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ON A CASE OF FATAL POISONING BY STRYCHNIA;
259 She complained that the opium made her con- poison ; and in a very short time after this general tremors and tantly drowsy and unfit for her occupation as a needlewoman; violent spasmodic fits came on, which excited the alarm of the and the pain was, notwithstanding its use, occasionally so severe family, and I was immediately sent for.
tion of leeches. S
oblige
her to rise from bed and roll
the floor of her
I
On my arrival and examination of the patient, I found a general over the body, the limbs rigid, and the face exhibiting an In January, I determined upon a trial of congelation, having almost maniacal expression, which was soon followed by a viomade another careful examination of the uterus. fit The lent of tetanus. Between the fits she did not utter any exprespreviously disease had by this time considerably extended: the neck of the sion of alarm, but would occasionally request a little cold water. womb was now completely destroyed, and there were several The muscles of the jaws remained so rigid between the spasms as warty excrescences in the upper part of the vagina. Congelation to prevent their being opened sufficiently to admit the tube of the was effected by means of a frigorific mixture of two parts of stomach-pump being introduced, but were sufficiently relaxed to finely-pounded ice and one part of chloride of sodium, introduced admit of strong emetics being administered; it, however, repeatedly through a wide speculum of gutta percha, having the lower part happened, that the attempt of the patient to take liquids was folof its upper opening of a cup-like form; and in order that the lowed by so violent a spasmodic fit as to prevent her swallowing temperature might be maintained at the requisite low degree, or it, and to give that apparent dread of water, so well marked in below zero of Fahrenheit, the dissolved ice was continuously cases of hydrophobia. Even after her request for water, on atdrawn off by a syphon of peculiar construction. This peculiarity tempting to give it to her, she would find herself so incapable of principally consists in a large two-necked bottle being connected swallowing it, as to request that its administration might be deferred with, or constituting part of, the long arm of the syphon; and the until the fit was over, the effort to place the cup to the mouth purpose of it is, that a stream of water may continue to flow along being generally sufficient in itself to induce a relapse of the this part of the syphon, and keep up the suction at its upper ex- spasms. During the tetanic fits the whole body was stiffened and tremity, notwithstanding any interruption in the supply. A tube of vulcanized india-rubber forms the remaining part of the syphon, straightened; the neck violently drawn back; the chest fixed; with a small glass tube where it enters the speculum, in order the eyes protruding from their sockets in a horrible manner ; the that the rising column of liquid may be seen and regulated by a legs pushed out and widely separated ; the muscles of the face convulsed; pulse imperceptible, and no breathing could be perstop-cock. The success of this application exceeded my expectation. So ceived ; the face was livid, more particularly the lips, and froth Soon as I had learned to apply the frigorific properly, I was able issued from the mouth. It is also worthy of remark, that during to give immediate and entire relief, and this has generally con- the paroxysm the pupil was much dilated, becoming contracted tinued complete for about a week. The discharge was soon after the violence of the fits had subsided. As the fit passed diminished, and became much less offensive, and the tendency to away, the pulse gradually rose; she perspired freely, and comhaemorrhage ceased. From twenty to thirty applications of the plained of thirst, but not of sickness, although powerful emetics were comparatively few, frigorific have now been made, and scarcely any other remedy had been administered. The severe fits has been used. No advance of the disease appears, on examina- but between them slight fits came on in rapid succession ; indeed tion, to have taken place, and in other respects there is decided the attempt to take any liquid would be generally sufficient to improvement. The patient is not so thin ; her appetite is: induce one, and even merely pressing gently the muscles of the tolerably good; she is stronger, and able to occupy herself in thejaw, or an attempt to open the mouth by pressing on the lips and usual household affairs. teeth, was sufficient to excite an attack. The emetics at one She is directed to call whenever the pain returns. The specu- time began to operate, but the violent fits coming on about the lum is generally introduced by herself while in the supine posi- same time seemed to paralyze any further action of the stomach. tion, and she covers her extremities with a