Helleborus niger

Volume II — Main text

HELLEBORUS . Helleborus niger, L. Christmas rose. Nat. Ord., Ranunculacea. I. Provings.-1 . HAHNEMANN, Mat. Med. Pura, vol. iii oforiginal, vol. i of translation. Contains 92 symptoms from self, 162 from 8 fellow- observers, and 34 from authors. 2. NENNING. Very indifferent mood, without joy or sorrow (1st d.) ; anxious mood, with same indifference ; is contented with nothing (2nd d.); extreme inclinationto be irritable, the most trifling thing which is contrary to the wish excites anger (2nd d.) ; involuntary sighing ; giddy, with increased heat in stomach and bowels (immediately after taking it); so stupid and giddy that all objects seem to move in a circle, stupidity lasts till and d.; unsteady in head, especially on walking, all d.; dull pain in frontal eminencewith vertigo while sitting; dull frontal headache, e., with pressure in 1. temple; blunt pressive feeling on upper head like clavus; con.

tinual headache, as from compression, all d.; feeling in upper head as if brain were pressed in; momentary pain, as if blunt needle were thrust into upper margin of 1. orbit, towards inner canthus (also in eye), relieved by pressure, but returning when this is removed, for h. (2nd d.); roughness in throat as after sharp, spirituous things ( h.) ; great appetite, with frequent empty, tasteless eructations; nausea, with the same ; heat rising from stomach to head, with qualmishness, also same extending over whole body; distressing feeling of fasting, like bulimia (4 h.); painful feeling ofdistension in stomach ; disagreeable fulness in stomach,with crackling inabdomen ; in m., fasting, biting in stomach, then some griping and borborygmi, then only a slight soft stool, followed by urging (3rd d.); biting pain in stomach and gnawing there,with canine hungerduring a short walk, with great prostration of lower limbs ; burning, pinching, and biting in stomach, as from worms, lasting all d.; pain in stomach after meals, as if ulcerated, for 7 d.; 1. false ribs seem to be screwed on to spine (4 h .) ; sharp stitches under 1. false ribs, in walking ; whole abdomen swollen and sensitive (3rd d.); colic, as before diarrhea; urging to stool, ineffectual; same tourinate,with little result, and much burning in urethra; while urinating no free flow, as if bladder had lost power (throughout proving) ; urine dark yellow, itdecomposes in a few h.; general relaxation of genitals, without desire forcoition. Frequent dry hacking cough,with painful tension in l. false ribs (5 h.); constriction of chest and dyspnœa; during each deep breath blunt stitches in 1. chest, while lying down at n.; continued blunt stitches, with gnawing, in middle of spine; pain in sacrum, as from incarcerated flatus ; chilliness along back, relieved by warmth of stove, but soon returning. (HARTLAUB and TRINKS, Reine Arzneimittellehre, i.) 3. a. LEMBKE took, May 30th, 8 a.m., I gr. of powdered root; 9.30, severe pains in muscles of 1. thigh for some m.-31st, 8 a.m., 2 gr. No effect.- June 1st,8 a.m., 3 gr. Continued heat in interior ofsinciput from 8.30a.m. till e. Repeated pressure in l. side ofhead, a peculiar feeling of heat innose, especially nostrils, for some m. I p.m. , severe pressive pain deep in umbilical region, lasting upwards of I h.; several times severe boring in outside of r. knee, afterwards on l. zygoma, e. in knee.-3rd, 8 a.m., 3 gr. 8.30 a.m., pain in anterior muscles of1. thigh, later in 1. thoracic muscles and r. calf, pressive pain deep in interior ofhead, sensation in eyes as if all were too bright, and black spots hovering before eyes . Pressure in 1. side of head, later in r. knee. 9 a.m, heat deep in head. Several times pain deep in umbilical region, very severe 9 p.m.-4th, 5 p.m, 5 gr. 5.30 p.m., severe pressive pains in l. forearm, later in l. pectoral muscles. Pressure and pain in sinciput, also e. Severe pressure in r. wrist.-6th, 7.30 a.m., 6 gr. Pressure externally in l. knee, stitches in apex of lungs. 8 a.m., black spots before eyes tlll 9 a.m. Heat in head, extending to nape and back, continued. Pressure in r. toes. 9 a.m., hot feeling deep in umbilical region with obtuse pain there. The heat of head increased, cheeks and ears red, pulse quick, 100 or more when sitting. Frequent flushes of heat fromhead to back, down to sacrum, lasting till noon. Sensitiveness of eyes to light, pupils contracted. Pressure and drawing alternately in 1. fingers, calves, 1. elbow, under r. shoulder, in l. cervical muscles, r. knee, from 9 to 12 noon, afterwards more rarely in toes and 1. side of head. 10.30 a.m., smarting in r. eyelids.-8th, 7.30 a.m., 7 gr. 8.15, pressure in occiput, continued pressure in l. knee, r. shoulder, toes. Black spots and rings before eyes, continued severe pressure on vertex, quick pulse. Much heat in back till II a.m.; sensitiveness of eyes to light. 9 a.m., heat deep in umbilical region, heat in head and face for 1 h. Continued pressure and heat in sinciput all d. Pressure in l. zygoma, knees, elbows, burning in nostrils, pressure in wrists, pectoral muscles, 1.

