Vol. XXX ST. LOUIS, AUGUST 25, 1906. Papers for the original department must be contributed exclusively to th's magazine, and should be in hand at least one month in advance. French and German articles will be translated free of charge, if accepted. A liberal number of extra copies will be furnished authors, and reprints may be obtained at cost, if request accompanies the proof. Engravings from photographs or pen drawings will be furnished when necessary to elucidate the text. Rejected manuscript will be returned if stamps are enclosed for this purpose. COLLABORATORS. ALBERT ABRAMS, M. D., San Francisco. ARTHUR R EDWARDS, M. D., Chicago, Ill. Mr. REGINALD HARRISON, London, England. HOBART A. HARE, M. D., Philadelphia. THOMAS LINN, M. D., Nice, France. LEADING ARTICLES A CASE OF CAMPHOR POISONING.* O. M. RHODES, B. S., M. D. BLOOMINGTON, ILL. ON August 25, 1905, just at the noon hour, I was called by phone to come three miles into the country. A woman was phoning, and as she was excited and crying, 1 was unable to get the details, but managed to infer that something serious had happened her husband. I was there in about fifteen minutes. Several neighbor men who were helping on the farm were rubbing and doing such things as seemed to them best to relieve the victim, whom I found sitting in a chair, fearing to lie down and being unable to stand. Respirations 60-70 per minute; pulse 130 and weak, but regular. Face bore an anxious expression and was very pale; lips cyanotic; pupils practically normal and equally dilated. Cold perspiration on forehead and face; extremities cold and trembling. Patient was thoroughly conscious but was unable to speak above a whisper, and then but a few words and with much difficulty. On inquiry I succeeded in gathering from the patient himself that he had taken a dose *Read before the Brainard District Medical Society, at Bloomington, Ill., October 26, 1905., No. 4 from a bottle which contained only camphor and alcohol. It occurred to me that I might have a case either of wood alcohol or camphor poisoning, but on smelling the bottle I decided it must be camphor. Immediately gave 1-250 gr. of glonoin by the mouth and 1-30 gr. of strychnia nitrate hypodermically. Within a very few minutes there was a cessation of difficult breathing, but it was soon followed by another wavelike attack which began, as the patient afterwards told me, in the feet and swept up the limbs and arms to the back, and finally to the top of the head. This he complained of as being a very peculiar feeling, as if the top of his head were lifting off, or as if he were swinging in the air. Marked dyspnea accompanied each wave-like attack, which was increasing in frequency, duration and severity until the glonoin and strychnia were given. Shortly after giving the above I gave a pint of warm water, to which a little salt had been added, to precipitate any camphor remaining in the stomach, and also to promote vomiting, the patient at this time being sufficiently recovered to object strenuously to the passage of the stomach tube. The warm salt water produced free enmeses. The vomited matter consisted of material resembling the precipitate formed by placing camphor in water and smelled strongly of camphor. Several pints of the warm salt solution were repeated and vomited until the stomach was apparently pretty well cleansed. From this time on the improvement was rapid, but there was slight dyspnea for a day or so, and from the continuance of a few doses of glonoin and strychnia no further attention was given. As expressed by the all, at any time. patient after the attack there was no pain at There was a tingling and numbness of the whole body, beginning in the toes and extending upwards, and for the time being a paralysis of the legs. There was a feeling of swinging in the air and a sense of impending death from inability to breathe. There was no nausea before the warm salt solution was given, no cramps or diarrhea. By way of explanation I will say that the mixture taken (sample exhibited) was said to be made up of two ounces of gum camphor dissolved in one pint of alcohol, or sixty grains of camphor to one ounce of solution or seven and one-half grains to the drachm of solution. The patient had been in the habit of taking a teaspoonful of this solution at frequent intervals with no ill-effect, but this time took without measuring, probably twice that amount or two teaspoonful of solution. As the ordinary so-called teaspoon holds considerably more than one dram, it is fair to suppose that the individual had been in the habit of taking about 10 grs. of camphor cr the maximum dose, but this time probably took between 20 and 30 grains. According to Potter as many as 2 grs. of camphor have been taken without fatal results, yet 6 or 7 grs., have produced extreme drowsiness and weakness of the pulse. Twenty grs. laid an Alpine guide up for a day. It was about one-half hour after the dose had been taken that I saw the case, and I was not with him more than one hour. THE HUACOS (MUMMY-GRAVE) POTTERIES OF OLD PERU (A STUDY IN PRE-COLUMBIAN PATHOLOGY). ALBERT S. ASHMEAD, M. D. NEW YORK. ON digging up the graves of the cemeteries of ancient Peru, we find by the side of the mummified body certain objects of use to him. His pious hands always have placed within reach somethings thought to be necessary for his eternal voyage. In so dry a climate as Peru is, drink especially was thought to be indispensable. Hence