DIGITALINUM.
By Timothy F. Allen — The Encyclopedia of Pure Materia Medica
An active principle (glucoside) of Digitalis purpurea. [According to Schmiedeberg, Archiv für Experiment. Pathol, und Pharmak., 3, 16, Digitalis contains the following active principles, concering which great confusion has hitherto existed; Digitonine , forming most of the soluble part of the commercial Digitaline, a glucoside, C31H53O17 (very closely allied to Saponine C32H54O18 ), Digitaline , not precipitated by ether from aqueous nor from alcoholic solutions (as is Digitonine), a glucoside, C5H8O2; Digitaleïne , easily soluble in water (like Digitonine), and also in alcohol (unlike Digitonine), and
Digitoxine , the most active principle, the so-called crystallized Digitaline (of Nativelle), insoluble in water, not reducing Cuprum oxide, and therefore not a glucoside, but having the formula C21H82O7 , and therefore not an alkaloid.
It is probable that the provings and experiments here recorded are from substances composed of more or less of all of the above active principles, excepting that the Digitaline prepared after Homolle and Quevenne contains little or no Digitoxine. -T. F. A.]
Formula
, C5H8O2
Authorities.
1 , Bæhr, Monograph Digitalis (pulse before experiment averaged, in bed, mornings 51, on rising 60, after breakfast 63, evening 65, evening after exercise 69, evening in bed 59), took 2d trit. 1/5 gr. at 10.30 A.M. first day, at 10.25 A.M. second and third days, at 9.30 A.M. fourth day; 1/2 gr. at 10.5 A.M. fifth day, at 9.40 A.M. sixth day; 1 gr. at 10.45 A.M. seventh day; 1 b , same prover, second proving with 2d trit., 1 1/2 gr. at 10 A.M. first day, 11.45 A.M., second day, 2 grs. at 9.55 A.M. fourth day, 2 1/2 grs. at 10.45 A.M. seventh day, 2 grs. at 9.10 A.M. eighth day, 2 1/2 grs. at 10.28 A.M. ninth day, 2 grs. at 10.40 A.M. fifteenth day, 2 grs. at 10 A.M. sixteenth day, 2 grs. at 10 A.M. eighteenth day, 3 grs. at 9.59 A.M. nineteenth day, 3 grs. at 10.30 A.M. and 1 gr. at 10.30 P.M. twenty-first day, 3 grs. at 9.58 A.M. and 1 gr. at 11 P.M. twenty-third day, 3 grs. at 9.30 A.M. twenty-fifth day, 3 grs. at 10.40 A.M. twenty-sixth day; 2 , Baehr's wife, aged 28, took 2d trit, one dose of 1 gr. (pulse 72 sitting, 92 standing); 2 b , same prover took again 2d trit. 2 grs. first day, 1 gr. evening second day, 2 grs. morning third day, 3 grs. morning fourth day, 3 grs. morning sixth day; 3 , Baehr's proving on a man with 2d trit., 1/2 gr. first day, 1 gr. third day, 1 1/2 gr. fifth day; 4 , Lembke, provings 1/50 gr. (pure) doses (six provings) N. Z. f. H. Kl., 4, 177; 5 , Homolle et Quevenne, Archiv f. Phys., Jan., 1854, first proving with doses of 4 mill. a day for 8 days, 6 mill. on ninth day; 6 , same, second proving, doses of 4 mill. a day for 6 days; 7 , same, doses of 2 of 6 mill. a day for 8 days; 8 , Leroux, effects of overdose, 30 granules in two doses (30 milligrammes), on a patient aged 62, with œdema of legs (L'Union Méd., 1852), from Homolle et Quevenne; 9 , effects of getting some into the eye, H. and Q., p. 202; 10 , Treves, case of attempted suicide, from Husemann, Pflanzenstoffe; , poisoning of the window De Pauw, from Husemann; , poisoning of a woman, aged 34, by 46 granules (?), Union Med., 1854 (from Tardieu); , Heer, poisoning of a woman by 16 and 40 granules (?), Union Med., 1857; , Hardy, poisoning of a pregnant woman, Archiv Gén. de Méd., 1864; , Stadion, general results of experiments on self, Prag. Vjsch., 74, 97, from Hom. Obs., 1864; , Dubue, poisoning of a man, aged 45, by 45 to 50 granules, Gaz. d'Hôp., 1865; , Nunneley, general results of experiments, B. and F. Med.-Chir. Rev., 1869; , Magnin, poisoning of a woman with an affection of heart by 1/4 of a grain, Gaz. hebdom., 1874; , Homolle, London Chemist, 1845, from Journ. de Pharm., took five doses of 5 milligrammes each for three days, at intervals of four or five hours; , Winogradoff, effects on several persons of all ages while taking 3/10 to 2/7 of a grain in twenty-four hours for five days; Virchow, Archiv, from Syd. Soc. Year-book, 1862, p. 452; , T. L. Brunton, effects on self (conclusions only taken, tables and sphygmographic tracings omitted, the latter not at all characteristic), Monograph, London, 1868, p. 23, et seq.
