Aloe socotrina

Volume I — Main text

ALOE,

jf/wf Socotrina^ Lam. Gum aloes. Nat, Ord„ LiUacf^g,

L Proving$, — 1. Every healthy person who takes a certain quantity of A, has some stools from it. He experiences otherwise no symptoms^ unless it be sometimes a little heat and uneasiness in region of Jivcr. The effect is rarely felt for the first 8 h», often not till after 12 h., and this whether the dose is great or smalL The stool is often preceded by some pinchings, and at times accompanied with tenesmus. The excrements are mixed with bile ; they are not watery, and have an odour quite sui gimris. The effect of A. on the stools is the greater the more inclined one is to free biliary secretion. By the evacuations provoked by A« the system is not refreshed as it is by purgation induced

by other agents, especially by the neutral salts; it is rather a little heated, and that the more according as the evacuations are copious and frequent. If the dose is strong, the pulse is often quickened, dryness of mouth and thirst are induced, the urine is passed in smaller quantity, and is burning j there is felt in the hypogastrium a disagreeable warmtn, sometimes even a throbbing, and in the r, hypochondrlum pressure and tension are noticed. If the use of the A. is continued for many suecessive days, its effects increase, unless the dose is diminished , this applies also to the heating. If the subject is disposed to haemorrhoids and to too copious menstruation, A. sometimes provokes h^emorrhoidal sufferings and augments the catamenial flow: Small doses, moreover, often cause erections, and increase the sexual appetite. (Wedekind, Rust's Magaz,y xxiv, 2, 304.)

1. A. hardly ever does more than produce one stool, which seems to be merely an evacuation of what may be supposed to have been present for the time in the great intestines* It is remarkable that it does this in a very small dose, and it is equally remarkable, that though the dose is increased to ten times the quantity the effect is much the same, 1 have found that hardly any dose under 20 grains will procure a liquid stool, and when it happens, it is always with pain and griping. .• ... As A. operates especially upon the intestinum rectum, there may be a foundation for the common opinion of its producing hsemorrhoidal affections ; and from the large and frequent use of A., I have had instances of such effects. (Cull en. Treatise 0/ the Alateria Medica^ ii, 525.)

2. in the course of three years Giacomini took 120 grammes of A, I to 3 grains taken fasting caused, usually, a few eructations tasting of the drug, but always increased feelingof hunger, and after 8 tor oh., often after previous pricking in the bowels, one or more light copious stools of soft yellowish- brown faeces, mostly accompanied by discharge of flatus, and having a strong and peculiar odour at times ; the evacuation was repeated more scantily some h, afterwards, 8 to 10 grains appeared not to increase these effects, although the pulse (after 3 h.) was slowed. At 16 to 20 grains, evacuations only seldom occur which can be said to be effects of the remedy; in place of this the pulse is slowed 4 to 8 beats in a minute, and the urine is copious and turbid. Once after a scruple dose, the stool only occurred after 28 h., and there was nothing further to be observed than a certain anxietas. After 30 grains between m. and e. followed a n. of perfectly calm sleep, but next d. there were two tolerably fluid stools, copious urination, general depression, and very urgent inclination for food. In his numerous experiments instituted with small doses, he sometimes experienced biting pains in the intestines, which were (he says) the forerunners of the pending evacuation, and manifestly depended upon the descent of the separate intestinal humours. {Trattato Filosofico SperimentaUy 1833, iv, 336-8O

4- A. B — ^ a young physician, proved A. in 1833.

a. Took one grain at 6 a.m., and shuddered 40 m. thereafter. In 4 h, feeling as if head were expanded from within ; a single twitching drawing over 1. eye and outwards through it ^ after a meal, coldneas

2l8

(objective and subjective) of hands and feet, latter grew warm after walking, former less so, in e. both warm ; late in getting to sleep. Urine transparent, dark, not increased. Awoke at 3 a.m., with hasty urgency to stool, dull gripings, movings about in abdomen, thin, pappy, copious evacuation, afterwards feeling as if more would come. Woke again at 7 completely active ; had canine hunger in forenoon ; at noon sore pain in r. vertex, touching hair hurts the spot — later j in c. same pain in other small places ^ in afternoon and e. pressive boring in L temple, followed by stitching drawing in h eye outwards coming from brow ; bruised pain between and on scapul^e^ as after long stooping. On 3rd d,, awoke at 7 with feeling of hunger and urgency to micturition ; during forenoon, copious emission of light-yellow urine, and two extra stools ; at 11 a.m. driven to urinate quickly, he can scarcely hold it ; feeling as if he had taken cold in bowels, after the m* stool ; pressive or paralytic drawing in r. upper arm near the shoulder, at rest and in movement „ drawing stitches, not deep, over r. temple ; tensive numb sensation spreads from forehead over scalp, with feeling of increased warmth ; in afternoon, more frequent, quicker urgency to micturate, with less quantity than in m. ; in c. and next m. while lying in bed sprained feeling in several joints. During these d., face had pale, sickly colour. On 4th d,, awoke at 3 with urging to urinate, and had a copious, thin, pappy stool without straining ; felt also pressive pain in pharynx, feeling of rawness and swelling, especially on swallow* ing, with hawking of thick mucus (all going on on rising). Remained wide awake till 6, when he had movement in umbilical region, with urgency to stool and hunger ; a second stool followed, with flatus and a sort of tenesmus j at 7 a third stool with straining ; when he thought he had finished, still more came; at 11 a fourth stool; drawing in front of urethra when sitting ; drawing tension on r, side of neck, as if in muscles, burning on stooping (same sensation 2nd and 3rd d.) j pain in and about meatus auditori us almost like ear-ache ; also when closing jaws sense of numbness behind ear, drawing down to lower jaw through a back tooth ; dull drawing and shooting on n forehead, con* fusing head, and compelling him to make the eyes small. On 5th d*, in m., on rising, hawking of thick, tenacious, lumpy mucus, like jelly, easily detached ; soon after breakfast hungry feeling in stomach, with collection of water in mouth ; afternoon, some blood blown from nose. Throughout d. increased urgency to micturition, urine not more copious than usual. On 6th d., sleep having been bad, was excited mentally, yet dozy ; and had violent urging to micturate.

