Naja tripudians

Volume III — Main text

1. Provings, — I. a. Dr. Stokes, act, 37, stout and robust, made a paste of the i, trit. with some (soft) water, and introduced on a clean vaccine point some of this preparation into 3 punctures made by a lancet in front of 1. forearm ; also rubbed some of the trit. into one of the wounds. (This was on Nov. 7th, 1852, at 9.30 a.m.) There followtd indefinable sensation of" all-overishness '* with lightness in head, slight, lasting about ^ h. II. 15, slight aching in ring and tittle linger of r. hand, followed by peculiar sensation as of thumbing in middle of triceps of 1. arm. 12.30, inoculated poison into a new wound in upper 1. ann. There followed, fine tingling in legs and feet while standing ; slight aching in backs of thighs j burning pressure at a point in back of throat, (or several h. in afternoon , prcssive and drawing sensation at points on lower limbs and feet, several times. There was tired feeling in cervical and dorsal vertebrae, with the peculiar burning often attendant on exhaustion, all d. 8th. — Hard pressure on chest just above r. nipple, p.m. 9th. — Rheumatic drawing in 1. shoulder, m. At 10 a.m. inoculated well a puncture in 1. upper arm with the poison paste, and felt immediately the all-overishness as at first, lasting ^ h. ; then dull shoots up occiput and very fine pricking in 1. eyebrow. Since 7th and till I4.th easily affected by alcohol, and sleep broken and disturbed.

b. 14th. — Mixed 6 dr. of 2nd dil. in J"] of water, and took j^u in forenoon without efftct. 15th. — Took 2 doses. In e. felt momentaiy pain dart from 1. ilium forward into abdominal muscles. In r. chest, dull warm pricking at a great multitude of points, over lower anterior half from 5th rib downward, with heat extending up bronchi to larynx ; a hard cough came on immediately, lasting for i h., ending in expectoration of a little thick mucus. i6th. — Sadness or serious disposirion this d. and two following ones. 17th. — Took Jj. 18th. — Mixed 6 dr. of 3rd dil. in ^^j of water ; took ^^j in e., and felt pricking in stomach soon after. 19th. — Took 2 doses of ^j each. E., from 6 to 8, very chilly, could not stay away from tire ; after that better. In m. uneasiness and pressure in bladder. Sadness and irresolution. 20th.— Pricking pain in stomach after dinner. Took 5'j to-day. 2i8t. — E., asthmatic constriction of chest for ^ h., ending in mucous expectoration. c. Feb. 24th, 1853, smelled at ist dil. Soon after, pressure on upper part of r. sterno-mastoid, extending to angle of jaw, for 5 m. E., melancholy i began to form images of possible wrongs and mis* fortunes, over which the mind broods ; very wretched at times. 25th. — Feeling of large stool in rectum, which when voided was but small. 11.30 a.m., 8 glob, of 2nd potency. Very soon after, burning of cars. E. while walking, sudden prostration of strength in limbs, for i h. 26th, 27th. — Each d, 12 glob, of same; no symptoms. 28th, — One dr. of 2nd dil. March 3rd. — For 3 d. sense as of something wanting about praecordia. Tried to sing, but had no power to throw out voice. Yesterday and to-day very wretched ; a slight cause sets him

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in a perfect agony of mental suffering on another's behalf; there is feeling of depression and lowness about heart ; mind broods over imaginary troubles. Craving for stimulants, which aggravate the condition ; memory confused j shoots down legs and tingling in feet. Better in e. For several d. itching in cicatrix of an ulcer. 4.th. — 1 dr. of 2nd dil. on tongue. No symptoms. 5th. — 3 dr. Makes himself imaginary troubles, and frets over them (2 h.). A small boillike swelling on back of r. little Anger ; fades in 3 d. 6th. — Little inclination for sleep, brain appearing irritable. Great desire and power for walking yesterday ; to-day reaction. For 10 m. in m. pressure and gagging in throat. Decided pressive pains in 1. pectoral muscles for a few m., a.m. i2th. — Yesterday and to-day r. nostril is extremely sore ; feels as if ulcerated. Took 6 dr. of 2nd in water. Pressure as from stones in stomach after each meal, with acidity.

In August, mark of principal puncture on arm was livid yet, {Brit. youm. of Horn. ^ xi, 95, 596,)

1. a. Rosa, xt. 19, robust and sanguine, was inoculated by same, Nov. 8th, in r. upper arm. Great aching all up arm to shoulder all d. j temper quicker than usual j face flushed in e.,and burning hot. 9th. — Throat dry on waking ; face red on rising, and covered with hard knots as in erysipelas; this disappeared after washing. Appeared at breakfast with small papules on inflamed base at point of nose, which was tender ; they did not go away til) 14th.

h. 14th. — Took I dr. of 2nd dil. Next d. a pimple appeared on upper lip, and in m. eyelids were puffy. On 18th, another pimple on 1. ala nasi.

c, Jan. 17th. — Took 3 glob, of 4th three times a d. for a week. After 1st dose, dragging and weariness in limbs while walking, with slight frontal headache. Nothing else save on 20th, when neck and body broke out in small white blisters on an inflamed base, very itchy ; passed off m an h. From 27th took 6th dil. for a week, but without effect. {Ibid.^ p. 96, 598.)