MIND
- Strange hallucinations (after two hours); repeated (second day), 13.
- Agitated, 14.
- Great agitation (after eleven hours), 13.
- Irritable and excitable about trifles (nineteenth day), 1b.
- Irritable mood and ill-humor, which I have noticed during the last few days, are decidedly increased to-day (ninth day), 1.
- Very irritable and sensitive during the past few days, easily vexed by trifles (ninth day), 1b.
- Intellectual.
- With the languor and prostration, the mental faculties seemed enfeebled, as, while reading for an examination, the eye glanced over the words, but the mind refused to receive or retain their import (12 mill.), (after ninth day), 21.
HEAD
- Confusion and Vertigo.
- Confusion in the head, especially in the forehead, with slight stitches through the frontal region, after fifteen minutes, in the evening (twenty-first day), 1b.
- Head confused, especially in the forehead, with pulsating pain in the occiput, relieved by walking in the open air, and nearly disappearing by evening (ninth day), 1b. [10.]
- Feeling of confusion in the occiput, 4.
- Tendency to vertigo while walking, 4.
- Vertigo, 8
(after two hours in earlier part of first night), 13 , etc.
- Vertigo, with unsteady vision, while sitting; it seems as though distant objects could only be fixed with difficulty (twenty-first day), 1b.
- Vertigo and stupefaction commence after half an hour, with unsteadiness and trembling of the hands (twenty-sixth day), 1b.
- Very violent vertigo, all objects seem to turn horizontally from left to right; on closing the lids the vertigo was somewhat diminished, but returned on opening them; I hoped that repeated opening and closing the lids would put an end to this unpleasant sensation, which was accompanied by nausea, but it was not so; I stood up with some difficulty and dressed myself; even slight stooping or looking up increased the vertigo and also the nausea, together with coldness of the back, quite cold hands, yawning, and at intervals short dry cough, on waking at 7 A.M. (second morning), 4.
- Sensation of vertigo while standing, with indistinct vision and some confusion in the head (ninth day), 1b.
- Sensation of vertigo and vanishing of the senses, on waking at night; continues to get worse while lying, and obliges him to involuntarily rise (this condition was frequently repeated during the provings), 4.
- Dizziness, 7.
- Sensation of dizziness, as though the head was compressed (twenty-fourth day), 1b.
- General Head. [20.]
- Head thrown backwards (second day), 12.
- Sensation of a rush of blood to the head, in the afternoon (fourth day), 1.
- Heaviness of head, 7.
- Heaviness of the head the whole day, 4.
- Sensation of heaviness in the head, with slight vertigo on rising and stooping, in the evening (twenty-third day), 1b.
- Intolerable pain in head, 14.
- Head hot and confused towards evening (first day), 1.
- Headache in the afternoon (first day), 1.
- Slight headache, 8.
- Violent headache without disturbance of the intellect, 10. [30.]
- Intolerable headache, 11.
- Severe lancinating headache, 8.
- Forehead.
- Sensation in the forehead and upper part of the nose as though coryza would occur (first day), .
EYE
- Objective.
- Eye glittering (after two hours and a quarter), 12.
- Very considerable exophthalmia of both sides (after seventy-two hours), 13.
- Catarrhal affection of both eyes, with soreness of both external canthi with slight secretion; the eyes pain on sewing or reading; slight redness (such an attack had been experienced eight weeks previously, and there was doubt whether this was the result of Digitalinum; the trouble was rather obstinate but did not last as long as the former attack), 1b. [60.]
- Slight pain in the eye, 9.
- Eyes felt as if they had become larger and were starting from their orbits (second day), 13.
- Violent stitches through the right eye, lasting several minutes, in the afternoon while lying down soon after eating (twenty-sixth day), 1b.
- Orbit.
- Tension above the orbits, 7.
- Pressure in the supraorbital region, extending to the frontal sinuses, lasting one day (after all three doses), 3.
- Lids.
- Eyelids closed (second day), 12.
- Violent burning itching in the eyelids, obliging him to rub them, without being relieved thereby, lasting about an hour (fourth day), 1b.
- Conjunctiva.
- Conjunctiva of a lemon color (after seventy-two hours), 13.
- Ball.
- The crystalline lens has an opalescent appearance, 9.
- Pupil.
- Pupil very slightly dilated and less contractile, 9. [70.]
- Pupils much dilated (after seventy-two hours), 13.
- The right pupil somewhat larger than the left (nineteenth day), 1b.
- Pupils contracted, 4.
- Pupils contracted, but sensitive to light (second day), 12.
- Vision.
- Impaired vision (second and third days), 19.
- Dimness of sight
(after four to five hours), 9.
- Sight very dim, 7.
- Illusions of vision (40 gram.; after one hour), 13.
- Muscæ volitantes, at noon while walking for a short time; in the evening, while walking, it seemed as though the upper part of the field of vision was covered by a dark cloud (twenty-fourth day), 1b.
- Black rings and spots float before the eyes, with some sensitiveness of the eyes to light, 4. [80.]
- Floating of many black spots and rings before the eyes, with general heat (after half an hour), 4.