The tenesmus was occasioned by an unpleasant sensation in anus, as if more fasces would follow, which must be held back on account of soreness ; yet for some cause cannot draw anus together.

b. Took 4 grains, washed down with some water, in forenoon. Soon after, pulse became very slow (55), weak and suppressed, and there was coldness, especially through legs ; ^ h, later, pulse still subnormal in force and frequency, but face was warm and flushed, and he felt lively and excited ; in i h. warmth in stomach, with feeling of hunger, pulse 60, weak, sometimes intermitting a beat. During siesta, no sleepiness, feet and hands cold, only warming up gradually* Urine

passed in afternoon was, after standing, cloudy with whitish sediment (cloudiness finely granular) ; it was small in quantity, and of foul ammoniacal odour. Felt unusually vigorous at this time, but weary early in e. ; had sensitive drawing pain in head^ most externally ; more pressure to urinate, but less passed j drawing pain in hands and feet. The n. was restless. On rising, hasty urging to stool, with continued rumbling in abdomen ; spattering after stool j some rawness in fauces, chiefly in soft palate and uvula, with some hoarseness of voice, which disappears during breakfast, but returns (forenoon) on going into cold open air. Pulse after rising, 60, weak and suppressed ; in afternoon over 60. A painful crack in under-lip, near r, angle of mouth. This d, and next dry lips, looking whitish if not frequently moistened ; and now and then weakness of whole chest. At 2 a.m. on 3rd d., woke with urgency to urinate ; same urgency on rising at 5, and again at 8 and 9.30, no increase of quantity. Every time he passes urine, he feels as if some thin faeces would escape with it. Pulse early was 70 ; at 3 p.m<, 62. Long dozy mid-day sleep, cannot arouse himself j frequent yawning after it. In afternoon, excitement of mind and body | sensitive jerking drawing, as in flesh, from forearm to middle hand, 6 or 8 times in quick succession, while sitting still and writing ; sudden attacks of coryza* In e. cold feet, hindering his going to sleep* On same d. are noted : — Labour soon becomes tedious to him ; dryness of mouth ; sickening odour from mouth, noticeable to himself, as if he had been long without food on a warm day ; frequent desire for food, ate apples between meals i much flatulence ; stool passed without his needing to make any exertion,- — fell, as it were, out of rectum ; highly coloured urine, of strong odour, remaining clear. In n., r. testicle felt cold to touch ; no sound sleep ; cold ; woke at 3 a.m. from a mass of confused dreams. On then getting up, chill, lasting throughout d., in open air and in room ; very sensitive during its continuance ; in afternoon it is more severe, runs through skin of whole body, with some oppression in forehead ; in e. feet only remain cold, Coryza also during whole d. After mid-day meal dozy half-sleep, eyes heavy. In e. severe stitches in middle of chest, about 6th rib, hindering deep inspiration. On this d. also, little disposition to mental exertion ; feels discouraged as to success ; no apperite for meat this d. or next ; frequently a sensitive drawing in different parts of body, as if involving bones ; sooner fatigued on movement ; from this till 8th d., r, nostril scabby and sensitive within. Since rising, palate and fauces felt swollen, and increasingly during d., on empty swallowing and yawning. There was pain in arches of palate. On 5th and 6th d. these sensations continued ; swallowing food did not hurt ; on chewing, sides of soft palate pained as if sore, or as if burnt by hot food. At various times on these d., urgency to stool, which he could overcome ; with stool always a feeling as if still more were at hand. No mid-day sleep on 5th d. ; in c., pressure in r, eye- ball, severe but transitory ; during d. at times, a flying pain in L meatus auditorius externus, especially during mastica* tion i early, while stretching, a shooting drawing in L chest in region of 6th and 7th ribs, only superficial, but hindering respiration. From this to 8th d. weakness of chest on bodily exertion^ and from 6th to

aio

8th^ lips as on 2nd and 3rd) under! ip swollen, with a thick-skinned flat vesicle at inner margin of red, of size of flaxseed^ yellowish ; it makes lip thick. Throat as on 5th and 6th d. On 7th d.^ peculiar sensation E)n last phalanges, of 1. hand particularly, as if hairs there raised them-

elves slowly ; it seemed as if a hair lay on fingers. On 8th d., head

iras confused, oppressed, uncomfortable.

[Some of these symptoms continued a day or two longer, and fresh ones are noted as occurring up to the 25th d. ; but their causation by the drug is too dubious to admit of their insertion. It may also be fairly questioned whether certain of the foregoing symptoms were not due to a catarrhal chill. — Eds.]. {Jmtr. Arxnetprufungen.)

5, Dr. GosEwiscH took 4th trit., and reports : Headache in m, allowing incomplete evacuation of bowels, lasting until a 2nd stool

'follows a few h. after j stool on following m. is goldcn-yellow ; strong pulsation in anus, while sitting, after dinner, {Ibid,)

1. Dr. Helbig took 5 grains one afternoon. Next m., on awaking, aching over a large space in middle abdomen ; is compelled thereby to lie bent and to press upon the abdomen, which relieves. After rising, pain passed into mild cutting, and he had two normally coloured pappy evacuations. At same time, pain on inner margin of metatarsal bone of great toe, on walking and at rest ; first, there is a pressure, then follows a slight drawing, as if the pressure extended itself. On 3rd d., on rising in m., severe aching in a small circle around navel, as if he had received blow from fist on abdomen. He plainly felt the pain, however, in the intestinal canal, and pressure on umbilical region increased it much j therewith yellow pappy diarrhoea and some nausea* The stool is accompanied by pricking in anus, as if it would tear (in front). Afterwards, a continued pain in anal passage, which obliged him frequently to draw it together, whereby it became tense and ached. In e, slight squeezing pain in n ear. On 6th d. a jerking pain in region of U lower ribs, internally, from above downwards, and from without inwards (on walking in m.). On 9th d., at n. in bed, pressive pain in r. forearm, beginning midway and ending in wrist, where it seemed as if it would force bones of joint asunder.