sheet before I enter It was found impossible to produce any relaxation of the body the apartment. The nates are raised, in order that the speculumi during a fit ; the head was firmly bent back, the hands were may be sufficiently upright to contain enough of the frigorific,, clenched, the arms bent, the legs and body extended, and if which has usually been kept applied for a period varying from aL moved she remained in that fixed position. About half-past quarter to half an hour. There is a slight sensation of smartingreleven A.M. a fit more violent and of longer duration came on, produced for a minute or two, and the pain from the disease has which terminated her existence. As soon as death had taken generally ceased within the first five minutes. If the womb be place, the limbs relaxed, the face and lips gradually lost their livid hue, and became as well as the body extremely pallid; innow inspected by removing the frigorific from the speculum, the greater part of its visible surface will be found perfectly whites deed similar to that which we observe in persons who have died and hard. The application is terminated by allowing about afrom internal haemorrhage. The quantity of strychnine taken in quart of cold water to run rapidly through the speculum and1 this case must have been nearly a grain and a half. During the this case I also administered large doses of vinegarsyphon for the purpose of gradually restoring the natural tem- progress ofwhich and-water, remedy I was induced to employ for the reasons perature, and washing away any remaining salt. I subjoin, having, when experimenting on animals with the St. be continued.) (To Ignatius’ bean of Manilla,* succeeded in a partial degree in counteracting the effects of the poison with that remedy; in this case it appeared in some degree to lessen the violence of the spasms, but the effects of the poison had advanced too far to render the ON A CASE OF FATAL POISONING BY remedy of any avail. As the experiments above alluded to (and STRYCHNIA; published in the -Iledical and Surgical Journal of Feb. 1832) EXPERIMENTAL ITS EFFECTS ON INTO REMARKS WITH INQUIRIES will serve to elucidate the above case, I have re-copied them from ON ANIMALS. that journal :" BY GEORGE BENNETT, Esq., M.R.C.S., Sydney. During a visit to Manilla, I tried experiments of the poisonous effects of the seeds of the ignatia amara. (named cabalonga by the ABOUT ten A.M. of the 20th of April, 1838, my immediate attendance was requested on Amelia H-, a female servant in the natives) in two instances; one on a dog about ten months old, employ of W. A’Beckett, Esq. On my arrival I found her suffer- and with the following results:-At fifty-five minutes past ten A.M. ing from violent spasms, resulting, as I understood, from poison- I gave half a drachm of the seed, cut into small pieces and enveing by strychnine. The account I received was, that on the day loped in a piece of meat, to a dog: it was swallowed without any previous she had consulted a surgeon for amaurosis, for which he of the pieces being lost. The dog was lively and playful, but at prescribed three grains of strychnine in a solution of ten drachms times would appear restless and uneasy, as if some internal of cinnamon-water, directing twenty drops to be taken three times annoyance was occasioned by the poison. At twenty minutes daily in a wineglass of water; a written label of directions was past eleven he suddenly fell, with violent convulsion of the attached to the bottle, and she was also verbally informed of the limbs, which were extended with great rigidity, and they afterdangerous nature of the medicine. On the bottle containing the wards remained in that rigid position ; this was followed by exmedicine being produced, I found the unfortunate young woman cessive panting and trembling of the muscles; the saliva became had taken about four and a half or five drachms, which had been viscid, and the tongue, as well as the saliva with which it was poured out by a little girl thirteen years of age, who on being to’d covered, had a dark appearance. The poison acted on the to pour out twenty drops, and probably being ignorant of the nervous system; the dog exhibited no indication of pain; meaning of a drop, poured out the above quantity. After taking no yell escaped him; the eyes assumed a dull appearance; the medicine, she went about her work, cleaned out a room, and the mouth had a movement as if the animal had been snapwent into the kitchen to breakfast, had swallowed a cup of tea, ping at fliers ; and there was a constant spasmodic twitching and was commencing a second, when she complained of feelmg * A paper on this subject was read before the Medico-Botanical Society very ill, having a peculiar kind of twitchings over her limbs, which of London, January 10, 1832, and subsequently published in the &Iedicai and hour after the of administration the Surgical Journal for February, 1832. began rather more than an
as to
on
room.
tremor
.
.
.
