dose at 10 p.m., and at 7 a.m. on 11th. No special symptoms during this d. save hoarseness ; frequent pain in 1. metatarsus when walking, as if a false step would cause dislocation; and slight return of eruption. 12th.-Eruption more pronounced, especially after beer at noon ; end of nose red, sore and burning. 13th.-Face scaling again. After 3 d. without evacuation, a soft stool after breakfast, with considerable discharge of cherryred blood. On 15th, painful stiffness in neck, continuing all 16th, when also he had severe pain in l. elbow on movement only. On 18th, noted penis much shrivelled and shrunken, and states that he had had no sexual appetite since proving began. c. 21st.-Took 3 dr. of 1st cent. at 9 a.m. Beyond corrosive acid belchings, no symptom during d. 22nd.-Woke tired, and with very bitter taste in mouth, disappearing after breakfast. At 10 a.m. repeated dose. Violent sticking constrictive pain in neck near commencement of œsophagus, as if a bone were sticking there, returning several times during d. Severe heartburn, exciting cough. Prickling again felt in fingers and feet. 23rd.-Rested well. At 10 a.m. 6 dr.; heartburn all d.; pains in loins, knee, and sole. Repeated dose on 24th at n. 25th.-Painful weariness and bruised feeling in all parts ofbody, especially back, loins, and feet. Pain in r. knee as if dislocated, repeated several times. Extrao Extraordinary discharge of wind, both upward and downward, when walking. In e. violent sticking pain in stomach through to back, when resting epigastrium on window-sill and taking deep inspiration, repeated each time he breathes deeply. 26th.-Thin pappy stool after breakfast. 27th.-8 dr. at 6.30 a.m., fasting. L. epididymis seems swollen again, though but slightly painful ; dislocative pain in r. thigh and 1. foot. 28th.- Repeated dose ; felt very well, and had no pain in testicle, though swelling is greater. 29th.-Same dose. Violent cough immediately on lying down in bed at n., caused by continual and very troublesome tickling high up in pharynx, exactly as if snuff had lodged on uvula, cough convulsive anddry,straining chest and making it sore, lasting h. 30th.- 10 dr. in m. Similar cough at 10.30 a.m. , inclination to cough all d., and some hoarseness at noon, as if from a cold. A pappy stool escaped involuntarily when urinating in afternoon. Stools always pappy and scanty.

• State of testicle is not noted again for some d., when it is said to be smaller, and not at all troublesome.-EDS .

31st and 1st June.-10 dr. each m. on bread. More uneasiness in testicle. Violent stitch- like crampy pain in neck of bladder when making water at midnight, extending into urethra, and accompanied by similar pain in anus and rectum, hardly bearable while it continued. Returned next forenoon, but not so violent. d. 10 dr. of 7x were mixed with zvj of water, and received 100 shakes. From 3rd to 10th took tablespoonful of mixture each m. On 3rd, copious eructations of wind and discharges of flatus; heartburn whole d., especially after smoking ; very sleepy after glass of wine in e., but wakeful in bed. 4th.-Tablespoonful at 6.30 a.m. , fasting. Mouth bitter on waking; and saltish sourish taste, noticed since commencement of proving, is very pronounced to-day. Pinching in stomach ; violent heartburn all d., and sore frontal headache, with burning in eyes; scalp tender on brushing hair. 5th.-No special symptoms. 6th.-Frontal headache all d. 7th.- No symptoms. 8th.-Violent frontal headache all forenoon. Stools still pappy, and to-day considerable discharge of blood. Testicle more troublesome last 2 or 3 d. Took a second dose at n. N. very restless and dreamful. 9th.-Toothache in r. lower molars ; buzzing and singing in r. ear ; face eruptive after shaving. 10th.- Testicle still worse. Medicine omitted ; but on 12th violent headache. e. On 13th, took 5 dr. of a 1 to 5 sol. Pungent, garlicky taste; pressure in stomach and eructations of wind immediately after dose ; burning in stomach up through œsophagus in forenoon; much discharge of flatus; fine sticking burning pains in 1. spermatic cord, running deep into abdomen, returning e. in bed, n. good. Repeated dose on 4 successive m. 14th.-Immediately on waking at 5.30 a.m. was obliged to go to stool, and had a copious, thin, yellowish evacuation, with subsequent burning at anus. Pains as yesterday in 1. spermatic cord. 15th.-Same pains in cord and stitches in l. ear. 16th.-Same. 17th.-Violent stitches under middle of sternum, extending upwards, like lightning, soon after dose. 18th. " I notice, since I have been taking this drug, an extraordinary fulness and inflation in gastric region." 19th.-Violent lumbo-sacral pains on waking in m. Throbbing headache all d., aggravated by moving head. Great painful lassitude and weariness in soles after dinner. Very restless n. Stool with mucus and cherry-red blood. (N. Am. Journ. of Hom. , ii, 374.) 2. Dr. Jos. KNAP has a disposition to cerebral congestion, but had no head symptoms while making the proving.-March 20th, 2 dr. on sugar. Immediately ontongue first feeling of coldness, which soon changed to shooting-burning, after which a feeling remains like that after taking an acrid and astringent substance, e.g. pepper. On swallowing the medicine the same feeling in fauces. Soon after swal. lowing it, eructation of gas, with taste of medicine. At 8 a.m., 2 dr., which caused anagree agreeable warmth through whole stomach, and increased appetite. At 9 a.m., 2 dr., the peristaltic movements became more lively, rumbling, discharge of flatus, and urging tourinate. At 10 a.m., 2 dr., repetition of the same symptoms, especially theheat in pit of stomach,which spread up through the whole chest, the peristaltic movements and appetite increased, to which was added increased secretion of saliva. -24th, 6 a.m., took 4 dr., which caused the same sensations on tongue and fauces, but more severe ; warmth in stomach, eructation smelling of the medicine, rumbling in bowels, and discharge of flatus. 7 a.m., 5 dr., which caused increase of appetite, flow of saliva, increased activity of mental functions, urging to urinate. 8 a.m., 7 dr.; this caused increase of all the symptoms, and in h. heaviness of head.- 25th, 5 a.m. , 8 dr. caused warmth of stomach, eructation, rumbling in bowels and flatus . 6 a.m., 12 dr.; to the above symptoms were added an intense warmth, rising up through chest to head, and spreading around navel ; face, hands, especially palms, became warm, mental activity increased, appetite and saliva also. 7 a.m., 15 dr.; the warmth of stomach increased, and spread to hypogastrium, it was also increased in chest, face, and hands, slight pressure in stomach, slight tearing pain in bowels, and urging to urinate. 8 a.m., 20 dr., increased warmth, diminished appetite, metallic sulphurous taste, flow of saliva, disgusting eructations, frequent slight colicky pains, pressure in stomach, confusion of head, pressure in orbits, pulse quickened; thereafter the symptoms gradually declined, but all d. the head felt confused, and the teeth felt on edge. April 10th, 6 a.m., 3 dr., and at 10 a.m., 3 dr.; same symptoms.- 11th, 7 a.m. , 20 dr. caused the same symptoms. 8 a.m., 30 dr.; great increase of the warmth in stomach, which spread up and down, especially to face and palms, salivation, disgusting eructations, tearing in stomach and bowels, urging to urinate,

