Chapter 6

Once introduced into Hawkins' native country, England, the rise of the upright piano became rapid. In 1807, at latest, the now obsolete high cabinet piano was fairly launched. In 1811, Wornum produced a diagonal. In 1813, a vertical cottage piano. Previously, essays had been made to place a square piano upright on its side, for which Southwell, an Irish maker, took out a patent in 1798; and I can fortunately show you one of these instruments, kindly lent for this paper by Mr. Walter Gilbey. I have also been favored with photographs by Mr. Simpson, of Dundee, of a precisely similar upright square. I show his drawing of the action--the Southwell sticker action. W. F. Collard patented another similar experiment in 1811. At first the sticker action with a leather hinge to the hammer-butt was the favorite, and lasted long in England. The French, however, were quick to recognize the greater merit of Wornum's principle of the crank action, which, and strangely enough through France, has become very generally adopted in England, as well as Germany and elsewhere. I regret I am unable to show a model of the original crank action, but Mr. Wornum has favored me with an early engraving of his father's invention. It was originally intended for the high cabinet piano, and a patent was taken out for it in 1826. But many difficulties arose, and it was not until 1829 that the first cabinet was so finished. Wornum then applied it in the same year to the small upright--the piccolo, as he called it--the principle of which was, through Pleyel and Pape, adopted for the piano manufacture in Paris. Within the last few years we have seen the general introduction of Bord's little pianino, called in England, ungrammatically enough, pianette, in the action of which that maker cleverly introduced the spiral spring. And, also, of those large German overstrung and double overstrung upright pianos, which, originally derived from America, have so far met with favor and sale in this country as to induce some English makers, at least in the principle, to copy them.

I will conclude this historical sketch by remarking, and as a remarkable historical fact, that the English firms which in the last century introduced the pianoforte, to whose honorable exertions we owe a debt of gratitude, with the exception of Stodart, still exist, and are in the front rank of the world's competition. I will name Broadwood (whose flag I serve under), Collard (in the last years of the last century known as Longman and Clementi), Erard (the London branch), Kirkman, and, I believe, Wornum. On the Continent there is the Paris Erard house; and, at Vienna, Streicher, a firm which descends directly from Stein of Augsburg, the inventor of the German pianoforte, the favorite of Mozart, and of Beethoven in his virtuoso period, for he used Stein's grands at Bonn. Distinguished names have risen in the present century, some of whom have been referred to. To those already mentioned, I should like to add the names of Hopkinson and Brinsmead in England; Bechstein and Bluthner in Germany; all well-known makers.

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THE POISONOUS PROPERTIES OF NITRATE OF SILVER, AND A RECENT CASE OF POISONING WITH THE SAME.

[Footnote: Read before the Medico Legal Society, April 5, 1883.]

By HENRY A. MOTT, JR., Ph.D., etc.

Of the various salts of silver, the nitrate, both crystallized and in sticks (lunar caustic, _Lapis infernalis_), is the only one interesting to the toxicologist.

This salt is an article of commerce, and is used technically and medicinally.

Its extensive employment for marking linen, in the preparation of various hair dyes (Eau de Perse, d'Egypte, de Chiene, d'Afrique), in the photographer's laboratory, etc., affords ample opportunity to use the same for poisoning purposes.

Nitrate of silver possesses an acrid metallic taste and acts as a violent poison.

When injected into a vein of an animal, even in small quantities, the symptoms produced are dyspnoea,[1] choking, spasms of the limbs and then of the trunk, signs of vertigo, consisting of inability to stand erect or walk steadily, and, finally retching and vomiting, and death by asphyxia. These symptoms, which have usually been attributed to the coagulating action of the salt upon the blood, have been shown not to depend upon that change, which, indeed, does not occur, but upon a direct paralyzing operation upon the cerebro-spinal centers and upon the heart; but the latter action is subordinate and secondary, and the former is fatal through asphyxia.

[Footnote 1: Nat. Dispensatory. Alf. Stille & John M. Maisch, Phila., 1879, p. 232.]

