Zinc chloride, ZnCl2. Preparation: Solutions in water or alcohol.
Greatly emaciated. Great emaciation was observed; the skin looked as if it was stretched tightly over the bones of the face and hands. Extreme emaciation (one hundred and sixteenth day). Lay prostrate in bed. Bent nearly double. A gradual improvement was made for the first two months, but too early a return to business brought on an attack of illness of extreme severity. The patient was seized with symptoms resembling the onset of influenza; there was excessive nervous prostration, hyperaesthesia, and great irritability, which passed into a condition resembling tetanus; no noise could be borne; the slightest shocks caused a start; if the bedclothes touched the toes, tremors approaching convulsions ensued. For five nights there was no sleep. There was a terrible pain in the right side of the head, which lasted for hours; when this subsided, nausea and retching ensued; the pulse rose to 120 or 130. There was some febrile movement: the skin was alternately very dry and moist. During this secondary attack the liver again evinced a sluggishness of action, and the urine, which had hitherto been normal in quantity, became excessive; on one occasion, seven pints were passed in five hours. For fourteen days the patient was confined to his bed, when the intensity of the symptoms had subsided, he still complained of the gnawing pain in the stomach. Sometimes paralysis. Convulsion. General spasms. Jactitation and restlessness (after five hours). During the night she had occasional fits, losing consciousness, and having twitchings of the facial muscles. Spasmodic movements of the muscles of the face and extremities. Weak and thin; reeled rather than walked. Great weakness. General exhaustion, 17 23. Profound prostration, followed by collapse and death. Restless. Faintness, 1 10, etc. Great faintness (second day). The collapse had become extreme; the face and extremities were purple, and the voice thick and husky, and subsiding into a hoarse whisper; the heart’s action quite imperceptible, both at the wrist and cardiac region, yet the state of things was more like that of a cholera patient than one in syncope; the pupils were largely dilated, and he complained of being unable to see distinctly (after nearly seven hours); he died without a spasm or struggle of any kind, retaining his consciousness to the last (after seven hours, and forty minutes), 15. Collapse, closely resembling cholera. Pain in the affected part.
Excessive nervous derangement and prostration. Great disposition to pick the bedclothes. 11. Anxiety. Anxiety and alarm, 5 10. Considerably depressed. Anxious and depressed face (second day). Though apparently quite conscious, she had no recollection of what occurred to her for some time. Intellect clear by day, but she wandered by night. Semicomatose state, vital powers much prostrated. Insensibility.
Giddiness, 9 21 22. Vertigo and fainting. Vertigo and rush of blood to the head, as if she had taken some strong spirit. Rush of blood to head. Most distressing headache. Headache in the occipital and frontal regions.
Eye sunken. Pupils widely dilated (in fifteen minutes). Pupils small. Pupils contracted to the size of a pin’s head (after one hour); dilating (after five hours). Loss of sight, 9 21 22.
The sense of smell underwent a very singular perversion. Every kind of roast meat, if ever so slightly burnt, roasted coffee, tea, etc., had to my patient an intolerable putrid odor; roast mutton was especially offensive. Scents and perfumes with alcohol gave an odor resembling that of hemlock; on the other hands, putrid and fecal matter had no apparent odor at all.
Face distorted with agony, and livid. Anxious expression of countenance, 16 18. Countenance pale and anxious. Face pale, then livid. Countenance dusky and anxious. Face flushed (after one hour). Swelling of the lips, and thick transparent mucus adhering to them. Vesication of the lips and tongue (in one hour and a half).
Teeth. Toothache in carious teeth. Gums. Gums spongy (one hundred and sixteenth day). Gums red, and covered with white sordes. Tongue. Tongue furred. Tongue gradually became coated (after ten days). Tongue and mucous membrane of fauces milk white (third day). Tongue coated with a white fur (after twenty one days). Tongue yellow. Tongue and pharynx coated with a thick yellow fur. Tongue intensely red. Tongue, mouth, and gums covered with brown sordes. General Mouth. Frothing at the mouth. Peculiar fetor of breath (one hundred and sixteenth day). Lining membrane of mouth had the appearance of having undergone the action of a corrosive substance. Back part of the mouth and fauces much inflamed. Saliva. Salivation. Taste. Astringent taste. Metallic taste, as of copper in the mouth. The perversion of taste was not less remarkable than that of smell. Roast meats and crusts of bread were intolerable; and most foods had a burnt taste, especially raw oysters, which resembled burnt flour, and felt quite dry, clinging to the mouth. Things naturally insipid, such as the crumb of bread and potato, gave a more natural flavor, and were better relished. Acids did not taste acid, nor alkaline alkaline, and to him quinine was not bitter.
