Poisoning With Water Hemlock
The Journal of the American Medical Association for October 16th contains an interesting report by Louis M. Gompertz, M. D., New Haven, Conn., of seventeen cases of poisoning with Cicuta maculata, water hemlock.
This is the American water hemlock as distinguished from Cicuta virosa, which is indigenous to Europe, Germany and France more especially. After citing certain historical facts and giving a description of the plant, the author presents the following:
Careful studies of the toxic principles of Cicuta have been made by several investigators. The poisonous component of this plant is a resin which was first isolated by Boehm, in 1876, who named it cicutoxin. Cutting the root stock causes an aromatic, yellowish, oil-like substance to exude, with an odor similar to parsnip.
Cicutoxin has been described as a clear, brown, sticky resin having an acid reaction. It was found to be soluble in ether, alcohol, chloroform and dilute alkalis. The root stocks are the most virulent, although the leaves, stems and particularly the basal parts of the plant, especially in the early stages of growth, contain sufficient poison to prove fatal when ingested. Judging from the case reports, the plant is most poisonous in the spring. The explanation made by some observes is that during the growing season the stored material of the root stock is absorbed in the development of the plant, which is thereby rendered less virulent later in the year. This observation, however, seems to be open to question.
REPORT OF NECROPSIES.
Observations at necropsy, made by different observers, may be thus summarized:
1. Noncoagulation of the blood after twenty-four hours.
2. Widely dilated pupils.
3. Multiple hemorrhages of the mucous membrane of the stomach and duodenum.
4. Emphysema and edema of the lungs.
5. Generalized congestion of the central nervous system.
REPORT OF CASES.
June 16, 1925, I was called to attend seventeen boys, inmates of the New Haven County Home, who had been taken suddenly ill. The boys ranged in age from 9 to 13 years. All of the children in the institution had been dismissed from their classrooms at 3.30 P. M., apparently well, and immediately adjourned to their playground. At 5.15 the boys were in the dining-room at their evening meal. The matron in charged observed that several of them refused their supper and appeared pale and sickly. Two of the children asked permission to leave the room, complaining of nausea, but before going very far fell to the floor in violent convulsions.
About twenty minutes later, when I arrived, five children were in convulsions; twelve others were vomiting and appeared seriously ill. It was evident that the children were suffering from some form of poisoning, and I soon learned that they had partaken of a plant, the nature of which was unknown to me at the time. It later appeared, however, that in a plot of swamp land adjoining their playground water hemlock grew in abundance. While some of the boys had eaten the roots, the majority had partaken only of the leaves or flowers. It is noteworthy that the five boys who had eaten the root stock were very sick with accompanying convulsions, while the other twelve, who had eaten leaves or blossoms but no roots, did not have convulsions.
Without relating in detail all of the cases, that of Clarence D. aged 13 years, is illustrative of those of the convulsive type. He was totally unconscious, manifesting violent tonic and clonic convulsions, frothing at the mouth and protruding eyeballs. The froth was slightly blood-tinged, probably from biting the tongue. There was a marked internal strabismus with pupils widely dilated, the iris being scarcely visible. Cyanosis was extreme. The corneal reflexes were entirely absent. The jaws were firmly set, with violent twitching of the facial muscles–a horrible spectacle. In our necessarily hurried examinations, nothing of importance was noted in the abdomen. The hands were tightly clenched and the finger nails cyanotic. Respiration was rapid, and during the convulsion it seemed as if the boy was about to die from suffocation.
The convulsions lasted on an average about ten minutes, gradually diminishing in severity and being followed by a state of exhaustion, the patient remaining unconscious and cyanotic. During the convulsion the pulse rate was increased, but slowed down considerably during the quiescent state. The patellar reflexes were present, but diminished. The greatest number of convulsions noted was in this patient, with a total of six, the least being two. After the last convulsion the lad, apparently exhausted, fell into a deep sleep. On awakening in the morning he was as well as ever, with no recollection whatever of his illness. This was characteristic in all instances.
All of the boys who had eaten of the blossoms or leaves complained of faintness, nausea and general weakness. In some instances, there was slight cyanosis and nervous twitchings. Dizziness was a prominent symptom. Coldness of the extremities and general collapse were present. After treatment there was a prompt recovery in these cases.
The treatment consisted of gastric lavage and high enemas. In the children who were unconscious lavage was difficult, as the jaws were so firmly set that it was necessary to use metal mouth gags in order to pass the stomach tube. In the cases of those who were able to swallow, hot water containing salt was given, followed by lavage. After the stomachs of all were evacuated it became necessary, in three instances, to administer morphine hypodermically. When indicated, stimulants were administered to the children; active purgation was initiated in each one. In other words, they were treated symptomatically. Normal conditions were thus brought about, as the seventeen patients all made a complete recovery.