metallic taste, confusion of head, pressure in sinciput, orbits, and temples, pulse quickened. During whole proving the secretion of urine was increased. (Allg. Ztg. für Hom., ii, Suppl. 63.) 3. Dr. J. BUCHNER, æt. 30.-Dec. 20th, 8 a.m., 3 dr.; immediately pricking burning on tongue, irritation in buccal cavity and fauces, with feeling of narrowing of larynx, causing cough and retching with mucous expectoration, quickened respiration, eructations. After h. coldness of feet and general warmth of upper part of body. 10 a.m., abdomen distended, afterwards vertigo. Appetite and rumbling in bowels, taste impaired.-March 1st, 3 p.m., th dr.; some heat of cheeks for h., confusion of sinciput with feeling of contraction of hemispheres, fulness of stomach with eructations, gnawing and nausea; later the fulness spread all over epigastrium, vertigo. Sleep after midnight very disturbed, disagreeable dreams.-2nd, m., oth dr. After h. burning in soft palate, confusion of head and vertigo, aggravated by wine. Aug. 1st, 7 a.m.; 12th dr., fulness in chest, and dyspnea proceeding from r. anterior part of diaphragm, nausea, relieved byeructation, confusi confusion of head, vertigo in sinciput, tendency to fall forwards.-14th. th dr.; soon, burning in mouth, hot breath, dyspnea, with pressure on sternum; inward-pressure in temples, afterwards extending to crown. The oppression of chest increased in impure air and in the close room, with anxiety. Chest symptoms increased by going upstairs. Noon, hurried call to stool ; e., sensitiveness of anterior chest when sneezing.- 15th. th dr.; stickiness of saliva and desire for drink; congested state oflungs inupper lobe.- 18th.th dr.; hoarseness of larynx, and especially in its posterior wall, irritation to hawk or coughfor 36 h., afterwards irritation to cough at bifurcation ofbronchi ; eructation,abdomendistended, stool soft. After dinner,jerking-shooting pain along middle ofthigh, dr.;like noneuralgia, symptoms.for h. Afternoon, - 25th. th dr.;same heatpain between in larynx, tibia and irritation fibula.-21st. there, increased warmth of expired air, tension in sacrum, especially on going upstairs, with single jerks about hip-joint. During proving, relaxed condition of genitals. (Ibid. , 65.) 4. M. H-, æt. 24.-Nov. 19th. I dr., burning in œsophagus down to stomach, pupils somewhat dilated for a few m.-20th. I dr., burning in œsophagus, pupils somewhat dilated, pulse rose from 76 to 92 for 10 m.- 21st. I dr. , same symptoms, and frequently recurring slight stitches from r. elbow along extensors to wrist.-22nd. I dr. At 9 a.m. , formication from 1. elbow to tips of fingers; also throughout r. arm, as if it went to sleep. From 3 p.m. great drowsiness, and yet long of falling asleep at n.-23rd. No med., only the formication ofboth forearms, with slight prickings. -24th. I dr., momentary rush of blood, quickened pulse, headache, confused head, thinking difficult. After dinner pain in abdomen. 2 p.m., drowsiness commenced, then discharge of flatus, with itching in rectum ; long of falling asleep at n.-25th. No med., m. slight stitches in arms from shoulder-joint to wrist. Afternoon, great drowsiness .- 26th. 2 dr. , soon nausea, pressure, and cold feeling in stomach ; diarrhœa commenced in the n. (this she was accustomed to have every four to six weeks, lasting navel, about 1 to 2 which d.), of was yellow, frothy, sour-smelling retracted, and tenesmus.fluid, with colicky Afternoon, greatpains, especially drowsiness.- 27th. Pain and burning in throat and catarrh.- 28th. 1 dr., transient dilatation of pupils, quick pulse; dull frontal headache with nausea, weight of whole head, also drawing and tearing pains, going from forehead to temples, lasting all d., better in open air, worse in room, and when resting. Heaviness of eyelids, and dimness of vision. Sensation of a hair in fauces ; frequent sour eructation. Afternoon, great drowsiness, but long of going to sleep at n., sleep broken, vivid dreams. Disposition depressed and irritable.-29th. No more med., complained of chilliness, weakness, stopped nose, itching in head, dim vision, taste sweetish, putrid with sour eructations, frontal headache. No subsequent recurrence of her habitual periodical diarrhea. The previously regular menses came five days too soon. (Ibid., 67.) 5. Dr. HELD, æt. 27, subject to toothache, otherwise well.-Nov. 18th. Took 2 dr. The taste was disgusting, acrid, and scraping, causing burning in fauces, and along œsophagus; aft. 2 m. excitement of the whole body, which subsided in a few m.-19th . 2 dr. Immediately vertigo, increased rapidity of pulse ; after h. tearing frontal headache, lasting till afternoon, and spreading to temples . E., throbbing pain with burning in last 1. molar, lasting all n.; at n. a transient urging to urinate in fossa navicularis.-20th . I dr. caused a long-continued confusion of head, as from alcoholic drink ; pressure at insertion of temporal muscle, drowsiness, increase

oftoothache, with swelling around painful tooth, spreading to palate, with tension and itching in it, hindering chewing; frequent attacks of vertigo when sitting.- 21st. Swelling of gum abated; taste bitter-sweet.-22nd. Swelling nearly gone.- 23rd, 7 a.m., 1 dr. 9 a.m., slight headache, lasting 2 h. Low spirits, capricious. Afternoon, vertigo when sitting. Sleep restless, many dreams. -24th. I dr., taste bitter, somewhat sour; appetite increased ; thirst great, especially for beer; itching pressure on eyes, and with itching-burning there came on upper eyelid a small pustule, which itched much, much whitish-yellow mucus in eye. The pustule lasted 4d. Nose stopped up, ringing in ears lasting several d.; lips very dry, toothache returned, and was tearing and drawing, increased towards e., and only went off after midnight. Sleep came late, was restless, and often in n. had slight stitches from inner side of 1. knee to big toe. - 25th . I dr. After h. drawing from 1. hip to knee-joint, and feeling in knee as if it was dislocated. Very cross, tendency to furious rage. The toothache was the worst, it lasted all d. and n.-26th. No med., toothache persisted, but in slighter degree, eyelids itched much, also skin of back and both thighs ; this lasted 2 d. The toothache lasted till 29th. (Ibid. , 69.) 6. Anna G-, æt. 28, was treated for sore-throat, toothache, and swollen gums with C. sulph., and in 4 d. had nothing but slight swelling of gum remaining. As she was leaving for the country she thought she could not do better than take a lot ofthe medicine which had cured her, and she swallowed drachm. After 1 h. the doctor found her weeping and moaning in bed, forehead hot, pupils dilated, face swollen, red, angles of mouth twitching, rumbling in bowels. She complained of confusion of head, vertigo, burning and scraping all down œsophagus, increased secretion of saliva, constant sour eructation, feeling of warmth in chest, burning in scrobiculus cordis and stomach, rumbling and colicky tearing pain in belly. The worstwas the horrible burning in œsophagus and stomach; pulse 90 to 95. She was treatedwith opium and gum emulsion. The vertigo, burning, scraping subsided in 8 h., but she got violent diarrhea of sour-smelling fæces, with severe tenesmus. She got other treatment, and recovered in 3 d. (Ib (Ibid., 71.) 7. Dr. KÖNIGSHOFER, æt. 36, in good health.-March 14th, 6 a.m., took 10 dr., 2nd dil. After h. confusion of head, dull pain in forehead and temples, in r. temple a peculiar pressive pain, with slight nausea, and inclination to vomit, rumbling in bowels for 1 h. During d. transient stitches in rectum, pressive pain in gastric region, increased discharge of flatus. E., unusual sleepiness.- 15th, 6 a.m., 20 dr., only weariness and slight dyspnea noticed.-16th, 6 a.m., 30 dr. Soon, transient stitches in stomach; rumbling in bowels, empty eructation, dull shooting pain inhypogastrium when pressed.-18th, 6 a.m., 50 dr. Soon, confusion of head, dull pressure in forehead and temples, with drowsiness; scraping feeling, with fine pricking in throat; dry cough ; dull pressive pain ain in r. side of chest ; rumbling in bowels, drawing pain in 1. temple ; almost all d. pressive frontal pain, with occasional transient tearing pain in temples.- 19th, 6 a.m., 10 dr. of ist dil. During forenoon, drawing pain in r. sterno-cleido-mastoideus muscle; transient twitchingshooting pains in1. instep and r. wrist; dull pressive pain in l. heel ; scraping feeling in throat, causing cough ; nausea; pressive frontal headache; griping in small intestines, with discharge of flatus.-20th, 6 a.m., 20 dr. Soon inclination to vomit, pressure in stomach for a short while ; tearing pains in l. foot, especially tarsal bones ; tensive pain in r. hough when walking and extending leg; pain in abdomen when pressed; griping in bowels, followed and relieved by stool. Afternoon, fluctuating pain in both temples, especially when shaking head, and treading strongly. All d. flow of sweetish saliva; quivering ofeyelids.- 23rd, 6 a.m., 40 dr. Griping pain in umbilical region, with urging to stool, nausea and flow of saliva for 1 h.-26th, 6 a.m., 5 dr., 1st dec. dil. Soon, pepper-like burning on tip of tongue and in œsophagus, empty eructation. All d. dull pressive frontal headache.-27th, 6 a.m., 10 dr. No more symptoms. (Ibid. , 73.) 8. Mrs. KÖNIGSHOFER, æt. 26.-March 12th, 10 a.m., 10 dr., 2nd dil. After h. great confusion of head, tearing in l. temple, occasional dull pressure in fore. head down to eyes; drowsiness, with heaviness of upper eyelids, which felt like to close; great nausea and inclination to vomit ; eructation of air. After 1 h. vomiting ofbitter water. Sleep at n. disturbed by many disagreeable dreams, accompanied by weeping.-13th, 6 a. m., 15 dr. Confusion of head and pressive pain in sinciput.- 14th, 6 a.m., 25 dr. In forenoon, the pressive headache, with burning in borders of VOL . II . 3