- Dazzling of the eyes (one to four days), resembling flashes of light (fourth day), 19.
- The flame of a candle appears surrounded by a rainbow-colored halo (after four to five hours), 9.
- Derangement of sight was of two kinds: First, a general mistiness of objects, such as is seen before fainting; and secondly, a large bright spot advancing before him, which sometimes resembled a ring showing prismatic colors faintly, and similar in character to, though less distinct than, that seen round a light when Digitaline has been introduced into the eye, 21.
- When Digitaline is introduced into the eye, it causes smarting and profuse lachrymation, which passes off in a short time and nothing more is felt, except perhaps an occasional rough feeling of the conjunctiva, till four or five hours after, when, on looking at a light, you see it surrounded by a halo, presenting the prismatic colors, and not quite close round the light, but with a dark space between. This halo increases in diameter the farther you move from the light, and becomes smaller and narrower as you approach; exactly like the appearance when light cirrhi are crossing the moon, 21.
EAR
- Drawing pain in the left ear towards the forehead (fifteenth day), 1b.
NOSE
- Objective.
- Frequent sneezing in the afternoon, and in short, all the forebodings of a coryza (first day), 1.
- Frequent sneezing, with dry nose (sixth day), 1b.
- Frequent sneezing, and occasional paroxysm of coughing, with expectoration of very hard tenacious mucus (eighth day), 1b.
- Frequently obliged to sneeze, with profuse secretion from the nose (first day), 1b. [90.]
- Found that for some days before vomiting came on, clear drops of water were always gathering at the nose, 21.
- A peculiar affection of the mucous lining of the nose, declaring itself under the form of a violent coryza, seems to constitute a characteristic symptom, 15.
- Violent coryza occurred without known cause, with pressive-throbbing pains in the arms, and violent headache (this coryza has quite different symptoms from the attacks that I usually experienced, and is remarkably similar to the attack which I had in the beginning of the proving; if this has not been caused by Digitaline, still its course seems to have been modified by it), (thirty-sixth day), 1b.
- Coryza broke out more violently than I had experienced since the proving of Digitalis, although during the winter I had several times suffered from coryza; particularly remarkable was the frequent sneezing, which I did not usually have in coryza (second day), 1 . [I cannot attribute the coryza to the action of the remedy, though its great severity and the violent sneezing may dependent upon it.]
- The coryza continued to decrease, though not the painfulness of the left nostril; the mucous discharge in the morning is streaked with blood (tenth day), 1.
- Symptoms of commencing coryza came on towards evening (third day), there was no trace of them the next morning, but they came on more violent in the evening, with complete stoppage of the nose and great confusion in the head (fourth day), 2b.
- Nasal mucus streaked with blood in the morning (I do not remember having lost blood from the nose for several years), (ninth day), 1b.
- Subjective.
- The coryza is much better, though the left nostril is very sensitive and painful on blowing the nose, as far up as the glabella (ninth day), 1.
- Pain in the left nostril returned as in the previous proving (second day), 1b.
- Smell. [100.]
FACE
- Objective.
- Very sickly expression, so that several asked what was the matter, during the last few days (tenth day), 1.
- Face red and hot (after one hour, fifth day), 1.
- Face red and hot, as though the blood forcibly pressed behind the eyes (fourth day), 2b.
- Face flushed (second day), 12.
- Face pale (after two hours and a quarter), 12.
- Paleness of the face, 11.
- Extreme pallor of the face (after seventy-two hours), 13.
- Subjective.
- Hot face, as if feverish, towards evening, in the open air (second day), 1.
- Lip.
- Constant jerking of the upper lip of the left side (after one hour and a half), 4.
- Chin. [110.]
- Teeth firmly clenched, 16.
- Toothache in the left upper eye-tooth and first back teeth, together with pulsating pressure in the forehead, above the left brow (sixteenth day), 1b.
- Transient burrowing toothache in the right back lower teeth, in the afternoon (fourth day), 1b.
- Pulsating-sticking pains in the left upper incisors, for a short time (eleventh day), 1b.
- Throbbing toothache for a short time in the right upper incisors, in the evening in bed (twenty-third day), 1b.
- Transient throbbing toothache in the lower incisors (nineteenth day), 1b.
- Tongue.
- Tongue slightly coated, and yellow on sides; dry and light-red on middle and tip, 8.
- Tongue large and smooth; with a saburral coating (second day), 12.
- Dry, whitish tongue (40 gram.; second day), 13.
- General Mouth.
- Mouth half open (second day), 12. [120.]
- Large doses occasionally cause a feeling of dryness in the mouth, along with some salivation, but it is not constantly observed, 21.
THROAT
- Sensation as though food remained in the upper part of the œsophagus (nineteenth day), 1b.
STOMACH
- Appetite.
- Awakened with violent sensation of hunger (twenty-second day), 1b.
- Appetite very little, though the tongue was quite clean, and the taste normal (seventh day), 1b.
- No hunger, though the usual time for breakfast had long since passed (twenty-fifth day), 1b.