These are all the dated symptoms ; but the following also arc reported : — Pressive pain in 1. temple especially, occurring now and then i pressive sensation on vertex ; pressive aching at angle of r. occiput i aching, like a pressure, in occipital scalp ; pustules in r. external angle of eye, surrounded by many red vessels j in c. h., remarkable coldness of nose to touch ; thirst, especially for beer, which seems to alleviate pains in anus \ bitter eructations for several days ; hard pressive pains in region of r. lower ribs, alternating with just such pains in upper chest, as if below sternum, — former transitory but more fre. quent, latter more enduring but rarer ; painfulness of whole abdomen, especially in sides and in front about navel, which parts cannot bear to be touched j on making a false step on pavement it hurts much in epigastrium ; stool indeed daily, but difficult to pass, distending rectum first ; he must go to stool soon after a meal \ after loud rumblings and movements in abdomen, a thin evacuation, passing almost involuntarily, consisting in part of thin, yellow faeces, partly of bilious mucui

21 r

streaking these^ thereafter crawling in anus, compelling rubbing ; scraping feeling in throat, producing cough, dry at n., and more moist in m, i chest in front and sides up to axillar painful to touch as if [beaten, pain seeming to be between bones and flesh, excited also (in front) by deep breathing (with abdominal pain as above, muscles there painful on rising after lying), pectoral muscles painful on moving arms, and abdominal (at costal attachments) on pressing at stool, lasting 8 d. ; pain in coccyx, as if he had fallen on it ; aching in lower knuckles of first fingers of r. hand, e. ; soles painful in walking on pavement, as if he had made a long journey — also at rest ; in e., biting griping at navel, obliging him to rub it.

The following are observations by Dr. Helbig :

a. E* S. took 2 grains, triturated with sugar of milk. Was morose and ill-humoured for several d. ^ on 4th d, had severe drawing sacral pains, spreading over whole pelvis, filling him with ill-humour ; they increased in evenings, and lasted 8 d.

b. Took 2 grains at noon. Had immediately painful sensation in abdomen j towards following m», three yellowish diarrhceic stools, therewith dull pain across under ribs, with slight distension, some frontal headache, crawling in bowels, and chilliness, so that he felt very cold whenever he left stove j last stool accompanied by burning in rectum, haemorrhoidal pains, and much flatus, and followed by constipation for 2 d.

r. Took an unknown quantity, and had bitter taste, with loss of appetite, and cutting in hypochondria.

d. Another reports downward and inward pressing pain towards nose in mid-forehead, and grasping beneath pit of stomach.

/, A girl, aet. 9, who licked a piece of A., had pressure in forehead immediately, and later displayed unusual cheerfulness.

f, A woman who rubbed tincture on abdomen had (besides some local irritation) aching in upper and middle parts, going downwards, with sense as of stone within, hurting her, and, when lying on one side, seeming to move to other. She sweated very much during n., and on next d., was taken with dry coryza and diarrhoea, {Ibid,)

1. Dr. Hencke. — a. Took 10 drops of tincture (i to 5). During first h. had frequent tenesmus, and in n. and following d. blunt stitching pain and grasping between shoulders^ most towards r. On 2nd d., had tn m. nauseating bitter taste in mouth j on rising, sacral pains, and during d. drawing about there, with sense of weight, especially in sitting; head confused, with dislike to any exertion; blunt stitches, now in L, now in r., hypochondrium ; sense of fulness in abdomen; pressure and drawing in r. renal region; this d* and next, two pappy stools. On 3rd d,, periodical movements and distension of abdomen, especially after eating ; on this d. and next, sacral heaviness continues, involving rectum. On 5th and following d., hard evacuations.

Referred to this dose, but without note of time, are : Dull stitches through 1* temple, into brain j dull drawmg in 1. side of occiput ; after dinner acrid risings ; after breakfast some pressure in epigastrium, relieved by eructations j grasping pain in splenic region j fine cuttings

■ ■ ■

in upper abdomen ; periodical drawing in n inguinal region ^ a transitorjr but recurring drawing in 1. buttock* Cutting pains become worse after any sour food,

i. Took 30 drops in m. On ist d., after 12 h., a thin pappy scool, and in j h. another ; also anxious uneasiness, preventing mental labour ; pressure about temples, with periodical heat of face and flickering before eyes ; a twisting and griping pain in upper abdomen soon after dinner and supper ; the dull sense of weight in sacrum, relieved bv walking, recurs, and lasts 8 d. ; on this and following d., periodical clutching tn coccygeal region for several m* at a time ; periodical blunt stitches in hepatic region, at times moving into chest, and obstructing respiration ; and sensitive pressure in orbits. On 2nd d., in m., some drops of blood from nose ; twisting and griping in upper abdomen and around umbilicus, compelling him to sit bent up, which relieves ; therewith repeated urging to stool, but only flatus passes, very offensive, and producing burning in anus, with temporary relief to pains J heaviness in legs. On 3rd d., frequent tenesmus without stool. On all 3 d., burning in anus for some time after emission of hot flatus.

c. Took in m. 2 grains, rubbed up with 4 of sugar of milk. Outpressing pain in forehead towards temples began soon, and continued, worse on walking, but especially on stooping; in i h., after frequent urging, scanty, dry stool, with sense as if more would come ; in 3 h., an internal sense of congestion under short ribs ; in afternoon, a slight cutting in abdomen, which increases on movement, or when body is drawn up, relieved by sitting bent j in e., emission of very offensiv^e flatus, which gives case ; at n., awakes with blunt stitches in splenic, going to sacral, region. On this d, also, feeling in nose as if blood would come ; grasping in both hypochondria ; a few blunt stitches in hepatic region ; gri pings occasionally in umbilical region, sending a shudder through whole body j pappy stool at unwonted time (10 h. after). On 2nd d*, peevish and morose ; head confused j dim sight while writing ; after evacuation, cutting at navel ^ stool twice, which is quite unusual with him, more pappy j rush of blood to chest, provoking, several times, dry cough ; dyspnoea, with periodical pressure and grasping in chest, especially in r. half ; on this and following d., drawing about and twisting in bowels. On 3rd d., pressive pain in forehead I involving orbits. From 3rd to 5 th d,, very stiff in sacrum after sitting, rising up was difficult ; then feeling as of a load in sacrum and pelvis.