-
260 of the muscles of the face. At twenty-five minutes past eleven, the body became less convulsed; the urine was passed involuntarily, but not the fseees. On passing the hand before the eyes of the animal, the eyelids were moved, indicating that consciousness had not yet departed; the orbicularis oculi muscles had a convulsive quivering; the snapping and panting still continued. At thirty-five minutes past eleven, a general convulsive action of the muscles came on, and terminated the existence of the animal. An hour after the death I inspected the body. On opening the thorax, the viscera had no unusual appearance. On inspecting the stomach, it was found partly filled with rice, among which the small pieces of the seeds of the ignatia amara were intermingled: on emptying the stomach of its contents, the inner coat was found of a pale, pinkish hue. The liver had a healthy appearance, but if any portion of that organ was cut, a quantity of blood, in a fluid state, immediately flowed; (and it is an interesting question, why we find the blood destitute of fibrin in those cases in which death proceeds from causes acting immediately on the nervous system, as where a person is struck dead by lightning, &c. ?) The remainder of the abdominal and pelvic viscera had a healthy appearance. The whole of the muscles of the animal had a bloodless, blanched appearance; the vena cava and aorta were also filled with blood in a fluid state. On inspecting the brain, no .particular appearance was observed, excepting that the vessels appeared totally destitute of blood. The second experiment was on a dog, a year and a half old. At thirty-five minutes past four P.3i., half a drachm of the seed, cut into small pieces, was given to the animal. At five minutes past five P.m., he suddenly fell with violent spasms of the limbs, which soon became stretched out and rigid, with spasms of the lower jaw. I was desirous of trying vinegar as an antidote; so, as soon as the spasms of the muscles of the lower jaw relaxed, I poured down some quantity ;* the animal appeared nearly dead. About two minutes after the vinegar had been administered, he was so much recovered as to stand up; it was, however, but of short duration, for at ten minutes past five he reeled and fell, with similar spasms as before. Another dose of vinegar was given, with the same good effects : the animal recovered, and stood up ; the eyes, however, preserved throughout a dull, glairy appearance. The dog appeared uneasy, as might have been expected, and trembled exceedingly, but no expression of pain escaped from him; he seemed bewildered. At fourteen minutes past five he fell, with similar effects as before; the spasms The same remedy was given, with were not, however, so severe. the same reviving effects. The fits were accompanied, at first, by violent spasmodic action of the muscles of the lower extremities, which afterwards became extended and rigid, whilst other parts of the body were convulsed. The muscles of the jaw had invariably a strong spasmodic action at the commencement of the fit, but soon became relaxed. The panting and snapping were not so marked in this as in the preceding experiment. At eighteen minutes past five he again fell: the urine was passed involuntarily, ’, but not the facces, and he appeared nearly dead. Vinegar was ’ again administered; but he lay for some time without hardly an indication of existence. I thought life was extinct. At twentyfive minutes past five, the respiration, before scarcely to be perceived, became laborious, as if the circulation of the blood had again taken place, by a renewal of the heart’s action ; the eyes became animated, and the dog regained his sensibility; the laborious state of respiration only continued for a short period. At thirty-five minutes past five, he had not risen from his extended position on the ground, but no fit had again yet taken place. On causing him to be raised from the ground, the limbs displayed a contracted, rigid appearance, but they could be readily placed by the hand in a relaxed position. He was soon afterwards able to sit up by his own exertions; he was then so far recovered as to run the length of the cord to which he was tied, but the limbs, when he moved, appeared stiffened and paralytic. The animal, a short time previous to his being brought to me, had received an injury of the left hind leg, which had occasioned lameness :-. when the spasmodic action of the muscles came on, during the paroxysms the injured limb was drawn upwards and backwards, whilst the other limbs were drawn, stiffened downwards and outwards. The animal continued apparently well, but in a miserable, debilitated state, until fifty minutes past five, when he moved about, and fell down suddenly, with the same tetanic symptoms as before; the eyes had again their dull, glairy appearance ; the jaws were kept firmly closed by the violence of the spasms, which severe spasms were extended over the whole of the body ; and in the *
About
a
minute had
elapsed from the time
to the administration of the vinegar
as an
of the
antidote.
poison taking effect
space of a minute he was dead. The quantity of vinegar taken was about half a pint. The poisonous effects of these seeds are speedy and violent. Magendie considers that its active principle-the strychninestrongly excites the spinal marrow, without affecting, except indirectly, the functions of the brain. After the dog has taken the poison, his playful manner still continues, but mixed, at the same time, with a restlessness, which increases as the poison begins to act ; he then feels inclined to lie down, then rises again, until he suddenly falls with tetanic symptoms, and during the action of the poison the animal appears bewildered. The active principles of the ignatia amara are strychnine and brucine, of which the first is the more powerful, and is said to be found purer in the ignatia than in the nux vomica; but it is met with purest in the upas tiente of Java. Sydney, New South Wales, Oct. 1849.
