Potassic chlorate, KCLO3.
I. C. W.A. BLAUFUSS, aet, 22, robust, choleric temperament. – Nov. 6th, 8 am., took 1 gr. After 1 hours pulse quickened. – 7th, 8 am., 1 gr. No symptoms. – 9th, 8 a. m., 3 gr. Oppression of chest with strong heart’s beats. – 13th, 9 a. m., 10 gr. Immediately taste like vitriol. After 6 hours pressure on epigastrium, pain in abdomen, cold shudder over back and neck with warm feet. After 2 day dazed head. – Time not indicated: Frequently recurring twitching on lower and upper part of forehead going off after 8 h. Great rush of blood to eyes. No stool at 10 p. m., when he usually had one. Strong, almost audible, heart’s beat with oppression of chest and cold feet. Pulse 80. Cold feet and palpitation of heart. Itching all over body, evening in bed, next morning numerous small red papules. Chilliness in open air for 2 d. Persistent chilliness. Intolerable heat in bed, evening, febrile state with violently throbbing pulse and heart. Restless sleep often disturbed by disagreeable dreams. (MARTIN, Archiv, xvi, i, 182.) 2. G. GRAFE, aet. 22, sanguine temperament, took Nov. 6th, m., 1 gr. After 12 hours violent diarrhoea, always watery, at last after 6 day nothing but mucus evacuated, went off of 9th d. Along with the diarrhoea, furred tongue and transient weakness. ( Ibid., 183.) 3. G.F. HILPERT, aet, 22, choleric temperament. – Nov. 6th, 1835, 6 a. m., 1 gr. Headache in afternoon. – 7th, 1 gr., and after 1/2 hours 1 gr. No symptoms. – 8th, 1 gr. 3 times at 1/2 hours interval. After 8 hours, irritation in nose causing frequent sneezing with increased discharge, also next day with jerking in masseter (the nasal symptoms occurred after 5 gr.). – Time not indicated: Pretty severe headache; tension in sinciput; papules on forehead, very hard dry stool; drawing in thigh and forearms; great weariness and drowsiness. – 15th, m., 5 gr. Soon, pulse 70 (is usually 64). After 24 hours feeling of strength in eyes. After 36 hours pain in upper eyelids, papules between lips and chin. After 48 hours, humming in ears, with painful stool, of dry faeces, latterly mucus and blood, and persistent pain in rectum; another such stool 4 hours later. After 60 hours eyes red and painful, very much out of humour after cheerfulness. After 72 hours irritation in eyes with rush of blood into them violent epistaxis. After 76 hours faeces soft, passed without pain. – Time not indicated: Increased sensitiveness of whole face, tearing in root of nose, tickling in canthi of eye; jerking in nerve of lower jaw at foramen maxillary posticum, transient bitter – sour taste. – May 9th, 1836, took 1 gr. No symptoms. – 10th, 1 gr. No symptoms. – 12th 1 gr. Frequent sneezing. – 21st, 4 gr. After 6 hours dryness in throat, hoarseness. After 8 hours persistent headache, pressure in right and left hypochondrium to navel. After 12 hours violent erections with emissions, chilliness evening through whole body. After 20 hours voluptuous dreams with emission. After 24 hours itching in urethra, continued erections with itching on scrotum. – Time not indicated: Restless sleep, flushes of heat in face. – 24th, 4 gr. Pains in head. – 26th, 4 gr. After 20 hours violent coryza. (Ibid.) 4. H. HORN, aet, 21. nervous irritable temperament. Nov. 6th, 1835, 1 gr. After 2 hours pain in temporal region. After 4 hours cutting in stomach. Chilliness for several day – 7th. 2 gr., chilliness. – 8th. 3 gr., miliary rash with single painful papules on left shoulder for 10 days – 13th. 5 gr., after 1/2 hour cutting headache down to malar bones. After 2 hours tension over forehead, then sneezing and coryza.; pain from temples into carious teeth, violent pressure in eyes, sneezing, then coryza, eructation. After 7 hours toothache in upper jaw. After 24 hours hard stool. After 70 hours epistaxis at n. After 72 hours urine very turbid. – Time not indicated: Warmth in stomach. Pulse 78 (Usually 70). Chilliness for several days – May 23rd, 1836, 4 gr. Headache on left side of head. Attack of ravenous hunger, later anorexia. – 24th. Chilliness, ill humour, anxiety, hypochondriacal tension of ganglionic nerves lasts until relieved by epistaxis. – 26th. 4 gr., after 24 hours nose bled twice; great hunger at unusual time. (Ibid., 184.) 