Scientific American Supplement, No. 385, May 19, 1883

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Chronic poisoning shows itself in a peculiar coloring of the skin
(Argyria Fuchs), especially in the face, beginning first on the
sclerotic. The skin does not always take the same color; it becomes in
most cases grayish blue, slaty sometimes, though, a greenish brown or
olive color.

Von Hasselt thinks that probably chloride of silver is deposited in
the rete malpighii, which is blackened by the action of light, or that
sulphide of silver is formed by direct union of the silver with the
sulphur of the epidermis. That the action of light is not absolutely
necessary, Patterson states, follows from the often simultaneous
appearance of this coloring upon the mucous membrane, especially that of
the mouth and upon the gums; and Dr. Frommann Hermann[1] and others have
shown that a similar coloring is also found in the internal parts.

[Footnote 1: Leh der Experiment. Tox. Dr. Hermann, Berlin, 1874, p.
211.]

Versmann found 14.1 grms. of dried liver to contain 0.009 grm. chloride
of silver, or 0.047 per cent. of metallic silver. In the kidneys he
found 0.007 grm. chloride of silver, or 0.061 per cent. of metallic
silver; this was in a case of chronic poisoning, the percentage will be
seen to be very small. Orfila Jun. found silver in the liver five months
after the poisoning.

Lionville[1] found a deposit of silver in the kidneys, suprarenal gland,
and plexus choroideus of a woman who had gone through a cure with lunar
caustic five years before death.

[Footnote 1: Gaz. Med., 1868. No. 39.]

Sydney Jones[1] states that in the case of an old epileptic who had been
accustomed to take nitrate of silver as a remedy, the choroid plexuses
were remarkably dark, and from their surface could be scraped a brownish
black, soot-like material, and a similar substance was found lying quite
free in the cavity of the fourth ventricle, apparently detached from the
choroid plexus.

[Footnote 1: Trans. Path. Soc., xi. vol.]

Attempts at poisoning for suicidal purposes with nitrate of silver
are in most cases prevented from the fact that this salt has such a
disagreeable metallic taste as to be repulsive; cases therefore of
poisoning are only liable to occur by accident or by the willful
administration of the poison by another person.

Such a case occurred quite recently, to a very valuable mare belonging
to August Belmont.

I received on Dec. 6, 1882, a sealed box from Dr. Wm. J. Provost,
containing the stomach, heart, kidney, portion of liver, spleen, and
portion of rectum of this mare for analysis.

Dr. Provost reported to me that the animal died quite suddenly, and that
there was complete paralysis of the hind quarters, including rectum and
bladder.

The total weight of the stomach and contents was 18 lb., the stomach
itself weighing 3 lb. and 8 oz.

Portions were taken from each organ, weighed, and put in alcohol for
analysis.

The contents of the stomach were thoroughly mixed together and measured,
and a weighed portion preserved for analysis.

The stomach, when cut open, was perfectly white on its inner surface,
and presented a highly corroded appearance.

The contents of the stomach were first submitted to qualitative
analysis, and the presence of a considerable quantity of nitrate of
silver was detected.

The other organs were next examined, and the presence of silver was
readily detected, with the exception of the heart!

The liver had a very dark brown color. A quantitative analysis of the
contents of the stomach gave 59.8 grains of nitrate of silver. In the
liver 30.5 grains of silver, calculated as nitrate, were found (average
weight, 11 lb.). From the analysis made there was reason to believe that
at least one-half an ounce of nitrate of silver was given to the animal.
Some naturally passed out in the faeces and urine.

I was able to prepare several globules of metallic silver, as also all
the well known chemical combinations, such as sulphide, chloride, oxide,
iodide, bromide, bichromate of silver, etc.

From the result of my investigation I was led to the conclusion that the
animal came to death by the willful administering of nitrate of silver,
probably mixed with the food.

The paralysis of the hind quarters, mentioned by Dr. Provost, accords
perfectly with the action of this poison, as it acts on the nerve
centers, especially the cerebro-spinal centers, and produces spasms of
the limbs, then of the trunk, and finally paralysis.

I might also state in this connection that, only two weeks previous
to my receiving news of the poisoning of the mare, I examined for
Mr. Belmont the contents of the stomach of a colt which died very
mysteriously, and found large quantities of corrosive sublimate to be
present.

Calomel is often given as a medicine, but not so with corrosive
sublimate, which is usually employed in the arts as a poison.

