Carboneum Oxygenisatum

Carboneum oxygenisatum, Carbonous oxide, CO. This gas may be obtained, in a state of purity, by the action of Sulphuric acid upon Ferrocyanide of Potassium ; it is soluble in water (about two per cent, at ordinary temperatures).

Authorities.^ 1, Meglin, Journ. de Med., 1786 (Frank's Mag., 1, 765), five cases of poisoning from coals in an open vessel in a room ; 2, Berthold, Heucke Zeit., 1830 (Fr. Mag., 3, 224), several cases, same cause as the last ; 3, Schroeder, Rust's Mag., 1830 (Fr. Mag., 1, 553), several cases, same as last; 4, Wagner, Hufeland's Journ., 1836; 5, Hergenrother, Med. Corr. Bl., Bayer, 1841 (Schmidt's Jahrbucher, 34, p. 26) ; 6, Mark, Bayer. Corr. Bl., 1843 (S. J. Suppl., Bd. 4) ; 7, Demeures, Bull. d. 1. Soc, homoeop. de Paris, 1849 ; 8, Buchner, All. Horn. Zeit., 28, 158, 1850 ; 9, Piorry, Gaz. des Hop., 1851 (S. J., 70, 175) ; 10, Chenop, a chemist, L'Union, 1850, poisoning, from inhaling the pure gas; 11, Gaz. des Hop., 1857, poisoning of three women ; 12, Jachimowicz, Zeit. f. Ver. Oest., 1857 ; 13, Ozanam, L'Union, 1857 (S. J., 94, p. 26) ; 14, Freud, Om. Schr. f. Geburt., 1858 (S. J., 104, 190), poisoning of a woman seven months pregnant; 15, Siebenhaar and Lehman, S. J., 101, p. 274, 1858 ; 16, Thompson, Edinb. Med. Journ., 1860; 17, Haste, Pr. Ver. Zeit., 1859 (S. J., 105, 41), poisoning of five soldiers ; 18, Brit. Med. Journ., 1862 ; 19, Oest. Zeit., 1862 (All. Horn. Zeit,, M. B., 7, 34) ; 20, Leudet, Virch. Archiv. (S. J., 127, 24), 1865 ; 21, Klebs, Virchow's Archiv., 1865 (S. J., 127, 17) ; 22, Leudet, as last ; 23, Pirain, S. J., 127, p. 24, 1865 ; 24, Huber, All. Milit. Zeit., 1865 (S. J., 127, p. 162) ; 25, Gull, Lond. Lancet, 1866 (S. J., 133, p. 33) ; 26, Fau re (S. J., 92, 220), Archiv. Gen., 1856, general treatise on asphyxia ; 27, Malaga, Edin. Med. Journ., 1868, three cases; 28, Linas, Gaz. Med. de Paris, 1869 : 29, Sulzer, All. Horn. Zeit,, 1873 (Halm. Month., 8, 519) ; 30, Hirt, in Ziemssen, Handbuch der Spec. Path, and Therap., Baud 1, general statement ; 31, Martin, Casper's Vjhschft., 25, 197, several cases; 32, Prof. Leeds, Phil. Med. Times, 1870, inhaled about a gill of the pure gas.

Mind

Emotional. Condition resembling intoxication the whole day

A woman was found upon the street half unconscious, talking senselessly, screaming violently, only able to say that several of her family were similarly affected ; after she got to the house was taken with a violent shaking chill, followed by decided heat

Spasmodic crying

Screaming and convulsions

Patient depressed and stupid

Sadness and despondency

Frightful anxiety, and instinctive impulse to seek change of air, while he felt powerless to overcome the paralysis of his muscles and move from where he sat

Great anguish

Apathetic

With the lassitude, an unusual apathy, and indisposition for any muscular exertion

After supper, felt buoyant and in good humor, an effect never produced by tea ; this mental sensation soon passed over into an irritable and sarcastic one, so that I sharply criticized an article in a medical journal, which a few hours ago I hardly thought worth that trouble, and threw away in disgust a book of reference, as flat and superficial, which I highly value at other times