1. The poisonous properties of water hemlock ( Cicuta maculata) have been recognized since the middle of the sixteenth century.
2. The toxic principles have been separated.
3. A definite train of symptoms prevails in man and animals when the root stock, blossoms or leaves have been eaten.
4. The plant is very poisonous at all times.
5. Eradication of this plant should be advocated.
6. In cases of poisoning by water hemlock, prompt action by the use of emetics, the stomach tube and purgatives can save lives.
I have failed to find another record of so many cases of Cicuta poisoning of simultaneous occurrence. IT is not unlikely, however that intoxication by this plant has been widespread in many places. As the single experience here put on record has demonstrated the readiness with which no less than seventeen children were simultaneously affected, in an environment by no means unusual, the problem of prevention emphatically presents itself. The menace of water authorities wherever this plant grows. The possibility of poisoning by Cicuta maculata will be reduced to a minimum.
The report emphasizes the knowledge already possessed by homoeopaths and obtained from the original provings by Hahnemann and others, of Cicuta virosa. It seems too bad that Dr. Gompertz did not refer to the homoeopathic provings, which are so full of evidence of the dangerous toxicity of this plant. It is likewise unfortunate that he did not glimpse the homoeopathic relationship and possibilities.
Syphilis of the Third Generation.- “The history of Cornaz patient is as follows: Her father had contracted syphilis eighteen months before she was born. Twice she was treated for keratitis, and now presents corneal opacities, with evidences of dystrophic disturbance in bone and teeth from unmistakable congenital syphilis. Married at 29, she gave birth to two apparently healthy children within six years. Then came a third infant, stillborn. Necropsy disclosed congenital syphilis with spirochetes in the organs. Syphilis, cornaz says, was positively excluded in the husband. The case shows how ineffectual is local treatment in congenital syphilis. Only intensive and prolonged general therapy should be employed, even if the Wasserman test is negative.” J.A.M.A.
Yes, and this intensive and prolonged general therapy is best pursued along strictly homoeopathic lines.
Drug Treatment of Epilepsy a Failure. – “Clark emphasizes the fact that the drug treatment of epilepsy at best fulfils little; least of all does it promote an enduring arrest of the seizures in epileptic patients. This is especially true if a sedative plan solely is followed, but combined with other supportive treatment the picture is less gloomy.
The maximum of drug advantage is secured if they are employed as adjuvants to an otherwise more embracing therapy. The greatest and surest permanent benefits are obtained when sedation is held to the minimum and supportive and restorative remedies are mainly employed.” J.A.M.A.
Well, well ! Was ist? Give the restorative remedies a chance and let them be selected in accord with the law of symptom similarity, as friend Krauss, of the great American Hub, would say. We really believe that homoeopathic therapy has the better of it in this trying disease, especially now that Clark admits orthodox therapy to be a failure.
Iodine in Treatment of hyperthyroidism. – “Compound solution of iodine was used by Thomas and Rienhoff in the treatment of thirty cases of exophthalmic goiter. After the patients had received this solution for three or five days, the restlessness and nervousness became less marked, the tremor diminished and in many the skin was less flushed. In most cases the maximum results were obtained in from five to fourteen days. In three cases the maximum result was not obtained until between the twenty-first and twenty-fifth day.
The basal metabolic rate decreased in all of the cases, varying from II to 72 per cent., an average fall of 34 per cent. In 50 per cent. of the cases, the rate was reduced to normal. In 33 per cent. of the cases the basal metabolic rate was reduced to below 40 per cent. above normal, and in 6 per cent. the reduction was so slight that rest in bed alone might account for it In most instances when the patients were operated on their basal metabolic rate was not more plus 30 per cent.” J.A.M.A.
Nothing new, but nevertheless of interest to homoeopaths and showing that the crude drug has its place as well as the potency. Homoeopaths must fit the potency to the plane of the disease, as Kent so wisely taught. Broadly considered, the more crude the pathology, the cruder the drug, though to be sure, exceptions are numerous.
Homoeopathy in India. – Under the leadership of Dr. Ajit Sankar De. of 8 Victoria Road, P.O. Barnagore, Calcutta, India, a society,” The Homoeopathy Serving Society,” has been formed.
This organization is dedicated to the welfare of homoeopathy and will endeavor to combat the commercialism and exploitation to which homoeopathy is subjected and from which it has suffered grievously, at the hands of unqualified, self-appointed practitioners in India.
Inasmuch as homoeopathy is not recognized by the Government in India, advantage has been taken of this important fact to the great detriment of the true followers of Hahnemann. Among the several laudable objects of this new society we find the important one ” to attempt to persuade the India Government to give recognition to homoeopathy.” The society will also endeavor to abolish the practice of adulteration of homoeopathic medicines by alleged homoeopathic pharmacists of Calcutta.