eyelids. Two stools in rapid succession.- 15th, 35 dr. After breakfast, pain in abdomen, and belching up of breakfast without nausea. During forenoon frequent slight pressure in stomach, burning of borders of eyelids, confusion of head, slight pressive frontal headache, increased by reading and stooping; drawing pain in temples; sleep disturbed by dreams.- 16th, 6 a.m., 50 dr. After h. smarting in r. lower eyelid, burning of borders of lids, which are red. After h., pain in belly, discharge of flatus, stool with relief of pain. After 2 h., shooting in 1. ear, later, drawing pain in l. thigh when walking. After breakfast, pain in stomach, especially on breathing deep; abdomen painful to pressure,marked feeling of cold and chilliness fromwithin outwards ; cold feet. (These symptoms not unusual.) Afternoon, heat of face, especially cheeks. Alld. constant scraping, rough feeling in throat as it catarrh was coming on.- 19th, 6a.m., 10 dr. , 1st dil. Soon, uncomfortable feeling in stomach. Transient pain in r. temple when stooping ; headache when reading. (Ibid. , 75.) 9. L. M-, æt . 60, a strong healthy man.-March 19th, 7 a.m., took 10 dr., 2nd dil. No effect.-20th . 20 dr. The following n. tearing pain in r. elbow and 1. shoulder (where he had formerly often rheumatic pains).-21st. 30 dr., no effect.- 22nd, 7 a.m., 40 dr. Pain in abdomen as from a purgative.- 23rd. 50 dr., griping and rumbling in bowels as if diarrhea were coming on.- 26th, 2 a.m., 10 dr., 1st dil. No effect from this nor from 20 dr. , taken 24 h. later.-28th, 2 a.m., 30 dr. Inh. heat all over with slight headache and hard pulse ; cramp in calves and toes (accustomed to cramp after fatigue). 5 a.m., the heat went off, and he fell asleep.-29th, 2 a.m., 35 dr. Same sort of attack, but milder; after a good sleep woke quite well. (Ibid. , 77.) 10. Dr. PRIMBS.-April 7th, m., 3ss of4th dil. Fulness in stomach,pressureunder sternum, hoarseness for 2 h., slight pressive pain in forehead, pressure in r. parietal bone ; pressive pain in l. forearm on touching or leaning on it, pain in l. wrist-joint. -9th, m., 3ss of 1stdil. Slight frontal pain,which soon spread to 1. parietal bone, and lasted there 2 h., pressure under sternum and in stomach.- 10th, m., on rising, slight pressive headache, soon going off.-11th, 9 a.m., 1 dr. of pure C. sulph. Eructation with taste of medicine ; burning pain in gullet; after a few m. slight transient pain in forehead, gradually spreading to 1. temple; pressive pain in temples ; heat in head and face. After dinner, single stitches in r. ear, recurring at intervals of h., pressive frontal pain with hot feeling for 2 h., lacrymation when reading; towards e. the stitches in r. ear increased and lasted nearly h. , eructation. -12th . On waking, slight pain in forehead, soon going off.-13th, 9 a.m., 3 dr. Eructation with nausea, pressive pain in forehead, from frontal protuberance to 1. temple, with occasional tearing in that direction; pressure and heat in 1. eyeball ; burning in gullet and root of tongue, prickling on tip of tongue; increased flow of saliva, burning feeling in stomach increased by pressure, slight colicky pains; going to sleep of 1. arm, with pain and weariness in it. After dinner, which was relished, diarrhœa suddenly came on, repeated twice during the afternoon with colicky pain. E., the headache returned ; shooting in r. ear; very excited at n., strong erections with burning in urethra.- 14th. Slight headache ; weariness of whole body, especially of 1, arm, going off at noon.-16th, 9 a.m., 5 dr. Violent burning in gullet; nausea, eructations, and inclination to vomit; great increase of saliva and metallic taste, chilly feeling, urging to stool, slight pains in forehead, occasional burning in 1. side of chest and under sternum, trembling and shooting in l. forearm, especially in wrist, pressive pain in r. ear repeatedly, as ifa blunt instrument were roughly struck against drum-head; twice watery diarrhea, pain under sternum increased at Is a.m. Pain in r. ear persistent; burning in stomach andihepatic region increased by pressure ; hot feeling in forehead with moderate pressive pain and desire to stroke the forehead with hand; pressure in eyes, shooting in 1. temple, extending to occiput ; burning and scraping in fauces and œsophagus, shooting in l. wrist; constrictive feeling in stomach, and yet good appetite. Afternoon,tearing pain in r. knee and ankle-joint; pressive pain in l. forearm, increased by pressure, lasting h.; slight pressive pain in forehead ; distension of abdomen, with sore feeling ; 2 watery stools ; drawing pain in l. lower jaw; pressure under sternum; urging to stool; tearing and pressure in sacrum. Excitement at n., erection and emission.-17th. Slight frontal pain, occasional shooting in 1. half of thorax, feeling of fulness in stomach, which is sensitive to pressure ; sore feeling in walls of abdomen ; watery diarrhea. Afternoon, drawing in sacrum ; burning and itching in anus ; feeling of fulness ; single stitches

in r. ear; mucous diarrhea, erections; very restless n., frequent waking, alternating with dreams.- 18th. Confusion of head, occasional pressivepain in r. arm; mucous diarrhoœa; occasional shooting in r. ear.-19th. All symptoms gone.-20th. 6 dr., immediately eructation, burning on tongue, slight frontal pain. (Ibid, 78.) 11. Dr. PEMERL, æt. 36. Except tendency to chest congestion, well. -March Ioth, 7.30 a.m., 1 dr. No effect.- 11th, 7 am , 5 dr. of solution of 10 parts of C. sulph. in 90 parts alcohol. Prickling in tip of nose, like inclination to sneeze; after h. rumbling in belly like flatulence. After h. single fine tearings from r. side of middle abdomen towards bladder, itching pricking in various parts of skin. After h. on small spots on inner side ofupper arm and thigh, intermittent dull shooting pain (painful twitching of some muscular fibres). After 3 h. slight attacks ofnausea, dull shooting in proximal joint of l. index; after 3 h., tearing in abdomen frequently recurring till dinner-time ; dull jerking-shooting in lower r. side of chest. Similar jerking-shooting pains occur occasionally in r. hough, and in hypogastrium towards spermatic cord till dinner-time. After 5 h. a dry stool.-12th, 6.30 a.m., 10 dr. After 2 h. dull jerking-shooting pain in cæcum, lasting 1 to 2 m. After 3 h. slight nausea. After 4 h. nausea with flow of saliva. After 5 h. stool.- 13th. Hunger, and yet dislike to eat.- 14th. 15 dr. of 1st dil. Soon, slight attack of jerking pricking pain in a small spot on inner side of r. arm. After coffee, slight shooting inhypogastrium, followed by semifluid broken-up stool ; soon afterwards shooting without stool. After 2 h. slight shooting in a carious upper tooth onr. side. After 3 h. similar shooting in a sound lower r. molar. After 3 h. watery stool. After 34 h. nausea with flow of saliva lasting some m., and frequently returning till after dinner. After 4 h. fine itching pricking repeatedly in various parts ofskin ; jerkingshooting pain in last phalanx of 1. 4th finger, frequently recurring during d.; slight cutting inhypogastrium, stooping and laying arm over abdomen are disagreeable, the first causes nausea, the last bellyache ; a violently itching wheal (like nettle-rash) on back of r. forearm, making him scratch; single pricks in ear. After 5 h. hunger, but distaste for food, which, however, tasted well. After 5 h. jerking-shooting pain in l. testicle for 2 m. After 8 h. boring in r. ear. After 9 to 11 h. pain in the insertion of tendo Achillis to heel when going upstairs. After 11 h. jerking in elbow.-14th. The itching pricking in various parts of skin occasionally. Soon after breakfast soft pappy stool preceded by cutting in belly; the itching-pricking pains in various parts frequently recurred, especially on tuberosity of r. ischium, and the insertion of gracilis and sartorius muscles in hough.- 15th. 20 dr. Several discrete papulæ on r. forearm, itching when touched. After 2 h. nausea and uncomfortable rumbling in hypogastrium ; great distraction, difficulty of comprehending what he reads; soft mucus hawked up ; itching pricks in r. nipple ; cutting about navel and slight nausea 1 h. after dinner; dull shooting or itching pains in various parts alld.; little appetite. E., scanty soft stool passed with difficulty.-16th, m., inbeddull stitches in cæcal region with discharge of flatus; itching in calves and legs; single stitches in r. eye. After 1 h. at first firm, then liquid stool, with burning in anus; 3 h. later a fæculent stool, followed by burning in anus. When going to bed itching on thighs.-17th, 5 a.m., in bed, the peculiar itching-pricking painin external tendons of 1. hough lasting a few m. 6 a.m., the former pain in cæcum, going off by discharge of flatus. Itching in bend of r. elbow above and below it, and in thighs. Alld. single transient stitches on chest and under 1. short ribs. 9 a.m., scraping rough pain (as from a foreign body) in 1. side of throat extending to 1. ear when swallowing, lasting I to 2 m. Between 9 and 10 a.m., two stools, the first soft and lumpy, the last liquid. All d. occasional itching and itchingpricking in various parts of body.-18th. Many dreams towards m. On waking itching in both thighs, r. side ofback up to renal region, and r. forearm, making him scratch ; there came there small colourless papules, which itched more when scratched, became red and formed an itch-like eruption; they bled and burned when scratched. 9 a.m., jerking-shooting pain, first in the r. then in the 1. hypochondrium, for a few m., burning acrid sour eructations after dinner. Slight itching-pricking pain on r. side under navel, followed by semi-fluid stool. Itching-shooting pain in r. sternocleido-mastoideus muscle. Voice rather hoarse.-19th, m., in bed slight itching in same places. 7.15a.m., 20 dr., 1st dil. Jerking-shooting pain in r. shoulder-joint. After 1 h. burning sour eructation, pricking in various parts of body. After 3 h. uneasiness in hypogastrium with nausea, increased by stooping and moving. Insuffi.

