A text-book of medicine for students and practitioners / by Adolf Strümpell ; With editorial notes by Frederick C. Shattuck.
- Adolph Strümpell
- Date:
- 1901
Licence: Public Domain Mark
Credit: A text-book of medicine for students and practitioners / by Adolf Strümpell ; With editorial notes by Frederick C. Shattuck. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![headacHe, etc. Treatment: Sulphate of zinc, or some other emetic; stomach- pump. [One-per-cent. solution of permanganate of potassium.—V.] Tan- nin. Cafe noir. Atropine may be tried as a physiological antidote. Stimu- lants (camphor, ether) are best, also cold baths with shower-baths; arti- ficial respiration. 2. Chronic (morphine habit) : Emaciation, ansemia, headache, vertigo, wakefulness. Tremor. Mental disturbance. Unconquerable longing for morphine; and, if this be denied, the appearance of grave symptoms. To break up the morphine habit is almost impossible except in hospitals and special asy- lums. The withdrawal of the drug is abrupt according to the practice of some, and gradual according to others. Eor particulars consult monographs. 32. Ergot (Ergotine).—1. Acute: At first nausea, vomiting, colic, and diar- rhoea. Then vertigo, headache, and muscular weakness. Pulse slow. In severe cases, sopor, disturbance of respiration, and sometimes death. Treatment: Emet- ics and purgatives. Tannin. Ether, camphor, and cafe noir as stinaulants. 2, Chronic ergotism: Gastric symptoms, vertigo, languor, cardiac weakness. The nervous disturbances are, however, of especial importance. Of these, parsesthesia has long been recognized. Recently attention has been attracted to the great resemblance of the nervous symptoms to those of tabes dorsalis; and there is, moreover, an anatomical change in the posterior columns of the cord. Convul- sions and psychical phenomena are also observed. A second form of chronic ergotism is called gangrenous ergotism. It results in dry gangrene of the hands and feet. A line of demarcation forms and the gangrenous parts slough off. The process may be attended by fever and pysemia. The probable explanation is that the minute blood-vessels become spasmodically contracted and thrombi form under the influence of the poison. The different symptoms are due in part to the different constituents of the ergot. The best known are sphacelinic acid, which is probably the cause of g-angrenous ergotism and ergotine tabes; cornutine, which causes severe convulsive symptoms (convulsive ergotism) and uterine contrac- tions; and finally ergotinic acid. The treatment of chronic ergotism is purely symptomatic. 33. Poisonous Mushrooms.—1. Poisoning from morels: Fresh morels (mor- eheln or lorcheln ) contain a poison which is readily soluble in hot water, and which evaporates completely if the morels be dried. Morels that have been dried or parboiled are therefore perfectly harmless, but the fresh ones are poisonous. The symptoms are nausea, vomiting, diarrhcea, headache, coma, and, above all, haemoglobingemia and hsemoglobinuria (q. v.), associated with which is a hsematogenous icterus. In severe cases death occurs, ushered in by convulsions. Treatment is symptomatic, and includes the administration of emetics, purga- tives, and stimulants. 2. Poisoning from the red agaric (amanita muscaria). This contains the poisonous alkaloid muscarine. Gastric symptoms and diar- rhoea. Mental excitement, delirium, tetanic and epileptiform convulsions. A rapid pulse, small pupils, disturbed vision from spasm of accommodation, sweat- ing, salivation, and in most of the severe cases sopor and death. Treatment: Emetics, etc. Atropine, which acts as a physiological antidote to muscarine. Also tannin, and stimulants. 3. Poisoning from hulhous mushrooms (ama- nita phalloides), confused with young button mushrooms (champignons). Di- gestive disturbances, later jaundice, somnolence, coma. The autopsy shows fatty degeneration of the liver, kidneys, and stomach, as in phosphorus poisoning. 34. Poisoning from Sausages (BotuUsmus).—This sometimes occurs as the result of eating partially decayed sausages. The symptoms are pain in the stom- ach, nausea, vomiting, colic, and diarrhoea. There are also marked feebleness, prsecordial anxiety, and dyspnoea; vertigo, headache, somnolence; and very often disturbance of vision (amblyopia, spots before the eyes), and, what is surprising, ptosis. In severe cases, dysphagia, as a result of more or less complete paralysis-](https://iiif.wellcomecollection.org/image/b21206296_1242.jp2/full/800%2C/0/default.jpg)
