Mercury, Oils

Anomalies and Curiosities of Medicine
by George M. Gould, M.D., Walter L. Pyle, M.D.

(Page 27 of 44)

Iodin Preparations. The eruptions following the administration of small doses of potassium iodid are frequently noticed, and at the same time large quantities of albumin have been seen in the urine. Potassium iodid, although generally spoken of as a poisonous drug, by gradually increasing the dose can be given in such enormous quantities as to be almost beyond the bounds of credence, several drams being given at a dose. On the other hand, eight grains have produced alarming symptoms. In the extensive use of iodoform as a dressing instances of untoward effects, and even fatal ones, have been noticed, the majority of them being due to careless and injudicious application. In a French journal there is mentioned the history of a man of twenty-five, suspected of urethral ulceration, who submitted to the local application of one gram of iodoform. Deep narcosis and anesthesia were induced, and two hours after awakening his breath smelled strongly of iodoform. There are two similar instances recorded in England.

Pope mentions two fatal cases of lead-poisoning from diachylon plaster, self-administered for the purpose of producing abortion. Lead water-pipes, the use of cosmetics and hair-dyes, coloring matter in confectionery and in pastry, habitual biting of silk threads, imperfectly burnt pottery, and cooking bread with painted wood have been mentioned as causes of chronic lead-poisoning.

Mercury. Armstrong mentions recovery after ingestion of 1 1/2 drams of corrosive sublimate, and Lodge speaks of recovery after a dose containing 100 grains of the salt. It is said that a man swallowed 80 grains of mercuric chlorid in whiskey and water, and vomited violently about ten minutes afterward. A mixture of albumin and milk was given to him, and in about twenty-five minutes a bolus of gold-leaf and reduced iron; in eight days he perfectly recovered. Severe and even fatal poisoning may result from the external application of mercury. Meeres mentions a case in which a solution (two grains to the fluid-ounce) applied to the head of a child of nine for the relief of tinea tonsurans caused diarrhea, profuse salivation, marked prostration, and finally death.

Washing out the vagina with a solution of corrosive sublimate, 1:2000, has caused severe and even fatal poisoning. Bonet mentions death after the inunction of a mercurial ointment, and instances of distressing salivation from such medication are quite common. There are various dermal affections which sometimes follow the exhibition of mercury and assume an erythematous type. The susceptibility of some persons to calomel, the slightest dose causing profuse salivation and painful oral symptoms, is so common that few physicians administer mercury to their patients without some knowledge of their susceptibility to this drug. Blundel relates a curious case occurring in the times when mercury was given in great quantities, in which to relieve obstinate constipation a half ounce of crude mercury was administered and repeated in twelve hours. Scores of globules of mercury soon appeared over a vesicated surface, the result of a previous blister applied to the epigastric region. Blundel, not satisfied with the actuality of the phenomena, submitted his case to Dr. Lister, who, after careful examination, pronounced the globules metallic.

Oils. Mauvezin tells of the ingestion of three drams of croton oil by a child of six, followed by vomiting and rapid recovery. There was no diarrhea in this case. Wood quotes Cowan in mentioning the case of a child of four, who in two days recovered from a teaspoonful of croton oil taken on a full stomach. Adams saw recovery in an adult after ingestion of the same amount. There is recorded an instance of a woman who took about an ounce, and, emesis being produced three-quarters of an hour afterward by mustard, she finally recovered. There is a record in which so small a dose as three minims is supposed to have killed a child of thirteen months." According to Wood, Giacomini mentions a case in which 24 grains of the drug proved fatal in as many hours.

Castor oil is usually considered a harmless drug, but the castor bean, from which it is derived, contains a poisonous acrid principle, three such beans having sufficed to produce death in a man. Doubtless some of the instances in which castor oil has produced symptoms similar to cholera are the results of the administration of contaminated oil.

The untoward effects of opium and its derivatives are quite numerous Gaubius treated an old woman in whom, after three days, a single grain of opium produced a general desquamation of the epidermis; this peculiarity was not accidental, as it was verified on several other occasions. Hargens speaks of a woman in whom the slightest bit of opium in any form produced considerable salivation. Gastric disturbances are quite common, severe vomiting being produced by minimum doses; not infrequently, intense mental confusion, vertigo, and headache, lasting hours and even days, sometimes referable to the frontal region and sometimes to the occipital, are seen in certain nervous individuals after a dose of from 1/4 to 5/6 gr. of opium. These symptoms were familiar to the ancient physicians, and, according to Lewin, Tralles reports an observation with reference to this in a man, and says regarding it in rather unclassical Latin: " . . . per multos dies ponderosissimum caput circumgestasse." Convulsions are said to be observed after medicinal doses of opium. Albers states that twitching in the tendons tremors of the hands, and even paralysis, have been noticed after the ingestion of opium in even ordinary doses. The "pruritus opii," so familiar to physicians, is spoken of in the older writings. Dioscorides, Paulus Aegineta, and nearly all the writers of the last century describe this symptom as an annoying and unbearable affection.

In some instances the ingestion of opium provokes an eruption in the form of small, isolated red spots, which, in their general character, resemble roseola. Rieken remarks that when these spots spread over all the body they present a scarlatiniform appearance, and he adds that even the mucous membranes of the mouth and throat may be attacked with erethematous inflammation. Behrend observed an opium exanthem, which was attended by intolerable itching, after the exhibition of a quarter of a grain. It was seen on the chest, on the inner surfaces of the arms, on the flexor surfaces of the forearms and wrists, on the thighs, and posterior and inner surfaces of the legs, terminating at the ankles in a stripe-like discoloration about the breadth of three fingers. It consisted of closely disposed papules of the size of a pin-head, and several days after the disappearance of the eruption a fine, bran-like desquamation of the epidermis ensued. Brand has also seen an eruption on the trunk and flexor surfaces, accompanied with fever, from the ingestion of opium. Billroth mentions the case of a lady in whom appeared a feeling of anxiety, nausea, and vomiting after ingestion of a small fraction of a grain of opium; she would rather endure her intense pain than suffer the untoward action of the drug.