cient liquid stool after cutting in abdomen. Distraction, cannot take in what he reads ; flow of saliva and nausea frequently; diminished appetite ; after eating slight cutting in abdomen; jerking-shooting in rectus superior muscle of r. eye. After 5 h. fine jerking stitches in 1. ear. All afternoon malaise, nausea with slight colic, disgust at beer.-20th. On waking at 6 a.m. dull drawing-shooting toothache in a carious upper molar and the corresponding lower molar, till he got up. Pinching in bowels with discharge of flatus. The former pain in hough, not lasting long. After rising and washing itching on belly and r. shoulder ; single obtuse stitches in r. eye when reading ; nose rather stuffed. 9 a.m., jerking-shooting pain in the carious tooth; discomfort in abdomen and slight nausea, followed by soft fæculent stool ; discomfort returns after stool. Jerking stitches on various parts of body. Nausea increased by the pressure on abdomen whilst sitting and writing, relieved by open air; disagreeable cold feeling in both cheeks during the abdominal symptoms ; disagreeable painful feeling in left lobe of liver in fits ; flow of saliva ; unsatisfactory belching ; hunger, but dislike to food. These symptoms removed in open air and after eating. 5 p.m., pressive-shooting sensation in last r. ribs, about 4 fingers' breadths from scrobiculus.- 21st, 4 a.m., after waking cutting pains in abdomen, with rising up, as from displacement of flatulence, increased by inspiration and pressure to shooting pain, andbecoming settled in cæcum, lasting 1 h.; turning from one side to the other, and bending body together, increased the pain, or made the former pain return. 6 a.m., cutting pains rising up and recurring in fits near scrobiculus in region of r. false ribs. Itching and pricking in various parts of head all forenoon.- 22nd, 10 a.m., a soft insufficient stool. During d. frequent pinching stitches in r. side of abdomen; jerking stitches in various parts of body, especially muscles of r. eye ; some pain in 1. orbicularis oculi muscle towards its outer canthus, especially when moving lids.- 23rd. Last e. andduring n. jerking-shooting pain in tendonofbiceps infor forearms coming and going in fits; reminiscence of yesterday's symptoms in hypochondria and abdomen, last n. and this m. 8 a.m., slight sour eructation 1 h. after coffee. Jerking shooting in muscles of r. eye in fits and alternately. 11 a.m. , two small loose stools, preceded by shooting pain in l. lobe of liver, and followed by shooting pain in cæcum.-24th. On waking, m., some flatulent symptoms ; observed some sore pimples among hair. Since 11 a.m. after sitting some time recurrence of flatulent symptoms in hypochondrium, and occasional jerkingshooting pains in 1. deltoid and both houghs at insertion of sartorius and gracilis, also in r. tuberosity of ischium.-26th, 7 a.m., 30 dr. Eructations of air as after eating radishes. Prickly nipping in 1. hypogastrium. Cloudy sight. 7.30 a.m., roughness in throat, hoarse voice, sneezing, prickly twitching in 1. hypochondrium. Jerking stitches at insertion of tendo Achillis in heel; mucus expectorated has a salt taste. 8.30, after coffee discomfort in abdomen, much hawking with inclination to vomit, sneezing and traces of blood in nasal mucus. ro a.m., nasty pappy taste, scraping in throat. Head confused, distraction, violent cramp in r. sole, frequent inodorous eructations of air with burning in scrobiculus. Stool at first firm, then loose, followedby feeling as if more were to come. Nausea and flow ofsaliva ; itching pricks in various parts. After supper severe cutting in bowels with hurried call to stool.- 27th. Some jerking stitches in ball of r. toe ; rough and scrapy in throat, rough hoarse voice; pinching-shooting in cæcum, constipation.-28th-31st. Similar symptoms, but slighter.-April 3rd, 6.30 a.m., 10 dr., 3rd dec. dil. 7 to 8 a.m., scrapy rough feeling in fauces; jerking stitches in various parts of skin, fits of pinching jerking on a small spot to r. of navel in attacks of m. duration; empty eructation, itching on a small spot on r. forearm, where later some papules appeared ; when driving pain in tuberosity of r. ischium and along flexor aspect of leg. Ε., unsatisfactory hard stool with straining. -4th, 8 a.m., the pain in r. hypochondrium returned. 9 a.m., jerking-shooting pain in r. lumbar region for 1 m. 10 a.m., slight cutting in abdomen. Loose stool. 11 a.m., jerking-shooting pain in cæcum.-5th, 7 a.m., 36 dr. Prickling-jerking in various parts of skin, jerking-shooting in middle of r. thigh, in metacarpal joint of index and in ball of r. big toe. 11 a.m., discom. fort in epigastrium, with flow of saliva and slight nausea ; jerking-shooting in various finger-joints.- 6th. After coffee transient stitches at 1. of sternum. 7 p.m., jerking stitches in r. lumbar and 1. thumb-joint; great itching in 1. hip and pelvic region.- 7th. Itching in various parts, jerking stitches in upper arm and shoulder-joint. Cross humour. The itching and jerking-shooting pains lasted several days longer. (Ibid., 8 r .)

1. Dr. MOSER, Aug. 2nd, 6 a.m., 10 dr. Ist dil. Disagreeable feeling in stomach with nausea, frequent eructation of air. During d. much flatulence and discharge of flatus.-3rd. 20 dr., same symptoms.-4th. 20 dr., discomfort, empty feelingg in stomach, eructation of air, inclination to vomit on coming into a room or going thence into open air.-5th. 50 dr., nausea and inclination to vomit, confusion ofhead, loose stool. Alld. pressure on forehead and dull pain there ; great pressure on eyes.-6th. 50 dr., inclination to vomit, eructation, pressure on eyes, confused head, weariness and prostration, and in ankles pain as after a long walk.-7th. 50 dr. same symptoms.-8th and 9th, I dr. tinct. Same symptoms.-roth. 5 dr., nausea to faintness, inclination to vomit, great drowsiness all d., confusion of head, and slight painful pressure and digging in forehead. E., great drowsiness and dizziness inhead, pressure on eyes and want to shut them. Pappy taste, pressure in stomach, stitches in abdomen here and there. All d. sleepy, but restless sleep at n.; head heavy, cannot liestill for long. Transient jerking pain occasionally in ankle-joints. Took no more medicine till 16th, and duringthat time had hot skin ; it burnt inmany places as from nettles, dry and hot skin kept him awake at n.-16th and 17th. 8 dr., no new symptoms.- 18th . 10 dr. , eructation of air, head confused, stitches here and there in forehead and often a transient twitching pain there, pappy taste, anorexia, yawning, legs weary, burning and tingling pain injoints of feet. From 3rd d. had for several weeks jerking pain in wrist-joints which only lasted a few seconds, but recurred frequently duringd. For several weeks the jerking pains were felt in the forehead and leg and arm-joints. Head heavy and confused, sleep restless, with constant turning about in bed. Skin dry for weeks, perspiration suppressed, appetite diminished; distension of abdomen after eating; soon satiated; disinclined for all work, drowsiness when working and pressure on eyes. Weariness and prostration of whole 13.body. (Ibid. , 90.) M. QUAGLIO, medical student, æt. 21, took 2 dr. on sugar. This caused only burning on tongue and pharynx, followed by eructation and flatulence. 3 dr. caused greatburninginlips and tongue ; eructation; irritation to cough, feeling as if about to vomit and flatulence. 4dr. caused great burning in lips and tongue with flatulence. 2dr. of 1st dec. dil. caused weariness of lower extremities, drawing and pain in kneejoint, malodorous flatus. (Ibid. , 92.) II. Poisonings.-1. W. G-, æt. 33, was admitted at 6 p.m. apparently suffering from narcotic poisoning. (He was subsequently found to have swallowed about zij ofC. sulph.) He lay with all muscles relaxed ; face pale, and covered with clammy sweat; lips blue, and moist with salivaand frothy mucus; eyelids closed; conjunctiva slightly sensitive to touch; pupils dilated and insensible to light. Breathing deep and laborious, almost stertorous; pulse 100, regular, but very weak. Patient had vomited ; seemed very sleepy, and could only with difficulty be made to move hands ; whenpinched inside thigh he did not speak, but whenstomach pump was passeddown œsophagus he made a noise and struggled. Warm water was injected into stomach but immediately vomited. Bowels were evacuated ; motions of light colour and solid consistence. At 7 patient was placed in bed, where he had a shivering fit ; feet, arms, and legs felt cold to touch, and face became paler, followed by perspiration and return of colour. This only lasted 3 or 4 m. Hot bottles were applied. After this, on shaking him well,he opened eyes and said that he had taken some stuff to do away with himself, and again lapsed into sleep with heavy breathing. Was given repeated doses ofmucilage, vomiting always after it ; in intervals sleeping as before. At 8 another shivering like last. At 10, after much vomiting, clearer, does not want to sleep, no pain, but some giddiness. Pulse stronger, 100 ; temp. 101° ; resp. 20. During n. complained ofburning pain in throat and stomach, and next m. ofslight headache, conjunctivæ congested; pupils less dilated ; tongue furred white; pulse 100 ; temp. 9999°. Headache and giddiness gradually passed assed off during next 4 d., and patient 2. Ileft hospitalwell. have breathed (Med. vapour andTimes and Gaz., exhibited it to 1878, aboutii,20350.) other persons, and it is certainly a very rapid and powerful anæsthetic. One or two stated that they found it evenmore pleasant than chloroform ; but in several it produced depressing and disagreeable visions, and was followed for some h. by headache and giddiness even when givenonly in small doses. When given in one case for removal of tumour of breast, patient was restless during latter part of operation, but felt nothing. Like several others,while under it her eyes remained wide open. After operation she was extremely