1. J. McS — , ;rt. 38, commenced taking cobra poison, Aug. 4th. Dose, gtt. iij of 2nd potency in 3j ^^uar. In e. felt tired and sleepy, bad to retire at 9 p.m. Slept directly after going to bed. 5th. — Thermometer at 62°. Awoke with troublesome tickling in larynx with nausea, sneezing and coughing. 2 p.m., took gtt.iij as before. Continuance of tickling v^th scanty expectoration of tasteless mucus. 6th, — Thermometer 69^. Gasping for breath all this d,, yesterday, and the d. before, but particularly so to-d., with several deep-drawn inspirations. At 10 p.m. took gtt. iij as before. 7th, — -Awoke early with hawking of viscid mucus. 2 p.m., took gt- iij. Tickling continues, but less. 8th. — At i p.m. took gtt. iv, and felt immediately afterwards increased tenderness over trachea. Gasping for breath both yesterday and to-d. (therm. 66°) ; for several h. feeling as if there were a hair in trachea. 9th. — Ther. 66°. 2 p,m., tookgtt. v, and soon afterwards felt increased tenderness of throat and over sternum, lasting all d. lOth. — Therm. 66'^, To-d. an ulcer on frenum of tongue. This m., on awaking, expectorated freely a whitish viscid mucus. Soon afternoon took 12 dr. Almost while taking med. felt all above sym-

ptoms greatly increased, added to which, feeling of hollowness over entire head, which continued several d.^ and caused him to leave further provings. (M, Horn. Rtu.^ iii, 162.)

1. a. Dr. RuTHERFCRD RussEtL,Jan. 31st, i853,in bedat6a.m took in a little water i gr. of ist trit. In 6 m. uneasiness of stoi soon passing off. While doxing was roused by sudden sense of ( ing, a sort of grasping at throat ; a few m. later felt sudden jerking of 1. masseter. In about j h. had unusual beating of heart, audible co himself. No other eifect that d. Feb. xst. — At 7 a.m. cook same dose. Soon after, slight palpitation of heart, and uneasy dryness of fauces. 2nd. — Took same at 6 a.m. In 20 m. uneasy constriction or irritation of larynx, giving rise to desire to cough ; this returned several limes. On previous d. had felt rather dull in spirits, without obvious cause, and to-d, had great depression ; also occasional whizzing in 1, ear, with insipid, almost nauseous, taste in mouth, and now and then tearing pain in abdomen. 3rd. — At 6.30 a.m. took same dose dry on tongue. Soon felt sharpish prick in larynx, with desire to cough. In about \ h. drawing painful sensation in r. jaw ; at spot of tongue where powder fell there is sense of rawness, as if it would rise to a blister i occasional pains in bowels during d, ; very low spiriu. On next 2 d. took same dose, but no effect was observed. A catarrh here supervened, which caused discontinuance of proving.

h. May 3rd, resumed daily morning doses of i gr. of 1st trit., coa cinuing them till the 7th. Soon after dose of 3rd, griping in 1. abdo» men for about 10 m., and a few stitches in I. temporal region. Duri 6th and 7th, especially latter, had considerable pain in forehead, wakin; him at n., and he awoke with this on m. of 8th. Pain was attend by fluttering of heart ; was dull, with occasional stitches in frontal eminences. Tongue was coated with chick yellow hir. On 8ch, while walking in country, was suddenly seized with most urgent desire to evacuate bowels \ matter discharged was of light colour, and rather watery, coming with great force, as if he had taken a strong cathartic On 9ch again loose stool, with slight pain. On 10th diarrhoeic condition continued, and on nth he was still uneasy. For last few d. he had felt languid and indifferent. On I2ch and 13th he bad no stool ; and felt great languor and loss of appetite. On 14th and 15th motions were partly costive, partly loose, and attended with slight pain in abdomen. Was told he looked pale and ill, and felt out of sorts, without any special complaint.

c, Oct. 1st., 1853, at 5.30 a.m., took 1 dr. of ist dil. on sugar of milk, washing it down with water. In a few m. uneasiness about umbilical region, and in a short time slight pain in front of r. thigh, which soon passed off \ also slight pain in 1. frontal eminence. Slight nausea and empty eructations during forenoon, and occasional twisting pain in umbilical region. Took another dose at n., and a third next m., without noteworthy effect. Repeated same on n. of 2nd, and m. of 3rd. i ^ h. after latter slight fulness and pain in upper forehead, and in 2 h. slight shooting pain in 1. tonsil. 3 p.m., slight headache, dulness of spirits, tormina in lower bowels with desire co evacuate them. "Continued same doses up to 7th. In m. of 5th slight pain and fulncn

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of upper forehead and peculiar stringent sensation in pharynx ; also nervous sensation about heart ; and several times in course of d. clogging up of larynx and trachea with thick tenacious mucus; frequent sharp griping about umbilicus. After m. dose of yth rather severe and steady pain in L frontal region, and slight nausea.

d. Nov. nth — 14th, took I gr. of 1st trit. n. and m. Soon after 1st dose slight pinching sensation in stomach and slight pain in forehead. After 2nd, peculiar oppression about heart, and slight pain in one tonsil ; also darting pain running across forehead. After 3rd slight spasmodic pain in stomach and sense of scraping in throat -, next m. on waking pains between shoulders, which continued all d. Nausea after last 3 doses, with same feelings in throat and stomach, and slight frontal headache. Pain between shoulders increased alt 14th, and continued till j6th \ it was worse on moving arms. For last 2 d. urine in m. thickly loaded with red sediment, which gathered like a cloud at bottom oi vessel, and seemed mixed with mucus. Repeated dose n. of 17th and m. of J 8th. After ist dose griping in stomach, and after 2nd return of pain between shoulders. Dec. yth — 21st. — Took this dose every m. Soon after 1st dose, nausea and pain in brow, audible beating of heart, and sense of depression. In course of d., while busily occupied, attention was arrested by heavy dragging sensation in spine between shoulders ; it lasted about ^ h., and caused much uneasiness. During whole d. nausea and depression of vital energy to unusual degree. 8th. — After dose, while warm in bed, several fits of coughing, with pecular sensation about fauces and larynx \ slight nausea. Thereafter, slight frontal headache was a constant symptom ; on 2 m., cough with taste of blood in m. Large painful pimple on brow. Much scurt on head. Pain as before between shoulders. (Brit. Joum. of Hem.y xi, 593 and

xii, 244.)

