was an unlicensed practitioner who resided in that town. It seems scarcely necessary to give the particulars; our chief object in mentioning the case being to allude to the point of practice as the propriety of administering mercury, to the extent of salivation, in cases of disease of the kidneys. According to Mr. Taylor's observations, "it may be clearly admitted as a general rule that mercurial preparations, even in small doses, are liable to produce excessive salivation in persons affected with renal disease." Certain it is that the system is unusually apt, in many such cases, to be most rapidly and severely mercurialized. Mr. Harrison, a surgeon of Reading, mentioned, upon the present trial, two cases of this sort. occurred in a woman affected with Bright's disease; one drachm of mercurial ointment was rubbed in upon her side; profuse salivation and exfoliation of the jaw followed. In the other case, said to be of Atrophy of the Kidneys, the most intense salivation was produced by two grains of the Hydrarg. Creta!

One

The following extract from a letter recently addressed by Dr. Christison to Mr. Taylor, on the point under consideration, will meet with attention: it takes a sober and, we think, a right view of the question.

"In cases of this disease (granular degeneration of the kidneys) I have repeatedly observed that mercurial action is brought on by unusually small doses of the compounds of mercury, or unusually soon; and I have also sometimes observed the action to be unusually violent in such circumstances. I cannot say that I have ever seen violent uncontrollable action induced on any occasion; neither have I seen mercurial action, even in its slighter degrees, brought on by the very small doses (such as a single dose, or two doses of calomel) which are well known to act with violence in certain constitutions not otherwise materially unsound.

'I suppose, from what some London physicians have written on the subject, and from the case alluded to by you in your letter, that the constitutional sensibility to mercurial action, induced by disease of the kidney, has been noticed in a greater degree in London than here. At all events, we are not deterred here, by anything we have witnessed, from using mercury as an adjunct to other remedies, such as diuretics and cathartics, in granular disease of the kidneys. We watch it more narrowly, find its constitutional action more easily excited, but experience no difficulty in controlling this action when brought on."-P. 458.

3. Case of Poisoning by arsenic; Pregnancy not followed by Abortion; Detection of the Poison in an Entozoon.

A young unmarried woman died, after seven hours' illness, of what was at first supposed to be violent English Cholera. Suspicions, however, being awakened, the body was examined; and the surgeon in attendance reported that he had reason to believe that the deceased had died from the effects of some irritant poison: she was in the fifth month of pregnancy. On analysing the contents of the alimentary tube, a large portion of arsenic was readily discoverable.

As there was a lumbricus found in the ileum, Mr. Taylor was desirous of ascertaining whether it had become impregnated with the poison which had caused death. It was first carefully washed from all adhering mucus or blood, and then cut into pieces and boiled for two hours in one part of muriatic acid and eight of water. Traces of arsenic were readily discovered in the acid liquid, previously filtrated. Mr. Taylor expresses his regret that he had not the opportunity of examining the fœtus in this case, as

1847] Mr. Taylor's Cases in Medical Jurisprudence.

115

"the analysis of some of the organs might have thrown light on the absorption and diffusion of poisons."

4. Passing over three cases of Poisoning by Corrosive Sublimate, we come to the case of Poisoning by Lead, which is interesting alike in a diagnostic and in a medico-legal point of view. When the patient, a woman of the most intemperate habits, was received into Guy's Hospital, it was not known that she had swallowed any poisonous matter. Constipation, vomiting, and severe constant pain in the loins and abdomen were the most conspicuous symptoms of her case. On the third day after admission, a distinct blue line was noticed on both gums; and it was found at the same time that the patient could not extend her wrists completely out. She died, a few days subsequently, convulsed. It seems that no direct information could be obtained by the medical officers as to whether the woman had ever swallowed any poison, or not; but the symptoms now named naturally suggested the probability of lead having been the toxic agent. It was therefore an interesting point to determine whether the parenchymatous substance of any of the viscera contained traces of this metal.

We

The dissection, we may remark, revealed nothing very satisfactory to account for death; perhaps the most remarkable appearance was the irregularly contracted and distended state of the large intestines. shall give Mr. Taylor's account of his chemical examination of the Liver -the organ, in which Orfila and others have generally best succeeded in detecting the presence of mineral poisons in the tissues of the body.

