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membrane between the valvula conniventes. The mesenteric glands are swollen. Wucherer supposes that the larvae of the worms are introduced into the system by drinking water. He has never found the acylostomes or their eggs in the patients' dejections. The medicines of most use are the juices of anthelmintic plants, especially that of ficus doliaria. ·Deutsches Archiv für Klinische Medicin, vol. x, Sept., 1872; and Revue des Sciences Médicales en France et à l'étranger, Janvier, 1873, tome i.

On the Variations of Temperature in the course of Tuberculosis.— Lebert, from observation of the temperature in 153 cases of tuberculosis has formulated the following conclusions:-1. The course of the temperature in tuberculosis is such as we observe in inflammatory diseases of long duration; it does not exhibit specific characters. 2. Although the fever of the tuberculosis rarely attains a high degree of intensity, it powerfully contributes by its long duration and frequent irregularities to induce the exhaustion of consumption. 3. Neither age nor sex, at least after puberty, exercise an appreciable influence over the intensity of the fever. 4. In the typhoid form, which especially appertains to acute tuberculosis, but which may also be observed in the commencement of chronic cases, the course is quite other than that of typhoid properly so called. There is not the progressive rise during the first days; the mean temperature is less high; the remissions are less marked, they do not present any regularity, and it is not rare to see them come on in the evening. 5. The course of fever in phthisis often presents peculiarities for which neither the form nor the evolutions of the disease account. It is probable that morbid products are developed in phthisis which exercise a pyrogenetic action, and which perhaps contain a more or less poisonous element. 6. The information, therefore, furnished by the thermometer cannot throw light sufficiently on disturbances which nutritive changes undergo in phthisis. 7. In the morning the temperature is often normal at the beginning and at the end of the disease. 8. In the evening the temperature is generally febrile, rarely very high; generally from 39° to 39-15°; 40° is often reached, 42° very rarely. In the last stage the evening temperature falls, generally not lower than 38°; occasionally only it rises temporarily to a high number. 9. In acute tuberculosis high temperatures are somewhat more frequently observed. 10. The long duration and irregular course of the fever in tuberculosis are to be referred rather to the increasing weakness of the patient than to the intensity of pyrogenetic processes. 11. The decrease of fever in the ulcerative stage of the disease is to be attributed to collapse. The temperature is affected by two sets of causes. Pyrogenetic processes tend to raise it, whilst other causes tend to lower it, and so produce collapse. The latter predominate at first in the morning, after that later in the evening. 12. In most cases temperature attains suddenly a high number, without any circumstance to account for it. 13. In the last weeks or last days of the disease the temperature suddenly falls enormously. It may go down to 35°, 34°, and even to 32.5°; generally there is a consecutive rise almost as great. It is a sign of the end, nevertheless death rarely takes place during this

period. 14. The chart may show considerable oscillations in the temperature of one day; this is a peculiarity characteristic of the temperature in tuberculosis. 15. The morning temperature generally influences the type of the fever. 16. In certain cases the inverse type predominates. 17. When the disease undergoes a temporary arrest it is not a bad sign if the morning temperature remains below the normal. 18. When death approaches, the temperature may fall progressively, or it may remain normal, or it may rise at times to a considerable height, even 42°. In acute tuberculosis especially, the final temperature becomes high. 19. In the first stage of chronic disseminated pneumonia the temperature is at first normal; gradually there is a slight evening rise, which does not much exceed 38°. 20. When this disseminated tuberculisation is accompanied by fever the temperature may take a different course. 21. When the tubercular foci multiply it may be accompanied by fever, with evening exacerbations. Fever is also more intense when the morbid products undergo retrogressive metamorphoses. 22. After abundant hæmoptysis, fever may notably diminish or entirely fall. 23. Intense febrile changes may be developed in the course of chronic tuberculosis without any complication or occasional cause. In favorable cases they gradually recede. 24. Febrile exacerbations observed in phthisis are not due to the resorption of the products of decomposition; they occur where there is no softening; and, on the other hand, in broncho-pneumonia with caverns the fever may remain constantly moderate. The thermometric range in caseous pneumonia is not characteristic. 25. When in the last period of chronic tuberculosis there is a development of miliary granulations, fever rarely undergoes a notable increase; it generally retains its preceding character. 26. Acute or subacute miliary tuberculosis of the lungs, whether primitive or consecutive, presents almost as many varieties as chronic tuberculosis. Fever may be slight, or of moderate intensity, with evening exacerbations. At other times intense and continuous at the beginning, it soon becomes irregular. In some cases it presents a remittent type. 27. The same may be said of miliary tuberculosis of the peritoneum and meninges. 28. The occurrence of pneumothorax causes a rapid rise of temperature, which is not long maintained. 29. Intercurrent inflammations cause the temperature to rise. 30. Perforation in peritonitis, when it kills rapidly, produces a sudden fall of temperature-as low as 34°.-Deutsches Archiv für Klin. Med., Nov., 1872; and G. Hayem's Revue des Sciences Médicales en France et à l'étranger, Avril, 1873.