Throat inflamed and painful. Throat swollen and painful. Constriction of the throat. Pain in the posterior part of the throat, immediately. Throat sore, and some difficulty in swallowing (second day). Burning sensation in throat and chest. Burning pain in the gullet, 3 10. At once a burning sensation all down the throat, with great pain and a sense of tightness in my stomach. Soft palate, uvula, tonsils, and pharynx inflamed (second day); the mucous membrane of the soft palate covered with a white film, not unlike diphtheritic membrane, a slough was separating from the right tonsil and uvula (fourth day); soft palate covered with a yellowish slough (eighth day), 24. The first symptom experienced was a sense of constriction in the fauces, and then a hot burning sensation in the stomach, marked the arrival of the fluid in that organ. Burning pain in oesophagus and stomach (in one hour and a half). Hot burning pain along the course of the oesophagus, and at the pit of the stomach. Difficulty of swallowing. Inability to swallow food, an entirely nervous symptom, as there was no stricture of the throat (after a month).
Appetite and Thirst. No natural appetite, but a morbid craving for something wherewith to allay the irritation at the stomach. After two days she gradually pined away, refusing food, or only swallowing it after great persuasion, and invariably rejecting it in about an hour and a half, slightly altered (as by partial digestion), and sometimes mixed with a little blood. Indisposition and want of appetite for three weeks. Anorexia for some weeks. Constant thirst, but an intense aversion to swallowing any fluids (after twenty-one days). Distressing thirst (after five hours). Hiccough. Nausea and Vomiting. Nausea. Great nausea. Constant nausea and occasional vomiting. Nausea and pain; indisposition and want of appetite for three weeks. Most violent sickness; vomiting of a frothy liquid. Nausea and vomiting. Frequent retching (second day). Ten days after swallowing the poison she was suddenly seized with violent retching, and vomited a mass of black blood, followed by several small clots, all of dark color. Vomiting, 15, etc. Distressing vomiting. Vomiting; continued more or less for a week, and all food was rejected for three weeks. Constant vomiting; after some hours he vomited little else than blood of a dark color. Frightfully vomited and purged (in five minutes). Vomiting of all her food; she rejects everything, except boiled milk, for two months. Vomits shreds of mucous membrane nearly an inch square. Vomited the contents of the stomach (immediately); less vomiting, but still a little retching, with which she brought up a little mucus (third day); vomiting began again, when she brought up a potful of back fluid, with much mucus, some threads of tissue, and much clotted milk (tenth day); vomiting and pain both increased (fifty eight day); continued vomiting; the vomited matter contained a considerable quantity of altered blood (sixth-fifth day); vomited matters white brown in color, with a dark sediment (seventy- fourth day); retched and vomited at intervals, a brownish fluid, with a flocculent sediment (ninety-fifth day); vomited fluid tinged with bile (one hundred and eighth day); retched at intervals and vomited a greenish fluid (one hundred and sixteenth day), 24. Spontaneous vomiting (after one hour); after this time the mixture (eggs and milk ) was thrown off instantly, after being taken by the most violent action; it returned as a solid coagulated mass, one portion of which was so large and firm as almost to cause suffocation. This treatment was kept up through the night and until 2 P.M. of the following day, the patient vomiting continuously, and rejecting the milk and eggs in the same curdled state. In the evening blood appeared in the vomited matter, a quantity of mucus, and a portion of mucous membrane, measuring an itch and a quarter square. Throughout the third day the vomited matter was still streaked with blood. Vomiting (after ten minutes); the sickness continued, and ever since, after taking food, she has vomited. Violently and continually vomiting, the matter ejected being a muco-biliary fluid. Full and free vomiting to the amount of many pints, after emetics; after five hours the stomach could retain nothing. Vomiting at first of food and the disinfecting fluid (after mustard and water); afterwards tendency to vomit from slightest pressure on stomach; later vomiting at intervals of large quantities of mucus, mixed with a considerable portion of dark-colored blood, 16. Blood was vomited at frequent intervals, sometimes bright, often partly digested, and frequently with a most offensive odor. Hematemesis occurred to a considerable amount. Stomach. Many weeks elapsed before he lost all his symptoms; dyspepsia was immediately produced by taking solid animal or stimulating food, and about three months passed before he was quite well. Much tenderness on pressure at the epigastrium (second day). Upon pressing the region of the stomach, next day, he winced very much. Pain in the stomach, 19 10 25. Pain in stomach and throat. Violent pain in the epigastric region, 7, etc. Violent pain in the epigastric region, as if spreading from other parts of the abdomen. Great pain and heat in the stomach and bowels. Pain in region of stomach increased by the slightest pressure. Severe but not agonizing pain at the pit of the stomach, with a sense of distension; the epigastric pain extended into the right hypochondrium, and was somewhat increased by pressure (after one hour); afterwards the pain increased and extended towards the umbilicus; it became intolerable, and it was difficult to keep the patient in bed (after two hours and a half), 15. Pain and nausea, 49 A feeling of sinking and an urgent craving for food. Violent clawing pain in the stomach, which persisted in great severity for a long time. Severe pain and burning in the stomach. Burning in the stomach, 1 10. Burning heat in stomach. Burning and griping pain in stomach (instantly). Burning pain at the epigastrium, and under the left ribs (second day). Burning pain, griping in stomach, great nausea, and sense of coldness, vomiting of inodorous matter. Burning sensation in stomach, nausea and vomiting. Severe burning and twisting pain in stomach; the legs are drawn up to the belly. Immediately seized with a violent burning pain at the pit of the stomach, and vomited the contents of it.
