Lycopus virginicus

Volume III — Main text

LYCOPUS.

Lycopus 'virgi/tUuSf Michaux. Bugle weed. Nat. Ord., Labiala.

I. Provings. — I. a. Dr. G. E. CHANDLER, St. 30, in good health, on Dec. 26th, 1865, took 10 dr. of tinct. at 10 p.m. 27th. — At 7 a.m. took 1 ] dr.,, and also at 12 m. 1 1 dr. more ; at 5 p.m. a marked pressing pain in supra-orbital region for a few m. ; at 5.16 took 11 dr., and also at 10 p.m. 28th. — Took 12 dr. i h. before each meal, and also before retiring, agih. — At 2^° p.m., dull pain in 1. supra-orbital region of several h. duration. Took 13 dr. 4 times, as yesterday, 30ch. — Very marked sensation in cardiac region, constrictive, lasting 3 h., accelerated respiration during exercise, worse while ascending stairs. These symptoms were in early part of d. ; during d. a huskiness (sic) in 1. patella, dull pain in knee, lasting through d., more intense while in motion. Took 14. dr. as yesterday. 31st. — Took 15 dr. as yesterday. Jan. ist, 1866. — Peculiar beat of heart, 1st sound displaced by a blowing sound. 6th, — At 5.30 p.m. took 15 dr. immediately before eating. 7th. — Last n. very restless, full of troubled dreams ; severe pressure in forehead, particularly I. Eyes full, painful, and pressing outwards. 8 a.m., pulac 48, weak and irregular in force; pressure in forehead- Sp.gr.

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of urine 120. 9 a.m., 15 dr. ; 2 p.m., I. limb feels | in. shorter than other, and foot sounds on side walk as if this was so. 8th. — At 8 a.m. 20 dr. ; 12, m., diarrhoeic symptoms, tenderness in I. hypochondrium ; eyes press out; 12.30 p.m., stitch-like pain in cardia, causing an exclamation ; 2, constricting pain and tenderness around heart ; pulse 65, weak and irregular in force ; 5, increased action of bowels, aggra> vated diarrhccic symptoms ; could have had a passage any time of d.^ but had perfect control of sphincter ani ; pressure in forehead all d. -, passed during d, 32 oz. of urine; 11.30, 30 dr. gih, — At 8 a.m. tenderness in bladder ; frontal and vertical portion of head dull and pressmg out ; took $:> dr. ; pulse 56 ; sp. gr. of urine 1020 ; 9, slight huskiness of 1. patella in motion; 1 impulse 64; 1 1.45. circumscribed pain and compression in epigastric region ; 12, m.» pain steady and deep in r. parotid gland, and at angle of r. maxilla ; burning of r. ear for i h. or more ; 3.30 p.m., dull pain in lumbar region, particularly I., and bladder feels much distended when empty. 12th. — At 8 a.m. took 20 dr. of 1st; 9, severe colic pains followed by profuse and forcible diarrhoeic evacuation ; 4 p.m., heart-beat, much more distinct on r. of sternum than on 1.; pulse 68, and full; 7.30, i]atulence ; 8.45, rumbling of bowels with colic ; eyes full and heavy all d. ; 11, took 20 dr., soon followed by griping in bowels ; pulse regular in force, 13th. — At 8 a.m. tenderness in abdomen; painful prcssurein eyeballs; heart-beat peculiar, as noted on 1st. 14th. — Pressing pain in front of head, but not as marked as formerly ; pulse 64, irregular in force. 15th. — 3 p.m. throbbing pain in cardia; constant pressure in front of head and eyes; pulse bo and irregular in force. 16th. — No symptoms, 17th. — Same pain in rront of head and eyes, but not constant; 9.45 p.m., tugging pain in spleen of several h. duration ; flatulence all d. i8th.— Slight pressure in head and eyes in e. ; 7.30p.m., pulse 60, and slightly irregular in force ; very sensible pressure in cardiac region, the cardiac viscera pressing outwards, but not painful. (■• During this partial proving of the drug I have not changed my mode of living in any particular, my diet plain and varied. 1 have never been addicted tjo the use of tobacco in any form, or spirituous drink of any kind ; scarcely ever drink coffee, occasionally tea. During the proving I lost more or less control of my mind, it being wandering from one thing to another. The symptoms were more marked on alternate days.")

