Crotalus Horridus

Rattlesnake poison. Crotalidæ.

The first regular provings of the poison were made by C. Hg., and his provers, who proved the first and second triturations ; see Hering's Monograph on the Effects of Snake Poisons, 1837 ; a single proving with the third dilution on an unmarried lady, æt. 35, by Stokes, is recorded among the aforementioned, and the effects of the bite, from various sources, recorded in vol. 3 of Encyclopædia. The Monograph on Crotalus, by J. W. Hayward, of Liverpool, published 1884, is the most complete record of the effects of Crotalus virus on the sick and well we have had hitherto. We have drawn from it largely to complete our collection of clinical and guiding symptoms, rendering due thanks to the author of the valuable monograph who thereby enriched our literature.

CLINICAL AUTHORITIES.

• Delirium tremens , Mackechnie, Raue's Rec., 1874, p. 62 ; Delusions during incipient stage of senile dementia , Hayward's Mon., p. 255 ; Sensorial disturbance , Hayward's Mon., p. 260 ; Headache , Neidhard, Hayward's Mon., pp. 267, 268 ; Sick headache, with vertigo , C. Hg., MSS ; Affection of eyes , Neidhard, Hayward's Mon., p. 272 ; Amblyopia , Decran, Rück. Kl. Erf., vol. 5, p. 147 ; Ciliary neuralgia , Decran, Rück. Kl. Erf., vol. 5, p. 141 ; Otorrhœa , Hayward's Mon. ; Ozæna , Nankivell, Hayward's Mon., p. 276 ; Distortion of face , Hayward's Mon., p. 280 ; Papular eruption on face , Hayward's Mon., p. 280 ; Diphtheria , Hayward's Mon., p. 287 ; Cushing, Organon, vol. 1, p. 223 ; Spasm of œsophagus , S. P. Burdick, Hayward's Mon., p. 296 ; Bilious vomiting , Hayward's Mon., p. 367 ; Atonic dyspepsia , Hayward's Mon., p. 296 ; Hepatic disorder (2 cases), Neidhard, Hayward's Mon., p. 301 ; Peritoneal inflammation , Hayward's Mon., p. 300 ; Perityphlitis , Hayward's Mon., p. 300 ; Intestinal hemorrhage , Hayward's Mon., p. 305 ; Hæmaturia (4 cases), Hayward's Mon., p. 310 ; Dysmenorrhœa , Hayward's Mon., p. 310 ; Mastitis and milk leg in a primipara , C. Hg., MSS. ; Pertussis , Hayward's Mon., p. 317 ; Palpitation of heart , Hayward's Mon., p. 327 ; Tubercle on wrist , Hayward's Mon., p. 337 ; Red spot on finger , Hayward's Mon., p. 337 ; Ecchymoses on lower limbs , Hayward's Mon., p. 342 ; Tingling and prickling in hands and left leg , Hayward's Mon., p. 338 ; Paralysis of extensors of left foot after typhus , C. Hg., MSS. ; , Neidhard, Hayward's Mon., p . 268 ; , Weber, Rück. Kl. Erf., vol. 1, p. 91 ; , Hayward's Mon., p. 357 ; , W. Jackson Simon, Hayward's Mon., p. 368 ; , Neidhard's Mon., p. 49 ; Hayward's Mon., p. 366 ; , Neidhard's Mon., Hayward's Mon. ; (2 cases), Plate, Rück. Kl. Erf., vol. 4, p. 664 ; also used successfully by Hardenstein in an epidemic ; , Bryce, Hayward's Mon., p. 369 ; , Hayward's Mon., p. 352 ; , Hayward's Mon., p. 352 ; (2 cases), Hayward's Mon., p. 362 ; (4 cases), Hayward's Mon., p. 365 ; , Bryce, Hayward's Mon., p. 353 ; , Weber, Rück. Kl. Erf., vol. 4, p. 183.

MIND [1]

Memory weak ; obtuse, stupid, cannot express himself correctly ; makes ridiculous mistakes in spelling.

Perception diminished.

Confused speech ; disconnected answers, with coldness of skin and rapid pulse.

Torpor, sluggishness, incoherency, hesitation and quiet indifference.

Mental delusions, such as mistakes in keeping his accounts and in writing letters, forgetfulness of figures, names and places ; awaking in the night struggling with imaginary foes ; imagines himself surrounded by enemies or hideous animals ; taking antipathies to members of family. θ Incipient stage of senile dementia.

Delirium : with languor, drowsiness, stupor ; at night ; with moans ; with wide open eyes ; in yellow fever.

Loquacious delirium, with desire to escape from bed.

Muttering delirium of typhus.

Delirium tremens, nearly constant drowsiness, but with inability to sleep ; trembling ; numbness of extremities ; repeated attacks ; broken down constitutions.

Mania in zymotic diseases and when connected with puerperal or ovario-uterine disease.

Moaning and groaning.

Pains in head, with oppression of chest, burning fever and accelerated pulse ; loss of speech, sopor from which he cannot be aroused, muttering and lockjaw. θ Apoplexy.

Marked indifference, seems only half alive ; utter apathy.

Sadness, her thoughts dwell on death continually.

Oppression, as if brain had been intoxicated by carbonic acid, or by degraded or non-oxygenated blood.

Depression, anxiety and lowness of spirits. θ Intestinal hemorrhage.

Nervousness and depression of spirits. θ Headache.

Excessive sensitiveness ; moved to tears by reading.

Weeping mood, agony and despair.

Melancholy, with timidity, fear ; anxiety ; weeping ; or snappish temper.

Melancholia, with timidity, fear, distress and anguish.

Suspicion and snappishness, or quiet indifference.

Anxious and pale, with cold sweat.

Anxiety and distress, mental and bodily.

Great anxiety, intense restlessness, much delirium.

Anguish, moaning and groaning, with sleeplessness.

Snappish temper ; irritable, cross, infuriated by least annoyance.

Intense restlessness, twitching and nervous agitation.

Lethargy, weakness, debility, powerlessness, staggering, trembling, vertigo, numbness, loss of co-ordination of movements.

Fits of drowsiness or coma.

SENSORIUM [2]

Vertigo : with faintness, weakness, nervous trembling ; with pale face ; with falling and loss of consciousness ; epileptic ; auditory ; cardiac, with soft, weak pulse ; anemic, > resting head ; with venous congestion and degraded blood ; with dilated pupils ; from lightning or sunstroke ; from fright.

Fainting : on assuming an upright position ; in attacks ; and falling.

Attacks of dizziness, fainting and weakness, with occipital headache, several times a day.

Apoplectic convulsions, especially at onset of some zymotic disease.

Apoplexy in hemorrhagic or broken down constitutions, or in inebriates.

INNER HEAD [3]

Severe frontal headache, with coma and delirium, difficult deglutition, nausea and bilious vomiting.

Awakes in morning with headache over eyes. θ Dysmenorrhœa.

Headache extending into eyes.

Dull, heavy pain and heat over eyes and in sides of nose, also dull, pressing pain at back of ear, heat in forehead, lightness of head in open air, sickness of stomach in morning, nausea and vomiting, with nervousness and depression of spirits.

Headache in forehead above eyes, in temples, < in right, with vertigo, nausea and vomiting of bile ; is obliged to lie down ; constipation ; > from walking in open air.

Pressure and oppression above eyes.

Bilious headache every few days, beginning behind left ear and passing around lower forehead as a pressing down on eyes, with nausea and vomiting. θ Distortion of face.

Severe pain at centre of forehead ; dilated pupils ; profuse menses.

Dull, heavy, congested feeling in front of brain, < from exerting intellect.

Frontal headache in left anterior lobe, particularly at its under surface.

Pressure and heavy pain on top of head from 6 A. M. until evening.

Very severe pain in right eye and top of head, on right side down back of neck, at intervals, for twenty years.

Sick headache, with vertigo, heat on top of head and general sweat.

Throbbing and heat in left side of head, with nausea before menstruation ; vomiting green bile ; urine high colored.