shoulder, r. eyeball, lasting till e. From 10 a.m. till I p.m., scraping in fauces, and again at 10 and II p.m. From 5 p.m. pressure, tearing, heat in sinciput.-13th, 8 a.m. 8 gr. After h. pains commence in single joints as above ; later, heat in head, pressure in forehead, quick pulse, flickering before eyes, heat in stomach . II a.m. , much heat in back. Very severe pressure in last r. metacarpal bones. Pressure deep in r. eye. Eyes sensitive to light, small pupils ; severe pressure on muscles above knees. 7 p.m., pains in sinciput increase ; heat in back ; much empty eructation.- 18th, 7.30 a.m., 10 gr. After h. pressure in anterior muscles of thighs, on wrists, in sinciput ; weight in sinciput all d. 8.30 a.m., shooting in tongue, pressure on r. knee, in metacarpal bones ; shooting and pressure in calves ; severe pressure in r. shoulder for a long time; compression above 1. knee ; flickering before eyes, great heat in face and head ; quick pulse. 9.30 a.m., scraping and shooting in throat for some h.; burning under nose ; heat in back till noon. 11 a.m. , pressure in pectoral muscles, and deep in umbilical region, for 2 h.-19th. Pains in limbs continue.-23rd, 7.30 a.m., 10gr. Symptoms as before. -25th, 7.30a.m., 12 gr. After h. pressure in shoulders, then in thighs and knees. Head very hot, heavy, painful ; heat in face ; flickering before eyes ; pressure in ears ; quick pulse ; heat in back down to sacrum ; scraping in throat ; redness of face. 9 a.m., pressure in upper arms ; pressure deep in umbilical region, in anklejoints, tibiæ, eyes ; severe drawing in fingers and toes ; pain in various parts of back. The heat of head and back last till 5 p.m. Pain and weight and pressive pains in limbs all d.-July 4th, 7.30 a.m., 12 gr. Same symptoms. b. July 13th, 8 a.m., 1 gr. ext. Hell. After h. much flickering before eyes ; pressure in knees, toes, shoulders ; weight of sinciput. 9 a.m., scraping and dryness in fauces till 3 p.m. 10 a.m. , great heat of face, back, whole body ; pulse quick ; head heavy, confused, till e. Noon, vertigo when walking, must stand still, else would fall.-15th, 8 a.m., I gr. Severe pressure in r. ankle and leg, then in r. shoulder, in joints of r. finger between metacarpus and fingers ; flickering before eyes ; pressure in sinciput ; scraping in throat ; tearing in various parts of head; severe pressure in lower part of thigh, in elbows. 8.30, heat and heaviness of head. The pains injoints jump from one part to another. 9 a.m., heat and redness of face, quick pulse ; heat in stomach, much eructation ; stitches under 1. ribs. 2 p.m., several times severe shooting in 1. eyeball. All d. dryness in mouth and scraping in throat. 4 p.m., considerable increase of heaviness, heat, pressure in sinciput, which lasts till 6 p.m., then ceases ; suddenly violent pressure in r. upper arm, and the head symptoms go off, but soon return when the pain in arm ceases, and then head symptoms alternate with pain in knee, in r. leg, 1. hand, and upper arm ; pulse quick, hands cold, head and face feel hot, but the head symptoms are always the worst, and do not cease till 11 p.m. N., troubled with anxious dreams.- 16th. Head still heavy. During d. same pains in arms, toes, knees.- 17th. Occasional slight pains in fingers, knees, and shoulders.- 25th, 8.30 a.m., 1 gr. After h. pressure and weight in sinciput. Pressure in r. knee, legs, tibiæ, joints of fingers, wrists, and

