561

to the nape of the neck, sinapisms to the feet, cold to the head,and a purgative and diuretic mixture as in he other case.Nov. 26th.-Is very pale; both pupils dilated, but the right

very much more so than the left ; vision is not present in theleft eye, the lid of which is drooping, inflamed, and very pain-ful when touched. The catheter is not now required, and con-sciousness is perfect, but much debility and weakness remain.He, however, sleeps well and naturally. The constitution ofthis boy seems to be bad.CASES 3 & 4.-A boy, aged nine, and another, ten years of

age, treated as out-patients. The general symptoms of poison-ing were present in each, from drinking a solution of the ex-tract of belladonna, but they were not so severe as in the firsttwo cases, probably from the quantity taken being muchsmaller. Both were more or less unconscious, with slight deli-rium, dilated pupils, pain in the stomach, and absence of anyskin eruption, or dysphagia. Their treatment consisted of

purgative and diuretic mediciues, and on the 26th November,both were much improved, and fast recovering from the effectsof the poison. In one of these boys one pupil is much moredilated than the other-a peculiarity also noticed in Case 2.

MIDDLESEX HOSPITAL.POISONING BY THE EXTRACT OF BELLADONNA IN A

CHILD SEVEN YEARS OLD ; RECOVERY.

(Under the care of Dr. H. THOMPSON.)THE little boy who forms the subject of the present case was

in such a state on admission that but feeble hopes were enter-tained of his recovery. Under the influence of the alkaline

treatment, after the stomach was well cleared out, his recoverybecame remarkably rapid, and the good effects were attributedto the influence of the potash upon the belladonna in destroyingits activity, as first pointed out by Dr. Garrod. (THE LANCET,vol. ii., 1857, p. 577.) It was prescribed with this view byMr. Fleetwood Bury, the resident medical officer, who kindlyfurnished us with the following short account of the boy’scase :-

J. D-, a child seven years of age, was admitted on the23rd of November, at half-past eleven P.M., with symptoms ofpoisoning by belladonna. On admission, he was wildly de-lirious, but quite fantastic, almost hysterical, laughing andcrying, and not at all conscious. His pupils were widely di-lated ; no cutaneous eruption or discoloration, nor dysphagia;no tendency to stupor; no difficulty in micturition then, norduring the night. He evidently saw visions, as in deliriumtremens, for he was constantly grasping and picking at imaginaryobjects. The odour of belladonna was strong from his handsand fingers. He was first noticed to be ill at half-past eightP.M., and was found wandering in the streets. He was quiteblind, and stared vacantly. The stomach-pump was used byMr. Bury, but the patient resisted a good deal. Some warmwater (one pint) was injected into the viscus, and a quantityof dark fluid was then removed having the odour of belladonnamost strongly marked, and remaining very persistenc. Sina-pisms were applied to the calves of the legs and nape of theneck, and cold affusion to the face; he was also ordered byMr. Bury to take, twenty minims of Brandish’s liquor potassæ,in milk, every two hours.

Nov. 24th.-He did not sleep during the night, and was de-lirious for fourteen hours, but slept towards the evening, andwoke up conscious, and able to see. It is unknown whetherthe belladonna was taken in the form of extract or mixed withwater, but it is probable the former, from his hands beingsmeared with it on admission.26th.-He is now perfectly recovered in every respect, but

the pupils are still somewhat dilated.

ST. MARY’S HOSPITAL.

POISONING BY THE ROOT OF ACONITE, IN A MAN AGED

FIFTY-EIGHT; FATAL RESULT.