Head aches all over, with high fever, < at night, with great drowsiness ; aching in all the bones ; heat in forehead and burning in chest, < from motion.

Frightful headache. θ Diphtheria.

Dull, heavy, throbbing occipital headache, faint spells ; hunger and general trembling.

Terrible headache ; pain as from a blow in occiput. θ Cerebro-spinal meningitis.

Headache : especially of a dull, heavy, aching, drawing, pressing, compressive, or pulsating character ; shooting, or stinging ; in morning on awaking, generally going off while dressing ; after mental exertion ; confusion and loss of memory, especially for words and figures ; vertigo, nausea, vomiting and malaise.

Headache as if constricted, then sensitiveness of brain ; pulsations ; sensitiveness of heart when lying on left side.

Cerebral congestion ; severe headache, vertigo, nausea or vomiting ; accompanying zymotic or septic diseases.

Meningitis resulting from extension of ear disease ; toxemic, alcoholic, albuminuric, scarlatinoid, varioloid, particularly at period of effusion, accompanied by paralytic symptoms or mental deficiency.

Softening of brain, hydrocephaloid, or apoplexy following toxemic states in broken down constitutions.

OUTER HEAD [4]

Violent itching of scalp ; eruptions, pustules, boils, carbuncles, with tendency to unhealthy hemorrhagic contents, or recurrent, or slow, or with œdematous surroundings.

Falling off of hair, especially as a result of toxemia, such as scarlatina, typhus, variola, etc.

SIGHT AND EYES [5]

Illusions, blue colors, dimness, or loss of vision ; vanishing of sight while reading.

Momentary disappearance of vision, with profuse lachrymation.

Amblyopia, caused by grief and overuse of eyes in sewing ; cutting pains around eyes ; muscæ volitantes and various colored flames.

Retinal hyperesthesia in debilitated, broken down strumous and hemorrhagic constitutions.

Hemorrhages into retina, whether occurring during course of retinitis albuminurica and other diseases, or when it seems to be of spontaneous origin.

Retinitis, especially albuminuric and syphilitic.

Amblyopia, amaurosis, especially from hemorrhage, debility and exhaustion.

Diplopia ; glaucoma.

Ecchymosis, chemosis, conjunctival hemorrhage, especially in course of zymotic disease, menstrual irregularities and in hemorrhagic states of body.

Ophthalmia, conjunctivitis, iritis, especially as occurring in eruptive diseases, variola, morbilli and syphilis, or other blood diseases.

Exopthalmic goitre ; when traceable to any exhausting or toxemic cause, such as overlactation, excessive or suppressed menstruation.

Dilated pupils ; blue rings around eyes.

Outward distortion of eyes.

Paralysis of ocular muscles.

Yellow color of eyes.

Blood exudes from eye.

Tearing, boring pain, as if a cut had been made around eye, sometimes sticking in character and < morning and evening ; great sensitiveness to light, especially lamplight ; lids swollen in morning, with pains in forehead and occiput ; palpitation of heart, especially at menstrual periods. θ Ciliary neuralgia.

Sensation of dryness and burning ; redness with a zone around cornea.

Burning in eyes ; redness with lachrymation.

Pressure and oppression above eyes.

Eyes weak and very red, with agglutination of lids, sight very weak ; photophobia.

Blepharitis ; œdema of, or hemorrhage into eyelids, especially when of an erysipelatous character and when occurring in the course of septic or zymotic diseases.

Ptosis.

To clear up the vision after an attack of keratitis or kerato-iritis.

HEARING AND EARS [6]

Sensitive to noises.

Feeling of fulness in ears.

Deafness ; illusions of hearing ; auditory vertigo.

Otorrhœa the result of exanthemata, menstrual irregularities, alcoholism, albuminuria, naso-pharyngeal catarrh, diphtheria, typhoid, syphilis, etc.

Erysipelas of external ear, in broken down or hemorrhagic constitutions.

Abscess and furuncle in meatus, or external ear ; frost-bite.

Severe otorrhœa after scarlatina, offensive and sanguinolent, with considerable deafness.

Blood oozes from ears.

SMELL AND NOSE [7]

Epistaxis ; at onset or during course of zymotic and septic diseases ; or in broken down constitutions, or depraved state of blood and where blood appears thin, degraded, uncoagulable, dark ; also with flushes of face, vertigo or fainting.

Catarrh ; with sanguinolent discharge.

Ozæna ; especially left by exanthemata or syphilis, discharge sanguinolent rather than offensive.

Redness and blueness of point of nose ; with swelling and coldness. θ Old inebriates. θ Zymosis.

Bleeding from nose and all the orifices of body.

UPPER FACE [8]

Expression : besotted ; anxious, pale ; excited, flushed ; of indifference.

Paleness of face, as in faintness.

Yellow color of face.

Flushes of face.

Color : livid, bloated ; purple, face tumid ; blue around sunken eyes ; chalky ; deathlike pallor ; leaden.

Red, puffed face.

Distended red face with delirium tremens and fever.

Wakes up during night grinding her teeth and face much distorted, mouth and nose drawn to left side.

Frequently recurring erysipelas of face.

Cold sweat, drawn features, formication, trembling and quivering of lips and eyelids.

Face swollen, puffiness at angles of lower jaw ; swelling of parotid and submaxillary glands.

Acne : all varieties ; of masturbators ; of drunkards.

Discoloration, blueness, varicosis of nose and lips. θ Heart disease. θ Asthma.

Neuralgia of a dull character, chronic or periodic.

Parotitis.

LOWER FACE [9]

Lips swollen ; stiff and numb.

Lockjaw. θ Apoplexy.

Copious, red, itching papular eruption on face, especially chin, which has existed for some months since menstruation has been delayed.

TEETH AND GUMS [10]

For years subject to grinding of teeth during sleep, most of molars broken ; mouth and nose drawn towards left side. θ Distortion.

Gums : white ; swollen ; painful ; borders reddened.

TASTE, SPEECH, TONGUE [11]

Complete loss of taste. θ Hepatic disorder.

Tongue and all around throat feel tied up, he cannot speak a word.

Tongue very red, smooth and polished, feels swollen. θ Atonic dyspepsia.

Tongue : red and sore ; yellow ; stiff and numb.

Tongue yellowish-brown, dry in centre. θ Remittent.

Foul tongue having red tip. θ Peri-typhlitis.

Swelling of tongue till there is no more room in mouth, with inflammation.

Tongue swollen to nearly twice the normal size.

Tongue protruded.

Œdema of tongue ; after sting of insects.

Glossitis ; erysipelatous or gangrenous symptoms.

Syphilis of tongue.

Cancer of tongue, with much tendency to hemorrhage.

INNER MOUTH [12]

Fetid breath ; peculiar mouldy smell from mouth. θ Bilious remittent. θ Malignant intermittent. θ Yellow fever.

Mouth feels foul and sticky on awaking. θ Dyspepsia.

Stomacace or putrid sore mouth ; cancrum oris.

Salivation ; flow bloody or frothy.

PALATE AND THROAT [13]

Sensation of tight constriction of throat.

Throat dry and swollen, with thirst ; connective tissue greatly infiltrated ; glands enlarged.

Scraping, rancid sensation down œsophagus to stomach.

Sensation of a plug in throat to be swallowed, or sensation of contraction or choking, or as if uvula or velum was elongated or stiff, or as of a dry spot or a tickling in throat, especially left side, < on awaking from sleep.

Sore, raw or pricking pain, especially at left side, near root of tongue, or extends to ear, or is as if proceeding from ear ; < from empty deglutition and from swallowing fluids rather than solids.

Neuralgic drawing in fauces, < left side, near root of tongue, almost causing choking.

Deglutition of any solid substance quite impossible ; soup must be strained in order to remove all meat fibre and solid particles. θ Spasm of œsophagus.

Fauces much swollen and dark red ; pulse 120, very small and weak ; skin hot but perspiring ; frightful headache ; great prostration, can hardly raise himself in bed ; great thirst. θ Diphtheria.

Nervous sore throat ; pain out of all proportion to the visible trouble ; fauces dry, great irritability and sensitiveness to dry or cold air.