It is to be regretted that up to the present moment, even with the best
detectives, the perpetrator of this outrage has been at large. Surely
the very limit of the law should be exercised against any man who would
willfully poison an innocent animal for revenge upon an individual.
Cases have been reported in England where one groom would poison the
colts under the care of another groom, so that the owner would discharge
their keeper and promote the other groom to his place.

A few good examples, in cases where punishment was liberally meted out,
would probably check such unfeeling outrages.

* * * * *

TUBERCLE BACILLI IN SPUTA.

Prof. Baumgarten has just published in the _Ctbl. f. d. Med. Wiss_., 25,
1882, the following easy method to detect in the expectorated matter of
phthisical persons the pathogenic tubercle bacilli:

Phthisical sputa are dried and made moist with very much diluted potash
lye (1 to 2 drops of a 33 per cent. potash lye in a watch glass of
distilled water). The tubercle bacilli are then easily recognized with a
magnifying power of 400 to 500. By light pressure upon the cover glass
the bacilli are easily pressed out of the masses of detritus and
secretion. To prevent, however, the possibility of mistaking the
tubercle bacilli for other septic bacteria, or vice versa, the following
procedure is necessary: After the examination just mentioned, the cover
glass is lifted up and the little fluid sticking to its under side
allowed to dry, which is done within one or two minutes. Now the cover
glass is drawn two or three times rapidly through a gas flame; one
drop of a diluted (but not too light) common watery aniline solution
(splendid for this purpose is the watery extract of a common aniline ink
paper) is placed upon the glass. When now brought under the microscope,
all the septic bacteria appear colored intensely blue, while the
tubercle bacilli are absolutely colorless, and can be seen as clearly as
in the pure potash lye. We may add, however, that Klebs considers his
own method preferable.

As the whole procedure does not take longer than ten minutes, it is to
be recommended in general practice. The consequences of Koch's important
discovery become daily more apparent, and their application more
practicable.

* * * * *

[Concluded from SUPPLEMENT No. 384, page 6132.]

MALARIA.

By JAMES H. SALISBURY, A.M., M.D.

PRIZE ESSAY OF THE ALBANY MEDICAL COLLEGE ALUMNI ASSOCIATION, FEB.,
1882.

VIII.

Observations in Washington, D. C., September 5, 1879, 8:35 A.M., Boston
time, near Congressional Cemetery.

1. Seized with sneezing on my way to cemetery. Examined nasal excretions
and found no Palmellae.

2. Pool near cemetery. Examined a spot one inch in diameter, raised
in center, green, found Oedegonium abundant. Some desmids, Cosmarium
binoculatum plenty. One or two red Gemiasmas, starch, Protuberans
lamella, Pollen.

3. Specimen soft magma of the pool margin. Oedogonium abundant, spores,
yeast plants, dirt.

4. Sand scraped. No organized forms but pollen, and mobile spores of
some cryptogams.

5. Dew on grass. One stellate compound plant hair, one Gemiasma verdans,
two pollen.

6. Grass flower dew. Some large white sporangia filled with spores.

7. Grass blade dew, not anything of account. One pale Gemiasma, three
blue Gemiasmas, Cosmarium, Closterium. Diatoms, pollen, found in
greenish earth and wet with the dew. Remarks: Observations made at the
pool with clinical microscope, one-quarter inch objective. Day cloudy,
foggy, hot.

8. Green earth in water way from pump near cemetery. Anabaina plentiful.
Diatoms, Oscillatoriaceae. Polycoccus species. Pollen, Cosmarium,
Leptothrix, Gemiasma, old sporangia, spores many. Fungi belonging to
fruit. Puccinia. Anguillula fluviatilis.

9. Mr. Smith's blood. Spores, enlarged white corpuscles. Two sporangia?
Gemiasma dark brown, black. Mr. Smith is superintendent Congressional
Cemetery. Lived here for seven years. Been a great sufferer with ague.
Says the doctors told him that they could do no more for him than he
could for himself. So he used Ayer's ague cure with good effect for six
months. Then he found the best effect from the use of the Holman liver
ague pad in his own case and that of his children. From his account one
would infer that, notwithstanding the excellence of the ague pad, when
he is attacked, he uses blue mass, followed with purgatives, then 20
grains of quinine. Also has used arsenic, but it did not agree with him.
Also used Capsicum with good results. Had enlarged spleen; not so now.

2d specimen of Mr. Smith's blood. Stelline, no Gemiasma. 3d specimen,
do. One Gemiasma. 4th specimen. None. 5th specimen. Skin scraped showed
no plants. 6th specimen. Urine; amyloid bodies; spores; no sporangia.