A. Dr. R. LuDLAM makes the following report, after an examination ot prover's heart: — Jan. 15th, 1866, 4.30 p.m. Found on auscultation first sound of heart lacking, sometimes faintly perceptible, displaced by a blowing sound of mitral regurgitation. The second sound is pointed, short, sharp, and more emphatic than natural. Pulse 58, a little irregular; sometimes drags a little and then hurries up; weak. (Dr. J. S. P. Lord confirmed this examination.) 16th. — Pulse 64 and more regular ; first sound of heart more distinct, blowing correspondingly less so ; second less sharp and emphatic ; in short the heart's action more normal in every respect. (Dr. £. M. P. Ludlam attests.) 1 8th. — First sound a little more distinct ; pulse 56 ; blowing sound more marked than when last examined. 19th. — Same as yesterday, excepting that first sound is a little more distinct, and

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blowing sound less so ; pulse 56. 22nd. — Same report ; normal sound more evident, blowing sound more faint ; pulse 62. 24th. — Pulse 60 and more regular ; sound distinct at apex ; this blowing sound is heard upwards in clavicular region and particularly between scapulx. Feb. 14th. — Same excepting in degree; the blowing is less distinct ar intervals, sounds are nearly normal, and then for 6 — 10 beats blowing displaces Brst sound. Pulse 70, probably accelerated somewhat by a walk of 4 a mile in violent snowstorm. (Not having examined Mr. C — prior to his talcing the drug 1 cannot declare positively that this abnormality is wholly due to the Lycopus, but the probabilities arc certainly very strong in support of that view. — R. L.) (Hale, Nnu Remtiiies^ and ed.)

2, Dr. MoRRissoN. Health usually good, though not robust; for< ]last 9 years, since residing in England, tendency to rheumatic pains, with slightly depressed cardiac action. The oppression of crowded rooms induces faintness. For about a week a tendency to diarrhoea. Slight attacks of spasm of intercostals have troubled me for about a month, caused by arsenical wall paper. Depression of vital energy from a long strain of work. Examiner^s report. — " Impulse of heart rather feeble. Percussion shows that heart is of natural size. There is a distinct systolic basic murmur at second interspace, which I have no doubt is hnemic. The first sound at apex is not good, and is rather murmurish. Occasional intermissions in the heart's beats." Pulse 70, sitting i temp. 3640° C. ; rcsp. 20. Urine clear, bright even after standing whole n. ; acid, sp. gr. 1012, free from albumen.

a. Sept. 5th, 1872, 10 p.m., took 10 dr. of tinct. Within 15 m. slight pain in 1. frontal eminence, quickly transferred to r., then ceasing and returning in both ; succeeded by slight burning r. side back of palate, lasting 10 m. 6th. — 10 a.m., 10 dr. No effects. 2 p.m., 10 dr. Within 5 m. oppressed feeling in brain, succeeded by subacute pain an inch below and to outer side of 1. nipple, quickly subsiding j 20 m. after taking, dull pain in both frontal eminences, succeeded by slight return of subacute pain at apex of heart. 10 p.m., 15 dr. Within 10 m. distinct sensation of rawness at back of palate, r. side, extending over to 1. Pulse 72, sitting ; temp. 36-30° C. j urine clear, acid, sp. gr. 1016, free from albumen. 7th. — 10 a.m., 20 dr. After 20 m. slight rawness at back and r. side of palate. 2 p.m., 20 dr. Within 5 m. slight burning in palate ; slight obtusion of intellect, with dull aching through sinciput. 10, 20 dr. Slight burning r. side of palate, m usual spot. Pulse 76, fairly regular. 8th. — 10 a.m., 20 dr. Within 15 m. frontal headache, succeeded by burning in usual spot of palate. 11, sharp pain in usual spot, lasting several m.

2 p.m., 25 dr. During afternoon prcssivc frontal headache, relieved by current of air, returning on entering house. 7, cardiac oppression l;uting J h. \ pulse 80, standing, with distinct intermissions \ tendency to toothache in r. lower molars, sound teeth, succeeded by subacute pain, first in 1., then in r. frontal eminence. 9th, — 9 a.m., 30 dr.