sick, with much and long-continned headache, and for 50-60 h. subsequently her pulse was high and rapid, without rigor or other symptoms of fever. It was also givenin a case of midwiferyat intervals during h. Patientwas easily brought under its influence ; but it was found impossible to produce by it the continuous sleep attending the use of chloroform. When given as a pain threatened or commenced it immediately affected the power of the uterine contractions so as oftento suspend them ; but the state of anæsthesia generally passed off in 1 or 2 m. During its use she was occasionally sick and vomited several times. Latterly, her respiration became rapid, and the pulse rose extremely high. (SIMPSON, Monthly Fourn. ofMed. Sc., 1848 ,viii, 740.) 3. T. WILSON, æt. 38, in good health, was exposed on e. of April 14th, 1857, to vapours in small room for h. Next d., in afternoon,paincommenced suddenly in r. lower eyelid as if bruised, soon extending to upper, over lachrymal gland ; globe ofeye underneath has same sensation ; pains all aggravated by movement or pressure These ; lids feel as if swollen, but are not so ; some redness ; humming noise in l. ear. feelings quite strange tohim. 16th.-Same portionoflower lidto-dayquite inflamed. 17th. Since yesterday continued humming in l. earextending to back of head; stye forming on lid. 18th.-Humming as of distant wind ; when talking obliged to raise voice because of its loudness ; in e, and n. always sense of fulness at back of head, with humming there, all gone in m. Punctured stye ; has been drowsyd. and n. since exposure to vapour. Yesterday afterdinner, and to-day duringdinner, 1. ear feelsdeaf as if obstructed by thick substance. 19th .-Noise continues, worse after food ; 1. ear rather deaf and feels obstructed. Eyelid discharges thick yellow pus. 20th.- Noise not quite so loud ; vertigo this m. at back of head ; severe cough since yesterday, with soreness of chest, this m. expectoration ofthick mucus. 22nd.-Cough continuous, but not so severe ; to-day thick coryza, with lachrymation and headache. Noise in ear much less. 27th.-No noise to-day, save a little before rising, and no deafness ; still coryza in m. 30th .-Return of noise, like gusts of wind through hollow tube ; coryza continues, herpetic eruption on upper lip. Catarrh now gradually declined, but tinnitus continued, varying and intermitting, for months. Another stye formed on lid May 28th. (Brit. Journ. ofHom., xvii, 274.) 4. a. Victor D-, æt. 27, in good health, began in 1853 to work at dissolving india-rubber in sulphide of carbon and employing solution for repairs. For 3 mo. he suffered only from violent headache; after that he was seized with general malaise and intense vertigo, so as after a few h. to be obliged to relinquish work. His hearing became affected, and in a week he was so deaf that persons were obliged to shout into his ear to make him hear ; this deafness disappeared spontaneously after a time. His memory became so weak that he forgot every minute where were the tools he hadjust used. His temper also became very changeable ; sometimes he was excessively lively, and sometimes angered by the most trifling circumstances, so that he would break everything near him. He slept with difficulty, if at all; and often awoke suddenly from frightful dreams with convulsive starts, rigors, heats, and profuse perspirations. Even during d. he was at times icy cold for h., feeling afterwards as if over-tired or bruised all over. He had severe fits of colic, frequent indigestion, nausea, vomiting of greenish matters several times in d., and transient fœtid diarrhea alteruating with constipation. Appetite was lost, mouth pasty, expectoration frequent. He became so weak he was obliged to sit at his work, to use a stick in walking, and to rest at each step in going upstairs. This debility, which affected both upper and lower limbs, was accompanied by cramps in muscles of hands, depriving him, while they lasted, of the use of his fingers. Sexual appetite and power were completely abolished. b. His wife, whenshe had remained for some time with him in his workroom , was seized with headache and muscular debility ; she fell into a state analogous to his own, but much less severe. Their young child, after passing 3 d. in the workroom, was seized with a kind of furious delirium, and rushed on his father to bite him. c. In March, 1854, V. D- entered the Bicêtre. He was thin and pale, and his breath smelt strongly of the sulphide. He could walk only with a stick, and had pain in limbs, which were much diminished in size, especially in the muscular parts. He resembled a man under the influence of lead, the hands hanging prone, from weakness of the extensor muscles; the flexors, however, were also weakened. Muscular contraction was feeble and tremulous, and fibrillary quivering was readily induced. Sensibility and electrical contractility were normal ; and the intelligence was clear.

There was an intermittent but very distinct bruit de soufflet in the cervical vessels, as might have been anticipated from the general weakness and pallor. There was no organic disease in the chest, but he had frequent short cough. d. Treatment had little effect, but residence in country improved him much, solar light and heat being found specially beneficial for the pains in the limbs. In following January, being much better, he returned to work. Impotence, however, had remained absolute ; and anæmia and even thinness persisted. Headaches soon returned, and patient, seized with vertigo, was frequently obliged to leave work abruptly, and wander about, hardly knowing what he did. He was also subject to fits of terror without justifying cause. (DELPECH, Mém. surles accidents chez les ouvriers en caoutchouc, &c. , 1856.) 5. The following is a summary of 24 cases observed by Delpech, occurring under similar circumstances : " The workpeople may live for weeks or evenmonths in the poisonous atmosphere before the severe symptoms occur, but, as arule, theyexperience some inconvenience the first time they remain long in the bad air. The attacks repeat themselves daily and gradually get worse and worse. The chief thing is an intensea feeling with oppressive headache,and ofgiddiness spreading from the root of intoxication, of the the of which noseworkpeople towards bothcomplain temples, when they go home in thee. In several cases it was noted that a more or less marked excitement now showed itself. These people became remarkably lively, chatty, and excitable, and their sexual passions were greatly excited; sometimes their appetite for food became insatiable. This stage of excitement, however, is not only often absent, but almost always intermingled with many symptoms of depression. All, without exception, complained very quickly ofan evident loss of muscular strength. In later stages,many were troubled with remarkable loss ofmemory. They fell into a deep apathy, could not think, strove in vain tor the words they wanted, and spoke with a stammering and almost paralysed tongue. Their mental condition was strikingly obtuse, the energy of the will greatly depressed. With this were associated many anomalous symptoms in the sensory and motor spheres. The faculty ofvision declined, beginning with a slight obscuration ofthe field of sight and going on to complete inability to recognise small objects. Hearing also was greatly impaired, and a great many complained also of a persistent and troublesome ringing in the ears. The loss ofmuscular power was generally most noticeable in the extremities, and in the severer cases there was a considerable amount of paresis so that the patients could only walk with the help of crutches or sticks. All movement was accompanied with a feeling offatigue. As regards sensation, there were severe lancinating pains in various groups ofmuscles, increased by pressure; formication ; anesthesia of the soles; and almost constant complaints of a feeling oficy coldness in the whole lower half of the body. Cramps and fibrillary contractions of various muscles and muscular groups were very seldom absent. Severe cramp in the calves commonlyharassed the patient during the n.; "and several b. In epileptiform the domain convulsions of what are occurred called the in several vegetative cases.the anomalies are less functions uniform. Apart from the rarer cases in which the appetite is enormous, digestion is always more or less impaired. A good many suffer from vomitings, others from severe and very frequent attacks ofcolic. Inthe early stages of the poisoning, diarrhœa and constipation alternate with each other; in the later stages, the latter predominates, and is generally associated with troublesome flatulence. The urine is generally innormal quantity, and contains neither albumen nor sugar, but is passed with a painful sensation of scalding. The organs of circulation and respiration exhibit no special alteration in their action. The sexual passion, which is increased at first, rapidly declines at a later stage, and finally, there is complete psychical and physical impotence, with decrease of the size of the testicles. In women who work long inthe india-rubber factories,menstruation always takes place prematurely, and ismore profuse thanit should be. They never have a child, and their sexual appetite becomes entirely lost. Youths who are exposed during pubescence to the influence of the poisonous gas, never develop properly. "c. As regards the general condition of those poisoned, it has been noticed that a good many suffer from a febrile movement at n. Sleep is disturbed with bad dreams, generally associated with nightmare, and sometimes prevented by pains and cramps in he muscles. When the poisoning is protracted, the patients lose a good deal of flesh, but no special atrophy of muscles has been met with.

"d. A fatal termination is rare, but so also is complete restoration to health . The nervous system continues depressed, and in some cases a definite psychosis supervenes." (ВОЕHM, Ziemssen's Cyclopædia, xvii.) 6. The following is the Report of Committee appointed to investigate the action of the vapours of bisulphide of carbon and chloride of sulphur on sight and health. Amixture of chloride of sulph. and bisulph, ofcarb, is used in rubber factories and gives off much vapour. The two substances act in the same way ; if anything the bisulph. is most powerful. The earliest and most constant symptom is a severe heavy pain in forehead or temples, the head feeling as it compressed in a vice or supporting a heavy weight. The earliest symptoms of the stage of exaltation are loquacity, vertigo, feeling of drunkenness on going from shop to open air. Temper irritable, spirits variable, hilarity alternating with dejection. Appetite enormously increased, often excessive sexual excitement. Objects seem veiled in a mist, this sometimes relieved by taking food. Some who had vertigo complained ofconstantly seeing an open hole closetothem into which they were afraid offalling. Hearing impaired. General hyper. æsthesia of integument sometimes. In the stage of depression, appetite fails, insomnia and sleep disturbed by distressing dreams, spirits dejected, indifferent to surrounding circumstances. Memory fails, shown by forgetfulness of words when talking. The hyperæsthesia of skin is replaced by loss of sensation in limbs, often reaching to groin and deltoids-not affecting trunk. Paintul cramps, muscular weakness, especially of lower limbs, loss of sexual desire, sometimes complete anaphrodisia. Fingers seem stiff, awkward and numb. Appearance offog before eyes and dimness, most observed in daylight. Pupils dilated but active. In some there is pallor of discs and even loss of definition of margins. These symptoms increase in severity if patients remain at work, the loss of memory becomes absolute, the muscular weakness so great patient cannot stand without support. Improvementit commences when patient is removed, but is slow. The most intractable symptoms were the anaphrodisia and weakness of lower limbs. (Trans. ofOphthal. Soc. of U. K. , V, 157. 1885.) " 7. James W. M-, æt. 20, had worked for 10 months in " casing room of an india-rubber factory, exposed to vapour from bisul. carb., 32 parts, chloride of sulph ., I part, for 4 or 5 h. daily. After 3 or 4 months health began to fail, weakness of limbs and nausea. Headache as if head opened and shut, once free epistaxis, numb ness . Three weeks before admission to hospital found when riding on omnibus could not see people on pavement. Next d. could only read with difficulty, since then sight became worse. V. with each eye separately 70, reads 12 J. badly at6", not improved byglasses, can distinguish blue and yellow but not red and green. No medicine, only constant current employed. After 2 months sight improved and could recognise red and green. Had ill-defined scotoma for red a little to the outer side of centre in each field. (NETTLESHIP, Ibid., v, 149.) 8. Elizabeth M-, æt. 23, had worked for several years in rubber factory exposed to fumes of bisulph. carb. She grew weak in limbs, especially legs, coldness and formication. Headache and giddiness and anorexia. Admitted 30th July. For 6 weeks could not read. V. of R. = fingers at 2 in. (about ) and of L. = fingers at 4 in. ( ), pupils medium size and sluggish . Slight neuritis in each eye. Optic disc pale and hazy, the haze extending a disc's breadth into retina, veins engorged, arteries too small. Central scotoma for red, not for white-besides this she had atrophy of thenar eminence of thumbs and interossei muscles. (FUCHS , Ibid. , 152.) III. Experiments on animals.- 1. According to Hermann's and Hirt's experiments, which we ourselves have lately repeated with similar results, bisulphide of carbon acts upon frogs just like chloroform, ether, and alcohol, by simply paralysing them. The experiments also of Delpech, Cloez, and Hirt on mammals do not exhibit any remarkable difference between the action of bisulphide of carbon and that of other volatile anæsthetics. (ВОЕНм, loc. cit.) 2. A rabbit, placed under a bell-jar with some bisulphide, was affected with incomplete paralysis ofmotion. The paralysis, more marked in the posterior than in the anterior extremities, was preceded by violent convulsive movements. Sensibility was retained. On withdrawal, it had completely regained its health at end of 24 h. Again exposed to vapour, it had some convulsive movements; incomplete paralysis, more marked on r. than on 1. side; respiration became very slow, pulse disappeared completely, and the animal died, after screaming out most piercingly. On dissection, brainwas found soft; lungs very pale, an ecchymosed spot at 1. base; heart, especi.