Intellectual. Mental inactivity

Mind sluggish

Very contracted range of ideas

Incapacity to draw inferences, or to compare ideas

Confused ideas

Felt in a very confused and stupid state

Confusion and stupefaction of the senses and intellectual faculties, amounting at last to complete unconsciousness

Answers only with difficulty

On attempting to describe their sensations (according to letters left by suicides) the first few lines are well written, afterwards phrases are incomplete, and at last there are only words and letters

Dull and ever-changing images passed before my mind, but I felt unable to concentrate my mind on any one

Memory much impaired ; remembered nothing of his attack ; could not answer questions correctly for two days, and was not able to resume his occupation for a month (after three days)

Memory completely lost for five days

Stupor and imbecility

Fell to the ground stupefied

Unconscious

Quite unconscious till the third day

Consciousness disappears

Complete loss of consciousness

Consciousness is sometimes suddenly lost, as if the person had been struck upon the head

Unconsciousness and piteous moaning

Shortly became insensible

Struck senseless to the floor (after one moment)

Coma

Comatose

Could not be aroused/.

Head p. 611

Confusion and Vertigo. Gloomy confusion of head

Inclination to turn in a circle

Tendency to vertigo, and to turning in a circle

Vertigo,39™, etc.

Vertigo, to staggering and falling

Vertigo, with flickering before the eyes

Vertigo, and turning black before eyes

Vertigo, and temporary darkness before the eyes

Continual vertigo, especially on rising after lying down

Giddiness

Giddiness and trembling, so that he fell to the ground

On rising up, staggered, was obliged to hold fast to something, and sank exhausted into a chair

General Head. Heaviness of the head

Heaviness of the head, without vertigo

Excessive heaviness in the head

Dull heaviness of the head

On rising, heaviness of head, which lasted all day (second day)

Sudden pain in head

Headache,1 3, etc.

Headache and vertigo, for several days

Headache, especially in the temples, together with violent pulsation of the temporal arteries

Headache, beginning in the morning, and spreading throughout the whole head, but felt chiefly in the occiput, which seems pressed outwards. The nape of the neck seems swollen when touched ; the whole posterior portion of the head from about the summit of the occipital bone to the base of the neck seems tense, swollen ; the head can hardly be moved

Headache commenced generally with confusion and heaviness of the head, and dull undefined pressure in the temporal region, it then gradually increased and extended from the temples forward and backwards, encircling the whole head; usually it increased rapidly to an extreme severity

The headache, which is the first symptom, is also the last; in a young girl it continued with great severity for more than a month, almost without interruption

Violent persistent headache

Symptoms commenced with violent headache, which soon became very intense

Violent and constant headache, worse in the frontal region and accompanied with a sensation of tightness and constriction towards the temples

Dull headache

Pressive headache

In brain, severe pressure

Painful sawing pain through middle of head, which feels congested

Forehead. Intolerable pain in the forehead

Frontal headache, extending over the whole head, but chiefly felt in the forehead, which seems pushed out

Constant frontal headache (second day)

Pressing pain at the forehead and parietal bones

A severe pressing frontal headache, as if the brain were compressed, and simultaneously severe palpitations of the heart, with which I am never troubled

Weight across forehead

Throbbing pain in forehead and temples

Temples. The attack commences with a vague, dull pain in the temporal region, which gradually extends forward and backward, encircling the head ; it becomes exceedingly intense

Headache characterized by compression of the temples

Sticking in temples

Throbbing in temples

Vertex, Dulness and oppression in the crown of the head

External Head. A small red spot (similar to the streak on 'the arm), on the right temple, near the outer margin of the orbit

Eye. Eyes weak and dim, sunken

Eyes wild, staring

Eyes wearylooking

Eyes distorted in the orbits

Eyes fixed and insensible

Eye hyperemic

Eyes half-open, staring

The eyes are contracted and sunken

Eyes staring and protruding

Idiotic staring at one point

Lids. Lids and lips bluish-red

Conjunctiva. Vessels of conjunctiva injected

Conjunctiva dull red

Pupil. Pupils dilated,8 22 25.