ankles until e., but gradually diminishing. 10 a.m., much heat in back ; scraping in throat ; smarting in borders of eyelids. I p.m., vertigo when stooping. Symptoms on the whole slighter than on previous occasion.-Aug. 5th, 5 p.m., I gr. Same symptoms as above. At n., when sitting up, vertigo, also on waking in m., it lasts some m.; head heavy, then nausea comes on ; when sitting and bending head forwards is better, but nausea and vertigo recur when he raises head.-6th, m., pressure in shoulders, weight and pressive pain in sinciput. For some d. visible twitching of 1. index towards thumb, sometimes thumb twitches along with index, sometimes quick twitching of muscles between these fingers, distinctly visible under skin ; this is frequently repeated during d.; it comes on when walking, sitting, and reading.- 7th . Frequent tearing in toes and fingers. All d. head heavy and confused, inclined to vertigo, especially in room ; better in open air, but even then a feeling as though vertigo would come on . c. Nov. 24th. Took 5 dr. tinct. (110). After h. pains in forehead, knee, dorsum of foot, calf, occiput. After I h. heat and fulness of head ; pressure in stomach . Towards e. pressure and shooting in knees and thoracic wall. Effect lasted 12 h.-28th. 10 dr. , caused more heat and weight in face and head, in between increased coldness in back, then pain in thoracic wall, in heel, legs, cranial bones. All d. sinciput dazed, heavy, painful. Twitching in upper eyelid.-Dec . 5th. 15 dr. , after h. pressure in sinciput, head hot and heavy ; intolerance of light, pain in knee, big toe, leg. Nausea ; pressure in muscles of arm, scapulæ, temples, cranial bones, lumbar muscles ; shooting in thoracic wall. Effect lasted 14 h.-12th. 25 dr., acted more strongly. Immediately pain in knee ; prickling and numbness of r. hand, whichfelt furry, coldness all through r. arm ; all this lasted 2 h. Numbness in both feet ; boring and shooting in forehead, occiput, r. thigh and leg. Deepin throat shooting, burning,dryness ; heat in back, violent boring deep in r. eye. Effect lasted 10 h.-20th. 30 dr., soon drawing in calves, numbness of r. hand, coldness all through arm to points of fingers ; prickling in l. foot ; sinciput heavy; before eyes dark and bright spots ; pressure in thoracic wall, toes, and fingers, in r. groin, deep in l. eye, in knees and ankles, frontal bone, dorsum of feet, heels and calves. For several h. coldness throughout body, with cold hands and feet ; heaviness in sinciput, anorexia, painful distension of abdomen. E., violent cutting in belly, great pressure deep in sinciput.- Jan. 11th. 40 dr. , after h. heaviness ofhead,great coldness through back, furry feeling with increased coldness in r. arm and hand, shooting and tearing in ankle to toes. Pressive burning pain in stomach ; pressure on eyes ; formication in l. cheek; shooting in calves, shoulders, toes ; prickling in all toes. All d. pressure in sinciput; boring and drawing in forehead, fingers, forearm, knee ; the symptoms lasted till II p.m. -12th, m., boring in forehead and along coronal suture. E., pressure in r. ankle and above and below it, then in metacarpal bones. Effect lasted 36 h. (N. Z. f. hom. Kl. , vii, 172.) 4. FRANK, æt. 29, sanguineo-choleric temperament, healthy though rather delicate. Feb. 8th, took for a troublesome vesicle on tongue which had been there a few d., at 10 p.m. 3 or 4 dr. H. I on

