Rhus venenata

Volume III — Main text

HhllB venenata^ poison sumach, dogwood. I. Provings. — i. Dr. BuRT, beginning with increased dose till jss was taken at uncc. He

50 dr. of 3rd dil., then took tinct., at

fint ro dr. several times a d., then more and more till) he reached 150 dr. Atiogether '^j of tinct. was consumed in the proving. Its daybooks have been lost, but the following symptoms were observed : — Skin hot and dry at n., with great restlessness ; palms of hands dry and hot ; cracks at end of fingers, bleeding readily ; fine vesicular eruption on forearm, wrist, back of hands, and fingers, also on scrotum and ankles, seated on inflamed base, and itching intolerably, especially in e. in a warm room, and in bed, worse after scratching, which nevertheless is irresistible, and which causes much serous exudation ; constant itching of under lip for several d., with bright red appearance, also great burning and Itching of arms j cellular tissue round eyes much swollen ; a number of boils on forehead, neck and arms (after the proving). Wrists, ankles and feet ached so severely at n. that he could not sleep; great restlessness after midnight. Very weak and languid. Great sadness, no desire to live, everything seems gloomy ; absence of mind, cannot concentrate it on particular subjects. Fulness of head ; dull heavy frontal headache, aggravated by walkin? and stooping. Constant lachrymation and dull aching in eyeballs. Great dryness of nostrils on two several occasions, each time lasting about an h. Slimy, calty-slimyj or flat rough taste in mouth i tongue white-coated j scalded feeling on tongue; dryness and constant irritation of fauces; distress at root of tongue and fauces j tonsils very red and congested, with dull aching distress in them, and frequent inclination to swallow, which aggravates this ; wants to drink much. Dull aching distress in stomach and whole abdomen, with occasional sharp cutting pains about umbilicus,— these especially before a stool, which relieves but does not remove them ; later, severe cutting pains in umbilical and hypogastric regions for 6 d., with 3 — 4 very soft, loose, blackish stools daily, — pains worse before stools ; intolerable itching and burning at anus, and neuralgic pains there. Scrotum much swollen, of deep red colour, and covered with vesicles ; severe itching and burning on it. Constant dull pains whole length of spine; back very stiff; severe pain in 1. elbow for j h., forbidding movement of limb ; drawing pains in forearms ; dull pains in wrists and fingers, which are very stiff, with occasional drawing ; constant aching distress in hands, which are hard, rough, and tender ; hands greatly swollen, of deep red colour, and covered with watery vesicles that itch intolerably ; knees and ankles ached constantly ; severe cramp in calf at n., followed by soreness there next d. ; dull drawing pains and distress in knees, ankles, feet and toes ; great weakness of knees and ankles ; ankles and feet ached so severely for 8 weeks after proving, that it was very painful to stand or walk, especially p.m., when he had to lie down daily ; ankles very red and swollen, with watery vesicles and blisters all over these and the feet, itching intolerably, and exuding copious serum ; trembling of all limbs, with twitching of muscles. (iV. Am. Journ, of Horn. ^ xiii, 411.)

a. Dr. Bu'i'MAN made, in spring, 1K65, a tinct. fi'om the blossoms and adjoining leaves. While collecting these he had dull frontal head-

ache, nausea, lassitude and diuresis. From Oct. 19th to 24th he took tinct. in increasing doses^ till he was taking 180 dr. at a time. It developed the following symptoms : — Skin hot and dry ^ itching on various parts of body j eruption on face, head and chest resembling that of enteric fever, disappearing on pressure, Great restlessness at n. j sleep disturbed by dreams. Inability at times to connect ideas ^ forgetfulness ; dull and stupid feeling. Sensation as if brain were pressing up against skull ; dull headache, with sharp darting pains in parietal bones ; sensation as if head were bound. Feeling as if eyes were being pressed out of head ; sharp pain in r. eye, extending to supra-orbital region. Dryness of nose, which later is filled with tenacious mucus. Face flushed, feeling as if burnt. Tongue coated white ; slight accumulation of viscid mucus in mouth ; dryness with burning in throat ; sensation as if tongue were being pulled out by roots. Loss of appetite ; continual nausea j borborygmus, with pain from lumbar region to umbilicus j pain in 1. abdomen ; fzces dark, hard, and scanty i blood from rectum after stool. Desire to micturate frequently, but small quantities only passed ; burning in urethra. Pain in back ; sharp pain under 1. scapula, going through to ribs. Sharp darting pain in both arms, from elbow to index fingers and thumbs ; aching pains throughout proving from hips to knees, worst at knees, and on I. side. Continual shivering down back ; general feeling of lassitude. All symptoms increased on a damp d. A subsequent proving with dilutions produced no new symptoms. (N. Engl, Med, Ga%,^ iv, 200.)

