Amygdalæ Amaræ Aqua

Amygdalus communis, L. (includes A. amara and A. dulcis).

Nat. order , Rosaceæ.

Common names , Bitter almond, Mandelbaum, Amandier.

Preparation , An ounce of alcohol is added to a pound of bitter almonds, then add six pounds of water, and distil down to three pounds (Jœrg).

Authorities. [Nos.

1 to 4 , from Jœrg's Materielen; 5 to 10 , from Hartlaub and Trinks; 11 to 17 , from "Pathogenesie," Journ. d. l. Med. Hom., 1845-50.]

1 , Engler; 2 , Meurer; 3 , Siebenhaar; 4 , Jœrg; 5 , Schwartze; 6 , Pierer; 7 , Wolf; 8 , Chivoud; 9 , Pouzaire; 10 , Brodie (took the oil); 11 , Bullet. de Thérap.; 12 , Haller; 13 , Giacomini; 14 , Mestzdorf; 15 , Chavasse (oil); 16 , "B.;" 17 , "X." (Annal. d. Montpellier); 18 , Rassi (Fr. mag., 1, 13); 19 , Cattell (B. J., 11); 20 , Smith (Lancet, 1844), (t. from oil); 21 , Letheby (Lancet, 1845); 22 , Purcell (Lancet. 1855), (t. from oil); 23 , Ellis (Lancet, 1863), (t. from oil.)

MIND

• Mild delirium; the patient stammers incoherently, 15.
• Appearance of intoxication, 11.
• Complete intoxication, 12.
• She is so much affected that she can hardly utter a word (after four hours), 5.
• The feelings were deeply affected; she began to weep, 5.
• Extreme anxiety, 17.
• She falls down unconscious (in ten minutes), 5.
• Loss of consciousness, 4.
• (In a hypochondriac, forty-eight years old; from an emulsion of bitter almonds.)
• Loss of consciousness, of voice, and of motive power (in a child of three years, after five or six bitter almonds), 6.
• Senseless, 18, 20. [10.]
• Coma, with stertorous respiration and involuntary stools; but she revives suddenly and looks wildly about her, 19.

HEAD

• Heaviness and confusion of head and of thought, 4.
• Heaviness and confusion of head as in beginning coryza, with a diminished (five beats) pulse (fifty drops), 2.
• Confusion of head, 4, 18.
• General confusion of the head (forty drops), 2.
• Complete confusion of whole head, which in the afternoon was confined to the left side.
• Also inclined to sleep during the afternoon, and was weary (forty drops), 1.
• The whole forenoon, the left half of the head was confused; it gradually passed off by noon, 1.
• Vertigo, in strong air, 13.
• Vertigo, as if intoxicated, followed by sudden death (from taking many bitter almonds), 8.
• Head drawn between shoulders, 18. [20.]
• Violent headache, 11.
• The whole night (after twenty drops), violent headache spread over the whole head, which disturbed the sleep; pulse depressed, 1.
• During the forenoon a sense of heaviness in the forehead, 1.
• Slight pressure in forehead, 4.
• Sense of weight and oppression on top of head, 19.

EYES

• Sunken eyes, 18.
• The eyes are turned upwards; they become fixed and seem about to start from their sockets, 7, 14.
• Eyes glassy, 23.
• The eye had a brilliant and glassy appearance throughout; mere physical brilliancy, without mental expression, 20.
• Excessive brilliancy of the eyes, 19. [30.]
• Eyes wide open and motionless, 7, 14.
• Eyes closed, cold, 18.
• Eyelids closed, 20.
• Spasmodic movements, especially of the eyelids, 15.
• Upper eyelids convulsed, for some hours, 19.
• Eyeballs remarkably prominent, accompanied with rolling motion, and nearly protruding from their sockets, 22.
• Eyes open and rolling from side to side, 21.
• Eyes both drawn to left side, 20.
• Contracted pupils, 5, 19.
• Pupils dilated, 21. [40.]
• Fully dilated pupils, 19.
• Pupils widely dilated, and insensible to light, 22.
• Motionless pupils, 7, 14.
• Dimness of sight, 13, 19.

EARS

• Ears white and cold, 18.
• Humming in the ears, 16.

NOSE

• Nose white and cold, 18.

FACE

• Pale face, 15, 18.
• Face becomes deadly pale, 15, 21.
• Face yellowish-gray and moist, 18. [50.]
• Countenance very much flushed, 22.
• Spasmodic distortion of the features (after some minutes), 14.
• Frequent convulsive action of muscles of face and neck, 22.
• Sardonic laughter; joyful countenance; sparkling eyes, 15.
• Lips pale and bluish, 23.
• Lips white and cold, 18.

