CHAPTER XXXVI.

OF POISONING WITH SQUILL, MEADOW-SAFFRON, WHITE HELLEBORE, AND FOXGLOVE. The natural family _Liliaceæ_, and the allied family, _Melanthaceæ_, contain many species which possess narcotico-acrid properties. Those which are best known in Europe are squill, meadow-saffron, cevadilla, and white hellebore. To these may be added foxglove, as possessing properties in some measure analogous, and also rue and ipecacuan. _Of Poisoning with Squill._ The root of the squill, or _Squilla maritima_, possesses the properties of the narcotico-acrids. Orfila’s experiments on animals, indeed, assign to it only an action on the nervous system. He found that two ounces and a half of the fresh root, when secured in the stomach of a dog by a ligature on the gullet, excited efforts to vomit, dilated pupil, and lethargy; and in two hours the animal suddenly fell down in a violent fit of tetanus, and expired. From thirty-six grains injected into the jugular vein no effect followed for sixteen hours; when at last, as in the former case, the animal dropped down convulsed and died immediately.[2272] The effects, however, caused by squill on man leave no doubt that it is also an active irritant; for it causes sickness, vomiting, diarrhœa, gripes, and bloody urine, when given in over-doses. It has likewise produced narcotic symptoms in man. Lange mentions an instance of a woman, who died from taking a spoonful of the root in powder to cure tympanitis. She was immediately seized with violent pain in the stomach; and in a short time expired in convulsions. The stomach was found every where inflamed, and in some parts eroded.[2273]—A woman, whose case is mentioned in a French journal, after taking from a female quack a vinous tincture made with seventy-five grains of extract of squill, was seized with nausea and severe colic, to which were added in twenty-four hours a small contracted pulse, extreme tenderness of the belly, and cold extremities; and she died in the course of the second day.[2274] Twenty-four grains of the powder have proved fatal.[2275] I have seen a quarter of an ounce of the syrup of squills, which is a common medicinal dose, cause severe vomiting, purging, and pain. An acrid principle, named scillitin, has been discovered in the squill. A difference of opinion prevails as to its nature. Some chemists consider it to be a resin; but Landerer has obtained it in the crystalline form, with alkaline properties. A grain of it will kill a dog. _Of Poisoning with White Hellebore and Cevadilla._ White hellebore, the root-stock of _Veratrum album_, and cevadilla, the seed and capsules of _Asagræa officinalis_, and possibly of _Veratrum sabadilla_, seem to be characteristic examples of the narcotico-acrid poisons. They both possess a strong bitter taste, followed by acridity. The cevadilla-seed in particular has an intensely disagreeable and persistent bitter taste, and produces at the same time a combination of acridity and numbness of the lips, tongue, and cheeks. They owe their active properties chiefly to an alkaloid of great energy, termed veratria. White hellebore root is familiarly known to be a virulent poison. The best account of its effects is contained in a Thesis by Dr. Schabel, published at Tübingen in 1817. Collecting together the experiments previously made by Wepfer, Courten, Viborg, and Orfila, and adding a number of excellent experiments of his own, he infers that it is poisonous to animals of all classes,—horses, dogs, cats, rabbits, jackdaws, starlings, frogs, snails, and flies;—that it acts in whatever way it is introduced into the system,—by the stomach, rectum, windpipe, nostrils, pleural membrane of the chest, an external wound, or the veins;—that it produces in every instance symptoms of irritation in the alimentary canal, and injury of the nervous system;—and that it is very active, three grains of the extract applied to the nostrils of a cat having killed it in sixteen hours.[2276] _Symptoms in Man._—Its effects on man are similar. A singular account of several cases of poisoning with the root is contained in Rust’s Journal. A family of eight people, in consequence of eating bread for a whole week, in which the powder of the root had been introduced by mistake instead of cumin seeds, were attacked with pains in the belly, a sensation as if the whole intestines were wound up into a clue, swelling of the tongue, soreness of the mouth, and giddiness; but they all recovered by changing the bread and taking gentle laxatives.[2277] Another set of cases of a more aggravated nature, though still not fatal, is given in Horn’s Archives.[2278] Three people took the root by mistake for galanga. The symptoms that ensued were characteristic of its double action. In an hour they all had burning in the throat, gullet, and stomach, followed by nausea, dysuria, and vomiting; weakness and stiffness of the limbs; giddiness, blindness, and dilated pupil; great faintness, convulsive breathing, and small pulse. One of them, an elderly woman, who took the largest share, had an imperceptible pulse, stertorous breathing, and total insensibility even to ammonia held under the nose. Next day she continued lethargic, complained of headache, and had an eruption like flea-bites. A fatal case is quoted by Bernt from Schuster’s Medical Journal. A man took twice as much as could be held on the point of a knife, was attacked with violent and incessant vomiting, and lived only from morning till night. The gullet, stomach, and colon were here and there inflamed.