Sudden sore throat as if uvula and velum were swelling, with dry mouth ; preceded by palpitation and trembling of heart.

Quinsy ; with much venous congestion, dark, bluish color of surrounding parts, much œdema, tonsils bulge and are tender to pressure at angles of lower jaw ; pain < from empty deglutition ; especially with scarlatina or diphtheria.

Angina tonsillaris ; constriction of throat ; tongue yellow.

Diphtheria, throat swelling fast ; difficult swallowing.

Malignant diphtheria, life threatened by blood poisoning, much œdema or gangrene of fauces or tonsils, or much swelling at angles of lower jaw, head thrown up and backward, difficult respiration, dark, swollen, puffy countenance ; great prostration, much tremulousness, very soft, scarcely perceptible pulse ; or if vomiting or diarrhœa be present.

APPETITE, THIRST. DESIRES, AVERSIONS [14]

Hunger with trembling, weakness and occipital headache.

No appetite, extreme thirst. θ Peri-typhlitis.

Unquenchable burning thirst. θ Diphtheria.

HICCOUGH, BELCHING, NAUSEA AND VOMITING [16]

Heartburn ; œsophagus as if full of a rancid fluid.

Eructations sharp, sour ; acrid or rancid.

Sickness of stomach in morning.

Nausea and malaise, anxiety ; deathly sickness.

Ineffectual retching, with feebleness.

Nausea and vomiting. θ Headache.

Vomiting : and giddiness ; incessant with thirst ; preceded by faintness ; violent, of food ; green ; of bile ; of blood ; on least exertion.

Nausea on movement ; bilious vomiting every month after menstruation. θ Hepatic disorder.

Bilious vomiting, with violent fever and delirium ; dulness of head, with great apathy and forgetfulness ; everything tastes bitter, and sometimes acid ; very fetid diarrhœa ; tongue dark brown ; constant drowsiness ; dryness of skin ; urine high colored.

Bilious vomiting, with anxiety, palpitation, weak pulse.

Cannot lie on right side or back without instantly producing dark green vomiting ; soreness in back part of head on pressure, < on motion or sitting up in bed ; drawing in right side of head, < after eating and producing great dizziness in back part of head ; sleeps only in middle of night, after which she feels better ; feels sick if she sleeps in daytime ; light hurts the eyes and everything looks yellow (at first everything looked blue).

Black vomit. θ Yellow fever.

SCROBICULUM AND STOMACH [17]

Frequent faint, sinking, hungry sensation about epigastrium, with trembling and fluttering sensation a little lower down, followed by flushes of heat over whole body ; extreme weakness ; tongue very red, smooth and polished, and feels swollen ; mouth foul and sticky on awaking.

Weight on stomach, tremulous weakness, as from impending evil ; soreness, tenderness.

Violent cramp in stomach after eating.

Agonizing pain, restlessness, coldness, weak pulse.

Pylorus constricted ; lining of stomach turgid.

Cannot bear clothes around stomach and hypochondria.

Painfulness in pit of stomach.

Stomach irritable, unable to retain anything.

Hematemesis from ulceration.

Distressing sensation of sinking, craving for stimulants.

Gastric disturbances of nervous origin, cerebral, sensorial, or reflex, and such as occur on invasion of zymotic or septic diseases, or in connection with menstrual or uterine complaints, jaundice, nephritis, albuminuria, etc.

Hematemesis ; blood has little or no tendency to coagulate, or is dark, as if from passive congestion or malignant disease, or atonic ulcer, or when disease is sympathetic, as in vicarious menstruation.

Cancer : much hemorrhage or much vomiting of mucus, slimy or sanguinolent.

HYPOCHONDRIA [18]

Intolerance of clothing about epigastric region and hypochondria.

Shooting in region of liver.

Stitches in region of liver on drawing a long breath, < by pressure ; complete loss of taste ; constipation ; urine jelly-like and red like blood.

Pain in region of liver, also on top of shoulder ; pulsating in ascending aorta, nausea on movement, stools white ; bilious vomiting every month after menstruation.

Aching in liver ; great heaviness in stomach, with vomiting of everything she eats in morning, can eat better in afternoon, feels sometimes as if she could eat fat pork ; continual acid taste on tongue ; constipation ; menses too early and too sparse, dark at first ; roaring in ears ; great numbness of arms and legs, with coldness at times ; skin very dark brown. θ Bilious vomiting.

Passive hepatic congestion ; especially when from heart disease, or from imperfect performance of uterine functions, or if a sequel of malarial fever.

Acute atrophy of liver.

Violent pain in left side near last ribs, as if in diaphragm.

Jaundice ; malignant jaundice ; dark hemorrhages from nose, mouth, etc. ; dark, scanty urine.

ABDOMEN AND LOINS [19]

Heat and tenderness of abdomen, can scarcely bear her clothes on. θ Peritoneal inflammation.

Swelling of whole abdomen.

Violent pain in course of colon.

Pulse 140, skin hot and dry, extreme pain in region of appendix, with frequent paroxysmal aggravations, great tenderness on pressure in a spot size of small orange, with some feeling of hardness ; cannot bear right leg straightened, but lies with it bent and supported by pillow. θ Peri-typhlitis.

Typhlitis and peri-typhlitis ; low type, red-tipped tongue, prostration ; no stool, or discharges very offensive.

Peritonitis ; in course of septic or zymotic disease ; temperature below normal ; low, debilitated or hemorrhagic condition ; effusion of bloody serum.

Enlarged inguinal glands ; sloughing, unhealthy pus.

Swelling of inguinal glands, bubo ; from septic absorption, as from sloughing sores on genitals, or gangrenous affection of toes, etc.

STOOLS AND RECTUM [20]

Violent purging, with disagreeable sensation through whole body and nauseous taste.

Stools : black, thin, like coffee-grounds ; offensive.

Liquid, dark green stools, followed by debility ; yellow, watery, with stinging in abdomen ; a number of liquid stools, with colic, or with nausea and colic, or with scraping in posterior wall of rectum ; lowness of spirits and indifference to everything.

Nausea and diarrhœa ; shuddering with diarrhœa ; pulse feeble and quick, then slow ; aphonia.

Diarrhœa : from noxious effluvia ; imbibition of septic matters in food or drink ; from "high game ;" summer diarrhœa ; cholera, etc.

Dysentery : of septic origin ; from foul water, food, etc. ; excessive flow of dark, fluid blood, or involuntary evacuations ; great debility and faintness.

Bowels irregular, either diarrhœa or constipation. θ Distortion of face.

Constipation, with congestion to head and headache.

Vomiting, purging and micturition simultaneously caused by spasmodic contraction, with tenesmus and strangury.

Stools white. θ Hepatic disorder.

Bleeding from anus and other orifices.

Bloody passages from bowels, sometimes involuntary.

Intestinal hemorrhage ; when occurring during course of septic or zymotic disease ; when of hepatic, splenic, or cardiac origin ; or from cancer, atonic ulcer, menstrual irregularities, or if blood is dark, fluid and uncoagulable.

Dark, fluid hemorrhage with stool, with oozing of blood on standing or walking ; debility, faintness, and aching in left iliac region ; with depression, anxiety and lowness of spirits ; bowels relaxed.

Cholera ; sudden and extreme coldness and blueness ; collapse, cramps, diarrhœa, vomiting ; embarrassed respiration, scarcely perceptible pulse, suppression of urine.

Varicosis of anus and lower bowels ; idiopathic hemorrhoids, with great tendency to bleed on using paper, or straining a little at stool, or on standing.

Hemorrhoids ; bleeding piles ; blood dark, thin, and little disposed to coagulate ; also in pregnant women, and with menstrual irregularities, and connected with heart disease, liver disease, or the hemorrhagic diathesis, in broken down constitutions, in chronic inebriates.

URINARY ORGANS [21]

Passive renal congestion ; when from embarrassed circulation, as from obstructive heart disease, asthma, chronic bronchitis, etc., particularly during a course, or as sequela, of zymotic disease.