1. a. G. E. Stewart, set. dr. of 1st dil. m. and e. In ^ h.

2. Took, Oct. 1st — 6th, 1853, ^ after ist dose, felt irritation in larynx, as from inspiring acrid vapour, with warmth and rawness, causing hoarseness and tickling cough -, this continued till i p.m., and returned about 4 for some h. 10.30, sensation for some time on small spot about 1. palate as when aconite has been chewed ; head heavy, with dull confused mental state ; frequent yawning — these last continued till X, and at 4 headache returned, with numbness in hands and crampy pains in 1. palm, also shifting achings specially felt in shoulder-joints. 2nd. — After retiring last n. much troubled with flatulent colic; and both then and this m. for i h. after rising stinging, aching, somewhat burning pain along r. side of penis, as if immediately under skin. Mouth dry this m. on waking. Same sensations in larynx and head followed m. dose, but less strong and lasting ; also, tightness in upper chest ; pains as yesterday, drawing and shooting in 1. elbow-joint being severe ; occasionally during d. transient stitches in hypochondria and aching round loins ; for i — 2 h. after dinner anguishing pain in I. hypochondrium and loins, and flatulence. This pain, m loins and abdomen generally, came on again for about an h. after going to bed. 3rd, — Laryngeal symptoms very slight ; occasional colic and flatulencei not so

bad J once or twice considerable uneasiness in upper chest, not lasting long. After e. dose pain in I. lumbar region, with occasional stitches spreading over whole abdomen and to r. groin, cased by bending forward ; dull stitching in r. face for a few m., and $amc in upper chest, ankles, and lower third of thighs (not in knees) ; transient vertigo, followed by "stounding" pain in r. head. Went to bed with these pains in head, loins and abdomen ; but woke on 4th free from ihem. After m. dose, almost immediately irritating, raw, rough pain in windpipe, which increased rapidly and was very annoying, giving rise to frequent, severe, hard cough, which made him quite gidcfy, and caused noise in head and pain in chest j slight hoarseness j severe dull frontal ^ aching, with stoundings, not increased by cough ; dull pain in r. hypo- ^B chondrium and loin. These feelings continued pretty severe for t\ h^ ^^ then gradually decreased till i p.m., when he felt well, save for dulncss in head, and occasional dull pains in abdomen during d. After e. powder (7 p.m.) laryngeal irritation returned, but with little cough ; dull aching contractive pains in chest ; chilly creeping over L foot and leg; usual slight headache ; occasional crampy pains in thighs, shoulders, and nape ; numb pain in hands. 9 — 12, heaviness ana dull pain in eyes, with suffusion, then tired aching, though they had not been much used; severe frontal headache; hot sore feeling of lips; creeping itching in various parts of body fi-om time to time ; aching in loins. 5th.— -Few and slight symptoms to-day, which was much warmer than any since commencement of proving. 6th. — Same, in spite of raw chilliness in air, during d. ; but all symptoms recurred in some force in e., with momentary but very violent shooting pain in r. side and dull aching in many joints, "th. — Woke with laryngo-tracheaJ irritation, which continued for an h. or more, with hoarseness i much Hatulence; aching in loins.

b. Took 3rd dil. in same way for a week in Nov. There was a recurrence of all the previous symptoms, but only to a slight degree; irritability of larynx, especially on exposure to cold air, being most marked. (/i;V., xii, 215.)

1. a, M. C, woman, xt, 38, proved drug under superintendence of Dr. Stewart, and in same way. After ist dose, taken 15 m. before breakfast, felt sickish from feeling at pit of throat ; nauson, with disagreeable sensation about stomach, headache above eyes, belching up of water, and flatulence, continued till midday. P.m., began to feel pain in throat again, also severe throbbing headache (frontal). In e. acute pain in small of back for 2 — 3 h., hot skin, and pain in a small cyst she has in neck. 2nd. — Clammy mouth in m. and horrible taste. After m. dose feeling in pit of throat as if skinned ; burning heat in face at different times in d., with flushing ; headache all d., but very slight save for a short time about 3 p.m., when it was severe and throbbing. 3rd. — No symptoms during d. j but after e. powder severe gnawing pain in lower part of back, worse after going to bed, and keeping her awake some time. 4th.— Took dose at 8.30 a.m. Soon after breakfast very bad headache, especially acute over I. eye, for an h. ; rawness in throat for several h. ; frequent yawning ; hot pain at back of eyeballs; pain shooting through ftY>m I. scapula to front of chest. After

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e. dose, recurrence of all these symptoms, with burning in face, especially 1. side, and slight flushing. Thought of giving over taking drug, on account of the violence of the headaches caused by it. 5th.— Woke this m. with very bad headache, and great noise in the ears as if a mill were going in the head ; slight pain in loins. By 9.30 aching and noise were almost gone, and little effect was produced by the day's doses. On 6th, however, after m. dose, headache was very bad, and there was disagreeable feeling in stomach.

if. Nov. 1st — 6th M. C. took i dr. of 3rd dil. m. and e. Beyond slight headache on first and last d. there was no e^ccc. 12th — 15th, took I dr. of 1st dil. (a new preparation) m. and e. During these d. some of the old symptoms recurred, but only slightly in comparison. Dec. 1 2th — 17th, took 1 dr. of 6th dil. in same way, with still less effect. (y^V., p. 248.)