tongue without swallowing them.-9th. Woke about 5 a.m. with pain in belly and urgent call to urinate, though there was but a small quantity of urine in bladder. The pain in belly continued, consisted of cutting and twisting round navel, a sort of flatulent colic, which could only be alleviated by lying curled up. Flatus was discharged, and the pain gradually subsided, was quite gone in 1 h., and left behind a feeling of disagreeable relaxation of abdomen, which was relieved by pressing on it. He hardly felt the vesicle on tongue, and after a few h. chewing was hardly interfered with, but he had a sore pain in the affected part of tongue for a short time. 8 a.m., stool passed with difficulty, as though the bowel had no contractive power, though the stool was soft and partly thin. Nothing more all d. On going to bed took 4 dr.- 10th, 7 a.m., a transient pain in abdomen with discharge of flatus. 10.30a.m., twitching cutting from r. iliac region downwards, and from navel outwards, extending to 1. side of umbilical region. Immediately afterwards the same pain, which remained confined to the first-named point, and this was painful to pressure. Continued to take the med. to the extent of 3 to 5 dr. in e., but felt nothing peculiar from it. (Allg. h. Z., xviii, 114. ) 5. Dr. BRUNO LINCK, æt. 36, with exception of occasional catarrhal attacks, strong and healthy, took, Sept. 27th, 6 dr. tinct. All d. scraping sensation in soft palate and fauces, occasional eructation ofair, and twice a pinching sensation, once in the r. side of chest in front, the other time on the 1. side or cardiac region.--28th, 10 dr. After I h., forcing and pressing asunder in anus, followed by a difficult stool, consisting of balls of fæces with a frothy substance intermixed. After 2 h. cold feeling in abdomen, such as usually precedes an attack of colic, but it soon went off. At every inspiration a rattling in throat, as from mucus there, not observed during expiration ; it sounded like the opening and shutting of a ventilator. On inspiring, the respiratory passages seemed to be narrowed, and the act of inspiration, in place of being noiseless, was audible as after running when catarrh is present.-29th. No med. Pressing asunder suddenly in rectum, as though about to have a stool, but the evacuation was of thick dry fæces, passed with difficulty and with sore pain in anus, which lasted some time after the stool. E., a very violent pressive tearing pain on a small spot at external side of 1. orbital border, as though seated between eyeball and orbit and involving the eyeball ; this lasted 5 m. , and there were three fits of it. After this, a very marked painfulness of the whole anterior and external part ofr. thigh, something like sciatica, a sort of tearing cramp not moving from one part to another ; it lasted but a short time. Great drowsiness in e.-30th. Large, formed, difficult stool with burning sore pain in anus, which continues afterwards in sphincter. In e. pain like sciatica as before. All d. feeling in anus as if suffering from obstinate constipation.-Oct. Ist., m., no call to stool, feeling in anus as if it were completely closed, then sudden pressure and distended feeling with call to stool, at first merely flatus, then a large firm stool, during and after which extreme sore feeling in anus. E., tired pain in both legs,especially when standing, with bruised pain in sacrum.-2nd. 20 dr., pain in l. knee, in patella, aggravated by

