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May. 1899.] T H E O P T BO PI CA L M E D I CI N E . 26 1

ST . ERMIN'S ,W E 8 T = 'NHIGH-CLASS RESIDENTIAL HOTEL.

Handiomely Furnished Suites or Single Chambers.Cuisine, Luxury, and Comfort.

Unexcelled forSPECIAL ACCOMMODATION FOR INVALIDS.

O r i g i n a l C o m n r o n i e a t i o n s .A NOTE ON LATH YEISM.

By W. J. BUCHANAN, B.A., M.B., Dipl. State Med. (Dubl.).Capt., I.M.S. ; Superintendent, Central Jail, Bhagalpur, Bengal.

T H E accompanying photographs (see plate) illus-t rate, as far as stance and gait are concerned, the

the people of the country are well aware of its noxiousproperties and only use it as a food in times ofscarcity, and then only with the hope of being ableto soon stop its use. The occasional use of this pulse,or its use along with Other food grains, is harmless orattended with symptoms of colic, dyspepsia, &c, only ;bu t if freely emp loyed, especially for long period s, theform of paraplegia known as lathyrism is a veryfrequent sequel. In olden days , when famines werelooked upon as visitations of Providen ce, to beregretted but scarcely prevented, we heard muchmore of this disease. Now a-days it is rare, and I haveonly been able to hear of a few cases during therecent famine in the district of Gaya and Shahabad inBengal, and in the Central Provinces. Wh ereas, in1860, Dr. Irving ha s recorded th at in one Bengaldistrict no less th an 4 per cent, of the populationsuffered from its toxic effects. Colonel Sleem an'saccount of the disease, as seen by him in Oudh in thefamine years 1831 to 1833, is as follows : " I n 1833,"he writes, " the younger part of the population of thevillages of Eastern Oudh, from the age of thirtydow nw ards, began to be deprived of the use of the irlimbs below the waist by paralytic strokes, in all casessudden, but in some more severe than in others.About half the yo uth of thes e v illages of both sexesbecame affected durin g 1833 and 1834, and m anyhaving lost the use of their limbs entirely are unableto move. . . . T he yo uth of the surround ingvillages in which hesri formed the chief article of foodhave suffered in an equal degree. . . . no persononce attack ed has been found to recover the use ofth e limbs affected. They describe the attack ascoming on suddenly, often during sleep and withoutany warning."

That we have heard so little of this disease ofrecent years is due to the fact that Government hasrecognised it as part of " t h e white man's b urd en"to " fill full the mouth of famine."

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262 THE JOUENAL OF TEOPICAL MEDICINE. [May, 189Mutiny in 1857) gives a description to the sameeffect : " Limbs and joints appear loose, weak, andagitated, and give so much at every step that whilethe person is walking the figure has a constant up-and-down motion . . . the patient walks dragginghis toes along the ground."The two illustrations show this stance and charac-teristic movement of the limbs.The skin reflexes are usually lessened, and the knee-jerk and ankle-clonus exaggerated. The patient isusually emaciated, and often takes up the trade ofbeggar, and hops with the aid of a long stick all overthe district. The condition appears to be incurable.The Pathology of this disease has been inferredbriefly from the symptoms, which point to implicationof the posterior and lateral columns of the cord.Cantarri, of Naples, has described the post-mortemappearances in some cases. He appears to havefound no affection of the spinal cord, but describes afatty degeneration of the muscles, especially theadductors of the lower extremities, the transversestriae being diminished and the ultimate fibres con-taining little drops of oil.

JEtiology.That these symptoms of paraplegia willfrequently follow the prolonged and excessive use ofLathyrus sativus is well known to the people in India,but it is only in times of scarcity that they makemuch use of this pulse.2 Its use is forbidden in allGovernment institutions in India.Astier is quoted by Watt (op. cit., p. 592) as havingfound by analysis a volatile liquid alkaloid probablyproduced by some proteid ferment, which exhibits thetoxic effects of the seeds, and which is destroyed byheat. The importance of this discovery lies in thefact that the alkaloid is volatile. It is thereforeprobably absent when the food is thoroughly cooked.

The toxic effects of this pulse are not confined tothe human species. Similar effects have been notedamong cattle and horses. In Smith's " Veterinary

THE ETIOLOGY AND TEEATMENT OFBLACKWATEE FEVEE.B Y L. W. SAMBON, M.D. (NA PLE S).London.

I I .Is IT QUININE POISONING?

PROFESSOR TOMASELLI, of Catania, being aw:that the clinical features of blackwater fever diffeiwidely from those of the co-endemic malarial deases, and having observed that the administratiof quinine frequently aggravated the blackwaiparoxysms or seemed to provoke new relaps