W.R.H. Stewart
1891 The Lancet  
1388 seemed very depressed, complained of pain in the abdomen, especially in the epigastrium, and was suffering from jaundice. She had a mitral systolic murmur, and the heart-sounds were feeble. Her liver was enlarged and tender, and her tongue furred. She gave me the following history. For some years she had been subject to epileptic fits, and on Wednesday, Nov. 4tb, had had eleven distinct fits. Since then she had been getting worse, but did not send for advice sooner, as she had suffered
more » ... similar attacks previously. (Nothing was said regarding her having taken poison, and after her death I found that she had never suffered from jaundice.) I diagnosed jaundice, due probably to gall-stones or to an irritant taken as food. Hot fomentations were ordered to be applied to the abdomen, milk diet to be taken, and podophyllin and taraxacum, with dilute nitro-hydrochloric acid, given. She died on the following day, having lived four days and a half from the date of taking the poison. No post-mortem examination being ordered by the coroner, I received permission to make a partial one. The body was well developed. On opening the abdomen there was a distinct garlic-like odour. The heart was fatty, and cavities empty. Posterior surfaces of lungs cedematous, and peteehiae scattered over these surfaces. The stomach was filled with a dark-brownish fluid having the smell of lucifer matches. The mucous membrane of the cardiac end was of normal appearance, but that of the pyloric end was deeply injected, and of a deep crimson colour. The transition in colour between the two halves of the stomach was sudden. I No ulceration present; no peritonitis. Intestines empty I , and normal in appearance, except at the upper end of the duodenum. The liver was enlarged, fatty, and very friable. Uterus fatty, and membrane similar in colour to that of the pyloric end of the stomach. The bladder con-I tained urine. The kidneys were slightly fatty. ' The above is another instance of the ease with which one can obtain the most dangerous poisons for the purpose of taking away life, and though the deceased was in a state of semi-intoxication when she purchased the poison, she had no difficulty in obtaining it. Stamford-hill, N. WITHIN the last few months I have treated with chromic acid three cases of ranula and seven of cystic goitre with such satisfactory results that I venture to make them known. The three cases of ranula occurred in two males and one female : the former had received previous treatment without any benefit ; the latter had not sought advice before. All three had large cysts, and the mode of treatment followed was the same in each. A portion of the cyst was cut away, and the contents washed out. A saturated solution of chromic acid was then freely applied with a chromic acid carrier to several points of the cyst wall. At the end of the week, the cavity having much diminished, the acid was again applied, and in from a fortnight to three weeks the wound had healed and all signs of the tumour had disappeared. There were no bad symptoms. The seven cases of cystic goitre were in females. The tumours were tapped in the usual manner and the contents washed out. After all haemorrhage had ceased, the saturated chromic acid solution was applied with a
doi:10.1016/s0140-6736(02)05011-0 fatcat:3z7prbxpfvhjjawvtge35c6vsa