Referred to same dose, but without note of time, we have : Drawing in lower front teeth j during deep breathing, stitches in pra^cordia ; dyspnoea, and dull stitches in lower part of chest ; stitches in right sac ral r egio n , { Ibid, )

8, — a. Dr. Hering took one dose of gr. \ of the i^ trit., and $ub» sequenthr the 3rd. From former he reports, 3 h. after, a second soft stool ; 8 h. after, a third. From latter, — after 2 or 3 m., pressure in middle of r. half of brain, and cold feeling of 1. side of tongue ; 3 h. after, sense of fulness like congestion in the hemorrhoids j later, an indistinct urgency to stool, and a second small stool, which was entirely

1*3

unusual, whereby the haemorrhoids protrude very much^ and there is pain, as if sore and chapped, in anus } 8 h, after (5 p.m.), again a small, thin stool (quite unusual), followed by much fulness and urging in anus J 3 to 4 h. after, on bending to h side, short (inch-long) severe pinching stitches, deep within, at back of L chest, and under L nipple, at times impeding inspiration, changing in a few m, to higher up in front ; in 20 or 30 m. later, similar stitches in r. chest, in same place, less severe ; 9 h, after, pain as if sprained and bruised in tendo-AchiUis, especially of 1. foot.

The following symptoms, without date, are also referred to 3rd : — Very peculiar vertigo for some days, — during movement, he feels as if he ought to lie down ; there is an internal sensation which makes everything seem insecure, and causes great anxiety, then fol lows coryza, first on L side, then on n, with copious scretion of mucus, which soon becomes thick, on which the vertigo goes off wheezing, panting respiration in e. after smoking ; sensation as if a hair lay on back of hand and of fingers, many times ; itching first in r., then in L, popliteal spce ; places scratched sore pain very sensitively,

L The following symptoms are marked as H.s, but without specification of dose: — After i h., internal pain in 1. thigh, and pressure on I. parietal eminence ; on ist d», stitches on r. head, between forehead and vertex, from above inwards ^ pain in hepatic region, as if strained from great exertion ; and some itching on small spot on inside of L thigh, above knee. On 3rd d., iJl-humour, and peevish mood ; painful pimples, like nodules, in skin under chin, behind jaw on r. side j in forenoon, I. hand falls asleep while sitting; in e, after much straining, with flatus, a scanty stool, with much pressing, small and soft. Fifth d., on L scalp, near vertex, feeling as if it had been beaten, so that pressure thereon is painful, though it does good.

The following are even without note of time : — Painful compression of head every m. ; pain deep in orbits, as if in muscles, worse on r* side ; pain in back of throat on swallowing ; in e, much offensive flatus, loud and silent i early in m., in folds of skin near anus (1. side), a violent irresistible itching in little points ; while stretching out I. hand, sense as if nerves were too short, and became dragged, with electric*like shock ^ indolence, and if he sits, he deliberates about standing up ; in e,, in open air, frequent violent yawning, without sleepiness. The afternoon was generally his time of aggravation, especially for symptoms of mucous membranes,

c, I'he following symptoms are vouched for by Hering, but marked A. Prover seems to have taken daily small doses of 1, trit, for some days. From him are reported, — dull pain in r. side under ribs, the same in all positions, worse while standing, so that he bends himself forwards ; burning thorugh whole abdomen; sensation in rectum as if loose ; diarrhceic stools on m. of 7th d. ; pains of weakness in ankles and wrists ; for several n, wakes with thirst, drinks a glass of cold water, and breaks out into a sweat. {Ibid,)

9, Dr. Koch took 3X trit., and reports in m. after waking an exceedingly fine but violent stitch on under part of tongue from behind forward^ which twice recurs during movement of tongue (neuralgia

M4

sublingualis) j K epididymis very painful^ on walking and when handled, whole forenoon; sacral pains on wakings with lassitude; painful weari* ness in walking, especially in calves, hip-joints, and inguinal region, {Ihid.)

lo* — a. Dr. Neidhard took gr. j of i, trit., at 10.30 a.m. Immediately, strong sense of firmness of will, and pain in r. side oi stomach, followed by commotion in lower abdomen with downward tendency. In afternoon, soreness in h side of mouth within* At 5 p.m., crushing sensation in stomach and abdomen, with ineffectual desire to evacuate bowels, but in spite of constant tenesmus nothing results but a violent and easy discharge of flatus. Later in e, two pappy bilious evacuations, with much wind ; also gnawing pain in a carious tooth of lower jaw, which continued off and on — as did also the expulsion of ftatus — all the n. During next d. all symptoms disappeared.

h. Dr. N — gave to another gr, ij of 2x trituration every e, for two weeks. First dose caused, in 5 m», weight in abdomen passing down to rectum, lasting S m., also a loose pappy evacuation from towels. Each succeeding dose had less laxative effect, and finally obstinate constipation set in, with knotty passages. Prover also experienced — increased appetite j weakness in r. hypochondrium ; pressure in anus ; paler and more copious urine, flowing easily, but requiring waiting awhile before it came \ dryness and inflammation of throaty with cough and expectoration, and weakness of chest. {Ibid,)

n. Dr. Preu made four provings with a trituration of one part (by weight) of Cape aloes with three of milk-sugar.