1. Dr. Wallace McGf.orge proved a tinct. made by macerating leaves. Of sanguine temp., 28 years old, in good health, except for some catarrh in head and slight indigestion.

a, Aug. 1 oth, 1 869, at 1 1 .45 a.m., took 2 or 3 d r. in water. 1 1 th. — Good spirits i quite cheerful all d. 12th. — On rising, mouth and lips dry ; lips sore and swollen, blistered and cracked; it is impossible to keep mouth moist \ this got easier 1 h. afterward, but came on again, and lasted all d. 10 a.m., took another dose. Headache of stupefying nature. 4 p.m., itching of upper lip and chin \ tongue and mouth feel as if burnt with acid. 6, lips and mouth become more feverish, and, 8, breath feels like steam, it is so hot ; lips painfully hot and dry, cannot get them cool, they burn constantly ; headache all d., and yet docs not feel in low spirits. 1 3th. — 6.30 a.m. On waking, uncomfortable feeling in mouth and lips; cannot speak distinctly ^ palate fallen, and feeling as if there was something in mouth impeding speech, unchanged by hawking or clearing throat ; lips painful, dry, and swollen to double their natural size; white vesicle on lower lip j tongue red on tip j mouth moist \ gums swollen \ on drinking anything warm, slight irritation of inner side of lips, gums, and tip of tongue j eyes dull \ dull headache; feels rather languid; pulse 72, rather weak; no pain anywhere in body. 8 p.m., itching of tongue and roof of mouth; lips and tongue feel as if cracked \ lips swollen, upper one the worst ; itching in corner of mouth, 14th. — Upper more swollen than lower lip ; lips and tongue i^c\ as if cracked ; lips peel off somewhat, they burn and itch considerably when washing; tongue feels as if scalded, and itches awfully, he has to scratch it and rub it with handker-

chief; nose itches at n. ; face swollen ; slight headache; dull-looking appearance of eyes ; breath hot and feverish by spells, it smelt as if stonnach was disordered ; fccts tired and weary ^ low-spirited. 15th.-— Lips worse than ever, upper one must affected, black on edges, yellow vesicles on inner side, which break, discharging a thin sticky fluid, agglutinating them together (12 m.) j lips hot and dry, and burning, aggravated by washing in cold water, or touching them with tongue, or when eating anything sour ; tongue red, and cracked in middle ; face swollen ; eyes dull and heavy ; languid feeling ; itching of hands (lingers and palms) after washing; itching of anus ; appetite and excretions normal ; pulse 82 ; when sitting, at 3 p.m., it was normal, 68 to 70 ; feels worse when the weather is very hot; cream applied to lips relieves the burning sensation, but hot applications ameliorate more than all; anus itches terribly towards n. i6th. — On rising, face swollen; lips swollen and covered with a thick skin or crust that in breaking emits an offensive discharge, resembling that from a sore, thin and sticky, warm water makes them feel comfortable and pleasant ; feels low-spirited, and disinclined to employ his time in any manner; stools dark, and partly undigested ; itching at anus ; itching in palm of I. hand, and appearance of vesicles on fingers, itching terribly, aggravated by cold water ; insupportable feeling at anus ; nose feels sore, as if it was going to peel off; acid food hurts his lips ; poor appetite in m. P.m., itching in anus, which becomes exceedingly annoying, relieved temporarily by scratching; lips are getting better, and do not smart so much ; warm water relieves them still. E.j itching of hands continues j vesicles appear on fingers of both hands ; shivering for 10 m. when undressing, accompanied with chattering of teeth, followed by heat and perspiration, with drowsiness, but itching at anus becomes so unbearable that he cannot sleep ; pinching and pressing afl^ords no relief; brandy applied on a compress aff^ords relief and abates pain in 2 to ^m.^ but when first applied creates such a terrible burning that he cannot lie still, and almost goes into spasms ; restless sleep afterward. 17th.— 3 a.m., wakes up with the itching at anus, which yields to application of brandy as before ; as soon as he feels comfortable, and when falling asleep, the hands begin to itch and prevent his sleeping for an h. ; afterwards sound sleep; no dreams at any time through n. ; lips are better, but still smart a good deal when touching acids, relieved by hot water ; tongue cracked in centre, and covered with little white vesicles ; inside of lips filled with similar vesicles ; appetite good ; stools lighter in colour, and partly undigested ; urine normal ; itching of genitals, especially prepuce ; increase of saliva ; face less swollen ; itching at anus less troublesome. i8th. — Very little itching at anus ; troublesome itching and burning of hands and fingers ; lips and tongue improving ; face looks better, swelling almost gone ; slight itching of genitals. iQih. — Intense itching of hands upon awaking and immersing them in water, showing, after rubbing, little raised streaks of a yellowish colour. (These are composed of patches of little yellowish vesicles, worst between the fingers and in the cracks or lines in the palms of the hands.) Itching worst in m. ; itching on scrotum and prepuce worse; lips, tongue, and anus arc more comfortable ; pimples