Pupils somewhat dilated

Pupils dilated and insensible

Pupils contracted, insensible

Pupils become insensible to the light, and the conjunctiva to foreign substances

Vision. Dim sight

Almost constant dimness of sight and vertigo

Dimness of vision, with flickering and fluttering before the eyes

Vision obscured

Flickering before the eyes, with vertigo

Ears p. 612

Noise in ears

After a short time, confused sounds in the ears, which are exceedingly painful ; afterwards there is a continuous dull vibrating, similar to the noise of a wagon, mingled with pulsating sounds, which at first seem to be indistinct and distant, but gradually become stronger ; whilst lying in deep stupor, there is an incessant humming, which gradually disappears as consciousness returns

Ringing in the ears, with various kinds of illusions of hearing

Roaring in ears,2 12 26.

Troublesome roaring and singing in the ears

Nose p. 612

Violent inflammation of the nose and throat, which makes swallowing very difficult (second day)

Bleeding from the nose

Face p. 612

Looks anxious

Face pale

Pale face, warm to the touch

Very pale face, continued for several days

Face livid

The complexion had assumed the livid hue of death

Cyanotic

Face red

Face red (four children)

Face red and puffy

Face bluish-red

Face tumid

Face puffy and reddish-brown

Features distorted

Convulsions of the facial muscles

Lips bluish

Lips and tongue rosy-red

Jaws firmly clenched,6 (and others).

Trismus

Trismus, with epileptic convulsions

Mouth p. 612

Tongue. Paralysis of the tongue

General Mouth. Mouth drawn

Saliva. Froth from mouth

Foaming at the mouth

While eating, flow of a slightly acid water into the mouth, which mingles with the food without causing disgust

After supper, the mouth is lined with mucus so viscid that, on trying to spit it out, it sticks to the lips

Excessive sensitiveness of taste and smell, Avhich lasts four days, and goes on diminishing, until, in six days, these two senses are duller than formerly

Appetite as usual at dinner, but bread and all sorts of food had a foul taste, even sugared rice-cake (second day)

Throat p. 612

Dryness of the throat

Pain in the throat, from swallowing saliva; lasted all night

The sore throat continues, and extends to the right ear (second day)

Violent burning pain in the fauces

Stomach p. 613

Appetite and Thirst. In the after noon, three hours before supper, sudden paroxysm of hunger, which soon ceases without eating (second day)

No inclination to eat

Anorexia

No appetite, but food relished well

Disgust for everything

Thirst

Nausea and Vomiting. Felt sick, and retched once or twice

Nausea

Slight nausea

Nausea and vomiting,3 25 29.

Nausea and vomiting every now and then ; the stomach could bear only liquids in very small quantities

Vomiting,26 27 31.

Repeated vomiting

Vomiting after meals

Vomiting, caused by the smallest quantity of food

The stomach was so irritable that everything taken was immediately vomited (second day)

Pressing on abdomen causes vomiting of a yellowish, almost fecal-like fluid

Stomach. Digestion disturbed

Very severe and obstinate pain in the epigastric region

Abdomen p. 613

Pains in the abdomen

Frequent crying out that they had pains in the abdomen ; it, however, was not distended or tense

Violent pains in the bowels

Stool p. 613

Involuntary evacuations

Stools thin, painless

Constipation

Urinary Organs p. 613

Kidneys and Bladder. Pains in kidneys

Paralysis of the bladder

Bladder remains paralyzed a long time

Paralysis of the bladder lasted nine days after the attack

3Micturition. Involuntary evacuation of urine and fseces

Urination from the first became more and more scanty

Urine. Urine contained sugar

Sugar is found in the urine (Snuff)

Urine contains a trace of sugar

Respiratory Organs p. 613

Larynx, Trachea, and Bronchi. Rattling of mucus in air-passages

Bloody mucus is raised from the bronchi

Respiration. Respiration audible, almost rattling, slow, stertorous

Respiration rattling

Respiration rattling, now and then intermitting

Stertorous breathing

Expired air of a peculiar smell

The expired air felt, to the back of the observer's hand, cooler than usual

Respiration is for a long time quiet, but afterwards it becomes accelerated, frequently with extraordinary energy and rapidity; expiration is quick, inspiration deep, rattling ; later there occur periods of complete intermission, followed by four or five inspirations

