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ART. IV-A Case of Poisoning by Oil of Tansy. By A. C. BLODGET,
M. D., Youngville, Pa.
Case-Mrs. 0-, aged about 30, of medium size, nervous temperament, and three months pregnant, took at 5 P. M. August 2d, 1866, fld. 3iij of oil tanzy. Saw her about three-quarters of an hour afterwards. She was then suffering from nausea and vomiting, which, having been promoted by copious draughts of warm water, had continued freely for the last twenty minutes. The pulse was 110, small and feeble, surface cool and moist, intellect confused with tendency to stupor, breathing much distressed, and clonic spasms appeared. There was moaning and a general appearance of distress, but she acknowledged no pain. The stomach having been apparently well emptied, she was ordered an ounce of castor oil with an equal amount of whisky, to be followed with whisky and milk, equal parts, as freely as the stomach would bear, until the pulse rose. Also sinapisms over the stomach and feet, and friction with hot water and capsicum along the spine and limbs, as freely as practicable. Within an hour and a quarter from taking the drug she became completely unconscious, with pulse almost extinct; skin cold and clammy, breathing very laborious, and the spasms violent at intervals, varying from five to ten minutes. This condition continued between three and four hours, when copious diuresis occurred, followed, in a few minutes, by free alvine discharges. Within the next half hour the oppressive influence of the poison seemed wearing off. The pulse rose a little, the breathing became less labored, and the surface warmer. Directed the use of the whisky to be lessened, and discontinued as soon as reaction was decided. To use mucilaginous drinks, and morphine as far as necessary to control subsequent pain and restlessness. At 9 o'clock next morning there appeared a general improvement; pulse 90, rather small and quick, intellect clear, free from spasm, some pain in the stomach and bowels with tenderness, occasional nausea and slight headache. Treatment continued; i.e., morphine sufficient to keep pain and restlessness well subdued, and mucilaginous drinks. From this time the case progressed favorably and was convalescent in about three days from the beginning. The quantity of whisky taken during the stage of depression, was about six ounces, and probably one-fourth of this was vomited. The condition of the patient's stomach together with the difficulty of inducing her to swallow, rendered a more free use of the stimulus impracticable, if it had been desirable. Subsequently, when questioned, the woman insisted that she felt no pain after taking the tansy, until she emerged from the stupor; that about ten minutes after taking it she felt faint and sick at the stomach, and a feeling of numbness with a sensation as though her arms and legs were suddenly swelling. About this time vomiting commenced, her intellect became confused and she remembered nothing more distinctly until next morning. The drug produced no perceptible effect on the uterus, and the woman was subboquently delivered at full time of a healthy child.
ART. V. - Abstract of Proceedings of the Buffalo Medical Association.
TUESDAY EVENING, October 1st, 1867. The meeting was called to order at the usual hour by the President Members present-Drs. Eastman, Potter, Daggett, Smith, Kamerling, Boardman, Congar, Strong, Wetmore and Johnson.
The minutes'of the last meeting were read and approved.
DR. BOARDMAN, Chairman of the Committee on Constitution and By-Laws, presented the report of the committee and pointed out the proposed changes in the By-Laws. He also reported a Fee Bill for the consideration of the Association.
Considerable informal discussion was had upon the subject of the above report.
The President informed the meeting that final action would be had upon the Constitution and By-Laws at the next regular meeting.
DR. BOARDMAN said he would like to inquire if any of the members had seen any unusual sequele of scarlatina ? He had seen an , unusual tendency to pain in the lower extremities, with swelling and slight redness coming on after the rasb and fever had subsided, and lasting three or four days.
DR. EASTMAN said that he had seen several cases of scarlatina within the month, but had not seen any of the peculiarities mentioned by Dr. Boardman.
DR. STRONG had seen no such cases this year, but had in former years. No especial disease was reported as prevailing.
VOL. 7. NO. 44-18.
Dr. Henry Nichell was elected to read an essay at the regular December meeting. Adjourned.
T. M. Johnson, M. D., Sec'y.
The Activity of the Skin in the Absorption of Medicines.
BY DR. ROUSSIN. While it is abundantly proved that many articles of the materia medica, united with fatty matters, applied to the skin with a proper amount of friction, are absorbed, experiments with similar articles in a state of solution give different results. According to Laurés, and others, a man may sit for hours in a bath containing 200 to 300 grammes of iodide of potassium, without the urine showing the slightest traces of iodine; in the same way one may remain in a bath containing from 20 to 60 grammes of corrosive sublimate, without the slightest salivation being produced, while it would be occasioned by much smaller quantities rubbed into the skin. Finally, Magendie left a rather concentrated solution of strychnine in contact with the skin without causing the slightest spasm.