a. Took two grains. On ist d. moroseness ; bitter eructation j feeling of weakness in abdomen as if diarrhoea would result, and after 8 h, a copious evacuation with much flatus ; in metacarpal joint of 4th finger a frequently recurring shooting and cramp-like pain. On and d, very ill-humour, seldom moderated by sadness ; peevish towards himself without reason ; dull pressive pain in anterior part of head, aversion to drinks, especially cold drinks ; distension of whole colon, especially at 1, flexure, with pain, increased on movement and suddenly disappearing on emission of fiatus. On 3rd d., internal restlessness and excitement j drawing cutting pains across and through abdomen all d., with ill-humour, fretfulness, aversion to society, and indisposition to go into open air, though pain is made better thereby. On 4th d. indisposition to mechanical or mental exertion, with great disposition to desultory thinking ; now and again rumbling in abdomen.

b. Took 3 grains. At 8 p,m. sudden urging, which passes off just as suddenly ; at 9 diarrhcea j itching and burning in anus, painful to the last degree, prevent his sleeping for a long time. On 2nd and 3rd d., flatulent distension, with overwhelming despondency- On 4th and 5Ch d., dull pressive pain in hepatic region.

c. Took 2 grains. On ist d., dull pressive pain ia supraorbital region ; emission of hot flatus, with burning in anus j at n., frequent sudden urging as to soft stool with sense of gurgling in abdomen^ passing off as quickly, without stool. This d. and next much rumbling in abdomen, and, till 3rd d., lassitude and inertia. On 2nd d., great

restlessness and excitement, but in middle of d* great kziness ; increased " appetite ; transient stitches in hepatic region ; distension of upper abdomen ; many times urgency as to diarrhoea^ and hot flatus only passes^ with great relief, but urging soon returns with sensation as of a plug wedged in between os pubis and coccyx ; in e., a diarrhoeic stool ; flying stitches In metacarpal joints of hands. On 3rd d,, lassitude alternating with great mental activity ; some abdominal distension*

ii. Took 4 grains. On ist d., soon after do«e, troublesome sense &f fulness in gastric region, followed by distension of epigastrium and hypochondria, with pain in r. hypochondrium, going away after expulsion of flatus » but returning with renewed distension ; dull pressive pain in sinciput {afternoon) ; pressure in stomach with feeling of warmth there ; in abdomen flatulence drawing about, with distension ; late in e. copious evacuation of bowels, not liquid, in addition to ordinary m» one ; outward drawing pain in axilla ; painful drawing and stiffness of 1. middle finger, especially fixed in metacarpal joint; outward pressing pain in r, thigh. During the pains everything disgusts him. On 2nd d,, indisposition to movement^ — and especially to mental labour, which soon fatigues 9 burning pain in r, eye, as if a fine current of hot air passed through axis of vision (this also on previous drj ; sense of fulness in pharynx, with or without tasteless eructations ; great appetite for stimulating food, with fulness in stomach j copious pappy evacuations in m. ; dull stitching pain under shoulder-blades ; pressure outwards in I, axilla, and dull stitching pains from thence to ulna ; weariness of r. arm ; jerking drawing in metacarpal joint of L fourth fingen On the 3rd d., ill-humour and incapacity for labour, with peevish restlessness ; pressive pain in forehead from this till 5th d, ; dull pain in 1. hypochondrium ; hot flatus ; distension, especially in epigastrium, and stitches as on 2nd d. ; pain and stiffness in corresponding joint of r» hand. Smelling camphor relieved troubles quickly and considerably, so that for a while there followed even inclination and ability for mental work requiring clear thinking ; after an h., however, the troubles returned. On 4th d,, troublesome beating of external occipital arteries, with cold feeling of back of head ; twinging ear-ache, crampy pain in r, ear ; oppression and painful oess of whole 1, side of face, extending from an inflamed spot in I. mouth and from forehead ; pressure in epigastrium and up into pharynx ; painful pressure under 1, itcrnum alternating with same under r. ribs ; same in 1, hypochondrium ; [distension and drawing in abdomen ; excessively painful tearing stitches in second joint of L fourth finger ; weight and weary pain in r. thigh. On 5th d., jerking-drawing, blunt stitching pain in finger, knee and elbow joints ; several pimples in various places and a furuncle on upper arm. On 6th d., dull stitches in splenic region through 1. chest, also in supra-orbital region, in frontal eminences, and in finger-joints. On 7th d., much exhaustion and laziness ; eructations as on 2nd d. -, transitory splenic stitches ; distension and drawing in colon. On 8th d., lassitude and heaviness in limbs with dull stitching pains in joints,

1. — a. Dr. Raue took hourly doses of 1, trit., 3 times in c. and twice next m. At 9 a.m., tenesmus, after | h. small thin stool, then

J5

for some h, griping in belly as after a chill, and hereupon headache* From 1 1 o'cloclc, feeling of dull pressure through whole head, shaking on movement as if brain lay loose in it, sensibly increased in fresh cold air, and also when hanging head down, and for awhile after rising up a beating, thumping, pulsating pain, especially in occiput ; eating relieved for a time. Tongue next d. was coated whitish-yellow, and there was bad taste (as after senna leaves) all forenoon ; stool occurred as yestcr* day, preceded by tenesmus and followed by belly-ache ; and there was the same headache, but slighter. On 3rd d. no headache j slighter urging to stool all d. ; two normal motions in e.

b, A woman proved tinct. and reports ; Vertigo as if everything whirled round with her, worse on going upstairs and turning quickly ; dull headache all over forehead, with heaviness in eyes and nausea i headache in forehead and vertex {4th d,) like a load, worse in warmth, better in cool air; no appetite j and feverish feeling (pulse 104)] much eructation with pressure in stomach (2nd d.) ; on several d,l nausea immediately after dose, must sit still to keep off vomiting, therewith pains from stomach to both sides of chest ; pressure in pit of stomach through to back like a load, with soreness, rising and falling, accompanied bv frequent eructations; weak feeling in pit of stomach, like a load^ and burning there ; diarrhoea, during gripings, after midnight, stools yellowish* green, with pain before and after ; stitching pain over arch of pubes (4th d.) ; a sharp pain drawing through groin to middle of thigh ; pain in heart, going through to under I. scapula 1 sacra! pains, in rest and movement (2nd d,)* (llnd.)