on forehead. 20lh. — Troublesome itching of scrotum, penis, and especially of prepuce — worse on becoming warm (weather exceedingly hot) i no trouble with anus, lips, or mouth ; hands smart and burn considerably after scratching and rubbing them ; pimples on forehead. 2ist. — Itching of hands and fingers same as yesterday, showing same yellow patches previously described ; the fingers are much swollen, also palms ; herpetic eruption on forehead, resembling herpes phlyctenoides ; itching of scrotum, penis, and prepuce through d., unchanged by scratching. 2ind. — Wakes up during n. with itching of hands, rubs and scratches them until sore ; violent burning and smarting, preventing him from sleeping a long time ; lips, tongue, and mouth seem all right; no itching at anus ; very slight itching on genitals. Hands itch violently through d., relieved by putting them in very hot water, as hot as can be borne without scalding ; this seems to make the pain fcic in the very bones, but relieves for some h. after a thorough soaking ; hands and fingers swollen — cannot wear his ring, which generally is too large for him; skin appears raised in ridges of a yellow colour, puffy to the touch, the other skin on hands appearing red ; hands become sore from severe rubbing, and vesicles appear between fingers. 23rd. — Itching on rising, same as for 3 or 4 d. ; cold water allays a little for the time being, but the itching and stinging can be felt very distinctly ; yellow, puffy ridges on palms of hands; skin on forehead appears rough ; profuse secretion from r. nostril of a thin ichorous fluid. 24.th. — Wakes up at 4 a.m., and has to rise and wash hands in order to allay the itching, rubbing only making it worse; itching of hands during d. ; skin on forehead not so red or so rough ; secretion from r. nostril slightly excoriating ; no discharge from 1. nostril, which is stopped up. Sept. 1st, — Gradual abatement since the 25th ult., skin peeling off fingers and palms. 5th. — Skin still peeling off hands, loth. — Skin peels off most, and began to peel, where the vesicles were on fingers and palms ; stools black as pitch, and hard, no unusual smell, I2th. — Skin peeling off slowly ; stools black as before, soft, and rather putrid ; bowels move twice, 16th to 24th. — Skin still peeling off; nothing else unusual observed.

A. Oct. I2th, 1869. — Passed a swamp wherein Rh. v. grows^ the sun shining quite warmly at the time ; had frequently passed the same swamp before taking the drug without observing any effects ; this e. had considerable itching of penis and scrotum. 13th. — Passed restless ^'t lying awake to scratch; lips feel uncomfortable; in m. lips are much swollen ; breath is hot and feverish, almost like steam, and tongue covered with little vesicles on tip; intense itching of genital organs. 12 m., itching continues unaltered ; warm water ameliorates; fine eruption around neck of penis ; intolerable burning and itching of whole genital organs ; intense heat of penis, especially on glans ; lips swollen ; breath hot. 7 p.m., itching on genitals becomes unbearable, relieved by warm water cloths applied to parts, after an hour's constant application the itching almost entirely disappears, the water has to be changed frequently and can be borne up to boiling heat ; prepuce considerably swollen ; back becomes covered with blotches ; itching is excited or brought on by exposure to cold

air J gentle scratching relieves the burning and itching on back ; later the blotches disappear, back becomes covered with ridges, and a fine^ pale-red rash appears, 14th. — Itching occasionally on penis and scrotum through n. ; itching on back is brought on in a moment by cold air blowing on it ; prepuce very much swollen, as also glans penis ; desire for an embrace, but the itching and burning is so severe that he cannot complete the act ; his wife complains of a terrible prickling and burning in vagina after coition, lasting several m. ; face much swollen, shining glistening appearance ; lips peeling off; nose itches severely; vesicles on lips and face emitting an odour similar to a sore (same as on Aug. i6th) ; desire to rub face continually ; hot water relieves, and causes peeling of the skin ; general health good ; appetite &ir ; stools and urine normal ; pulse 78, and regular ; tongue redder than usual ; breath hot, but not unpleasant or offensive. 15th. — Abatement of all the symptoms. 1 6th — 25th. — Symptoms become lighter and pass entirely away.

c. Next summer, in passing a swamp where some Rh. v. grew, became again poisoned ; symptoms were similar to those in 3 ^, but not quite as violent. In June, 1871, in preparing some of the tinct. touched his finger accidentally to the cork of the vial. Next d. was completely poisoned, and the symptoms ran a course similar to that of the first proving, the itching being worse on the hands, genitals, anus, lips, mouth, and nose ; hot water afforded great relief, and clematis erecta cut the disease short, but did not prevent the skin peeling ofF the hands. In preparing some of this medicine for some provers, in 2nd and 3rd attenuation, became again affected in a manner like that described before.

In all the provings the itching was worst on the cuticle and mucous membrane ; hot water always relieved the itching ; appetite good, more so than usual ; dyspeptic troubles, or belchings after meals, very much better; the catarrhal trouble was less also. Pulsatilla, croton tiglium, rhus toxicodendron and clematis erecta were taken as antidotes during the later provings, but the last-named seemed to exert the most beneficial effect. Previous to proving or taking this remedy, was never subject to Rhus poisoning ; could pull up the Rhus radicans and other poisonous vines without observing any effect, but now is very susceptible to their influence, and poisons very readily. (Hahn. Monthly^ vii, 315.)

