Hyoscyaminum

An alkaloid from Hyoscyamus niger.

Formula uncertain, C15H17 NO, Kletzinsky; C20H32N2

O, Wadgymar.

Preparation , Provings made with aqueous solutions of the sulphate of H.

Authorities. (Harley, Old Veg. Neurotics.)

1 , General effects of subcutaneous injection of 1/16 to 1/12 of a grain; 1 a , Effects of 1/30 to 1/24 grain; 1 b , Effects of larger doses than 1/12 grain; 2 , Effects on Samuel M., aged 49 (sufferer from facial neuralgia), of 1/24 grain, subcutaneously; 2 a , same, 1/10 grain; 3 , Charles V., aged 32 (chronic lumbago), effects of 1/48 grain, afterward 1/30 grain; 3 a , same, 1/20 grain; 3 b , same, 1/12 grain; 3 c , same, 1/8 grain; 4 , J. W. (lumbar neuralgia), effects of 1/12 grain; 5 , Mrs. F., 1/24 grain; 6 , Mrs. E. W., 1/24 grain; 7 , John E., 1/8 grain.

MIND

• Dull, heavy and sleepy, and very giddy (after thirty minutes), 3c.
• Mind quite clear when engaged in conversation, but when left undisturbed, he relapsed into a dreamy condition, with the eyes wide open; twice he reached out a hand to an object on the table, and began to look about on the floor, and when I asked him "What for?" he said, "Oh, I thought something had dropped off the table, the walls appear to move a little" (after three-quarters of an hour); he remained quiet, but inclined to be meddlesome when his attention was not engaged in conversation, grasping at objects on the table, or in the waste-basket on the floor, and attempting to remove them before the hand reached them, evidently misjudging the distance (after one hour); left alone, he lapsed into a state of forgetfulness and dreamy meddlesome delirium, picking at objects, and, having reached them after several unsuccessful efforts, fumbling them about until he dropped them, and then, in the attempt to pick them up, losing his balance, and, but for constant attention, falling over; when aroused he rubbed his hand, gaped, and answered my questions readily; a remark which I made at this time excited a risibility which he was unable to restrain, and every now and then the suppressed chuckle burst out into a hearty laugh (after two hours), 7.

HEAD

• Vertigo.
• Giddiness (after three-quarters of an hour), 2.
• Giddiness (after ten minutes); he staggered a little on rising from the chair (after forty minutes), 3a.
• Giddiness (after five minutes); on attempting to rise from a chair he began to reel (after twenty minutes); giddiness across the forehead (after forty-five minutes); diminished (after two hours); he could walk without assistance, but still reeled a little (after three hours and a quarter), 7.
• Much giddiness (after fifteen minutes), 6 ; (after one hour), 3b.
• Excessive giddiness, and staggered much in walking (after twenty minutes), legs felt too weak and he was too giddy to walk without assistance (after one hour); too giddy to walk without laying hold of the furniture or supporting himself by the wall (after one hour and a half); rapidly passing off, but he walked very cautiously (after two hours and a half); soon passed off, 2a.
• Excessive giddiness and a weight across the forehead, continuing about an hour (after ten to twenty minutes), 1a.
• Reeled much in walking (after twelve minutes), 3c. [10.]
• Tottering and giddiness, so that she had to make two or three efforts before she could raise herself from the chair, and then began to reel, and could not walk safely without support, 5.
• Forehead.
• Great weight across the forehead, 5.