REPORT ON TOXICOLOGY, FORENSIC MEDICINE, AND HYGIENE.

BY BENJAMIN W. RICHARDSON, M.D., F.R.S.

Chronic Poisoning by Fumes of Zinc Oxide. - Dr. Leo Popoff reports the case of a man thirty-six years of age who had been a bronze founder for twelve years, and had lived, consequently, in an

At first he

atmosphere charged with fumes of oxide of zinc. suffered from pyrosis, from gaseous eructations; then, every day, when he returned home, he perceived upon his lips a whitish efflorescence, arising from a deposit of oxide of zinc, at the same time experiencing a very decided metallic taste in his mouth. In the winter, when the doors of the workshops could not be kept open, the intensity of the occurrences increased; he often had violent choleraic attacks (intense headache, severe shiverings, cramp in the extremities and especially in the calves of the legs, nausea, vomiting, and considerable action of the bowels). At this time he was placed under the care of Professor Botkin; the vomitings had become almost continuous, returning regularly three or four hours after a meal; he had always pyrosis and acid eructations, and complained of a dull pain in the epigastrium and on the right of the umbilicus: : a general weakness, more marked on the right side, and habitual constipation continued during six, eight, and ten days. He slept badly, and was often disturbed by violent headache and painful cramps in the calf of the legs; had extreme sensitiveness in the forehead, and an appetite small, capricious, and at times even altogether failing. There was paleness of the mucous surfaces, with disappearance of the subcutaneous cellular tissue, and atrophy of the muscular system, much more marked on the right side, in the face as well as in the limbs. Decrease of sensibility to touch; tickling, on the contrary, was more quickly responded to than in the normal state. The temperature in the morning was 36°, in the evening 363°; weight of the patient, 45 kilogr. His answers were slow, and he spoke as if in a bad temper. The daily quantity of urine was 550 c. c.; it was neutral, or even alkaline, containing neither sugar nor albumen; nevertheless, appropriate reagents revealed in it the presence of zinc two and a half months after the patient had left off work. The first cardiac sound was hoarse and rather prolonged; the liver was voluminous. The stomach was considerably dilated as far down as the navel, its peristaltic movements at times being very appreciable through the abdominal wall; the pylorus hypertrophied, sunken, and movable, formed a tumour sensible to the touch, sometimes to the right, sometimes to the left of the umbilicus. At last, under the right false ribs another hard tumour was found, slightly indented, not well defined, but painful when pressed, and which gave rise to the idea that a new growth depended from the liver; but repeated examinations showed that its size was very variable, that prolonged pressure of the fingers caused its gradual disappearance, and that it was most evident during the violent gastric crises from which the patient suffered; it was caused purely by the contractions of hypertrophied muscle, on the right side, resting upon a solid surface formed by the increased mass of the liver.

The matters vomited, the daily quantity of which varied from 600 to 2000 grammes, gave an acid reaction and a smell of rancid oil. Besides the remains of the food the presence of products of fermentation was proved, such as butyric acid and lactic acid, the existence of a large number of sarcina and cryptogams. The gas from the

eructations burned in daylight with a pale flame, scarcely visible, indicating the presence of hydrogen.

The patient had chlorine water administered to him for the stomachic fermentation, rhubarb for the chronic catarrh of the stomach, and his diet was composed exclusively of animal food. He left the hospital cured.-Berlin. klin. Wochens., 1873, No. 5; and Revue des Sciences Médicales, Tome I, No. 2.

Toxicological Studies on Hydrocotarnin.-Dr. F. A. Falk has made. with this alkaloid of opium two series of experiments, one on rabbits, the other on frogs. He employed the chlorhydrate of hydrocotarnin, administering it by subcutaneous injection.

The results at which he arrived were:-For killing a rabbit, two decigrammes of the salt were required for every kilogramme of the animal's weight. This new alkaloid then takes its place as an active agent of the third rank, after thébaine and codéine, but before morphine.