United States Magazine store grounds. Observation 1. Margin of
Eastern Branch River. Substance from decaying part of a water plant.
Oscillatoriaceae. Diatoms. Anguillula. Chytridium. Dirt. No Gemiasma.

Observation 2. Moist soil. Near by, amid much rubbish, one or two
so-called Gemiasmas; white, clear, peripheral margin.

Observation 3. Green deposit on decaying wood. Oscillatoriaceae.
Protuberans lamella, Gemiasma alba. Much foreign matter.

Mr. Russell, Mrs. R., Miss R., residents of Magazine Grounds presented
no ague plants in their blood. Sergeant McGrath, Mrs. M., Miss M.,
presented three or four sporangias in their blood. Dr. Hodgkins, some in
urine. Dr. H.'s friend with chills, not positive as to ague. No plants
found.

Observations in East Greenwich, R.I., Aug. 16, 1877.

1. At early morn I examined greenish earth, northwest of the town along
the margin of a beautiful brook. Found the Protuberans lamella, the
Gemiasma alba and rubra. Observation 2. Found the same. Observation 3.
Found the same.

Observation 4. Salt marsh below the railroad bridge over the river.

The scrapings of the soil showed beautiful yellow and transparent
Protuberans, beautiful green sporangias of the Gemiasma verdans.

Observation 5. Near the brook named was a good specimen of the Gemiasma
plumba. While I could not find out from the lay people I asked that any
ague was there, I now understand it is all through that locality.

Observation at Wellesley, Mass., Aug. 20, 1877.

No incrustation found. Examined the vegetation found on the margin of
the Ridge Hills Farm pond. Among other things I found an Anguillula
fluviatilis. Abundance of microspores, bacteria. Some of the Protococci.
Gelatinous masses, allied to the protuberans, of a light yellow color
scattered all over with well developed spores, larger than those found
in the Protuberans. One or two oval sporanges with double outlines. This
observation was repeated, but the specimens were not so rich. Another
specimen from the same locality was shown to be made up of mosses by the
venation of leaves.

Mine host with whom I lodged had a microscopical mount of the
Protococcus nivalis in excellent state of preservation. The sporangia
were very red and beautiful, but they showed no double cell wall.

In this locality ague is unknown; indeed, the place is one of unusual
salubrity. It is interesting to note here to show how some of the algae
are diffused. I found here an artificial pond fed by a spring, and
subject to overflow from another pond in spring and winter. A stream of
living water as large as one's arm (adult) feeds this artificial pond,
still it was crowded with the Clathrocyotis aeruginosa of some writers
and the Polycoccus of Reinsch. How it got there has not yet been
explained.

The migration of the ague eastward is a matter of great interest; it
is to be hoped that the localities may be searched carefully for your
plants, as I did in New Haven.

In this connection I desire to say something about the presence of the
Gemiasmas in the Croton water. The record I have given of finding
the Gemiasma verdans is not a solitary instance. I did not find the
gemiasmas in the Cochituate, nor generally in the drinking waters of
over thirty different municipalities or towns I have examined during
several years past. I have no difficulty in accounting for the presence
of the Gemiasmas in the Croton, as during the last summer I made studies
of the Gemiasma at Washington Heights, near 165th St. and 10th Ave.,
N.Y.

Plate VIII. is a photograph of a drawing of some of the Gemiasmas
projected by the sun on the wall and sketched by the artist on the wall,
putting the details in from microscopical specimens, viewed in the
ordinary way. This should make the subject of another observation.

I visited this locality several times during August and October, 1881. I
found an abundance of the saline incrustation of which you have spoken,
and at the time of my first visit there was a little pond hole just east
of the point named that was in the act of drying up. Finally it dried
completely up, and then the saline and green incrustations both were
abundant enough. The only species, however, I found of the ague plants
was the Gemiasma verdans. On two occasions of a visit with my pupils I
demonstrated the presence of the plants in the nasal excretions from my
nostrils. I had been sneezing somewhat.

There is one circumstance I would like to mention here: that was, that
when, for convenience' sake, my visits were made late in the day, I
did not find the plants abundant, still could always get enough to
demonstrate their presence; but when my visits were timed so as to come
in the early morning, when the dew was on, there was no difficulty
whatever in finding multitudes of beautiful and well developed plants.

To my mind this is a conclusive corroboration of your own statements in
which you speak of the plants bursting, and being dissipated by the
heat of the summer sun, and the disseminated spores accumulating in
aggregations so as to form the white incrustation in connection with
saline bodies which you have so often pointed out.