Nephritis albuminosa ; when occurring in course of any of the toxemia, or in pregnancy ; urine dark, smoky from admixture of fluid blood.

Hemorrhage from urethra.

Suppression, or painful retention of urine.

Urine : extremely, scanty, dark red with blood ; jelly-like ; green-yellow from much bile ; copious and light colored.

Hæmaturia ; with cancer of bladder or prostate.

MALE SEXUAL ORGANS [22]

Sexual instinct increased with entire relaxation of penis.

FEMALE SEXUAL ORGANS [23]

Ovaritis ; in hemorrhagic constitutions, or connected with menorrhagia or puerperal septicemia ; ovarian abscess.

Ovarian neuralgia ; in form of pure neurosis, and at climacteric, with flushings, or pressing pain in vertex.

Menorrhagia ; during course of septic or zymotic disease, or other toxemic states, as Bright's disease ; or in hemorrhagic diathesis ; blood dark, fluid, offensive.

Sharp neuralgic pains, intermittent, from left side of womb to transverse colon, thence cutting across as if from both sides towards centre ; thence up to face and temple ; dull frontal headache.

Menstruation delayed, dark and scant. θ Papular eruption of face.

Menstruation late, six to eight weeks interval, scanty and dark, very painful at beginning. θ Distortion of face.

Catamenia a week too soon ; very profuse with severe frontal headache, weight in head and ears, with pains in abdomen and back, cold extremities ; yellowness of skin.

Five days before menstruation, much pain in hypogastrium and down thighs, lasting during first two days of flow ; flow very copious first three days and then lingers on and off for four days more ; much dull, continuous, aching pain in region of heart, down left arm and through to left shoulder blade, < on drawing deep breath and going up-stairs or a hill ; feet cold. θ Dysmenorrhœa.

Vicarious menstruation ; in debilitated, depraved states.

Leucorrhœa offensive, bloody.

Menopause ; flushings, perspirations ; head troubles (throbbing, noises, giddiness) ; cardiac troubles, as sudden palpitations ; "sinking at stomach ;" fainting at epigastrium ; weak, debilitated constitutions ; or when there is metrorrhagia or other hemorrhagic phenomena, blood being dark, fluid and offensive.

Cancer uteri, fungoid, malignant sarcoma, cauliflower excrescence, with much tendency to hemorrhage ; in very degraded states of system.

PREGNANCY. PARTURITION. LACTATION [24]

Miscarriage during course of septic or zymotic disease ; and in nurses exhausted by long nursing of zymotic or septic patients ; and from other blood-poisoning causes.

Puerperal fever or convulsions ; in connection with albuminuria ; torpidity, coma ; blue, bloated countenance ; septic or zymotic influence, or in hemorrhagic or broken down constitutions.

Lochia very offensive, from retained and decomposing matter ; also after-pains with such lochia.

After parturition, left breast inflamed and hard, with fever and prostration, yellow spots on face ; trembling tongue ; breast discharges thin, milky pus and masses of broken down tissue from an opening beneath the nipple ; pulse small and rapid ; stitching pain in a hard lump which formed in the lower outer part of breast.

Phlegmasia alba dolens ; left leg swollen to twice its size, grinding pain in leg, < from slightest touch.

VOICE AND LARYNX. TRACHEA AND BRONCHIA [25]

Loss of speech. θ Apoplexy.

Laryngismus stridulus, spasmus glottidis : from local nervous irritability, or from central irritation, being a part of a general convulsive condition ; during course of zymotic disease ; hysteria.

Hoarseness, with weak, rough voice.

Paralysis glottidis (paralytic aphonia) from muscular or nervous irritability, as in hysteria.

Laryngitis acuta ; œdema glottidis ; acute catarrhal aphonia, especially erysipelatous and scarlatinal ; from scalds, stings of insects ; irritating vapors, with great sensitiveness and irritability on talking, or to contact of dry, cold air, or to pressure (which also induces coughing) ; sore, raw, pricking pain, < on left side ; or as if in a small dry spot ; much tickling irritability and hawking, as if from presence of a little sticky mucus, which had to be got up ; also during course of scarlatina, morbilli, variola, etc.

Ulceration from necrosis of cartilages of larynx.

Bronchiectasis, putrid bronchitis, chronic bronchorrhœa, especially in broken down or hemorrhagic constitutions, with tendency to gangrene.

RESPIRATION [26]

Dyspnœa, anxiety, thirst, nausea, diarrhœa.

Breathing : anxious ; embarrassed, with constriction of throat ; jerking ; quick, labored, with weak pulse and nervous agitation ; slow, labored, imperceptible pulse ; difficult, as if lungs would not expand.

Asthma ; especially with cardiac disease ; great debility and prostration, blue, puffy countenance, cold sweat.

COUGH [27]

Nervous cough, especially laryngeal ; dry, tickling, constant, choking, as if from dry, irritating vapor, or salt or pepper, or as if from dry spot in larynx, < on l. side ; or as if provoked by dry or cold air, or by deep inspiration, by speaking and particularly by external pressure on larynx which cannot be borne ; or is very apt to occur on awaking from sleep.

Extreme sensitiveness and irritability ; dry cough on speaking, < in dry or cold air ; much hawking ; hoarseness or loss of voice ; sudden tickling causing choking, spasmodic cough.

Pertussis : with great debility, much cardiac weakness, blueness or pallor of countenance after an attack and tardy return to natural color ; attacks followed by puffiness of face or hemorrhagic spots, purple lips, bloodshot eyes, epistaxis, or much frothy, stringy, sanguineous expectoration ; when there is any threatening of pulmonary œdema or paralysis.

Cough ; in phthisis when incessant and apparently from nervous sensitiveness and irritability.

Cough with stitch in left side and bloody expectoration.

Spitting of blood.

INNER CHEST AND LUNGS [28]

Excessive oppression of chest ; in old people affected with hydrothorax ; in fever and ague ; in apoplexy.

Burning in chest, with heat in forehead.

Stitch pains in chest ; pleurisy with remittent fever.

Hæmoptysis.

Hydrothorax : in broken down constitutions ; whether secondary dropsy or left by pleurisy ; with weak heart, albuminuria, menstrual irregularities or hepatic disease.

Œdema pulmonum ; gangrena pulmonum ; in inebriates and old persons ; in course of septic or zymotic diseases.

Abscess or cancer pulmonum ; tendency to gangrene ; with typhoid symptoms ; with hemorrhage or fetor.

Pneumonia ; with tendency to gangrene or hemorrhage.

HEART, PULSE AND CIRCULATION [29]

Much dull, continuous, aching pain in region of heart, down left arm and through to left shoulder blade, < on drawing deep breath and going up stairs or a hill. θ Dysmenorrhœa.

Heart tender when lying on left side.

Pain in heart ; heart beat rapid, sometimes intermittent.

Palpitation, with sore pain in and about heart, feeling as if heart tumbled over, or trembling of heart.

Palpitation of debility, obesity, or fatty heart ; nervous palpitation, angina pectoris, and the imitation of the latter occurring in hysterical women.

Heart beat feeble, or imperceptible.

Pulse : rapid ; slower than natural (sixty beats), or intermitting and scarcely perceptible ; feeble and quick, then slow ; feeble, fluttering, frequent, small, quick, threadlike, weak, scarcely perceptible, trembling, wavy, or slow ; irregular.

Pulse 120, very small and weak. θ Diphtheria.

Passive and venous congestions in low states of vitality and in broken down constitutions, where there is a tendency to general or local venous relaxation or torpidity, such as liability to chilblains, frost-bite, etc.

Pernicious anemia, leucocythemia ; in constitutions broken down by gonorrhœa, syphilis, alcohol, etc., tendency to hemorrhages from gums, mucous membranes and skin ; blood non-coagulable.

Hemophilia, hemorrhagic diathesis, softening in vascular walls, or disorganization of blood ; blood indisposed to coagulate, even though arterial, or is dark in color.

Passive hemorrhages, where blood appears to ooze through vascular walls and escapes into surrounding tissues, or over or from free surfaces, mucous membranes, etc., as if blood was dissolved, or as if vessels had no power to retain within them the circulating fluid, as if whole system was in a state of dissolution.

