An Account of an Extraordinary Case of a Lady, Who Swallowed Euphorbium. By Dr. Willis, of Lincoln: Communicated by Sir Francis Dashwood, Bart

sition, the stone did no more press on his bladder. He never missed doing soldier's duty till his last sickness, about seven days before his death. We have examples of membranes, and of several soft parts of the body, being ossified; but I believe there is not such a monstrous production as this to be seen anywhere. About 20 years ago I saw at Mantua, two inches of the aorta near the heart turned to bone, in a man that was a long time tormented with a violent palpitation of heart. I know, Sir, relations of such extraordinary appearances are often, and with reason, suspected of exaggeration, but you may depend upon the veracity of this. I am, Reverend Sir, Your most humble, and most obedient Servant. Brussels, March 29, 1760. Terence Brady, M.D. LXIII. An Account of an extraordinary Case of a Lady, who swallowed Euphorbium. By Dr. Willis, of Lincoln: Communicated by Sir Francis Dashwood, Bart. Read Apr. 24, 1760. In December 1758, Mrs. Willis of Lincoln fell into a slow fever, occasioned by too small a discharge of the lochia after lying-in, lying-in, and a redundancy of milk, the consequence of her not suckling her child. On the 18th day after her delivery, by the mistake of her nurse, she took, instead of a draught that was ordered for her, two ounces of the tincture of euphorbium*. The shocking symptoms, which immediately ensued, violent suffocation, and an intolerable burning pain in the mouth, throat, and stomach, soon discovered the horrible mistake. I was in the room in about four or five minutes after the accident happened, unapprised of the nature of it, and therefore the more shocked, when I found every body in tears of despair, offering at no means of relief, as they had no hopes of success. As soon as I was made acquainted with what had happened, it occurred to me, that warm water and oil were the likeliest things to correct and expel the poison. I imagined a large quantity of warm water might probably make the patient vomit, and in some measure help to discharge the caustic tincture. I was sure the water would at the same time mitigate its violence, by diluting it, and by precipitating the acrid gum from the spirit, whereby it would necessarily be hindered from touching the membranes of the stomach and bowels in so many points, and from penetrating into their substance. There was happily a large tea-kettle of water on the fire, of which, being first qualified with a proper * The tincture was thus made, R Gum. Euphorb. 3ij. Spt. Vin. rectif. 3ij. Sol. add. Camph. 3ij. The camphor was ordered to weaken the caustic quality of the tincture, which being applied to a horse's leg without the camphor had made a blemish. quantity of cold water, I immediately gave the patient a basin lukewarm, and repeated it as fast as possible, conjuring her to use her utmost resolution to swallow; which she certainly did in a most surprising manner. After the third basin, she vomited very freely: what was brought up smelt very strong of the camphor, and seemed to contain a good deal of the tincture, with the gum separated from the spirit. She still drank on, but complained of excessive burning and torture in her stomach, crying out continually, she was burnt to death. I had then recourse to oil between whiles, in the quantity of two or three ounces at a time; and drenched her plentifully sometimes with oil and sometimes with water. She vomited very copiously, and I repeated the oil and water interchangeably, till she had taken, as well as I could guess by the vessels, two gallons of water and a flask of oil in a very short time †. Dr. Sydenham, being called to a man, who had taken Mercur. sublim. corros. about an hour before the doctor saw him, the poison having affected his lips, &c. only ordered water to be taken in a large quantity, and thrown up copiously in glitters. But as the corrosive sublimate of mercury is to be considered as a poison, whose caustic acrimony consists in a saline principle, and water is the proper solvent, diluent, and vehicle of all saline substances, the propriety of Sydenham's ordering water alone is sufficiently apparent. Poisons of a saline nature being dissolved in the fluids of the stomach and intestines, do not confine their ravages to these parts only, but are apt to enter the absorbent vessels, and insinuate themselves into the road of the circulation. Water is here a good antidote, as it dilutes such substances, washes them off the sensible membranes, destroys their acrimony, and readily passing through all sorts of canals, soon Imagining the deleterious draught had not had sufficient time to bring on any violent inflammation or excoriation, or to make its way into the blood, vomiting and purging, with plenty of diluents and sheathing substances, seemed the likeliest means to save the patient, if anything could be hoped to succeed in so perilous a situation. I therefore ordered a mild but operative emetic of Pulv. Rad. Ipecacuan. and a mixture with Sperm. Ceti and oil to be taken occasionally; still following up the patient with oil and water. I had reason to expect the emetic would also purge as well as vomit, and not only clear the stomach of the remains of the poisonous draught, but likewise carry downwards what portion of it might have passed through the pylorus by the contraction and agitation of the ventricle on the preceding vomiting. The apothecary demurred at the emetic, and soon carries them out of the body. But the case is otherwise with gummy resinous poisons, such as euphorbium. These being indissoluble in water, are not so apt to enter the absorbent vessels, and pass into the blood, but, by their acrimony, shut up the orifices of those canals, and preclude a passage. Therefore oil here should be called in to the assistance of water. For the caustic resinous substance of euphorbium being precipitated or separated from the spirit, and formed into clots by the water, would still be apt to stick to the tender nervous membranes of the stomach and bowels, and by its intolerable acrimony cause violent ulcerations, inflammations, and gangrene. But the oil contributes greatly to prevent these fatal effects, by