the Hence the was taken that the departed loved one should have at hand a number of clay vessels or bottles, filled with wine or water, so that thirst might be appeased. These vases are of human shape. And as in the case of those little statuettes of the Egyptians, or of the earthern glasses of the Greeks in the tombs of Tanagras, these huacos pots of the old Peruvians, command our greatest admiration. Historians agree in recognizing in those Grecian and Egyptian images the double or soul which survives the departed one. Death was believed to be only definitive, when the statuetttes had disappeared. This belief in a soul, so widespread in all peoples, also existed in old Peru. To more completely satisfy it, these people, of the ancient Incan civilization, found it convenient to transform their drinking vessels into the image of the deceased. The potteries thus had a pleasing reality also to the artist, who evidently took keen delight in depicting this belief, to make it more real. The variations in form and manner of exhibition of the soul, are quite numerous, from the representation of the infant, to that of the old man or woman, from the fat to the lean, and with every expression of physiognomy, the sad the joyous, the angry, etc. Many are shown with musical instruments in their hands. Curator Chas. W. Mead of the Department of Archeology, in the American Museum of Natural History, New York, has fully studied the question of the musical instruments of the Incas of old Peru. He has published a plate, showing an ancient Peruvian dance around the wine or water bottles of old Peru placed upon the ground. One of the dancers is represented with a square block for a foot, evidently he was a cripple. The musical instruments represented at the dance, are being played. There is a newly born child. shown tied to the back of a woman. The plate is a reproduction of the decoration on a pottery vessel of old Peru. Drums which are represented in the hands of some of the human shaped grave potteries of Peru, are never found buried with the mummies, only their representations in the clay of the vessels. The skins of some of the old Peruvian drums were obtained from the human skin of an enemy. The drum idea, therefore, was not consonant with the idea of the soul's peaceful passage to Paradise. Wine and water bottles, as we find them in the graves, are connected with the sick or dying, the thirsty, and those needing medical care, or administration of liquid medicine. The drums were beaten only to ward off sickness. These wine or water bottle dances of old Peru were in reality "sick dances." The participants acted around the wine or water bottles, which at the death of patients, would be buried, as the image of the diseased one, as his "double," or representative of his soul, in the grave with him. The musical instruments then in the hands of so many sick or mutilated persons in supplicant attitudes represented in clay, on the mummy-grave pots, does not mean in my opinion, that the individuals represented as holding them were really beggars, because of their mutilations, but rather that they were sick persons, and were applying superstitious. medical care, the best they knew; they were trying to frighten away the evil spirit of their diseased condition. It was, like their dances were, a medical performance or treatment. They perhaps supplicated some god, in this superstitious manner of praying to cure themselves of their diseases. There are other interesting and characteristic vases representative of mutilations of the nose, lips and legs on the anthropomorphous clay figures. phous clay figures. These more particularly have given rise, for several years past, to ex tended discussion in the anthropological scientific world, as to the causes or meaning which should be attributed to the lesions. I have the honor of first bringing forward this question and of introducing this last subject to the attention of the Anthropological Society of Berlin. The discussion was participated in by Prof. Virchow, Dr. Polakowsky, Dr. Ed. Seler, Professors von der Steinen, Bastian, Reiss of Berlin, Jimenez de la Espada of Madrid; Stubel, Middendorf and Dr. Lehman-Nitsche, the director of La Plata Museum, Argentina. This last named gentleman afterwards went most thoroughly over the work, and his publications and those of others in South America upon the same question, since the original discussion, are already too numerous to mention. Suffice it to say, that the position of opinion which I originally took respecting these evidences of religious medical evolution, in the brain of ancient Peruvians, has been corroborated by scientists all over the world, and the opinion has been since accepted by the authorities of the Smithsonian. In the argument, among other things, it was said that the causes of such lesions as appear on the faces of the human shaped clay-images, must be due to mutilations, intentionally applied as punishments, or else to effects of disease. Today there is not one of scientific standing, in the anthropological world, who accepts, or dares to defend the first opinion, originally propose by Carras quilla, of Bogota, Colombia; notwithstaning the fact that in the literature, there are indications which make known to us that ancient Peruvians mutilated individuals for certain misdeeds. This subject was reservedly considered by Lehman-Nitsche, until he had looked into the matter with more exceeding carefulness. But