Phlebitis ; in low, debilitated, erysipelatous state of system.

Varicosis, varicose veins, varicocele, venous torpidity, especially resulting from alcohol.

Lymphangitis, angioleucitis ; from septic absorption, pyæmia, etc.

NECK AND BACK [31]

Drawing, tensive pain from right shoulder along neck, as from a tense tendon, < from pressure and moving arm.

Carbuncles, boils, pustules, pimples or bed sores owing to a degenerate state of blood.

Pain in top of shoulder ; also in ascending aorta. θ Hepatic disorder.

Aching pain in right kidney and in stomach. θ Headache.

Softening of spinal cord, bed sores, spinal congestion, or irritation, spinal meningitis, myelitis, or spinal paralysis.

UPPER LIMBS [32]

Left axillary glands swollen and tender.

Paroxysms of bruised pains in bones of shoulder.

Throbbing pains in finger tips, etc.

Paralyzed sensation, trembling, jerking, cramps and neuralgia in arms.

Large inflamed furuncle on right upper arm near elbow.

Tight, cord-like feeling extending from front of left elbow down front of forearm, with "round spots" of pain here and there along front of forearm ; the "spots of pain" remain only for a few minutes and then pass away, but recur frequently during both day and night, cannot grasp with left forefinger and thumb, cannot extend left arm without pain. θ Pyæmia resulting from injury to r. middle finger.

Right middle finger swollen, hard, tense and of a glossy blue-grey, color, quite rigid and incapable of any movement ; the other fingers also more or less involved ; blush of redness on back of hand, with pain extending to elbow ; loss of appetite ; she feels low, miserable, weak ; finally angioleucitis of palm, then three red lines and an abscess in right axilla discharging. θ Pyæmia.

Tubercle on wrist, near end of radius, size of a large split pea and rather blue, resulting from sting of insect several years ago, had existed ever since, being more pronounced during Summer months.

Vesicular and pustular eruption about wrists.

Trembling of hands.

Tingling and prickling, "going to sleep" of hands, especially of left one, on least exertion, "they become quite dead" when she sews ; left leg similarly affected.

Coldness and blueness of hands and fingers connected with weak nervous system and heart.

Violent, spasmodic pain in left palm as from a bee-sting.

Itching and heat of palms.

Parchment-like condition of skin of hands.

Burning, itching red spot on back of left third finger, originally resulting from bite of insect twenty years ago ; had returned regularly at same time every year since, each time lasting about a week.

Oozing of blood from under nails.

Chilblains, especially when threatened with gangrene, and when chronic or occurring in not very cold weather, thus indicating a low nervous and vascular vitality.

Psoriasis palmar, pimples, pustules, boils, suppurating axillary glands, tubercles, petechiæ and numbness.

LOWER LIMBS [33]

Starting ; jerking ; trembling and cramps of lower extremities.

Legs "go to sleep" and tingle while sitting, or when crossing them.

Drawing suddenly from left hip to foot.

During and after walking feels as if a tendon was drawing from sole of right foot through bone of leg.

Cramplike pains in calf, heels and toes.

Sore pain in calf ; in sole of foot.

Swelling of feet every evening.

Paralysis of extensors in left foot after typhus ; drags toes.

Itching of skin on lower extremities.

Pimples ; pustules ; boils ; tubercles ; petechiæ ; hemorrhagic spots ; varicose veins ; ulcers, especially varicose, hemorrhagic, gangrenous ; chilblains.

Small purple spots appearing on legs and very soon both legs, from knees to ankles, became covered with ecchymosis ; some bleeding with stools and general circulation very languid.

LIMBS IN GENERAL [34]

Painful paralytic sensation.

Starting, jerking, trembling and unsteadiness of limbs.

Rheumatic and neuralgic pains.

Bruised pain in joints and bones.

Heaviness, as if bones were made of heavy wood.

Numb pain, as after cramp, in anterior of fingers and in toes.

Drawing pains in knee, tibia, back, etc.

Contraction of flexors.

Gonorrhœal rheumatism ; in chronic syphilitics and inebriates.

REST. POSITION. MOTION [35]

Resting head : > vertigo.

Lying down : headache compels.

Cannot lie on left side.

On lying on right side or back : dark green vomiting.

When lying on left side ; sensitiveness of heart.

Cannot bear right leg straightened, lies with it bent and supported by a pillow.

Head thrown up and backward, with diphtheria.

Sinking down towards foot of bed.

Sitting : legs go to sleep.

Standing : oozing of blood from anus ; great tendency of hemorrhoids to bleed.

Motion : vomiting ; soreness in back part of head < ; nausea ; heat in forehead and burning in chest <.

Can hardly raise himself in bed.

Sitting up in bed : soreness in back part of head <.

On assuming upright position : fainting.

Legs go to sleep when crossing them.

On moving arm : pain from right shoulder along neck <.

On sewing : going to sleep of hands.

Walking : headache, with vertigo, nausea and vomiting > ; oozing of blood from anus ; as if a tendon was drawing from sole of right foot through bone of leg during and after.

Going up stairs : aching in region of heart, down left arm and through to left shoulder blade, also on ascending hill.

Exertion : vomiting on least ; going to sleep of hands from least ; easily tired by slightest.

NERVES [36]

Tremulous weakness all over, as if some evil was apprehended.

General loss of power ; muscles refuse their service.

Easily tired by slightest exertion. θ Dysmenorrhœa.

Sudden and great prostration of vital force.

Great prostration, can hardly raise himself in bed. θ Diphtheria.

Frequent fainting spells, with imperceptible pulse and inclination to vomit.

Palsy, old rheumatisms.

Paralysis : following apoplexy, particularly of right side glosso-pharyngeal ; post-diphtherical ; of the insane ; general.

Myelomalachia, with entire absence of, or very little local pain ; pain only < from pressure, weakness of back, impaired mental activity, difficult speech, oppression of chest, convulsions, painless paralysis of extremities, with numbness and great coldness of affected limb.

Multiple sclerosis, lateral sclerosis, locomotor ataxy, progressive muscular atrophy, tetanus, etc.

Hysteria : especially when convulsive or apoplectiform.

Neuralgia : when occurring as a sequel of septic, toxemic or even miasmatic disease, or chronic bilious, climacteric or albuminuric conditions.

Local spasms, cramps, trismus, etc. ; when occurring as a sequel of toxemia, or in broken down constitutions.

Convulsions, with trembling of limbs, without foaming at mouth ; loss of senses ; indifference, seems only half alive ; paleness of face as in faintness ; sensation of tight constriction of throat. θ Epilepsy.

Convulsions : occurring at onset of exanthemata ; also puerperal, and particularly if there be albuminuria, coma, blue bloated countenance, with frothy, sanguinolent saliva, or tendency to hemorrhage.

Convulsions and paralysis. θ Cerebro-spinal meningitis.

Cramps and convulsions, with shrieking or delirium.

Convulsions resulting from extension of disease of ear, after the exanthemata and in whooping cough.

Epileptic convulsions, occurring at onset of septic or zymotic disease.

Chorea : especially when it can be traced to anything septic or toxemic, and even if autogenetic, as in rheumatic, gouty, albuminuric, or amenorrheic subjects.

Tremblings and twitchings, especially if resulting from alcoholism, or septic or zymotic disease.

Hydrophobia.

SLEEP [37]

Yawning, with oppressed nervous system, or degraded blood supply.

Torpor and drowsiness of invasion, or termination of zymotic or septic disease or other toxemia, such as albuminuria, menstrual irregularities, hepatic or cardiac disease, etc.

Sopor, from which he cannot be aroused. θ Apoplexy.

Constant drowsiness, with inability to sleep. θ Delirium tremens.

Sleeplessness from nervous and mental distress connected with bodily suffering, but out of all proportion to the suffering.

Chronic sleeplessness.

Starts in sleep.

Symptoms < after sleep.

Dreams : of traveling ; of quarrels ; of the dead.