"The liver was dried and incinerated, and the ash thus obtained was digested in water, containing one-eighth part of strong nitric acid. The acid solution thus obtained contained a large quantity of phosphate of lime and iron, and left, on evaporation, silica, probably derived from the crucible. The acid liquid, evaporated to dryness, was again digested in a small quantity of very diluted nitric acid and filtered. Diluted sulphuric acid gave, with this liquid, a white precipitate, not entirely soluble in potash, because phosphate of lime was precipitated by the alkali from the acid solution. The acid liquid was also precipitated, of a deep greenish-black, by a current of sulphuretted hydrogen gas; and on adding more nitric acid, the sulphuret of iron was removed, and a light-brown precipitate remained, which was sulphuret of lead. A portion of the original liquid was then strongly acidified with nitric acid; sulphuretted hydrogen was passed into it, and a brown precipitate of sulphuret of lead only was now thrown down, the iron being suspended. A portion of the original liquid, nearly neutralised by potash, gave, in a few seconds, the brilliant yellow precipitate, in crystalline scales, of iodide of lead. The galvanic test of zinc and platina did not answer, the quantity of lead present being too small. The tests acted clearly and decidedly, leaving no doubt that lead was present in the liver of the female in comparatively large quantity."P. 473.

The case which follows is one, wherein a middle-aged woman swallowed an ounce and a half of sugar of lead with the intention of committing suicide. Fortunately she vomited at the time, and no alarming symptoms ensued.

The concluding cases of Poisoning, one from a very large dose of Oil of Bitter Almonds, and the other from Prussic Acid, are instructive in several points of view. In both instances, a period of several minutes elapsed after the patients had taken the poisonous dose, before the fatal effect was induced. In the first, it is supposed that the man swallowed

nearly five or six drachms of the oil of bitter almonds; and that he retained for four or five minutes not only his full consciousness, so as to reply rationally to questions addressed to him, but even his ability to get up from his chair and walk towards the door of the apartment. Then the symptoms of poisoning appear to have come on suddenly; first vomiting, and almost immediately afterwards insensibility, convulsive breathing, slight opisthotonos, and death. There were no convulsions, if we except the partial opisthotonos; nor was there any scream or shriek preceding death. This case therefore, as well as others, clearly shows that neither of the symptoms now named can be regarded as, at all, of uniform occurrence in this kind of poisoning.

In the second case, two drachms, it is supposed, of the dilute Hydrocyanic Acid of the Pharmacopoeia were taken. "The peculiar interest of this case results from the duration of the power of volition after so large a dose had been taken, the deceased having descended thirty stairs, and walked about twenty paces, before he became powerless; this happened whilst he was in the act of attempting to open the street door. The proprietor of the house and the servant were in a back room on the ground-floor, level with the coffee-room he passed through upon coming down stairs, and they saw him proceed directly to the door: the servant advanced to open it for him, and had no sooner gained his side than he fell, and, to use her own words, 'threw his arms about, and made a noise in breathing, fetching it hard, but there was nothing approaching to a scream'he very soon became still."*

Mr. Taylor makes the following remarks upon this case:

"Thus, then, an individual was here enabled to walk, and otherwise exert his bodily powers, after having swaliowed more than two grains and a half of anhydrous prussic acid! Many facts of this kind have been recorded of late years; but I am not aware of any instance in which such a series of voluntary acts has been performed, and such a power exerted, after so large a dose of the poison had been taken. The case, therefore, creates an additional caution; namely, that we must make full allowance for the occurrence of some delay in the accession of symptoms, even where the dose is large.-P. 492.

In this instance also there was no scream before death. It may be also worthy of notice, that the medical gentleman, Mr. Lowe of Aldersgate Street, who was called to the deceased, could perceive no odour of prussic acid about his mouth, although a considerable dose had been taken only a few minutes before.

In closing our notice of these painfully-instructive reports, we cannot but again express our astonishment that the most active poisons should be so readily procurable, in every part of the country, by persons who can have no proper object in view in purchasing them. It is high time that chemists and others, who deal in such dangerous articles, should be prohibited by penal enactments from pandering-we can call it nothing else to the awful crimes of Suicide and Murder.

*This description of the symptoms in this instance, by an eye-witness, closely corresponds with the account given by Tawell of those, which he witnessed in the case of Sarah Hart.

1847] Donné & Underwood on Management &c. of Infants. 117

I. CONSEILS AUX MERES SUR L'ALLAITEMENT ET SUR LA MANIERE D'ELEVER LES ENFANS NOUVEAU-NES. Par Al. Donné. D.M. &c. 2nd Ed. 12mo. pp. 340.. Baillière : Paris, 1846.

Advice to Mothers on the Suckling and Bringing-up of Infants. By Al. Donné, M.D.

II. DR. UNDERWOOD'S TREATISE ON THE DISEASES OF CHILDREN; with Directions for the Management of Infants. with Additions. By Henry Davies, M.D. &c. London, 1846.

10th Edition 8vo. pp. 600.