1. Aug. 1 2th, 1869, Miss F — , set. 22, took 2 dr. of tinct. ; next d. slight itching of hands and lips \ 2nd d., itching of hands and body as well as face ; face swollen ; eruption on corner of mouth ; became alarmed, and took no more of the medicine, and did not record any other symptoms. {^Ibid,)

2. Miss L. H. G — , act. 18, sanguine temperament, took 3 dr. of 1st dil., Oct. 26th, 1871. 27th. — Pain at umbilicus, with diarrhoea ; creeping sensation on face and arm \ itching of face in e., particularly lips. 28th. — Pain in bowels, with diarrhoea ; itching of upper lip ; stretching and tired feeling ; blue finger-nails ; skin feels cold, similar to the way some persons describe their feelings when they have a chill, lasting one h. ; has not had a chill. 29th. — Low spirits ; itching of face

and !ips, and somewhat of fingers and lower limbs ; chilly, creeping sensation over scalp. 30th. — Drawing pain in lower part of I. side ; considerable headache ; itching of face, particularly nose, and some on lower limbs ; a liitle pain in sacrum. 31st. — Symptoms slight ; some itching of lips and lower limbs, with slight frontal headache. Nov. ist. — Slight lancinating pain in sternum and r. leg; fever-sore on mouth. {Ibid,)

1. a, KuNzE, Dec. 1st, 9 p.m., took 20 dr. 5X dil. Next m, drawing pressivc pains in r. knee-joint, radiating downwards, then in r, wrist, extending through bones of forearm to elbow j the same pains in 1. elbow, 1. ankle, and pes anscrinus. — 2nd, 7 a.m., 30 dr. Drawing in I. knee and r. upper row of teeth; paralytic and bruised pain in thighs 'y peculiar feeling of tension, with noise like creaking, under r. ankle; frequent ringing in r, ear; drawing pain towards I. temple; whirling vertigo ; stitches in heart. — 3rd, 5 p.m., 40 dr. Drawingsqueezing pain in 1. thigh, dorsum of r. foot, r. upper and lower maxillaf, drawing in 1. temple. The pains come and go quickly, wander to and fro ; eructation. — 4th, 7 a.m., 10 dr. 4X dil. After ^ h. frequent eructation, with pains in belly and rumbling ; prickling and smarting in eyes as though they would water and inflame ; jerking tearing in bone behind r. car ; paralytic drawing and bone pains in ). leg. — 5th, 8 p.m., 15 dr. Jerking drawing in r. foot from ankle-joint to heel, and shooting upwards with bone pains ; jerking pain in occiput, drawing in 1. leg, —6th. No mcd. ; pains slighter, increased during rest, wandering to and fro, radiating from a point through periosteum downwards and upwards.— 7th, m., 20 dr. Jerking drawing in legs, in r. ankle-joint, thence downwards to heel-bone, a peculiar feeling of horripilation as though the foot were going to sleep ; when it is more considerable it is a creaking feeling. This sensation is persistent with only short intervals. Boring in r. upper maxilla, drawing in r. wrist and I. leg, shooting from ankle-joint through long bones into knee-joint, 8 p.m., 25 dr. The horripilation continues, and affects the 1. arm also, especially when it is lying^ down, at same time drawing in upper and fore-arm and the three last nngersof 1. hand ; the arm is as if paralysed. Palpitation and stitches in heart j heaviness of head and vertigo. — 8th, 7 a.m., 30 dr. The horripilation and creaking continue ; pressive drawing in r., then in I. ankle-joint, in r. wrist-joint ; pressive drawing in r. upper maxilla ; shooting in r. lower maxilla j tearing in r. temple, shooting into 1. half of head upwards along forehead in bone, thence to 1. side of occiput and nape. Drawing in I. leg ; cramp-like tension in r. calf. Shooting deep in r. eye, then smarting in eyes as though they would inflame and water. Bruised feeling in body, especially lower extremities, as after great exertion ; pale face and weariness, prostration, drawing in r. little finger and thumb. — 9th, 7 a.m., 70 dr. Drawing in r. ankle-joint, in 1. knee-joint, through lumbar muscles to hip, also in muscles of calf; tearing in 1. arm radiating from elbow upwards, feeling as if bones would break. Drawing in r. wnst-joint, stitches in r. upper maxilla, sacrum feels bruised, loth, 7 a.m., 20 dr. 3rd dil. Drawing in I. calf, in 1. loin, shooting tearing in r. upper maxilla, drawing in 1. temple and in occiput ; cramp in dorsum of foot. Pains always worst when at