EYE

• Eyes suffused (after fifty minutes); natural (after two hours and a quarters), 3c.
• Membranes of the eyes sometimes slightly injected, continuing about an hour (after ten to twenty minutes), 1a.
• Sclerotic and conjunctiva a little injected (after one hour); quite gone (after two hours), 3b.
• Conjunctiva.
• Conjunctivæ a little injected (after thirty minutes); natural (after three hours), 3c.
• Ball.
• Eyeball restless (after fifty minutes), 3c.
• Eyeballs unsteady (after two hours), continuing an hour and a quarter, 7.
• Pupil.
• The pupils slowly dilate during the latter part of the action of the medicine, and at its close attain their maximum degree of dilatation, 1a.
• Pupils dilating (after twenty minutes); 1/5" (after forty-five minutes); a little over 1/5" (after one hour), 7. [20.]
• Pupils between 1/5" and 1/4" (after two hours); nearly 1/4" at the light (after three hours and three-quarters), 7.
• Pupils 1/6" (before the proving); the dilatation was such that it contracted to 1/4" only at the bright light of day (after two hours and a half), 4.
• Pupils at the light 1/8" (before the proving); 1/5" (after three hours and a half), 5.
• Pupils 1/9" (before the proving); dilated to 1/8" (after two hours), 2.
• Pupils 1/9" (before the proving); dilated to 1/8" (after one hour): 1/7" (after one hour and a half); 1/6" (after two hours), 2a.
• Pupils 1/10" (before proving); 1/8", sidewise 1/6" (after three-quarters of an hour), 6.
• Pupils 1/10", sideways 1/7" (before the proving); dilated to 1/8"; sideways 1/6" (after three-quarters of an hour, and two hours and a quarter), 3.
• Pupils 1/10", sideways 1/7" (before the proving); 1/8", sideways 1/7" (after one hour); 1/7", sideways 1/5" (after two hours), 3b.
• Pupils 1/10", sideways 1/7" (before the proving); slightly dilated (after forty minutes); at light 1/7", sideways 1/5" (after two hours and a quarter), 3a.
• Pupils 1/10", sideways 1/7" (before the proving); 1/8" (after thirty minutes); 1/7", sideways 1/5" (after one hour and a quarter); "1/6", sideways 1/4" nearly (after two hours and a quarters), .

Times news-paper fluently; he recognized a lightning conductor, a rod of the thickness of the little finger, as a film projecting from the side of the chimney-pot; by means of a double convex lens or a pinhole in a card he was able to read any type at a distance of three inches from the eye (after two hours and a half), 4.

FACE

• Looked very heavy, had slept, and great somnolency continued (after fifty minutes); somnolency passing off (after two hours and a quarter), 3c.
• Some flushing of the face, 4.
• Face a little flushed (after twenty minutes); face, chiefly the cheeks, hot and flushed (after one hour); disappeared (after two hours), 3b.
• Face hot and flushed (after thirty minutes), 6.
• Face hot and flushed (after fifty minutes); natural (after two hours and a quarter), 3c.
• Cheeks occasionally a little flushed, continuing an hour (after ten to twenty minutes), 1a.

MOUTH

• Tongue.
• Anterior part and margins of the tongue quite wet with an acid secretion (after three hours and a quarter), 7.
• Tongue dry and hard (after three-quarters of an hour), 2.
• Tongue dry and brown, remaining so for an hour and a half (after thirty minutes), 5. [40.]
• Tongue dry and brown at the centre (after two hours), 2a.
• Tongue dry and brown down the centre, the rest of the mouth very clammy (after one hour), 3b.
• Tongue and mouth generally dry; hard palate quite dry (after twenty minutes), 7.
• Tongue uniformly dry (after twelve minutes), 3.
• Tongue more or less completely dry, rough, and brown, the hard and soft palates dry and glazed (after ten to twenty minutes); after continuing about an hour, the tongue and hard and soft palates become covered over with a sticky, acid offensive secretion, agreeing in all respects with that which follows the action of Belladonna, 1a.
• Tongue, excepting the margin, quite dry and rough (after forty-five minutes), 7.
• Articulation indistinct from the great dryness of the tongue and throat (after forty-five minutes), 7.
• Tip of the tongue quite dry (after thirty minutes), 6.
• General Mouth.
• Dryness of the mouth and throat (after effects), 3c.
• Mouth quite dry, excepting the gums (after one hour), 7. [50.]
• Mouth and throat very dry and parched (after one hour and a half), and remained so, 2a.
• Slight dryness of the mouth (after two hours and a quarter), 3.
• The mouth was parched, 4.
• Both palates dry and glazed (after twelve minutes), 3c.
• Both palates dry and glazed, remaining so for an hour and a half (after thirty minutes), 5.
• Both palates dry and glazed (after two hours); a portion of the hard palates dry (after two hours and a half); soon passed off, 2a.
• Both palates completely dry and glazed (after forty-five minutes), 7.
• Hard palate quite dry (after thirty minutes), 6.

THROAT

• Throat dry (after one hour); very dry (after two hours), 2.
• Although the mouth was moist, the throat was very dry (after one hour and a quarter), 3c.