THE new editions of these two excellent works furnish us with some interesting matter to lay before our readers. M. Donné, it is true, is writing more for the public than the profession, and confines himself to the legitimate province of hygiene and the prevention of diseases; but many of his observations are very original and well deserving the attention of the medical man. Dr. Underwood also intended his well-known work for the perusal of parents, and prepared an abridged edition of it to that end. Happily this move in imitation of Buchan's notorious publication did not succeed, and what would have been a mischievous book in the hands of the public at large, has proved itself a very useful class-book to the professional portion of it. The portion of the book, indeed, relating to the management of children would be well worthy the attention of parents, but, conjoined as it is to an account of their diseases, it is much better in professional hands. As the present editor has made no material additions to this part of the work, we shall pass it by as well-known to most of our readers, and content ourselves with abstracting some of his observations on disease; first, however, turning our attention to M. Donné's Advice to Mothers.

M. Donné commences his work with a chapter on the "Questions to be resolved prior to the Birth of the Child," and, after protesting against the indolent lives which some pregnant women lead, enquires whether we can determine beforehand that a woman will be enabled to suckle her child, as far at least as the quality of milk is concerned. The external characters usually cited as determinative of this, such as the degree of development of the breasts, the colour of the hair, condition of the skin, &c., are not to be relied upon. "The only circumstance of this kind at all indicative of a certain degree of plumpness (embonpoint), the possession of which is usually necessary in a good nurse; not that a woman need be fat to have good milk, but certainly a good nurse is seldom very thin." However, there is a more positive sign, for the examination of the secretion from the mammary gland during pregnancy furnishes us with a useful indication of its probable qualities after confinement.

"From among 60 cases in which such examination was made in women of different ages, temperaments, &c., only three exceptions to this law presented themselves. Women, in reference to the colostrum, may be divided into three

classes. In the first, at whatever epoch of pregnancy the breast may be examined, the secretion will be found to be so slight that scarcely a drop can be drawn out by any degree of pressure. In such, to almost a certainty, the milk after confinement will be small in quantity, poor in quality, and insufficient for the sustenance of the infant. The breasts of women of the second class secrete an abundance of a watery colostrum, resembling thin gum-water, and destitute of streaks of a yellow, thick, viscid matter. Such women may have abundance of milk, but it will be poor, watery, and unsubstantial. Thirdly, when the secretion of colostrum is sufficiently abundant to enable us to easily obtain a few drops for examination, and especially when the fluid contains a more or less deeply coloured, thick, yellow matter, distinct in colour and consistence from the rest of the fluid in which it forms distinct streaks, we may be almost certain that the woman will produce a sufficient quantity of rich and nutritious milk. The microscope shows that such colostrum is rich in already well-formed, good-sized milk globules, without mixture with mucous globules, and that it contains more or less of the granular bodies."

This examination may prove of great utility as respects women whose power of suckling their children may be doubtful, and is best made about the eighth month. It is well to bear in mind that some accidental circumstances, such as cold or timidity on the part of the woman, may temporarily contravene the success of the experiment.

On Suckling.-M. Donné insists strongly, where it is practicable, that a mother should suckle her own child, observing that many women are wellfitted for this, whom he would not accept as the nurses of the offspring of other persons. This fact must be familiar to our readers, and should be borne in mind when wet-nurses exhibit the thriving condition of their own infant as a testimony of their fitness for the office. Even a medium condition of the general health seems consistent with successful suckling; and, if no hereditary disposition to disease prevails in her family, there is no tendency to chronic disease in herself, her digestive functions are active, her sleep sufficient, and her milk presents the requisite qualities, the mother should always be advised and encouraged to attempt suckling.

Some young mothers, however, deceive themselves in consequence of the great abundance of milk at first; for even the worst nurses have a large quantity of some sort of milk when they commence suckling, and it is only after from four to six weeks they find it has diminished. They attribute this to some accidental cause, forgetting that a good nurse is not influenced by such; but if they persist in the attempt, serious consequences sooner or later occur. Other young nurses exhaust themselves by the indiscreet zeal with which they undertake the office, and those who are rather delicate forget the cautions that are necessary. The reparation of the losses of each day is essential,. and this can only be effected by the aid of a good digestion and sound sleep, the latter being even more important than the former. In her ardour to perform her maternal duties, the anxious mother gives the infant the breast at every moment, day or night, wakening herself at intervals lest it want. But for a woman of the world, who desires to suckle her child successfully, from six to seven hours uninterrupted sleep are essential, and to obtain this she must renounce suckling by night. The infant should not sleep with its mother, and when it wakes in the night, which if it continues well will be only two or three times, a little