sheathing the corrosive acrimony of the poison, preventing its adhesion to the delicate lining membranes of these first passages, and defending them from the violence of its attacks; while at the same time it promotes the discharge of their contents. These qualities of oil also render it very serviceable in other species of poison. objected the danger of its aggravating the effects of the poison by its stimulus and irritation. Though I was not in the least convinced by the objection, yet, from an apprehension of the reflections, which might probably be made after the tragical scene, which seemed to be inevitable, I was staggered in my proceeding, and wished the objection had not been started. My brother, observing my uneasiness, asked me, if she should send for Dr. Dymock. I gladly accepted this offer, as it rid me of my perplexity, and would give satisfaction to all concerned to have had the best advice. In the mean time, I plied the patient with oil and water alternately, with which she vomited; but still grievously complained of a burning heat in the stomach and bowels. Her breath and all she vomited smelt very strong of the camphor. Her pulse was moderate, and not much quickened. I had now given her about a gallon more of water, and half a flask more of oil, when Dr. Dymock arrived. Upon informing him of all the particulars of the case, he, without hesitation, ordered an emetic of Vin. Ipecacuan. 3. which was immediately given: but the patient complained more and more of an inward burning heat, which made it necessary to supply her with more water before the emetic operated. It had however in a short time the desired effect, and operated plentifully both by vomit and stool, especially the latter way. The stools, which continued to be discharged for near an hour, without any griping pain, very manifestly discovered both camphor and oil being mixed with them. The purging now began gradually to abate, and soon after the burning heat in the region of the stomach became more more tolerable, and insensibly grew better, the camphor being no longer perceptible in the breath or evacuations. Her drink now was water with the addition of a little milk. The patient's spirits, which, by means of the great irritation and feverish tumult the caustic tincture had excited, kept up surprisingly, now began to fail her, and she was with difficulty got into bed: where, after complaining for a short time only of a soreness in the first passages, she lay sweating profusely for four hours in a very low desponding condition. A gentle opiate was exhibited, which took effect; and after a sound sleep of five hours the patient waked very easy, took some of the sperma ceti mixture, and had another sleep of three hours. She now found herself free from all her complaints; the previous slow fever, as well as the effects of the poisonous tincture, being entirely carried off. It is remarkable, that the patient found herself, for four days successively, in so happy a state of ease and tranquillity, as she had never before experienced, and to this day enjoys a perfect state of health. Thus have I laid before you the true history of this case; for the simple relation of which I flatter myself I need make no apology, when I reflect, that the practice of physic must derive much greater advantages from plain histories of matter of fact, and just deductions drawn from them, than from the most ingenious hypotheses and speculative theories. These were of baneful influence to the progress of true knowledge, till your illustrious Society taught the world the true method of investigating the laws of nature, nature, by observation of fact, experiment, and rational deduction. The following observations, which this case naturally suggests, seem to deserve our attention. 1st, That in any similar accidents of swallowing corrosive poisonous substances, a quick and resolute administration of these simple bodies, water and oil, in a large quantity, seems to be the most effectual method of preventing any bad consequences, and far preferable to the numerous boasted antidotes, which have been handed down to us. 2dly, That an emetic may be more safely and effectually administered, and its operation waited for, after the acrimony of the poison hath been sheathed and blunted, and the coats of the stomach defended from its attacks, by a liberal use of water and oil, than immediately after it is swallowed. 3dly, That as the slow fever and redundancy of milk, as well as the poison, were carried off by the copious discharge excited in the easy manner above-mentioned; might we not often hope for success in fevers occasioned by similar causes, plenitude and obstruction, from plentiful evacuations, brought on after the same manner, by simple, diluent, and sheathing medicines? 4thly, The camphor was undoubtedly of great service in curbing the destructive effects of the euphorbium, by blunting its acrimony, and soothing the nerves into an insensibility of irritation, and consequently an incapacity of spasmodic affections. I have tried the *tinct. euphorb. cum camphorá* on a horse's horse's leg several times, and find it not near so caustic as without the camphor. And it is well known how much camphor involves the spicula, corrects the acrimony, and mitigates the effects of cantharides, saccharum Saturni, and rough, mercurial, and antimonial preparations. 5thly, To water and oil therefore we may justly add camphor as a powerful corrector and expeller of poisons in general. This it probably effectuates, 1st, by blunting the acrimony; 2dly, by calming the nervous system, and securing it from spasmodic tumult and convulsion, which may be a consequence of its sheathing quality; 3dly, by its extreme subtilty and volatility, whereby it freely penetrates the smallest recesses of the body, and powerfully promotes a diaphoresis. Some late instances of the effects of camphor in poisonous cases greatly confirm this account. These three simple bodies then, water, oil, and camphor, challenge the first place among the antidotes hitherto discovered, both for internal and external use, and are much more to be depended upon than any of the elaborate compositions calculated for this purpose by the ancients, as the Theriac. Androm. Mithridat. Conf. Paulin. &c.