592 IMPORTANT POISONS AND THEIR TREATMENT 



kidney. The abuse of alcohol at a relatively early age may produce arterio- 

 sclerosis also. Cutaneous changes of all kinds — acne, dilatation of the veins — 

 may be due to chronic alcoholism. The influence upon the liver is particu- 

 larly prominent and typical; alcoholic cirrhosis with ascites, caput Medusae, 

 the small, tough degenerated liver, form a clinical picture peculiar to this 

 disease. An entire array of nervous diseases as well, such as polyneuritis, etc., 

 and apoplexy due to arteriosclerosis, threaten the alcoholic, who frequently 

 indeed betrays himself as such by the tremor of the hands. 



The proper therapy of chronic alcoholism requires primarily the avoidance 

 of alcohol in any form. In such cases, however, this abstinence usually comes 

 too late, for alcohol has already produced irreparable organic changes. For 

 this reason all our efforts must be directed toward lessening -the abuse of 

 alcohol. 



The modern movement against the use of alcohol is calculated to produce 

 a change in this direction. It will be long in taking deep root, but its prin- 

 ciple is correct. Only by an example of total abstinence may we hope to bring 

 about results. In writings and popular lectures, etc., this standpoint should 

 be defended, and finally it will enable us to combat the dire consequences of 

 chronic alcoholism. 



A word regarding sulphonal, teional and tetronal. All of these 

 remedies are useful hypnotics, but they are also poisons, and the prolonged, 

 continued use of them will lead to hematoporphyrinuria, a very serious dis- 

 turbance of metabolism. For this reason the greatest care is necessary in their 

 use, and the continued employment of them should be prohibited. 



We shall now devote our attention to cases of poisoning produced by agents 

 of the aromatic group. 



The fact that our modern antipyretics, also our modern antineuralgics, 

 belong to this category gives them special importance. 



In this brief article, I can emphasize few symptoms, but must confine 

 myself to the discussion of some general phenomena of this poisoning. 



Above all, I must reiterate the fact that all of these remedies are Hood- 

 poisons; all have the property of forming methemoglobin in the blood, to 

 which we may probably attribute the cyanosis which intoxication with these 

 remedies produces. Furthermore, the majority of these agents are combined 

 with sulphuric acid or glycuronic acid in the organism, and are excreted from 

 the organism as combinations. 



The symptoms of poisoning by niteo-benzol (mirbane oil, artificial bitter 

 oil of almonds) and anilin are of unusual interest. There is extreme cyano- 

 sis. Loss of consciousness recurs repeatedly in paroxysms — a symptom due to 

 the changes in the blood produced by nitro-benzol toxicosis and peculiar to 

 such poisonmg. Although these toxicoses show exceeedingly threatening 

 symptoms— for example, pulmonary edema — they may, nevertheless, run a 

 favorable course. Nitro-benzol poisoning and amido-benzol poisoning have 

 lately been observed frequently. They are incident to certain occupations, 

 and it is not too much to expect that since the danger which these industries 

 entail has been recognized proper prophylaxis will in future make such eases 

 of poisoning much more rare. 