5. H. KUNZMANN, aet, 26, phlegmatic, in good health, took Nov. 6th, m., 1 gr. Immediately nausea with slight shivering. After 1/2 hour eructation. After 8 hours tensive pain in right hypochondrium relieved by discharging flatus. – Time not indicated: Turbid urine; shivering all over. – 7th 1 gr., after 3 hours flashes of light in both eyes when coughing and sneezing. Easily intoxicated by beer; urine turbid. – 9th. 2 gr., after 1 hours confusion of head, weariness. After 2 hours vertigo after strong exercise with congestion of blood to head. After 2 1/2 hours congestion of blood in chest, oppression of chest, violent heart’s beats, pulse at right wrist full, soft, lazy, 68, intermitting every 25 or 30 beats, not synchronous with heart’s beats, which are 80, strong and regular, at left wrist small, soft, compressible. – 11th. 1 gr., urine turbid. – 15th. 5 gr., the urine, previously turbid, became clear. Itching of skin, n., next m. small red papules on thighs and shoulder, not in the joints; they dry up after 40 hours, and there then appear some small papules on face. (Ibid.) 6. E. MARTIN, aet. 26, irritable nervous constitution, subject to rheumatic affections, at present healthy. – Nov. 6th, 1835, took at 6 and 10 a. m., 1 gr. Immediately persistent bitter taste, cold feeling of tongue. Soon, slight tearing in right wrist, and along ulna. After 3/4 hours pressive pain in right malar bone under border of orbit, the tension in neck, cheek, and temple; this recurs after 8 h. After 1 hour violent sneezing, pricking burning in tongue; expectoration of mucus removes the bad taste. After 1 1/2 hours drawing in root of nose. After 3 hours tongue furred at back, anorexia, tightness of chest, confusion of head. After 6 hours repeated. After 12 hours very burning papule on left cheek. – Time not indicated: Painful pressure in left upper coastal region; stool very sluggish, occurs at 11:30 p. m., liquid stool next m., urine very turbid, great chilliness, shivering all over body. – 7th, at 6 and 10 a. m., 1 gr. After 1/2 hour drawing and tension in right side of face. After I hours violent sneezing. After 3 hours liquid stool. After 48 hours a very much inflamed hang – nail; urine turbid. Time not indicated: Tension in right cheek under eye, extending to ears, afterwards on left side; gums bleed readily when brushing teeth. – 10th, 6 and 10 a. m., 1 gr. After 1/2 hour drawing pain in right cheek, making him sneeze. After 1 hours violent sneezing. – Time not indicated: Tongue furred at back. Pressure in scrob. cordis with apathetic disposition and chilliness. Transient internal coldness in right forearm, Itching vesicle on back of right hand. Great chilliness. Tranquil dreams of prophecies of death on several n. Sad, desponding, apathetic disposition with chilliness in e. Sexual desire very much diminished. – 11th, 6 and 10 a. m., 1 gr. Immediately bitter taste as usual. Chilliness with stiffness of hands; restless sleep, full of vexatious dreams. Quiet dreams of death from typhus fever. – 12th. 5 gr. Soon coldness in precordial region. After 10 m. pressure and empty feeling in stomach. After 4/1 hour distinctly perceptible but not quick heart’s beats with coldness in precordial region. After 20 hours roughness in oesophagus. After 1 hours distinctly perceptible but not quick heart’s beats with coldness in precordial region. After 20 hours much twitching in head and body. After 24 hours very itching papules with small vesicles on back of left hand; disappeared during day but recurred next m. After 72 hours rheumatic pains in several parts. – Time not indicated : Constant urging to stool, which is normal in character. Great chilliness with shivering. – 17th. 5 gr., similar symptoms. – May 12th, 1836, m., 1 gr. K. chl. mixed