bending knee and pressure as from a violent blow. After I h., discomfort in abdomen, with cold feeling as if diarrhea were coming on. Soon afterwards, sudden call to stool with cutting in abdomen, and then another stool, pappy, with relief of discomfort. Trachea full of mucus, breathing audible, all these symptoms gone by noon. After dinner, extreme heat of face, burning red face.-3rd. Pain like sciatica in l. hip ; discomfort in abdomen with some drawing, as when colic is about to ensue, then urging to stool and pappy evacuation. In afternoon renewal of sciatica-like pain in fits in the region of the outer surface of os ilii. Chilliness along back, dodging about near the vertebræ of l. side ; for a moment spreading over 1. shoulder forwards. Painful pressure in a small spot in l. eyeball between this and external superior orbital wall. The same pain as in the l. hip in the r. hough. Tearing in l. shoulder.-4th. Pain in abdominal parietes in front and side, as if bruised ; sudden, obtuse pressure as from foreign body in anus, with call to stool, but only flatus comes ; after a while renewal of the pressure and evacuation of a scanty thick-shaped stool. In scrobiculus cordis, and just below it, a pain like spasm of stomach, compelling him to rise up, whereby it is ameliorated, with nausea. While walking, this feeling goes off, but returns when sitting immediately ; then eructation, without relief. The sacral pain continues. Bruised pain in anterior and lateral abdominal integuments. Fine tearing in r. forearm ; tendency to sweat in afternoon. All d. nearly, painful feeling in l. hip as if excoriated or burnt, aggravated by the slightest touch.-5th. Fruitless call to stool ; fine tearing pressive pains in l. frontal protuberance, affecting 1. eye. Continued burnt pain in l. hip. (A. h. Z., xxxix, 282.) 6. GOTTLIEB SCHROFF, farmer, æt. 23, phlegmatic temperament, subject to pimples on face. Sept. 20th. 4 dr. tinct. Boring stitches in spine close under shoulders. Obfuscation and pressure in forehead, and especially in eyes, as though something would fall out of them.- 22nd. 4 dr. Shooting in l. costal region.-23rd. 5 dr. Bitter taste of food all d.-24th. 7 dr. Pain in forehead as if head would burst, violent pressure deep in orbits. Digging pain in abdomen. Stools more frequent, pappy, and undigested. E., relaxed state of arms and legs. Staggering vertigo with tendency to fall forwards. Qualmishness and nausea with constant inclination to vomit; frequent yawning ; loss of appetite ; some transient slight stitches in 1. side of chest occasionally.- 27th. 10 dr., feeling in stomach as ifhe should vomit.-29th. 10 dr. Painful pressure in head above eyes.-30th. to dr. Bitter taste lasting long ; after 5 to 8 h. sourish taste with increased saliva. Sneezing with nausea.-Oct. Ist. Full feeling in stomach along with ravenous hunger. Stool badly digested ; confusion of head with heat, increased by stooping. Belching up of bitter fluid, hiccup ; sense of smell dulled ; cross humour ; heaviness of limbs ; symptoms worst p.m. and e. Fermentation in abdomen ; shooting in 1. eyeball. (Ibid., 284.) 7. Experiments on healthy persons. The watery extract was given in doses of 5, 6, 10, 15, 20 and 29 gr., the alcoholic extract of the root gathered in October, 5, 10 and 15 gr., or the alcoholic extract of the May root in doses of 15 gr. The altered extract of the October

