Am.  Jour.  Pharm.  "> 
December,  1919.  J 
Benzine  Poisoning. 
805 
began  to  have  generalized  pains  over  his  abdomen  with  nausea  and 
vomiting  after  meals.  He  also  had  a  feeling  in  his  head  which  he 
describes  as  a  "  compression  on  the  inside  "  or  a  "  pressing-in  like." 
On  October  I,  1914,  he  went  to  a  hospital.  At  this  time  he  also  had 
a  feeling  of  heaviness  in  the  arms  and  legs,  which  made  them  feel 
like  leaden  weights.  These  symptoms  cleared  up,  but  on  going  back 
to  work  the  nausea,  vomiting,  and  dizziness  returned  and  have  be- 
come progressively  worse.  The  nausea  and  dizziness  have  often 
been  so  severe  that  he  has  had  to  leave  work.  He  has  been  grad- 
ually losing  strength,  the  weakness  before  admission  being  so  ex- 
treme that  it  often  took  an  hour  to  walk  to  his  home  when  it  had 
ordinarily  required  only  twelve  minutes.  At  times  he  has  fallen  in 
the  street.  For  the  past  three  months  he  has  been  getting  drowsy, 
his  memory  has  been  failing,  and  he  has  had  difficulty  in  thinking. 
He  has  had  a  feeling  of  coldness  in  his  legs  for  the  past  two  months, 
which  he  describes  as  a  feeling  "  as  if  menthol  were  rubbed  on 
them."  He  has  had  shooting  pains  in  the  arms  with  cramp  in  the 
muscles  ending  in  hyper-extension  of  the  fingers.  Recently  he  has 
had  spontaneous  cramps  of  other  muscles.  His  legs  felt  as  if  "  a 
thousand  needles  were  stuck  in  them."  The  sense  of  heaviness  of 
the  limbs  continued  until  they  felt  like  "  bags  of  cement."  He  has 
noticed,  also,  tremor  of  the  fingers  and  eyelids  and  failing  memory ; 
his  head  has  not  felt  clear,  and  the  left  ear  as  if  bubbles  were  flow- 
ing out  of  it.  During  all  this  time  the  nausea,  vomiting,  dizziness, 
and  weakness  have  been  progressive.  He  has  had  some  dimness  of 
vision.  Five  weeks  before  entering  the  hospital  he  noticed  that  his 
urine  was  becoming  dark.  Two  days  ago  someone  told  him  that  he 
was  jaundiced.    He  has  had  marked  anorexia  and  constipation. 
Physical  Examination :  The  patient  is  undernourished  and  looks 
sick.  He  is  very  dull  mentally,  and  answers  questions  slowly. 
There  is  well-marked  jaundice  of  the  skin  and  mucous  membranes. 
There  is  a  sweetish  odor  to  the  breath.  The  pupils  are  equal  and 
active.  There  is  no  glandular  enlargement.  There  are  signs  of 
fibroid  changes  at  both  apices.  The  heart  is  negative.  Blood  pres- 
sure 100/65.  The  liver  edge  extends  two  finger-breadths  below 
the  costal  margin  and  is  firm  and  tender.  The  spleen  is  palpable. 
The  tendon  reflexes  are  very  active  everywhere,  but  equal  on  the 
two  sides.  When  the  patella  tendon  on  one  side  is  struck  there  is  a 
contraction  of  the  thigh  muscles  on  the  opposite  side.    The  super- 