ON THE SPECTRAL ILLUSIONS IN EPILEPSY MENTIONED BY ARETÆUS AND OTHERS. BY ALFRED HAVILAND, ESQ., M.R.C.S.E., Bridgewater. THE following observations may be interesting to the readers
of the
case
of
epilepsy
which
was
the care of Dr. recorded in THE
lately under
Owen Rees, in Guy’s Hospital, and which LANCET for July 13, 1850, p. 57.
was
Spectral illusions, as prominent signs in cases of epilepsy, have by many of the ancient writers on medicine, and especially by Aretoeus, whose graphic description of this particular disease proves not only that he was acquainted with the been alluded to
affection, but also that he must have had under his own immediate observation a great many cases of it. In his essay, (n-:p[ p. 3. 10, 11, he says, that in many instances the patients are under the apprehension that wild animals are chasing them, or that they are followed by a shadow just before they fall awayDr. Petit, in his learned commentary on the writings of Aretseus, says, with regard to the first part of this observation-" Quod iis potissimum accidere arbitror, quibus causa morbi est humor melancholicus. Est enim ingenium ejusce humoris atri et frigidi terribiles imaginationi formas objicere." From the remarks recorded of the personal appearance of Rebecca L-, the subject of the case in question, I am led to infer that she was of the temperament to which Petit refers. A more minute description of her history, temper, habits, and personal appearance, would be interesting. The term tþavraatJ], in the above passage, is undoubtedly equivalent to the English one " appearance." In some other passages of the same author, we find it made use of to denote " visions," as p. 13. It is not, however, limited in its use to the description of the illusions of the mind dependent upon derangement of that portion of the encephalic mass which is associated with the organ and function of sight, for we find Aretasus describing by it the delusion that icteroid patients are under with regard to the taste of bitter and sweet thingsticrepov, p. 53. 4 ; also in the religious form of mania he uses the term to denote the superstitious idea p. 38. 36. Again, in his essay, p. 35.19, the term may be translated by the English ones " crotchet" or "fancy," the last of which is etymologically allied to it, inasmuch as it springs in common with it from cþaLvw. In writing on the affections of the liver, Aretseus (7rEpt fj7raTOf:, p. 48. 13) mentions, that when the patients are icteroid, they are not altogether free from dreams-"
In the chapter, which P. Petit says,
that curious sensation, of Mirum hoc symptoma, et ut censeo inexplicabile," spinal column moving down into the legs, " &phgr;av&tgr;a&sgr;í&e gr; &tgr;&zgr; &rgr;á&khgr; ∈&zgr; &Ggr;&ohgr; &sgr;&kgr;∈&lgr;∈ K&ugr;∈oµ∈&ngr;&eegr;&zgr;" is expressed by the same word. The term &phgr;a&ugr;&tgr;a&sgr;í&e gr; is used in some other passages to convey a meaning equal in value to the English one "sense" or "feeling," as a sense of fulness in the stomach&sgr; t o&micr ; ag ve &khgr; o &phgr;a n &tgr;a s &i cute; &eegr; ∈&eegr; "p.146.27; &sgr;∈ ∈&pgr; or a feeling of water flowing over parts-" &phgr;a&ngr;&tgr;a&sgr;ía a&ugr;&tgr;∈o&sgr; &ohgr;&zgr; &dgr;∈&kgr;&thgr;∈0&ngr;&tgr;0&zgr; &ugr;&g r;&rgr;0&ugr; p. 66. 23. The object-matter of these &phgr;a&ngr;&tgr;a&sgr;ía are phantoms—&phgr;a&ngr;&tgr;á&sgr;µa&tgr;a, and to the perverted mind they certainly must appear clothed in reality, or the effects they produce would not be such as they are known to be. In the case before us, they did not affright at first, but only after the disease had gained
of the
"
tion of leeches. S
oblige
her to rise from bed and roll
the floor of her
I
On my arrival and examination of the patient, I found a general over the body, the limbs rigid, and the face exhibiting an In January, I determined upon a trial of congelation, having almost maniacal expression, which was soon followed by a viomade another careful examination of the uterus. fit The lent of tetanus. Between the fits she did not utter any exprespreviously disease had by this time considerably extended: the neck of the sion of alarm, but would occasionally request a little cold water. womb was now completely destroyed, and there were several The muscles of the jaws remained so rigid between the spasms as warty excrescences in the upper part of the vagina. Congelation to