with 1 gr. 3rd. trit. Immediately coldness of tongue and oesophagus for 5 m. After 20 m. drawing in right cheek and gums with a kind of cramp of muscles of r. check. After 1 hours slight irritation to cough in larynx. After 2 hours increase of saliva. After 3 hours drawing and tearing in both wrists. Taste of cherry – laurel water with salt. – 16th. Same dose. Drawing tension in right cheek followed by desire to sneeze. Violent coryza with much sneezing and great flow of nasal mucus. – 17th. Same dose. No new symptoms. – 26th, 6 a. m. 4 gr. Immediately feeling of shivering. After 3 hours headache in left temple; feeling of warmth in stomach; frequent rumbling in belly with tendency to diarrhoea. After 6 hours much flatus during d. After 12 hours frequent urging to urinate. – Time not indicated : Confusion of head when walking in open air. Drawing in right cheek with pain in lobe of ear, worse sometimes in masseter muscle, sometimes under orbit. Sourish after – taste. Very itching papules and small vesicle on back of left hand, going off during. but returning next m. – 27th, m., 4 gr. After 12 hours itching vesicles on back of right hand, lasting several d. After 24 hours restless sleep, wakes towards m. from anxious dreams, lying on back, loudly snoring and breathing with difficulty. – Time not indicated : Tensive drawing in left cheek under orbital border. Scraping in throat. Many not very itching vesicles filled with pus and with red areola on limbs. (Ibid.)
7. W. OEHLER, act. 22, of sanguine irritable disposition, took Nov. 7th, 1835, m., 1 gr. Much eructation, with pains alternately in chest and belly. – 8th, 9th, 10th, m., 2 gr. No symptoms. – 13th, m., 5 gr. Violent cough and coryza. Constant chilliness. After 7 day urging to urinate. – May 21st, 1836, 4 gr. After 8 hours flow of mucus and saliva, sharp, burning, sour taste, pain in pelvic region, itching all over body. – 23rd. 4 gr., the pain in pelvic region increases, and is accompanied by diarrhoea, which lasts 10 day, gradually going off. – 24th, 4 gr., headache with vertigo. Papular eruption on thigh and right corner of mouth. Many dreams of events that occurred during day (lbid.)
8. FR. REICHMANN, aet. 20, sanguine temperament, took November 6th, 1 gr. Disagreeable salt sour taste. Soon, sneezing. Swelling of upper lip. Some eructations, griping in belly. Pulse 74, generally 70. Coldness of right arm. – 7th. gr. Soon sneezing; increase of swelling of upper lip – 15th. 5 gr., tension in face with forcing towards eyes, especially right side. Urging to stool. On 5th n., epistaxis from right nostril. After 6 day spasm in left eye, swelling of lower lip, cramp in right index and leg. (lbid.) 9. F. VULPIUS, aet. 21, phlegmatic melancholic temperament, took November 5th, 1835, 1 gr. Sneezing with violent coryza. Pulse, usually 65, rose in 4 hours to 80, then to 90, for several hours – Nov. 6th. 2 gr., sneezing with coryza, pulse 85. – 7th. 3 gr., sneezing with coryza, sourish taste. – 14th. 5 gr. Soon spasmodic drawing in cheek to maxillary joint sometimes with tearing in superior maxilla. After 6 hours pulse 85. After 8 hours shooting pain in right temple, going and coming; violent rigor, afternoon. After 12 hours, in evening, violent headache, goes off next day, spasmodic pressure in maxillary point, with single stitches in both jaws and teeth, especially right side; sneezing with coryza. After 24 hours pain in occiput, sometimes extending to both jaws; evening, occasional shooting in various parts of face. After 28 hours vesicles on lower lip. After 72 hours rheumatic pains in various parts. After 6 days pain in right temple, urine very turbid. – May 18th, 1836. 4 gr., burning alkaline taste. After 6 hours violent shooting pain in right knee – joint. After 48 hours confusion of head, some cough. – 30th. 4 gr., violent coryza. (lbid.) 10. F. WERTHER, aet. 23, choleric temperament, took Nov. 6th, 1 gr., 7th, 2 gr. No symptoms. – 8 to. 3 gr., violent itching all over body. (ibid.)