1. tf. Dr. Craig began Aug. 12th to take i gr. of 2nd trit. at 7 and II a.m. daily. Little effect was observed till 15th, when he had, so a.m., uneasiness about heart while walking j 12, dull pain to r. of sternum, immediately behind 3rd rib, passing under sternum — the spot tender to touch ; chest tight across upper part ; 2, after a moderate walk heat and uneasiness in 1. chest, with aching pain, felt particularly about 2 in. below middle of 1. clavicle. 6, dull heavy pain over lower half of r. chest, with stabbing on inspiring deeply, which causes short cough, but no aggravation by movement i in bed could not lie for a m. on T. side, but pain and breathing were much relieved by lying on affected side. Took dose of bryonia 3. i6ch. — Chest much easier, but cannot expand it without considerable stabbing pain; dulness on percussion distinct as high as r, nipple. Noon, chest comparatively easy i took a dose. 17th. — 8 a.m., r. chest quite easy, some aching in 1. chest in front. Noon, aching sticking in 1. side much worse, seems more diffused and external. 4, cannot ride and can scarce walk for the pain ; has to press 1. side with hand and bend that way ; on attempting to walk fast it is as if there was a broken rib tearing lung ^ on attempting to breathe deeply there are horrid lancinations in all directions through chest, and short puffing cough, which also recurs spontaneously every m. 8, chills and partial heats, and general feeling of being unwell. IJ, considerable fever with partial chills i 1. side as before; resp. 34, pulse 98 ; again can lie only on affected side. j8th. — Slept well, and felt much better in m.> though there was still cough and considerable pain in 1. side. 19th. — Chest much better, can take breath and cough without much inconvenience. 20th. — Quite well.

b, Oct. 3rd — 8th, took I dr. of ist dil. once or twice daily. On 7ch, 10 a.m., distinct dull shooting in various localities in 1. chest, and slight pricking pain in 1. pharynx. 8 p.m., chest better, but throat much worse. 8th.— L. side of throat is red, with considerable pain on swallowing. 8 p.m., throat very painful ; took dose 0/ belladonna. 9th. — L. tonsil inflamed and painful. No further record. Nov. 7th — i8th took same (new preparation) in same way. On yth, at 2 p.m., while writing, sudden attack of fluttering at heart, with rising in throat. On 1 2th, extreme coldness of feet, and on 13th same of hands also ; Oil i4th« same of feet, with aching at vertex capitis. On i jth, e.,

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uneisy aching about chest, particularly 1. side \ and on i6th» e., same with heat. 17th, quite free from any symptoms during d., but uneasiness about heart again in e. 1 8th.— -Woke with soreness of I. throat* 8 p.m., after riding some distance conBiderable pain in heart, extending through to 1. scapula, not alfected by deep inspiration ; lasted some h. and was very marked. [Ibid.^ p. 221.)

1. W. R — , act. 27, took ist dil. in OcL, 3rd in Nov., and 6th in Dec. There was so much amiss with his health on commencing proving, and so little fresh occurred, save some catarrh and a gingivitis which may well have been accidental, that no record of his experiences need be given here. (Ibid,^ p. 223.)

2. Mrs. R — , wife of above, «t, 23, proved 3rd dil. in usual way during Nov. Was suckh'ng an infant 4 — 5 mo. old, and at same time had profuse menstruation, with much leucorrhcra during periods -, also liable to congestion of head. She became ill while taking drug, — feverish, thirsty, diarrhoeic (as was infant also), and colicky, with frequent sick turns ; but the detailed symptoms are so blended with those, of her previous far from healthy state that they cannot here be givexu (She did not enjoy very good health after taking the medicine, but the leucorrhcca she formerly suffered from entirely disappeared.) {Uid^ p. 246.)

3. a, William Gillow, <ct. 27, affected with pityriasis of scalp^ hzmorrhoids, and frequent severe attacks of flatulence \ otherwise healthy. Oct. ist — 6th, took m. and e. i dr. of rst dil. 2nd. — Passed a wakeful n. (very uncommon, and no reason for it) ; dreamed vividly,

d woke up very frequently with very dry mouth. 3rd. — On going bed peculiar headache, dull constricted feeling across forehead, with heaviness of eyes \ slight nausea, dry mouth and very cold feet, though he had been sitting in a warm room. This m.^ after dose, had some slight headache, with dryness of mouth and cold feet. 7*30 p.m., very sudden and relaxed motion, with return of m. symptoms. On 4th no symptoms, and none on 5th till after e. dose, when on going to bed he felt peculiar morbid condition of body and mind ^ constant violent sexual desire, with little physical power. Thus n. was passed most miserably, — frequent waking, with vivid imaginations and most painful state of mind. [No. 8 notes unusual excitement of genital instinct and power more or less throughout proving. — £ds.] There were involuntary emissions, followed by great prostration and distress. He never felt these symptoms in the same way before. 6th, — Felt prostrate and miserable in body and mind ; dulness about head, heavy aching over eyes, dry mouth. This continued more or less all d. In e. felt better, and (though n. was restless) continued so till e. of 7th, when symptoms came on which eventuated in a severe cold.