URINARY ORGANS

• Urine, before taking, 2 ounces, acid, pale, sp. gr. 1016; 1000 grains contained chlorine 4, 56 grains, urea 14.80 grains, phosphates and sulphates 7.01 grains, uric acid no excess; three hours and three-quarters after taking, acid, nearly colorless, 9 ounces, sp. gr. 1008; 1000 grains contained chlorine 2.42 grains urea 9.00 grains, phosphates and sulphates 3.75 grains, uric acid a trace; three hours after taking, an urgent call to pass water, dysuria and discharge in a feeble dribbling stream, partial retention (urine contained Hyos), 7.
• Urine before taking, acid, pale sherry-colored, sp. gr. 1015; two hours and a quarter after 1/48 grain, feebly acid, whey-colored, sp. gr. 1010, 3.
• Urine, before taking, acid, sp. gr. 1016, contains much uric acid; two hours after 1/30 grain, 15 1/2 ounces, alkaline , sp. gr. 1008, much less uric acid, 3.
• Urine, before taking, sp. gr. 1016, much uric acid; two hours and a quarter after 1/20 grain, neutral , sp. gr. 1008, a trace of uric acid, 3a.
• Urine, before taking, faintly acid, sp. gr. 1010; two hours after 1/12 grains, very alkaline , sp. gr. 1005, 3b. [70.]
• Urine before taking, acid, sp. gr. 1015, bright on boiling; 1000 grains contained chlorine 2.95 grains, urea 12.32 grains, sulphates and phosphates 4.16 grains; two hours and a quarter after 1/8 grain, alkaline, sp. gr. 1008, opalescent on boiling, chlorine 1, 55 grains, urea 5.33 grains; sulphates and phosphates 3.24 grains; three hours after 1/8 grain, still more alkaline, otherwise about the same, 3c.
• Urine at time of injection, acid, sp. gr. 1034; after twenty-two minutes, same, but a few drops dilated the pupil from 1/8 to 1/6, and maintained it so for ten hours, 2.
• Urine before taking high-colored, acid; three hours and a half after, glaucous green, sp. gr. 1007, quantity 15 1/2 ounces (chloroform extracted a brown varnish, smelling strongly of the original Hyosc., 2 drops of its solution in 10 drops of water dilated pupil), 4.
• Urine half an hour after Hyosc., acid, sp. gr. 1017; 1000 grains contained chlorine 3.00 grains, urea 16.66 grains, sulphates and phosphates 8.60 grains; after two hours and a half, acid, sp. gr. 1023; 1000 grains contained chlorine 5.49 grains, urea 21.66 grains, sulphates and phosphates 8.80 grains (both specimens normal in uric acid), 8.
• Urine, before taking, acid, sp. gr. 1010, bright on boiling; after two hours and a half, alkaline , sp. gr. 1025; much phosphatic opalescence on boiling, and deposit of triple phosphates on standing, .

RESPIRATORY ORGANS

• Dry tracheal cough, during the last hour (after one hour and a quarter), 3c.

HEART AND PULSE

• After doses (1/16 to 1/12 of a grain) sufficient to produce complete dryness of the tongue and the hard and soft palates, the pulse will generally experience an acceleration of 10 or 20 beats, and be increased slightly in force and volume; this change in the pulse will be observed in from ten to twenty minutes after the subcutaneous injection of Hyoscyamin; the acceleration does not usually continue for longer than twenty or thirty minutes, and rarely lasts for an hour; then the pulse slowly declines, and gains a little in force and volume; it usually decreases about 5 beats for every interval of twenty or thirty minutes, until at the end of an hour and a half or two hours it attains its minimum rate; after a small dose (1/40 of a grain) the pulse will usually fall without any previous acceleration, 1.
• Pulse 76 (before the proving); accelerated 26 beats of undiminished volume and power (after thirty minutes); accelerated 24 beats (after forty minutes); accelerated 12 beats (after fifty minutes); fallen to 9 beats below the initial rate, regular, and of undiminished power and volume (after one hour and a quarter); decreased 18 beats, regular, softer, of good volume (after two hours and a quarter); decreased 21 beats, being now 53, regular, and of natural volume and power (after three hours), 3c.
• Pulse 78 (before the proving); rose 18 beats during the first twenty minutes, and then during the next two hours gradually fell to 20 beats below the initial rate; during the first half hour the force and volume were slightly increased; afterwards the pulse assumed its natural character, 4.
• Pulse 74 (before the proving); increased 18 beats, regular (after twenty minutes); accelerated 8 beats (after one hour); 5 beats (after one hour and a half); 72, reduced 2 beats, of the same volume and power as before the injection (after two hours); still 72, regular, and of good volume (after two hours and a half), 2a. [80.]
• Pulse 76 (before proving); increased 15 beats, regular, a little increased in volume (after twenty minutes); increased 4 beats (after one hour); 20 beats below the initial rate, of natural volume and power (after two hours), 3b.
• Pulse 74 (before the proving); accelerated 15 beats (after twenty-three minutes); accelerated 10 beats, regular (after three-quarters of an hour); 74, of natural volume and power (after one hour); 72 (after two hours), 2.
• Pulse increased 12 beats, full and regular (after twenty minutes); increased only 2 beats, of natural volume and force (after forty-five minutes); pulse fallen 1 beat full and regular (after one hour); decreased 6 beats, but still remained of good volume and force (after two hours); pulse 60, very regular, and of natural force and volume; it had continued so from the second hour (after three hours and three-quarters), .