Occupational Disease Among Zinc Workers. – “In a small galvanizing plant McCord and Friedlander have detected widespread gastro-intestinal conditions, varying from gastro-enteritis, in the younger workers, to well established gastric and duodenal ulcers among workers employed for a long time. Twelve out of fifteen workers employed for a long time. Twelve out of fifteen workers employed seven years or longer have presented severe gastro-intestinal lesions. In a second plant, in which all employees are new at this work (less than six years) and in which the general work conditions are better and exposure to trade process fumes is much less, no cases of this gastro-intestinal disease have been found.” – J.A.M.A.
The production by zinc of gastric and duodenal ulcers is on importance, since, homoeopathically considered, Zincum has not been looked upon as a likely remedy in either of these conditions Arg. nitr, Kali bichr. and Phosphorus have more usually been considered as “ulcer” remedies. However, the pathogenesis of Zincum is rich in gastric and intestinal symptoms and it is easy to conceive that a given totality might call for this remedy.
Silver Chloride and Gastric Ulcers. – ” cut off parts of the mucous membrane of the stomach in dogs. He then – following Saxls suggestion – administered silver chloride to some of them, and noted a better healing tendency than in the control.” J.A.M.A.
Silver Chloride and Gastric Ulcers-“Saxl and Kelen treat gastric and duodenal ulcers by administration of a 2 per cent. solution of colloidal silver chloride. about 2-4 cc. of it is taken in half of glass of water before breakfast and before retiring. An alkali must not be taken immediately before or after the silver chloride, since it may dissolve it and cause argyria”-J.A.M.A.
Also of interest,although not exactly new, to homoeopaths; the homoeopathicity of silver chloride is no doubt similar to that of silver nitrate; the chloride has, however,received a fragmentary proving only, be Lembke. See Allens Encyclopedia of Pure Materia Medica.
Veratrum Viride in Auricular Fibrillation-“Wedd and Drury summarize their clinical and experimental observations as follows: Alcoholic solutions of veratrum viride, when given to patients suffering from auricular fibrillation, produce slowing of both the auricular and ventricular rates of beating and a fall in blood pressure. These circulatory changes are independent of general toxic effects. Veratrum viride has, in addition to the vagal action already observed, a direct action, similar to quinidine, on the auricular muscle of the dog.
This direct action will, on the circus movement theory of auricular fibrillation, tend to show, and the vagal stimulation tend to enhance, the rate of the auricular oscillations. The relative preponderance of these two actions will determine the resultant auricular rate when the drug is administered to patients suffering from auricular fibrillation. The slowing of the ventricular rate by veratrum given orally occurs much earlier than that following digitalis bodies. However, as a therapeutic agent, veratrum is somewhat handicapped by uncertainty and irregularity of action. It may be useful in cases in which simultaneous slowing of ventricular rate and lowering of blood pressure is desired.”-J.A.M.A.
The knowledge is of interest and may be of some practical use to homoeopathic prescribers. If Veratrum viride lowers the blood pressure as above stated, conversely, it may be of value in some of our cases of lowered pressure, other symptoms agreeing.
Pharmacology of Garlic-“Sunzeri injected aqueous and alcoholic extracts from Allium sativum into dogs. A rapid drop in the blood pressure, due to stimulation of the vagus, followed. Later on, the blood pressure was lowered by an action on the blood vessels.”-J.A.M.A.
This observation should be of special interest to Italians, since to judge by odors prevalent in our New York Italian quarters garlic plays a major role in the dietary of these temperamental people. However, as in the case of Veratrum viride, Allium sativum materia medica throws little light upon the subject, though in Allens Encyclopedia, Vol.I, page 162, under GENERALITIES we read: “General lassitude, especially in the lower limbs, to such a degree that he dreads having to go two or three steps upstairs. Morning lassitude. . . . . Relaxation of the muscles. Sense of oppression; weakness,” Such weakness as herewith described is commonly associated with a lowered bloodpressure.
Mercurial Poisoning From Dental Fillings-“Flury concludes that mercury poisoning was possible with the old-fashioned amalgams, especially of copper, but not with the complex mixtures which are being used at present. He believes that about I mg. of mercury contained in a filling could yield only fractions of a milligram if resorbed within five to ten years. Stock, who has suffered together with his collaborators from chronic mercury poisoning due to the mere presence of mercury in his laboratory, which was not diagnosed until recently, points out that far smaller amounts of mercury-some hundredths of a milligram daily-may cause chronic poisoning in a few years. Its symptom are slight headaches, mental fatigue, impaired memory, irritability, restlessness, and chronic colds. He has learned recently about fifty similar cases among chemists and physicists.”-J.A.M.A.