[2279] No detailed inquiry has yet been made respecting the properties of cevadilla; but there can be no doubt that it will prove an energetic poison, similar in its effects to white hellebore, and probably more active. Wibmer quotes Villemet for the fact, that half a drachm of the seeds excites vomiting and convulsions in the cat and dog, and Lentin for the case of a child, who died in convulsions in consequence of the powder having been used inwardly and outwardly.[2280] The alkaloid, veratria, has been made the subject of experiment by various physiologists. The most complete investigation yet undertaken is that of Dr. Esche;[2281] who found that it causes in a few minutes restlessness, anxiety, salivation, slowness and irregularity of the pulse, slow respiration, nausea, violent vomiting, borborygmus, spasms of the abdominal muscles and brisk purging of watery mucus, often tinged with blood;—that by and by the muscles become extremely feeble, so that the animal cannot support itself;—that coldness of the surface succeeds, together with spasmodic contractions of the throat, face, and extremities, but without any stupor;—and that finally the respiration and pulse gradually become extinguished, extreme prostration ensues, and death takes place in a fit of tetanic spasm. No particular morbid appearance was found in the dead body, and especially no sign of inflammation. Magendie found, that one grain in the form of acetate killed a dog in a few seconds when injected into the jugular vein, and in nine minutes when injected into the peritonæum; and that the principal symptom in such rapid cases was tetanic spasm. _Of Poisoning with Meadow-Saffron._ The _Colchicum autumnale_, meadow-saffron, or autumn-crocus, is a more familiar poison in this country than white hellebore, and seems to possess very similar properties. Two parts of the plant are met with in the shops, the _cormus_ or bulb, and the seeds; both of which are poisonous. Both have a strong, disagreeable, persistent, bitter taste. The seeds, and probably the bulb also, contain a bitter crystalline principle, called colchicina, which is soluble in water, neutralizes acids, and possesses intense activity as a poison. A good physiological investigation into the action of colchicum as a poison is still wanting. Baron Störck found that two drachms of the dried bulb caused in dogs violent diarrhœa and diuresis, ending fatally.[2282] Sir Everard Home observed that the active part of about two drachms dissolved in sherry, caused in a dog, when injected into the jugular vein, slow respiration, languor of the pulse, vomiting, diarrhœa, extreme prostration, and death in five hours.[2283]—Geiger and Hesse, the discoverers of colchicina, gave a cat a tenth of a grain, which occasioned salivation, vomiting, purging, staggering, extreme languor, colic, and death in twelve hours.[2284] The effects of colchicum on man, like those observed in animals, rather associate it with the acrid than with the narcotic poisons. In the Edinburgh Journal a case is briefly noticed of a man who took by mistake an ounce and a half of the wine of the bulb, and died in forty-eight hours, after suffering much from vomiting, acute pain in the stomach, colic, purging, and delirium.[2285]—Chevallier has described a similar case arising from the wine of the bulb having been given intentionally as a poison. In a few minutes burning pain, urgent thirst, and frequent vomiting of mucus ensued; and death took place in three days.[2286]—Three American soldiers, who drank by mistake a large quantity of colchicum wine prepared from the bulb, died with similar symptoms. One of them, who took eighteen ounces, and died in two days, presented the leading symptoms of malignant cholera, namely, frequent vomiting, copious rice-water stools, cramps of the abdominal muscles and flexion of the extremities, coldness of the skin, tongue, and breath, blueness of the nails, dull, sunken eyes, contracted pupils, and collapse of the features. The two others had at first similar symptoms, which passed into those of chronic dysentery, and proved fatal in a few weeks.[2287]—M. Caffe has related the case of a young lady who destroyed herself by taking five ounces of the wine containing the active matter of rather more than the fourth part of one bulb. She was soon seized with acute pain in the stomach, then with frequent vomiting, general coldness and paleness, a sense of tightness in the chest and oppression of the breathing, a slow thready pulse, and extreme prostration,—and subsequently with severe and constant cramps in the soles of the feet. In eleven hours she had less frequent efforts to vomit, but was excessively exhausted; in twenty hours the pulse was imperceptible; and in two hours more she died. There was no suppression of urine, no purging, no diminution of sensibility, delirium, convulsions, or change in the state of the pupils.[2288] About a twelvemonth afterwards the sister of this patient put an end to herself with the same preparation, of which she took the same quantity; and she died, with precisely the same symptoms, in twenty-eight hours.