Sex in Relation to Society
1780. He was the eighth child of his parents, and, together with all
7898 words | Chapter 24
his brothers and sisters, was stout and healthy. At the time of
observation Waller was about fifty years of age. He had dark hair, gray
eyes, dark complexion, was of bilious and irascible temperament, well
formed, muscular and strong, and in all respects healthy as any man,
with the single exception of his peculiar idiosyncrasy. He had been the
subject of but few diseases, although he was attacked by the epidemic
of 1816. From the history of his parents and an inquiry into the health
of his ancestry, nothing could be found which could establish the fact
of heredity in his peculiar disposition. Despite every advantage of
stature, constitution, and heredity, David Waller was through life,
from his cradle to his grave, the victim of what is possibly a unique
idiosyncrasy of constitution. In his own words he declared: "Of two
equal quantities of tartar and wheat flour, not more than a dose of the
former, he would rather swallow the tartar than the wheat flour." If he
ate flour in any form or however combined, in the smallest quantity, in
two minutes or less he would have painful itching over the whole body,
accompanied by severe colic and tormina in the bowels, great sickness
in the stomach, and continued vomiting, which he declared was ten times
as distressing as the symptoms caused by the ingestion of tartar
emetic. In about ten minutes after eating the flour the itching would
be greatly intensified, especially about the head, face, and eyes, but
tormenting all parts of the body, and not to be appeased. These
symptoms continued for two days with intolerable violence, and only
declined on the third day and ceased on the tenth. In the
convalescence, the lungs were affected, he coughed, and in
expectoration raised great quantities of phlegm, and really resembled a
phthisical patient. At this time he was confined to his room with
great weakness, similar to that of a person recovering from an
asthmatic attack. The mere smell of wheat produced distressing
symptoms in a minor degree, and for this reason he could not, without
suffering, go into a mill or house where the smallest quantity of wheat
flour was kept. His condition was the same from the earliest times, and
he was laid out for dead when an infant at the breast, after being fed
with "pap" thickened with wheat flour. Overton remarks that a case of
constitutional peculiarity so little in harmony with the condition of
other men could not be received upon vague or feeble evidence, and it
is therefore stated that Waller was known to the society in which he
lived as an honest and truthful man. One of his female neighbors, not
believing in his infirmity, but considering it only a whim, put a small
quantity of flour in the soup which she gave him to eat at her table,
stating that it contained no flour, and as a consequence of the
deception he was bed-ridden for ten days with his usual symptoms. It
was also stated that Waller was never subjected to militia duty because
it was found on full examination of his infirmity that he could not
live upon the rations of a soldier, into which wheat flour enters as a
necessary ingredient. In explanation of this strange departure from the
condition of other men, Waller himself gave a reason which was deemed
equivalent in value to any of the others offered. It was as follows:
His father being a man in humble circumstances in life, at the time of
his birth had no wheat with which to make flour, although his mother
during gestation "longed" for wheat-bread. The father, being a kind
husband and responsive to the duty imposed by the condition of his
wife, procured from one of his opulent neighbors a bag of wheat and
sent it to the mill to be ground. The mother was given much uneasiness
by an unexpected delay at the mill, and by the time the flour arrived
her strong appetite for wheat-bread had in a great degree subsided.
Notwithstanding this, she caused some flour to be immediately baked
into bread and ate it, but not so freely as she had expected The bread
thus taken caused intense vomiting and made her violently and painfully
ill, after which for a considerable time she loathed bread. These facts
have been ascribed as the cause of the lamentable infirmity under which
the man labored, as no other peculiarity or impression in her gestation
was noticed. In addition it may be stated that for the purpose of
avoiding the smell of flour Waller was in the habit of carrying camphor
in his pocket and using snuff, for if he did not smell the flour,
however much might be near him, it was as harmless to him as to other
men.
The authors know of a case in which the eating of any raw fruit would
produce in a lady symptoms of asthma; cooked fruit had no such effect.
Food-Superstitions.--The superstitious abhorrence and antipathy to
various articles of food that have been prevalent from time to time in
the history of the human race are of considerable interest and well
deserve some mention here. A writer in a prominent journal has studied
this subject with the following result:--
"From the days of Adam and Eve to the present time there has been not
only forbidden fruit, but forbidden meats and vegetables. For one
reason or another people have resolutely refused to eat any and all
kinds of flesh, fish, fowl, fruits, and plants. Thus, the apple, the
pear, the strawberry, the quince, the bean, the onion, the leek, the
asparagus, the woodpecker, the pigeon, the goose, the deer, the bear,
the turtle, and the eel--these, to name only a few eatables, have been
avoided as if unwholesome or positively injurious to health and
digestion.
"As we all know, the Jews have long had an hereditary antipathy to
pork. On the other hand, swine's flesh was highly esteemed by the
ancient Greeks and Romans. This fact is revealed by the many references
to pig as a dainty bit of food. At the great festival held annually in
honor of Demeter, roast pig was the piece de resistance in the bill of
fare, because the pig was the sacred animal of Demeter. Aristophanes in
'The Frogs' makes one of the characters hint that some of the others
'smell of roast pig.' These people undoubtedly had been at the festival
(known as the Thesmophoria) and had eaten freely of roast pig, Those
who took part in another Greek mystery or festival (known as the
Eleusinia) abstained from certain food, and above all from beans.