root in 5, 10, 15 gr. In none of the provers was there any increase of stools, in several a certain amount of slowness of evacuation of the fæces was observed. The most noteworthy alterations were observed in the organs of circulation, in the brain and organs ofsense, and in the alimentary canal. Pulse always became slower, either immediately, or after a transient quickening. But the change did not last long, 2 or at most 3 h. If the pulse was at first quickened the increased rapidity lasted only or at most 1 h., and amounted to 5, 20, or 25 beats per m. The slowing never exceeded 2 h., often much less, and amounted to 5 to 10, at most 15 beats per m. The cerebral symptoms were never absent ; they showed themselves in confusion, weight of head, dull headache in forehead and sinciput, vertigo, drowsiness, and either in deep sleep or in restless sleep disturbed by dreams, or in coma-vigil ; at same time head and face were sometimes hot and extremities cold. There were also roaring and tinnitus aurium, and moderate dilatation of pupils, and in one prover the sight was clearer. Usually there was dryness of mouth. Pains in stomach and bowels usually after 2, 4, or 6 h. In addition there was inclination to vomit, mostly late in e., sometimes in m., but actual vomiting never occurred. Rumbling in bowels and uneasiness in abdomen continued the following d., but diarrhea never occurred. The larger doses caused more or less prostration, weariness, malaise, which lasted over the next d. In one prover there was unusual depression and sadness, which lasted several h. b. A delicate, emaciated man, æt. 31 , commenced with scruple n. and m. and this was continued 3 d. Ist d., no stool ; 2nd, a normal stool ; 3rd, none. 4th and 5th d., the dose was increased to a scruple twice a d. 6th d., 2 scr. m. and e., a firm stool e. He now got 3j m. and following d. 7th, no stool. 8th and 9th, firm stool. Hitherto nothing abnormal had been noticed except some increase in quantity of urine. IIth d., at r. , some pain in abdomen. After walking in garden remarkable pallor, sunken features, unsteady gait; violent cutting in abdomen and weakness. He leant on a tree, supported by an attendant, the arms hung helplessly down, hands cold, face pale, eyes deeply sunken, lids closed, pupils uniformly dilated, hardly responsive to light, lips bluish, tongue clean, skin of face covered with sticky perspiration, pulse thread-like, 102. He did not speak, was put to bed, and was hardly in before he was seized with violent, painful purging, followed by some retching, and he vomited twice a slimy yellowish fluid. The pains in belly and retching lasted 3 h., during which time he had 3 liquid stools with violent tenesmus. (SCHROFF, Viertelj. f. d. prakt. Heilk. , lxxii , 72, 1859.) II. Poisonings.-1 . Two men drank each a glass of decoction of rad. Helleb. nig., Sig. Salomonis and Fol. Hederæ. After h. violent pains came on ; one of them took another glassful, whereupon the pains increased. Vomiting, raving, violent twitchings, extreme cold feeling, and lastly death, were the consequences. The other died with similar symptoms 2 h. after taking the poison. P.M. 16 h. after death. Lungs congested with blood, m.m. of stomach inflamed, of brownish black colour, almost gangrenous. (FERRARY, Journ. univ., 1818, April, p. 121 ; in Wibmer.) VOL . II . 41

1. A woman who had just been confined took a few grains of extr. Hell. nig., and had loose stool ; some h. later vomited mucus, sneezed about 12 times, and died sneezing. (HILDANUS, Cent. 4, Obs. 12 ; in Wibmer.) 3. A man, æt. 50, took drm. extr. aquos. Hell. nig. He had pain in bowels and vomiting, and died in 8 h. P.M., whole intestinal canal inflamed, especially large intestine ; 42 h. after death limbs were supple. (MORGAGNI, De Sed. et Caus. Morb., epist. 59, art. 15 ; in Wibmer.) 4. A youth, æt. 19, took by mistake a tablespoonful of powdered Hell. Soon, frequent vomiting. When seen by the doctor after 2 h. he had vomited 60 times, was covered with cold sweat, face pale and altered, small trembling pulse, abdomen distended, slightly painful to touch. The retching and vomiting continued, spasmodic jerkings in muscles of thighs, violent burning in stomach and esophagus. After 3 h. almost all symptoms gone. (FAHRENHORST, Rust's Mag., xxv, pt. 1, p. 190 ; in Wibmer. ) 5. A woman took a teaspoonful of an infusion of It oz. of root in 12 oz. water (kept in a covered jar in an oven all n.). It caused pain and pricking in tongue, fauces, and throat " as if 100 pins were pricking her." Painful sense of constriction and strangury (? strangulation) ofthroat, with difficulty of swallowing ; pain at epigastrium, very violent sickness. Tongue and other organs of deglutition began to swell ; much viscid mucus voided from mouth. Eyes sunk, excessive prostration, discoloration about eyelids, great collapse of vital powers, like collapse of Asiatic cholera ; extremities cold, surface of body covered with cold, clammy sweat. Pulse from 30 to 50, very small, at times scarcely perceptible. After sulph. zinc emetic, camphor, coffee, hot applications to extremities, she rallied in 3 or 4 h. Pulse rose to 68 ; complained of headache. Purgatives given and she soon recovered. (MASSEY, Lancet, 1856, ii, 100.) III. Experiments on animals. I. a. The activity of the several species of the genus Helleborus has been found to depend upon the presence of two glucosides, helleborin (C36H4206) and helleborein (C6H44015). The former is not found so largely in the H. niger as in certain allied species. It is a very energetic substance, though having no action on the skin, and acting less intensely on mucous membranes than its fellow. Administered by the stomach to mammals, it caused licking and chewing movements ; teeth-grinding ; a certain amount of salivation in cats and dogs ; vomiting in dogs and birds ; pains in the belly (apparently) in dogs and rabbits ; efforts at evacuation in dogs. On dissection, mouth and œsophagus were healthy; in pigeons the crop was always extensively inflamed ; in mammalia stomach and intestines showed signs of irritation in varying degrees, from simple increase of secretion to inflammation of high grade with extravasation of blood. The remoter actions of the drug fell upon the nerve-centres, especially the brain, paralysis of which appeared to be the cause of death. In mammals a period of excitement and restlessness was followed by paresis of the hind limbs, with tremor and vacillation of the whole body ; a further stage was marked by profound paralysis and anesthesia ; cats