3 p.m., subacute p^in in both frontal eminences, succeeded by frontal headache. 9, marked cardiac oppression \ pulse 80, sitting, with distinct intermissions ; sighing and yawning \ unsteadmess of hands.

rendering writing difficult j stranec sensations extending up

and locating in pharynx, lo, feeling of unsteadiness in wmlkingi

tinuous subacute aching in frontal eminences, especially I. % tcndencr

to toothache, first in r. lower molars^ sound teeth, then tranifiencd

I. sound teeth. lo, 30 dr. Within ( h., subacute pain in I. frontal

eminence and pharynx, in latter increased by deglutition ; pulse 66,

sittings temp. 3590^ C. ; resp. 19 ^ urine, cloudy deposit, add,

sp. gr. 1021, free from albumen. 10th. — Retired 2 a.m. On lyvK

down, cardiac depression, with dull, heaving beating, lasting seraou

m. ; sleep in n. dreamy and disturbed, not restless & awoke bcfiae

8 a.m. ; on rising, continuous dull, frontal headache not relieved by

cold affusion, sli^tly relieved by stronz pressure. 10 a.in^ 30 dr.

Return of tremulous feeling in bands while writing, lasting several n.;

during d., dull, pressive, frontal headache, occasional pains in L firontil

eminence, xo p.m., 40 dr. AVithin 2 m. general feeling of omatf

sion, inducing him to sit down ; sharp rheumatoid pain Urom I. knee 10

ankle, quickly settling in loins, then accompanied by sharp daitiBg

pains in I. thumb succeeded by acute pain in nape of neck (cervicu

muscles) ; pressive frontal headache, with acute pain in cerebrum

from succussion of walking} ii>30, steady subacute pain in ceiyicsl

muscles, more to 1. side ; subacute pain in I. frontal eminence i pake

74, sitting and standing, varying in volume. Ex^wumn^t nfmL

^^Hxmic murmur lessened, apex murmurishneu imperceptible, poka^

tion stronger, 70 standing or lying, nth, — Awoke 6.30, bad slept

better, then intermittent cardiac pulsation at 7th, 8th, 6tb, aiat« 9CI1,

23rd, and 88th beats } a few m. later, intermissions between 6th and

15th beats; later heart beats regularly 70, lying; before rising tnt

from headache, which immediately slightly returned, not relieved bf

cold affusion. 10 a.m., 40 dr. Pulse at first steadier, then

intermissions; increased headache. 1 1, subacute pain in both

12.15 p.m., pain in temples transferred to cerebellum, like

subacute pin at apex of hearty of short duration ; rheumatoid

calves of legs, especially ]., succeeded by acute rheumatoid loin

extending to lower dorsal region ; acute pam in 7th cervical vei

pain from cerebellum transferred to temples, more acute, ls«4Jy^

congestive pain in occiput, without mitigation of aching in trmpksi.

constant severe lumbar aching ; slight rheumatoid pain in 1. siqtnK'

scapular muscles ; general feelingof weakness and weariness} piibeTfi^'

sitting and standing. 2.30 p.m., flying muscular pains, with

aching in loins and occiput, worse by movement, not IcswningSK. formerly after a meal ; depression of vital power. 6.30, bv 4 o'mck. pains had almost left, but after running upstairs returned sharply^ ~ in loins, then 1. leg, extending up thigh, afterwards in r* Kg, increased weakness and weariness j flying pains in various parts} feel weak as if the system were much over-^tigued ; symptonis- Mlt relieved by e. meal ; pulse 72, sitting and standing, with occBrionsl; intermissions, lo, symptoms severe; pulse 68 sitting, regalar, |I4^ standing, irregular ; temp. 36*20° C. ; resp. 19 j urine, cloudy acid, sp. gr. 1016, free from albumen, phosphates, lithates, an microscope shows mucus, epithelial cells, and very minufiB