13, Whitey took 1st cent, trit., and reports throbbing headache and (e*) dryness of tongue and mouth, with increased thirst and redder lips. [Ibid,)

14, ZuMBROCic, after triturating drug, observed feeling like tenesmus in rectum near anus, more towards perinaenum , and sudden blunt shoots from below upwards on r, side of head, in c. and following m* {Ibid.)

1 5^ B. and St*, each set. 20, former of bilious, latter of lymphatic temperament, took small doses of A. (one to three grains). Symptoms observed were :

a, (St,) Violent but transient stitches in 1, temporal region, increased by every step ; dryness in mouth and much thirst, dry heat in mouth, tongue very red and rather dry ; dryness in throat ; congestions in abdomen \ boring pain in umbilical region ; all d.,discharge of much fetid flatus ; blood comes after stool ; burning pain in anus after a hard stool J urine scanty, scalding j at n., heavy dreams.

h, (B.) Attacks of vertigo; drawing, shooting pain in 1. inner ear, afterwards also in n ; superficial cracking of upper lip towards inside, when laughing ; stitches in third right hollow molar ; throbbing in same after smoking tobacco ; nausea ; empty eructation ; eructation with taste of ingesta ; rumbling, wind on stomach ; fulness of stomach after drinking water, and bilious eructation ; pressure and tension in r. epigastrium ; increased heat in abdomen ; rumbling, gurgling, rolling in belly ; full feeling in belly ; distension; dull stitches in umbilical region when sneezing; discharge of much flatus j pinching

^

before stool ; bilious stool ^ frequent call to stool ; after a pappy stool, straining, but without further evacuation ; frequent calls to urinate j urine deep yellow ; tearing in r, thigh ; pulse quicker than usual. (BuCHNER, JlJg, horn. Zeit^ xx, 263.)

r6. — a. Dr. Watzke proved A. from 20th to 26th of April, 1853, commencing with 3 drops of tincture, and increasing the dose by 1 drop each d. From thence to May 2nd he took medicine only every 2nd d., increasing as before by i cfrop daily. The dose was always taken i or 2 h. before noon meal. The only symptoms he could positively attribute to A, belonged to the abdomen and its functions. On the first days, he twice had increased tension and peculiar sensation in abdomen soon after dinner, with hurried call to stool, only a little brownish slimy, half-fluid motion being passed. On 6th d. stool, though soft and copious, was passed with difficulty and repeated effort. In the last days, feeling of fulness, swelling and heat in the rectum, recurring repeatedly and especially when walking, lasting 10 to 15 m. Creeping, itching, smarting on various parts, e.g, perinaeum, houghs, calves, inner side of thigh, were felt throughout the proving. Thinks it possible but not probable that these symptoms were due to the medicine.

^. The proving was continued in the same manner till May 20th, and from 24th to 31st 20 drops were taken daily in morning fasting. Former symptoms occurred, but more severely. He woke in m* with urgent caJl to stool, which continued after the (copious) motion. After dinner a small soft stool, followed by sore feeling in abdomen for some h., as though stool would come. On June 4th, when eating dinner an extremely painful cutting in the bowels prevented further eating j this went off in 10 m., and was not followed by stool.

f. The after-effects were very persistent, lasting from 6 to 8 weeks. W. enumerates them as: A difficulty in evacuating even a soft stool j a distressing, occasionally very marked, fulness and painful tension of abdomen ; violent cuttings in intestines ; urging to stool at unusual times and frequently during the d., which persisted even after a stool, and sometimes was followed by sticking, cutting pain in rectum i feeling of heat and swelling in rectum, usually more acute when walking ; and decided weakness and powerlessness of the sphincter ani, which closed so lazily and incompletely after stool that it was difficult to wipe the anus clean. {Ibid,^ Ixxiv, 29.)

1. — a. A boy, aet. 5, took at 10 a.m. 3 drops of 3X, Slight bellyache followed, with tension and some inflation of abdomen, then discharge of inodorous flatus. Three d. after he complained of pain at anus and had frequent tenesmus, during which he pressed out small quantities of yellow mucus. He had intercurrent chilliness and bellyache with retraction of the umbilicus.^ (J. O. Muller, Zeitschr. d, Fireim d, horn, Mrt%., ^857, t, 38.)

b. A healthy, strong brunette, aet. 32, took at 4 p.m, 5 drops of same potency. Two h. afterwards came on intermittent tearing in

^ Dr. M. thinks it necessary to mention that the boy haid sat on a cold doorstep. This, however, he had often done before with impunity ; and on the present occasion the bellyache, tenesmus, and chilliness preceded his doing so, — Eds.