- A sensation of hunger which was very great when taking the dose, entirely disappeared after one hour; it seemed as though the stomach were very much distended and its contents were standing up in the throat (twenty-fifth day), 1b.
- Diminished appetite, 7.
- Appetite diminished, especially in the evening (tenth day), 1. [130.]
- Very little appetite (sixth day), 2b.
- Want of appetite (third day), 19.
- Thirst.
- Urgent thirst (40 gram.; second day), 13.
- Very urgent thirst, 16.
- Thirst very great, especially for beer (ninth day), 1b.
- No thirst; refuses to drink, as it renews the nausea, and brings on vomiting, 8.
- Eructation.
- Frequent, tasteless eructations (third day), 2b.
- Nausea and Vomiting.
- Disposition to nausea, 6.
- Nausea, 8 , etc.
- Nausea the whole day (sixth day), 2b. [140.]
- Nausea, in the morning, 7.
- Nausea and vomiting (40 gram.; after one hour), 13.
- Nausea, and a sensation of fulness, after eating a little (fifth day), 2b.
- Almost continual nausea (third night), 19.
- Slight sensation of nausea (nineteenth day), 1b.
- Inclination to vomit, 16.
- Vague disposition to vomit, in the morning, ceasing after a swallow of rum, 7.
- Efforts to vomit in the morning (first day), 5.
ABDOMEN
- Objective.
- Retracted abdomen, without colic, 8. [180.]
- Movings in the abdomen, with emission of much offensive flatus (twenty-fourth day), 1b.
- Gases developed in the intestines (third day); causing rumbling (fourth day), 19.
- Much offensive flatus for several days, 1b.
- Emission of much offensive flatus, in the morning, immediately after rising, followed by copious pasty stools, with violent griping in the abdomen (twenty-first day), 1b.
- Sensation as though diarrhœa would occur, with griping and burrowing in the abdomen; though followed by normal stool (nineteenth day), 1b.
- Slight abdominal pains (third day), 19.
- Burrowing pains in the abdomen, as if diarrhœa would follow, although a normal stool had occurred an hour previously (after half an hour), (eighteenth day), 1b.
- Griping in the bowels, immediately after rising, in the morning, with frequent emission of offensive flatus (twenty-second day), 1b.
- Griping pain in the abdomen, several times in the evening (twenty-sixth day), 1b.
- Some griping pains in the abdomen, in the morning (sixth day), 2b. [190.]
- Digging pain in the abdomen as though diarrhœa would follow, in the evening (twenty-first day), 1b.
- Drawing-pressive pain low down in the abdomen (twenty-fifth day), 1b.
- Several dull stitching, lightning-like pains through the abdomen, in the afternoon (fourth day), 1.
- Colic without result (second day), 13.
- Some colic, 5.
- Colic-like pains, with sensation as though diarrhœa would occur, between 10 and 11 A.M. (fourth day), 1.
- Colic-like pains in the abdomen, with a feeling of nausea as though the breakfast eaten a short time previously still remained in the throat, while walking (twenty-second day), 1b.
- Colic-like pains in the bowels, with urging to stool, which is normal, a quarter of an hour after the dose (sixteenth day), 1b.
- Slight colic-like pain below the umbilicus at 11 A.M. (seventh day), 1.
- Violent colic-pains attacked me at midnight while riding in a wagon, so that I was obliged to go into the house; when the pains were felt, I was unable to walk, but was obliged to stand quite still and bent over; there followed copious diarrhœa-like stool, with much flatulence and persistent burning in the anus (eleventh day), .
RECTUM AND ANUS
- The desire for stool, which existed before taking the dose, became urgent, with sensation as though diarrhœa would follow, yet the stool was normal (fifteenth day), 1b.
- Urgent desire for stool, with violent griping pains in the abdomen; evacuation not copious, soft, though not diarrhœa-like; towards evening, another pasty stool preceded by griping and offensive flatus (twenty-second day), 1b.
STOOL
- Diarrhœa.
- Many stools (after three hours and a half), 12.
- Two stools in forenoon (first day); three stools in forenoon (third day); two stools (fourth day), 5.
- Two stools since morning, soft but not like diarrhœa (fourth day), 1.
- Diarrhœal stool (fourth day), 19.
- Shortly after vomiting had a loose stool, but no persistent diarrhœa, 21.
- Constipation.
- Constipation, 18.
- In small doses it seems to produce constipation, 21. [210.]
- Bowels open once; stool extremely scanty, consisting of about a dozen pellets like those of rabbits, and one about the size of a walnut; the latter floated, the former sunk in water, 21.
- Stool hard and unsatisfactory, although during the last two days I had walked more than usual; the first after two days and a half (twenty-ninth day), 1b.
- No action of the bowels (second day), 13 ; (third day), 19.
URINARY ORGANS
- Micturition.
- Urine increased (apparently in consequence of the much cooler temperature), (twentieth day), 1b.
- Amount of urine increased, although less than usual had been drunk the previous evening; I was awakened between 4 and 5 A.M. by desire to urinate, with passage of a large quantity, followed by violent erections (twenty-eighth day), 1b.