"Again, as we all know, mice are esteemed in China and in some parts of
India. But the ancient Egyptians, Greeks, and Jews abhorred mice and
would not touch mouse-meat. Rats and field-mice were sacred in Old
Egypt, and were not to be eaten on this account. So, too, in some parts
of Greece, the mouse was the sacred animal of Apollo, and mice were fed
in his temples. The chosen people were forbidden to eat 'the weasel,
and the mouse, and the tortoise after his kind.' These came under the
designation of unclean animals, which were to be avoided.
"But people have abstained from eating kinds of flesh which could not
be called unclean. For example, the people of Thebes, as Herodotus
tells us, abstained from sheep. Then, the ancients used to abstain from
certain vegetables. In his 'Roman Questions' Plutarch asks: 'Why do the
Latins abstain strictly from the flesh of the woodpecker?' In order to
answer Plutarch's question correctly it is necessary to have some idea
of the peculiar custom and belief called 'totemism.' There is a stage
of society in which people claim descent from and kinship with beasts,
birds, vegetables, and other objects. This object, which is a 'totem,'
or family mark, they religiously abstain from eating. The members of
the tribe are divided into clans or stocks, each of which takes the
name of some animal, plant, or object, as the bear, the buffalo, the
woodpecker, the asparagus, and so forth. No member of the bear family
would dare to eat bear-meat, but he has no objection to eating buffalo
steak. Even the marriage law is based on this belief, and no man whose
family name is Wolf may marry a woman whose family name is also Wolf.
"In a general way it may be said that almost all our food prohibitions
spring from the extraordinary custom generally called totemism. Mr.
Swan, who was missionary for many years in the Congo Free State, thus
describes the custom: 'If I were to ask the Yeke people why they do not
eat zebra flesh, they would reply, 'Chijila,' i.e., 'It is a thing to
which we have an antipathy;' or better, 'It is one of the things which
our fathers taught us not to eat.' So it seems the word 'Bashilang'
means 'the people who have an antipathy to the leopard;' the
'Bashilamba,' 'those who have an antipathy to the dog,' and the
'Bashilanzefu,' 'those who have an antipathy to the elephant.' In other
words, the members of these stocks refuse to eat their totems, the
zebra, the leopard, or the elephant, from which they take their names.
"The survival of antipathy to certain foods was found among people as
highly civilized as the Egyptians, the Greeks, and the Romans. Quite a
list of animals whose flesh was forbidden might be drawn up. For
example, in Old Egypt the sheep could not be eaten in Thebes, nor the
goat in Mendes, nor the cat in Bubastis, nor the crocodile at Ombos,
nor the rat, which was sacred to Ra, the sun-god. However, the people
of one place had no scruples about eating the forbidden food of another
place. And this often led to religious disputes.
"Among the vegetables avoided as food by the Egyptians may be mentioned
the onion, the garlic, and the leek. Lucian says that the inhabitants
of Pelusium adored the onion. According to Pliny the Egyptians relished
the leek and the onion. Juvenal exclaims: 'Surely a very religious
nation, and a blessed place, where every garden is overrun with gods!'
The survivals of totemism among the ancient Greeks are very
interesting. Families named after animals and plants were not uncommon.
One Athenian gens, the Ioxidae, had for its ancestral plant the
asparagus. One Roman gens, the Piceni, took a woodpecker for its totem,
and every member of this family refused, of course, to eat the flesh of
the woodpecker. In the same way as the nations of the Congo Free State,
the Latins had an antipathy to certain kinds of food. However, an
animal or plant forbidden in one place was eaten without any
compunction in another place. 'These local rites in Roman times,' says
Mr. Lang, 'caused civil brawls, for the customs of one town naturally
seemed blasphemous to neighbors with a different sacred animal. Thus
when the people of dog-town were feeding on the fish called
oxyrrhyncus, the citizens of the town which revered the oxyrrhyncus
began to eat dogs. Hence arose a riot.' The antipathy of the Jews to
pork has given rise to quite different explanations. The custom is
probably a relic of totemistic belief. That the unclean
animals--animals not to be eaten--such as the pig, the mouse, and the
weasel, were originally totems of the children of Israel, Professor
Robertson Smith believes is shown by various passages in the Old
Testament.
"When animals and plants ceased to be held sacred they were endowed
with sundry magical or mystic properties. The apple has been supposed
to possess peculiar virtues, especially in the way of health. 'The
relation of the apple to health,' says Mr. Conway, 'is traceable to
Arabia. Sometimes it is regarded as a bane. In Hessia it is said an
apple must not be eaten on New Year's Day, as it will produce an
abscess. But generally it is curative. In Pomerania it is eaten on
Easter morning against fevers; in Westphalia (mixed with saffron)
against jaundice; while in Silesia an apple is scraped from top to
stalk to cure diarrhea, and upward to cure costiveness.' According to
an old English fancy, if any one who is suffering from a wound in the
head should eat strawberries it will lead to fatal results. In the
South of England the folk say that the devil puts his cloven foot upon
the blackberries on Michaelmas Day, and hence none should be gathered
or eaten after that day. On the other hand, in Scotland the peasants
say that the devil throws his cloak over the blackberries and makes
them unwholesome after that day, while in Ireland he is said to stamp
on the berries. Even that humble plant, the cabbage, has been invested
with some mystery. It was said that the fairies were fond of its
leaves, and rode to their midnight dances on cabbage-stalks. The German
women used to say that 'Babies come out of the cabbage-heads.' The
Irish peasant ties a cabbage-leaf around the neck for sore throat.
