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A CASE OF BULLOUS ERUPTION CAUSED BY MAY-WEED.
560 birth as a routine although too weak to suckle. Immediately after the establishment of lactation on third day breast pump was used and breast milk so withdrawn was given to child by pipette or spoon-a drachm every two hours for first few days-increased gradually in three weeks to six drachms every three hours. Progress has been uninterrupted, as shown by the marked increase in weight. There has been no vomiting or diarrhoea since birth ; stools have always been normal. Weight.-At birth, 1 lb. 6 oz. ; end of first week, not recorded; end of second week, 1 lb. 14 oz. ; end of third week, 2 lb. 10 oz. ; end of fourth week,3 lb.½ oz.
a common field-weed. Abrasions, produced by her occupa,tion of pea-picking, apparently preceded the lesions. She described other cases amongst workers similarly employed, and on inquiry in South Essex I obtained a history of other cases in which individuals had been obliged to give up work for some weeks. Inquiries made for me in Kent elicited the same information. The lesions were dressed with a powder of zinc, starch, and calomel and speedily healed.
May-weed,
Remarks. In Bernhard Smith’s work on " Poisonous Plants of All Countries " (p. 73) Anthemis cotmla (May-weed) is included in the appendix of plants " reputed to be poisonous." In Maisch’s " Manual of Materia Medica," seventh edition, p. 260, Anthemis cotula, May-weed, wild chamomile, belonging to the natural order Compositae, Anthemidae is described as having an unpleasant aromatic odour, bitter acrid taste. Its constituents are a volatile oil, valerianic acid, acrid fat, tannin, anthemidine (?), anthemic acid (crystal. line, bitter, soluble in ether). Valerianic acid is classed as an irritant by B. Smith (loc. cit.). I obtained some fairly fresh plants and rubbed the juice of the leaves and flowers into my forearm, both into the unbroken surface and into a scarified area. In the spots treated with the juice of the leaves a rather tender papule developed the same evening, both in the scarified and unbroken parts. The papules lasted for five days and cleared up, leaving no mark. There was no vesication. The specimen weed had been gathered 12 hours, and it is possible that the plant is more virulent at certain times than others.
The whole case is interesting in that various authorities, including Budin of Paris, have stated that mortality of premature babies weighing under 3 lb. is 100 per cent., and also as emphasising the importance of breast feeding in premature babies. It is especially in the first few days of lactation that the
child
derives from mother’s milk those immune bodies which are capable of protecting it against infections of all kinds. A CASE OF
BULLOUS ERUPTION CAUSED BY MAY-WEED. BY J. H. SEQUEIRA, M.D., F.R.C.P. LOND., F.R.C.S. ENG., PHYSICIAN,
SKIN
DEPARTMENT,
LONDON HOSPITAL.
THE attention recently called to plant dermatitis and the fact that this is the first case of its type seen in my clinic at the London Hospital has led me to publish this note. On June 30th, 1921, a married woman, aged 51, presented
A CASE OF
herself at the Skin Department at the London Hospital with a remarkable eruption of blebs on the left elbow and both wrists. She was a strong, healthy woman, and her face, forearms, and hands were deeply tanned by the sun. She FIG. 1.
Showing
the bullous
CONGENITAL ABSENCE OF RIGHT PECTORALIS MAJOR. BY A. G. MILLOTT SEVERN, M.D. BRUX., M.R.C S., F.C.S.,
FIG. 2. left forearm and hand; eruption (1) (2) on right hand. on
been engaged in peaIt was in Essex. difficult to get exact dates, but apparently the eruption for which she consulted me had come on acutely two or three dayss before. When examined she had an enormous, irregular, flaccid blister over the left elbow, extending down the back of the forearm for 3½ to 4 inches. A similar bleb, 3 inches in its long diameter and from 1 to 2 inches wide, was present over the ulnar side of the back of the left wrist, and a rather larger bulla over the ulnar aspect of the back of The fluid the right wrist. the in blebs was clear serum- and there was no zone of erythema round them (Figs. 1 and 2). The patient complained of pain and some irritation. She ascribed the lesions to poisoning with
PATHOLOGIST,
EAST SUSSEX COUNTY MENTAL HOSPITAL.