^. Nov. 14th — Z2nd took same, at lirst m. and e., later at noon only. Was then in his usual health. 15th. — JVl., mouth very dry, nd headache over eyes, peculiar oppressive and constricted feelings cnt off after breakfast. 1 6th. — Same. 17th. — Peculiar distress about generative organs, with great depression of mind \ sexual desire morbidly strong, yet no physical power. i8th. — In 2 h. after (midday) dose, return or dry mouth and headache. No moral symptoms to-day.

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19th. — One h. after dose slight heaviness over eyes, with constricted feeling and dryness of throat. 20th. — M. stool for some d. getting scantier, and to-day less than ever. 21st and 22nd. — Same costiveness. No further eiFeccs. In Dec. took several doses of ist, 2nd, and 3rd trits. without effect. (IbU.)

II. fl. Dr. Pope, »t. 23, took, Oct. ist — 7th, i dr. of ist dil. m. and e. On 2nd slight aching in both temples for 2 — 3 h., and on 3rd similar pain all d., and tightness in larynx on getting into bed. He fielt this again on waking next m., and it continued all d., with slight headache. On 5th same, with cough, and oppressive aching in temples. On 6th and 7th felt tightness in larynx immediately after e. dose, and in m. of 7th aching in temples and across forehead recurred.

i, Nov. 6th — 1 2th took same (new preparation). 8th. — Severe aching across forehead, particularly over each temple, and weight over eyelids. Tightness over vertex. Depression of spirits, inability for exertion, everything seemed going wrong. Pain lessened as d. advanced, but was aggravated by motion or exertion of any kind. 9th. — Pain in head of same kind, but less severe ; was at once dissipated by a very little alcohol or tobacco. loth. — Headache like that on 8th came on after m. dose, and remained for 2 or 3 h. 1 ith. — Slight headache over r, eye and in r. temple j spirits better. 12th. — Same.

c. Dec. 4th — loth, took i dr. of 6th dil. m. and e. On 6th slight headache and great restlessness ; on 9th slight headache and great depression of spirits ; on lOth, aching over whole head and depression of spirits^ continuing during following d. without any more medicine.

[The foregoing is Dr. ropes revision, in his present lights, of the record of his proving. To latter headds the following remarks : — " On reviewing the abnormal symptoms which have succeeded my taking the N. poison, I find that the most persistent and best marked have been severe headache, usually accompanied by intense depression of spirits. The headache was very severe, at times almost unendurable, and the melancholy equally distressing. The headache was most marked, and usually began, m the r. temporal region (also occupying the I,, though in less degree), and involved the eye of the same side. The pain was a deep-seated, severe aching, occasionally shooting ; it gradually extended to a sense of dull aching over forehead and vertex, but always remaining most severe in each temple. The least motion aggravated it intensely. It was relieved by going into the open air, though but slightly ; smoking procured more marked relief, and alcoholic liquors completely dissipated it. This pain was present whenever the poison was taken, though most severe on Nov. 8th and 9th. It was, as before remarked, accompanied by great depression of spirits. This melancholy was of a peculiar kind. I felt that everything that was done was done in a wrong way, and could not be recrified. If I felt that I had some duty to perform, I had at the same time a strong impulse not to do it, and was extremely restless in consequence. These moral symptoms were not present at all during Oct. ; they were very distressing while taking the Nov. doses, and, though present, were much less severe in Dec He goes on to say that he only once felt this headache and depression before, viz. when— some

6^7 years previously — residing in the relaxing atmosphere of Torquay.] {Ibid., p. 234.)

OHN L.

26, took I dr. of ist dil. n. and m.

.ANDELL,

Oct. 2nd — 8th. — Had coryza at beginning of proving, and had had rheumatism of shoulders 6 weeks previously. This last recurred after 1st jx)wdcr. The usual frontal headache of N. began on 3rd, and continued all d. on 4th. On e. of 5th felt sick, almost to vomitings irritable, restless ; frontal headache, throbbing of temples, and disagreeable fubicss of head when lying ; feeling of weariness and frequent yawning. On m. of 7th tearing pains in abdomen for 2 h. ; still headache, weariness, and yawning \ chilblains have appeared on feet last 3 d., very painful, cannot put boots on, has not had them before for 5 or 4 years.

h. Nov. 1st— 7th, took n. and m. i dr. of 3rd, and, nth — i/ih, 1 dr. of 1st dil. From first, no effect save slight headache and transient though sharp abdominal pains. On 12th, sharp shooting pains from one temple to the other ; nausea with pain and beating in stomach, and feeling of prostration ; all relieved in open air. On 15th, chilblains, which had been better, were worse j with usual headache, there was forgetfulness and prostration. On 17th, gum of I. canine inflamed, and opposite to it an ulcer of under lip, which did not disappear till 12 d. after finishing med. In Dec. took 6th dil. in same manner for a week, but without result. [Ibid,, p. 241.)

1. Dr. Drvsoale took ist dil. for a week in Oct. without result, and the same may be said of his trial of the 3rd dil. in Nov. In Dec. he took the fresh preparation of ist dil., without noticing any deviation from health save that on 6th, while driving, he felt a sudden pang of pain through 1. side of head, from behind forwards, lasting only a m. or two. (Ibid, p. 243.)

2. I was giving it to a very intelligent lady, a physician's wife, for organic disease of the heart. She experienced no benefit from its use, but complained that it occasioned a symptom altogether new to her — a violent crampy pain in the region of the 1. ovary, (HotcoMBE, U, S, M. and S. Journ.y i, 234.)