rest, many dreams. — nth, 7 a.m., 30 dr. Pressive drawing in r. anklejoint and r. wrist-joint. Drawing in r. calf, with lame pain in hough as after exertion ; jerking drawing in nerves of head here and there. Throbbing in veins of both feet as from congestion of blood. 8 p.m., 40 dr. Dreams with vivid visions, pressive drawing in both legs as if bruised, then a persistent pressive cutting pain in ankle- and kneejoints, radiating through the tendons of dorsum of foot to toes, also from wrist to tips of hngers, especially 1. index; jerking cutting shooting in ear ; ringing and rattling in r. ear ; great itching behind and within r. ear; jerking drawing in r. upper maxilla; creeping and creaking in r. foot. Pressure in head, and heaviness as if too full of blood ; jerking drawing in upper part of 1. side of head ; stitches in apicesof both lungs. — 12th, 8 p.m., 20 dr. 2x dil. Drawing in r. ankleand wrist-joints up to knee or elbow ; tinnitus in r. ear ; transient stitches in r. concha; tension like ulcerative pain on 1. ankle, as if gathering, when treading ; jerking pain in muscles of both arms ; cramp pain in calves and formication as if gone to sleep. Drawing in fingers of r. hand ; bruised pain, especially in legs ; transient tearing in r. upper and lower maxillae. Violent anxiety-causing stitches in 1. lung, especially on breathing. — 13th. No med. The above pains, but in slighter degree. — i+th, 7 a.m., 30 dr. Stitch under 1. sole; wandering drawing pains in thighs and legs and 1. arm. Palpitation of heart, heaviness of head ; pulsation in veins of r. foot. — 15th, 7 a.m., 10 dr. I, dil. Paralytic drawing in r. arm, especially wrist to fingertips ; drawing in both feet ; shooting under r. sole; drawing in r. upper maxilla; constant tinnitus in r. ear; drawing in nerves of head; stitches in apices of both lungs ; itching behind r. ear. — i6th, 7 a.m., 20 dr. Same drawing pains, stitches in lungs, palpitation and stitches in heart; itching all over body. — 17th, 25 dr. Same symptoms but more severe ; on scratching the itching places red spots come out on arms and hands ; pimples like commencing boils on scapulz and neck ; slight moisture behind r. ear. — 18th, 7 a.m., 3 dr. tinct. Same symptoms ; furuncles were developed, moist place behind ear. — 19th, 4 dr.; 20th, 5 dr. ; 21st, 6 dr. Same symptoms ; violent drawing pains in arms. legs, and head ; violent stitches in lungs, congestion of blood to chest, with anxiety ; pulsation of vessels of head and feet; palpitation and stitches in heart ; itching of skin with red spots, furuncles and moisture behind r. ear ; bleeding hasmorrhoids, which had never had before. The stitches in lungs went off after 2 d., and the symptoms of venosity soon afterwards disappeared. But the rheumatic pains continued with greater or less severity till middle of February, though he had never before suffered from rheumatism. Alter a chill they became very violent, and were removed by ran. bulb. 2 in 3 d.

h. External application of tinct. caused small itching vesicles, which burst and ended in desquamation with moderate redness. When the tinct. was rubbed on the desquamated spots they became very red, and larger vesicles filled with lymph were developed, which turned to pus and ended with formation of scabs, lasting altogether 3 weeks. (JV. Zeitsch.f. Horn. KL^ xii, 155.)

1. Dr. Bute and his wife report following symptoms from handling

pUnt : — Sudden violent stitches through lungs, lo m. after breathing in vapour. Blackness before eyes when he looks at anything. Swelling of face with red eyes. Red spots on f^cc, not removed by pressing on them. Feeling of rawness and burnt sensation on lips. Groups of vesicles come out on fingers and other parts of body ; at first they itch, and then burn and feel sore. On liwallowing sore pain down 1. side of throat. A group of vesicles behind 1. ear. The itching begins suddenly, sometimes in one place, sometimes in another, and then becomes permanent. Cramp in dorsum of foot. Sudden violent cramp in r. ankle, as if it were squeezed. Swelling mostly on I. side of face. Dislocation pain in r. hip. Hard elevated pimples on hands, on which are vesicles, itching much. Violent itching on various parts of body like gnat-bites, eroding. The itching is worse after midnight and m. Violent itching m palms. Itching wheals deep under skin in palms. Rheumatic pains in 1. elbow- and shoulder-joints, worse on moving. Sudden sharp, startling stitches through lungs waking him out of sleep. Dreams of murder and misfortunes, i^t n. Swelling in face, with red spots and wheals, always itching and burning after being rubbed. Red elevated wheals on various parts of body, especially face, neck and chest. The menses, which were nearly due, came immediately, discharge very clotted, like lumps of flesh. Rigor up back, without coldness. Goose-skin. Intolerable weight of head. Redeyes. Heaviness in the swollen face. On waking, m., the light is painful to eyes. Dimness of eyes when reading. Forehead is so greatly swollen that it quite hangs over and feels heavy when going upstairs. (Bute, j^rchlvy XV, I, 179.)

8, Dr. Clary, Nov. aind, 1863, held a stick of Rh. v. in his hand for ^ m., and, a small piece of its cuticle being shaved off, touched with his tongue the minute drop of juice which exuded. On the 30th (nothing having been felt before) while at dinner tongue felt as if scalded, and p.m. this feeling extended over entire mouth and fauces, producing great dryness and stinging pain, which increased rapidly till he retired at n. At 2 a.m. severe griping came on i but being somnolent he remained in bed 2 h, longer, when he was suddenly forced from it and a large watery stool shot out, with severe colicky pain. I'his was repeated 3 times during next 4 h., after which all ceased. On rising, felt weak ; no appetite ; chills over whole body. During d. (Dec. ist), frequent stinging and itching about neck, chest and back. On m. of 2nd, found forehead swollen and red ; during d. this extended to whole head and face ; upper lip terribly swelled ; itching greatly increased, especially in septum narium i burning pains and swelling in eyes. Four haemorrhoids (he had had nothing of the kind for 2 years) protruded, with extreme itching and burjiing. No evacuation this d. Towards e. itching extended over whole body (though no eruption appeared), and at n. was so great that he could hardly endure it. After a sleepless n., in m. he (ound the vesicular eruption of Rhus on the forehead (then for first time recognising the cause of his troubles) ; and during this and following d. it spread over trunk and extremities, especially bad on sexual organs; there were also transient shooting pains in sternum and chest } lameness and soreness