ally r., gorged with firmly coagulated blood, without fibrinous transformation, but adherent at some points ; liver congested; gastric mucous membrane in great cul-desac presented a great number of ecchymosed spots, having exactly the appearance of purpura. * Urine contained no albumen, but was coloured red-brown by potash and caustic lime. (DELPECH, op. cit.) 3. a. Two young dogs had respectively 15 and 30 min. of the bisulphide given internally. There was no anæsthesia, but distressing tenesmus, with considerable prolapsus, protruding membrane excessively red and covered with mucus. b. Two young cats had respectively 5 and 10 min. The symptoms were exactly the same as in the dogs, save that in the one which had the larger dose the prolapsus was very considerable, and the tenesmus most excessive. The next m., 16 h. after, at least 2 in. of entire circle ofgut was protruding, as congested as possible, with constant tenesmus and great contraction of abdominal muscles. (NUNNELEY, Trans. of Prov. Med. and Surg. Ass., xvi, 1849.)

Volume II — Appendix

Carboneum sulphuratum.-(Additional poisonings.) 9. J. N-, æt. 24, was admitted to the Manchester Royal Infirmary on May 5th, 1886, under the care of Dr. Ross. a. Previoushistory.-The patient is an unmarried man, and never suffered from any serious disease up to the date of his present illness. He has always been well clothed and fed, has never indulged in any alcoholic excesses, and has for a considerable time before admission been a total abstainer. He has never been infected with syphilis. The patient is of Irish extraction,but has lived in Salford for the last eleven years. During the greater part of the time he has been in this country he was employed in a calico-printing works; but being out of work about eight months ago, he obtained atemporary engagement in anindia-rubber factory. In his new situation he was employed in the "curing room," where he inhaled the fumes givenoff from certain chemicals used in the process of manufacturing, and said to consist chiefly ofbisulphide of carbon. After working for a few weeks in this place the patient suffered from a bu burning sensation in the hands and face,and these were also hot to the touch and of a red colour. He found, however, that when he put his hands in cold water they immediately turned of a livid colour, and became cold and numb as if they were dead, or, as the patient at another time expressed it, " they looked justas iftheyhad beenfrost-bitten." In consequence ofthe effect cold waterhad upon hishands, and to a less extentupon his face,he was obliged to wash himself in warm water. On getting home at night he suffered from a fidgety and restless feeling, which prevented him from being able to sit still for more than a few moments at a time. After working for a few weeks longer the patient experienced tingling sensa. tions and numbness in his feet and hands, his legs began to feel heavyand feeble, and he noticed a considerable degree ofweakness atboth wrists. He continued,however, at his work for some weeks longer, but owing to the progressively increasing weakness of his limbs he was at last obliged to desist. The patient now rested for two or three weeks, and during this time made a rapid, and, he believes, a complete recovery, and then returned to his old work in the " curing room." He was, however, not many weeks at work before he felt the old uncomfortable sensation in the hands and feet,while the weakness soon became much greater than it had previously been. He now experienced the greatestdifficulty inwalking, and couldscarcely hold anything in hishands, which,besides being feeble, trembled a good deal, more especially when he attempted to grasp anything. The senses ofsight and hearing remained unaffected, but everything seemed to smell ofthe vapours of the factory even when he was away from his work, and his food seemed either to be tasteless or to taste only of the gas. The patient loathed the sight of food; he lost astone in weight, and observed that the wasting of his legs and arms was out ofall proportion to that ofthe rest of his body. On leaving his work in the e. he often * For these corrections we are indebted to Dr. Berridge's paper in Hom. Phys. for Jan., 1887. As regards the omissions he notes, we venture to think that we have given an amply sufficient series of observations for illustrating the action of thedrug.

walked like a drunken person, and talked a good deal of nonsense, He had at all times a stupid feeling, and his memory failed almost completely, while at n. he was restless andhis sleep was disturbed byhorriddreams. Inthe m. he feltthoroughly miserable and depressed, and was glad to get back to his work, as inhaling the gas brought some relief, at first at least, to his feeling of wretchedness. The patient at last got so feeble that he could scarcely walk at all, and for the last four weeks he ceased to go to his work. He,however, got a temporary engagement at atarpaulin manufactory, but he soon found that he was unable to do the work owing to the weakness of his hands. b. Present condition.-The patient is a tall and fairly well-nourished man,but the muscular masses of the extremities are considerably wasted, the emaciation being specially marked in the muscles of the legs and those of the forearms. When the forearms are held out horizontally in the prone position the patient experiences con. siderable difficulty in maintaining the hands extended on the forearms and the fingers at the metacarpo-phalangeal articulations, while the slightest pressure on the backs of the hands overcomes the contractions of the extensors and causes flexion at the wrist. When he grasps any object the hand becomes bent forwards on the forearm, and the greater the effort the patient makes to compress the object the more pronounced does the flexion at the wrist become,thus showing a predominance in the strength of the flexors over that ofthe extensors. The triceps muscle is flabby and wasted, and only acts feebly in extending the forearm against resistance. The supinator longus, the flexors of the arms, and the shoulder-muscles are comparatively unaffected. The patient can only extend the small toes very feebly atthe metatarsophalangeal joints, and whenheis sitting on a chair with his feet flat on the ground he isunable to raise the ball of either foot. When sitting on a table with the legs pendulous the toesdrop so that the backs of the feet are almost in a line with the anterior surfaces of the legs, or only form very obtuse angles with them. On being seated on achair the patient canwith considerable effort extend the leg on the thigh and raise the heel from the ground,but the slightest pressure on the leg, the thigh being supported, causes flexion at the knee-joint. The patient can draw the knees together with considerable force by the action of the adductors of the thighs, but separationofthem is only effected in afeeble manner by the abductors. Flexion oftheleg onthe thigh is performed with great power, but the patient experiences considerabledifficutty in attaining the erect posture,having to assist himselfwith his arms either by holding some article of furniture, or by grasping his thighs and pushing up the trunk as is done in pseudo-hypertrophic paralysis, thus showing that theextensors ofthe bodyupon the thighs are feeble. On standing erect the patient maintains his feet about fourteen inches apart in order to widen his base, and on being got to place them side by side along their inner borders he sways slightly from side to side, and these swaying movements become greater whenthe eyes are closed, but he can still maintain the erect position, although with manifest effort. The gait of the patient is the one which has been comparedby Charcot to that of a high-stepping horse, and by Schulz to that of a dancing master. The chief peculiarityofthis gait is causedby the factthat the muscles which produce dorsal flexionofthe foot are paralysed. Let us suppose that the patient has advanced the r. foot and planted it firmly on the ground. The abductors of the r. thigh now contract and the line of gravity is transferred to that side, so that it passes through the arch ofthe r. foot, which is nowthe active one. Theweight of the body having been removed from the 1. limb, which is now the passive one, the heel is slightly elevated so that the toes alone rest on the ground, while there is the slightest possible flexion at the knee-joint, and a still less at the hip-joint. In ordinary locomotion a slight dorsal flexion of the foot would now be produced, the toes of the passive foot would thus be raised from the ground and the limbwould swing forwards by its own weightwithout muscular action. The patient, however, is unable to produce dorsal flexion of the foot, and,consequently, compensatory movements have to be effected in order to clear the toes off the ground. These movements consist of an unusual degree offlexion ofthe thigh upon the trunk, and of the leg upon the thigh, which causes ashortening inthe length of the whole limb. The heel ofthe passive foot become. raised from the ground indirect proportion to the elevation of the knee-joint by the flexion of the thigh on the body,but owing to the paralysis of the anterior muscles of the foot the toes continue todrop until their further depression is arrested