One-third of a grain injected into the jugular vein killed a dog in four and one-half hours, with violent tetanic spasms.[1]

[Footnote 1: Medical Jurisprudence. Thomas S. Traill, 1857, p 117.]

Devergie states that acute poisoning with nitrate of silver, administered in the shape of pills, is more frequent than one would suppose. Yet Dr. Powell[1] states that it should always be given in pills, as the system bears a dose three times as large as when given in solution. The usual dose is from one-quarter of a grain to one grain three times a day when administered as a medicine. In cases of epilepsy Dr. Powell recommends one grain at first, to be gradually increased to six. Clocquet[2] has given as much as fifteen grains in a day, and Ricord has given sixteen grains of argentum chloratum ammoniacale.

[Footnote 1: U.S. Dispensatory, 18th ed., p. 1049. Wood & Bache.]

[Footnote 2: Handbuch der Giftlehre, von A. W. M. Von Hasselt. 1862, p. 316.]

Cases of poisoning have resulted from sticks of lunar caustic getting into the stomach in the process of touching the throat (Boerhave)[1]; in one case, according to Albers, a stick of lunar caustic got into the trachea.

[Footnote 1: Virchow's Archiv, Bd. xvii., s. 135. 1859.]

Von Hasselt therefore urges the utmost caution in using lunar caustic; the sticks and holder should always be carefully examined before use. An apprentice[1] to an apothecary attempted to commit suicide by taking nearly one ounce of a solution of nitrate of silver without fatal result. It must be remarked, however, that the strength of the solution was not stated.

[Footnote 1: Handbuch der Giftlehre, von A. W. M. Von Hasselt. Zweiter Theil, 1862. p. 316.]

In 1861, a woman, fifty-one years old, died in three days from the effects of taking a six-ounce mixture containing fifty grains of nitrate of silver given in divided doses.[1] She vomited a brownish yellow fluid before death. The stomach and intestines were found inflamed. It is stated that silver was found in the substance of the stomach and liver.

[Footnote 1: Treatise on Poison. Taylor, 1875, p. 475.]

It is evident that the poisonous dose, when taken internally, is not so very small, but still it would not be safe to administer much over the amounts prescribed by Ricord, for in the case of the dog mentioned one third of a grain injected into the jugular vein produced death in four and one-half hours.

The circumstance that more can be taken internally is explained by the rapid decomposition to which this silver salt is liable in the body by the proteine substance and chlorine combinations in the stomach, the hydrochloric acid in the gastric juice, and salt from food.

The first reaction produced by taking nitrate of silver internally is a combination of this salt with the proteinaceous tissues with which it comes in contact, as also a precipitation of chloride of silver.

According to Mitscherlich, the combination with the proteine or albuminous substance is not a permanent one, but suffers a decomposition by various acids, as dilute acetic and lactic acid.

The absorption of the silver into the system is slow, as the albuminoid and chlorine combinations formed in the intestinal canal cannot be immediately dissolved again.

In the tissues the absorbed silver salt is decomposed by the tissues, and the oxide and metallic silver separate.

Partly for this reason and partly on account of the formation of the solid albuminates, etc., the elimination of the silver from the body takes place very slowly. Some of the silver, however, passed out in the fæces, and, according to Lauderer, Orfila, and Panizza, some can be detected in the urine.

Bogolowsky[1] has also shown that in rabbits poisoned with preparations of silver, the (often albuminous) urine and the contents of the (very full) gall bladder contained silver.

[Footnote 1: Arch. f. Path. Anatomie, xlvi., p. 409. Gaz. Med de Paris, 1868, No. 39. Also Journ. de l'Anatomie et de la Physiologie, 1873, p. 398.]

Mayencon and Bergeret have also shown that in men and rabbits the silver salt administered is quickly distributed in the body, and is but slowly excreted by the urine and fæces.

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 fæces 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 Palmellæ.

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, Oscillatoriaceæ. 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. Oscillatoriaceæ. 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. Oscillatoriaceæ. 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 algæ 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 æruginosa 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.