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Since commencing proving bowels have acted regularly twice a d., motions papcsccnt or waiery till co-day, now decidedly constipated. 1 2th. — Retired last n. at 1 1, slept well till daylight, then awoke (quite unusual) and had light dreamy sleep after. Before rising, quite free from pain \ immediately after, rheumatoid aching in r. scapular muscles. XI a.m., pain in scapular muscles continues, otherwise feels well. Took 50 dr. In 10 m. dull frontal headache; pain in 1. lower molars, tranj^ferred to r. ; during d.^ rheumatoid pain, commencing in I. calf and finishing in r. ^ lumbar pain j frontal headache; occipital pain; flying pains ; general malaise ; all symptoms much less marked than yesterday. At 1 1 p.m., pulse 72 sitting and standing, 62 to 66 lying, irregular and intermittent, especially when lying, quickened by each inspiration ; bowels moved twice to-day, motions loose, light in colour ; urine deposits mucus, acid, sp. gr. 1012. 13th. — Did not sleep as soundly as usual ; on awaking, slight aching in 1. calf, quickly transferred to r. i slight aching down 1. forearm ; after rising, cardiac distress scarcely amounting to pain, most marked at apex. 10 a.m., 50 dr. (new tinct.). In 20 m. frontal oppression, with trembling weakness of hands; return of rawness at back of palate r. side; during afternoon return of lumbar aching, most on 1. side ; frontal headache ; pains in limbs ; general malaise; in e. lumbar aching ; occasional pains in legs, especially 1. ; slight pain in molars passing from r. to 1. ; pulse 72, lying, silting, and standing, quickened by inspiration ; temp. 36'30° C. ; resp. IQ; urine deposits mucus while cooling, acid, sp. gr. on passing lOio, after standing, 1014J motion slimy, of peculiarly shining dark brown colour. Examiner's report, — " Pulsation scarcely perceptible to touch, harmic murmur again indistinct, apex murmunshncss again perceptible, pulse 72, sitting and standing ; all symptoms increased by movement, in lying down^ or standing up." In e. cardiac action regular, pulse 74, not intermittent. 14th. — A woke 5 a.m. after dreamy, though not restless sleep; pulse 74, intermissions at 7ih, tlth, 31st, loch, and 20ih beats; slept again indilFcrently till 8, then awoke free from pain or ache ; pulse 72, not intermittent. At 10 a.m., pulse 74, lying and sitting, 82 standing ; gi^ncral debility. Took 60 dr. Within 10 m. severe lumbar aching; frontal headache; pulse 82 sitting, 86 standing, irregular and intermittent ; 5 m. later subacute pain at apex, extending to 3rd I. interspace ; later, cessation of frontal headache, succeeded by occipital aching and subacute pain in jth r. interspace, each quickly abating ; succeeded by return of pain in temples ; loin pain persists. Ji a.m., pulse 72 sitting, 82 standing, occasional intermissions. 12, noon, loin pain and headache in temples persists ; slight pain at apex ; rheumatoid pains especially in 1. leg and forearm ; afiernoon, sharp aching in r. leg, not relieved by friction ; short achings in various parts, I. side the worst. At n, pulse 74; temp. 36'40° C ; urine deposits mucus, acid, sp. gr., when fresh, 1012, on cooling 1016, free from albumen. J5th. — On awaking at 6.30 pleurodynia from 3rd to 7th 1. interspace, with acute pain at apex of heart ; contraction of intercostal muscles, worse lying on r. side, lasting till 10 a.m. ; pulse 68, with oppressed cardiac action. 1 1 a.m., took 80 dr. Within ^ h. sharp pain in r. lower molars, passing to r. temple, then to 1. lower

