[1] This case has been reported in detail, in the Medical Gazette of
Paris, of the 5th of January, 1839, by the attending physicians, _Maïa_
and _Reis_. We transcribe it for the benefit of our readers.
Mariano José Machado, fifty years old, of athletic form, bilious-sanguine
temperament, was afflicted with elephantiasis leontina Alibert. The whole
body, especially the extremities, were insensible. The skin and the
cellular tissue were thickened, hard, rugose and covered with tubercles
which were somewhat raised but not ulcerated. A few pustules under the
arms, looked like itch-pustules, and seemed to indicate a complication
with this disease. The epidermis and nails began to alter, and the
fingers had lost their normal shape. Internally, the patient felt quite
well, enjoying both vigor of mind and body. After six years of suffering,
he had come to the determination to try this dreadful experiment, which
would either lead to death or a deliverance from his horrible affliction.
On the morning of the fourth of September, at fifty minutes past eleven
o’clock, he was bit by a rattle-snake, the crotalus cascavella, in
the two last fingers near the metacarpus. He felt neither the bite,
nor the poison as it penetrated into the wound. A few drops of blood
came out of the wound, and the hand began immediately to swell.—In
five minutes: slight feeling of coldness in the hands.—Twelve o’clock:
slight pain in the hollow of the hands.—Twenty minutes: the hand swells
a good deal.—Thirty minutes: swelling of the jugular veins. Alteration
of the features. Formication in the face.—Fifty-five minutes: the
sense of swelling extends through the whole forearm.—Twenty minutes
past one: trembling of the whole body.—Thirty-six minutes past one:
the head is affected, with frequent pulse, difficulty of moving the
lips, disposition to slumber, constriction of the throat, violent pain
in the whole arm, the hand swells more and more.—Thirty-eight minutes
past one: sense of chilliness; the patient covers himself.—Forty-eight
minutes past one: pain in the tongue and larynx, increased pains and
swelling of the bitten hand; sense of coldness in the feet.—Twenty-five
minutes past two: difficulty of swallowing,—anguish,—copious sweat on
the chest.—Fifty minutes: weakness of the arms,—nosebleed,—anguish,
now and then,—restlessness,—pulse 96.—In three hours and forty
minutes: pulse 100.—Fifteen minutes: intensely violent pains in the
arms.—restlessness.—Thirty minutes: pulse 98,—red face,—continual
bleeding of the nose.—Thirty-five minutes: the patient drinks some wine
and water without any difficulty, and changes his linen which was all
wet from the perspiration.—Intense redness all over.—In four hours:
pulse 100,—the whole of the skin, especially on the bitten arm, is
very red,—violent pains in both arms, which do not leave the patient
any rest,—constriction of the throat,—impeded respiration.—Fifty
minutes: pulse 104,—the body is very hot all over,—flow of saliva.—In
five hours, thirty minutes: torpor,—copious emission of urine,—thick,
viscid saliva, which it is difficult to get out of the mouth,—muscular
debility,—frequent moaning on account of the pains which he feels
in the whole body,—quiet breathing,—pulse full and frequent, skin
soft,—the bitten hand swells enormously.—In seven hours: somnolence
with moaning,—after waking the pains in the arms are less, but he
experiences violent pains in the chest,—sensation of a lump in his
throat,—copious emission of urine,—great difficulty of swallowing, white,
viscid saliva,—discharge of a bloody liquid from the nose,—inability to
swallow a drink composed of water, sugar and brandy.—In eight hours:
the sweating abates,—restlessness,—moaning,—emission of urine.—In nine
hours, ten minutes: the moaning ceases,—deep sleep.—In ten hours: takes
an infusion of guaco,—pulse 108,—the bloody discharge from the nose
ceases,—shrivelling of the tuberculous formations on the arms and in
the face, they exhibit an erysipelatous redness.—In ten hours, twenty
minutes: emits two ounces of a natural urine,—a few minutes’ quiet
sleep, without moaning.—In ten hours, forty minutes: the pains abate
a good deal, but he complains of pains in the thighs and feet, where
he had felt a considerable coldness until now,—pulse 108,—ordinary
thirst,—the patient sits up in order to drink, and swallows the drink
with ease.—In eleven hours: takes four spoonfuls of a strong infusion
of guaco.—In eleven hours, forty-five minutes: emits a deeply-colored
urine,—pulse 119,—the bitten hand and arm are very much inflamed and
intensely painful,—restlessness.—In twelve hours: quiet sleep, disturbed
by eructations,—pulse 112,—emission of urine.—In twelve hours, thirty
minutes: restlessness,—screams,—despair.—In twelve hours, forty minutes:
emission of urine,—pulse 116,—sensation of burning heat in the legs,
which he uncovers.—In thirteen hours: emission of urine,—quiet,—he takes
an infusion of guaco.—In fourteen hours: he sits up in bed, and drinks
water, during which he moves about violently and screams.—In fifteen
hours: emission of urine,—the swelling of the lower lips abates,—the
salivation ceases.—In fifteen hours, forty-five minutes: pulse
110,—involuntary motion of the right thumb and left foot.—In seventeen
hours: the patient feels very sick,—pulse 100,—frequent moaning.—In
nineteen hours: excessive debility,—involuntary motion of the lower
jaw, and lower extremities,—bloody urine.—In twenty hours: accelerated,
intermitting pulse,—increase of the convulsive motions,—the swelling of
the extremities, and the redness of the skin are less,—extreme difficulty
of swallowing,—anxious respiration.—In twenty hours, fifty minutes:
diminution of the convulsive motions.—In twenty hours, fifty-five
minutes: the convulsions cease.—In twenty-one hours: he takes an ounce
of lizard-oil, which he swallows with difficulty.—In twenty-one hours,
thirty minutes: death.—In a few minutes, the blue-colored body, swoll
considerably.—Twenty-three hours after death, the body had swollen
enormously, was covered with blue and red spots, and smelt so horridly
that no post-mortem examination could be made.—HEMPEL.
[2] To avoid unnecessary repetition, the natural order of the
symptoms has been left out, it being nearly the same as Hahnemann’s
arrangement—_Ed._