According to Gerarde, the Spartans ate watercress with their bread,
firmly believing that it increased their wit and wisdom. The old
proverb is, 'Eat cress to learn more wit.'
"There is another phase to food-superstitions, and that is the theory
that the qualities of the eaten pass into the eater. Mr. Tylor refers
to the habit of the Dyak young men in abstaining from deer-meat lest it
should make them timid, while the warriors of some South American
tribes eat the meat of tigers, stags, and boars for courage and speed.
He mentions the story of an English gentleman at Shanghai who at the
time of the Taeping attack met his Chinese servant carrying home the
heart of a rebel, which he intended to eat to make him brave. There is
a certain amount of truth in the theory that the quality of food does
affect the mind and body. Buckle in his 'History of Civilization' took
this view, and tried to prove that the character of a people depends on
their diet."
Idiosyncrasies to Drugs.--In the absorption and the assimilation of
drugs idiosyncrasies are often noted; in fact, they are so common that
we can almost say that no one drug acts in the same degree or manner on
different individuals. In some instances the untoward action assumes
such a serious aspect as to render extreme caution necessary in the
administration of the most inert substances. A medicine ordinarily so
bland as cod-liver oil may give rise to disagreeable eruptions.
Christison speaks of a boy ten years old who was said to have been
killed by the ingestion of two ounces of Epsom salts without inducing
purgation; yet this common purge is universally used without the
slightest fear or caution. On the other hand, the extreme tolerance
exhibited by certain individuals to certain drugs offers a new phase of
this subject. There are well-authenticated cases on record in which
death has been caused in children by the ingestion of a small fraction
of a grain of opium. While exhibiting especial tolerance from peculiar
disposition and long habit, Thomas De Quincey, the celebrated English
litterateur, makes a statement in his "Confessions" that with impunity
he took as much as 320 grains of opium a day, and was accustomed at one
period of his life to call every day for "a glass of laudanum negus,
warm, and without sugar," to use his own expression, after the manner a
toper would call for a "hot-Scotch."
The individuality noted in the assimilation and the ingestion of drugs
is functional as well as anatomic. Numerous cases have been seen by all
physicians. The severe toxic symptoms from a whiff of cocain-spray, the
acute distress from the tenth of a grain of morphin, the gastric crises
and profuse urticarial eruptions following a single dose of
quinin,--all are proofs of it. The "personal equation" is one of the
most important factors in therapeutics, reminding us of the old rule,
"Treat the patient, not the disease."
The idiosyncrasy may be either temporary or permanent, and there are
many conditions that influence it. The time and place of
administration; the degree of pathologic lesion in the subject; the
difference in the physiologic capability of individual organs of
similar nature in the same body; the degree of human vitality
influencing absorption and resistance; the peculiar epochs of life; the
element of habituation, and the grade and strength of the drug,
influencing its virtue,--all have an important bearing on untoward
action and tolerance of poisons.
It is not in the province of this work to discuss at length the
explanations offered for these individual idiosyncrasies. Many authors
have done so, and Lewin has devoted a whole volume to this subject, of
which, fortunately, an English translation has been made by Mulheron,
and to these the interested reader is referred for further information.
In the following lines examples of idiosyncrasy to the most common
remedial substances will be cited, taking the drugs up alphabetically.
Acids.--Ordinarily speaking, the effect of boric acid in medicinal
doses on the human system is nil, an exceptionally large quantity
causing diuresis. Binswanger, according to Lewin, took eight gm. in two
doses within an hour, which was followed by nausea, vomiting, and a
feeling of pressure and fulness of the stomach which continued several
hours. Molodenkow mentions two fatal cases from the external employment
of boric acid as an antiseptic. In one case the pleural cavity was
washed out with a five per cent solution of boric acid and was followed
by distressing symptoms, vomiting, weak pulse, erythema, and death on
the third day. In the second case, in a youth of sixteen, death
occurred after washing out a deep abscess of the nates with the same
solution. The autopsy revealed no change or signs indicative of the
cause of death. Hogner mentions two instances of death from the
employment of 2 1/2 per cent solution of boric acid in washing out a
dilated stomach The symptoms were quite similar to those mentioned by
Molodenkow.
