ATRIPLICISMUS 



20I 



Symptomatology. — -The disease begins suddenly without prodro- 

 mata, some ten to twenty hours after the plant has been eaten. 

 The tips of the fingers and the back of the hands begin to itch, 

 though sometimes the irritation may be at first limited to the thumb 

 and forefinger. The affected parts soon become painful, swollen, 

 cyanosed, and cold, while the pain and swelling spreads up the 

 hands on to the forearms. The face and eyelids itch, and in due 

 course become swollen, and the nose becomes cyanosed and cold. 

 Sensibility to touch is diminished in the affected parts, but much 

 increased to heat and to the sun's rays. Bullae and ulcers may 

 appear on the affected parts, the latter often giving rise to keloid 

 scars. There is considerable itching. Ecchymoses may appear in 

 various parts of the body. Gangrene of the fingers may also occur. 

 The general health of the patient is not much aSected. 



Diagnosis.— Atriplicismus may require to be diagnosed from 

 Raynaud's disease and erythromelalgia, but there should be no 

 difficulty, because in the former there is no. cede ma, and in the 

 latter there is redness as well as oedema. 



Treatment. — The treatment is s^^mptomatic, and consists in 

 applying anodynes and cold compresses locally, and giving purga- 

 tives and disinfectants, such as salol, internally. Good food and 

 good hygiene are also requisite. 



Prophylaxis. — The aetiology must be settled before definite rules 

 for prophylaxis can be given. 



Fabismus. 



Synonyms. — Favism, II Favismo, Bohnenkrankeit. 



Definition. — Fabismus is a disease attributed to the eating of 

 fresh beans ( Vicia faha) or to the scent af the flowers thereof when 

 in blossom. 



Historical. — It has been known for many years in Sardinia, and 

 has been carefully studied by Fermi in 1905, and then by Frongia 

 in 1907, followed by Zoja in 1914, and Gasparrini in 191 5. 



etiology.- — The actual cause is unknown, but it is associated 

 with the period of the year when the bean is ripening. It seems 

 to appear only in certain families, and there is a personal idio- 

 syncrasy, and no immunity is confirmed by an attack in sus- 

 ceptible persons, who may have repeated seizures. It occurs in 

 Sardinia, and it is suggested that it may be found in other Mediter- 

 ranean countries. 



Symptomatology.— Within a few hours of eating the beans or 

 of being exposed to the scent of the flowers an acute febrile attack 

 associated with marked blood destruction sets in. The red cells 

 fall to 2,000,000 per cubic millimetre, and the haemoglobin to 

 20 per cent., and icterus sets in, with liver tenderness, but no 

 enlargement of that organ or of the spleen. Bile may be vomited 

 and passed in the motions, while haemoglobin, urobilin, and indican 

 are found in the urine. Children die in a few days, but adults 

 recover quickly. 