TIME [38]

Time

In morning : on awaking, headache over eyes ; sickness of stomach ; headache, going off while dressing ; pain around eyes < ; lids swollen, with pains in forehead and occiput ; sickness of stomach ; vomits everything she eats.

In afternoon : can eat better.

During day : feels sick if she sleeps.

In evening : pains around eyes < ; swelling of feet.

At night : awakes struggling with imaginary foes ; delirium ; headache with fever < ; wakes up grinding teeth, face much distorted ; sleeps only in middle of night.

TEMPERATURE AND WEATHER [39]

Open air : lightness of head ; headache with vertigo, nausea and vomiting better.

Cold air : great irritability and sensitiveness of throat to dry or ; laryngitis acuta with great sensitiveness to dry or ; dry cough < in dry or.

Summer : diarrhœa ; tubercle on wrist more pronounced.

FEVER [40]

Surface cold, especially extremities.

Chilliness every afternoon ; a kind of crawling up and down back and afterwards all over for five or six hours ; severe pressure on top of head, running to ears, with lightheadedness and confusion and heat from head to feet ; shooting pain from occiput down spine and arms ; foul breath ; tongue coated yellow ; bitter taste in mouth and nausea ; soreness right side of pit of stomach through to shoulders ; aching in middle of chest to back ; dull pain across hips and also in back and left shoulder ; constant inclination to stool, with dark brown, blackish discharges.

Chilliness alternately with heat, occasionally sudden cold perspiration, pulse full and 100 ; eyes sunken, with dark brown rings ; tongue dry in centre and yellow, point red ; constant vain efforts to evacuate bowels, nausea, sick stomach ; passages, black, slight and pappy ; soreness in chest and stomach, pain on touching them ; cannot lie on left side ; great drowsiness and excessive weakness. θ Bilious remittent fever.

Flushes of heat all over.

Tongue dry and cracked, dark brown streak down centre, edges of a deep red color ; occasional bilious discharges ; no appetite ; cold, clammy perspiration on forehead and temples ; skin yellow ; would speak when roused by shaking, seemed entirely unconscious of everything ; urine dark red, depositing a dark, yellowish-red sediment ; pulse 50 and weak. θ Bilious fever.

Intense fever, copious, dark, confluent eruption, considerable œdema of face ; ophthalmic and nasal symptoms very severe, throat and chest symptoms moderately so ; some delirium. θ Morbilli.

Burning fever, accelerated pulse. θ Apoplexy.

Skin hot and dry, pulse 140. θ Peri-typhlitis.

No sweat ; patient sometimes cold, but it is a dry cold.

Sweat cold ; sudden attacks of cold sweat.

Sweat colored, especially axillary ; bloody sweat.

Malignant scarlet fever, with great infiltration of connective tissue, especially at throat.

Bilious remittents of the South ; low type, tendency to hemorrhage.

Fevers with hemorrhagic symptoms, or tendency to putrescence.

Yellow fever ; hemorrhagic tendency, oozing of blood from every orifice and even pores ; skin yellow ; vomiting of bile or blood ; fetid, bilious or bloody stools ; liver tender ; heart weak ; fainting.

Fevers resulting from septic absorption and in purpuric cases of zymotic diseases ; puerperal fever.

Pyæmia ; hectic fever ; attending suppuration, ulceration, burns, scalds, maturation stage of variola, compound fractures, lacerated wounds, dissection wounds, cellulitis, erysipelas, malignant pustule, carbuncle, stings of insects, phagedena, etc. ; for that attending diphtherial and scarlatinal absorption ; or that of secondary or tertiary syphilis ; cholera.

Typhus ; oppression of nervous centres ; eyes congested, countenance heavy, dull, bloated, besotted ; eruption dark, purple, copious ; during second week, heart becomes markedly soft, systolic sound nearly inaudible, pulse soft, flagging, tremulous ; great and distressing restlessness, much stupor, twitching, jerking, tremulousness, sinking down towards foot of bed, or deafness ; pneumonia or œdema glottidis supervenes ; swelling of salivary glands, diarrhœa, albuminuria, or suppression of urine.

Relapsing fever ; tendency to syncope, hemorrhage, epistaxis, menorrhagia, petechial eruption or œdema of lungs or legs, effusion into joints, ophthalmia, diarrhœa, dysentery ; in old or intemperate subjects.

Cerebro-spinal fever ; glanders ; plague.

ATTACKS, PERIODICITY [41]

Sudden : sore throat ; extreme coldness and blueness ; palpitations ; tickling, causing choking ; great prostration of vital force ; cold perspiration.

Frequent : erysipelas of face ; faint sensation about epigastrium, with trembling above umbilicus, followed by flushing of heat ; paroxysmal aggravations of pain in region of appendix ; fainting spells.

Constant : drowsiness, with inability to sleep ; vomiting ; acid taste on tongue ; cough ; inclination to stool ; vain efforts to evacuate bowels.

Several times a day : attacks of dizziness, fainting and weakness, with occipital headache.

Every afternoon : chilliness and crawling sensation for five or six hours.

From 6 A. M. until evening : pressure and heavy pain on top of head.

Every few days : bilious headache.

Every month : vomiting after menstruation.

For some months : eruption on face.

Periodic : neuralgia.

Marked periodicity : pains come and go suddenly or reappear every three months, every year, etc.

For years : grinding of teeth during sleep, with distortion of face ; tubercle on wrist.

Chronic : neuralgia ; chilblains ; sleeplessness ; bronchitis ; bronchorrhœa.

For twenty years : severe pain in right eye and top of head, on right side down back of neck, at intervals.

Burning, itching red spot on finger resulting from bite of insect twenty years ago, returning regularly at same time every year since, each time lasting about a week.

LOCALITY AND DIRECTION [42]

Acts more on right side.

Right : headache < in temple ; severe pain in eye and top of head, on side down back of neck ; drawing in side of head ; cannot bear leg straightened, lies with it bent and supported by a pillow ; drawing, tensive pain from shoulder along neck ; aching in kidney ; large inflamed furuncle on upper arm near elbow ; middle finger swollen, incapable of movement, other fingers also involved, pain extends to elbow, abscess in axilla ; as if a tendon was drawing from sole of foot through bone of leg ; paralysis of side.

Left : bilious headache beginning behind ear ; frontal headache in anterior lobe ; throbbing and heat in side of head ; throat < on side ; neuralgic drawing in fauces < on side ; pain in side, near last ribs as if in diaphragm ; aching in iliac region ; aching in region of heart, down arm and through to shoulder blade ; neuralgic pains from side of womb to transverse colon ; breast inflamed and hard ; leg swollen twice its natural size ; laryngitis acuta < on side ; stitch in side with cough ; tight, cord-like feeling from elbow down forearm ; round spots of pain along front of forearm, cannot grasp with forefinger and thumb, cannot extend arm without pain ; going to sleep of hand and leg ; violent spasmodic pain in palm ; red spot on back of finger ; drawing from hip to foot ; paralysis of extensors of foot ; dull pain in shoulder.

SENSATIONS [43]

As if brain had been intoxicated by carbonic acid, or by degraded blood ; as from a blow in occiput ; as if head was constricted ; as if a cut had been made around eyes ; as if tongue and all around throat were tied up ; as if tongue was swollen ; as of a plug in throat to be swallowed, or of contraction or choking, or as if uvula or velum was elongated or stiff, or as of a dry spot or tickling in throat ; as if uvula and velum were swelling ; as if œsophagus was full of rancid fluid ; as if lungs would not expand ; as of a dry spot in larynx ; as if heart tumbled over ; as of a tense tendon from right shoulder along neck ; as if arms were paralyzed ; as from a bee-sting in left palm ; as if a tendon was drawing from sole of right foot through bone of leg ; as if bones were made of heavy wood.

Pain : in head ; at centre of forehead ; in right eye and top of head, on right side down back of neck ; in forehead and occiput ; in pit of stomach ; in region of liver ; on top of shoulder ; in left side, near last ribs, as if in diaphragm ; in course of colon ; in region of appendix ; in abdomen and back ; in hypogastrium and down thighs ; in heart ; in top of shoulder ; in ascending aorta ; violent, spasmodic in left palm.