[2289] M. Ollivier met with two cases of death within twenty-four hours, in consequence of a tincture being taken which contained the active part of forty-eight grains of the dry bulb; and a third case of death in three days caused by three doses of a watery decoction made each time with 46 grains of the bruised bulb collected in July. Severe purging and prostration followed each dose. There was no symptom of any affection of the brain.[2290]—Mr. Henderson describes a case occasioned by an ounce of the tincture. No injury accrued for three hours. The patient then had gnawing pain in the stomach followed by vomiting, and then by purging, at first bilious, afterwards watery, and attended with numbness in the feet, and subsequently a sense of prickling. In the course of the second day there was intense gnawing pain in all the joints of the extremities, profuse acid sweating, tightness in the head, and pain in the hindhead and nape of the neck. Blood-letting, laxatives, and hyoscyamus were employed with success; but the case seems very nearly to have proved fatal.[2291] The seeds produce similar effects. Bernt has noticed the cases of two children who were poisoned by a handful of colchicum seeds, and who died in a day, affected with violent vomiting and purging.[2292] Mr. Fereday of Dudley relates a carefully detailed case of a man who died in forty-seven hours after swallowing by mistake two ounces of the wine of the seeds, and in whom the symptoms were acute pain, coming on in an hour and a half, then retching, vomiting, and tenesmus, feeble pulse, anxious expression, afterwards incessant coffee-coloured vomiting, suppression of urine, excessive weakness of the limbs and feeble respiration, and, for a short period before death, profuse, dark, watery purging. There was neither insensibility nor convulsions.[2293]—Blumhardt relates a similar case caused by an infusion of a large table-spoonful of the seeds. In three-quarters of an hour the man was seized with griping, and then profuse diarrhœa and vomiting. Next morning, twelve hours after the poison was taken, his physician found him still affected with vomiting and purging, but not with pain. He seemed, indeed, to suffer so little, and to improve so much under the use of emollients, that he was thought to be fairly recovering. But next day the pulse was almost imperceptible, the countenance and extremities were cold, the voice hoarse, the breathing hurried, the eyes sunk, the pupils dilated, the epigastrium tender, and the forehead affected with pain; and he died at twelve the same day.[2294] The leaves, too, are poisonous. Dr. Bleifus has related a case in proof of this. A man gathered the leaves in the middle of May, and, after cooking them, ate about two ounces for supper. In six hours he was seized with violent colic, vomiting, and purging. In fifteen hours, when his physician first saw him, the countenance was ghastly as in malignant cholera, the pupils dilated and scarcely contractile, but the mind entire. He complained of rheumatic pains in the neck, and burning pain in the pit of the stomach. He had frequent vomiting and purging, spasms of the muscles of the belly, coldness of the skin, a slow, small, wiry pulse, and cramps of the fingers and the calves of the legs. Coffee and lemon-juice allayed the vomiting, and a temporary amendment ensued. But early on the third morning he became worse, and soon afterwards the narrator of the case found him dying.[2295] The flowers are not less poisonous than the bulbs, leaves, and seeds. A case is noticed in Geiger’s Journal of poisoning with a decoction of some handfuls of the flowers, where death occurred within twenty-four hours, under incessant colic, vomiting and purging.[2296] Doubts exist as to the degree of activity of colchicum. Some practitioners direct half an ounce of the tincture of the seeds to be given as a medicinal dose,[2297] even four times a day.[2298] Others administer from one to two drachms night and morning. According to more general experience, these are dangerous doses. Dr. Lewins, junior, has seen dangerous symptoms from a drachm given thrice a day for a week;[2299] a fatal case occurred a few years ago in the Edinburgh Infirmary, from this amount having been given for a few days only; I have known very violent effects produced by half an ounce taken by mistake, although most of it was brought away by emetics in an hour; and, in medical practice, I have seldom seen the dose of a sound preparation gradually raised to a drachm thrice a day, without such severe purging and sickness ensuing as rendered it prudent to diminish or discontinue the remedy. There is no doubt, however, that larger doses have occasionally been taken without any ill effect. Constitutional peculiarity can alone account for such differences in the instance of the tincture of the seeds. As to the preparations of the bulb, an additional source of diversity of effect is a difference in the activity of the bulb according to season. On this point no accurate facts have yet been brought forward. The bulb is usually directed to be gathered in July, when it is most plump and firm, and most charged with starch. Orfila, however, says that three bulbs, collected at this time, had no effect whatever on a dog;[2300] and Buchner maintains that it is most energetic in the autumn, when the flowering stem is rising.