OF RHUS TOXICODENDRON.**

BY N. M. PAYNE, BATH, ME.

In November of 1857, I accidentally spilled some of the tincture of Rhus toxicodendron on the back, and ring finger of my left hand.

After the lapse of about 24 hours, itching, and burning commenced, lasting from 1/2 to 2 hours. After about 36 hours, swelling of the parts, with violent itching and burning, increased on touching or moving the parts affected, as if pierced by hot needles. White transparent vesicles appeared on the highly red and inflamed skin. Rheumatic pains in the knee joints, extending to the ankles, lasting from 4 to 8 hours. Violent throbbing, tearing, rending pains in the head. Burning pressure in the left eye. Biting and itching in the external surface of the lid, below and around the left eye, also on the cheeks and nose; nose feels sore as if abraded; sore feeling in the left nostril. Smarting and prickling around the mouth, with vesicular watery eruption below the vermillion border of the lower lip; lobule of the left ear swollen. Itching and burning in the rim and lobule of the left ear; dim sightedness; appearance as if gauze was before the eyes. Vesicular eruption on the cheek, with intense itching and burning. Violent burning, itching, and prickling in the swollen eyelids, and lobules of the ears. The epidermis peeled from the cheeks, leaving the parts hot and rough. Soreness in the corners of the mouth. Swelling of the prepuce, and glans penis. Violent itching, burning, prickling, and cutting around the root of the penis, and in the prepuce: transparent swelling extending from the prepuce to the scrotum -more on the left side, with watery vesicles, discharging a transparent fluid. Prepuce very sore, looks and feels like a scald. Great desire to sleep; constant drowsiness; with itching in the eyelids. Burning pain in the knee joints, and lower extremities; chills after 72 hours. Objects were seen double, and sometimes only one half of the object could be seen. Objects appeared to be removed only one half of the real distance. Intense itching in the eye ball. Feels desponding; don't like to be spoken to, nervousness; starts suddenly at every slight noise.

Fourth day; itching, burning, and stinging increased. Rending pain in the diaphragm, more so in the horizontal position. Pain in the knees and lower extremities; dull throbbing pain in the head, at intervals. Itching, burning, biting, and stinging, shifting from the face to the genitals, and from the genitals to the left hand. Left eye closed from swollen lids, with feeling as if a piece of glass or sand was in it.

Fifth day; severe pain in the diaphragm, and pit of the stomach, so distressing I could not lie in bed. Pain in the hips, knees and head; swelling about the head; swelling of the left hand and prepuce greatly increased; watery vesicles nearly covering the left hand. Rheumatic pains in the hands. The itching and swelling extended to the groin, and inside of the thigh, pubes and abdomen, as far as the navel.

Sixth day; itching and swelling of the left ear and lobule of the right ear, also of the left hand, increased to bursting of the skin. Swelling of the inguinal glands. Throbbing pain in the left hand, at intervals. Intense itching and stinging in the palm of the left hand, at intervals, worse in the evening; throbbing pain in the left hand extending to the elbow joint. Itching worse in the night and evening, also in the morning, from 1 to 2 hours, not so much in the day time. Swelling of the inguinal glands, after 8 days. Small boils on the pubes, gradually increasing in size and number. At midnight, intense itching, burning, and stinging, suddenly attacking the palm of the left hand, and extending to the elbow, lasting about two hours. In the palm of the left hand there was a considerable elevation, studded with itching vesicles, which burst and discharged serum in considerable quantity.

Ninth day; the itching was more severe in the morning, and consequently there was at this time, a freer discharge of serum. Pubic region very sore, from the great number of boils. On the 10th day; itching in the palm of the right hand; vesicles filled with opaque matter on the right hand; at midnight there was severe itching and prickling in the right hand as if it were asleep, lasting from 1 1/2 to 2 hours; left eye closed; very sore around the right eye; intense itching in right, groin; the little boils on the lower part of the abdomen, in the groins and on the inner parts of the thighs, were very sore and suppurated. On the 11th day, itching in the palm of the hand ceased, became very sore to touch, and the vesicular discharge became yellowish. On the 12th day, aching pains in the legs, inability to rest in any position but for a moment. Great drowsiness, languor in the afternoon, requiring great exertion to move about. The abdomen, thighs and groins are very sore, and red; boils the size of a walnut, discharging pus. Cold feet and legs; aching pains in the hollow of the feet.

Thirteenth day, unusual restlessness at night. Smarting, throbbing, burning pain in the boils on the pubes, and abdomen; chills and entire sleeplessness.

Fourteenth day; soreness returned around the left eye, left eye sore and swollen as if bruised; upper lid much swollen, and severe itching. Dull, aching pain in the pubic region. Mons veneris swollen to twice the normal size. 16th day; boils increased in size one third. 17th day; distressing pain in the stomach, as if closed, and being split open with a knife; could not remain in a horizontal position; violent headache. Severe itching and stinging in all the parts affected with the poison. 21st, 22d and 23d day; all the symptoms seemed to be renewed at this period. Itching, burning, stinging, and smarting at intervals; the parts were very sore to touch, dry and cracked; violent head ache. 24th day; intolerable itching on the pubic region. Boil on the edge of the upper lid of the left eye, the size of a pea, the eye again entirely closed. 30th day; boil on the left eyelid discharging freely, with abatement of swelling; new boils, in great numbers, are constantly appearing in the groins, on the legs and abdomen, and increasing in size, some half as large as a hen's egg. Inguinal glands swollen to a very great size. Pains in the legs alternating with cold feet; hollow of the feet ache with the cold.

Thirty-fifth day; constipation with continual urging to stool. Ineffectual stool with a great deal of flatulence, and rumbling in the abdomen; incessant headache, ineffectual desire for stool immediately after eating. Pain in the epigastrium.

Forty-fifth day; skin peeled from the left hand entirely. Itching intolerable. Skin peeling from all the parts affected. Constant urging and straining at stool. Pains in the knees and legs at short intervals, very sore. Many of the above symptoms did not disappear until after the sixtieth day.

More than twenty years ago I was thoroughly poisoned by Rhus toxicodendron when gathering the fresh plant, or shrub. My whole body, from the top of my head even to the ends of my toes, was enormously swollen; for eight or ten days my eyes were closed. Penis so badly swollen, could not void urine for five days; the symptoms were the same as those above described, only much more severe. About thirty days after the poisoning, a swelling came on the left side of my neck under the ramus of the lower jaw, which increased to the size of a man's fist, so large that it turned my face directly to one side, causing my chin to rest on the right shoulder. The swelling was quite hard, and disappeared in about two months, without suppurating. But the effects of the poison remained for eight years; when, after a typhoid fever (so called by the doctors,) which continued for thirteen weeks, all symptoms of the poisoning disappeared and never returned. During the eight years, continued constipation with violent headache, loss of appetite; almost constant pain in the epigastric region; sallow complexion; weakness of the joints of the lower extremities; restlessness and sleepless nights, with drowsiness during the day; great despondency; severe headache in the morning, immediately after rising, and great aversion to any kind of labor.

---