Causticum

Authorities, 15, Zeit. Ver. Horn. JErz. CEst., vol. i, p. 420, a man, aged forty-six years, drank a swallow ; 16, Darto-Massart, Gaz. Med. de Paris, Kov., 1836 (^m. Journ. Med. Sci., vol. xxi, p. 247), Mr. D., aged thirtyfive years, drank some instead of wine; 17, Dr. Jackson, Bost. IMed. and Surg. Journ., vol. Ixvii, 1862, p. 362, a man, aged seventy-two years, drank some, and at once took a large quantity of sweet oil, after four months he entered the hospital; 18, John W. Ogle, M.D., St. George Hosp. Rep., vol. iii, 1868, Elizabeth G., aged forty-four years, swallowed a quantity of American potash ; 19, J. D. Norris, M.D., Maryland Med. Journ., a child, aged four years, swallowed a dessertspoonful of a solution.

Face

Face pale, presenting the appearance of intense suffering (after a quarter of an hour)

Mouth

Tongue and back part of the mouth threw off a very thick and tough membrane (after two days)

Mouth and fauces very corroded; on introducing the stomach-pump, small shreds of softened membrane were found clinging to the tube when removed

On the following morning the mouth and fauces were in an extremely affected state. Everywhere the epidermal coating of the mucous membrane had been abraded, but still hung partly to it in large pieces, the mucous membrane itself was swollen and loose, the tongue was injected scarlet, the papillae swollen, arch of the palate and the umda extraordinarily swollen, the colors of these parts intensely dark red. In the mouth and fauces the patient had the sensation as if gloiving eo(ds were there, together with constant pressure to swallow and hawk up, ivhich increased the pain; he discharged in a large quantity a secretion consisting partly of saliva, partly of mucus. The voice was hoarse and nasal, his disposition bounding on desperation. To these symptoms were added remarkable febrile symptoms (pidse 120) and unquenchable thirst

Throat

Ejection of raucous membrane of oesophagus presenting perfect cylinder of tube

Pain along course of oesophagus

Dysphagia from the first, and had lived mainly on a liquid farinaceous diet (after four months) ; probangs were used, and there was reported a stricture five and a half inches from the incisor teeth ; probang used till some weeks before his death, when he said he could swallow well enough without it

Stomach

Nausea (soon)

Regurgitation

Vomited immediately

Severe pains in the epigastric region (soon)

Great pain in the region of the stomach and the course of the diaphragm

Stool

Black stool followed the perspiration

Fever

General coldness (after a quarter of an hour)

Slight perspiration continued for two hours