[2301] I suspect, on the other hand, that it is very energetic in the spring, when it is watery, more membranous, and shrivels much in drying; for it is then very bitter. The morbid appearances are chiefly those of inflammation of the alimentary canal. In the bodies of the children mentioned by Bernt there was considerable redness of the stomach and small intestines; in Geiger’s case inflammation of the stomach and duodenum only; in the case mentioned in the Edinburgh Journal, and in that related by Chevallier, there was no morbid appearance at all to be found. In Mr. Fereday’s case the omentum was curled and folded up between the stomach on the one hand, and the liver and diaphragm on the other; the stomach and intestines were coated with much mucus; there was no appearances of inflammation there but on two points, one in the stomach, the other in the jejunum, where a red patch appeared, owing to blood effused between the muscular and peritoneal coats; the bladder was empty, the pleura red, the lungs much gorged, their surface, as well as that of the diaphragm and heart, covered with ecchymosed spots; and the skin over most of the body presented patches of a purple efflorescence.—In Blumhardt’s case the muscles were rigid twenty-three hours after death; the heart and great vessels contained coagulated blood; the cardiac end of the gullet was internally dark-violet; the stomach externally of a clear violet hue, and its veins turgid; the gall-bladder turgid with greenish-yellow bile; and the inner membrane of the whole small intestines chequered here and there with red, inflamed-like spots.[2302]—In one of M. Caffe’s cases there was congestion of the cerebral vessels, coagulated blood in the heart, uniform grayness, softness, and brittleness of the mucous coat of the stomach, and enlargement of the muciparous follicles of the small intestines, as well as unusual distinctness and lividity of the Peyerian glands. In the other case putrefaction was so far advanced in forty-eight hours as to make the appearances equivocal. The treatment consists in evacuation of the stomach and bowels by emetics and oleaginous laxatives in the early stage, and afterwards in the employment of opium, stimulants, the warm bath, and occasionally blood-letting. _Of Poisoning with Foxglove._ Foxglove, or _Digitalis purpura_, a plant which is common in this country both as a native and in gardens, possesses powerful and peculiar properties. The leaves are considered its most active part. They contain an alkaloid; but chemists have not fixed its nature with precision. M. Le Royer of Geneva procured a pitchy, deliquescent, uncrystallizable substance;[2303] but more lately M. Pauguy obtained a principle in fine acicular crystals, soluble in alcohol and ether, but insoluble in water, alkaline in its reaction, and of a very acrid taste. This principle is called digitalin.[2304] It seems to be the same substance, which has also been detected by Radig, as quoted by Dr. Pereira.[2305] The leaves, like those of other narcotic vegetables, yield by destructive distillation an empyreumatic oil similar in chemical qualities and physiological effects to the empyreumatic oil of hyoscyamus.[2306] From an extensive series of experiments on animals by Orfila with the powder, extract and tincture of the leaves, foxglove appears to cause in moderate doses vomiting, giddiness, languor, and death in twenty-four hours, without any other symptoms of note; but in larger doses, it likewise produces tremors, convulsions, stupor and coma. It acts energetically both when applied to a wound, and when injected into a vein.[2307] Mr. Blake has inferred from his researches, that when injected into the jugular vein, it occasions both obstruction of the pulmonary capillaries, and direct depression of the heart’s action. In the dog an infusion of three drachms of leaves arrested in five seconds the action of the heart; which was motionless after death, turgid, inirritable, and full of florid blood in its left cavities. An infusion of an ounce, injected back into the aorta from the axillary artery, caused in ten seconds great obstruction of the systemic capillaries, indicated by sudden increase of arterial pressure in the hæmadynamometer; the heart was unaffected for forty-five seconds, when it became slow in its pulsations, and the arterial pressure diminished; and in four minutes the heart ceased to beat, although for a little longer it continued excitable by stimulation. As no affection of the brain or spine was apparent before the heart became affected, the author infers that the action depends on the poisoned blood being circulated through the substance of the heart, and not on any intermediate influence upon the nervous centre.