even this cautious savant after he had gone into the matter deeper finally was compelled to yield, that my contention against Carrasquilla's position was sound. The old writers on ancient America, treat of servants and guardians of the women of the Cacique of Puna, who were horribly mutilated, and their noses and ears cut off for the purpose of giving them a less seductive appearance. There was also cited the passage from Oviedo, who informs us, that they likewise, as penalty, plucked out the eyes of certain delinquents. Herrara, however, does not mention directly this class of condemned, although he speaks of stones on the shoulders, tortures and death as penal'ies that were applied as late as his time. But it is not possible to deduce clearly from his statements what these tortures consisted of; whether they were plucking out the eyes, or effecting other mutilations, such as cutting off the nose, etc., of the condemned. From what we read in the chapter of Herrara, where he treats of the different penalties, we know only that the justice of old Peruvians was exceedingly cruel, and consequently, it would be strange if there had not been amputations of nose, lips, etc. Garcillaso cites as penalties: death, the lash, banishment and others like these. His text continues: "Certainly considering that the rigor of their laws had for the most part, even for unchastity, which was considered crime, the penalty of death it may be said that they were barbarian laws." Throwing criminals from a precipice, was a method of penalty in old Peru, but here the intention was to kill the transgressor. This method was not applied to enemies who were beheaded and their skulls carried home, as trophies or embalmed (resins before the flesh had naturally Idried on the bones. In spite then of the possibility, I insist still on the point that there is nowhere mentioned, direct data, in pre- or post-Columbian publications, to prove that the mutilations offered on the old Peruvian Huacos potteries, treat really of penalties. Some neighboring tribes, more savage perhaps, may have practised it. Carrasquilla has communicated a passage from Restrepo's work (which I have in my library) on the ancient Chibchas, wherein it is stated according to an old chronicle: "They cut off the hands, nose and ears, and give lashes for other transgressions, considered less grave." In Historia de las Indians by Francisco Lopez de Gomara (which I found by the courtesy of Dr. Delgado in the library at Seville, where most of the archives of the Indies are deposited, rather than in the Vatican at Rome) the following passage occurs (it is this which probably has served for Restrepo's reference) Gomara speaks of the chastisements which were used in Bogota (Carrasquilla's country) against malefactors. "They punish severely public sins, theft, murder and sodomy, which is not allowed, by whipping, taking off the ear, cutting off the ear, cutting off the nose, hanging, etc. And for nobles or honored persons, they cut the hair of the head, as punishment or tear the sleeves of the shirt." intention is to hide the stumps of the ears. For then why should not the disgrace of the other stumps be concealed too. If the loss of ears was due to punishment the loss of nose and feet would also be due to the same dis. grace of disfigurement, perhaps greater. Many representations, too, show blind persons. In place of the eyes, there are deep cavities, or the eyelids are closed, and the supplicant attitudes of these same unfortunates, give greater proof that they have lost the light of day. In the presence then of such cases we must ask the question, Can they be punished tention that such cases represented pre-Columbian leprosy, was an error. Only one per Supported Virchow in his contention, a Mr. Bloch, of Berlin Mr. Virchow thus made a grave mistake, leprosy was not known in Pre-Columbian America. A third explanation of some of the vases was later published by myself; on a vase submitted by Prof. Bastian, of the Royal Museum, Berlin. It belonged to Prof. von den Steinen, and was in the care of Dr. Edward Seler, curator of the American Potteries of the Museum. It had been found at Chimbote, Peru. The tip of nose and the This Huacos has hands, in what we would term. an attitude of supplication or prayer. Perhaps the feet are gone. but this is not sure. criminals who have had their eyes put out or did they lose their sight in some other way, by disease or surgical remedy for disease for example? As to the first category of vases, those which present mutilated noses, lips, and so often legs cut off at the ankle, today the opinion that they treat of delinquents is not admitted. It is believed, on the contrary, that they represent effects of a disease typical to Peru, Uta, skin tuberculosis (wolf-cancer) a kind of lupus. It has also been accepted as proved that Virchow's con upper lip were represented destroyed cleancut off, the cheeks blown out," and furrowed with wrinkles and scars. This vase showed especially surgical knife treatment for the cure of some disease. The nose and upper lip had been cut off, not eaten off by disease, crudely, as shown in so many other vases. Here it was said, is an instance of punishment by cutting off the nose and upper lip. But why should the "punishment" have included the upper lip. On the contrary, we have many instances showing eating away of nose and upper lip, and therefore it is more logical to deduce that the cutting away of