by the anterior ligaments of the ankle-joint The consequence of the continued drooping of the toes while the heel is being elevated, is that an observer, standing behind the patient, sees more of the sole of the foot at each forward step than in ordinary locomotion, and, on standing laterally, notices the drop ofthe toes and the unusual elevation of the knees with each advancing step. When the patient is laid in bed the feet assume the position of a double ankle drop. The small toes are hyperextended to a very slight degree at the metatarso-phalangeal joints, and flexed at the phalangealjoints,but the big toe is flexed at both the metatarso-phalangeal and the phalangealjoints. The patient can voluntarily extend,to a slight degree, the small toes at the metatarso-phalangeal joints, and can produce a little eversion ofthe foot, but he is quite unable to produce dorsal flexion at the ankle-joint, extension of the big toe, or inversion of the foot on either side. These observations show that a slight degree of motorpower remains in the longextensors of the toes and the peroneal group, but that the extensors of the big toe and the tibialis anticus are completely paralysed. The consequence of this distribution of the paralysis is that the sole of the foot is not only directed backwards towards the plane of the bed, owing to paralysis ofthe muscles causing dorsal flexion of the foot, but that it also has a slight inclination outwards, or is somewhat everted, because the peroneal muscles have still retained some degree of motorpower, while the tibialis anticus iscompletely paralysed. The paralysed nerves and muscles react to a moderate strength on the faradic current, and, indeed, it can hardly be said that the faradic contractility is even lowered. The extensors of the toes on the r. side give a minimum contraction on cathodal closure to 20 cells and on anodal closure to 15 cells, and on the 1. on both cathodal and anodal closure to 20 cells Leclanché. In the extensors of the thigh and those of the forearm anodal closing contraction is equal to or greater than cathodal closing con. traction. The reflex of the sole is absent, but the other cutaneous reflexes are normal. The patellar tendon reactions are absent. The patient complains ofa feeling ofnumbness and tingling in his toes and feet and in the tips of his fingers, but the sensations of pain, touch, and temperature are found tobe normal, or nearly so, to objective examination. Pinching of the skin over the external aspects of the legs appears to cause an unusual degree of pain, but there is no undue sensitiveness of the muscles on palpation. The patient complains that he has no proper taste for his food, but he readily identifies salt and sugar when placed on his tongue. He also says that his smell is blunted, but he recognises camphor when apiece is applied to his nostrils. The sense of hearing is normal. c. May 27th. The condition ofvision was examined by Dr. Little this m., and he reports as follows : " The patient does not complain ofany defect ofvision. The acuteness of vision is normal in both eyes, and the fundi are apparently healthy. The perimetric chart of the field of vision for the r. eye shows a considerable restriction for all colours. A general examination of the l. eye shows that it is similarly affected. " Beyondthe muscular wasting no trophicchanges are noted. The hands, whenwarm, are reddish, and are moist and clammy to the touch, but when placed in cold water they immediately assume a livid colour, and become cold,looking just as if they had been frost-bitten, or in the early stage of Reynaud's symmetrical gangrene. The patient lost all sexual desire a few weeks after he began work in the " curing-room, " and even at the present time he never has any erections. The loss of this function was not preceded by a stage of sexual excitement. No marked psychical symptoms have been observed, although the patient complains very much ofloss ofmemory. d. The treatment adopted consisted of rest, good nourishment, massage, and galvanism. A tonic mixture was prescribed, with the view of aiding digestion. During a residence of amonth in the Royal Infirmary the patient improved considerably, but he was still unable to produce dorsal flexion of the feet, and the patellartendon reactions remained absent. He was now sent to the Convalescent Hospital at Cheadle, and 6 weeks afterwards appeared as an out-patient at the Infirmary, when scarcely atrace of the previous paralysis couldbedetected. The patellar-tendon reactions hadreappeared,but were still sluggish, anddorsal flexions ofthe feet, although capable ofbeing effected,were notproducedwith normal strength. The patient soon afterwards disappeared from observation. (Med. Chronicle, Dec., 1886.) 10. P. S-, æt. 36, was admitted to the Manchester Royal Infirmary, under the care of Dr. Ross, on May 12th, 1886 . a. Previous history. -The patient is of Irish extraction, but he has lived in

Pendleton for the last twenty-four years. He is a moulder, and was always engaged at his own trade until work was scarce at the beginning of last winter, and up to that time he enjoyed good health,never being laid up for a daywith with any kind of illness. The patient has always beenwell fed andclothed, and although he is not a total abstainer, he has never indulged in alcoholic excess, and was not a heavy smoker. He has been married 8 years, and has one child, who is living and healthy. His wife never had miscarriages or still-born children, and there is nothing in his history pointing to syphilis. About 9 months ago, being out of work, he obtained employment inan india-rubber factory, and worked inthe " curing-room," where he was exposed to fumes supposed to be bisulphide of carbon gas. He worked for 3 months inthisplace before he felt any ill effects from the gas,but at the end of this time his appetite completely failed, his food tasted of the gas, and everything about him seemed to smell of it. He soon found himselfunable to read, the letters seeming to run into one another. He also became deaf in the l. ear, but he thinks the r. was not at any time much affected. His lower limbs now felt heavy, and he became so feeble inashort time that he could scarcely walk, and occasionally felldown. About the same time he experienced tingling sensations and numbness of his hands ; they also began to tremble, andhis grasp was so weak that he could scarcely hold any. thing. He also experienced similartingling sensations in the toes,and his feet felt sonumb anddead that it seemed to him as if he were treading on something soft instead of on solid ground, and walking, at all times somewhat uncertain, became specially insecure in the dark or on closing his eyes. His sexual appetite failed entirely afterworking for a few weeks in the " curing-room," and this loss was not precededby a stage ofundue excitement. On putting his hands in cold water they immediately became numb and white as if they were frost-bitten. It is difficult to ascertain fromthe patient's description whether he suffered from genuine cramp in the legs or from pains shooting along the course of the nerves, or from both of these disorders, He suffered at least from some kind of pains in the lower extremities which caused him on going to bed to wish for a frequent change ofthe position of his legs, andgreatly disturbed his rest, while the snatches of sleep he obtained were disturbedby horrid dreams, in which he fancied himself surrounded by cats andother animals. In the m. he got up drowsy and unrefreshed, and suffering from an intense headache, chiefly limited to aspot in the forehead and between the eyes, which lasted withmore or less intensitythroughout most of the day. He was, indeed, so utterly miserable and mentallydepressed on getting up that he wished himselfdead, and at the same time had a longing to get back to his work, as he found by experience that the inhalationof the fumes would bring temporary relief to his sufferings. After breathing the gas for a short time his mental depression gave place to ajoyous feeling which was but short-lived, being eing replaced replaced inthe afternoon byanindescribable feeling ofapathy andwretchedness. The patient's memory failed very much,his recollection of recent events being specially defective. He sometimes found himself talking nonsense while at his work, and he occasionally fancied that he was surrounded by cats, but he does not think that in this respect he was affected to anything like the same degree as some of his fellow-workmen. He says that some of the workmen whenunder the effects ofthe gas become very loquacious, and at other times talk a great deal ofnonsense. One man on coming to his work in the m. told his comrades that he was in Liverpool the previous n., a statement which could not possibly have been true. Another workman, apparently to escape from some imaginarydanger, jumped through a window, ran across an open court, and having crept under a joiner's bench, tried to hide by covering himself with shavings. One or two of the workmenhave gone quite mad, and have been sent to a lunatic asylum. b. Present condition.-When the patient is seated on a chair, with his feet flat on theground, he is unable to raise his toes off the ground bydorsal flexion of the feet. Hehas sufficient strength to extend the leg onthe thigh, and to raise the heel off the ground, but the slightest pressure on the front of the leg suffices to cause flexion at the knee-joint when the thigh is supported. When the forearms are held out horizon. tally, the hands being in the prone position, the patient can, with much effort,maintain the hands extended upon the forearms and the fingers extended upon the hands, but the slightest pressure on the backs of the hands causes flexion at the wrists, and onthe backs ofthe fingers flexion at the metacarpo-phalangeal joints. When the patient is laid on his back in bed there is double ankle drop; the big toe is flexed

into the sole at both joints, but the small toes are slightly hyperextended at the metatarsal-phalangeal and flexed at the phalangeal joints. It is, indeed, unnecessary todescribe in detail the distribution ofthe paralysis in the case of P. S-, inasmuch as it corresponds in almost every particular to that observed in the case ofJ. N-, just reported, the gait of the former being also so like that of the latter as to make a separatedescription superfluous. Whenthe patient stands with his feet approximated and with closed eyes, he sways from side to side and maintains the erect posture with manifest effort. The following reactions were obtained in the affected nerves and muscles to electrical examination :-The faradic irritability was diminished in the extensors of the forearm, and in those of the legs and thighs, as well as in the nerves which supply these muscles, but all the nerves and muscles reacted to a moderately strong current. The patient complained ofnumbness aud tingling ofthe hands and feet, and there was a slight diminution of the sense ofpain, as tested by pricking, and oftouch, as tested by separate points, in the outer aspects of both legs and feet, but the temperature did not appear to be affected. The various forms of cutaneous sensibility were found to be normal in the remaining parts of the body. Moderate compressionofthe affected muscles did not cause pain. On being asked to touch, withclosed eyes, his nose,with the tip ofhis index finger, he touched somewhat wide ofthemark at first, but effected the movement accurately with a little practice. The reflex of the sole was absent, but the cremasteric and other cutaneous reflexes appeared tobe normal. The patellar-tendon reactions were absent. The patient is able to distinguish salt, sugar, and quinine, when placed upon the tongue, and he also recognises camphor when applied to his nostrils, but he says that both ofthese senses are verymuch blunted, and that everything seems to taste or smell ofthe gas. He hears the ticking of a watch on the r. side when it is two feet from the ear, but not on the 1. side until contact is made. There is no undue collection of wax in the external meatus, and no discoverable disease in the tympanic membrane or external ear. c. During the patient's residence in the infirmary he improved considerably. The patellar-tendon reactions reappeared, but were still sluggish. The extensors of the forearms acquired a considerable degree of motor power, but the muscles which producedorsal flexion ofthe feet still remainedcomparatively paralysed, and the gait of the patient presents the high-stepping action which is so characteristic of paralysis ofthese muscles. After a month's residence in the infirmary the patient was discharged much improved, and an effort made two months later to get him to present himselffor examination,especially as to the condition of his vision,proved fruitless. The treatment was the same as in the case of J. N-. The pupils are dilated, but contract readily to light and to accommodation. The patient says that he cannot read because all the letters run into one another. His colour vision is defective ; purple he calls white, and is unable to distinguish red from blue. The patient's hands look as if they were frost-bitten, when dipped in cold water, but besides the wasting of the muscles there are no trophic disorders. No decided psychical disturb. ances are apparent, although the patient is morose and discontented,and says that his memory is still very defective. d. May 27th. The patient was sent to Dr. Little to-day for examination, and the following report ofthe state ofhis vision was obtained:-" Sight failing for about sixmonths. Vision ofr. eye is equal to 18, and of 1. to 16Jaeger. Refraction shows a slight degree of hypermetropia. An ophthalmoscopic examination showed that the r. opticdisc is distinctlypale but clear, while the l. is pale with a faint haze at some points in the margin. The fundus of each eye is healthy in other respects. The field ofvision is much contracted in each eye for white and blue, while red and green -are absent. " (Ibid.)