A POST-MORTEM examination performed at the Royal Sussex County Hospital on a man, aged 44 years, who died from perforated gastric ulcer, showed complete absence of the right pectoralis major, including both the pars sterno-costalis and the pars clavicularis. There was no remnant of muscular tissue or fascial band to be found ; the ribs were normal, being covered only by the skin and subcutaneous tissue where the pars sterno-costalis should be; the condition may therefore be assumed to have been congenital. The right pectoralis minor and both the pectoral muscles on the left side were present and well developed, and there was no other muscular deficiency or abnormality of the thorax. Absence of all or part of the pectoralis major on one or both sides is decidedly rare, but Bing and other anatomists have stated that variations occur more often in the pectoral group than in any other of the skeletal muscles-after allowing that abnormality of the pectorals is more easily detected than is the case with other smaller or less apparent muscles. Developmentally this group of muscles is among the last to be acquired, and therefore one would expect to find in them the most frequent variation. In this case the condition had apparently caused but little disability during life, for the man had followed a laborious occupation ; in fact, in most of the recorded cases where pectoral muscle abnormalities were not associated with other deformities, no inconvenience or functional weakness was observed on account of the muscular deficiency-the deltoid and other shoulder muscles sufficing for all the movements of the arm. These observations tend to show how good a functional result may be expected in a patient whose pectoral muscles have been removed for- malignancy. References.-R. Bing: Virchow’s Arch., 1902, clxx., p.175.
had
picking
I
J. Gardiner: Journ. Amer. Med. Assoc., Feb. 1915, p. 508. D. M. Greig: Edinburgh Med. Journ., 1912, N.S., viii., p. 248. Rev. d’Orthopedie, J. Martirené : Paris, 1903, p. 209. G. Variot: Bull. Soc. de Pediatrie de Paris, 1907, ix., p. 2. W. Wendel: Mitteil. a.d. Grenzgeb. d. Med. u. Chir., 1905, xiv., p. 456.
a common field-weed. Abrasions, produced by her occupa,tion of pea-picking, apparently preceded the lesions. She described other cases amongst workers similarly employed, and on inquiry in South Essex I obtained a history of other cases in which individuals had been obliged to give up work for some weeks. Inquiries made for me in Kent elicited the same information. The lesions were dressed with a powder of zinc, starch, and calomel and speedily healed.
May-weed,
Remarks. In Bernhard Smith’s work on " Poisonous Plants of All Countries " (p. 73) Anthemis cotmla (May-weed) is included in the appendix of plants " reputed to be poisonous." In Maisch’s " Manual of Materia Medica," seventh edition, p. 260, Anthemis cotula, May-weed, wild chamomile, belonging to the natural order Compositae, Anthemidae is described as having an unpleasant aromatic odour, bitter acrid taste. Its constituents are a volatile oil, valerianic acid, acrid fat, tannin, anthemidine (?), anthemic acid (crystal. line, bitter, soluble in ether). Valerianic acid is classed as an irritant by B. Smith (loc. cit.). I obtained some fairly fresh plants and rubbed the juice of the leaves and flowers into my forearm, both into the unbroken surface and into a scarified area. In the spots treated with the juice of the leaves a rather tender papule developed the same evening, both in the scarified and unbroken parts. The papules lasted for five days and cleared up, leaving no mark. There was no vesication. The specimen weed had been gathered 12 hours, and it is possible that the plant is more virulent at certain times than others.
