[Reprinted from The Medical News, October 24, 1891. 
UNUSUAL MODE OF TRANSMISSION IN A CASE 
OF DERMATITIS VENENATA. 
By J. ABBOTT CANTRELL. M.D., 
DERMATOLOGIST TO THE PHILADELPHIA HOSPITAL. 
Mary G., thirty-four years of age, was admitted into 
the general wards of the Philadelphia Hospital on Sep- 
tember 24, 1890, and was removed on October 26th to 
the maternity ward, where she was delivered of a male 
infant. She continued well until the 29th, when she 
complained of an itching and burning sensation of 
the abdomen, which showed an inflamed surface, cov- 
ered with vesicles and bullas. 
I subsequently learned that two nurses, one from the 
surgical and the other from the maternity ward, left the 
hospital at 2 p.m. on the 26th instant, taking a stroll 
through an adjacent cemetery gathering leaves and 
bringing a number back with them. Among the leaves 
were a number of ivy leaves, but this fact was not known 
by the nurses at this time. At 4 p.m. some of these 
leaves were placed on a table in the maternity ward, but 
in a separate compartment from that in which the 
patient was confined. They remained until the morn- 
ing of the 28th, when they were thrown away. The 
nurse stated that after her return her hands were washed 
several times with ordinary soap and water, and when 
dressing the young mother her hands came in contact 
with the skin of the abdomen, and thus probably con- 
veyed the ivy poison to the spot affected, as her hands, 
which at this time were apparently not affected, showed the eruption in a day or two. It also appeared on the 
abdomen of the patient at about the same time. 
I saw the patient for the first time, upon invitation of 
Dr. Barton Cooke Hirst, the obstetrician on duty, on 
October 29th, two and one-half days after her con- 
finement. I found situated upon the abdomen and sur- 
rounding the umbilicus, having a radius of full five 
inches, a vesicular and bullous eruption, with the whole 
surface swollen and edematous and covered with the 
characteristic yellowish-brown, gummy discharge of 
dermatitis venenata. Upon inquiry, I then learned the 
foregoing facts. After using a solution of fluid extract 
of grindelia robusta, two drachms to the pint of water, 
for about a week, the eruption entirely disappeared. 
From a search through the literature of the subject I 
can find only one parallel case-that referred to in an 
exhaustive work on the subject by Dr. J. C. White, of 
Boston. This patient was a child of six years, that had 
received the poison from a servant who was himself 
unsusceptible to the poison. This servant had been 
clearing weeds, among which were some ivy vines from 
the garden surrounding the house, after which he had 
washed his hands thoroughly several times with vinegar 
and soap after entering the house. In the afternoon he 
took the child to a pond for a bath, holding him by the 
armpits, and afterward rubbing the axillae and the back. 
In two or three days deep ulcers formed in both re- 
gions. 
The point of interest in these cases is the mode of 
contracting the disease. It has been known for years 
that the poison may be absorbed by handling the leaves 
or by being near the vine. In the latter case there 
seems to be an idiosyncrasy to the disease. I believe 
the case of Dr. White and this one are the only cases 
recorded wherein the disease was contracted by the 
mere handling of a person affected.