11. P. H. WILKEN, act. 22, sanguine temperament, took June 3rd, after breakfast, 4 gr. Immediately increased mucus in mouth. After 8 hours some stitches in eyes; empty feeling of occiput with peculiar feeling in nape muscles, then pain in occiput; anorexia. – 4th, after breakfast, 4 gr. After 10 hours stool rather looser than usual. After 12 hours, in evening oppression of chest with feeling as if lungs were slightly constricted with a narrow thread. Next m. this was nearly gone, He then took 4 gr. In afternoon the chest pain returned with greater force, and by evening had become very violent. The following 3d. the chest pains continued, but went off on 4th day, when he took 4 gr., where – upon the chest pains recurred, but again went off in 2 d. Feeling of uneasiness. (lbid.) 12. A girl, act. 25, suffering from face ache, took 1/5 gr. This caused dryness in throat and chest with cough and constriction of chest as from sulphur vapour. (ibid.) 13. I took a single dose of 5 gr. dissolved in water, and found a sense of congestion to the head, accompanied by pain of forehead. A few weeks after, I took a dose of 10 gr., and the same symptoms were produced, continuing about 2 d. I then waited for a period of some months, and took a dose of 15 gr. in a glass of water. It first produced slight acceleration of spirits, followed by congestion of brain to such an extent that one half of head, face and nose felt paralysed. The symptoms continued for 2 day, and then gradually subsided. There was also a loss of taste, being scarcely able to distinguish different kinds of meat. The muscles of the plate felt contracted, and the mucous membrane of mouth and throat appeared tanned, as from tannic acid. I have frequently used (while attending scarlatina patients) a solution of K. chl. as a wash for the mouth in the m., but if continued for 2 or 3 day in succession, similar symptoms to those I have described, but in less degree, were produced. (OSBORN, LANCET, 1859, ii, 364.) 14. E. T.D. -, in perfect health, took Jan. 7th, 1832, and on 11th, 3j, without effect. On 16th took, which caused considerable diminution of appetite, and some flatulence, for several d. On 21st, at 4 p. m., pulse 80, took. In an hours pulse was 64; in another hour it varied from 56 to 65, a little exertion or movement instantly raising it to latter number; it was also much smaller and weaker. Shortly after dose, weight, fulness and distension began to be felt in epigastric region, gradually increasing, with twisting sensation and flatulence, to 10 p. m., when brandy relieved. N. was quit, but next day weight and fulness, with twisting, recurred, amounting to rather severe pain, but subsiding spontaneously towards n. The same thing occurred on two following days, requiring opium for relief, and for some days yet all food caused uneasiness. For several weeks following prover had hemorrhoidal protrusion, which he had never experienced before. There was also diuresis for first 18 hours. (TULLY, Bost, Medorrhinum and Surg. Fourn. vi 327.) 15. W. N.B -, in perfect health, likewise took -)j and zj without effect. Jan. 16th, at 7 p. m., pulse 76, took zss. In an hours or two pulse was diminished considerably in force, and about 10 beats slower. Some diuresis occurred, but n. was quiet. Next day strong sense of weight and distension at stomach, with deficient appetite and flatulence. These symptoms continued through 18th and 19th, so that animal food could not well be taken. On 21st, being well again, he took at 4 p. m. zj pulse 72. In an hour it had fallen, and was considerably smaller and weaker than usual. It continued at same point to 7 o’clock, rising to 64 on exertion; by 8 it had fallen to 48, and was still smaller and weaker. Between 7 and 8 copious alvine evacuation. Between 8 and 9 walked 1/8 mile, and immediately on returning had some heavy oppressive pain and sense of sinking at stomach, so urgent as to require speedy mitigation. Pulse now only 36; moderate sweating; 2 oz. of brandy relieved, and n. was quite. Next m. weight and pain at stomach recurred, relieved by brandy again, but returning after food, and at length became so severe after a short walk as to require full doses of opium (up to 20 gr.). Pain had now extended to umbilical region, and become lancinating; there was swelling, hardness and soreness, intolerance of least pressure, in both epigastric and umbilical regions, with inability to sit erect, and much flatulence and eructation. By evening the opium had relieved, but a paroxysm of vomiting occurred at 9 p. m. N. was good, and next m. he only felt some vertigo. (ibid.) 16. Dr. TULLY himself took same doses with similar results, including the hemorrhoidal protrusion, and rather more diuresis. (lbid.) 17. ISAMBERT experimented on himself and others with K. chl. He found it eliminated rapidly and unchanged, principally by salivary glands and kidneys. Doses of 1 – 6 grm. produced no appreciable result. From 8 or more grm. salivation occurred for 2 – 3 hours with saline taste, and salivary glands continued “weak” for 5 or 6 d. A slight alteration in voice was noticed. The only constant effect on the digestive function was increase of appetite. In high doses it showed well – marked diuretic properties. Twenty grm. daily induced frequent micturition, and slight sense of weight and pain in renal region. Urine during whole time of elimination was strongly acid, and deposited urates abundantly. (lbid., lxiii 32.).