- Abundant and limpid urine (third night), 19.
- Urine abundant, and causing heat in passing (fifth day), 19.
- Urination rather more copious, 5.
- Awakened twice at night (first night) by urging to urinate, with copious emission of colorless urine; (on the last evening, instead of beer as usual, I had drunk a cup of tea; tea had never caused such an effect, and it had been taken too early and in too small a quantity; I was still more satisfied that the tea was not the cause, since on the next day I was awakened early in the morning without having drunk tea in the preceding evening;) the desire to urinate was every time accompanied by persistent erections, which frequently occurred in the morning, also during the last three days (thirty-first to thirty-third day), 1b.
- Very copious urination, without pain in renal region (after eleven hours), 18. [220.]
- The amount of urine evacuated was large, although very little has been drunk the previous evening; urine clear, but of an unusually strong odor, somewhat like freshly baked bread, in the morning (twenty-first day), 1b.
- With small doses the urine varied just as the pulse had done, being generally increased to a slight extent while I took the drug, but sometimes not, while, with large doses, the diuretic effect was marked; with the larger doses, especially of the powder, there is a marked increase in the amount of urine before intoxication appears, then a sudden fall during its continuance, and another rise of still greater extent after it has passed off, and after the medicine has been discontinued; the actual increase in the amount of urine may to some appear small, but when it is considered that the amount of fluid ingested is the same, and that, in a normal condition, very rarely has a large amount of urine been passed on more than two consecutive days, the distinct and persistent diuresis is remarkable, 21.
- Digitaline produces in the physiological organism a diminution of the quantity of liquid secreted by the kidneys, 15.
- Urine diminished (eighth day), 1b.
- The urine seems to be diminished in quantity; that passed in the evening is unusually dark but clear (third day), .
SEXUAL ORGANS
- Male. [240.]
- It exercises an energetic influence upon the sexual organs by depressing them, and it may momentarily arrest entirely the activity of the sexual system, 15.
- An emission at night, without waking (fourth day), 1.
- Female.
- Menstruation two days too early, and without the usual premonitory pains in the abdomen and back (first day), 2.
- Menstruation seemed to be more profuse than usual (second day), 2.
RESPIRATORY ORGANS
- Voice.
- (During supper on the eleventh day I must have suddenly taken cold; I became so hoarse that I could scarcely speak, with violent sticking pains in the larynx), 1.
- Voice extinct (40 gram., second day), 13.
- Cough and Expectoration.
- Some cough the last two days, with expectoration of consistent mucus (tenth day), 1.
- The cough which had been previously noticed became more decided, short, with hard, whitish-yellow expectoration (ninth day), 1b.
- Hacking cough, with easy expectoration, continues to be more and more troublesome (fourteenth day), 1b.
- Frequent hacking cough, with easy expectoration, in the evening (twenty-sixth day), 1b.
- Respiration. [250.]
- Respiration slow and embarrassed (second day), 12.
- Shortness of breath, in the morning while walking, with hawking up of much mucus; also afterwards while sitting, the breathing was very much impeded, though without pain (eleventh day), 1b.
- The shortness of breath remained while walking at noon; this was rather a necessity to take a very deep breath than real dyspnœa, without satisfying the sensation, which I would call a hunger for air (twelfth day), 1b.
- Attacks of shortness of breath, increasing in the afternoon while walking (precisely similar to those noticed during the proving of Digitalis), (sixth day), 1b.
- Great shortness of breath, in the morning on waking, with a feeling of weakness and prostration in the chest (twenty-fourth day), 1b.
- Sudden tightness of the breath, lasting several minutes, in the morning while rising, and also once on stooping (sixth day), 1.
- Several attacks of constriction of breathing, in the afternoon and evening while walking and sitting (eighteenth day), 1b.
- Oppression of breathing, while sitting, with several times a sensation of congestion to the chest (sixteenth day), 1b.
- Dyspnœa after a cup of coffee and food (after eleven hours); and in the night repeated (second day), 13.
CHEST
- Slight orgasm of blood in the chest, and some pressive throbbing pains still continue (thirty-fourth and thirty-fifth days), 1b. [260.]
- Renewed sensation of rush of blood to the chest (eighteenth day), 1b.
- Feeling of rush of blood to the chest, with inclination to breathe rapidly, and a sensation as though I had done something wrong, or some evil were impending; recurring now and then (twenty-fifth day), 1b.
- Great rush of blood to the chest, with feeling of great prostration at times (twenty-eighth day), 1b.
- Rheumatic pains in the chest, with constriction of breathing, accompanied by transient stitches in one or the other side of the chest (eighth day), 1b.
- Feeling of constriction of the chest, while walking slowly, without real dyspnœa, together with a sensation as though the heart were standing still, with subsequent palpitation, at 6.30 P.M. (fourth day), 1.
- Pressing sensation generally over the chest, making respiration difficult, 4.
- Oppression of the chest, with some palpitation, in the evening while walking (fifth day), 1.
- Slight dull stitches through the chest (forty-third day), 1b.