prevent their being opened sufficiently to admit the tube of the was effected by means of a frigorific mixture of two parts of stomach-pump being introduced, but were sufficiently relaxed to finely-pounded ice and one part of chloride of sodium, introduced admit of strong emetics being administered; it, however, repeatedly through a wide speculum of gutta percha, having the lower part happened, that the attempt of the patient to take liquids was folof its upper opening of a cup-like form; and in order that the lowed by so violent a spasmodic fit as to prevent her swallowing temperature might be maintained at the requisite low degree, or it, and to give that apparent dread of water, so well marked in below zero of Fahrenheit, the dissolved ice was continuously cases of hydrophobia. Even after her request for water, on atdrawn off by a syphon of peculiar construction. This peculiarity tempting to give it to her, she would find herself so incapable of principally consists in a large two-necked bottle being connected swallowing it, as to request that its administration might be deferred with, or constituting part of, the long arm of the syphon; and the until the fit was over, the effort to place the cup to the mouth purpose of it is, that a stream of water may continue to flow along being generally sufficient in itself to induce a relapse of the this part of the syphon, and keep up the suction at its upper ex- spasms. During the tetanic fits the whole body was stiffened and tremity, notwithstanding any interruption in the supply. A tube of vulcanized india-rubber forms the remaining part of the syphon, straightened; the neck violently drawn back; the chest fixed; with a small glass tube where it enters the speculum, in order the eyes protruding from their sockets in a horrible manner ; the that the rising column of liquid may be seen and regulated by a legs pushed out and widely separated ; the muscles of the face convulsed; pulse imperceptible, and no breathing could be perstop-cock. The success of this application exceeded my expectation. So ceived ; the face was livid, more particularly the lips, and froth Soon as I had learned to apply the frigorific properly, I was able issued from the mouth. It is also worthy of remark, that during to give immediate and entire relief, and this has generally con- the paroxysm the pupil was much dilated, becoming contracted tinued complete for about a week. The discharge was soon after the violence of the fits had subsided. As the fit passed diminished, and became much less offensive, and the tendency to away, the pulse gradually rose; she perspired freely, and comhaemorrhage ceased. From twenty to thirty applications of the plained of thirst, but not of sickness, although powerful emetics were comparatively few, frigorific have now been made, and scarcely any other remedy had been administered. The severe fits has been used. No advance of the disease appears, on examina- but between them slight fits came on in rapid succession ; indeed tion, to have taken place, and in other respects there is decided the attempt to take any liquid would be generally sufficient to improvement. The patient is not so thin ; her appetite is: induce one, and even merely pressing gently the muscles of the tolerably good; she is stronger, and able to occupy herself in thejaw, or an attempt to open the mouth by pressing on the lips and usual household affairs. teeth, was sufficient to excite an attack. The emetics at one She is directed to call whenever the pain returns. The specu- time began to operate, but the violent fits coming on about the lum is generally introduced by herself while in the supine posi- same time seemed to paralyze any further action of the stomach. tion, and she covers her extremities with a sheet before I enter It was found impossible to produce any relaxation of the body the apartment. The nates are raised, in order that the speculumi during a fit ; the head was firmly bent back, the hands were may be sufficiently upright to contain enough of the frigorific,, clenched, the arms bent, the legs and body extended, and if which has usually been kept applied for a period varying from aL moved she remained in that fixed position. About half-past quarter to half an hour. There is a slight sensation of smartingreleven A.M. a fit more violent and of longer duration came on, produced for a minute