The lesion most constantly found after death in rabbits poisoned by the salt was the dark colour of the blood contained in the left ventricle. But it is known that this transformation of the arterial blood into venous blood is to be found in numerous kinds of intoxications.

As with codéine, two symptomatic forms are distinguishable in poisoning with hydrocotarnin-a tetanic form and a narcotic form. In both cases the symptoms commence with respiratory disturbance and agitation, and there is always a final identical stage which is adynamic. In the tetanic form there is elevation of temperature, in the narcotic form the temperature decreases.

To poison a frog a dose ten times the quantity is required-two grammes, or two and a half grammes, of hydrocotarning per kilogramme of frog. The phenomena of intoxication are the same as with rabbits-tetanus, apparent death, then actual death. During apparent death the heart is the only organ still active.-Vierteljahrsschrift f. gerict. Med., Janvier, 1873, p. 49; and Revue des Sciences Méd., Tome I, No. 2.

Substances Antagonistic to Phosphorus as a Poison.-Professor Gubler states, in reference to substances antagonistic to phosphorus, that arsenic, which much resembles it in a chemical point of view, seems to be the antagonist of phosphorus as the bromide of potassium is in relation to the alkaline iodide. The gas arising from the combustion of carbon, sulphuretted hydrogen, the anæsthetics, the cyanides, and sulphide of carbon, are the dynamic. antagonists of phosphorus.

The chemical counter-poisons of phosphoric preparations are sufficiently numerous and tolerably efficacious. To neutralise acids derived by oxidation of the phosphorus the Professor advises the use of lime-water or of hydrate of magnesia (Brullé, Poggiale, C. Paul). By means of carbon, which he first recommended, he says it is possible not only to absorb the disengaged vapours of phosphorus in the alimentary canal, but also the metalloid in suspension in the aqueous liquids. The ulterior experiments of Eulenberg and Vöhl

upon animals also established and confirmed his previsions. But the most certain method of treatment, or, at least, that which has the most confirmed experience, is the use of the essence of turpentine, an agent employed for a long time in a manufactory at Stafford to protect the workmen during the steeping of the chemical matches. The first clinical experiment elsewhere and crowned with success was made by Dr. Andant, of Dax, in 1868. Other favorable facts were observed by the same gentleman, as well as by Dr. Sorbets, and, abroad, by Köhler. Personne also has made some interesting experiments on dogs, which place beyond doubt the efficacy of this method. But if all investigators agree in proclaiming the virtues of the essence of turpentine, and the same could doubtless be said of all hydro-carbonated essences, which, like those of bergamot, citron, lavender, copaiva, mint, mace, mustard, rosemary, and thyme, prevent the phosphorescence of the metalloid, they are far from unanimous in agreeing upon the mode of operation of this kind of chemical counter-poison. Personne attributes to the essence of turpentine the power of opposing itself to the oxidation of phosphorus, with which it penetrates into the circulation, and so prevents the production of asphyxia by possessing itself of the oxygen of the blood. This theory has been doubted by Currie and Vigier, who, taking advantage of their negative results, have denied the experimental proof and the theory of the original investigators. It seems, however, difficult to contest the good effects of the essence of turpentine in phosphorous poisonings. It might even be asked, as a German experimentalist did, whether the innocuous property of the phosphorus is not attained by means of a rapid combustion, effected by the ozone present in the hydro-carbonated essence, or whether the essence of turpentine, by surrounding the molecules of phosphorus and opposing combustion, does not at the same time suppress the production of ozone, cause rapid waste of the blood-globules, and of all the organic tissues, to which Gubler attributes the physiological excitement arising from small doses of phosphorus as well as the more serious results from large quantities.-Bulletin Général de Thérapeutique Méd. et Chir., Tome lxxxiv, 10e livraison, 30th May, 1873.

II.-FORENSIC MEDICINE.

Relation of Uramic and Alcoholic Poisoning to Testamentary Capacity.-Dr. Stephen Rogers relates the following history bearing upon the above-named subject. Near the close of the year 1869, E. Ť. Owas quietly, if not clandestinely, married to a man whom report says, her education, religious and secular, would, in the ordinary course of events, have led her to shun rather than to love.

A key to the secret of this untoward occurrence is furnished by accumulated evidence, to the effect that she was an incorrigible and hopeless inebriate. Though trained and fairly educated in one of the best schools for girls, this vice of drunkenness seized her soon after her return home from school, and as a consequence she soon became the cause of constant and harassing care to her friends, and

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