In recent years the medical profession has become well aware that in
its application to wounds it is possible for carbolic acid or phenol to
exercise exceedingly deleterious and even fatal consequences. In the
earlier days of antisepsis, when operators and patients were exposed
for some time to an atmosphere saturated with carbolic spray, toxic
symptoms were occasionally noticed. Von Langenbeck spoke of severe
carbolic-acid intoxication in a boy in whom carbolic paste had been
used in the treatment of abscesses. The same author reports two
instances of death following the employment of dry carbolized dressings
after slight operations. Kohler mentions the death of a man suffering
from scabies who had applied externally a solution containing about a
half ounce of phenol. Rose spoke of gangrene of the finger after the
application of carbolized cotton to a wound thereon. In some cases
phenol acts with a rapidity equal to any poison. Taylor speaks of a man
who fell unconscious ten seconds after an ounce of phenol had been
ingested, and in three minutes was dead. There is recorded an account
of a man of sixty-four who was killed by a solution containing slightly
over a dram of phenol. A half ounce has frequently caused death;
smaller quantities have been followed by distressing symptoms, such as
intoxication (which Olshausen has noticed to follow irrigation of the
uterus), delirium, singultus, nausea, rigors, cephalalgia, tinnitus
aurium, and anasarca. Hind mentions recovery after the ingestion of
nearly six ounces of crude phenol of 14 per cent strength. There was a
case at the Liverpool Northern Hospital in which recovery took place
after the ingestion with suicidal intent of four ounces of crude
carbolic acid. Quoted by Lewin, Busch accurately describes a case which
may be mentioned as characteristic of the symptoms of carbolism. A boy,
suffering from abscess under the trochanter, was operated on for its
relief. During the few minutes occupied by the operation he was kept
under a two per cent carbolic spray, and the wound was afterward
dressed with carbolic gauze. The day following the operation he was
seized with vomiting, which was attributed to the chloroform used as an
anesthetic. On the following morning the bandages were removed under
the carbolic spray; during the day there was nausea, in the evening
there was collapse, and carbolic acid was detected in the urine. The
pulse became small and frequent and the temperature sank to 35.5
degrees C. The frequent vomiting made it impossible to administer
remedies by the stomach, and, in spite of hypodermic injections and
external application of analeptics, the boy died fifty hours after
operation.
Recovery has followed the ingestion of an ounce of officinal
hydrochloric acid. Black mentions a man of thirty-nine who recovered
after swallowing 1 1/2 ounces of commercial hydrochloric acid. Johnson
reports a case of poisoning from a dram of hydrochloric acid.
Tracheotomy was performed, but death resulted.
Burman mentions recovery after the ingestion of a dram of dilute
hydrocyanic acid of Scheele's strength (2.4 am. of the acid). In this
instance insensibility did not ensue until two minutes after taking the
poison, the retarded digestion being the means of saving life.
Quoting Taafe, in 1862 Taylor speaks of the case of a man who swallowed
the greater part of a solution containing an ounce of potassium cyanid.
In a few minutes the man was found insensible in the street, breathing
stertorously, and in ten minutes after the ingestion of the drug the
stomach-pump was applied. In two hours vomiting began, and thereafter
recovery was rapid.
Mitscherlich speaks of erosion of the gums and tongue with hemorrhage
at the slightest provocation, following the long administration of
dilute nitric acid. This was possibly due to the local action.
According to Taylor, the smallest quantity of oxalic acid causing death
is one dram. Ellis describes a woman of fifty who swallowed an ounce of
oxalic acid in beer. In thirty minutes she complained of a burning pain
in the stomach and was rolling about in agony. Chalk and water was
immediately given to her and she recovered. Woodman reports recovery
after taking 1/2 ounce of oxalic acid.
Salicylic acid in medicinal doses frequently causes untoward symptoms,
such as dizziness, transient delirium, diminution of vision, headache,
and profuse perspiration; petechial eruptions and intense gastric
symptoms have also been noticed.
Sulphuric acid causes death from its corrosive action, and when taken
in excessive quantities it produces great gastric disturbance; however,
there are persons addicted to taking oil of vitriol without any
apparent untoward effect. There is mentioned a boot-maker who
constantly took 1/2 ounce of the strong acid in a tumbler of water,
saying that it relieved his dyspepsia and kept his bowels open.
Antimony.--It is recorded that 3/4 grain of tartar emetic has caused
death in a child and two grains in an adult. Falot reports three cases
in which after small doses of tartar emetic there occurred vomiting,
delirium, spasms, and such depression of vitality that only the
energetic use of stimulants saved life. Beau mentions death following
the administration of two doses of 1 1/2 gr. of tartar emetic.
Preparations of antimony in an ointment applied locally have caused
necrosis, particularly of the cranium, and Hebra has long since
denounced the use of tartar emetic ointment in affections of the scalp.
Carpenter mentions recovery after ingestion of two drams of tartar
emetic. Behrends describes a case of catalepsy with mania, in which a
dose of 40 gr. of tartar emetic was tolerated, and Morgagni speaks of a
man who swallowed two drams, immediately vomited, and recovered.
Instances like the last, in which an excessive amount of a poison by
its sudden emetic action induces vomiting before there is absorption of
a sufficient quantity to cause death, are sometimes noticed. McCreery
mentions a case of accidental poisoning with half an ounce of tartar
emetic successfully treated with green tea and tannin. Mason reports
recovery after taking 80 gr. of tartar emetic.