3. Poisonings. — x. A woman was bitten in the small of the leg by a cobra. I saw her about 10 h. after the accident. She had lost her hearing and feeling ; and deglutition was much impeded. A torpor and listlcssncss pervaded the whole system, and from the moment of ibe bite had gradually increased. She took three Tanjore pills at 3 — 4 h. interval, and in about 8 h. gradually recovered feeling and sight, and could swallow more ^ecly. She remained weakly for 8—10 d,, (Patrick. Russell, Brit, Journ, of Horn., xi, 84.)

4. A Dubash was bitten in the toe by a snake^ which from hit description appeared to be a cobra. A few drops of blood issued ^om the part, and he was sensible instantly of pain. When he came to mc, about \ h, after, the pain had advanced as high as the knee-joint ; I gave him a Tanjore pill. In 10 m. more the pain had got to the top of the thigh and had become much more severe. I then gave him two more pills anusome hot wine — part only of which he retained. Patient now complained of severe pains in his belly, which upon examination appeared

tense and much swelled. Sense of tightness spreading fast to heart, and respiration becoming extremely laborious, an attempt was made to induce him to take two pills more ; but deglutition being impeded a part of them only reached the stomach and was immediately rejected. From this time the stricture of the ccsophagus increased so much that nothing could be forced down the throat ; he foamed at the mouth ; his eyes stood staring and fixed ^ his pulse and breathing became hardly perceptible, and in short every vital motion seemed at a stand. I now applied spirits of hartshorn to his mouth and nostrils, by which in a few m. a strong sneeze being excited, he immediately began to breathe and soon pronounced the word " better." After he had recovered a little, he told me he felt the pain descending retrograde in the same track in which it had risen, and expressed a strong desire to sleep. He slept for i h., and upon awaking vomited plentifully. He had now recovered his senses, and said he felt only a little pain in his foot, which at last descended to the toe In the course of 2 h. he was able to walk home, but did not recover the fatigue for some d. {Ihid.)

1. A sepoy was bitten on the ankle by a large snake, believed to be a cobra, and was brought to Capt. Gander's house within \ h. after. His jaws were locked, his eyes fixed, and very little sign of life remaining J four large punctures were visible on the ankle, and on eau de luce being applied to these the man gave marks of sensibility by drawing up his leg. Two bottles of warmed wine were poured down his throat during \ h., the jaws being forced open so as to introduce a funnel ; and the ammonia was constantly applied for 3 h. Patient was then without any sense of feeling whatever; and had it not been for a gentle heave of his breast every 2 or 3 h. he would have been thought dead. He remained in this torpid state 40 h., and then began to show signs of returning life. It was 12 h. more before he recovered his speech, and he continued many days in a very languid state. (Ibid.)

2. A serpent-catcher was bitten by a cobra in the fleshy part between the thumb and forefinger. He felt instantly a sharp pain in the part bitten, which soon spread over the palm and upwards on the arm. He felt also sickness at stomach, but did not vomit. In less than an h. hand and wrist considerably swelled, pain extended nearer shoulder, he was sensible of confusion in his head and a strong disposition to doze. From this time he himself was for several h. ignorant of what had passed ; but those about him said that he at times showed much inquietude without making any specific complaint ; at other times he lay moaning and dozing. Towards midnight startings about his throat were observed, his breathing became laborious, he could not speak articulately, and seemed not to perceive objects though his eyes were open. They had applied a poultice of herbs to his arm, and administered a secret antidote internally, but finding he grew worse and worse, Dr. R — was sent for. He did not see patient till next m., when he found hand and arm monstrously swelled, but senses perfectly recovered (they had returned about 2 a.m.) \ the man complained only of confusion of head, languor, and pain in arm. The parts about the punctures mortified. The gangrene spread over back and palm of hand and part of wrist, laying tendons bare, and forming an ulcer of

VOL. Ul. il

considerable extent, which, however, healed favourably under the usual treatment. He recovered his health in 8 — lo d. {/hid,)

1. E.H.G— , act. 31, keeper in reptile-house of Zoological Gardens, went one m. to his charge partially intoxicated. At 8.10 a.m., while playing with a cobra, it made a dart at him, and inflicted a wound on the upper nose. After 20 m. — having previously shown no symptoms save agitation at what had occurred — he began to stagger in walking and to speak unintelligibly ; at same time movements, apparently convulsive, of mouth and of limbs were observed. He made no complaint of pain or other sensation. He was taken to the hospital, and during transit was observed to grow very rapidly worse. When seen by physicians (8.4.5) ^^ moaned, grasped his throat with some eagerness of action, tossed his head from side to side, and moved his arms and legs in an uneasy, restless manner, not apparently convulsive. When asked in a loud voice if he felt pain, he made no reply, and gave no evidence that he heard or understood the question. He was unable to support himself in a sitting posture. His face generally was slightly livid ; bis eyes fixed ; his pupils acting sluggishly to light. Skin was of natural temperature and moisture ; pulse 120, regular in rhythm, but unequal in force, most of the bears, however, being tolerably full and strong. On upper nose were a number of small punctured wounds, from one or more of which a small quantity of blood had flowed. L. eyelids, especially upper, were swollen and livid, lividity extending to r. side of nose but not to 1. There appeared to be no swelling of tongue.