We have no desire to arouse the old amalgam fillings war, but the above extract will be of interest to many readers. Perhaps many teeth have been unceremoniously yanked out whose filling have not been altogether guilty.
Local Application of Chamomile-“Arnold produced inflammation of the skin with mustard oil, light and tuberculin. These reactions could be inhibited by local application of an infusion of 5 gm. of chamomile flowers in 100 gm. of water. The ethereal oils seem to be the active substance.”-J.A.M.A.
Many a screaming baby with an intertrigo of fiery hue and a temper sufficiently vicious to make a saint swear has been relieved by Chamomile, internally given. Its outward application may be roughly homoeopathic; anyway, Arnolds observations are of interest. Our O.S. friends certainly display a remarkable ingenuity in planning their experiments and the dear little chamomile has been elevated to a position of scientific importance.
Treatment of Pernicious Anemia-“Bing expresses surprise the wider use is not made of systematic administration of hydro- chloric acid in treatment of pernicious anemia, as. Bie has been advocating for several years. In four of thirteen patients given once or twice a day 5 to 8 cc. of dilute hydrochloric acid, the improvement was remarkable and has persisted to date.
Two others improved under parenteral protein therapy (milk) but not to such an extent as under the acid substitution treatment-” J.A.M.A This observation of the Danish physician, Bing, commands attention; achlorohydria is a diagnostic symptom of pernicious anaemia and the administration of small amounts of dilute hydrochloric acid seems logical, as a measure of substitution therapy and in no way opposed to simultaneous homoeopathic prescribing.
Bismuth Subnitrate Causes Poisoning-“A case is reported by Resnik, in which bismuth poisoning followed administration of bismuth subnitrate by mouth. In a period of five days the patient took 30 gm. of bismuth subcarbonate, and no untoward symptoms were observed. About a month later the woman returned with new symptoms. The important symptoms were a bluish-black discoloration of the gums, tongue and buccal mucosa, with slight ulceration, moderate anaemia, basophilic stippling of the erythrocytes, with tenderness and swelling of the parotid glands. There were also abdominal colic and evidences of a mild peripheral neuritis, but the dependence of these symptoms of bismuth poisoning is questionable. The patient recovered.”- J.A.M.A.
The record of this case of evident poisoning has interest for homoeopaths. Bismuth subnitricum is not often prescribed homoeopathically, possibly not as frequently as it should be. The homoeopathic provings record the symptoms of abdominal colic. Clarke, under “Characteristics,”mentions” black borders on gums; loosening of the teeth.” This symptom corresponds with Resnicks finding.
Dr.Rafael Romero Makes a Request-Our good friend Romero, from Merida, Yucatan, the land of easy divorces, ruins of an ancient civilization and hot tamales, asks us to make known the fact that he has sent each month to all homoeopathic medical journals an exchange copy of his Revista homoeopatica International, but that he has received no copies in return, the RECORDER excepted.
We respectfully urge our contemporaries, far and wide, to pay heed to Dr.Romeros request, as he is doing a great work in spreading a knowledge of homoeopathy among the Spanish-speaking peoples of Central America, Mexico and Cuba. Dr. Romero is Mexican of charming personality and a dermatologist of note and contrary to popular notions in the effete East, does not wear a spangled 5 gallon sombrero, when in New York. His address is Call 66 No.521 C,Merida, Yucatan, Mexico.
Important Announcement-We have just received word from the Homoeopathic publishing Company of London, England, of the publication by them of SAMUEL HAHNEMANN, His LIFE AND WORK, based upon recently discovered state papers,documents, letters, etc., by Richard Haehl, M.D.
The work will be available in this country through Boericke & Tafel, 1011 Arch Street,Philadelphia,., at dollar 18.00 for the set of two volumes, duty included. Vol. I now on sale, Vol. II will be on sale in January, 1927.
To the student of homoeopathy, as well as to the student of the history of medicine in general, this work will stand as authoritative in the highest degree. Its translators and publishers are to be congratulated and thanked for the service which they have rendered to English-speaking homoeopaths.
THE HOMOEOPATHIC FAMILY PRACTICE, with a preliminary chapter on the essentials of anatomy and physiology, illustrated by 32 blocks; for the use of heads of families, missionaries,tourists, medical students and junior practitioners. Published by M.Bhattacharyya & Co,m 84 A, Clive Street, Calcutta, India. Price 3 Rupees, 8 annas.
This book of 435 pages is a practical, useful compendium of homoeopathic practice, with the usual indications for homoeopathic remedies in the numerous disease mentioned. It also contains a chapter on “Therapeutic Notes,” which presents the symptomatology of our many remedies, a chapter on the “Tissue Remedies” and one on the potencies commonly used, together with the duration of action of remedies.
The work will no doubt find a cordial reception among the homoeopathic practitioners and devotees in India.