1. An inquest held Jan. 16th on the body of Mr. John S. Tuttle, of Bergen, New Jersey, revealed the fact that deceased was suffering from phthisis; that he applied to a physician, who ordered zviij of K. chl. to be put up in twelve packages, one of which was to be taken daily in a pint of water. He took 4 powders on 4 consecutive days, when pains in bowels became very severe, incessant vomiting came on, and finally death ensued. Drs. Booth and Olcott made a P. M. examination, and found external coat of stomach inflamed; internal coat was yellow (as was matter he had vomited), it was soft and could be easily separated of with the handle of the scalpel, leaving the muscular coat bare. Both witnesses were of opinion that the medicine was the immediate cause of death. (Brit. Medorrhinum Journ., 1861, i,159.) 2. Dr. FOUNTAIN took on march 22nd, 1861, at a single dose, 1 oz. potass. chlor., with a view of verifying his belief in its innocuousness in large doses. The most violent results followed, viz. inflammation of the stomach and intestines, and a copious diuresis, lasting several h;, followed by complete suppression of urine for 6 day preceding his death. (Amer. Medorrhinum Times, April, 1861, p. 245.) 3. A little girl, aet. 2/1/2 years, took about 1/2 oz. of potass. chlor.; she had severe vomiting, which lasted for 7 hours, when she died of gastritis in spite of all help. Another remarkable symptom of the poisoning was the profound lethargy of the child, which probably prevented its showing symptoms of pain. ( Brit. Medorrhinum Journ., 1878, ii, 966.)
4. The patient was an Irish girl, single, aet. 20. She was admitted to N. Y. Hospital April 10th, 1888, at 4 p. m. She had taken on previous evening two tablespoonfuls of K. chl. by mistake for Rochelle salts. On admission she was in a state of profound prostration; temp. 99 degree, pulse 136, resp. 32. Surface was very cyanotic; breathing rapid, but not laboured; pulse very feeble. She vomited freely before and after admission. In spite of whisky, digitalis, and strophanthus, symptoms grew worse. At 6 p. m. temp. had risen to 104 degree. During n. bowels acted 3 times, motions dark brown and semisolid; dark coloured urine was passed involuntarily. It was proved to contain many blood cells, large masses of altered haemoglobin, and much albumen. Next m. temp. fell, and pulse and resp. improved for a new h; By noon pulse and heart were again profoundly weak, and temp. rose to 101.2 degree. There was a very extraordinary colour of skin, conjunctive, and lips, an intense anaemia with a cyanotic hue, and a very distinct sepia – brown chocolate tint where epidermis was thin; also great restlessness. Inhalation of oxygen produced no improvement. She slept constantly, and died 37 hours after poisonous dose. At necropsy, colour of blood was not materially changed, and a slight hue of jaundice was added to the anaemic and chocolate colouring. Blood in the great vessels was liquid, and of very dark chocolate colour. Heart was soft and flabby; lungs normal, but cut surfaces very brown. Spleen was large and firm. Kidneys large, capsules non – adherent, surfaces smooth; bladder contained 3 oz. of urine, of dark brownish – black colour and not at all translucent. All viscera were coloured like blood. Microscopically, very extensive fatty degeneration of heart was evident, especially in papillary muscles of left ventricle. Many straight tubes in pyramids of kidneys were found filled, even to distension, with broken – down blood – cells and methaemoglobin. Spectroscopic examination of blood revealed spectrum of methaemoglobin with much distinctness. Conversion of haemoglobin into methaemoglobin explains dyspnoea and altered colour. (PEABODY, N. Y. Medorrhinum Rec., July 21st, 1888.) 