The experiments of Dr. Roussin confirm what was previously known on the subject. He remained from an hour to an hour and a half in a bath, containing from 450 to 500 grammes of iodide of potassium; in no instance, when the body was dried or the solution of the iodide washed off on coming out of the bath, could the slightest trace of iodine be discovered within twenty-four hours in the urine, or the saliva. On the other hand, when, on leaving the bath, the solution adhering to the body, was permitted to evaporate spontaneously, iodine showed itself soon after in the urine. In one of his experiments the author wet his arms with solution of the iodide and then permitted the solution to evaporate spontaneously; four hours afterward iodine was found in both the urine and saliva. The experiments show that the skin being unbroken, iodide of potassium is absorbed only when it is left in substance in contact with the skin. This becomes still more evident from the following experiments :—The author sprinkled the anterior part of his body from the neck to the abdomen with finely powdered iodide of potassium, rubbing it into the skin. The urine for the next twenty-four hours gave abundant evidence of iodine. The same evidence was given when the experimenter wore a shirt which, with the exception of the bosom, had been wet with a solution of iodide of potassium (10 per cent. in strength,) and then dried.
Many other substances behave in a manner similar to iodide of potassium, and in this way we can understand the numerous symptoms of poisoning which have been observed, when through the medium of the clothes, or in some similar manner, poisons come in immediate contact with the skin.
The cause of this passive relation of the skin to medicinal substances dissolved in water with which it comes in contact, arises from the fact that it is not possible for the water to enter the pores of the skin, on account of the fatty character of its surface. On the contrary, water is repelled rather than attracted, just as it is by capillary tubes with fatty walls.
Dr. R. shows that the skin is not in reality wet by watery solutions brought in contact with it; that is to say, the water does not extend in a continuous layer over it, but being repelled by the greasy surface, forms drops upon it. Even after soaping of the skin, the spreading out, the adhesion of the drops which fall upon it, is only apparent; the solution again gathers into drops as soon as the layer of soap, which permitted its adhesion to the skin, is removed. The same thing is observed when the skin is treated with ether. So soon as this is evaporated, the original relations between the skin and watery solutions placed upon it are renewed, because a constant secretion of fat takes place from it. On the other hand, when a piece of skin, taken from the cadaver, is soaped after the removal of the layer of soap, water wets it, spreading itself out, without being gathered into drops.
The absorption of fatty matters hy the skin, finds its natural explanation in the laws of capilarity; they can, rubbed into the skin, pass easily through the capillary vessels, and with them the substances with which they are incorporated, provided only they are minutely enough divided.
In like manner we can explain the absorption of solid matters wben placed upon the skin in a pulverulent form, and here become mixed with its fatty secretion.
On the contrary, glycerine, which behaves toward the skin in a manner similar to water, is not to be used as a vehicle for substances which we desire to introduce into the economy through that organ.-(Rec. des Mem. de Med. etc. Milit. 3d ser. xviii, p. 134, Feb. 1867, in Schmidt's Jahrbücher, No. 7, 1867.)
Reported Death from Inhalation of Ether,
M. Laroyenne of Lyons, France, reported to the Medical Society of that place the following case: “Subject, a female aged 48 years, constitution feeble. Has an old affection of the left knee, with distortion of the lower extremities. Anästhesia practiced with caution, insensibility occurring after the inhalation of ten drachms of ether. In two or three minutes, the breathing became embarrassed, face pale, pulse insensible. The recumbent position and cold affusions roused her from this first syncope. Hardly had she been put in bed—fifteen minutes after the first syncope-when a new attack came on, and notwithstanding artificial respiration, prolonged insufllation, galvanization of the diaphragm and the intercostal muscles and of the heart by the aid of long acupunc ture needles, it was impossible to call her to life. An attentiveexamination of the thoracic organs before anæsthesia, had failed to demonstrate any organic lesion. The analysis of the ether by Professor Glenard proved that it contained no foreign substance other than three in 100 parts of water. Necropsy. Mucus in the larynx and trachea; pleural adhesions; tubercles in the left pleura; base of left lung congested. The pulmonary tissue was impreg. nated with the odor of ether. Small quantity of fluid in the pericardium; heart normal; ventricles empty; auricles gorged with blood; nervous centres sound, possessing a feeble odor of ether; a small quantity of fluid in the ventricles. Medulla compressed by a tubercular mass developed in the seventh and eighth dorsal vertebræ, which presented no appearances from without. The alteration had advanced to the left coxofemoral articulation, which presented tubercular masses and osseous fragments within the cap