EXTREMITIES IN GENERAL

• Limbs were fidgety, and occasionally affected with slight twitchings (after two hours), 7.
• Slight jerking of the limbs, 1b.

INFERIOR EXTREMITIES

• The legs were very weak and he could not walk without assistance (after twenty minutes), 7. [90.]
• Legs felt too weak to walk (after one hour), 2a.
• He could not rise from his chair, or walk without assistance; and as he sat, the extensors of the legs were slightly twitched now and then, so as to advance the foot with a little jerk (after forty-five minutes), 7.
• Quite unable to walk (after two hours), 7.

GENERAL SYMPTOMS

• The muscular system generally was flaccid, he did not sit erect in the chair, and a foot was occasionally advanced with a little jerk, and once or twice the hand was suddenly pronated and supinated with a jerk (after one hour), 7.
• The power of maintaining the erect posture will be lost, and at best the patient reels like a drunken man, 1b.
• Somewhat restless for an hour and a quarter, and if I left his side for a minute he would attempt to get up, reel for a few paces, and then fall together like a drunken man, upon the carpet (after two hours), 7.
• Felt heavy (after twenty minutes), 3b.

SLEEP

• Inclined to yawn (after one hour and three-quarters), 3.
• Frequently yawned and sighed (after one hour and a quarter), 3c.
• Gapish and tired (after three hours and a quarters), 7. [100.]
• Slight inclination to sleep (after three hours and a quarter), 7.
• Somnolency continuing about an hour (after ten to twenty minutes), 1a.
• Much somnolency, and had slept the last ten minutes (after one hour); had slept during the last hour, and still experienced somnolency (after two hours), 3b.
• Much somnolency (after fifteen minutes); continued very sleepy (after thirty minutes); she continued to sleep for an hour and a half (after three-quarters of an hour); when disturbed awaking with a start, 6.
• Great somnolency for three hours, 5.
• Great somnolency (after twenty minutes); continuing (after one hour and a half); nearly passed off (after two hours), 2a.
• Greater somnolency and giddiness than after 1/4 grain of acetate of morphia (used subcutaneously); the effects came on within five minutes, and he slept two hours soundly and continuously, 4.
• Such excessive somnolency that the patient cannot keep the eyelids raised for a few seconds, 1b.
• Either wakeful, quiet, and usually pleasing delirium, with illusions of the sight, or such excessive somnolency that the patient cannot keep the eyelids raised for a few seconds, but when aroused, lapses again into a dreamy sleep, broken by occasional mutterings and slight jerking of the limbs, 1b.

SUPPLEMENT: HYOSCYAMINUM. Authorities.

8 , J. S. Pearse, Lancet, 1876 (2), p. 319, effects of 1/240 grain, dropped on the conjunctiva; 9 , same, effects of injecting hypodermically.

HEAD

• Giddiness, 9. [110.]
• Headache, 9.

EYE

• Injection of the conjunctiva, 9.
• Dilatation of the pupil was very obvious, and usually present, 9.
• As soon as the topical action commenced, misty vision was frequently complained of, which lasted from a few hours to four days. This was present in about half the cases, and varied from a slight dimness to an extent which rendered it impossible for the patient to read unless the print was within two or three inches of the nose. The time required to produce full dilatation was found to be about fifteen minutes; the longest being twenty-five minutes, and the shortest ten minutes. In no instance did it fail to produce its results; and in the majority of the cases the dilatation was extreme, the iris being reduced to simply a narrow line. No diplopia was produced. There was total insensibility of the iris, lasting a variable time; the duration of dilatation also varied, lasting from two to twenty-one days, 8.

FACE

• Flushing of the face, 9.

MOUTH

• Dryness of the mouth and pharynx, coming on usually within half an hour, 9.

PULSE

• Pulse increased in frequency, 9.
• Pulsation of the carotids was increased and visible on the surface in a few instances, 9.

SLEEP

• Tendency to sleep, 9.

FEVER

• The skin in some instances became hot as well as dry, and a rise in the temperature to the extent of 10° in an hour was noted where the full constitutional effects was produced, 9.