of muscles, so that he could hardly walk ; nausea and loathing of food ; entire loss of taste and smell } pharynx and oesophagus became so irritable that it was painful and difficult to swallow ; food caused pain in passing and seemed to stop midway, and cold water (thirst was urgent) produced same sensation in going down as very hot tea would and same aching afterwards as sometimes follows the taking of ice-cold drinks. Haemorrhoids continued. On 5th dryness and pain came in larynx, with hoarseness, harsh dry cough, and constriction in chest. For more than 2 weeks there was pain over sternum ; and itching, cough, haemorrhoids and lameness all continued for same time. {Jmer, Horn, RevieWy v, 23.)

1. Dr. White, besides gathering leaves, &c., of Rh. vcn., rubbed juice upon his hands in several places, and allowed it to dry there. This was on Oct. loth. On 12th a single vesicle appeared on back of finger, with thick cover and dark look. On [3th another, and on 14th three more, appeared on wrist. No fresh ones appeared till 19th, when a very large one came on thumb, and from 21st to November 3rd a number of fresh ones appeared, all itching and burning extremely. (Dr. White maintains that the Rhus eruption is essentially an eczema, not an erysipelas \ differing from the idiopathic disease in that the vesicles are born such, instead of passing through an intermediate papular stage of development.) {New Tork 'Journ. of Med,^x\\y 225.)

2. a. Dr. Oehme, robust, but with a very sensitive skin, made his first experiments with Rh. v. in 1858. On Sept. 15th he applied juice exuding from between bark and wood to an oval place on back of I. forearm x^ in. long, 1 in. wide. This he repeated several times on that day and the next. From the 17th to the 29th he applied a tinct. he had now made to same spot 3 or 4 times daily, taking as often internally 4 dr. of the i, dil. In 24 h. after first application of juice, there was slight inflammation and swelling at spot, with some soreness on pressure. These symptoms increased steadily but slowly during next 11 d., with occasional itching and burning. On 28th, epidermis could easily be removed with the nail, and then scabs would soon form ; whole place red and much swollen — inflammation extending beyond limits of application. A fold of skin so affected was at least six times as thick as one on corresponding part of other arm, and I. arm at this point measured an inch more than r. The redness was not circumscribed, but passed over into an eruption like measles. Itching and burning were felt mainly when arm was covered, and more on surrounding surface than in inflamed spot, fiy 30th swelling measured 5i in. in length. He took this d. his last doses (3) internally, and ceased to make the local application. This d. and the next he was wakened early in m. by the violent itching and burning. Inflammation was now (Oct. ist) livid and phlegmonous, 6^ in. long and 6 in. wide. Part felt very hot, and a thermometer applied to it found it 8^^ warmer than corresponding spot on other arm. It was hard, like board; but not painful, save for occasional drawing sensation, extending into hand, and feeling of tightness. Nerves in T. axilla feel sore and are tender. Late in e., irregular red spots appeared on I. cheek. 2nd. — Swelling extends this m. from elbow to hand ; spots on face larger

and redder, somewhat elevated, and slightly burning; some swelling above 1. eye ; two red spots and a blotch under r. corner of mouth ; measle-lilcc eruption over 3rd — 5th metacarpal bones, and vesicles on fineers of 1. hand, appearing and disappearing very quickly, with most violent itching ; transient itching at various places on body in m., and, p.m., vesicles there; frequent brief sensation of coldness creeping over back (this also on subsequent days) ; at noon, drawing pain in large nerves of arm, from axilla downwards. 3rd. — Symptoms as before; whole forearm seat of phlegmonous inflammation — 9° hotter than the other; appetite and general health unaffected, 4th.— Skin now peeling off inflamed part, some pustules on new skin ; oedema of back of hand. 5th. — Arm now of normal temp., and swelling subsiding, 6th. — This m. another eruption of small pustules on same place, but a a little larger than yesterday : area peeling again, and still somewhat swollen, more than the thickness of a fold of skin would account for, so that deeper parts also must have been affected. From this time skin of arm gradually returned to its natural condition, but remained very irritable, slightest rubbing causing profuse eruption of blotches, vesicles and small pimples. From 31st violent itching several n. in succession, especially on back, but in daytime on face, neck and hands, followed soon by eruption as above. From this time up to March, nearly every n., especially at midnight, he had severe itching, particularly on back ; scratching aggravated it greatly, rubbing with a soft brush gave relief, but it was entirely subdued by washing with cold water or snow. During the attacks, back was burning hot, and covered with blotches and pimples.