or two, and the pain from the disease has which terminated her existence. As soon as death had taken generally ceased within the first five minutes. If the womb be place, the limbs relaxed, the face and lips gradually lost their livid hue, and became as well as the body extremely pallid; innow inspected by removing the frigorific from the speculum, the greater part of its visible surface will be found perfectly whites deed similar to that which we observe in persons who have died and hard. The application is terminated by allowing about afrom internal haemorrhage. The quantity of strychnine taken in quart of cold water to run rapidly through the speculum and1 this case must have been nearly a grain and a half. During the this case I also administered large doses of vinegarsyphon for the purpose of gradually restoring the natural tem- progress ofwhich and-water, remedy I was induced to employ for the reasons perature, and washing away any remaining salt. I subjoin, having, when experimenting on animals with the St. be continued.) (To Ignatius’ bean of Manilla,* succeeded in a partial degree in counteracting the effects of the poison with that remedy; in this case it appeared in some degree to lessen the violence of the spasms, but the effects of the poison had advanced too far to render the ON A CASE OF FATAL POISONING BY remedy of any avail. As the experiments above alluded to (and STRYCHNIA; published in the -Iledical and Surgical Journal of Feb. 1832) EXPERIMENTAL ITS EFFECTS ON INTO REMARKS WITH INQUIRIES will serve to elucidate the above case, I have re-copied them from ON ANIMALS. that journal :" BY GEORGE BENNETT, Esq., M.R.C.S., Sydney. During a visit to Manilla, I tried experiments of the poisonous effects of the seeds of the ignatia amara. (named cabalonga by the ABOUT ten A.M. of the 20th of April, 1838, my immediate attendance was requested on Amelia H-, a female servant in the natives) in two instances; one on a dog about ten months old, employ of W. A’Beckett, Esq. On my arrival I found her suffer- and with the following results:-At fifty-five minutes past ten A.M. ing from violent spasms, resulting, as I understood, from poison- I gave half a drachm of the seed, cut into small pieces and enveing by strychnine. The account I received was, that on the day loped in a piece of meat, to a dog: it was swallowed without any previous she had consulted a surgeon for amaurosis, for which he of the pieces being lost. The dog was lively and playful, but at prescribed three grains of strychnine in a solution of ten drachms times would appear restless and uneasy, as if some internal of cinnamon-water, directing twenty drops to be taken three times annoyance was occasioned by the poison. At twenty minutes daily in a wineglass of water; a written label of directions was past eleven he suddenly fell, with violent convulsion of the attached to the bottle, and she was also verbally informed of the limbs, which were extended with great rigidity, and they afterdangerous nature of the medicine. On the bottle containing the wards remained in that rigid position ; this was followed by exmedicine being produced, I found the unfortunate young woman cessive panting and trembling of the muscles; the saliva became had taken about four and a half or five drachms, which had been viscid, and the tongue, as well as the saliva with which it was poured out by a little girl thirteen years of age, who on being to’d covered, had a dark appearance. The poison acted on the to pour out twenty drops, and probably being ignorant of the nervous system; the dog exhibited no indication of pain; meaning of a drop, poured out the above quantity. After taking no yell escaped him; the eyes assumed a dull appearance; the medicine, she went about her work, cleaned out a room, and the mouth had a movement as if the animal had been snapwent into the kitchen to breakfast, had swallowed a cup of tea, ping at fliers ; and there was a constant spasmodic twitching and was commencing a second, when she complained of feelmg * A paper on this subject was read before the Medico-Botanical Society very ill, having a peculiar kind of twitchings over her limbs, which of London, January 10, 1832, and subsequently published in the &Iedicai and hour after the of administration the Surgical Journal for February, 1832. began rather more than an
as to
on
room.
tremor
.
.
.