2a8

head, here and there, with heaviness, confusion, and vertigo. To this were added scotomata — flickering or whirling before eyes, yellow rings that moved in field of vision in circles and were now and then replaced by shining bodies that shot across eyes. Eyes felt swelled and dim as if she had not slept for several nights. The head symptoms were worse in the dark, better in the light. She had also inclination to vomit when moving about hurriedly ^ rumbling and swashing in stomach and abdomen ; and very restless sleep, in which she threw off the bedclothes* She was very prostrate and weary, as in nervous i debility. On rising from bed, there was pain and shooting from sacrum | to anus, hips and abdomen, which went off as she moved about. ( Ikid.) €, Dr. M — himself took 20 drops of same. He had eructations of gas with slight pain in stomach and flow of saliva j pinching bellyache in umbilical region, with chilliness ; three thin, pappy^ darkcoloured, scanty stools during d., preceded by rumbling and pinching in hypogastrium, and followed by tenesmus-like pressure ; irregular contraction and unusual dirtiness of anus after evacuation, and sense of increased warmth in rectum and anus in intervals of stools. There was also tickling, creeping, and spotty redness on glans penis, especially about corona and frcnum i and urine was scanty and dark. {Ibid,)

1. Dr. a. Fischer gave to five persons 4 to 6 drops of tinct. every m., for 3 d.

a, A woman nursing a two months' old baby had, on 4th d., cramps 1 in hypogastrium and r, groin, going down r. thign beyond knee ; thereon^ followed metrorrhagia ; she felt ill all over, and very sensitive, and had tension and compression in nape, behind both ears. Her baby took a drop of tincture and had a green motion in 4 h. ; next d. was fretful, groaning during sleep, and screaming on waking (as a rule, he slept quietly), with copious sweat all over,

h. A woman, act. 28, had on ist d., at noon, a whistling in throat, as if something had fallen into trachea, and impeded respiration ; dyspnoea ; pressure behind sternum \ scraping in larynx.

€. In n* after third dose, a single woman, aet. 30, dreamed at raidnight of being seriously ill, and awoke with oppression at chest, breathing whistling and painful, larynx tight as if she would bcj strangled, throat dry, tongue dry and stiff; she cried, and was obliged to sit up in bed. This lasted I h., then came several fits of coughing, and gradually all passed away.

d, A child, <ct, 3, had, early in middle of d. after second dose, a soft, very abundant motion. On previous d. passed blood at stool, as from piles.

i. A child, zet. 4, 2nd d, had pains in nose, followed by coryza ; on 3rd d. had a stool, consisting of undigested material, with traces of blood. Being slightly chilled from uncovering himself in bed, was seized, during n., with hoarse, rattling, low-pitched cough, as if all the trachea were raw, harsh, and full of phlegm* On 3rd d. the child was troublesome, crying at the slightest thing.

/ The following symptoms arc not referred to the individual provcrs :

In 15 m,, nausea and feeling of emptiness in stomach, with digging

around navel. In 30 m., feeling of wind rising through throat, as before sickness. In 3 h,, quivering and shaking rn larynx and tongue, for some m, ; cough, followed by a sputum size of bean, yellow and tenacious ; stitches in sacral region on bending. In 4 h., throbbing in 1. side of head, at first painless, then aching for | h. at a time, head much affected* In 6 h,, burning, as of fire, in 1. nostril j stitches under r, side in region of liven At 4 p.m., pricking in 1. hypogastnum, deep in body, as if in I. ovary and uterine ligaments ; in e., headache on I. side, with tension J hoarseness and slight cough, with continual expectoration, provoked by tickling and scraping in larynx, thirst and dryness in throat (cough continued for several d,, worse towards m. j on ist d, there was pricking in r. side of larynx at each fit, and raw pain when expectorating) i pressing pains in r. side, under armpit, extending in direction of r, shoulder towards back. On this ist d. motions were soft and pasty, later solid or absent. On 2nd d. a round, red spot at edge of 1, lower jaw, between lower margin, angle and chin j motion followed by sensation of burning at anus ; urine scanty, twice only in 24 h., and little at a time, containing yellow, branny deposit ; pain under nail of 1. forefinger {in one of the children). On 2nd n, a man dreams he is mad, and that everyone is watching him. On 3rd d. tearing pain deep in r, eye, lasting some m. ; rumbling in belly, most frequently in hypogastrium ; piercing and twisting pain around navel ; pricking sensation in rectum (afternoon); the third finger of r, hand^ in which there is a torn sensation, presents a kind of ulcer on first phalanx, it is red, and seems inflamed. On 4th d,, pains on r. side of forehead ; in two subjects, nausea, mounting up into throat, with inability to vomit ; from afternoon till e., tearing sensation in r. thigh above knee ; stitches in r. knee (m three provers) ; in e,, pain, as if strained, in outer ankle of U foot while walking; at n. ineffectual tenesmus. In e. of ist 5 d., headache, involving whole head, and twitchings above r. eyebrow, deep in r. side of forehead. On 6th n., when but just in bed, sudden and clashing explosion in L car, like breaking of glass, — the noise seems deep in head, whence it goes towards r, ear.

Without note of time are mentioned : — Jerking pain in r. parietal bone towards vertex, with pain when touched ; head affected, with turns of nausea ; menses appeared 6 d. too soon, with a sensation of cold, blood dark, flowing abundantly, with clots ; coryza and heat of nose i stitches in r. chest, under (female) breast ; sleeplessness before midnight (three provers), from midnight to 5 a*m. (in one) ; dreams of monsters, and of all kinds of animals. {Journ, du Disp. Hahn.^ Bruxelles, iii, 235.)

19, Health sound, pulse 65, regular ^ took at 7 a.m. 10 drops i^diL in \ oz. water. 7,2. Increased ssdiva with eructations. 7.5. Itching behind knee, also of scalp; distension of stomach. 7.7. Itching in various parts ; distension and rumbling in bowels. 7.15. Borborygmus and drawing in bowels very annoying. 7.27, Drawing in r. tibia ; burning in r. foot ; eructations. 7.45. Pressure and drawing in hypogastric region, with drawing in spermatic cords ; griping in transverse colon

^followed ^ passed flatus with relief. 8.10. Drawing in cervical region;

Flegt and feet cold. 8.20, Pulse 75 j eructations ; arms *eel weak \

a3«>

hands cold to touch ; chilliness on moving ; cramp in r. foot. 8*45.