Arsenic.--The sources of arsenical poisoning are so curious as to
deserve mention. Confectionery, wall-paper, dyes, and the like are
examples. In other cases we note money-counting, the colored candles of
a Christmas tree, paper collars, ball-wreaths of artificial flowers,
ball-dresses made of green tarlatan, playing cards, hat-lining, and
fly-papers.
Bazin has reported a case in which erythematous pustules appeared after
the exhibition during fifteen days of the 5/6 gr. of arsenic. Macnal
speaks of an eruption similar to that of measles in a patient to whom
he had given but three drops of Fowler's solution for the short period
of three days. Pareira says that in a gouty patient for whom he
prescribed 1/6 gr. of potassium arseniate daily, on the third day there
appeared a bright red eruption of the face, neck, upper part of the
trunk and flexor surfaces of the joints, and an edematous condition of
the eyelids. The symptoms were preceded by restlessness, headache, and
heat of the skin, and subsided gradually after the second or third day,
desquamation continuing for nearly two months. After they had subsided
entirely, the exhibition of arsenic again aroused them, and this time
they were accompanied by salivation. Charcot and other French authors
have noticed the frequent occurrence of suspension of the sexual
instinct during the administration of Fowler's solution. Jackson speaks
of recovery after the ingestion of two ounces of arsenic by the early
employment of an emetic. Walsh reports a case in which 600 gr. of
arsenic were taken without injury. The remarkable tolerance of arsenic
eaters is well known. Taylor asserts that the smallest lethal dose of
arsenic has been two gr., but Tardieu mentions an instance in which ten
cgm. (1 1/2 gr.) has caused death. Mackenzie speaks of a man who
swallowed a large quantity of arsenic in lumps, and received no
treatment for sixteen hours, but recovered. It is added that from two
masses passed by the anus 105 gr. of arsenic were obtained.
In speaking of the tolerance of belladonna, in 1859 Fuller mentioned a
child of fourteen who in eighteen days took 37 grains of atropin; a
child of ten who took seven grains of extract of belladonna daily, or
more than two ounces in twenty-six days; and a man who took 64 grains
of the extract of belladonna daily, and from whose urine enough atropin
was extracted to kill two white mice and to narcotize two others. Bader
has observed grave symptoms following the employment of a vaginal
suppository containing three grains of the extract of belladonna. The
dermal manifestations, such as urticaria and eruptions resembling the
exanthem of scarlatina, are too well known to need mention here. An
enema containing 80 grains of belladonna root has been followed in five
hours by death, and Taylor has mentioned recovery after the ingestion
of three drams of belladonna. In 1864 Chambers reported to the Lancet
the recovery of a child of four years who took a solution containing
1/2 grain of the alkaloid. In some cases the idiosyncrasy to belladonna
is so marked that violent symptoms follow the application of the
ordinary belladonna plaster. Maddox describes a ease of poisoning in a
music teacher by the belladonna plaster of a reputable maker. She had
obscure eye-symptoms, and her color-sensations were abnormal. Locomotor
equilibration was also affected. Golden mentions two cases in which the
application of belladonna ointment to the breasts caused suppression of
the secretion of milk. Goodwin relates the history of a case in which
an infant was poisoned by a belladonna plaster applied to its mother's
breast and died within twenty-four hours after the first application of
the plaster. In 1881 Betancourt spoke of an instance of inherited
susceptibility to belladonna, in which the external application of the
ointment produced all the symptoms of belladonna poisoning. Cooper
mentions the symptoms of poisoning following the application of extract
of belladonna to the scrotum. Davison reports poisoning by the
application of belladonna liniment. Jenner and Lyman also record
belladonna poisoning from external applications.
Rosenthal reports a rare case of poisoning in a child eighteen months
old who had swallowed about a teaspoonful of benzin. Fifteen minutes
later the child became unconscious. The stomach-contents, which were
promptly removed, contained flakes of bloody mucus. At the end of an
hour the radial pulse was scarcely perceptible, respiration was
somewhat increased in frequency and accompanied with a rasping sound.
The breath smelt of benzin. The child lay in quiet narcosis,
occasionally throwing itself about as if in pain. The pulse gradually
improved, profuse perspiration occurred, and normal sleep intervened.
Six hours after the poisoning the child was still stupefied. The urine
was free from albumin and sugar, and the next morning the little one
had perfectly recovered.
There is an instance mentioned of a robust youth of twenty who by a
mistake took a half ounce of cantharides. He was almost immediately
seized with violent heat in the throat and stomach, pain in the head,
and intense burning on urination. These symptoms progressively
increased, were followed by intense sickness and almost continual
vomiting. In the evening he passed great quantities of blood from the
urethra with excessive pain in the urinary tract. On the third day all
the symptoms were less violent and the vomiting had ceased. Recovery
was complete on the fifteenth day.
Digitalis has been frequently observed to produce dizziness, fainting,
disturbances of vision, vomiting, diarrhea, weakness of the pulse, and
depression of temperature. These phenomena, however, are generally
noticed after continued administration in repeated doses, the result
being doubtless due to cumulative action caused by abnormally slow
elimination by the kidneys. Traube observed the presence of
skin-affection after the use of digitalis in a case of pericarditis.