nu)l;irs, then to 1. tcnip!c, returning t»> r. lower molars, then settling in luiiiN. with tiontal opprcssimi ; later p.iiii5 at apex of heart, iu I. wrist, i. leir, r. Icj!, nape ni neck, and loins, pai;>ing o(f quickly, not relieved hv u'wi'htii ; pilpitation on .sh;jht exertion \ general malaise. In e. conge^tive p.iin in nape nt neek, with severe contniuous lumbar and dorsal pain, w()rse towaids I. side. At 10.50 p.m., pulse 60 lying, 66 sitting, 80 st.ind!n<r, regular ; urine less clouded, acid, sp. gr., fresh lOl2, on cooliniT', lOiS. i')th.~()n waking at 0.;p, laboured cardiac pulsation, puUe 02. 10 a.m., pulse 72 sitting, 82 (Standing. 7'ook lOO dr. \ ithiii ] h. dull, pre^sive, frontal headache, pulse 76 sitting, 80 staniiinj: ; aching across loins. 12, noon, while sitting strong bearingdown in 1. inguinal canal, as if hernia would protrude, with acute pain on walking:, relieved by upward pressure tm external ring, lasting about lO ni. Arternoon, sliirht pain in various parts, 1. side the worst. £., rest!e-s activitv, ready for anv amount of work j slight aching in 1. lower molars, sound teeth. 9-,{0 p.m., bearing-down in r. inguinal canal, with su'nacute pain when walking, relie\ed by upward pressure on external ring, returning when pressure is removed, lasting 2 h., with so\ere loin pain, wo^^e to r. of spine, lasting till retiring. During d. there has been subacute pain at apex (tf heart, later in 4th J. intersparc ; urine less clouded, acid, sp. gr., fresh 1008, on cooling I0I2, hee from albumen. 17th.- — .Awoke at davlight free from pain, and slept but indirf'ercntly after. On hsing, aching returned in both ini:uiiial canaK, increased by walking, relieved by upward pressure on external rings ; shaip aching in 1. lower molars, sound teeth. 1 0 a.m., took 120 dr. Pulse immediately steadied, soft, regular, yb sitting, 84 st.tnding. Within \ h. sharp aching 1. l<)wer molars, accompanied by fronto-occipital headache ; return ot lumbar aching. 1 p.m., subacute superficial pain in 3rd 1. intei space, near sternum, becoming acute on moving, lasting 10 m., passing to mid-sternum ; continuous aching along inguinal canals, worse on r. side, obliging him to walk cautiously, contniuous b-in pain ; pulse 70 sitting, 77 standing. Afternoon, severe contir.uous lumbar aching; painful stiti'ness in 1. inframaxillary region, extending to na[>e of neck, interfeiing with movement of head ; slight tenderness in inguinal canals. K., continued tenderness of inguinal canals i pulse 70, jerking ; temp. jO'io C; urine less clouded, acid, sp. gr., fresh IC14, <mi cooling 1017. iSth. — No med. During m. vharp aching down r. tibia, causing lamene-s, not relieved by friction; achings in various parts, especially I. lower molars and loins ; general malaise. liowels acted this m. only, motion shinv, of peculiar greyish brttwn, as if mixed with ashes. N., pulse, 58 lying, 70 sitting, 72 standing ; temp. 3610 C. ; urine slightly clouded, acid, sp. gr., fresh i')i7, on cooling loio. i<)th. — On waking, spasms in r. intercostals ; slight aching down r. ingumal canal. 10 a.m., pulse, 70 sitting, 78 standing. Took 3 dr. Within 5 m. sharp aching in nape of neck, 1. side, soon transferred to r. frontal eminence j later, pulse very feeble, quickened, ;8 sitting, 86 standing, irregular. Acute pain in inner muscle^ of I. calf., with straining and lameness ; acute Hying pains to r. middle dorsal region, nape, frontal eminences, I. wrist, 1. lower molars (sound teeth), lumbar region, and agam in nape. 1 1 a.m.,