MOUTH

• Tongue dry and coated, 18.
• Mouth tightly closed, 18, 20.
• Froth at the mouth, 5. [60.]
• The breath has a strong smell of bitter almonds, 14.
• Considerable swelling of, and undulatory motion in the jugular veins; the carotids beat quickly and fully, 20.

THROAT

• Deglutition is impossible, 7.
• Burning sensation in throat, 19.
• Excessive burning heat in laryngo-pharyngeal region, 19.

STOMACH

• Nausea and vomiting of food, 6.
• Vomiting, 18.
• Vomiting of a bitter, viscid substance, 13.
• Vomiting of large quantities of food and bile smelling strongly of prussic acid, 15.
• A disagreeable feeling which seems to ascend from the epigastric region (immediately), 10.

ABDOMEN. [70.]

• Abdomen relaxed, soft, hardly of natural warmth, 18.
• Pains in abdomen, 18.
• Colicky pains, which increase, until, in less than two hours, the abdomen is distended like a balloon; convulsive movements of the jaws; loss of consciousness and frothing at the mouth; then sudden death (in a child, from taking milk of bitter almonds), 9.
• Copious, feculent, but especially watery evacuations, 1.
• Stool seldom, 18.

URINARY ORGANS

• Scanty and painful urination, 18.

SEXUAL ORGANS

• Penis shrivelled, 18.

RESPIRATORY APPARATUS

• Increased discharge of mucus from the larynx, 4.
• Scraping in larynx (eight drops), 4.
• Scraping in the larynx (after twenty-four drops), 3. [80.]
• Hoarseness caused by the scraping in the larynx, 4.
• Panting for breath, 21.
• Short, panting respiration; suffocative attacks, 15.
• Breathing stertorous, 22.
• Slow, stertorous breathing, which keeps getting slower, 7.
• Breathing stertorous, and at long intervals, 23.
• Breathing slow and gentle, 20.
• Respiration scarcely perceptible, 18.
• Respiration heavy, 18.
• Difficult respiration, 5.

CHEST. [90.]

• The chest heaved spasmodically, and its movements were hurried, 14.
• Oppression of chest, 18.
• Several transient stitches and pains coming and going just under the left nipple deep in the chest; it made respiration difficult (twelve drops), 4.

HEART AND PULSE

• Heart beats very feebly, 18.
• Beat of heart feeble, sometimes intermittent, 23.
• Pulse strong, frequent, and wiry, 19.
• Pulse at first small, frequent, and intermittent, then slow and regular, 15.
• Pulse full and strong, but slow, 22.
• Pulse slow, full, and moderately hard, 5.
• Pulse slow and vibrating, 19. [100.]
• Pulse from 70 down to 64 (quarter of an hour), (ten drops), 1.
• Pulse 100, 130, 140; very small, thready, 19.
• Pulse, from 70 down to 61 (one hour), (five and thirty-five drops), 1.
• Pulse sank to 50, in quarter of an hour, for an hour (after thirty and forty drops), 1.
• Pulse, 30; very feeble in carotid and radial arteries, 19.
• Pulse small, 18.
• Pulse slow and flickering, 23.
• Diminished pulse, 4.
• Pulse scarcely perceptible, 18.
• The pulse becomes imperceptible, 15, 20.

EXTREMITIES IN GENERAL. [110.]

• Limbs were completely lax, and fell lifeless when lifted, 20.
• Unsteadiness of the limbs, 16.
• Upper and lower extremities cold, 18.
• Heaviness of extremities and whole right thigh, 18.

LOWER EXTREMITIES

• Could not stand on legs, 18.
• Formication in the legs, with staggering gait, 16.
• Knees flexed on the abdomen, 18.

GENERALITIES

• Convulsions, 13.
• Most violent convulsions, which last almost three-quarters of an hour, 5.
• The convulsions returned after a quarter of an hour; but less violently (tinct. op. simp. palliated them), 5. [120.]
• General tetanus, 5.
• Complete opisthotonos, 22.
• Excessive languor, 13.
• General debility (from seven bitter almonds), 17.
• Feeling of weakness, as if the muscular vigor was deficient, and he would fall down, 10.
• Fainting, 17.
• Syncope, 15.
• Death in thirty minutes, 7.
• General malaise, 16.
• Weight on the eyes, and in the limbs, 13.

SKIN. [130.]

• Skin blue and bluish-red, especially on scrotum, where it was blue and almost greenish-yellow, 18.
• Wheals over the whole skin, 19.
• Urticaria febrilis, 19.

SLEEP AND DREAMS

• Yawning, with irresistible tendency to sleep, 19.
• Drowsiness, 19.
• Inclined to sleep the afternoon, 1.
• In the afternoon and evening depression, inclination to sleep through the night a sound and deep sleep, from which it was difficult to rouse; he felt as though he had not slept enough (fourteen drops), 1.
• She is plunged in a deep stertorous sleep, 5.