- Pains in the chest returned in the evening, especially on the right side (twenty-sixth day), 1b.
- The pains in the chest and abdomen frequently appeared at noon while walking, although not very violent (twenty-fifth day), 1b. [270.]
- The pains in the chest were worse in the middle of the day, and were associated with a pressive pain in the right side, which had hitherto been exempt; these pains occurred in paroxysms and independently of them, and even not aggravated by them, occurred a desire to breathe, that is, a need to breathe very often and as deeply as possible (sixth day), 2b.
- The pain in the chest became very violent in the evening, and so much aggravated by walking that breathing was difficult (fourth day), 2b.
- Front.
- Pain in the middle of the sternum united itself by some stitches with a similar pain in the scapulæ (second day), 2b.
- Dull stitches in the middle of the sternum (thirteenth day), 1b.
- Sides.
- Pain in the right side of the chest (eighth day), 1b.
- Pains in the right and left sides of the chest returned with increased violence, and were associated with confusion of the head, half an hour after the dose (twenty-fifth day), .
DIGITALINUM. HEART AND PULSE
- Præcordium.
- Sensation as though the heart stood still for a moment while playing the piano (first day), 1.
- Sensation as though the heart stood still, followed by transient sensation of palpitation, in the afternoon (third day), 1.
- Peculiar sensation in the heart, with great anxiety; no palpitation, but a trembling of the heart, with standing still, in the evening while sitting; repeated after half an hour (third day), 4.
- Extreme præcordial anxiety (after a few moments), 18. [300.]
- Extreme præcordial anxiety (seven hours after first dose, having taken second dose in the meantime), 8.
- Pains not very violent, in the præcordial region, in the evening while walking (third day), 1b.
- Pressive pain in the præcordial region, transient, but frequently returning (fourth day), 1.
- Dull sticking pain in the præcordial region, corresponding to the beat of the heart, in the morning (tenth day), 1b.
- Some stitches in the præcordial region (eighth day), 1b.
- Stitches in the præcordial region, for a long time towards evening, corresponding to the pulsations of the heart (fourth day), 1b.
- Stitches in the region of the heart (sixth day), 1b.
- Frequent stitches through the præcordial region, with persistent pressive-throbbing pains, three-quarters of an hour after the dose (nineteenth day), 1b.
- Persistent, violent, dull stitches in the præcordial region at noon while walking (nineteenth day), 1b.
- Pain in the region of the apex of the heart, like a pressive dull stitch, not returning (after a quarter of an hour), 1b.
- Transient pulsating pain in the region of the apex of the heart (after one hour, third day), 1.
- Heart's Action. [310.]
- Digitalinum acts with great energy on the heart, throwing it into violent and disorderly contractions, which quickly end in a cessation of movement. The frequency of the contractions is not increased, but is progressively diminished, and the functions of the heart are abolished very early, voluntary power surviving the death of the organ, 17.
- A feeling of palpitation, with dull sticking pain in the left side, towards evening while walking (fifth day), .
NECK AND BACK
- Neck.
- Stiffness of the neck in the morning, motion was painful (twenty-eighth day), 1b. [360.]
- Very sudden rheumatic pains in the left side of the nape of the neck; towards evening, they extend to the upper arm and very much impede the motion of the head, as well as of the left arm; they continue undiminished through the day, but are somewhat relieved in the evening, though inclining the head remains somewhat painful (ninth day), 1.
- Back.
- Very violent pain in the back (second day), 2.
- The pains in the back increased, became worse while lying, and extended into the anus and thighs; the abdomen was painful, with, in places, a sensation as though it would be torn asunder; menstruation lasted as long as usual, but was more profuse (second day), 2.
- Dorsal.
- Violent pain between the scapulæ, in the morning (fourth day), 2b.
- Sudden, very violent pain between the scapulæ, with oppression of the chest, like a cramp in the chest, followed by eructations, which afforded relief, at noon while walking (fifth day), 2b.
- Painful sensation, as though the shoulder-blades would be drawn together, in the afternoon (first day), 2b.
EXTREMITIES IN GENERAL
- Objective.
- The limbs are tremulous and unsteady in the evening, while walking (eighth day), 1.
- Spasmodic contractions of the limbs (after two hours and a quarter), 12.
- Weakness and unsteadiness of the limbs (fourth day), 1.
- Paralytic-like weakness of the limbs, with constant pain in the thighs (eighteenth day), 1b.
- Subjective. [370.]
- Feeling of weakness, loss of power in the limbs (nineteenth day), 1b.
- Sensation of weakness in the limbs and tremulousness of the hands that could scarcely be controlled while writing (twenty-first day), 1b.
- The limbs are heavy as if paralyzed (ninth day), 1b.
- Violent pains in the limbs, about 10 P.M., 4.
- Pressure in various places in the limbs and feet, 4.
- Pressure in various places in the muscles of the limbs rapidly changing, 4.
- Pains in the limbs, are worse during rest than during motion, 4.
SUPERIOR EXTREMITIES
- Heaviness in the right arm, 4.
- Drawings and uneasiness, especially in the arms, so that she was unable to sleep at night in bed (first day), 2b.