-
260 of the muscles of the face. At twenty-five minutes past eleven, the body became less convulsed; the urine was passed involuntarily, but not the fseees. On passing the hand before the eyes of the animal, the eyelids were moved, indicating that consciousness had not yet departed; the orbicularis oculi muscles had a convulsive quivering; the snapping and panting still continued. At thirty-five minutes past eleven, a general convulsive action of the muscles came on, and terminated the existence of the animal. An hour after the death I inspected the body. On opening the thorax, the viscera had no unusual appearance. On inspecting the stomach, it was found partly filled with rice, among which the small pieces of the seeds of the ignatia amara were intermingled: on emptying the stomach of its contents, the inner coat was found of a pale, pinkish hue. The liver had a healthy appearance, but if any portion of that organ was cut, a quantity of blood, in a fluid state, immediately flowed; (and it is an interesting question, why we find the blood destitute of fibrin in those cases in which death proceeds from causes acting immediately on the nervous system, as where a person is struck dead by lightning, &c. ?) The remainder of the abdominal and pelvic viscera had a healthy appearance. The whole of the muscles of the animal had a bloodless, blanched appearance; the vena cava and aorta were also filled with blood in a fluid state. On inspecting the brain, no .particular appearance was observed, excepting that the vessels appeared totally destitute of blood. The second experiment was on a dog, a year and a half old. At thirty-five minutes past four P.3i., half a drachm of the seed, cut into small pieces, was given to the animal. At five minutes past five P.m., he suddenly fell with violent spasms of the limbs, which soon became stretched out and rigid, with spasms of the lower jaw. I was desirous of trying vinegar as an antidote; so, as soon as the spasms of the muscles of the lower jaw relaxed, I poured down some quantity ;* the animal appeared nearly dead. About two minutes after the vinegar had been administered, he was so much recovered as to stand up; it was, however, but of short duration, for at ten minutes past five he reeled and fell, with similar spasms as before. Another dose of vinegar was given, with the same good effects : the animal recovered, and stood up ; the eyes, however, preserved throughout a dull, glairy appearance. The dog appeared uneasy, as might have been expected, and trembled exceedingly, but no expression of pain escaped from him; he seemed bewildered. At fourteen minutes past five he fell, with similar effects as before; the spasms The same remedy was given, with were not, however, so severe. the same reviving effects. The fits were accompanied, at first, by violent spasmodic action of the muscles of the lower extremities, which afterwards became extended and rigid, whilst other parts of the body were convulsed. The muscles of the jaw had invariably a strong spasmodic action at the commencement of the fit, but soon became relaxed. The panting and snapping were not so marked in this as in the preceding experiment. At eighteen minutes past five he again fell: the urine was passed involuntarily, ’, but not the facces, and he appeared nearly dead. Vinegar was ’ again administered; but he lay for some time without hardly an indication of existence. I thought life was extinct. At twentyfive minutes past five, the respiration, before scarcely to be perceived, became laborious, as if the circulation of the blood had again taken place, by a renewal of the heart’s action ; the eyes became animated, and the dog regained his sensibility; the laborious state of respiration only continued for a short period. At thirty-five minutes past five, he had not risen from his extended position on the ground, but no fit had again yet taken place. On causing him to be raised from the ground, the limbs displayed a contracted, rigid appearance, but they could be readily placed by the hand in a relaxed position. He was soon afterwards able to sit up by his own exertions; he was then so far recovered as to run the length of the cord to which he was tied, but the limbs, when he moved, appeared stiffened and paralytic. The animal, a short time previous to his being brought to me, had received an injury of the left hind leg, which had occasioned lameness :-. when the spasmodic action of the muscles came on, during the paroxysms the injured limb was drawn upwards and backwards, whilst the other limbs were drawn, stiffened downwards and outwards. The animal continued apparently well, but in a miserable, debilitated state, until fifty minutes past five, when he moved about, and fell down suddenly, with the same tetanic symptoms as before; the eyes had again their dull, glairy appearance ; the jaws were kept firmly closed by the violence of the spasms, which severe spasms were extended over the whole of the body ; and in the *
About
a
minute had
elapsed from the time
to the administration of the vinegar
as an
of the
antidote.
poison taking effect
space of a minute he was dead. The quantity of vinegar taken was about half a pint. The poisonous effects of these seeds are speedy and violent. Magendie considers that its active principle-the strychninestrongly excites the spinal marrow, without affecting, except indirectly, the functions of the brain. After the dog has taken the poison, his playful manner still continues, but mixed, at the same time, with a restlessness, which increases as the poison begins to act ; he then feels inclined to lie down, then rises again, until he suddenly falls with tetanic symptoms, and during the action of the poison the animal appears bewildered. The active principles of the ignatia amara are strychnine and brucine, of which the first is the more powerful, and is said to be found purer in the ignatia than in the nux vomica; but it is met with purest in the upas tiente of Java. Sydney, New South Wales, Oct. 1849.