[2308] _Symptoms in Man._—Upon man its effects as a poison have been frequently noticed, partly in consequence of its being given by mistake in too large a dose as a medicine, partly on account of the singular property it possesses, in common with mercury, of accumulating silently in the system, when given long in moderate doses, and at length producing constitutional effects even after it has been discontinued. The effects of a dose somewhat larger than is usually given, are great nausea, frontal headache, sense of disagreeable dryness in the gums and pharynx, some salivation, giddiness, weakness of the limbs, feebleness and increased frequency of the pulse, in a few hours an appearance of sparks before the eyes, and subsequently dimness of vision, and a feeling of pressure on the eyeballs. These effects may be occasioned by so small a dose as two or three grains of good foxglove.[2309] The symptoms arising from its gradual accumulation are in the slighter cases nausea, vomiting, giddiness, want of sleep, sense of heat throughout the body, and of pulsation in the head, general depression, great languor and commonly retardation of the pulse, sometimes diarrhœa, sometimes salivation, and for the most part profuse sweating. A good instance of this form of the effects of foxglove is mentioned in the Medical Gazette. A man took it at his own hand for dropsy during twenty days, when the pulse sank to half its previous frequency, he was seized with restless, want of sleep, incoherent talking with imaginary persons, dilated pupils, nausea, thirst, and increase of urine; and these complaints did not materially subside for six days.[2310] The depressed action of the heart may be the occasion of death in particular circumstances. Mr. Brande mentions from the experience of Dr. Pemberton the case of an elderly woman, who, while under the full influence of foxglove, fell in a fainting fit on walking across the floor; after which, although she at first got better, there were frequent attacks of fainting and vomiting till she died.[2311] In other instances convulsions also occur; and it appears from a case mentioned by Dr. Blackall, that the disorder thus induced may prove fatal. One of his patients, while taking two drachms of the infusion of the leaves daily, was attacked with pain over the eyes and confusion, followed in twenty-four hours by profuse watery diarrhœa, delirium, general convulsions, insensibility, and an almost complete stoppage of the pulse. Although some relief was derived from an opiate clyster, the convulsions continued to recur in frequent paroxysms for three weeks; in the intervals he was forgetful and delirious; and at length he died in one of the convulsive fits.[2312] A case which exemplifies the effects of a single large dose is related in the Edinburgh Journal. An old woman drank ten ounces of a decoction made from a handful of the leaves in a quart of water. She grew sick in the course of an hour, and for two days she had incessant retching and vomiting, with great faintness and cold sweats in the intervals, some salivation and swelling of the lips, and a pulse feeble, irregular, intermitting, and not above 40. She had also suppression of urine for three days.[2313] A somewhat similar instance may be found in the Journal de Médecine. A man, fifty-five years old took by mistake a drachm instead of a grain for asthma, and was attacked in an hour with vomiting, giddiness, excessive debility, so that he could not stand, loss of sight, colic, and slow pulse. These effects continued more or less for four days, when the vomiting ceased; and the other symptoms then successively disappeared, the vision, however, remaining depraved for nearly a fortnight.[2314] A very interesting fatal case, which arose from an over-dose administered by a quack doctor, and which became the ground of a criminal trial at London in 1826, is shortly noticed in the same Journal. Six ounces of a strong decoction when taken as a laxative early in the morning. Vomiting, colic, and purging, were the first symptoms; towards the afternoon lethargy supervened; about midnight the colic and purging returned; afterwards general convulsions made their appearance; and a surgeon, who saw the patient at an early hour of the succeeding morning, found him violently convulsed, with the pupils dilated and insensible, and the pulse, slow, feeble, and irregular. Coma gradually succeeded, and death took place in twenty-two hours after the poison was swallowed.[2315] This is the only case in which I have seen an account of the appearances in the dead body, and they are related imperfectly. It is merely said that the external membranes of the brain were much injected with blood, and the inner coat of the stomach red in some parts. The affections induced by poisoning with digitalis are often much more lasting than the effects of most other vegetable narcotics. Dr. Blackall’s case is one instance in point, and another no less remarkable in its details is described in Corvisart’s Journal. The usual local and constitutional symptoms were produced by a drachm of the powder being taken by mistake; and the slowness of the pulse did not begin to go off for seven days, the affection of the sight not for five days more.[2316] The preparations of foxglove are very uncertain in strength. From what I have observed in the course of their medicinal employment, I conceive few powders retain the active properties of the leaves, and even not many tinctures. Two ounces of the tincture of the London College have been taken in two doses with a short interval between them, yet without causing any inconvenience.