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Remarks. This disease is a very rare one amongst Europeans. Dr. MANSON who sent the patient here informed me that it was extremely rare, I have never heard of à European being affected with it before. It raises the important question whether Yaws is a distinct malady sui generis? or only a variety or modified form of syphilis, leprosy, or some other cachexia? (Vide Report on Leprosy and Yaws in the West Indies addressed to Her Majesty's Secretary of State for the Colonies by GAVIN MILROY, M.D., 1873.)
Whether syphilitic or not certainly this case tends to prove that antisyphilitic measures cure the disease, and in the Report above mentioned several Doctors (Dr. KEELAN, and BoWERBANK) state that mercury is their sheet anchor in the treatment of this disease. May it not possibly be a rare modifica- tion of syphilis, fostered and engendered amidst poverty squalor and dirt, as evinced in its prevalence and virulence amongst the natives of the West Indies prior to their Emancipation from slavery, it is undoubtedly a fact that the disease is inoculable, as from the foregoing Report we learn that "Negroes used to inoculate their children with the disease partly from the belief that they must pass through the disease at one period or another and partly as it afforded to the idly-disposed a pretext for shirking work in the cane-fields."
Doubtless in this case the patient was unfortunate enough to contract this disease in Malta.
II.-CASES OF DATURA POISONING.
Five Chinese coolies ages varying from 14-28 years, were admitted to the Hospital on the 17th July last with a Police order stating that they had been drugged.
An emetic was at once administered and the contents of the stomach kept for the purposes of analysis.
The patients were all much in the same condition-suffering from various hallucinations evidently due to some interference with muscular co-ordination, delirium-(this delirium being decidedly hilarious), their gait was very unsteady, and in one that of NG-A-YING æt. 18 insensibility set in about quarter of an hour after admission-this patient having probably taken more of the poison.
In each case the pupils were widely dilated, and the pulse very quick, strong coffee was adminis- tered and they were carefully watched during the night-next morning most of them were better the exception being the youth alone named, he still remained semi-insensible and subsultus-tendinum, picking at the bed clothes, &c., was strongly marked, in all the temperature two hours after admission was slightly increased (99.6° F.) they gradually improved, and informed me the next morning that on evening of the 17th they all went to a Chinese eating-house for their evening meal, and shortly after partaking of the food which consisted chiefly of boiled rice with fresh vegetables and fish, they became giddy and forgot all that happened afterwards.
The contents of the stomach were carefully analysed by Mr. CROW, the Government Analyst, and was found to contain some of the dried flowers of the Datura Alba the Naú Yeung-fa # in Chinese nomenclature. An alcoholic extract was obtained which evidently contained a powerful mydriatic alkaloid- this was proved by applying a few drops to a monkey's conjunctiva--in three minutes the pupil became widely dilated, this result occurring much earlier when applied to the human
eye.
This plant is very common in Hongkong and is evidently much used by the Chinese as a stupe- fying agent.
There was a similar case under treatment in the early part of this year--this was the first case of the kind I had seen and it perplexed me considerably, his symptoms were more severe, the pupils were widely dilated, insensibility more severe almost extending to coma, it was with great difficulty he could be aroused, and he had completely lost all muscular power, he did not recover for some six or seven days and for some time he had completely lost his memory.
III.-CASE OF TYPHOID FEVER SIMULATING TYPHUS.
H. R. C., a Swedish sailor, æt. 23, was admitted to the Hospital on 30th October last with the following history:-
That he had been feeling unwell for last few days, suffering from a feeling of general lassitude and slight diarrhoea.
He became much worse yesterday, having had one or two shivering fits.
On admission he was feverish, Temperature 101° F., skin hot and pungent, and he presented a roseolar eruption on the front of his chest and abdomen, no gurgling in right iliac fossa, tongue was the red at tip and edges and coated with a thick white fur, his pulse was 96, and he stated that his bowels had been open three times that morning.
*Notes on Chinese Materia Medica, by C, Ford, F.L.S.; Hokai, M.B.; and W. E. Crow 8, Datura Alba in China Review, Vol. XVI., p. 2.