I also have repeated your experiments in relation to the collection
of the mud, turf, sods, etc., and have known them to be carried
many hundred miles off and identified. I have also found the little
depressions caused by the tread of cattle affording a fine nidus for the
plants. You have only to scrape the minutest point off with a needle or
tooth pick to find an abundance by examination. I have not been able to
explore many other sites, nor do I care, as I found all the materials I
sought in the vicinity of New York.

To this I must make one exception; I visited the Palisades last summer
and examined the localities about Tarrytown. This is an elevated
location, but I found no Gemiasmas. This is not equivalent to saying
there were none there. Indeed, I have only given you a mere outline of
my work in this direction, as I have made it a practice to examine the
soil wherever I went, but as most of my observations have been conducted
on non-malarious soils, and I did not find the plants, I have not
thought it worth while to record all my observations of a negative
character.

I now come to an important part of the corroborative observations, to
wit, the blood.

I have found it as you predicted a matter of considerable difficulty to
find the mature forms of the Gemiasmas in the blood, but the spore forms
of the vegetation I have no difficulty in finding. The spores have
appeared to me to be larger than the spores of other vegetations that
grow in the blood. They are not capable of complete identification
unless they are cultivated to the full form. They are the so-called
bacteria of the writers of the day. They can be compared with the spores
of the vegetation found outside of the body in the swamps and bogs.

You said that the plants are only found as a general rule in the blood
of old cases, or in the acute, well marked cases. The plants are so few,
you said, that it was difficult to encounter them sometimes. So also of
those who have had the ague badly and got well.

Observation at Naval Hospital, N.Y., Aug., 1877. Examined with great
care the blood of Donovan, who had had intermittent fever badly.
Negative result.

The same was the result of examining another case of typho-malarial
(convalescent); though in this man's blood there were found some
oval and sometimes round bodies like empty Gemiasmas, 1/1000 inch in
diameter. But they had no well marked double outline. There were no
forms found in the urine of this patient. In another case (Donovan,) who
six months previous had had Panama fever, and had well nigh recovered, I
found no spores or sporangia.

Observations made at Washington, D.C., Sept., 1879. At this time I
examined with clinical microscope the blood of eight to ten persons
living near the Congressional Cemetery and in the Arsenal grounds. I was
successful in finding the plants in the blood of five or more persons
who were or had been suffering from the intermittent fever.

In 1877, at the Naval Hospital, Chelsea, I accidentally came across
three well marked and well defined Gemiasmas in the blood of a marine
whom I was studying for another disease. I learned that he had had
intermittent fever not long before.

Another positive case came to my notice in connection with micrographic
work the past summer. The artist was a physician residing in one of the
suburban cities of New York. I had demonstrated to him Gemiasma verdans,
showed how to collect them from the soil in my boxes. And he had made
outline drawings also, for the purposes of more perfectly completing his
drawings. I gave him some of the Gemiasmas between a slide and cover,
and also some of the earth containing the soil. He carried them home. It
so happened that a brother physician came to his house while he was at
work upon the drawings. My artist showed his friend the plants I had
collected, then the plants he collected himself from the earth, and then
he called his daughter, a young lady, and took a drop of blood from
her finger. The first specimen contained several of the Gemiasmas. The
demonstration, coming after the previous demonstrations, carried a
conviction that it otherwise would not have had.

AGUE PLANTS IN THE URINE.

I have found them in the urine of persons suffering or having suffered
from intermittent fever.

When I was at the Naval Hospital in Brooklyn one of the accomplished
assistant surgeons, after I had showed him some plants in the urine,
said he had often encountered them in the urine of ague cases, but did
not know their significance. I might multiply evidence, but think it
unnecessary. I am not certain that my testimony will convince any one
save myself, but I know that I had rather have my present definite,
positive belief based on this evidence, than to be floundering on doubts
and uncertainties. There is no doubt that the profession believe that
intermittents have a cause; but this belief has a vagueness which cannot
be represented by drawings or photograph. Since I have photographed the
Gemiasma, and studied their biology, I feel like holding on to your
dicta until upset by something more than words.

In relation to the belief that no Algae are parasitic, I would state on
Feb. 9, 1878, I examined the spleen of a decapitated speckled turtle
with Professor Reinsch. We found various sized red corpuscles in the
blood in various stages of formation; also filaments of a green Alga
traversing the spleen, which my associate, a specialist in Algology,
pronounced one of the Oscillatoriaceae. These were demonstrated in your
own observations made years ago. They show that Algae are parasitic in
the living spleen of healthy turtles.