h. These observations were made rapidly as patient lay on a couch in the casualty room. He was immediately transferred to the ward, undressed, and put into bed. The interval that elapsed between his being first seen and his being put to bed, though certainly not exceeding 5 ^'1 witnessed a material change in his symptoms. Just prior to being lifted into bed, respiration was 20 per m., very shallow, without stertor, and free from any sound indicating obstruction. By this time the movements of the extremities had entirely ceased, the lividity of the face had very markedly increased, free perspiration had occurred over surface generally^ and pulse continued tolerably good. As it was evident the man was rapidly dying from respiratory failure, preparations were immediately made for artificial respiration. Before it was begun, natural breathing had ceased, and pulse was 32 only, remarkably irregular both in rhythm and force, some of the beats being remarkably filU and bounding. When artificial respiration had been continuea a m., pulse was 70 and less irregular. It was persevered with fo 50 m. Pulse continued of fair power and volume, maintaining, however, its characters of irregularity and inequality. On two occasions it was 104, and once 72. At no time was there any indication of recovery of. natural respiration, but there was felt throughout, till within 4 h. of the cessation of the pulse, a clonic contraction of the sternomastoids, very irregular in rhythm. At 9,40 pulse ceased, and artificial respiration was discontinued. Skin had continued moist and, for the most part, warm till near the close, Lividity of face continued, but no other part was discoloured or swollen,

r. P,M* (30 h. later). — Bloody fluid had continued ever since to

ooze from highest and largest wound on nose, others being closed by coagula, and from mouth and nostrils a considerable amount of frothy blood had issued. There was livid discoloration of dependent parts, both externally and in lungs, whose posterior aspect was gorged and almost black. Air-tubes throughout were filled with black frothy fluid, such as exuded on section of lungs; and their lining membrane (including that of lower trachea) stained with similar colour. Heart healthy ; 1. side contracted and empty ; r. filled with dark fluid blood, in which was a little very loose coagulum. Alimentary canal healthy, save that stomach showed patches of pale colour alternating with patches of red — latter formed by aggregation of minute red spots (? alcohol). Liver and kidneys dark, but otherwise natural ; spleen enormously congested, almost black, substance very soft, exuding on section very dark blood. In brain and spinal cord scarcely anything abnormal. During the dissection, it was noticed that the body exhaled a peculiar sour odour. {Lancet^ 1852, ii, 327.)

1. A woman, bitten by a cobra, was found sitting on the ground suffering from a succession of swooning fits. She had had 8 before my arrival, 2 h. after the bite, the marks of which were seen on the ankle. While with her another swooning came on ; she fell forward from sitting posture insensible. After some time, with convulsive gasps, she came to herself. She took a native antidote, and had only one more fit, 2 h. after the last. (Fayrer, Ed. Mfd, Journ,^ 1869, p. 425.)

2. Mr. F. BuocLAND had skinned a rat which had been killed by a cobra-bite. " I had not walked a hundred yards/* he writes, " before all of a sudden 1 felt just as if somebody had come behind me and struck me a severe blow on the head and neck, and at the same time I experienced a most acute pain and sense of oppression at the chest, as though a hot iron had been run in, and a hundredweight put on the top of it. 1 knew instantly from what I had read that I was poisoned \ I said as much to my friend, a most intelligent gentleman, who happened to be with mc, and told him if I fell to give me brandy and eau dc luce, words which he kept repeating in case he might forget them. At the same time I enjoined him to keep me going, and not on any account to allow me to He down. I then forgot everything for several minutes, and my friend tells me I rolled about as if very faint and weak. He also informs me that the first thing I did was to fall against him, asking if I looked seedy. He most wisely answered, ' No, you look very well.* I do not think he thought so, for his own face was as white as a ghost. I recollect this much. He tells me my face was a greenish-yellow colour. After walking or rather staggering along for some minutes, I gradually recovered my senses and steered for the nearest chemist's shop. Rushing in, I asked fur eau de luce. Of course he had none, but my eye caught the words Spt. Am. Co., or hartshorn, on a bottle. I reached it down myself, and pouring a large quantity into a tumbler with a little water, both of which articles I found on a soda-water stand in the shop, drank it off, though it burnt my mouth and lips very much. Instantly I felt relief from the pain at the chest and neck. The chemist stood aghast, and on my telling him what was the matter, recommended a warm bath. If I had then fol-

lowed his advice, these words would never have been placed on rccoi After a second draught at the hartshorn bottle I proceeded on my way, feeling very stupid and confused. On arriving at my friend's residence close by, he kindly procured me a bottle of brandy, of which I drank four large wine glasses, one after another, but did not feel the least tipsy after the operation. Feeling nearly well, I started on my^ way home, and then for the first time perceived a most acute pain under the nail of the left thumb , this pain also ran up the arm. I set to work to suck the wound, and then found out how the poison had got intc the system. About an hour before I examined the dead rat, I had been cleaning the nail with a penknife, and had slightly separated the nail from the skin beneath. Into this little crack the poison had got when I was scraping the rat's skin to examine the woiind. How virulent, therefore, must the poison of the cobra be ! It had already circulated in the body of the rat from which I had imbibed it secondhand." (Curiosities of Natural History^ 2nd ed., p. 225.)

III. Experiments on anima is, — 1. June 1787, dog bitten on inside of thigh by a species of N. howled at first as if in much pain. After 2 or 3 m. he lay down, and continued at intervab to moan and howL After 20 m. he rose, but stood with difficulty, and was unable to walk ; his whole frame seemed greatly disordered. He soon lay down again, and in a few m. was seized with convulsions, in which he expired, 27 m. after bite. (P. Russell, op. cit.)

1. July, a large very stout dog was similarly bitten. In a m. or two thigh was drawn up, which is generally Hrst symptom of potsoa having taken effect. He continued, however, nearly an h. walking on three legs, seemingly not otherwise disordered i he then laid himself along, showed great inquietude, but did not howl ; purged once. About this time he became in an uncommon degree convulsed about head and throat, and made several vain efforts to rise, both hind legs being now paralytic. In this state he continued above an h., and then died, 2 h. after bite. (Similar results followed in 3 other cases.)