FEVER

• General coldness, 15.
• Surface cold and clammy, 23.

CONDITIONS

• Aggravation.
• ( Forenoon ), Left half of head confused; heaviness in forehead.
• ( Afternoon ), Confusion of left side of head; inclined to sleep; depression, etc.
• ( Evening ), Depression, etc.
• ( Night ), Headache, etc.; deep sleep.
• ( Strong air ), Vertigo.

SUPPLEMENT: AMYGDALÆ AMARÆ OLEUM. Authorities.

24 , Dr. Van Praag, Reil's Journ., vol. i, p. 588, a woman applied to her hair 1/2 oz. of an oil containing the oil of bitter almonds; 25 , Mr Howard Hopley, Pharm. Journ. vol. xvi, 1856-7, p. 291, a man, æt. forty-five, swallowing about 1/2 oz. of the oil of bitter almonds, and died after an hour; 26 , Fred. Hetley, Lancet, 1845 (2), p. 612, Harriet L. æt. twenty-one years, swallowed two penny's worth of the oil; 27 , C. G. Mitscherlich, Pharm. Journ., vol. ix, 1849, p. 233, effects of large doses of the volatile oil; 28 , Dr. Barclay, Lancet, 1866 (1), p. 255, a man, æt. fifty-seven years, swallowed two drachms of the oil, death; 29 , W. B. Shorts, Brit. Med. Journ., 1868 (2), p. 167, poisoning of a child, æt. three years, by the oil; 30 , Dr. Hunt, Med. Times and Gaz. (New Engl. Med. Gaz., vol. xiii, 1878, p. 135), a boy, æt. three years, ate an unknown number of bitter almonds; 31 , S. Wright, M.D. Am. Prac., vol. xviii, 1878, p. 219, a man took about two drachms of the oil. [140.]

• Insensible; eye sallow; pupil contracted; face puffy and flushed; pulse scarcely perceptible; groaning; breathing stertorously, 25.
• Before she lost consciousness she experienced sudden violent internal coldness, radiating from the head and back over the whole body; this coldness became more and more severe, and was at last associated with ringing and beating in the ears, followed by complete deafness, swimming before the eyes, paralysis of the arms and legs; as these last symptoms appeared she endeavored to rise, but became completely blind, and called for help, and knew no more. This was followed by general collapse and paralysis, extremely slow superficial respiration, and the beating of the heart was scarcely audible, 24.
• Fell senseless on the pavement, immediately after swallowing it. Some time later, on being found and questioned as to her feelings, she slowly answered, "Indeed, I do feel dreadfully ill;" and passing her hand over a very exsanguine countenance, she leisurely fell back in her chair, and became perfectly insensible. The respirations were noticed to be slow and regular, but the pulse small, thready, and at least 130-140, and the pupils contracted to an aperture of the size of a pin's head. She continued in this state for about three minutes, when the countenance assumed a pale lived hue, similar to that of an individual with advanced cardiac disease. During the use of the stomach-pump, the bladder and rectum acted involuntarily. On visiting her later she appeared like a person in deep sleep, and on feeling the pulse, which still remained 140, she suddenly roused and looking wildly about her, with a maniacal expression, inquired where she was. She now complained of excessive burning heat in the region of the larynx and pharynx, was hoarse, and talking, she said, distressed her; some pain and sensation of heat in the epigastrium, but no tenderness on pressure. She expressed a feeling of general numbness in arms and legs, without pain in them; but on pinching them she cried out. The arms and hands were mottled with a livid hue and cold. Great disposition to sleep, 26.
• Diarrhœa; increased secretion of urine; excited the vascular system and the respiratory organs, 27.
• In forty minutes he was speechless. The smell of the oil was very perceptible in his breath; no pulse could be felt at his wrist; the breathing was hurried; the pupils were dilated; the extremities cold and clammy, and there was a general purple hue on the face and other parts of the body; the tongue was furred; the fauces and uvula congested and œdematous, 28.
• Pupils dilated and fixed; foaming at the mouth; difficulty of breathing; pulse scarcely perceptible; surface of body very cold; general condition inanimate, 29.
• Lying apparently unconscious in his mother's arms, slightly cyanotic, and markedly pale, with eyelids closed. On raising the eyelids the pupils were seen to be moderately dilated. The arms were stiffened through tonic spasm of the muscles. The breathing was very low, with no catch in the act of respiration. The pulse could not be felt at the wrist. Slight improvement after vomiting (from emetics and tickling the throat), with speedy relapses towards the comatose state, so that it was not for nearly an hour and a half that all dangerous symptoms had subsided, .