Tardieu has seen a fluid-dram of the tincture of digitalis cause
alarming symptoms in a young woman who was pregnant. He also quotes
cases of death on the tenth day from ingestion of 20 grains of the
extract, and on the fifth day from 21 grams of the infusion. Kohuhorn
mentions a death from what might be called chronic digitalis poisoning.
There is a deleterious practice of some of the Irish peasantry
connected with their belief in fairies, which consists of giving a
cachetic or rachitic child large doses of a preparation of fox-glove
(Irish--luss-more, or great herb), to drive out or kill the fairy in
the child. It was supposed to kill an unhallowed child and cure a
hallowed one. In the Hebrides, likewise, there were many cases of
similar poisoning.
Epidemics of ergotism have been recorded from time to time since the
days of Galen, and were due to poverty, wretchedness, and famine,
resulting in the feeding upon ergotized bread. According to Wood,
gangrenous ergotism, or "Ignis Sacer" of the Middle Ages, killed 40,000
persons in Southwestern France in 922 A. D., and in 1128-29, in Paris
alone, 14,000 persons perished from this malady. It is described as
commencing with itchings and formications in the feet, severe pain in
the back, contractions in the muscles, nausea, giddiness, apathy, with
abortion in pregnant women, in suckling women drying of milk, and in
maidens with amenorrhea. After some time, deep, heavy aching in the
limbs, intense feeling of coldness, with real coldness of the surfaces,
profound apathy, and a sense of utter weariness develop; then a dark
spot appears on the nose or one of the extremities, all sensibility is
lost in the affected part, the skin assumes a livid red hue, and
adynamic symptoms in severe cases deepen as the gangrene spreads, until
finally death ensues. Very generally the appetite and digestion are
preserved to the last, and not rarely there is a most ferocious hunger.
Wood also mentions a species of ergotism characterized by epileptic
paroxysms, which he calls "spasmodic ergotism." Prentiss mentions a
brunette of forty-two, under the influence of ergot, who exhibited a
peculiar depression of spirits with hysteric phenomena, although
deriving much benefit from the administration of the drug from the
hemorrhage caused by uterine fibroids. After taking ergot for three
days she felt like crying all the time, became irritable, and stayed in
bed, being all day in tears. The natural disposition of the patient was
entirely opposed to these manifestations, as she was even-tempered and
exceptionally pleasant.
In addition to the instance of the fatal ingestion of a dose of Epsom
salts already quoted, Lang mentions a woman of thirty-five who took
four ounces of this purge. She experienced burning pain in the stomach
and bowels, together with a sense of asphyxiation. There was no
purging or vomiting, but she became paralyzed and entered a state of
coma, dying fifteen minutes after ingestion.
Iodin Preparations.--The eruptions following the administration of
small doses of potassium iodid are frequently noticed, and at the same
time large quantities of albumin have been seen in the urine. Potassium
iodid, although generally spoken of as a poisonous drug, by gradually
increasing the dose can be given in such enormous quantities as to be
almost beyond the bounds of credence, several drams being given at a
dose. On the other hand, eight grains have produced alarming symptoms.
In the extensive use of iodoform as a dressing instances of untoward
effects, and even fatal ones, have been noticed, the majority of them
being due to careless and injudicious application. In a French journal
there is mentioned the history of a man of twenty-five, suspected of
urethral ulceration, who submitted to the local application of one gram
of iodoform. Deep narcosis and anesthesia were induced, and two hours
after awakening his breath smelled strongly of iodoform. There are two
similar instances recorded in England.
Pope mentions two fatal cases of lead-poisoning from diachylon plaster,
self-administered for the purpose of producing abortion. Lead
water-pipes, the use of cosmetics and hair-dyes, coloring matter in
confectionery and in pastry, habitual biting of silk threads,
imperfectly burnt pottery, and cooking bread with painted wood have
been mentioned as causes of chronic lead-poisoning.
Mercury.--Armstrong mentions recovery after ingestion of 1 1/2 drams of
corrosive sublimate, and Lodge speaks of recovery after a dose
containing 100 grains of the salt. It is said that a man swallowed 80
grains of mercuric chlorid in whiskey and water, and vomited violently
about ten minutes afterward. A mixture of albumin and milk was given to
him, and in about twenty-five minutes a bolus of gold-leaf and reduced
iron; in eight days he perfectly recovered. Severe and even fatal
poisoning may result from the external application of mercury. Meeres
mentions a case in which a solution (two grains to the fluid-ounce)
applied to the head of a child of nine for the relief of tinea
tonsurans caused diarrhea, profuse salivation, marked prostration, and
finally death. Washing out the vagina with a solution of corrosive
sublimate, 1:2000, has caused severe and even fatal poisoning. Bonet
mentions death after the inunction of a mercurial ointment, and
instances of distressing salivation from such medication are quite
common. There are various dermal affections which sometimes follow the
exhibition of mercury and assume an erythematous type. The
susceptibility of some persons to calomel, the slightest dose causing
profuse salivation and painful oral symptoms, is so common that few
physicians administer mercury to their patients without some knowledge
of their susceptibility to this drug. Blundel relates a curious case
occurring in the times when mercury was given in great quantities, in
which to relieve obstinate constipation a half ounce of crude mercury
was administered and repeated in twelve hours. Scores of globules of
mercury soon appeared over a vesicated surface, the result of a
previous blister applied to the epigastric region. Blundel, not
satisfied with the actuality of the phenomena, submitted his case to
Dr. Lister, who, after careful examination, pronounced the globules
metallic.
