Benzinum nitricum

Authorities. 12, Dr. Mackenzie, Med. Times and Gaz., 1862, p. 239, a boy sucked some through a siphon; 13, E. Nicholson, Lancet, 1862 (1), p. 135, a student took a soap perfumed with nitrobenzol into a bath ; 14, Alfred S, Taylor, Guy’s Hosp. Rep., vol. x, 1864, Mr. Fotherby communicated to me a case, a woman, set. thirty years, swallowed not more than a drop, and spilled a tablespoonful, and did not immediately wipe it up; 15, Eiu Fall von Nitrobenzolvergiftung, Inaug. Diss., Dr. Herrmann Pagenstecker, Wurzburg, 1867, case of poisoning ; 16, Dr. Swederus, Hygeia, 35, 1873, S. J., 170, p. 232; 17, Ewald, Ceutralblatt fur die Med. Wissenschaften, 1873, Loud. Med. Rec., vol. iii, 1875, p. 75, a young woman, set. twenty-two years, took about a drachm of commercial bitter almond oil; another, set. eighteen years, took about 2^ drachms; 18, Ewald, general symptoms; 19, Dr. Bruglocher, ^Erz. Intell. Blatt, Jan. 5, 1875 (Loud. Med. Rec., vol. iii, p. 74), a soapboiler, set. forty years, took five or six drachms, with about twenty times its bulk of spirit; he took part at 2 a.m., the rest at 7 p.m. ; 20, Dr. Stevenson, New Remedies, 1876, p. 268, a man, set. thirty years, for pain in the chest and cough, took of the following prescription. Benzol, rect., 5ij., 01. Meuth. Pip. 3ss., 01. Olive, 3x, three doses of thirty drops (first and second days), one dose at 9 a.m. (third day); 21, Bruglocher (Bayr. Arztl. Intell. Blatt, 1875), S. J., 168, 128, poisoning by a small quantity ; 22, From the Swedish, S. J., 170, 232, a man took some by mistake for castor oil.

Mind

Stupor,A

First felt only a little sleepy, finally the stupor increased, and it was impossible to rouse him, and lie died twelve hours after

Both recovered after about five and twelve hours insensibility, and a further period of partial coma

Soon became unconscious, tossed about, with inarticulate, confused speech

Complete loss of consciousness

Extreme coma

Head

^[HO.] Headache

Slight headaches

Bye

Rolling of eyeballs

Constant slow movement of the eyeballs, from left to right, under the closed lids

Eyes partly closed

Pupils dilated

Pupils contracted

Eyes

Idema of face

Face intensely pale, bluish

Face bluish gray, covered with cold sweat

U^O.j Jaws spasmodically closed

Tenacious saliva flowed from the mouth

Stool

Vomiting

Stool

Involuntary evacuations

Urinary Organs

Diuresis towards the latter part of the case was greatly increased

Urine drawn by the catheter brownish red

The first urine passed iu case No. I was about 9 ounces, brownish red, slightly turbid, free from albumen, sp. gr. 1020, and smelling strongly of bitter almonds. It held a large quantity of cupric sulphate and potash in solution, but did not reduce the copper [? glycogen, glycocoll, or inosite]. The urine in the second case was twice drawn off by catheter (six and eight hours afterwards), and a third sam[)le passed spontaneously was also examined. The first samples equalled about half a pint together, sp. gr. 1017. The next was similar. The quantity is not stated. It partially reduced, but did not decolorize, Trommer’s solution, and failed to show appreciable amount of sugar by the polarizing apparatus

Respiratory Organs

Accelerated respiration,’®-

Respiration 18 and 22

Respiration irregular, scarcely 10 to the minute.

Respiration irregular, snoring

On every deep inspiration the wings of the nose dilated, the lower lip was somewhat drawn inward, and the epigastrium was much raised; with the respiration there was vesicular pharyngeal stertor

Pulse p. 384

Rapidity of pulse

Pulse 124 and 108

Pulse tense, irregular, intermittent, at times slow, sometimes rapid, about 96

Pulse weak, regular

The pulse became very slow and weak

Generalities p. 384

The blood taken by cupping was brownish in color, but gave no special spectrum bands

Powerful odor of bitter almond

There was an intense smell of the poison in the breath, vomit, etc., for three days. Even the urine smelled of it

Violent trembling followed by transient spasms, with drawing of the head backward, and to the lel't side

