whatever may be its nature and composition, excites, it is clear, a most effective irritation of the pneumo-gastric nerves, an irritation as truly energetic as that which might be excited by submitting the nerves to the influence of a series of electrical discharges.

Mussel Poisoning.

Some very serious forms of disease have been produced by taking mussels as food. There are certain persons who seem specially liable to irritation of the stomach even from taking a small quantity of mussels. There are others who suffer from nettlerash from the same cause. These facts are so general that the inference has been drawn that at certain seasons the mussel produces an irritant poison. In exceptional cases poisoning from mussels has been extremely severe and even fatal, the symptoms resembling those which have been described above as constituting the disease siguatera, with other peculiar nervous symptoms. The indications are those of nausea and vomiting, followed by constriction of the mouth and throat, difficulty of speech, numbness of the limbs, muscular exhaustion, coldness of the body, and death with faintness and torpor. Notwithstanding the violence of the symptoms, the appearances after death have been rarely of sufficient importance to explain any fatal phenomena. The real nature of the poison remains up to this day unknown. At one time it was supposed to be a salt of copper with which the mussels themselves were charged, but analysis, in fatal cases, has failed to establish this view. The probabilities are that the poison is of an organic kind, and is produced by the mussel itself at particular seasons.

The oyster has been accredited with producing disease under some circumstances, and I have myself known one example of oyster poisoning; but the occurrence is extremely rare. The symptoms are those of nausea and irritation of the stomach.

In the books of a recent past day treating on disease from foods, references are made to poisonous effects produced by the taking of sausages, pork, milk, and other animal substances. The symptoms cited refer, in nearly every case, to irritation affecting the alimentary canal, and various speculations are offered to account for the phenomena that have been observed. In these days much light has been thrown on that part of the subject which relates to disease from sausages, pork, and bacon, owing to the dis

covery in such foods of trichinæ and other parasitic forms of life. It is probable that in nearly all the instances of the kind recorded by the older writers the irritations described were due to parasitic introductions. We know now also that milk may be the bearer of various organic poisons, such as the poisons of typhoid fever, cholera, and probably diphtheria.

POISONING BY VEGETABLE SUBSTANCES.

Instances still occur in which peculiar forms of disease are produced by accidental feeding on vegetable substances which are poisonous. Fortunately these accidents are much less frequent than they were in former times; but, the College authorities still refer to the disease known as ergotism produced from taking ergot of rye; to disease from poisonous fungi and mouldy bread; and, to disease from certain poisonous grains or seeds, especially of the everlasting pea,-lathyrus sativus. I need to dwell only on two of these, namely, on ergotism and disease from the poisonous fungi.

Disease from Ergot. Ergotism.

Ergotism is an affection of a very distinct character, produced by eating the spur which forms on rye and other grasses, ergot, secale cornutum. This spur is a growth affecting several kinds of grain, especially rye, and the disease which it produces has, consequently, been most commonly observed in countries where the poor have fed on rye bread.

Ergotism, the disease caused by the ergot, takes two forms; one called convulsive, the other gangrenous ergotism.

Convulsive ergotism is marked by vertigo, yellowness of the skin, thirst, pains in the limbs and chest, cramps and convulsions, insensibility and death, with, in some examples, an eruption of dark spots on the body. In districts where the rye has been largely used the disease has assumed the epidemic form.

From the analogy which exists between the symptoms above described and those which characterize the severe affection recently recognized as cerebro-spinal meningitis or tetanoid fever, I have suggested that this latter disease is probably due to taking a diseased grain analogous in character to ergot. This view has received confirmation from the observations of the late Dr. Day of Stafford and of Dr. Baker of Michigan.

Gangrenous ergotism is a disease of much slower development and longer duration that the convulsive variety. It commences with debility and sense of tingling over the surface of the skin. The limbs then become cold, pale, and so benumbed that they are insensible to pain from external impressions. After a time pain comes on independently in them and is followed by death of the extreme parts, so that the fingers and toes completely die off by a dry gangrene. These last symptoms have given rise to the name gangrenous ergotism.

Poisoning from Fungi.