Itstressed feeling in cerebellum ; sharp achings in various parts ; acute superficial pain in jrd and 4th 1. interspaces ; continuous lumbar pain, not worse by stooping, increased by walking \ pulse, 82 sitting, 84 standing, regular. 11.30, while sitting, acute pain down r. inguinal canal, quickly abating, leaving a steady dull aching i cervical and lumbar pains continue. 12, noon. ExaminerU report. — "Heart-sounds indistinct, systolic running into diastolic, basic murmur very slight,apex mui murishness not perceptible, action very feeble ; pulse, ^8 sitting, 86 standing, not intermittent." 1.30 p.m., faint nausea, lasting I h.,not relieved by dinner \ marked cardiac depression ; shifting pains. 2, aching down flexor muscles of r. thigh, extending to knee and calf, then to I. knee and calf, then returning to r. thigh and knee, with slight lameness. During afternoon acute pains in usual spots, with stcadyaching in r. thigh and knee-joint ; faint perspiration on covered parts, when walking ; repeated sharp superficial and deep pains in precordial region. £., great debility, especially on walking ; has taken extra stimulant to keep him going. Continuous aching in various parts j cardiac pains; slight lameness-, slight return of faint nausea. Pulse 60 King, regular ; 62 sitting, regular i 64 standing, irregular; temp. 36" 10° C. ; resp. 17. Urine scarcely clouded, acid, sp. gr. fresh, 1008, after cooling 1012. Before retiring, giddiness, with tendency to stagger to r. Motion lo-d., dark shining brown, strong odour. 20th. — On awaking, pleurodynia below 5ch r. costal cartilage, passing to I., then again to r. side j pulse 70, feeble, regular, lying. On rising, aching down both thighs, with weakness in walking! slight achings, relieved by the electric current, not relieved by the galvanic. 10.30 a.m., aching in K inferior maxillary articulation, and 1. wrist. 1 p.m., subacute pain in I. frontal eminence and precordial region ; aching across lumbar region \ sensations of dimness, with unsteadiness in walking \ trembling in hands > tenderness of r. inguinal canal. Pulse 66 sitting and standing, regular. 5, severe aching in both temples, especially 1. ; remains of lumbar pain. 6 p.m., acute darting pains at apex of heart. £., shifting pains, most persistent in r. knee ; persistent nausea, rising ^om back of fauces, relieved by eructations, which taste of tea and drug ; succeeded by persistent giddiness while sitting, with staggering to r. on walking; acute pain in 1. temple passing to r., followed by severe lumbar aching ; darting pains at apex of heart; oppression of respiration; constriction of larynx j acute pain in 1. frontal eminence, with sensation of compression of brain ; aching down r. inguinal canal, while sitting ; restless activity notwithstanding nausea, giddiness, and pains, all of which have been very severe. 10. 30, pain from front of r. knee transferred to back of 1. 10.40, darting pains through r. wrist. On retiring, pulse 60 lying, 62 sitting, 64 standing. Urine deposits mucus, acid, sp. gr. fresh 1014, on cooling 1018, free from albumen. Bowels acted twice to-d., motions slimy, of the peculiar dark shining brown, gushing out.

b. list. — Awoke 5 a.m., light dreamy sleep after. On waking, sense of constriction at lower half of thorax, impeding respiration, witn subacute pain, increased by lying on r. side ; continuous aching in 1. lower molars. 10 a.m., took 3s»- Within i h.dull trontal headache ; vital depression ; heavy aching in cervical region ; acute pain at apex of

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hearty not relieved by pressure, but dnven by fricrion to 1. subscapular region, then passing to mid-dorsal region, severe ; continuous aching in 1. lower molars i return of acute pain at apex, with distress. Pulse regular, feeble, not altered as to rate ; later, parched feeling in upper lip ; severe aching in occiput, with cessation of cardiac pain ; general oppression of brain ; acute pain over 1. temple i giddiness, with tendency to stagger to the r. i2, noon, persistent lumbar aching ; dull oppressive headache. Pulse scarcely perceptible, 76 sitting, regular ; 84. standing, irregular, z p.m., acute pain down r. inguinal canal, partially relieved bv upward pressure on external ring ; occipital aching. Later, prictings, as if bitten by insects, in 1. forearm, hvpogasirium, r. leg, r. forearm, back, and again in 1. forearm ; slight achings in r. leg, lumbar region, nape of neck and r. inguinal canal. Examiner^s rfpori^ — '* Pulse extremely varying both as to time and volume, at first almost imperceptible, 76 to 86, sitting and standing, not intermittent ; cardiac pulsation much stronger than pulse indications would lead one to expect ; no special murmurs." N., slight achings; pulse 72, lying and sitting, regular ; 84 to 88 standing, varying in volume. Urine shows but little trace of mucus, acid, sp. gr. loio fresh, 1014 on cooling. For several m. excessive flatulent rumblings on awaking. 22nd.— Awoke during n. with pressive aching down 1. inguinal canal, relieved by upward pressure on external ring, lasting several m. Before rising, intercostal pains, worse when lying on r. side, extending to apex of heart. During the d. a double set of pains, from cold, and from the drug. The former chiefly aff'ecicd upper teeth on 1. side, decayed lower teeth, and head j the latter 1. lower molars, sound teeth, and lower limbs. The pains from cold were relieved by aconite, port wine, and warmth, increased by cold air. The dental drug pains were not relieved by aconite, mcrcurius, or direct warmth. E., feverish feeling (from cold), pain went from lower molars to lumbar region, then went rolling up spine like a ball, and settled in mid-dorsal region, chiefly to 1. of spine ; afterwards returned to I. lower molars ; severe general headache, with giddiness. Pulse 72, lying and sitting, regular ; 84 standing, regular ; feeble ; temp. 3670° C. Urine scarcely clouded, acid, sp. gr. fresh 1015, on cooling 1019. Bowels acted twice, second motion half solid, with straining, half-slimy, gushing out. 23rd. — On awaking severe intercostal pains, both r. and 1., with repeated acute darting pains at apex of heart, increased by lying on r. side; severe aching down spine, somewhat relieved by friction, passing ofl^ after rising i excessive flatulence. During d., severe and continuous aching in 1. lower molars, sound teeth ; frontal headache. During d. severe irritation, like urticaria, on various parts. Before retiring, troublesome urticaria, especially aflfecting 1. forearm and r. teg. 34th. — On awaking, subacute pain in lower dorsal region to 1. of spine. 2 p.m., acute darting from anterior superior angle of 1. parietal to malar bone, succeeded by sensation as if brain were compressed, followed by long-continued irritation of scalp over line of pain. During d, troublesome irritation (urticaria] especially of 1. forearm and r. leg. (** 1 cannot say this irritation is a drug effect, as I have had slight urticaria on previous occasions, but its development follows the rule of preceding symptoms.") First