Convulsions

The burning taste in the mouth was immediately followed by a sensation of numbness and tingling in the tongue and lips, and a strange feeling for the next hour. In an hour and threequarters after the occurrence her aspect was quite typical of prussic acid poisoning; the eyes were bright and glassy; the features pale and ghastly ; the lips and nails purple, as if stained by blackberries; the skin was clammy, and the pulse feeble. She was able to swallow a mustard emetic, after which she became rapidly worse; lost her consciousness; the teeth became set, the hands clenched and blue, the muscles rigid aud convulsed. She vomited freely a pale fluid matter, which had the peculiar odor of nitrobenzole. The breathing became much reduced, and the pulse could scarcely be felt. In about eleven hours there was reaction, consciousness returned, and she was able to swallow. At the end of seventeen hours she was much better; but she then complained of distorted vision, with flashes of light and strange colors before her eyes. For some weeks she continued weak. There is no doubt these severe sym{)toms were chiefly due to the breathing of the vapor in a concentrated form. A fellow-servant in the room at the time the nitrobenzole was spilled also felt sick from the inhalation of the vapor

Loquacity was followed by drowsiness, which was soon merged into complete insensibility. He was found quite unconscious at 7.30 P.M. At 8.30, when brought to the infirmary, all his limbs were paralyzed, as in deep chloroform narcosis; the jaw was clenched tightly, and was opened with great difficulty. The skin was cyanotic; the lips were of a violet-blue. He foamed at the mouth. His breathing was stertorous and superficial The pulse was scarcely to be felt. The heart’s impulse aud sounds were extremely weak. The surface was cold. The pupils were moderately dilated, insensible to light. The urine and faeces were passed involuntarily. He smelt strongly of bitter almonds

On the afternoon of the second day he was observed to look pale and weak, but he was not conscious of feeling ill until after taking the dose at 9 a.m., on the third day. All the morning he suffered from headache. He left the office shortly after 2 p.m., but had not walked more than forty yards when he fell. He was just sensible enough to state where his office was situated, but speedily became quite unconscious. When seen at 3.5 p.m. he appeared to be dead. The surface was bluish purple and cold. No pulse could be felt at the wrist. The lower jaw was rigidly closed, but the lower liinbs were flaccid and dropped powerless when raised. The heart could, however, be heard beating faintly and irregularly. No breathing could be perceived until twenty minutes later

He fell to the ground unconscious, the extremities paralyzed, as in deep chloroform sleep, eyes closed by spasms, skin cyanotic, lips blue, with frothing from the mouth. Respiration very superficial, temperature depressed, pulse scarcely perceptible, the heart’s action extremely weak. Pupils insensible. Involuntary evacuation of faeces and urine,'''h

Soon after he staggered to and fro in an almost unconscious condition, with inarticulate and confused speech. Tenacious saliva flowed from the corners of the mouth, the face assumed a bluishgray color, and was covered with cold sweat. The wings of the nose, eyelids, and lips were intensely blue. After a few minutes he fell down in an unconscious state, the eyes staring, the lids half closed, the jaws spasmodically closed. Hands almost cold. The whole body was covered with copious cold sweat. Pulse weak. Respiration became irregular, stertorous, often ceasing altogether, then beginning again with violent deep inspiration whenever the nostrils were irritated by Causticum ammonium. After this violent trembling began, followed by transient spasms, with drawing of the head backward and to the left. Excretions involuntary. The pulse became slow, weak, and a soporous condition set in. The whole body was covered with cold clammy sweat

Fainted from the effects of the vapors, and felt ill for some time afterward

Hyperteraia

Skin p. 385

P punctiform ecchymoses

Both patients were cyanotic, like a case of severe emphysema

Intensely blue color of the wings of the nose, eyelids, hands, and lips

Fingers and toes cyanotic

Two large ecchymosed spots, of a livid, bluish-black color, were found beneath the scalp, and on the gluteal muscles; two cuppings of the lower portion of the thorax discharged black thin blood

Fever p. 385

Temperature very much depressed

Chill came on the second day in the afternoon, with chattering of the teeth, after which the patient became worse, the pulse was more rapid, respiration irregular, and slower and slower till death

Rise of temperature

Temperature 100.8° and 97.6°

Sweatings

Whole body covered with cold clammy sweat

Whole body covered with profuse cold sweat