Respiration slower

Respiration slow

Respiration slow, frequently interrupted by yawning and sighing

Respiration very soon becomes slow and stertorous

Breathing now rapidly, now slowly (four children)

Respiration 24 (after one hour)

Respiration 20 to the minute

Respiration short and rapid

Expiration greater than inspiration

Respiration oppressed

Respiration difficult and interrupted

Respiration very labored

Somewhat impeded respiration

Sense of suffocation

Chest p. 613

The chest had ceased to expand and contract

Emphysema of the lungs, with some bloody sputa

Remarkably weak vesicular murmur on auscultation

Felt as if a stream of warmth passed from the abdomen into the chest, and thence into the head ; it roared in his ears, it affected his respiration ; he rose, and after tottering a few steps, fell down, attacked by sudden vertigo

Complained now and then of anguish and anxiety in the chest

Sense of a burden on the chest

On breathing, feeling as if a heavy load on chest

In chest, severe tearing pain

Heart and Pulse p. 614

Precordium. Intolerable pain in the region of the heart

Precordial anxiety

Heart's Action. Palpitation

Violent palpitation

Violent palpitation on exertion

Pressure in precordial region produced violent palpitation, a rapid, weak, trembling contraction and expansion

Desire to loosen clothing on account of palpitation

The action of the heart and of the lungs gradually decreased

Feeble action of the heart

Action of the heart slow and weak

Beating of the heart alternately increases and diminishes

The beating of the heart is at first increased, but afterwards it becomes slower

Beating of the heart at first strong, frequent, even amounting to palpitation, although associated with slow respiration ; at last it becomes irregular and intermitting

The action of the heart is at first strong and rapid ; it afterwards becomes very irregular, so that there is an intermission after four or five pulsations; the intermissions become prolonged on the approach of death, and afterwards become more frequent, so that they intermit every three or four beats

Pulse. At night, in bed, pulse high, rapid, 120 beats occupying a short time

Pulse 100,25.

Pulse regular, 80, weak

Pulse 72 (after one hour)

Pulse rising and falling (varying between 144 and 88)

Pulse small, rapid

Pulse rapid, very small

Pulse slow and full

Small, slow pulse

Pulse small and slow, scarcely to be felt

Pulse full, 68,16.

Pulse 64 (after thirty minutes)

Pulse 56,20.

Pulse 56, soft, compressible, undulating

The pulse is at first accelerated, afterwards retarded

Pulse very variable (four children)

Pulse weak, wavy

Pulse small

The pulse had stopped beating, or beat so feebly that in the agitation of the moment it was imperceptible

Neck and Back p. 614

Soreness of all the cervical muscles while exerting the brain (second day)

Burning pain at the right scapula, which soon ceases (second day)

Extremities in General p. 614

Extremities flexed

Feeling as if the left upper and lower extremities had gone to sleep and could not be moved

Inclination to stretch the extremities

Clonic cramps in the extremities

Clonic spasms of the extremities

Trembling of limbs

Convulsions in limbs and stiffness in joints

All limbs convulsed

Great weariness of the limbs

Paralysis of the left arm and left leg continues after the attack

Complete paralysis of the right foot and right hand, and also of the muscles of the right half of the face; persisted after the attack

Pains in the extremities, followed by paralysis

Superior Extremities p. 614

Arms flexed, could not be extended

Tossing about of the arms

The chorea-like movements of the right arm continued for some days, only on waking

The arms and hands are without strength (second day)

Spasm of flexors of forearm

A remnant of pain in the left knuckle-joints, caused by a fall on the ice six months before, returned with increased severity, and extended to the corresponding parts of the right hand (second day)

Fingers clenched

Numbness of three fingers of the right hand ; the fingers can only be extended with difficulty

Inferior Extremities p. 614

-Trembling of legs

Attempted to rise, but was unable to do so ; legs stiff and powerless

The legs can scarcely sustain the body (second day)