The whole case is interesting in that various authorities, including Budin of Paris, have stated that mortality of premature babies weighing under 3 lb. is 100 per cent., and also as emphasising the importance of breast feeding in premature babies. It is especially in the first few days of lactation that the
child
derives from mother’s milk those immune bodies which are capable of protecting it against infections of all kinds. A CASE OF
BULLOUS ERUPTION CAUSED BY MAY-WEED. BY J. H. SEQUEIRA, M.D., F.R.C.P. LOND., F.R.C.S. ENG., PHYSICIAN,
SKIN
DEPARTMENT,
LONDON HOSPITAL.
THE attention recently called to plant dermatitis and the fact that this is the first case of its type seen in my clinic at the London Hospital has led me to publish this note. On June 30th, 1921, a married woman, aged 51, presented
A CASE OF
herself at the Skin Department at the London Hospital with a remarkable eruption of blebs on the left elbow and both wrists. She was a strong, healthy woman, and her face, forearms, and hands were deeply tanned by the sun. She FIG. 1.
Showing
the bullous
CONGENITAL ABSENCE OF RIGHT PECTORALIS MAJOR. BY A. G. MILLOTT SEVERN, M.D. BRUX., M.R.C S., F.C.S.,
FIG. 2. left forearm and hand; eruption (1) (2) on right hand. on
been engaged in peaIt was in Essex. difficult to get exact dates, but apparently the eruption for which she consulted me had come on acutely two or three dayss before. When examined she had an enormous, irregular, flaccid blister over the left elbow, extending down the back of the forearm for 3½ to 4 inches. A similar bleb, 3 inches in its long diameter and from 1 to 2 inches wide, was present over the ulnar side of the back of the left wrist, and a rather larger bulla over the ulnar aspect of the back of The fluid the right wrist. the in blebs was clear serum- and there was no zone of erythema round them (Figs. 1 and 2). The patient complained of pain and some irritation. She ascribed the lesions to poisoning with
PATHOLOGIST,
EAST SUSSEX COUNTY MENTAL HOSPITAL.
A POST-MORTEM examination performed at the Royal Sussex County Hospital on a man, aged 44 years, who died from perforated gastric ulcer, showed complete absence of the right pectoralis major, including both the pars sterno-costalis and the pars clavicularis. There was no remnant of muscular tissue or fascial band to be found ; the ribs were normal, being covered only by the skin and subcutaneous tissue where the pars sterno-costalis should be; the condition may therefore be assumed to have been congenital. The right pectoralis minor and both the pectoral muscles on the left side were present and well developed, and there was no other muscular deficiency or abnormality of the thorax. Absence of all or part of the pectoralis major on one or both sides is decidedly rare, but Bing and other anatomists have stated that variations occur more often in the pectoral group than in any other of the skeletal muscles-after allowing that abnormality of the pectorals is more easily detected than is the case with other smaller or less apparent muscles. Developmentally this group of muscles is among the last to be acquired, and therefore one would expect to find in them the most frequent variation. In this case the condition had apparently caused but little disability during life, for the man had followed a laborious occupation ; in fact, in most of the recorded cases where pectoral muscle abnormalities were not associated with other deformities, no inconvenience or functional weakness was observed on account of the muscular deficiency-the deltoid and other shoulder muscles sufficing for all the movements of the arm. These observations tend to show how good a functional result may be expected in a patient whose pectoral muscles have been removed for- malignancy. References.-R. Bing: Virchow’s Arch., 1902, clxx., p.175.
had
picking
I
J. Gardiner: Journ. Amer. Med. Assoc., Feb. 1915, p. 508. D. M. Greig: Edinburgh Med. Journ., 1912, N.S., viii., p. 248. Rev. d’Orthopedie, J. Martirené : Paris, 1903, p. 209. G. Variot: Bull. Soc. de Pediatrie de Paris, 1907, ix., p. 2. W. Wendel: Mitteil. a.d. Grenzgeb. d. Med. u. Chir., 1905, xiv., p. 456.