This leads to the remark that all parasitic growths are not nocent. I
understand you take the same position. Prof. Reinsch has published a
work in Latin, "Contributiones ad Algologiam," Leipsic, 1874, in which
he gives a large number of drawings and descriptions of Algae, many of
them entophytic parasites on other animals or Algae. Many of these he
said were innocent guests of their host, but many guest plants were
death to their host. This is for the benefit of those who say that the
Gemiasmas are innocent plants and do no harm. All plants, phanerogams
or cryptogams, can be divided into nocent or innocent, etc., etc. I
am willing to change my position on better evidence than yours being
submitted, but till then call me an indorser of your work as to the
cause and treatment of ague.

Respectfully, yours, ------

There are quite a number of others who have been over my ground, but the
above must suffice here.

[Illustration: PLATE X.--EXPLANATION OF FIGURES.--1, Spore with thick
laminated covering, constant colorless contents, and dark nucleus.
B, Part of the wall of cell highly magnified, 0.022 millimeter in
thickness. 2, Smaller spore with verruculous covering. 3, Spore with
punctulated covering. 4, The same. 5, Minute spores with blue-greenish
colored contents, 0.0021 millimeter in diameter. 6, Larger form of 5. 7,
Transparent spherical spore, contents distinctly refracting the light,
0.022 millimeter in diameter. 8, Chroococcoid minute cells, with
transparent, colorless covering, 0.0041 millimeter in diameter. 9,
Biciliated zoospore. 10, Plant of the Gemiasma rubra, thallus on both
ends attenuated, composed of seven cells of unequal size. 11, Another
complete plant of rectangular shape composed of regularly attached
cells. 12, Another complete, irregularly shaped and arranged plant. 13,
Another plant, one end with incrassated and regularly arranged cells.
14, Another elliptical shaped plant, the covering on one end attenuated
into a long appendix. 15, Three celled plant. 16, Five celled plant.
10-16 magnified 440/1.]

I wish to conclude this paper by alluding to some published
investigations into the cause of ague, which are interesting, and which
I welcome and am thankful for, because all I ask is investigations--not
words without investigations.

The first the Bartlett following:

Dr. John Bartlett is a gentleman of Chicago, of good standing in the
profession. In January, 1874, he published in the _Chicago Medical
Journal_ a paper on a marsh plant from the Mississippi ague bottoms,
supposed to be kindred to the Gemiasmas. In a consideration of its
genetic relations to malarious disease, he states that at Keokuk, Iowa,
in 1871, near the great ague bottoms of the Mississippi, with Dr. J. P.
Safford, he procured a sod containing plants that were as large as rape
seeds. He sent specimens of the plants to distinguished botanists, among
them M. C. Cook, of London, England. Nothing came of these efforts.

2. In August, 1873, Dr. B. visited Riverside, near Chicago, to hunt up
the ague plants. Found none, and also that the ague had existed there
from 1871.

3. Lamonot, a town on the Illinois and Michigan Canal, was next visited.
A noted ague district. No plants were found, and only two cases of
ague, one of foreign origin. Dr. B. here speaks of these plants of Dr.
Safford's as causing ague and being different from the Gemiasmas. But he
gives no evidence that Safford's plants have been detected in the human
habitat. In justice to myself I would like to see this evidence before
giving him the place of precedence.

4. Dr. B., Sept. 1, 1873, requested Dr. Safford to search for his plants
at East Keokuk. Very few plants and no ague were found where they both
were rife in 1871.

5. Later, Sept. 15, 1873, ague was extremely prevalent at East Keokuk,
Iowa, where two weeks before no plants were found; they existed more
numerously than in 1871.

6. Dr. B. traced five cases of ague, in connection with Dr. Safford's
plants found in a cesspool of water in a cellar 100 feet distant. It is
described as a plant to be studied with a power of 200 diameters, and
consisting of a body and root. The root is a globe with a central cavity
lined with a white layer, and outside of these a layer of green cells.
Diameter of largest plant, one-quarter inch. Cavity of plant filled with
molecular liquid. Root is above six inches in length, Dr. B. found the
white incrustation; he secured the spores by exposing slides at night
over the malarious soil resembling the Gemiasmas. He speaks of finding
ague plants in the blood, one-fifteen-hundredth of an inch in diameter,
of ague patients. He found them also in his own blood associated with
the symptoms of remittent fever, quinine always diminishing or removing
the threatening symptoms. Professors Babcock and Munroe, of Chicago,
call the plants either the Hydrogastrum of Rabenhorst, or the Botrydium
of the Micrographic Dictionary, the crystalline acicular bodies being
deemed parasitic. Dr. B. deserves great credit for his honest and
careful work and for his valuable paper. Such efforts are ever worthy of
respect.

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