It still occasionally happens that accidental poisoning occurs from taking poisonous fungi,-those especially which are mistaken for the common mushroom, agaricus campestris. Christison defines that most fungi which have a warty cap with fragments of membrane adhering to their upper surface are poisonous; that all which grow in tufts or clusters from the trunks or stumps of trees are dangerous; and, that the sure tests of a poisonous fungus are an astringent styptic taste and a disagreeable pungent odor. The poisonous principle seems to reside in the juice of the fungus, and has narcotic and irritant properties.

The symptoms produced by the poisonous fungi vary, but, taken as a whole, are definable as narcotic and irritating, the irritation being seated in the alimentary canal and leading to great disturbance of the stomach and bowels. Sometimes the narcotic symptoms are dominant, in others the irritative. In an example under my own observation, where the fungus called toadstool was eaten by four children in mistake for mushroom, three suffered entirely from intestinal irritation, and one from the narcotic effect, which lasted until the offending substance was removed by purgation artificially induced. During the time when the fungus is producing its effects the body is cold and faint, while in the reaction which follows there is fever which lasts for several hours. The acute symptoms of poisoning occur, as a rule, within one or two hours after the fungus has been taken, but exceptions have been known in which several hours have elapsed before the development of the phenomena.

CHAPTER V.

DISEASES AND ACCIDENTS CONNECTED WITH PREGNANCY AND CHILDBIRTH.

DURING the pregnant state the female of human kind is liable to suffer from various local affections which are considered special to her condition at that time. Some of these affections are most distressing, but happily it is rare that the worst of them become fatal. In this brief chapter I will condense what needs to be said under different heads, according to the parts or systems of the body that are particularly affected.

DISORDERS OF THE DIGESTIVE SYSTEM.

One of the earliest derangements of pregnancy is a depraved and capricious appetite. The ordinary sense of taste is often much perverted; there is particular distaste for certain articles of food, and particular desire for others, such as shell-fish, cream, and various other delicacies not specially cared for under ordinary circumstances. This perverted taste and desire will often last for two or three months. Occasionally, with or without perversion of taste, there is a free and excessive secretion of saliva-saliva

tion.

Nausea and Vomiting, are other common dyspeptic affections in the earlier periods of pregnancy, and in certain instances they continue until the late months, giving rise to extreme misery and exhaustion, and remaining unchecked by any and every attempt at relief. The nausea or vomiting commonly comes on periodically, and most frequently in the early morning, lasting for many hours each day.

Heartburn, or cardialgia, is also a dyspeptic phenomenon in pregnancy, and when it is frequent it becomes very oppressive. It is commonly accompanied by eructation of acid fluid from the stomach into the mouth,-pyrosis or water-brash.

Intestinal cramp, or colic, is another affection of the pregnant state, which causes severe suffering if it take place in the later stages when the uterus has attained a large size.

Derangement in the action of the bowels is by no means infrequent during pregnancy. In some persons the derangement is from constipation, in others it is from relaxation, or diarrhea. Together with these derangements of the bowels there may be disorder of the liver, with jaundice as a temporary accompani

ment.

DISORDERS OF THE CIRCULATORY SYSTEM.

The circulatory system is apt to become painfully affected during the pregnant state. An obstruction to the flow of blood back to the heart by the large veins, an obstruction caused by the pressure of the enlarged uterus or womb, may give origin to enlargement of the veins in the lower parts of the body. Thus may arise large or varicose veins of the lower limbs, and hemorrhoids, or piles.

From the same pressure and obstruction to the return of venous blood there may be effusion of serum into the peritoneal cavity, ascites; a serous effusion into the cellular tissues of the lower limbs,-adema. From irritation connected with the uterus in various stages of pregnancy, and from reflex nervous action, the heart is sometimes disturbed in its movements and rendered irregular; or, the rapid action of the heart, known as palpitation, may be induced; or, the motion of the heart may be brought temporarily to partial arrest, and syncope or faintness be the result.

DISORDERS OF THE RESPIRATORY OR BREATHING SYSTEM.

Three disorders of the respiratory or breathing system are noted in the College lists as specially connected with the pregnant state. The first is Dyspnea, or difficult breathing, an affection most commonly developed in the later stages, when the enlarged womb pressing upwards upon the diaphragm interferes with the movements of that great muscle of respiration, and encroaches on the cavity of the chest itself. This oppression of breathing, though not in itself dangerous, except in the rarest instances, is distressing, and frequently remains until the end of the condition