- Shoulder.
- Pressure in the right shoulder, 4. [380.]
- Pressure in the left shoulder, 4.
- Sticking, pulsating pain in the left shoulder-joint, with feeling of lameness of the arm, while walking, four hours after the dose (fifteenth day), 1b.
- Arm.
- Drawing pain in the right upper arm, especially in the biceps, while sitting (thirteenth day), 1b.
- Elbow.
- Pressure in the left elbow, 4.
- Sudden throbbing-tearing pain in the right elbow, extending from the external condyle upward, at 4 P.M., very violent for a short time, then gradually decreasing (ninth day), 1b.
- Forearm.
- Bruised sensation in the left forearm (twenty-fifth day), 1b.
- Wrist.
- Drawing in the left wrist and fingers rather severe, though lasting only a moment (after half an hour), 4.
- Pressure in the right wrist, 4.
- Pressure in the left wrist, 4.
- Hand.
- Tremulousness of the hands (eighth day), 1b. [390.]
- Hands tremulous, and writing very difficult (twenty-fifth day), 1b.
- Fingers.
- Pressing asunder in the fingers, 4.
- Some throbbing, sticking pains in the middle joint of the right index-finger (fifteenth day), 1b.
INFERIOR EXTREMITIES
- Cramplike drawing from the toes of the left foot through the whole limb, so violent that for a moment it was impossible to bend the leg (twenty-sixth day), 1b.
- Thigh.
- Terrible cramps in thighs, calves, and feet, returning every fifteen minutes (after fourteen hours), 18.
- Drawing pain in the right thigh, as if extending from the sacrum (eighteenth day), 1b.
- Violent throbbing-tearing pain, extending upward from the inner condyle of the right femur, while walking (thirtieth day), 1b.
- Violent throbbing pain in the left tensor fasciæ latæ, while sitting quietly, increased by pressing upon the place, which is rather circumscribed, soon after the dose, lasting an hour (fifth day), 1.
- Knee.
- Pain in the knee, 4.
- Some pain in the knees and feet (soon), 4. [400.]
- Violent pain above the right knee (after one hour and a half), 4.
- Pressure in the knees, 4.
- Pressure in the right knee, also while walking, 4.
- Leg.
- Weakness of the legs (second day), 19.
- Sudden pinching pain in the right calf, in the afternoon, on rapidly ascending steps, lasting several hours, gradually disappearing (ninth day), 1.
- Awakened at night by very painful cramp in the calves, the effects of which I felt the next day (tenth day), 1b.
- Drawings in the right leg, 4.
- Ankle.
- Pressing in the ankles, 4.
- Pain in the right ankle, as if sprained, in the morning immediately after rising, lasting about a quarter of an hour, impeding walking (tenth day), 1.
- Foot. [410.]
- On walking, a sensation as though the ground sank away under the feet, 3.
- Peculiar sensation in the left foot as if numb, especially during rest, obliges him to move the foot frequently, 4.
- The pains in the feet and toes are worse while sitting, less while walking, .
GENERALITIES
- Objective.
- Rapid wasting, and slackening of nutrition, 15.
- Lying on back, with arms extended, and motionless (second day), 12.
- Trembling (after two hours), 13. [420.]
- Motion became impossible (second day), 13.
- Indolent and weary during the day (second day), 1.
- Debility and extreme prostration (second day), 12.
- Debility (40 gram., after one hour); gradually increasing, until she cannot move or utter a sound, 13.
- General debility, with sopor, 8.
- Great weakness, 11.
- Extreme debility (after fourteen hours), persistent for some time, after general improvement, 18.
- Rapid debility, 14.
- Prostration, 6, 7, 10.
- General prostration, 5. [430.]
- Extreme prostration (after twelve hours), 12.
- Very great uneasiness during the whole night (third night and fourth day), 19.
- Subjective.
- Sensation of fatigue, and muscular weakness (second day), 19.
- Felt great languor and prostration (12 mill.) (after nine days), 21.
- Lassitude and inclination to sleep (fourth day), 19.
- Great weariness the whole day (third day), 2b.
- Great weariness in the morning (second day), 2.
- Great weariness at noon, while walking; the limbs feel like lead (first day), 1b.
- Great weariness and indisposition, in the afternoon (twenty-first day), 1b.
- Very great weariness and disinclination to make calls, although the day was fresh and cool (nineteenth day), 1b. [440.]
- Sudden weariness towards noon, followed by sound sleep in a reclining chair, so that I did not hear the frequent opening and shutting of the door of my room, but awoke after two hours thoroughly unrefreshed (sixteenth day), 1b.
SKIN
- Constant sticking in the skin of the cheek, with a sensation as if the place were drawn upward, conjoined with burning, lasting a quarter of an hour, 4.
SLEEP
- Sleepiness.
- Yawning (fourth and fifth days), 19.
- Drowsiness (after three hours and a half), 12.
- Remarkable sleepiness at night, continuing for a week (12 mill.), 21. [460.]
- Unusually sound sleep (first night), 1.