0jeamiHfr*s report^ 5 p.m. — "Impulse feeble, heart-sounds very weak, action irregular in furce and rhythm, nut intermittent, no murmurs. Pulse feeble, very compressible ; 76 sitting. Bo standing." E., urticaria more troublesome, has extended to r, forearm. Before retiring, frontal headache ; slight aching to , of lower dorsal region \ irritation persists. Pulse feeble, compressible, 68 lying, 72 sitting, 76 to 82 standing, irregular in force and rhythm, not intermittent. Urine slightly clouded, acid, sp. gr. fresh 1004, on cooling 1006, free from albumen, phosphates, lithates, and sugar ; microscope shows scattered mucus and epithelial cells, abundance of spermatozoa, and oxalate of lime crystals. Motion to-d. slimy, of the peculiar shining dark brown, offensive, gushing out. 25th. — On waking, subacute pain in intercostal muscles, below 5th rib on each side, increased by lying on r. side. After rising, severe aching in 1. lower molars, sound teeth, spreading to 1. upper bicuspids, sound teeth, lasting several h. ; succeeded by frontal headache, on the passing off of which increased mental and physical activity. £., irritation has returned in I. forearm, r. leg, to 1. of lower dorsal vertebra, r. forearm, and 1. leg. Pulse 68 sitting. Motion slimy, of a shining yellow colour, offensive. 26th. — Sleep has been dreamy. On waking, laboured cardiac action, excessive flatulence. Pulse 62 lying, feeble, less compressible. During d., urticaria. K., marked cardiac depression, causing slight faintness on quickly ascending a few stairs, lasting J h. ; returning later, on quietly ascending, with subacute cardiac pain j cardiac action barely perceptible, pulse stronger than heart's action would indicate, less compressible, not intermittent, 72 lying, sitting, and standing. Urine slightly turbid, free from deposit, acid, sp. gr., fresh and on cooling, 10 jo. Motion partly solid, natural, partly slimy, dark brown, offensive. 27th. — On waking, intercostal pain \ urticaria persists. 5 p.m., subacute pain over cardiac region with cardiac distress \ slight aching in lower dorsal and lumbar region. Pulse compressible, irritable, varying greatly in force and rhythm, 74 to 76 sitting, 85 to 92 standing, with frequent intermissions. 7 p.m., acute pain in 1. axilla, extending down edges of pectoral muscles to thorax, then passing to base of heart, then to apex \ faintness with slight nausea when walking in open air j persistent giddiness, commencing when walking in open air, continuing after entering the house, while sitting; subacute pain down muscles of 1. calf; sighing respiration ; return of acute pain at apex of heart ; trembling of hands ; return of giddiness while sitting, with constriction ; shooting pain through h frontal eminence ; constriction to I. of larynx ; cardiac depression ; continuous constriction of larynx ; aching at superior curved line of occiput, an inch to 1. of occipital protuberance, passing to corresponding spot on r. side; pulse less compressible, irregular, and intermittent. Symptoms lasted over 3 h. Pulse, on retiring, 72 sitting, 80 standing, regular, not intermittent. 28ih. — Afternoon, severe general headache, lasting several h. ; slight pains. 29th. — Severe fronto-occipital headache, from 3 to 7 p.m., succeeded by laboured cardiac action, then by cardiac depression, with faintncss, lasting 2 h. j pulse at same time about 76, stronger than cardiac impulse indicates. lO p.m., sharp darting pains through epididymis of 1. testicle, several times repeated.