Oils.--Mauvezin tells of the ingestion of three drams of croton oil by
a child of six, followed by vomiting and rapid recovery. There was no
diarrhea in this case. Wood quotes Cowan in mentioning the case of a
child of four, who in two days recovered from a teaspoonful of croton
oil taken on a full stomach. Adams saw recovery in an adult after
ingestion of the same amount. There is recorded an instance of a woman
who took about an ounce, and, emesis being produced three-quarters of
an hour afterward by mustard, she finally recovered. There is a record
in which so small a dose as three minims is supposed to have killed a
child of thirteen months. According to Wood, Giacomini mentions a case
in which 24 grains of the drug proved fatal in as many hours.
Castor oil is usually considered a harmless drug, but the castor bean,
from which it is derived, contains a poisonous acrid principle, three
such beans having sufficed to produce death in a man. Doubtless some of
the instances in which castor oil has produced symptoms similar to
cholera are the results of the administration of contaminated oil.
The untoward effects of opium and its derivatives are quite numerous
Gaubius treated an old woman in whom, after three days, a single grain
of opium produced a general desquamation of the epidermis; this
peculiarity was not accidental, as it was verified on several other
occasions. Hargens speaks of a woman in whom the slightest bit of opium
in any form produced considerable salivation. Gastric disturbances are
quite common, severe vomiting being produced by minimum doses; not
infrequently, intense mental confusion, vertigo, and headache, lasting
hours and even days, sometimes referable to the frontal region and
sometimes to the occipital, are seen in certain nervous individuals
after a dose of from 1/4 to 5/6 gr. of opium. These symptoms were
familiar to the ancient physicians, and, according to Lewin, Tralles
reports an observation with reference to this in a man, and says
regarding it in rather unclassical Latin: "... per multos dies
ponderosissimum caput circumgestasse." Convulsions are said to be
observed after medicinal doses of opium. Albers states that twitching
in the tendons tremors of the hands, and even paralysis, have been
noticed after the ingestion of opium in even ordinary doses. The
"pruritus opii," so familiar to physicians, is spoken of in the older
writings. Dioscorides, Paulus Aegineta, and nearly all the writers of
the last century describe this symptom as an annoying and unbearable
affection. In some instances the ingestion of opium provokes an
eruption in the form of small, isolated red spots, which, in their
general character, resemble roseola. Rieken remarks that when these
spots spread over all the body they present a scarlatiniform
appearance, and he adds that even the mucous membranes of the mouth and
throat may be attacked with erethematous inflammation. Behrend
observed an opium exanthem, which was attended by intolerable itching,
after the exhibition of a quarter of a grain. It was seen on the chest,
on the inner surfaces of the arms, on the flexor surfaces of the
forearms and wrists, on the thighs, and posterior and inner surfaces of
the legs, terminating at the ankles in a stripe-like discoloration
about the breadth of three fingers. It consisted of closely disposed
papules of the size of a pin-head, and several days after the
disappearance of the eruption a fine, bran-like desquamation of the
epidermis ensued. Brand has also seen an eruption on the trunk and
flexor surfaces, accompanied with fever, from the ingestion of opium.
Billroth mentions the case of a lady in whom appeared a feeling of
anxiety, nausea, and vomiting after ingestion of a small fraction of a
grain of opium; she would rather endure her intense pain than suffer
the untoward action of the drug. According to Lewin, Brochin reported a
case in which the idiosyncrasy to morphin was so great that 1/25 of a
grain of the drug administered hypodermically caused irregularity of
the respiration, suspension of the heart-beat, and profound narcosis.
According to the same authority, Wernich has called attention to
paresthesia of the sense of taste after the employment of morphin,
which, according to his observation, is particularly prone to supervene
in patients who are much reduced and in persons otherwise healthy who
have suffered from prolonged inanition. These effects are probably due
to a central excitation of a similar nature to that produced by
santonin. Persons thus attacked complain, shortly after the injection,
of an intensely sour or bitter taste, which for the most part ceases
after elimination of the morphin. Von Graefe and Sommerfrodt speak of a
spasm of accommodation occurring after ingestion of medicinal doses of
morphin. There are several cases on record in which death has been
produced in an adult by the use of 1/2 to 1/6 grain of morphin.