- Extremely sound sleep during the night (second day), 1.
- Sleeplessness.
- Sleep frequently interrupted during the night (fourth night), 19.
- Night restless, disturbed by many dreams and frequent waking; in the evening it was with difficulty that I could fall asleep, although very tired (twenty-seventh day), 1b.
- Night somewhat restless (twenty-first night), 1b.
- Sleep bad (first night), 2.
- Want of sleep (third night), 19.
- Sleepless during the earlier part of the night (first night), 13.
- Dreams.
- Many dreams throughout the night (fifth night), 1 ; (fifteenth night), 1b.
- Sleep much disturbed by dreams (sixth night), 1. [470.]
- Very anxious dream in the first sleep at night, like a nightmare, from which I started up bathed in sweat, and with palpitation (twelfth day), 1b.
- Violent attack of nightmare, with violent internal chilliness during the first partial slumber, so that she believed she had not been asleep (first day), 2b.
FEVER
- Chilliness.
- Skin cold (after twelve hours), 12.
- Skin cold and damp (after seventy-two hours), 13.
- Chilliness (16 gram., after two hours), (40 gram., after one hour), 13.
- Frequent attacks of chilliness and shivering in the afternoon (first day), 2b.
- Great chilliness, with increased pains in the chest before dinner (fourth day), 2b.
- Violent chilliness and shivering in the evening, in spite of a high temperature (first day), 2b.
- Sensation of coldness, followed by shivering, with a feeling of goose-flesh, which, however, did not exist (after half an hour); this was frequently repeated during the succeeding hours and seldom during the whole day, although the thermometer was 21° R. in the shade (first day), 2.
- Shivering (after two hours), repeated after a cup of coffee and food (after eleven hours); and again (second day), 13. [480.]
- Frequent shiverings and general chilliness throughout the whole day (sixth day), 2b.
- Slight shivering, especially in the left leg and across the abdomen and back, lasting several minutes and frequently returning (thermometer 24° R. in the shade), (sixteenth day), 1b.
- Several violent shiverings (fifth day), 2b.
- Several attacks of chilliness over the back (twenty-fifth day), 1b.
- Extremities cool, 8.
- Feet and hands cold, 16.
- Palms of hands cold and moist (second day), 12.
- Several attacks of shivering over the back, especially in the sacral region (twenty-sixth day), 1b.
- Frequent shivering over the back, extending from the sacrum, at 5 P.M. (twenty-third day), 1b.
- Chattering of the teeth, after a cup of coffee and food (after eleven hours), repeated (second day), 13.
- Heat. [490.]
- Heat (after eleven hours), 13.
- Heat in the nape of the neck rising up into the head, extending through the whole body, very much distended veins and moist skin (after half an hour), 4.
- Feeling of warmth in the nape of the neck, afterwards in the whole of the body, with distended veins and warm skin, while previously the veins were contracted and the skin cool, in cool weather and while sitting still, .
(after a few moments), 18.
- Cold sweats after a cup of coffee and food (after eleven hours), repeated (second day), 13.
- Bathed in cold sweat, 14.
CONDITIONS
- Aggravation.
- ( Morning ), on waking, at 7 o'clock, vertigo, etc.; disposition to vomit; after coffee, pain in stomach; immediately after rising, emission of flatus; immediately after rising, griping in bowels; pain in abdomen; on waking, shortness of breath; white rising, tightness of breath; worse on deep breathing; pain in left chest; stiffness of neck; pain between scapulæ; immediately after rising, pain in ankle.
- ( Forenoon ), Between 10 and 11 o'clock, colic-like pains, etc.
- ( Noon ), While walking, pains in chest, etc.; while walking; pain between scapulæ; while walking, weariness.
- ( Afternoon ), Sensation in head; towards evening, head hot, etc.; while lying down, soon after eating, stitches through right eye; pains through abdomen; while walking, attacks of short breath; towards evening, while walking, feeling of palpitation, etc.; on rapidly ascending steps, pain in calf; weariness, etc.; attacks of chilliness, etc.; at 5 o'clock, shivering over back; heat of face.
- ( Evening ), On rising and stooping, heaviness in head, etc.; headache in forehead, etc.; while walking, stitches in side of forehead; headache; vomiting; pain in pit of stomach; pain in abdomen; while walking, oppression of chest, etc.; pain in chest; pressure in right chest; stitches in chest; palpitation; while walking, limbs tremulous, etc.; chilliness, etc.
- ( Night ), On waking, worse while lying, sensation of vertigo, etc.
- ( Before dinner ), Chilliness, etc.
- ( After dinner ), Immediately, stitch in pit of stomach.
- ( After eating ), Nausea, etc.
- ( While riding in wagon ), Pain in left side.
- ( Sitting ), Drawings in legs; pains in feet, etc.
- ( While standing ), sensation of vertigo, etc.
- ( Walking ), Tendency to vertigo; forehead feels full, etc.; pains in abdomen; pains in chest; pain from condyle of femur.
- Amelioration.
- ( Evening ), Pain in nape of neck.
- ( Walking in open air ), Confusion of head, etc.