Severe pain in the left hypochondrium (fourth day); pain constantly felt in the left hypochondrium, and increased by food (eighth day). Pain in left hypochondriac region. Abdomen painful, distended. Abdomen shrunken, and the edge of the liver sharply traceable (after twenty one days). Abdominal tenderness (after a few hours). Abdomen tender on pressure. Intense abdominal pain.
Diarrhoea, 39 11. Violent Diarrhoea. Several loose watery evacuations of the bowels. Sudden diarrhoea, with vomiting; she is found in a state of collapse. Frightfully purged and vomited (in fifteen minutes). Purging; the motions thin and of a dark-brown color. Large loose and watery motion (after half an hour); a desire to go to stool was accompanied for two hours by the discharge of nearly three pints of mucus, mixed apparently with shreds of the intestinal mucous membrane (after a few hours). Stools fetid. There was no action of the bowels until the third day, when they acted spontaneously; the stool was of a black coffee grounds appearance, and entirely wanting the odor of faces. It was quite a fortnight before anything but black stools appeared; then they were pale, clayey, dry, and crumbling, showing no evidence of bile. Bowels moved only three times in one hundred and sixteen days; a copious, black, pitchy stool followed the enema (twentieth day); after an injection another copious dark pitchy stool (fifty-first day); after an injection of warm olive oil, passed a copious motion, pultaceous in consistence, and of a greenish color; the first action of the bowels for eight weeks (one hundred and eighth day ), 24. Constipation.
Had passed daily on an average one pint of urine, of specific gravity 1025-1030, turbid with lithates, but containing no albumen (ninety-eighth day).
Voice. Spoke in a whisper from excessive debility. Voice feeble, almost whispering (second day). Voice reduced to the faintest whisper (one hundred and sixteenth day). Voice gone, and could express herself only by whispers (in one hour and a half). Lost her voice, but gradually recovered after five weeks. Respiration. Breathing thoracic and rapid. Short breath. Great difficulty in breathing.
Tremor of the limbs.
Pains at the shoulder and back of spasmodic character (second day). Occasional attacks of tetanic spasms in the right forearm and hand, which lasted for a few minutes and then passed off.
Legs drawn up on belly (in twenty minutes). Severe cramp in the lower extremities (after two hours and a half).
Utter inability to sleep. Slept restlessly, lying always on right side, with her legs drawn up, and ground her teeth during sleep (after ten days).
Chilliness. Coldness, 5 10. General surface of body cold and bedewed with perspiration. Surface cold and wet, with clammy perspiration. Very cold and pale (in fifteen minutes). Cold clammy skin. Chill and heat. Alternations of cold and heat. Extremities cold (after five hours), 15 21 22. Skin moderately warm to the touch, though she constantly complained of cold, notwithstanding the heat of the weather was intense (after twenty-one days). Heat. Sensation of warmth in the parts to which it is applied, quickly followed by violent burning pain for seven or eight hours, till the parts are dead, when a white eschar forms. Her temperature rose for the few days after the poison was taken till it reached 100.6 0; it then fell slowly, and reached its lowest point 96.4 0, the ninety-seventh day; from which time till death, it ranged from 96 0 to 98 0, but it never fell below 96 0, 24. Sweat. Forehead bathed in sweat, the general surface warm (after one hour). Clammy sweats (in one hour and a half). Cold sweat, 15 10. Surface bedewed with a cold clammy perspiration.
From the third day the skin assumed a ghastly bluish-green tint, this lasted for a long time. Skin dusky. Arms livid and cold. Skin dry and harsh as the child wasted after ten days); harsh and dingy in hue, exhaling that peculiar odor which is almost distinctive of starvation (after twenty-one days). Skin drawn tightly across the nose, and thinning off towards the mouth, in place of filling out to form the lips (after twenty-one days). Trunk and extremities had a strange bluish mottled appearance, from innumerable petechiae (one hundred and sixteenth day). Skin dry and hot. Skin of legs covered with thick scales (one hundred and sixteenth day).
Heart and Pulse
Pain in the precordial region. Pulse rapid. Pulse quick and fluttering. Pulse small, rapid, and contracted. Pulse very feeble and rapid. Small, rapid pulse, 12, etc. Pulse 144, very feeble (second day). Pulse 90. Pulse soft, about 80 (after one hour); sinking rapidly, becoming more weak and frequent (after five hours). Pulse small and weak, 45. Pulse 45, small, weak (in twenty minutes). Pulse quick and fluttering. Hard jerking pulse (after a few hours). Thready pulse (twenty-first day), 19; (second day). Pulse feeble. Nearly pulseless (in fifteen minutes), 12 18.