the nose and upper lip, in this one instance was done as treatment for the same disease afflicting so often the nose and upper lip. Besides, the very disease uta, the disease which afflicts nose and upper lip in Peru, is repre. sented on the face of one of my pots, by a bug like a beetle molded in the clay; it is represented as eating the flesh. The word 'Uta" in old Peru, means eating "away." And the disease was supposed by the common people to be due to some bug. In very truth the disease was due to bugs and other insects, which fed on dead parrots, dead of tuberculosis; and thus the inoculations of human beings with the consumption germ originally occurred in old Peru. Uta, the Peruvian disease, is in reality skin tuberculosis. What I have here said, will suffice to explain the very great interest which was aroused in scientific circles by my presentation of these objects of ceramics with their pathological questions for the history of medicine. There are some other vases with anthropomorphous pathological aiterations which were taken into the account. A vase belonging to the celebrated collection of Garcia Meron, is in the La Plata Museum, of Buenos Aires. It formerly belonged in the United States. It represents a "beggar" who offers a cup in the right hand in act of supplication, while the left hand holds a stick to crawl with, with more facility and sureness. This vase represents only imperfectly the exiremities. The left leg is entire while the right terminates in a stump. On the remainder of the body there is no sign of disease. Among Peruvian vases there are many of this style some of them are described in my various publications. Yet this is the first one known to me where the expert artist has taken the pains to draw so well on the surface of his clay instead of completely modeling it the lower extremities, and which when not modeled generally escape his consideration altogether. Although in Pre-Columbian Peru they did. not apply as punishment amputation of the feet we must here admit that the represented "beggar" has lost a foot either by disgrace or that it was an amputation in strict accordance with surgical art for another reason. It must not be overlooked too that perhaps it treats of chronic disaese of the foot or leg by which the patient had encountered much difficulty in getting around with it perpetually bandaged, or in an offensive condition. In fact the remaining right leg is shown on this image, still bound about, with bandages. This is easily recognizable, for its color is the same as that of the shirt. The modeling of the superficially traced other extremity is crude, but recognizable. The healthy foot is represented angular and clumsy, while the stump extremity has been executed most delicately. May we not then assume that it was some disease of the leg, which made it impossible for him to walk, which forced him to amputate it, and become a supplicant for medical relief, or for alms? The more sensible conclusion appears to be that he had preferred mutilation to the diseased impediment. We cannot prove this with absolute certainty but it is interesting in our study of old Peruvian ceramic art. I have some time ago published a vase representing a beggar walking on his knees with stumps of amputated limbs protruding behind him. I published also a representation of one who held across his knee the stump of his other leg amputated at the ankle; he dresses it from a cup, supposibly of salve. I reproduce here from the American Museum, New York, an image of a man holding with his hands his foot with the sole turned up across his other knee. He is examining it critically. The sole of this foot is represented eaten sieve-like with numerous perforations, showing multiple perforating ulcers, a condition just like the Peruvian disease Uta would be likely to produce.* Many anthromorphous vases from Peruvian graves have the face and head modeled in a masterly way, and likewise the other parts of the body, but with details inexact, and more or less faulty. In some in place of lower extremities, there are simply unfinished cut off stumps; in others, for toes, there are only plain surfaces, upon which are markings, and these made with but little care, so that many have six toes for a foot. This error is thought by some "scientists" to represent teratology or polydactylisin. I have in all my writings defined as amputations these mutilations of lower extremities, shown on the potteries exhumed with Ancon mummies. In my general consideration of the subject in an article entitled "The Question of Pre This opinion, however, is not concurred in by Mr. Chas. W. Mead, who has kindly furnished me with this photograph, as will be seen by the following letter. Mr. Mead's proposition I think is untenable, for the reason that the upper lip of the figure is represented diseased. "American Museum of National History, (Department of Anthropology) 71st and Central Park West, NEW YORK, April 27, 1906. DR. ALBERT S. ASHMEAD: Dear Sir: Professor Saville turned your letter, requesting photo of Pachacamas vessels, over to me. I took the vessels immediately to the museum photographer, but he has been so busy that I have been unable, until now, to get a print. I think the cavities in the soles of the feet represent the pits left after extracting the egg sac of the pique, a species of sand-flea. (See Dr von Tschudi-Travels in Peru Trans. by ThimasinaRoss, pp. 156, 157.) Yours sincerely, CHAS. W. MEAD." |