passing to r. testicle, leavin? dull achings, recurring till oiidnight; aching in 1. inguinal canal. Bowels acted twice, motion more ostuiaL 30th. — Before rising, spasms in r. intercostals while lying on r. side. After rising, acute aching in 1. testicle with occasional darting poiiOf changing to r., then again to 1. 11.30 a.m., acute^exteniive pain fiom ]. kidney to 1. inguinal canal, lasting several m. II noon, P^os in L testicle cause aching in 1. inguinal canal, and extend to r. testicle^ >t times very severe v aching across lower dorsal region. 1.45 p.in.^ acute pain in intercostal muscles over base of heart,laatiag sevenl ol 3 p.m., slight return of headache. 5 p.m., acute pain down anterior muscles of r. thigh, causing lameness, afterwards in both. £., acute pains in testicles, first I., then r., then both, recurring and laiting whole e., with achings in inguinal canals ; cardiac depression, causing faintness ; increased mental and physical activity. Oct. lat.— Slight achings in vanuus parts ; general depression. Exammf^s nptrt,^ " Cardiac impulse very feeble, haemic murmur again distinct, no other murmurs ; pulse feeble, extremely compressible, irregular in force and rhythm, not intermittent, 72 to 80 sitting and standing, quickened bj movement." Urine clear, acid, sp. gr. 1018, free from albumen. Motions of past 2 d. have been of peculiar shining brown, ofiensivet 3rd. — I p.m., aching in 1. testicle, 1. hand, and r. knee, while litdiig; later, slight achings in 1. wrist, r. knee, 1. ribia anteriorly, lower dond region, 1. knee, and r. forearm. Pulse 72 sitrin^, 78 standing, fceblc^ compressible ; temp. 3695° C. ; resp. 30. During past 5 £, Inmtal headache, extending afterwards through to occiput, commencing about 3 p.m., and continuing 2 or 3 h., similar to that of aQth ult,, but much Jess severe. Before retiring, severe pain in r. side thorax at intertioa of pectoral muscles, becoming acute on inspiring deeply. 4th. — On awaking in m., return of pain r. side thorax. £., slieht cardiac depmsion ; headache recurred 3 p.m., and continued till 6 p.m« 5tli.^* Sympcoms very slight ; bowels acted twice, first part of each motion solid and natural, last part slimy, of the peculiar shining brown, bat much less offensive. 6th. — 4.30 p.m., recurrence of frontal '

lasting till 6 p.m. ; succeeded by cardiac depression, followed bycardiac oppression, with quickened pulse ; giddiness, with strong tendencjr to scagt^cr to r. ; then neuralgic pain in r. supra-orbital region, and in-L testicle, with return of cardiac depression, causing faintness and with subacute pains at apex and base of heart, passing ofFbefore 10; with eructations and yawnings (while out walking). Pulse 78 sittingi 88 standing, irregular in rhythm, extremely compressible \ rcsp. 23. Urine clear, acid, sp. gr. loio. loth. — 7.30 p.m., marked cardiac depression ; pulse stronger than indicated by cardiac impulse, 66 Ijringi sitting, and standing, extremely irregular in force and rhythm ; respi oppressed, lasting till 9 p.m. During the past 5 d. faeces have bsMl partly solid and natural, partly soft and of the peculiar shining bnNrtty first part being passed with much straining, last part quite fiedy. 15th. — No special symptoms since last report. The fzccs are giadifr* ally assuming their natural character. Cardiac action still nthtr depressed. First examiner*s report. — " Cardiac impulse feeble, hsmic murmur distinct on strong pressure, systolic sound not quite nittuialac

apex, not amounting to a murmur, probably- due to feeble action ; pulse regular, very compressible, 76 sitting." IO.30 p.m., pulse 68 sitting, 72 standing, regular, compressible ; temp. 36*40 ; rcsp. 20. Urine clear, acid, sp. gr. 1014. [Monthly Ham, Review^ xvi, 737.)