The weakness in both legs continued to increase, to complete paralysis of the right and incomplete paralysis of the left

Thigh. Occasional shooting pains in the right nates, just where the ischiatic nerve emerges; there was noticed at this point an elliptical red spot half as large as the hand, without any trace of blisters, only the skin seemed to be somewhat puffy and elastic, without fluctuation

When sitting on a low chair, the gluteal muscles are painful, as if he had just got up after a severe sickness and was much emaciated (second day)

Let/. Extension of the right leg became difficult (second week)

When putting on his garters in the morning, they cause pain, and he is obliged to tie them so loosely that they slip down (second day)

The pains in the nates extended along the sciatic nerve, and the external popliteal nerve, down to the foot ; no pain on pressing on the os ilium or on moving the leg

Toes. Toes could not be moved (second week)

Generalities p. 615

Objective. Extreme emaciation followed the attack

The first effect is a stage of complete rest

The second stage is one of excitation, characterized by contractions and convulsions

Trembling of whole body

Body stiff

Hemiplegia (persistent)

Paralysis of the sphincters

Sphincters relaxed

Cramps

Tonic cramps

Spasms, without loss of consciousness

Spasms, returning every five minutes, with loss of consciousness and loss of speech; the head was drawn spasmodically backwards, the arms stiffly extended ; the spasms especially affected the cervical muscles

Violent spasms

Violent spasms, at first usually clonic, afterwards generally tonic, becoming tetanic

Tonic spasm of most of the muscles of trunk and extremities, so that it is difficult to make patient sit or lie

Repeated convulsions

Epileptiform convulsions, which were renewed every time the patient was touched or spoken to, although he lay quite still and apparently unconscious

Disinclination to labor

Great lassitude in hands and feet

Weakness

Weakness of the muscles

Extraordinary weakness

General debility and malaise

Felt his strength fail him

Every voluntary movement, even speaking, difficult

Rising and walking seemed a most tremendous exertion

In morning could not rise up

Prostration

Great prostration

Complete prostration

Inclination to faint

Fainting

Suddenly fell to the ground, as if struck by lightning

Very restless

An enormous restlessness, with anguish and oppression, forced me to get up and walk in another room where the window was open

Constant motion, continually flexing and extending the right arm with considerable force

The father was constantly moving about and complaining of his head

Continually tossing about

Four children were lying in bed senseless, tossing to and fro

Extraordinary sensitiveness

The third stage is one of anaesthesia, characterized by partial or absolute insensibility

General insensibility

Tactile sensibility was greatly diminished ; patient evinced no pain when pinched and pricked quite severely

Sensibility of sight, hearing, smell, and taste also greatly lessened

Blunted sensibility of the whole skin

Anaesthesia of the skin (persistent)

Anaesthesia of the skin, but the slightest touch with a hot iron recalls the sensibility

The sensibility of the skin is completely lost, especially to mechanical irritation ; only a glowing hot iron causes a reaction ; this insensibility is at first noticed on the extremities, whence it gradually extends to the trunk, last of all involving the mammary glands and the fossae under the clavicle and in the axilla

Complete anaesthesia

Subjective. Felt very tired and fat<nied

Generable, indefinable malaise ; feeling of painful weariness; dull pain in the limbs and loins

Dread of every noise or jar, which shoots through the body like an electric shock; continues for several minutes ; this condition gradually changes to a kind of insensibility, which is especially noticed in the tips of the fingers, and it varies in intensity with the condition of the atmosphere

-Body all sore

Whole body sore to touch

Soreness of all the muscles, as after excessive fatigue (second day)

Skin p. 616

General. Skin bloodless; the veins show through it blackish

Surface of body reddish-livid

Bluish, cyanotic color of the entire skin, especially of the face, neck, entero-superior portion of the chest and back of the hands ; on all which parts the skin was actually slate-colored ; this color was also noticed on the mucous membrane of the lip

The skin assumes a violet color; the veins are swollen ; the lips and. conjunctiva are cyanotic

Purple maculation of the skin

The skin had lost its normal tone and elasticity ; when pinched, the folds remained for some seconds and disappeared slowly