According to Wood, the maximum doses from which recovery has occurred
without emesis are 55 grains of solid opium, and six ounces of
laudanum. According to the same authority, in 1854 there was a case in
which a babe one day old was killed by one minim of laudanum, and in
another case a few drops of paregoric proved fatal to a child of nine
months. Doubtful instances of death from opium are given, one in an
adult female after 30 grains of Dover's powder given in divided doses,
and another after a dose of 1/4 grain of morphin. Yavorski cites a
rather remarkable instance of morphin-poisoning with recovery: a female
took 30 grains of acetate of morphin, and as it did not act quickly
enough she took an additional dose of 1/2 ounce of laudanum. After this
she slept a few hours, and awoke complaining of being ill. Yavorski saw
her about an hour later, and by producing emesis, and giving coffee,
atropin, and tincture of musk, he saved her life. Pyle describes a
pugilist of twenty-two who, in a fit of despondency after a debauch (in
which he had taken repeated doses of morphin sulphate), took with
suicidal intent three teaspoonfuls of morphin; after rigorous treatment
he revived and was discharged on the next day perfectly well.
Potassium permanganate was used in this case. Chaffee speaks of
recovery after the ingestion of 18 grains of morphin without vomiting.
In chronic opium eating the amount of this drug which can be ingested
with safety assumes astounding proportions. In his "Confessions" De
Quincey remarks: "Strange as it may sound, I had a little before this
time descended suddenly and without considerable effort from 320 grains
of opium (8000 drops of laudanum) per day to 40 grains, or 1/8 part.
Instantaneously, and as if by magic, the cloud of profoundest
melancholy which rested on my brain, like some black vapors that I have
seen roll away from the summits of the mountains, drew off in one
day,--passed off with its murky banners as simultaneously as a ship
that has been stranded and is floated off by a spring-tide--
'That moveth altogether if it move at all.'
Now, then, I was again happy; I took only a thousand drops of Laudanum
per day, and what was that? A latter spring had come to close up the
season of youth; my brain performed its functions as healthily as ever
before; I read Kant again, and again I understood him, or fancied that
I did." There have been many authors who, in condemning De Quincey for
unjustly throwing about the opium habit a halo of literary beauty which
has tempted many to destruction, absolutely deny the truth of his
statements. No one has any stable reason on which to found denial of De
Quincey's statements as to the magnitude of the doses he was able to
take; and his frankness and truthfulness is equal to that of any of his
detractors. William Rosse Cobbe, in a volume entitled "Dr. Judas, or
Portrayal of the Opium Habit," gives with great frankness of confession
and considerable purity of diction a record of his own experiences with
the drug. One entire chapter of Mr. Cobb's book and several portions of
other chapters are devoted to showing that De Quincey was wrong in some
of his statements, but notwithstanding his criticism of De Quincey, Mr.
Cobbe seems to have experienced the same adventures in his dreams,
showing, after all, that De Quincey knew the effects of opium even if
he seemed to idealize it. According to Mr. Cobbe, there are in the
United States upward of two millions of victims of enslaving drugs
entirely exclusive of alcohol. Cobbe mentions several instances in
which De Quincey's dose of 320 grains of opium daily has been
surpassed. One man, a resident of Southern Illinois, consumed 1072
grains a day; another in the same State contented himself with 1685
grains daily; and still another is given whose daily consumption
amounted to 2345 grains per day. In all cases of laudanum-takers it is
probable that analysis of the commercial laudanum taken would show the
amount of opium to be greatly below that of the official proportion,
and little faith can be put in the records of large amounts of opium
taken when the deduction has been made from the laudanum used. Dealers
soon begin to know opium victims, and find them ready dupes for
adulteration. According to Lewin, Samter mentions a case of
morphin-habit which was continued for three years, during which, in a
period of about three, hundred and twenty-three days, upward of 2 1/2
ounces of morphin was taken daily. According to the same authority,
Eder reports still larger doses. In the case observed by him the
patient took laudanum for six years in increasing doses up to one ounce
per day; for eighteen months, pure opium, commencing with 15 grains and
increasing to 2 1/4 drams daily; and for eighteen months morphin, in
commencing quantities of six grains, which were later increased to 40
grains a day. When deprived of their accustomed dose of morphin the
sufferings which these patients experience are terrific, and they
pursue all sorts of deceptions to enable them to get their enslaving
drug. Patients have been known to conceal tubes in their mouths, and
even swallow them, and the authors know of a fatal instance in which a
tube of hypodermic tablets of the drug was found concealed in the
rectum.
The administration of such an inert substance as the infusion of
orange-peel has been sufficient to invariably produce nervous
excitement in a patient afflicted with carcinoma.
Sonnenschein refers to a case of an infant of five weeks who died from
the effects of one phosphorous match head containing only 1/100 grain
of phosphorus. There are certain people who by reason of a special
susceptibility cannot tolerate phosphorus, and the exhibition of it
causes in them nausea, oppression, and a feeling of pain in the
epigastric region, tormina and tenesmus, accompanied with diarrhea, and
in rare cases jaundice, sometimes lasting several months. In such
persons 1/30 grain is capable of causing the foregoing symptoms. In
1882 a man was admitted to Guy's Hospital, London, after he had taken
half of a sixpenny pot of phosphorous paste in whiskey, and was
subsequently discharged completely recovered.
A peculiar feature of phosphorus-poisoning is necrosis of the jaw. This
affection was first noticed in 1838, soon after the introduction of the
manufacture of phosphorous matches. In late years, owing to the
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