Volume IV — Appendix

II. II. a. A man, xt. 32, was admitted into the Salford Royal Hospital on March 3rd, 1888. In April 1887 ^^ began to work in the '■'■ curing-room " of an india-rubber ^factory, where he was compelled to inhale fumes containing; a large proportion of bisulphide of carbon. He had always enjoyed the best of health until the beginning of his present illness ; had been a total abstainer for 16 years, and had never smoked or had syphilis. Soon after commencing work in the ^Ktory he began to suffer from headache, giddiness, and drowsiness ; tongue was dry, and taste of bisulphide constantly present. These symptoms disappeared (as they usually do) in the course of a few weeks. At beginning of Jan. 1888 headache returned, and was accompanied by delirium and illusions of sight ; he was compelled by frequent attacks of giddiness to take to bed on the lOth. So-called " rheumatic pains " were then felt in knees and ankles, and face and hands became yellowish in colour. He was also subject to attacks of unconsciousness coming on suddenly and without cause while he was in bed. About end of Feb. legs were noticed to be weak, and lower halves of legs felt numb. Sexual desire was abolished. On admission into hospital delirium and other cerebral symptoms had disappeared. Patient could neither walk nor stand without support ; but on being well supported on each side, he was able with great effort to drag the toe of one foot about 3 in. in front of the other foot. As he lay m bed there was distinct drop-foot on both sides ; he could barely move the toes, and could not perform dorsal flexion on the ankle. He was able to raise the heel from the bed slowly and with difficulty ; the legs could be adducted forcibly, but abduction was weak. No wasting could be detected. The knee-jerks and the plantar and cremasteric reflexes could not be obtained, and there was no ankle clonus. Almost complete loss of sensation as regards touch, pain, and temperature existed below middle of lee. On squeezing calf-muscles some pain was complained of, not connned to parts pressed on, but described as shooting upwards and downwards. The functions of bladder and rectum were performed naturally. Upper extremities were perfectly normal in every respect. Faradic contractility of muscles of legs was somewhat impaired } with the galvanic current muscular contraction was normal, and contraction occurred with a weaker current on cathodal than on anodal closure. No vaso-motor or trophic disturbance was present. Taste and smell were normal ; but patient complained of weakness of vision, interfering somewhat with reading. His .colour vision was not tested till March 15th, when it was found perfect, and the range of vision was found normal on both sides. (By this time, however, the defect of sight had almost disappeared.) The pupils reacted to light, and the discs were healthy.

i. The only treatment adopted was rubbing, and the internal administration of quinine. Improvement set in almost immediately*

On the 23rd anxsthesia had almost entirely disappeared on I. tide. On 29th he could walk unsupported ; knee-jerks were active on both sides, but r. foot and leg were still slightly anassthetic. He was discharged April i8th, walking well ; and on June 18th presented himself with both legs quite strong, and no anxsthesia to be detected anywhere. There was, however, no return of cremasteric or plantar reflex. He returned to the factory, but obtained employment in a room where he was not exposed to the bisulphide vapour. He felt quite well when showing himself Sept. 21st, but a considerable amount of ansesthesi* was found involving r. foot and lower third of leg ; and creraasteric reflexes were still absent. He acknowledged that when the wind mi in a certain direction the fumes generated in the "curing room** were blown into the room in which he worked. (Edge, Lanut^ April 7th, 1890.)

1. Changarnier describes the following cases :

a. A man presented himself with all the symptoms of alcoholic( amblyopia. He was, however, a temperate man, and not a smoker, He had worked for 8 mo. where sulphide of carbon was employed. H( had noticed a cloud before his eyes for about 6 weeks. His vision deteriorated daily and, after 12 — 15 d., he could not read. All objecd appeared yellow. Ophthalmoscope revealed nothing abnormal. Vlsiu field showed a centre scotoma for red and green. He was treated with eserine locally and potass, iod. internally, and recovered.

b. A man of 42 had worked in sulphide of carbon il mOi Vision had commenced to fail i mo. before he was seen. Symptoms, treatment, and result were as in former case. {Lend. Mta, Remi, 1886, 310.)

Volume IV — Supplement

CARBONEUM SULPHURATUM.

(See vol. ii, pp. 29, 73« 5 '<>•• »T» P- S3S-)

II. 13. A young man, aet. 18, after constantly using bisulphide of ■bon in the manufacture of footballs, has felt for 5 mos. past various rvous disturbances. Sleep is disturbed by dreams, nightmare ; and ;re are pains in the lower limbs, accompanied by cramps and tingling. r some time past, there has been a marked weakening of the memory d a considerable diminution of the sensibility of the upper limbs, as

as the elbow. This patient formerly had excellent vision, but since nos. ago there has been difficulty in distinguishing objects placed at ne distance. To-day he only counts fingers at 3'50 metres, and »ives no benefit from correcting glasses. The ophthalmoscope monstrates a very marked atrophy of the papilla of the 1. optic nerve. lie erect image shows that the vessels have a very much diminished ibre, and that they contain but little blood. There is slight conntric retraction of the left visual field, but no dyschromatopsia. hTMONT, BulUtin dt la Cliniqut NatimaU Ophthalmologique des ^inzf

HgtS, 1887.)

1. Young man, aet. 19, employed 7 years in the manufacture of bber, and daily exposed to the vapours of bisulphide of carbon } has ver felt any disturbance in his general health until 2 mos. ago, when (ion diminished progressively, without pain or inflammatory symptoms, esent condition : — R. visual acuity, counts fingers at two metres ; 1. lual acuity, counts fingers at one metre. No help from lenses. isual field remains normal. There is complete achromatopsia. No sesthesia of cornea. Media are clear. Optic disc is small, as if runken, and appears ischaemic. Along retinal vessels is found a tall zone of circumscribed retinitis, producing a double contdftr and adering them more projecting. There has been no previous disease, I ocular affection, no history of alcoholism or of nicotinism. No mptoms of ataxia can be found, and there are no family antecedents. ;and, Ibid.^ t886.)

2. Young man, aet. 16, has worked at the manufacture of rubber r three years, being exposed to the fumes of bisulphide of carbon for h. daily. In the beginning, and for 2 mos., he had pains in head, tttsea, and some vomiting : these disturbances disappeared, and since

then his health has remained good. Four months ago vision began to diminish progressively, without pain or inflammatory reaction, Present condition :—R. visual acuity, counts fingers at two metres ; 1. visual acuity, 110. No relief from correcting lenses. Visual field is normal, both for white and for colours. The ophthalmoscopic examination reveals nothing peculiar in the media ; the papilla is ischaemic, otherwise the fundus is normal. Antecedents, as to previous ocular affection, symptoms of ataxia alcoholism, nicotiniem oF heredity, are absent. (/bid.)

16, A workman, employed for six years in the manufacture of vulcanised rubber, had only been disturbed during that time by occasional vomiting, followed immediately by relief, An important change in the method of manufacture having exposed him to the influence of a greater quantity of bisulpide of carbon, vapour, the symptoms of poisoning quickly appeared, in the form of loss of appetite, involuntary micturition, genital weakness, general debility and prostration, nightmare, &cc, After a rest of six weeks, these symptoms partly disappeared, and he resumed his work in Jan.” The same symptoms reappeared quickly, still more marked, but the patient continued at his work withe out interruption. In April following, he noted that his vision had failed, and one day, after a prolonged exposure, he was attacked by fetal trembling, and all objects appeared to have a Bluth gray tnt.

fe could not see the telegraph poles on the opposite side of the road, the dial of the church clock, or the cows in the field at a distance of about thirty metres. He did not even see the title of a paper in large letters 5 al appeared grey, cloudy. Obliged toquit work, he presented at the clinic, where it was found that the largest letters of Snellen’s test types could only be read very near the eyes. Correcting glasses gave no help. Ophthalmoscopic examination, after the instillation of a drop of atropine, revealed nothing special. Some days later objects assumed a red, or rather, rosy, tint, in place of the greyish colour that first appeared.’ He complained of great pain in the head at the level of the occipital protuberance, ‘The health was gradually restored after six weeks in the country. Vision was completely reestablished after three or four months. (Bruce, Edinb, Med, ‘fourn., May, 1884.)