(Under the care of Dr. ALDERSON.)As a companion case to the preceding, we give the follow-

ing, in which a fatal result ensued from eating aconite rootwith a felonious intent. This subject has been well illustratedin our pages by the writings of Dr. Headland (vol. i., 1856,p. 340), and of Dr. Robert Jackson (ibid., p. 478), to which

we would refer the reader. Aconite root is often mistaken forhorse-radish, a striking example of which occurred at a dinnerparty at Dingwall, in Ross-shire, in 1856: the former wasserved up in mistake for the latter, and resulted in the deathof three individuals, and the illness of the entire party. The

report of a case appears in the first volume of this journal for1857, p. 349; and another, with an account of the post-mortem

examination, at p. 100 of the second volume for 1856, recordedby Dr. Massey, of Nottingham.The abstract of the following case we have taken from the

hospital books:-J. D-, aged fifty-eight years, admitted llth July last,

under the care of Dr. Alderson, at five minutes before one inthe morning. Is a gardener, and well acquainted with theproperties of plants; and being in great distress, he dug up aquantity of aconite, which he dried. On the night of admis-sion, about eight o’clock, he ate a good deal of it; this wasfollowed by severe pain at eleven o’clock, and he informed hisneighbonrs of what he had taken. Vomiting and purging setin; he lost consciousness for a few seconds, but at other timeswas sensible. He was in a state of collapse on admission; verypale; skin cold, and covered with perspiration; pulse slow,intermittent, and scarcely perceptible; bowels relaxed; con-sciousness perfect. Stimuli and animal charcoal were adminis-tered, but he died twenty minutes after entering the hospital.

Thirty-seven hours after death the principal appearances ob-served were as follows:-Brain healthy; heart large, flabby,and fatty, the cavities partly filled with blood; lungs emphy-sematous, and not collapsed. Abdominal viscera healthy, butmostly congested. The stomach contained three ounces of athick grnmous fluid, of a reddish tinge; it was highly congestedon its inner surface, and had a bright scarlet hue. Some ofthe longitudinal striæ were intensely reddened, but here andthere were minute patches of extrav1èsated blood, from therupture of small vessels. This bright redness extended pastthe pylorus, which was firmly contracted, into the first portionof the duodenum, and gradually became darker, until it wasnearly brown, and ceased in the jejunum. The rest of theintestine was natural. The duodenum contained several ouncesof thick reddish fluid, mixed with small solid pieces, whichwere likewise observed in the jejunum, but less red. The

œsophagus was injected, and tinged with a beautiful violetcolour, which extended upwards to the pharynx and fauces.The gall bladder was empty and shrivelled-,

CLINICAL RECORDS.

A MIXED POLYPUS OF THE NOSE AND ANTRUM.

j IN certain rare instances, polypi within the nose originate inthe frontal sinuses, or in the antrum, and project into thenostril, although they usually grow from some part of theethmoid and turbinated bones. A curious case, of a somewhatmixed character. was submitted to treatment on the 26th ofNovember, by Mr. Fergusson, at King’s College Hospital, inthe person of an old man, who had a projecting and inflamedtumour growing to the right side of the nostril, beneath theeye, and right in front of the antrum. It was made out to bea nasal polypus, and for its removal an incision was made fromthe inner angle of the eye alongside the base of the nose, roundthe ala into this organ. The skin was then reflected back, andwith the aid of the finger and the hæwlle of the scalpel, a quan-tity of material was taken away fr..’j.i the nose and from theantrum, consisting essentially of thee distinct substances: tll-.isthere were two or three true gelatinous polypi taken from thenose, whilst other portions of the disease consisted of fibrousmaterial, and the remainder distinct cerebriform or medullarysubstance. This mixed character of disease is certainly rareand peculiar; but as one of the elements is of a decidedly ma-lignant nature, it invests the case with some importance. Whenthe integuments were brought together by silver sutures, thedeformity was quite gone, but as that part around the site ofthe tumour is much inflamed and attenuated, there is a possi-bility of an early return of the malady. It is a fact of some

significance in relation to these nasal tumours, that when theyhave been thoroughly extirpated, even with well-marked cha-racters of malignancy, they have not returned, and a perfectcure has become established. Such cases we have seen oji

several occasions at King’s College Hospital, under Mr. Fer-gusson’s care. Every now and then, for some years past, onepatient in particular has returned to show himself, in whomthe primary disease was, or seemed to be, well-marked cancer