ON THE SPECTRAL ILLUSIONS IN EPILEPSY MENTIONED BY ARETÆUS AND OTHERS. BY ALFRED HAVILAND, ESQ., M.R.C.S.E., Bridgewater. THE following observations may be interesting to the readers
of the
case
of
epilepsy
which
was
the care of Dr. recorded in THE
lately under
Owen Rees, in Guy’s Hospital, and which LANCET for July 13, 1850, p. 57.
was
Spectral illusions, as prominent signs in cases of epilepsy, have by many of the ancient writers on medicine, and especially by Aretoeus, whose graphic description of this particular disease proves not only that he was acquainted with the been alluded to
affection, but also that he must have had under his own immediate observation a great many cases of it. In his essay, (n-:p[ p. 3. 10, 11, he says, that in many instances the patients are under the apprehension that wild animals are chasing them, or that they are followed by a shadow just before they fall awayDr. Petit, in his learned commentary on the writings of Aretseus, says, with regard to the first part of this observation-" Quod iis potissimum accidere arbitror, quibus causa morbi est humor melancholicus. Est enim ingenium ejusce humoris atri et frigidi terribiles imaginationi formas objicere." From the remarks recorded of the personal appearance of Rebecca L-, the subject of the case in question, I am led to infer that she was of the temperament to which Petit refers. A more minute description of her history, temper, habits, and personal appearance, would be interesting. The term tþavraatJ], in the above passage, is undoubtedly equivalent to the English one " appearance." In some other passages of the same author, we find it made use of to denote " visions," as p. 13. It is not, however, limited in its use to the description of the illusions of the mind dependent upon derangement of that portion of the encephalic mass which is associated with the organ and function of sight, for we find Aretasus describing by it the delusion that icteroid patients are under with regard to the taste of bitter and sweet thingsticrepov, p. 53. 4 ; also in the religious form of mania he uses the term to denote the superstitious idea p. 38. 36. Again, in his essay, p. 35.19, the term may be translated by the English ones " crotchet" or "fancy," the last of which is etymologically allied to it, inasmuch as it springs in common with it from cþaLvw. In writing on the affections of the liver, Aretseus (7rEpt fj7raTOf:, p. 48. 13) mentions, that when the patients are icteroid, they are not altogether free from dreams-"
In the chapter, which P. Petit says,
that curious sensation, of Mirum hoc symptoma, et ut censeo inexplicabile," spinal column moving down into the legs, " &phgr;av&tgr;a&sgr;í&e gr; &tgr;&zgr; &rgr;á&khgr; ∈&zgr; &Ggr;&ohgr; &sgr;&kgr;∈&lgr;∈ K&ugr;∈oµ∈&ngr;&eegr;&zgr;" is expressed by the same word. The term &phgr;a&ugr;&tgr;a&sgr;í&e gr; is used in some other passages to convey a meaning equal in value to the English one "sense" or "feeling," as a sense of fulness in the stomach&sgr; t o&micr ; ag ve &khgr; o &phgr;a n &tgr;a s &i cute; &eegr; ∈&eegr; "p.146.27; &sgr;∈ ∈&pgr; or a feeling of water flowing over parts-" &phgr;a&ngr;&tgr;a&sgr;ía a&ugr;&tgr;∈o&sgr; &ohgr;&zgr; &dgr;∈&kgr;&thgr;∈0&ngr;&tgr;0&zgr; &ugr;&g r;&rgr;0&ugr; p. 66. 23. The object-matter of these &phgr;a&ngr;&tgr;a&sgr;ía are phantoms—&phgr;a&ngr;&tgr;á&sgr;µa&tgr;a, and to the perverted mind they certainly must appear clothed in reality, or the effects they produce would not be such as they are known to be. In the case before us, they did not affright at first, but only after the disease had gained
of the
"