alone recovered comparatively soon from this state. Marmé and Husemann always detected marked congestion of the membranes ot the brain and cord. In rabbits there was also diminished consistence of the cord and extravasation of blood into the cranial cavity. Functions of other organs were affected in much the same way as by narcotic agents in general ; urinary secretion somewhat increased (in cats only) ; respiration slowed (during narcosis) ; hypostasis and hyperæmia in lungs after death. Heart's action was not reduced, except by heaviest doses ; especially in frogs and dogs cessation of pulsation was very late. Pupils dilated widely in narcosis, but contracted post mortem under electric stimulus . b. The experiments of Marmé with helleborein show interesting differences of effect from the above. The action is both local and remote. Locally, it does not affect skin, but is intensely irritant to mucous membrane. Absorbed, it exerts a powerful influence on the heart and the intestinal canal ; yet it does not seem so deadly to animals, in equal dose, as helleborin. Very small doses administered by the stomach for a long period produce a cumulative effect, shown by loss of appetite, nausea, and vomiting, which disappear rapidly on suspending the drug ; and occasionally this mode of administration has produced (as larger doses will) pain, increased secretion, and gastroenteritis. The special action of helleborein on the heart resembles that of digitalis, but is quantitatively much weaker. Small repeated doses slow the heart; larger doses hurry its action, and then usually arrest it suddenly ; the action is through the vagus, and blood-pressure is heightened both in the slowing and in the hurrying grade. Respiration lasts longer than the heart's action ; it is nevertheless affected,first quickened, then made slow and difficult. Salivation is always produced, whatever way the drug is introduced into the system ; diuresis is constant, and the kidneys are hyperæmic after death ; in female animals the uterine mucous membrane is invariably congested. There is semi-paralytic weakness of the limbs, and after very large doses there are severe convulsions. (PHILLIPS, op. cit.)

Volume IV — Appendix

HELLEBORUS.

(See vol. ii, p. 635.)

II. 6. A child under 2 was poisoned with an infusion of the leaves o( H. given him to destroy worms. Within 10 m. after taking 2 dessert-spoonfuls he was very sick, and was violently purged. The matter vomited was of a green colour and slimy. The sickness and purging continued till he died, 13 h. after having taken the infusion. There were convulsions before death. On inspection the whole body appeared blanched ; eyes were sunken and pupils dilated. There was diffuse inflammation of the mucous membrane of the stomach, and a well-marked patch of deep, inflammatory redness, about the size of a crown piece, near its centre. The small intestines, which contained . a brownish-yellow fluid, were much inflamed. The head and chest were not examined. (Taylor, Poistnsy ist ed., p. 750.)

1. Late one e. a young nun was brought to me suffering from violent and incessant vomiting and retching, the matter ejected consiming of frothy mucus. He was collapsed, with pulse at 48, dilated pupils, and dazed expression, complaining of burning pain at epigastrium and sense of constriction in throat ; fauces were swollen and reddened. He had taken an unknown quantity of the powdered drug (about two teaspoonfuls, he thought) stirred up with water ; and had speedily been seized with violent cramping pain, giddiness, dimness of vision, inability to stand, and violent vomiting. He had been driven two miles to see ni«. I sent him home (by which time his pulse had fallen to 40), and had him put to bed, and plenty of demulcent drinks and warm water administered. The vomiting soon ceased, and next morning he was

Juite recovered, but felt sore all over. (Ilott, Brit. Mtd. Jmm.^ >cc. 1 2th, i88q.)