A text-book of medicine : for students and practitioners.

  • Adolph Strümpell
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of medicine : for students and practitioners. Source: Wellcome Collection.

    1034/1108 page 1006
    ou with all movements, like the tremor in multiple sclerosis. The finer the movements the patient tries to make the more marked is the tremor. Mental excitement usually increases the tremor considerably. In severe cases the ti’emor is so great that the patients can not leave their beds. In rare cases there is also paralysis. Treatment: Dietetic and hygienic. Iodide of potassium, hyoscine, and some- times galvanism, are also useful. 15. Phosphorus.—(1) Acute jphosphorus poisoning, as from matches: Violent epigastric pain, vomiting—the vomitus smells of phosphorus, and it may he phos- phorescent. After these initial symptoms usually comes a period of comparative comfort, lasting two or three days. Then appear grave symptoms: jaundice, severe pain in the hepatic region and whole abdomen, hepatic enlargement, fevej', feeble and i-apid pulse, sometimes gastric or intestinal haemorrhage, cutaneous ecchymoses, hsematuria, epistaxis, or metrorrhagia. The intellect usually remains clear, except that just before death there may be drowsiness or convulsions. The urine contains albumen, blood, casts, bile-pigment, and sometimes leucine and tyro- sine. No urea is excreted. Death occurs usually at the end of one or two weeks, but it may be more speedy. In mild cases the above symifioms are not strongly marked, and recovery may ensue. A very grave prognosis shoiild be made in every case -at the start. Post-mortem appearances in acute x>hospliorus poison- ing : Jaundice. Dark blood. Numerous internal ecchymoses—for example, in the serous and mucous membranes and kidneys. Fatty degeneration of most of the internal organs, including the liver, heart, muscles, and kidneys. Treatment: In fresh cases, washing out of the stomach. Laxatives. As an emetic, sulphate of copper. The best antidote is old oil of turpentine (30-40 drops in mucilage). Oily substances .should be avoided, as phosphoms is soluble in oil. Narcotics and other symptomatic remedies may also be indicated. (2) Chronic phosphoms poisoning: Necrosis of the lower jaw, less often of the upper jaw, extending from caries of the teeth. Necrosis of the bone, with exuberant growth of osteo- lihytes. ■ 16. Arsenic (Arsenious Acid, Schweinfurth Green, Scheele’s Green, Arsenical Wall-paper).—(1) Acute arsenic poisoning: Symptoms of intense gastro-enteritis, suggesting cholera. Violent vomiting. Rice-water stools. Severe abdominal pain. Nervous symptoms: Vertigo, headache, faintness, twitchings. Cardiac weakness. Cyanosis. Collapse. Not infrequently a cutaneous eruption resem- bling urticaria or eczema. Sometimes albumen and blood are present in the urine. Severe cases are fatal in one or two days. With regard to arsenical paralysis, vide page 571. Treatment: At firet the stomach-pump oJ*emetics for example, sulphate of zinc. The best antidotes are freshly prepared ferric hydrate in water, two to four tablespoonfuls every fifteen to thirty minutes; ferrum oxy- datum saccharatum solubile (P. G.), in teaspoonful doses; magnesia; and, best of all, the compound of magnesia and ferric hydrate known as “ antidotum arsenici (P. G.), of which a tablespoonful may be given every fifteen to thirty minutes. (2) Chronic arsenic poisoning: Acquired iu arsenic works and glass factories, or from arsenical fabrics, papers, and flowers. Conjunctivitis, chronic gastro-intesti- nal catarrh, eczema, and cutaneous ulcerations. Anaemia and cachexia, falling out of the hair, loss of sleep. Treatment is purely symptomatic, except as regards prophylaxis. In poisoning with arseniuretted hydrogen, haemoglobinuria and jaundice occur, with severe nervous symj)toms. 17. Alcohol.—(1.) Acute alcoholic poisoning: Unconsciousness; anaesthesia; pupils either dilated or contracted, usually not reacting to light; pulse small, sometimes slow; skin cold and clammy; vomiting; stertorous respiration. There may be delirium and clonic convulsions instead of coma. Such cases last three or
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