rStool, unusually free and forcible, with noisy flatus, followed by drawing in bowels and extremities. 12*15 p.m. Slight nausea, griping and noisy rumbling in bowels ; cold feet are now hot ; pulse 90 ; normal urine. 1.30, Hearty meal followed by urgent stool with heat and irritation of anus. During p.m. increased rectal irritation with loud rumbling j pulse 94. 8,0. Gloominess and slight headache ; some languor and thirst ; n. sleep interrupted by haemorrhoidal irritation and unusual sexual excitement ; during sleep seminal emission without dream » Waked at 6 a,m with urgent call to stool^ difficult to retain, copious and loose, followed by hsemorrhoidal irritation ^ headache and languor until after brealcfast. Occasional sneezing during the day. (A. W. Woodward, MS. Communication,)

1. A. acts in small doses on the nervous plexuses and vessels of the abdomen ; in stronger doses it acts as well upon the intestinal canat»

I specially the large intestine i and produces, easily, and without inconvenience, increased and watery evacuations, though after some interval, at times as long as 24 h. ; in very strong doses it acts as a very drastic purgative, with griping, at times with bloody stools. (Voigtbl, SysUm der Arzniimitteluhriy ii, 2, 114.)

21* — tf. In large doses A. acts as a purgative. There are, however^ some peculiarities attending its cathartic operation deserving of notice. In the first place, these effects are not so speedily produced as by some other purgatives ; for 8, 12, and sometimes 24 h, elapse before they arc produced. Secondly, A. acts especially on the large intestines, and a full dose is in some persons apt to produce heat and irritation about the rectum, and tenesmus 5 and in those troubled with hscmorrhoids, it ts said not unfrequently to increase, or even to bring on, the sanguineous discharge* The purgative effects of A. do not arise merely from its local action on the alimentary canal, since this effect is sometimes pro* duced when the medicine has been neither swallowed nor given by the rectum \ so that it appears to be of a specific kind,

b. The uterus, in common with all the pelvic viscera, is stimulated by A. A determination of blood towards these organs^ and a fulness of the blood-vessels (especially of the veins), are produced, and thus uterine irritation and menorrhagia are apt to be increased by it. (Pereira, Mat. Mtd,^ sub voce.)

1. If pushed far, a slight degree of enteritis may be set up. The motions are highly coloured, Itlce bile, soft, seldom watery. ( Wibmer, Wirk. d, Ar%. u, Gifte^ i., 105.)

23, Administered in small doses of five to thirty centigrammes, once or twice a day, A* causes slight colic, followed by expulsion of one or several diarrhoeic stools. We see that the action of this purgative is very gentle \ stools rarely occur in less than 5 or 6 h., and it often happens that patients do not go to stool until 24 h. after the adminis* tration of the drug. The first effect, therefore, is to increase the number of stools or to facilitate them, and it also stimulates the functions of the stomach, but only m those cases where the weakness of digestion is not accompanied by signs of chronic gastritis. If the use of A, is continued for some time, we do not fail to see symptoms

of sanguineous flux towards tbe pelvic viscera i there are heat and feeling of weight towards the extremity of the intestinal canal ; excitement of the genitals and increased venereal appetite, with more frequent desire to urinate j in women, pain and weight in the womb, and in the loins ; increased flow of whites ; uterine colic more painful at the period, and increased menstrual flow. In heavy doses, A. acts hke all drastic purgatives* (Trousseau and Pidoux, Mat, Mid.^ sub voce.)

1. — a, A. evidently acts by irritating the mucous membrane of the intestines, and producing a larger secretion \ this is manifest from the large quantity of mucus often passed out with the evacuations when aloetic aperients have been taken. . , . When admfnistercd in larger doses than 2 to 5 gr., it is apt to cause griping, heat about the anus, and hemorrhoids ; it also loses its effect of properly emptying the large intestines, producing small frequent evacuations, consisting principally of mucus, and attended with tenesmus, the abdomen being at the same time distended and tender, the patient complaining that ** his bowels feel as ( scraped ; " the pulse is sensibly quickened, and a sense of distension is felt about the head. The long-continued use of aloetic aperients has a tendency to produce emaciation, and their action upon the bowels becomes capricious and uncertain, sometimes failing to produce any effect, and at others producing frequent small evacuations, as before described j the mucus being occasionally passed in long membranous bands, and sometimes in substances resembling pieces of flesh. I have also seen two cases in which the mucus passed along with the evacuations had all the appearance of fat.

h. I have seen cases of enteritis which I believed to be traceable to the inordinate use of A»

c. I have many times found that when squill, along with other diuretics, failed to act, the addition of A. has speedily produced a copious diuresis. (Greenhow, Lond. Med, Gaz.y xix, 269.)

li. Poisonings, — 1. A singular case occurred in Germany a few years since, wherein a medico-legal question arose respecting the poisonous properties of A, A woman aged 43, not labouring under any apparent disease, swallowed 2 dr. of powdered A. in coffee. Violent diarrhoea supervened, and she died the following morning, 12 h* after havine taken the medicine. On inspection, the stomach was found partially, and the small intestine extensively, inflamed. There was nothing else to account for death, and this was referred to the effect of the A. (Taylor, Pot sons ^ sub voce.)

III. Expiriments on animals. — i. Moiroud injected into the veins of a horse 5iv of A, dissolved in water with a little alcohol, and the next d* 5j more, without any other effect than the evacuation of a lar|e quantity of urine. The dung, however, was enveloped by a thin pellicle, formed by altered intestinal mucus. (Pereira, op, cit.)

2, To a young dog gr. iij were given twice, once 14 h. and again 2 h, before death. Liver was quite natural, moderately full of blood, gall-bladder moderately distended with yellowish bile. The whole length of the intestinal canal was tinged yellow by the bile which had

flowed out,* but was otherwise normaL There was accumulation of oily matter in the central cells of the lobules of the liver ; it also contained distinct whitish spots about the size of a pin's head. The cells were generally pale granular bodies, and did not contain more than a very decided yellow tint. The ducts were very distinct, being rendered opaque by oily deposits between their nuclei. (Handfield Jones, Mid.-Chir, Trans, ^ xxxv, 255.)