h. O — again exposed himself, Aug. 8th, 1859, to influence of Rh. V, He peeled off bark and cut it up into very fine pieces. Being out of doors, mosquitoes troubled him during work ; and he was frequently compelled to put hands to face in order to drive them off. He also chewed for some time a piece of bark, and passed water before washing his hands, loth. — On rising, oedema under r. eye ^ difficulty in looking down, with disagreeable sensation ; red spots on face, especially I., and on upper chest ; itching. During d. face swelled, i ith, — A round group of hydroa vesicles, filled with yellowish serum, between nose and I. corner of mouth, and another group under latter; I, face somewhat swollen, and covered with red spots ; 1. ear thick and red, posterior surface of it rough, some itching on lower part ; nose and r. face considerably swollen, especially close under eye, which is considerably irritated; rays of sun cause burning in face. Much itching of sexual organs, especially scrotum and prepuce; hydroa vesicles on back of some fingers of either hand. P.m., small yellowish vesicles on different parts of face j r. nose and cheek much swollen, r, nostril obstructed ; oedema of face worse than yesterday, skin rough (not chapped) and uneven ; on back of I, hand and on fingers some efflorescence, which looks strikingly like itch ; slight dull feeling in head. At 3 p.m. eruption like measles with unevenness of skin on back of I. arm close above wrist, soon followed by blotches with violent itching and burning ; discharge of a little water from 1. nostril, with sensation in nose as of a commencing cold ; face hot ; arms fall easily asleep.

In e. much itching and burning on different places in face; feeling of dulness in head worse ; burning in eyes and slight lachrymation. (Hale, New Remedies^ 2nd ed.)

II. Poisonings. — i, a. Dr. Hoyt, March i8th, 1857, wishing to prepare a tinct., went into a swamp and procured some sprouts or Rh. v. He had buckskin gloves on, and kept to windward ; but in [ ^ h. began to feel most intense burning and itching in scrotum and penis — glans being very painful, igth. — Symptoms continued in same severity. At 1 1 a.m. he cautiously scraped oiF the bark. At 3 p.m. itching and burning commenced on r. hand (between fingers on dorsal aspect). 20th. — Very restless all n. Woke with itching and burning in various parts of body j hands considerably swollen ; face red but not shining. As d. advanced itching and burning went on, always relieved by exercise and worse at rest ; hands and face covered with little vesicles, exuding clear serum \ r. eyelid swollen and stiff. Had two stools, loose, first preceded by griping ; abdomen tender to touch and pressure. 21st. — Symptoms all increased ; face much swollen, and swelling of hands extending halfway to elbow ; pain excessive. Dizzy sensation at times, much worse in e. 22nd. — Loose stools at 3, 6, and 9 a.m., sudden, pain in hypogastrium preceding them. Hands and face still worse ; mouth feels rough, and mucous membrane is abnormally red ; incrustations appeared on inside of thighs ; slight dimness of sight, lachrymation, and livid circle round eyes j considerable deafness ; chills ran up back, even when warm and in warmth. Towards e. mouth got worse, and fauces took on same condition, causing dysphagia \ eyes smarted and burned, with profuse lachrymation ; quite severe colic about umbilicus ; very restless all n, 23rd. — Dull feeling in head and considerable frontal headache (relieved by belladonna). Severity of other symptoms somewhat abated, save diarrhoea, which is more severe i stools dark brown. General malaise. On affected parts soreness and peeling are replacing previous symptoms ; exudation now slightly yellow. Several vesicles under tongue, which is white coated, with red edges. Little appetite; some nausea. 24th. — Desquamation now went on freely, cuticle being renewed 4 times; new skin at first red and shining, afterwards rough, hard, dry, and very tender. Dulness, heaviness, and aching in head continued, also deafness ; he had trembling of limbs and twitching of muscles ; no disposition to move about or study ; was apprehensive, restless, and of fitful humour.

b* Symptoms gradually subsided till April 5th, when by accident bottle of tinct. was broken, and he received full force of effluvium. Face, especially upper lip, was much swollen and exceedingly painful ; back of ears also swollen, and here and on lips vesicles were abundant. Every d. from 2 to 5 a.m. diarrhoea began, and continued till noon ; abdomen much bloated and painful on least pressure ; continual rumbling and griping pains, always worse just before stool ; colour of stools uniformly light. (This continued for 3 weeks, yielding to no remedy, till it was stopped — then and in subsequent recurrences — by juniperus virginiana i.) All muscles stiff, especially those of back of r. leg (this also lasted some time). As desquamation ceased, boils — 3 large, 10 smaller — appeared on face and extremities, and ran usual course.

Uniformly, throughout ihe whole experience, the symptoms were aggravated by rest, and relieved by moderate exercise in open air. [Uiii.)

