Medical diagnosis : with special reference to practical medicine. A guide to the knowledge and discrimination of diseases / By J. M. Da Costa ... Illustrated with engravings on wood.

  • Da Costa, J. M. (Jacob Mendes), 1833-1900.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis : with special reference to practical medicine. A guide to the knowledge and discrimination of diseases / By J. M. Da Costa ... Illustrated with engravings on wood. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    938/1004
    d action of tempei'ature, with rapid pulse, giddiness, inability to walk straight, double vision, and headache, in cases in which consciousness, sensibility, and muscular power have not been entirely suspended by the drug. Weak action of the heart is another of the dangers of chloral poisoning, and I have known a dilated heart almost paralyzed even by small doses. In some instances a stage of excitement like alcoholic intoxication pre- cedes the narcotism. The urine may or may not contain sugar.* Benzene, when taken internally, occasions noises in the head, muscular tremor and twitchings, and deep sleep; but the narcotic depression ends in recovery. Alcohol, if taken in large quantities and not much diluted, gives rise to symptoms like those caused by opium. The eye is in- jected and the seat of ecchymosis; the pupils are, as a rule, dilated and very sluggish ; the breathing is irregular and stertorous ; the temperature lowered ; the insensibility may alternate with convul- sions ; the breath has a strong smell of alcohol or may be quite free from spii'ituous odor. This absence of odor of the breath, although not usual, may give rise to a confusion between alcoholic poisoning and apoplexy, and the discrimination of these condi- tions must then depend in some measure upon evidence furnished by the history of the occurrence of the insensibility, and by the presence or absence of palsy. Alcohol may readily be detected in the urine. Woodbury'sf modification of Ainstie's test is very convenient. Into a tube containing a gramme of sulphuric acid (which should be colorless or nearly so) twice as much of the urine to be tested is poured. A small crystal of bichromate of potassium is then dropped in, and the liquid slowly mixed by rotating the test-tube. If alcohol be present in proportion as large as two or three parts per thou- sand, a permanent green discoloration results; if there be less than this, the liquid will remain of ruby color. Chloral in the urine does not produce the peculiar reaction. Belladonna, or its active principle, atropine, and hyoscyamus produce more marked excitement of the brain than opium does, * See a case of mine recorded in a Clinical Lecture on Chloral Poisoning, Phila. Med. Times, March, 1883. t Ibid.