5. Man, aet. 53, had been for two years in the habit of taking K. chl. largely for chronic throat trouble. He looked very pale and waxy. He fell ill with feverish sore – throat, after having taken more of drug than usual; became very anaemic, passed no urine, vomited, and was jaundiced. He became steadily weaker, and died comatose. P. M. appearances were as in former case, but spleen was xix times its normal size. (lbid.) 6. A healthy young man, aet. 22, had incautiously gargled with a strong solution of potass. chlor., in course of which he had swallowed a considerable quantity. The following day he complained of sickness and of pain in the sides and loins. Signs of acute gastritis rapidly followed; nausea and severe pain in the splenic region were the chief symptoms. Some enlargement of the spleen detected. Heart and lungs were normal, but distinct cyanosis, especially of lips and extremities, was present. Two days after the poisoning severe vomiting set in and lasted till the end. Icterus followed, but disappeared before death. On 4th day severe epistaxis; extreme praecordial anxiety followed, but without any notable signs in the heart or lungs; and some rigidity of muscles of extremities was observed. Death took place on 8th d. Throughout the illness hardly any urine was passed. Temp. subnormal; pulse fair. P. m., 4 d after death, revealed brown colour of blood – vessels; it was normal to spectroscope. Spleen greatly enlarged, brownish in places, and capsule soft. Kidneys enlarged and cortical portion expanded. microscopically, the straight and convoluted lobes were found filled with numerous brownish, irregular – shaped masses of haemoglobin. The stomach showed acute and chronic catarrh, with a few ecchymoses. The large intestine and rectum contained a large quantity of brownish watery fluid, and the mucous membrane appeared oedematous. Other organs normal. (Medorrhinum Times and Gaz., 1883, ii, 526) 7. a. VON MERING discriminates between acute and subacute poisoning by the chlorate. In acute cases – such, for instance, as result form one large dose, death results in a few hours from decomposition of the blood, with symptoms of severe vomiting, profuse diarrhoea, intense dyspnoea, cyanosis, and profound cardiac depression. After death a chocolate – brown colour of the blood is seen, while the tissues generally are relatively very little changed. The blood contains methaemoglobin, &c. With less acute forms death results from the accumulation of oxidation products in the organs as well as in the blood, especially in the kidneys.
b. The following conditions are seen: Grayish – violet petechiae, icterus, accumulation of haemoglobin in the blood, changes in the red corpuscles, dyspnoea, and cardiac depression; gastro – intestinal disturbances such as profuse diarrhoea and severe vomiting, the vomited matter being generally greenish black; and enlargement of the liver and spleen. Functional alterations in the kidney, such as anuria, occur; the scanty, turbid urine having a reddish – brown or block colour, and exhibiting spectra of methaemoglobin and haematin, and being also highly albuminous. It also contains numerous detritus – masses of red blood – corpuscles in the form of brownish cylinders or flakes. Neuroses, uraemic convulsion, delirium, coma and rigidity of the limbs are observed.