[2317] This assuredly could not happen with a sound preparation. _Of Poisoning with Rue._ The _Ruta graveolens_, or rue, although its wild variety is expressly declared by Dioscorides to be mortal when taken too largely, has attracted little attention as a poison in recent times, and is indeed scarcely considered deleterious. Orfila seems to have found it by no means active; for the juice of two pounds of leaves, secured in the stomach of a dog by tying the gullet, did not prove fatal till the second day, the symptoms were not well marked, and the only appearances in the dead body were the signs of slight inflammation in the stomach. Even when the distilled water was injected into a vein, the only effects were a temporary nervous disorder similar to intoxication.[2318] According to the late experimental inquiry, however, by M. Hélie,[2319] rue is possessed of peculiar and energetic properties. All parts of its organization, especially the roots and leaves, produce the effects of the narcotico-acrid poisons; and although he never met with any instance of a fatal result, its activity is such as to render this event not improbable, even when the dose is by no means very large. His attention was drawn to the subject in consequence of finding, that it was often employed in his neighbourhood for producing abortion,—a property ascribed to it immemorially by the country people of France; and all the instances he has seen of its poisonous action were cases in which it had been given with this object. Sometimes the juice of the leaves is given, sometimes an infusion of them, sometimes a decoction of the root; and in one instance a woman took a decoction of two roots, each about as thick as the finger. The effects were, severe pain in the stomach, followed by violent and obstinate vomiting, drowsiness, giddiness, confusion, dimness of sight, difficult articulation, staggering, contracted pupils, convulsive movements of the head and arms, like those of chorea, retention of urine, slowness of the pulse, and great prostration. There was never any purging. In the course of two days or a little more miscarriage took place, preceded by the usual precursors, and followed by abatement of the symptoms of poisoning. At the period of the milk-fever, however, these symptoms again increased, and the patient was also attacked with swelling and pain in the tongue and copious salivation. In about ten days the pulse began to increase in frequency; and a mild typhoid fever commonly succeeded, from which recovery took place slowly. In another case the symptoms throughout their whole course were so mild, that, although miscarriage occurred, the subject of it was not confined to bed, and in fifteen days recovered her health completely. M. Hélie adds, that with full knowledge of the doubts entertained by eminent authorities, whether any substance whatever possesses a peculiar property of inducing miscarriage, he is strongly persuaded that rue is really a substance of the kind, and that it will take effect even when there is no natural tendency to miscarriage, or any particular weakness of constitution. Notwithstanding these statements, it may be suspected that M. Hélie has overrated both its poisonous properties and its virtues as a drug capable of inducing miscarriage. _Of Poisoning with Ipecacuan._ Ipecacuan is well known as an emetic. It is procured from a plant of the natural family Rubiaceæ, the _Cephaëlis ipecacuanha_. It contains a peculiar principle, not yet crystallized, which is white, permanent in the air, sparingly soluble in water, easily soluble in alcohol and ether, fusible about 122° F., capable of forming crystallizable salts with acids, and possessing an alkaline reaction on litmus. It was discovered by M. Pelletier.[2320] Ipecacuan itself is not known to be a poison; because in consequence of its emetic properties it is quickly discharged from the stomach. But in doses of considerable magnitude it would probably be dangerous. In some constitutions the odoriferous effluvia from the powder induce difficult breathing, anxiety, and imperfect convulsions. I have met with several instances of this singular idiosyncrasy, and one in particular where the subject of it, a surgeon’s apprentice, suffered so often and so severely as to be induced to abandon the medical profession. A German physician, Dr. Prieger, has published a remarkable case of a druggist’s servant, who, in consequence of incautiously inhaling the dust of ipecacuan powder, was attacked with a sense of tightness in the chest, vomiting, and soon after an alarming sense of suffocation from tightness of the throat. When these symptoms had continued several hours the uneasiness in the throat was removed after the use of a decoction of uva-ursi and rhatany-root; but the dyspnœa remained several days.[2321] Its active principle, emeta, is a powerful poison. Two grains of the pure alkaloid will kill a dog; and the symptoms are frequent vomiting, followed by sopor and coma, and death in fifteen or twenty-four hours. In the dead body the lungs and stomach are found inflamed. The same effects result from injecting it into a vein, or applying it to a wound.[2322] It appears, then, to be a narcotico-acrid. But its irritant properties are so prominent that it might be properly arranged with the vegetable acrids.