Along the course of the radial nerve in each forearm a linear redness, without swelling of the subcutaneous cellular tissue, more on the right than on the left side

Circumscribed spots on the anterior surface of the left forearm and on the inner surface of the left lower leg, which were totally insensible to pricking and pinching (sixth day)

A brownish ecchymosis, as large as the palm of the hand, on the lower portion of the sacrum

Eruptions, 3toist. The whole skin was covered with large and small vesicles of pemphigus (sixth day)

Herpetic vesicles on the temple in the place where the redness had been noticed

Herpes zoster on the left side of the face along the course of the trigeminus; vesicles on the forehead, above the orbit, along the course of the ramus frontalis, on the cheek below the orbit, along the terminal filament of the infraorbital nerve of the chin, along the mental nerve (eleventh day after the poisoning)

A dozen herpetic vesicles, as large as a pin's head, on the inner portion of the right forearm, somewhat externally to the place where the redness had been noticed ; the subcutaneous tissue seemed to be somewhat swollen

About twenty herpetic vesicles, as large as a pin's head, along the course of the right sciatic nerve, situated upon a slightly red base; from them some red streaks extend up to the right nates, and from the point of exit of the sciatic nerve to the crest of the ilium

Abscesses form upon the chest and upon the left nates, caused by subcutaneous ecchymosis

Sensations. Burning sensation in the skin, especially of the cheeks, without intense redness, and without elevation of temperature (very soon)

Formication on both legs

Sleep and Dreams p. 616

Sleepiness

Great sleepiness for several days

Drowsy, but unable to sleep on account of the headache and pains in the stomach

Somnolence

Sound sleep (third night)

Sleep deep and prolonged, interrupted by cramps in cheeks and toes

Never slept so long before

Fever p. 616

Chilliness. Cold, mottled skin

The temperature of the body was rapidly falling

Bodily temperature remarkably lowered; skin cold, giving to the touch an impression like that caused by contact with a corpse some hours after death, before it is quite cold. Temp, in the axilla, + 34.6° ; in the mouth, 35.20,28.

Temperature 38° Cent.,25.

Coldness

Sensation of coldness in the whole body

The attack is followed by long-continued sensation of coldness and general trembling, which may last for weeks

Severe chill, with chattering

Violent febrile chill, for several days

Violent and continued shaking chill

Daily repeated chills, with a sensation of a heavy dragging up of the abdomen when walking and standing

Chilly all day

Cool extremities

Extremities cold

Extremities cold and numb

Hands and feet cold

Hands icy cold

Meat. Febrile symptoms

At night, in bed, burning heat all over, without thirst ; despite this heat and fever, slept lightly until 1 a.m., after which increase of heat, with thirst and dry mouth ; the thirst was satisfied by drinking only a little ; the heat, as well as the thirst and fever, now gradually diminished, and the bed, which had hitherto been too warm, was now too cold, so that he had to have more covering; sleep returned

Sensation of warmth in chest and abdomen, similar to that caused by spirituous liquors, but the hands and feet remained cold

Sir eat. Skin covered with sweat

Beads of sweat over whole body

A little sweat on the upper half of the body, in the morning, in bed

Slight frontal sweat

Conditions p. 617

Aggravation.

(Morning), On rising, heaviness of head ; in bed, sweat on upper half of body.

(Night), In bed, heat.

(Inopen air), Felt worse

(On breathing), Feeling of load on chest.

( While eating), Flow of saliva.

(After meals), Vomiting.

(On rising, after lying down), Vertigo.

Amelioration p. 617

(Fresh air), Marked relief, especially to heaviness on chest.

Footnotes

† But two of the authorities selected refer to the action of the chemically pure gas, viz., Nos. 10 and 32, the others refer to the effects of gas from smouldering coal, a mixture of the Carbonous oxide, and Carbonic dioxide, with some vapors of volatile carbon compounds; the effect of the gas is due to the very poisonous property of the carbonous oxide. The attention of therapeutics is particularly called to the peculiar headache, the trismus, and the hemiplegia caused by this substance.