2. A cobra de capello was made to bite a very large stout dog. At nrst the dog complained loudly, though neither was the thigh drawD up, nor for i h. did any symptom of poisoning appear. About thb time, breaking loose, he was pursued, and after a chase of ] ) h. was brought back, extremely heated and fatigued. After resting } h. water was offered to him, but he would not drink, though he ate some morsels of bread thrown into the water. About \ h. after eating the bread he grew sick, vomited, and began to howl and show much inquietude. After 10 m. he vomited a second time, and became extremely outrageous, struggled to get loose, snapped desperately at the stake to which he was tied, and howled incessantly. He then lay down, and was much agitated about belly and stomach j muscles of face also were convulsed, Being made to rise, he walked without any serious impediment froo the hind legs. At end of 3rd h. he still continued extremely ferocious so that it was necessary to tie his legs. From this time his howlings and strugglings grew gradually weaker, and the convulsive motions of his face increased. In this state he lingered about an h. longer, and

34«

then expired. Bitten pare was blacic for size of half-a-crown around.

1. A solution of I gr. of the poison in 5; of olive oil was slowly injected into the facial vein of a large rabbit. The operation did not occupy above a minute, and before it was complete the animal was quite dead. On dissection, it was found that the oil had passed freely through the lungs, as it was found in the liver and abdominal vessels ^ and so it is not probable that it was merely the pressure of the oil in the heart that had caused the death. The heart was found distended in all its cavities with dark bloody as if it had been wholly paralysed. (R. Russell, Brie. "Journ, of Horn. ^ xi, 592.)

2. A guinea-pig had injected into its peritoneal cavity a solution of ^ gr. of cobra poison in 10 dr. of distilled water, at 1.56 p.m. 2, sluggish \ docs not twitch as another did, which received similarly a dose of crotalus poison. (See Crotalus, iii, 6). 2.4, started and squeaked slightly, as though in pain. 2,5, slight twitching general. Paralysis and ataxy commencing ; drags legs with difficulty. 2.9, sharp twitchings of head and neck. 2.12, subsides on to belly ; head fallen over, crawls with difficulty ; is very feeble, almost paralysed. Eyes (it is an albino) have heavy dull look \ they have lost their bright pink. 2.I4j convulsed. 2.15, reflex action ceased; apparently dead, but heart can still be felt beating; occasional convulsive twitching of lower lips. 2.1 7, all movements have ceased, — those of heart also, save for slight flickering contractions of auricles. 2.20, electrodes in cord showed this and its nerves paralysed \ muscles contract freely to direct stimulus of current. Heart distended with blood, which, when removed, formed rapidly a firm coagulum. Intestines, peritoneum, and subperitoneal areolar tissue congested and ecchymosed ; sanguino- Icnt effusion into peritoneum, but not so well marked as in the crotalus poisoning. Peristaltic action of bowels ceased rapidly. (Brunton and Fayrer, Report on Sanitary Measures in India, 1873 — 4.).

3. Same dose was injected into jugular vein of a large rabbit at 2.55 p.m. Rabbit passed at once into violent convulsions, and was apparently dead before it could be removed from the board (i m.). Cord was immediately exposed, artificial respiration having also been begun j electrodes applied, with strong current, induced no reaction, cora was completely paralysed. Thorax examined 2.59. Heart had ceased to act \ ventricles moderately contracted, auricles distended with blood. Phrenic, on being irritated, gave no response \ diaphragm, when directly excited by current, contracts very faintly, but neighbouring muscles vigorously. Peristaltic action goes on ; electrodes applied to vagus appear to accelerate it, to splanchnic diminbh it. 3.7, ventricles have now contracted firmly, 3.15, blood taken from heart and large vessels has coagulated, but not firmly -, clot is small, and serum very red ; under microscope, blood shows no aggregation in rouleaux or

jcrenation of corpuscles. (Ibid,)

Volume IV — Appendix

NAJA. (See vol. iii, p. 3*8.)

fl. 8. A Hindu, xt. 40, was bitten on bare r. shoulder b j a blj cobra at 12.30 a.m. On inspection 5 m. later two small punctui were found over deltoid, from each of which had oozed a drop ofcl serous fluid mixed with blood. He complained of burning pain, rapii increasing in intensity, in an area round bites about size of a saac At 12.45 ^^ felt pain shooting towards throat and chest ; but \ calm and collected. Pupils were dilated, but responded to light; pu wa$ normal, and there was no embarrassment of respiration. In 5

more he began to lose control over muscles of legs, and staggered when left unsupported. At about i, paralysis of legs having increased, lower jaw began to fall, and frothy and viscid siuiva to ooze from mottth. He also spoke indistinctly, like a man under influence of liquor. At i.io he began to moan and shake his head frequently from side to side. Pulse was now somewhat accelerated, but regular } resp. also was quickened. He was unable to answer questions, but seemed to be quite conscious. His arms did not appear to be paralysed. Hitherto small quantities of brandy and water had been administered ; but new liquor ammoniac was injected, 25 min. under skin of forearm, then same dose into basilic vein. No improvement followed ; he continued to moan and shake his head from side to side, as if trying to get rid of viscid mucus in throat. Resp. was laboured, but not stertorous. Another 25 min. was now injected into jugular vein, but without benefit ; breathing gradually became slower and slower, and hnally ceaSed at 144, heart continuing to beat i m. longer. There were no oottvttlsbai befoK dissolution. (Hilson, Indian Mtd. Gaxtttt^ Oct., i«73.)