1. In 1814, Dr. PiERsoN accompanied me (BiGELOW) to collect the juice of the Rhus vernix. He had always supposed himself exempt from liability to the poison. The day was warm ; the effluvium from the incisions we made in the trees was very powerful ; we were exposed an h., he less than myself. His own account of the symptoms is as follows : ** I felt no unpleasant effects for 6 or 7 h,, when I perceived the backs of my hands were swollen and puffy without pain or itching ; my forehead and upper lip were soon in the same state. The following m. the tumefaction had increased^ and other parts were infected ; the backs of my hands and wrists began to show small watery vesicles. No applications were made until about noon ; I then applied cloths dipped in lead water to one hand and wrist, and a spirituous solution of corrosive muriate of mercury to the other. The parts began to itch ; the tumefaction increased j vesication began to take place on the swollen surface; small pustules formed and ran into each other, and at last some were as large as nutmegs. Next d. my eyes were nearly closed, from the swelling of my forehead, eyebrows, and cheeks. The contents of the vesicles were perfectly limpid ; inoculation from them to the other parts had no effect, nor at any other stage. The next e. the inflammation was at its height ; the burning and itching intolerable. The following d, the pustules began to appear a little milky, and by night the inflammation was evidently on the decline. This day I applied stramonium ointment. In a fortnight 1 was able to leave my chamber, and had a new cuticle from the roots of my hair on the forehead to my breast, and on the arms and inside the thighs. During the first 5 d. the pulse was increased 10 — 20 strokes." (Ibid.)

2. O. L — , aet. 16, a short stout lad, p.m. on Nov, 2ist, 1843, while ploughing in a field came to some shrubs in the way of the plough. These he removed with his hands, on which there were previously some abrasions. In about an h. afterwards his hands, arms, face and legs began to swell \ this was accompanied by slight redness of skin and by thirst ; no nausea or headache. On the 22nd I found great swelling of face, arms and legs ; some slight redness and swelling over chest, but trunk little affected. (The shrub was found to be Rh. v.) The swelling continued to increase till the e,, taking about 28 h, to reach its height. On the 24th it began to lessen, and by the 26th it had disappeared. Appetite remained good throughout. (Stratton, E(L Med, and Surg, "Journ.^ Ixxiii, 327.)

3. A gentleman, art. 30, hearing that Rh. v. was successful in the destruction of corns, applied tincc. to one on 1. foot 4 times, using fingers to rub it in. (He considers that by pulling sock on diffusion over foot occurred, and by possible change of socks other foot became influenced.) There came on intolerable itching and burning in I. foot ; vesicles formed there, and skin became congested, thick and stiff. Rubbing and striking part increased itching, as also did exercise. Similar itching and burning was now experienced in scrotum, forehead, eyelids, front of neck, and r. foot, attended with slightly puffed appear-

ance of all these parts. On 4th d. vesicles came out on r. foot, also in bend of 1. elbow ; occasional formication was felt in affected parts. On m. of 5th d. vesicles began to break, scabs following ; legs were oedematous, pitting on pressure. On 6th d., vesicles on fingers and back of r. hand. As the vesicles broke, and desquamation commenced, acute inflammation of surface (feet, hands. Sec), of dark red colour, supervened, with intense prickling heat, as though a hot iron plate was held in close proximity to the swollen parts ; flashes of heat, as though a stream of hot air was passing over body, with throbbing and tearing pains extending from each temple back to occipyt and down neck to each shoulder. There was suppuration of whole dorsum of 1. foot, and occasional patches of it of size of a half-dime to a dime halfway up to knee, also on r. foot and fingers ; these went on to deep, corroding, phagedenic ulcers, burning, prickling, and discharging thin, strawcoloured, acrid, and very foetid pus. By this time he was somewhat emaciated, and peevish and fretful to an extreme. The intensity of the symptoms continued about 3 weeks, but it was 3 mos. before he was entirely free from them. (Thomas, Brit Jeum, of Hom.^ xiVy 346.)

1. A little girl of 5 had been languid for % weeks, with no special symptoms, when one d. nose swelled up and became red, with slight fever. Dr. BuRT put 6 dr. of Is dil. into f of a tumbler of water, and ordered a teaspoonfiil every s h. Next d.

Katient was much better, and he ordered druff to be continued. On following d., owever, though nose was well, eyes were swollen and half closed, and she was very feverish. He gave aimphor as antidote, but next d. she was very much worse, very hot, pulse 130, soft and weak, face swollen enormously, eyes completely closed, tongue white coated, with watery vesicles on its sides and on fauces, which (with tonsils) were much inflamed ; urine very high coloured. She complained bitterly of soreness of throat, and said her limbs were so stiff that she could not walk. About 4 p.m. croupy symptoms came on, and continued to increase till midnight; head was thrown back, face almost black, cough very dry and of deep, hollow, crowing character; resp. almost impossible; pulse 140, soft and weak. Aconite was given, and next d. spongia. At n. the " croup '* came on again, but less violently. The croupy cough now left her, but she had a hard dry cou^h for a week, with much rattling of mucus in chest ; eyes remained closed for some time, and face very much swollen, but its colour was natural ; she could not open her mouth to eat for 1 weeks ; tongue was coated thickly, of dark grey colour, with very red tip ; pulse remained at 130, soft and feeble, for first week, in second came down to its natural standard; abdomen and lower limbs became enormously swollen, and it was 3 weeks before the oedema disappeared ; bowels costive and very tympanitic } legs could not be moved without making her cry, but if not touched she was perfectly easy. It was ten weeks before she became quite well. [Dr. Burt ascribes this illness to overdosing with the Rh. v.] {Med. I/tvest,, March, 1865.)