Tremulous weakness, as from impending evil.

Distressing sensation of sinking.

Agonizing pain : in stomach.

Cutting : around eyes.

Boring : around eyes.

Grinding : in left leg.

Stitches : in region of liver ; in hard lump in lower outer part of breast ; in left side ; in chest.

Stinging : headache ; in abdomen ; all over.

Pricking : in throat, especially left side, near root of tongue, or extends to ear, or as if proceeding from ear with ; laryngitis acuta ; of hands.

Shooting : headache ; from occiput down spine and arms ; in region of liver.

Tearing : around eyes.

Jerking : in arms.

Drawing : headache ; neuralgic, in fauces ; in right side of head ; from right shoulder along neck ; from left hip to foot ; in knees, tibia, back ; in bones.

Scraping : down œsophagus to stomach ; in posterior wall of anus.

Burning : in chest ; in eyes ; in spot on back of left third finger.

Raw pain : in throat, especially left side, or extends to ear, or as if proceeding from ear ; with laryngitis acuta.

Sore pain : especially at left side of throat, near root of tongue, or extends to ear, or as if proceeding from ear ; with laryngitis acuta ; in and about heart ; in calf ; in sole of foot.

Soreness : of throat ; in back part of head ; of right side of pit of stomach through to shoulders ; in chest and stomach.

Pressing : dull, at back of ear ; down on eyes ; headache ; in vertex.

Tensive pain : from right shoulder along neck.

Constriction : tight, of throat.

Contraction : in throat.

Compressive : headache.

Cramps : in stomach ; in arms ; of legs ; in calf, heels and toes.

Neuralgic pains : sharp, from left side of womb to transverse colon, thence cutting across as if from both sides towards centre, thence up to face and temples ; in arms ; in limbs.

Rheumatic pains : in limbs.

Paralytic pain : in extremities ; in bones.

Numb pain : as after cramp, in anterior of fingers and in toes.

Bruised pain : in bones of shoulder ; in joints and bones.

Dull pain : across hips, in back, in left shoulder.

Heavy pain : dull, over eyes and in sides of nose ; on top of head.

Aching : in bones ; dull, heavy in head ; in liver ; in left iliac region ; dull, continuous, in region of heart, down l. arm and through to left shoulder blade ; in right kidney and in stomach ; in middle of chest to back.

Pulsating : headache ; in brain.

Throbbing : in left side of head ; dull, heavy, in occiput ; in finger tips.

Fluttering : above umbilicus.

Oppression : of chest ; above eyes.

Pressure : above eyes ; on top of head.

Weight : on stomach ; in head and ears.

Heaviness : in stomach ; of limbs.

Congested feeling ; dull, heavy, in front of brain.

Fulness : in ears.

Dulness : of head.

Lightness : of head.

Dizziness : in back part of head.

Sinking : about epigastrium ; at stomach.

Faintness : about epigastrium.

Weakness : of back.

Numbness : of arms and legs ; of affected limb.

Crawling : up and down back.

Tingling : of hands ; in legs.

Tickling : in throat ; with laryngitis acuta ; cough.

Choking : in throat.

Heartburn.

Hungry sensation : about epigastrium.

Heat : over eyes and in sides of nose ; in forehead ; on top of head ; in left side of head.

Dryness : in eyes ; of fauces ; of mouth ; of skin.

Itching : of scalp ; eruption on face ; of palms ; in red spot on back of left third finger ; of skin on lower extremities ; all over.

TISSUES [44]

Very rapid and direct depressing influence on sensorium and medulla oblongata, deranging both circulation and nutrition ; after death, in subacute and chronic cases, the cerebrum, cerebellum and medulla are found in a state of engorgement, with dark, fluid, degraded blood, and apparently threatened with softening.

Cortical substance of brain, and membranes of brain in a state of engorgement, with dark, fluid, degraded blood ; the cortex highly congested and stained a deep brown color ; the arachnoid thickened, tough, opaque and adherent to the pia mater, and the meshes of the latter distended with serum ; extravasation and ecchymosis.

Seems to act primarily upon cerebro-spinal nerve centres, producing secondarily decomposition of blood and destruction of blood fibrin, hemorrhages, ecchymoses.

Affects principally the blood, the solar plexus and pneumogastric nerves ; also the cerebro-spinal system.

Organs of vision profoundly affected, even to extent of annihilating their functions.

Hemorrhages from all orifices of body, eyes, ears, nose, mouth and urethra, even bloody sweat ; blood flows suddenly from eyes, ears, nose, gums and beneath nails.

Œdematous swelling of whole body.

Indicated in diseases of an adynamic character, whether caused by previous low states of system, or by zymotic and septic poisoning, abuse of alcohol, etc. ; especially characteristic are evidences of cardiac debility, feeble pulse, sluggish circulation, bluish skin, faintness, general debility.

Bruised, drawing, or paralytic pains in bones, < on awaking.

TOUCH. PASSIVE MOTION. INJURIES [45]

Touch : left leg < from slightest ; laryngitis acuta, with great sensitiveness to ; pain in chest and stomach.

Cannot bear clothing around stomach, hypochondria, epigastric region or abdomen.

Pressure : at angles of lower jaw, tonsils sensitive ; soreness in back part of head ; stitches in region of liver < ; region of appendix very tender ; laryngitis acuta with great sensitiveness ; laryngeal cough ; pain from right shoulder along neck ; < myelomalacia, pains <.

Shaking : seemed entirely unconscious, would speak when roused by.

Great tendency of hemorrhoids to bleed on using paper.

From irritating vapors : laryngitis acuta.

After sting of insects : œdema of tongue ; laryngitis acuta ; tubercle on wrist ; burning, itching red spot on back of l. third finger.

From scalds : laryngitis acuta.

Burns, scalds, compound fracture, lacerated wounds, dissecting wounds.

Compound fractures ; in course of septic or zymotic disease, in broken down constitutions, old inebriates or other states of low vitality or degraded blood ; tendency to gangrene or unhealthy suppuration, threatening septic absorption.

SKIN [46]

Itching, stinging, all over ; urticaria.

Skin dry, stiff, like thin parchment ; usually cold.

Skin hot, perspiring. θ Diphtheria.

Yellow color of whole body.

Acute jaundice, of hematic rather than hepatic origin.

Petechia, little blotches, or ecchymosed purple spots.

Yellow-greenish and bluish spots, with decreased swelling.

Yellow and black spots all over.

Purpura hemorrhagica.

Scarlet erythema or scarlet redness with rash-like vesicles.

Blisters and livid spots on body.

Small blisters around eyes.

Vesicular eruption on septum narium.

Swelling on wrist containing serum.

Pimples on face.

Eruption around mouth.

Herpes on scrotum.

Swelling of whole body and of submaxillary glands and tonsils especially.

Suppuration of glands ; in broken down constitutions, with low fever, tendency to slough, and discharge of dirty or hemorrhagic matter.

Burns and scalds, threatening erysipelas or gangrene.

Ulceration ; especially phagedenic, sloughing, varicose, irritable, bubo, "soft sore," mercurio-syphilitic, with offensive discharge, etc., in constitutions broken down by previous disease or bad living ; in inebriates.

Stings of insects, when they assume an erysipelatous or gangrenous character.

On eighth day after vaccination, centres of insertion blackish, and circles filled with dark lymph and surrounded by a patch of inflammation ; small, red, raised papules on arm and forearm ; on ninth day skin of nearly whole upper extremity inflamed, dark red and thickened, skin of shoulder, neck, chest, abdomen and back in similar condition, and on lower extremities eruption in small patches ; about the elbow blackish. θ Erysipelas.

Pustular eruption after vaccination.

Abscesses on elbow discharging a red brown matter, with shiny particles.

Felons, pemphigus, pustules, boils, carbuncle, furuncle, gangrene abscesses, etc., when fever is low, parts bluish and discharges scanty, tardy, or dark fluid, unhealthy ; diarrhœa with gangrene.

Old cicatrices break open again.

