POISONING BY OLEANDER.

244 oodematous. The liver dulness extended in the nipple line from the fourth to the seventh ribs. There was some dulness in the flanks. Incisions were made in the legs and saline purgatives and infusion of digitalis were given without relief. The legs became more distended and the abdomen more swollen, with marked dulness in the flanks, fluctuation, and dyspnoea. On March 28th paracentesis was performed and yielded 5700 cubic centimetres of fluid. The abdomen became lax and the oedema disappeared. The fluid reaccumulated. On April 6th 6200 cubic centimetres were removed and on the 16th 7800. On each occasion the fluid presented the same striking appearance. It was milky white, with a tinge of pink. On standing the pink colour disappeared and a red deposit formed. The fluid contained 1 per cent. of albumin and 1’3 par cent. of fat. Microscopic examination showed no large fat globules but a number of fine granules in constant motion. There were 24,000 erythrocytes and 1800 leucocytes per cubic centimetre. The latter consisted of small lymphocytes, 665 per cent. ; large lymphocytes and transitionals, 13’per cent. ; and polymorphonuclears, 20 per cent. The patient became comatose A necropsy was made. The and died on April 26th. abdomen contained about 2800 cubic centimetres of pink fluid similar to that removed during life. There was a typical hobnail liver which weighed 1400 grammes. The ,receptaculum chyli and thoracic duct were occluded by a firm fibrous clot. The mitral valves were thickened and insufficient. Very few cases of chylous ascites associated with cirrhosis of the liver have been recorded. The nature of the connexion between these conditions is not clear. were

POISONING

BY OLEANDER.

collected in one part of France, the Vosges, produces a marked physiological effect, whereas in other parts as much as from four to eight grammes are given, while in Roumania so large a dose as from 12 to 15 grammes of the powdered leaves has been given without producing toxic effects. According to Allen3 the leaves of oleander contain two glucosides, oleandrin and neriin, having physiological effects closely analogous to those exhibited by digitalis. Oleandrin is alleged to have basic properties, though it is free from nitrogen, while neriin is not improbably identical with

digitalein. A

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REDUCTIO AD ABSURDUM PHARMACY ACT.

OF

THE

THE announcement was recently made in the Financial Timcs that a company had been registered to acquire a druggist’s business at Newmarket with a unique directorate. Of the seven gentlemen holding the position of director five are professionally connected with horse-racing; they are A. D. Sadler, S. Loates, and G. Chaloner, trainers of racehorses ; G. H. Martin, jockey; and E. Moore, turf commission agent; the remaining two directors being an auctioneer and a butcher. It is noteworthy that the board of directors is singularly lacking in members possessed of even allied a nodding acquaintance with pharmacy and the The situation of these gentlemen is decidedly sciences. Are we to think that they have been chosen Gilbertian. with a view of bringing their special knowledge to bear on any branch, however remote it might be, of the art of pharmacy. The Financial Times ironically suggests that this may be an application of the joint-stock principle to the medical treatment of horses and that the butcher and auctioneer may come in useful after the other "druggists" have had their innings. It emphasises an anomaly in the Pharmacy Act of 1868, whereby it is possible for limited companies of unqualified persons to practise as druggists and to use the title of druggist. The only safeguard to the public consists in the fact that the assistants employed in the shops of such companies must possess a pharmaceutical qualification in order to sell or to dispense scheduled poisons.

IN THE LANCET of Dec. 30th, 1905, p. 1894, Dr. F. Lucas Benham referred to the poisonous nature of oleander and desired information as to what instances of poisoning by In the event of no records of that shrub are known. its toxic effect being forthcoming there is direct and corroborative evidence sufficient to suggest the symptoms to be expected in cases of poisoning by oleander. It has been shown by M. Dubigadoux and M. Durieu1 that the branches of the Algerian oleander yield on incision a poisonous, milky THE STRAITS SETTLEMENTS POISON juice, from which can be isolated a substance chemically and ORDINANCE, 1905. the to identical with physiologically strophanthin, glucoside COLONIAL legislators frequently have the advantage over which strophanthus owes its activity. The generic name of oleander is Nerium and it belongs, as does strophanthus, to those who make laws for the mother country in that they do the natural order Apocynaceæ or the periwinkle family. To not always have to consider old-established customs or the same order belongs the ouabaio tree, the wood of which vested interests. In the Pharmaceutical Journal of Jan. 6th yields the glucoside ouabain, resembling strophanthin in its are given to the new rules made by the Governor in chemical constitution and physiological action but being Council under Section 13 of the Straits Settlements Poison much more toxic. Apocynum or Canadian hemp, another Ordinance, 1905, which afford a case in point. They include member of this family, contains two active principles several wise restrictions which are not imperative in this which act as cardiac tonics in a similar way to digitalis. country. The new Ordinance contains Schedule A, Parts I. Another member of the family, the white quebracho, is and II., almost similar to Schedule A of the Pharmacy Act, exceedingly active, affecting and, finally, paralysing the 1868, and the same precautions have to be observed in the It is retail sale of poisons in both parts of the schedule as obtain respiration, central nervous system, and heart. evident that the well-known members of the family to in this country. It is noteworthy that sulphonal is included In addition the rules provide that no poison which oleander belongs have a powerful action on the heart. in Part I. Digitalis itself, the best known of the cardiac tonics, is a shall be sold to any person under 18 years of age. member of a closely allied family, the scrophulariaceas. It is Licences to sell by retail the several poisons named and probable, therefore, that oleander also exerts an action on described in Schedule A shall be issued only to such persons the heart. It does not necessarily follow that the plant is as are duly registered as licensed chemists and druggists equally active when grown in other countries-e.g., in South under the Morphine Ordinance (XIV. of 1905). Schedule B Australia. It is well known that drugs vary enormously in is a new and commendable feature of the Ordinance. It respect of their active principles and potency according to includes several poisons which can only be sold wholesale the climate and soil in which they grow. Digitalis affords a by such persons as may be granted a wholesale licence good example of this. It has been shown by M. François under the provisions of the Ordinance. The quantities Franckthat from 0’ 2 to 1’ 0 gramme of the leaves shown opposite each poison in Schedule B shall be deemed minimum amount constituting a wholesale transaction. ———————————————————————————— 1 Journal de Pharmacie et de Chemie, 1898, p. 433. 3 Commercial 2 Archives de Organic Analysis, vol. iii., part 3, p. 137. Physiologie, 1891 and 1892. -

the