c. The subjective phenomena are: headache, anorexia, tenderness of the stomach on pressure, pains in the hepatic and lumbar regions, intense oppression of the chest, and a feeling of extreme weakness. After death the characteristic chocolate colour of the blood is noticed; the spleen, liver, and kidneys are considerably enlarged and filled with accumulated products of destruction of red corpuscles. The greatest alteration is seen in the kidneys, in which both the straight and the convoluted tubes are filled with cylindrical or irregular brownish masses. The osseous marrow is brown and contains many decomposed blood cells. The gastric mucous membrane is swollen and ecchymosed. (Lond. Medorrhinum Record, , 1884, p. 518) 8. A man, aet. 49, was ordered pot. chlor. on account of a vesical catarrh following gonorrhoea. He took by mistake 60 grammes (2 oz.) in 36 h. When seen by Dr. Bohm he was pale and collapsed, in a condition very suggestive of cholera, suffering greatly from pain over stomach, and with suppression of urine. Soon after a feeling of numbness and formication in the hands and feet came on, causing great distress and restlessness. The urine, blood, and the P. M. appearances were such as have been already described in other cases. (Ibid ., 1883, p. 436.) 9. Dr. F. MARCHAND has recently published four cases observed by himself (Virchow’s Archiv, Bd. 77, Heft. 3), three of them fatal, and had found that the P. M. appearances and the microscopic alteration of the blood coincided with those observed in animals experimentally poisoned with potass. chlor. The ages of Dr. M. ‘s patients ranged from 3 to 7 years. The dose varied from 12 grammes in 36 hours to 25 grammes in 30 h. The symptoms were vomiting, haematuria, a more or less icteric tint of skin, rapid wasting of flesh and strength, delirium, and coma. The urine contained quantities of disintegrated blood-corpuscles. The blood itself was of a remarkable chocolate colour, which did not alter on exposure to air. The same colour can be produced artificially by adding chlorate of potash to blood. If the proportion of the salt be considerable, the blood assumes a syrupy and even gelatinous consistence, and the red corpuscles tend to agglomerate into glutinous masses. The spectroscope shows that the lines characteristic of the haemoglobin have been replaced by a distinct absorption band in the red part of the spectrum, due to the conversion of the haemoglobin into methaemoglobin, an oxidation product of to former. The poisonous effects of the drug are therefore probably the result of its oxidising action on the red corpuscles. The debris thereof are either excreted by the kidneys, colouring the urine brown, or they accumulate in the renal cortex and cause death by suppression of urine and “uraemia.” The kidneys themselves are enlarged, and their surface is brown, but they exhibit no inflammatory appearances, the main alteration being the infarction of their tubules with corpuscular detritus. (Medorrhinum Times and Gaz., 1879, ii, 640.) 10. Hemoglobinuria produced by large doses of potass. chlor. – A woman was suddenly taken ill with cyanosis and dyspnoea, and passed masses of haemoglobin both per rectum and per vaginum; the urine and the vomited matter also contained masses of haemoglobin. On the 3rd day of her illness, the patient became slightly jaundiced, while the cyanosis passed off; on the 4th day she died. Beyond an enlargement of the spleen, which was painful to the touch, no organ was found during life the seat of disease. The blood showed increase of leucocytes, but the red corpuscles showed nothing very abnormal. The P.M. examination showed all the organs healthy except the spleen, which was large, soft, and looked like a blood – clot; the blood was fluid and dark brown; the kidney showed, in the cortical and medullary parts, chocolate – coloured streaks. The microscopical examination of the kidneys showed the convoluted tubes and straight tubes to be filled partly with granules and partly with small round discs of the size of blood – corpuscles, in which, however, the colouring matter was precipitated. The glomeruli were perfectly intact. The haemoglobin was not found within the glomeruli or in their capsules, but was abundant in the convoluted tubes, whose epithelium in most places was found intact. The patient had taken for a slight sore – throat about 1/1/2 oz. solid pot. chlor. (DRESCHFELD AND STOELLS, Trans. Internat. Medorrhinum Congress, 1881, vol. i,p. 398) 11. AMY W., aet. 3. suffering from purulent ophthalmia, was ordered, on March 9th, gr. chlorate of potash thrice daily. Much improvement resulted both locally and generally, and the medicine was continued until May 11th. The eyes several times seemed nearly well, but she had relapses due to unfavorable weather. Until May 11th the med. had apparently disagreed in no way; on this date the dose was reduced to 5 gr. “On May 18th she came with a very sore mouth. The saliva dripped from her lips, there were numerous follicular ulcer on the tongue and inside of lips, and one large one occupied a surface the size of a shilling on the back part of the dorsum of the tongue. The salivary glands were enlarged and tender, and the mouth full of saliva, although the ptyalism was not extreme, nor were the gums sore. In the latter respect, and in the existence of the larger ulcer on the tongue, the stomatitis differed from that caused by mercury.”( Medorrhinum Times and Gaz., 1858, vol. i, p. 527) 12a. A young man suffering from an acutely inflamed carbuncle on the nape took the chlorate in 15 gr. doses every 4 hours for 2 day, and then had 2 symmetrical ulcers from on the side of the tongue, each being about the size of a fourpenny piece. There was no general stomatitis, and the sores healed slowly when the remedy was suspended.