Hot swellings, with cold skin and sickly appearance.

Obstinate ulcers, even malignant, with yellow complexion and great indifference.

Anthrax, malignant pustule ; especially if of a dark color, with much fever or threatening gangrene, or if there be several of them, or if occurring in a constitution already broken down by disease or bad living ; sloughing, hemorrhage, fever of a low type.

Dissection wounds ; symptoms those of phlegmonous erysipelas ; accumulation of dirty pus in distant parts, typhous condition supervening.

Eschoriæ, dry and finally black.

Malignant ulcer where bite was inflicted (fourteen years before), with swelling of the parts.

Chilblains, gangrene pending ; circulation sluggish.

Gangrene, skin separated from muscles by a fetid fluid ; black spots with red areola and dark blackish redness of adjacent tissues.

General local phlegmonous, phlyctenous or œdematous erysipelas ; skin bluish-red, low fever ; during zymosis or in the enfeebled ; also in wounds ; more frequent in face.

Morbilli : especially malignant or purpuric form ; and for such sequela as gangrene of mouth or genitals ; and for retrocession of eruption ; also in later stages when eruption remains too long or reappears as a mottling.

Scarlatina ; when in primary invasion there is evidence of great intoxication, vomiting, general collapse and coldness, or brain greatly oppressed, coma, convulsions ; throat livid and rapidly swelling, much œdematous swelling at angles of lower jaw, chin raised and head thrown back, eruption patchy, dark or petechial, pulse extremely quick and feeble, frequent epistaxis, face dusky ; moaning and tossing about, or heavy, dull and stupid ; swelling of fauces and tonsils seem to threaten suffocation or gangrene, much puffiness around neck, tenacious, sanguineous mucus from mouth and nostrils, breathing irregular and jerky ; secondary infection by absorption from gangrenous and sloughing fauces, inducing a low typhoid state ; also for complications, œdema glottidis, laryngitis, meningitis, etc. ; and for succeeding dropsy, when urine is of dark, smoky color, bloody or albuminous.

Syphilis ; primary, if chancre becomes gangrenous or phagedenic ; secondary, for mucous tubercles and phagedenic and deeply penetrating ulceration of mucous membranes, necrosis of cartilages, etc. ; tertiary, for fetid and hemorrhagic ulceration, and if brain, liver or kidneys become implicated.

Pemphigus ; with low typhoid conditions, and, when contained fluid, assumes a dark or sanguineous character, or gangrene threatens.

Peliosis rheumatica ; with œdema, large purpuric spots and bullæ in which black purpuric patches, covered with a flaccid envelope of bullæ after serum had escaped, were like patches of skin which had mortified.

Dropsy : cardiac ; hepatic ; renal ; also general dropsy not dependent on organic disease of any of great central organs, but rather an expression of a debilitated, softened state of capillaries, or a general break down of vital powers, and particularly if it has resulted from chronic alcoholism, or from septic or zymotic or other depraving or debilitating diseases.

STAGE OF LIFE, CONSTITUTION [47]

Hemorrhagic diathesis.

Diseases caused by previous low states of system, or by zymotic or septic poisoning, abuse of alcohol, etc.

Low typhoid states.

Oppressed nervous system ; degraded blood supply.

Neuralgia : occurring as a sequel of septic, toxemic or even miasmatic disease ; or chronic bilious, climacteric or albuminuric conditions.

Convulsions of puerperal women, and children.

Rheumatic, gouty, albuminuric, or amenorrheic subjects.

Broken down constitutions.

T., æt. 4 mos., healthy and of a healthy family ; erysipelas after vaccination.

G., æt. 7 1/2, weakly constitution and eruptive skin, whose father died of heart disease and alcoholism, had severe scarlatina, followed by otorrhœa.

Miss H., æt. 9, and her brother, J. D. H., æt. 13 ; scarlatina maligna.

Boy, æt. 10 ; furuncle.

Girl, æt. 12 ; diphtheria.

GK., æt. 16, whose father was a bonvivant and had liver disease, is a weak, pale, bloodless boy, subject to bronchitis and asthma ; after a nervous shock and grief ; peri-typhlitis.

Miss D., æt. 19, sorter and ripper, working in a small, confined room connected with dye works, has been in low state of health for some time ; peritoneal inflammation.

A girl, æt. 20, paralysis of left foot after typhus.

Miss K., æt. 22 ; tubercle on wrist.

Miss M. S., æt. 22 ; bilious remittent fever.

Mr. W., æt. 23, weakly, strumous, lately married, very closely worked, constantly exposed to exhalations from leather ; sensorial disturbances.

Woman, æt. 25, weak menstruation ; ciliary neuralgia.

Miss K., æt. 25, of dirty, yellow, bilious appearance, subject to severe bilious headaches, of an epileptic family ; distortion of face.

A primipara ; mastitis and milk leg.

KD., æt. 27, in good health, but weak with overwork and anxiety, was exposed during day to exhalations of night soil ; diphtheria.

Miss D., æt. 28, pale, weak and strumous looking ; dysmenorrhœa.

Wm. W., æt. 28, constitution remarkably good, never been sick until two months previous, at which time he was in the West and had fever and ague, temperament bilious, sanguine ; bilious fever.

Mr. M., went with volunteers into Maryland, and was encamped on a small stream ; bilious fever.

Man ; suddenly seized with apoplexy.

Mr. G. had lived freely in youth, and suffered from syphilis, mercurialization, polypus, etc., had taken alcohol freely all his life ; chronic sleeplessness.

Lieutenant W., of Commodore Wilke's expedition, contracted yellow fever on coast of Cuba.

Hannah H., mother of four children, sews much and does housework ; for three years, throbbing in left side of head, etc., before menstruation.

Mrs. S., æt. about 30, has suffered for many years from spasm of œsophagus, seems to be hysterical in origin.

Miss R., æt. 33, very weak and low after much nursing, and the loss of her mother ; some years previously had syphilitic affection with revaccination, got her clothes damped, followed by catarrh ; affection of eyes.

Mrs. J., æt. 33, married six years, no children, but several miscarriages ; husband has chronic syphilis and has lately become impotent, for last twelve months she has had ozæna ; tingling and pricking in hands and left leg.

Mr. B., æt. 48, lived freely in his youth and had syphilis ; petechiæ.

Mrs. S., æt. 57, suffered from chronic hemorrhoids ; red, itching spot on finger.

Mrs. E., æt. 57, had gastritis two years ago, now much exhausted from nursing sick family, is debilitated and bloodless ; atomic dyspepsia.

Mr. S., æt. 58, subject to asthma and with weak heart ; after chill had bronchitis, with hæmaturia.

Mr. S., æt. 60, after unsuccessful allopathic treatment ; intestinal hemorrhage.

Mr. L., æt. 62, bachelor, of irregular habits, especially as to alcohol, living in an isolated way ; ecchymoses on lower limbs.

HD., æt. 69, during incipient stage of senile dementia, delusions, etc.

RELATIONS [48]

Antidoted by : Laches . ; its effects modified by Ammon., Camphor, Opium, Coffea, Alcohol , and radiated heat.

Compare : Laches., Naja , and Elaps . ; Crotal . is preferable in fluid hemorrhages, yellow skin (hence in yellow fever with black vomit, etc.), epistaxis of diphtheria. Naja has more nervous phenomena. Laches . has skin cold and clammy, rather than cold and dry ; hemorrhages with charred straw sediment ; and more markedly, ailments of the left side. Elaps . is preferable in otorrhœa, and in affections of the right lung. The Cobra poison coagulates blood into long strings. The Crotalus poison is acid ; the Viper neutral. The "Rotten-Snake" causes more sloughing than any other.

Compare also : C. Cascar . (thoughts dwell on death and dreams of the dead), Tarent. cub., Arsen., Lauroc . (tetanus, whooping cough), Apis, Carb. veg., Silic . (vaccination), Camphor . (in coldness ; probably Crotal . has more marked genuine collapse, with confused speech, etc.), Hyosc . (sleeplessness in delirium tremens), Opium, Nux vom . and Cuprum (cerebral congestion).