Curare

Volume II — Main text

CURARE .

Indian arrow-poison (composition unknown). I. Provings.-1*. ANNIE B.TAYLOR, in perfect health,normal pulse 72, temp. 98 °. a. Proved 3xtrit. Aug. 6th, 1883, at 10 p.m. took 2 gr., and repeated dose at 7 a.m. and 7 p.m. next d. At4 p.m. pulse was 90 and temp. 99°. Repeated dose on following d. at 7 a.m., 12 m., and 7 p.m., and so continued daily till m. of 15th. On 8th at 2 p.m., pulse 90 ; eyes very heavy, can hardly keep them open ; yawning ; cough in paroxysms, dry, harsh and hollow, irritation seems deep in chest, at base of lungs, no expectoration ; cough makes face red, and causes shattered, torn feeling in head, as if parts would flyto pieces. At 3 so drowsy she could not keep awake, and slept for 3 h. At 8 headache over r. eye, extending to vertex, sharp and darting, came on after eating, remained for 1 h., then suddenly disappeared. 9th.-Very restless n., head hot and confused. Pulse this m. 88. At noon, head feels large and confused ; darting pain through temples, worse on r.; coughing causes shattered, torn feeling, sides of head must be held together ; moving head, unless very gently, causes same sensation. Very pale all d., with dark circles round eyes. At 6.30 p.m. very chilly, teeth chattered, chills running up back and then into extremities ; chill came on after eating, lasting & h., followed by high fever-she was burning up with heat, face purple, eyes very red,hot, and sensitive to light, could not keep them open ; headache very severe all over, all vessels seem throbbing. At 8, pulse 110, temp. 101°; on trying to walk, limbs felt unsteady, gait as of one intoxicated. Fever lasted till nearly midnight ; no thirst with it, and appetite good; headache was congestive, worse after eating, and from motion, light or noise, better from pressure and quiet. Slept only from 12 till 4. 10th.-In m. pulse 86, temp. 99°. Weak, tired feeling all d.; no desire to do anything; limbs, especially lower, feel weak; 1. foot and leg go to sleep when sitting still. Frequent sneezing ; several paroxysms of coughing p.m., with usual effect on head. Ith.-Dry, harsh, hollow cough, worse after 3 p.m. till midnight, violent, shaking whole body, but head most; lungs feel dry. 12th.-Woke at 4 a.m., cough as on previous days, and in e. sharp darting pain through chest, now at apex, now at * The ladies who took part inthese provings(conductedunder the superintendence of Dr. C. Wesselhoeft) were all students of medicine in Boston University, anddid not know what drug they were taking. The drug employed was obtained from Merck, of Darmstadt.

base. 13th.-At 8 p.m. pulse 98, temp. 100°. Cough very troublesome in afternoon and e. Continues to wake every m. at 4. 14th.- Weak tired feeling all over ; no appetite, bitter taste, tongue white ; eyes dull, pupils contracted. At 3 p.m. head confused,heavy and dull, difficult to hold it up, it feels better when lying down ; there is dull heavy pain in it, with sense of great weight on vertex ; mouth tastes insipid ; half-nausea constantly; great aversion to bread ; stomach feels collapsed. At 8, pulse 90, temp. 991°. Great depression of spirits, inclination to tears, wants to be let alone; occasional temporary pain in bowels, causing faint sinking feeling ; no strength in limbs, legs tremble when walking. Sick all n., pain in bowels every few m., restless and weary. Took no more medicine. Diarrhea after 1 p.m. , preceded by pain, causing faint sinking sensation, stools milky white, sometimes like half-beaten eggs. No appetite,great aversion to bread ; feels weak, tired, depressed, cannot sit up ; great weight on vertex ; eyes look dull, pupils contracted, dark circles under eyes ; tongue thickly coated yellow, mouth tastes bitter. Had 20 discharges during d.; no thirst; pulse in e. 68, temp. 98° ; bowels feel sore and bruised, and must be held during coughing and walking. 16th.-Had 8 discharges during n.; less pain, but feeling of faintness during and after stool ; stomach still feels collapsed; empty feeling in head ; great effort to talk ; eyes feel better closed ; pale, sallow face ; no hunger or thirst, no strength to sit up ; bowels feels sore, bruised, and trembling. Had 8 more stools during d., without pain ; in e. weak, collapsed feeling, could not sit up, dizzy when trying to hold head up ; frequent sighing, great depression, do not care to talk or think, wish to keep perfectly quiet. 17th .-Had 5 stools in n. Weak to-day, but no pain, cough better, and more appetite. 18th.-All symptoms better. She has lost 4 lbs. since taking drug. Menses came on a week too early, with pain-griping in r. ovary, bearing down in uterus, dragging, tired, in all pelvic organs, severe (causing faintness) in lumbo-sacral spine, running down thighs. Flow scant and very dark, lasting 3 d. only, instead of 5 ; headache-as from weight on vertex-and dull, dragging pain in pelvic organs all the time, with at first loss of appetite, nausea and giddiness, and frequent micturition, and very weary feeling for several d. after flow ceased.

b. Oct. 29th, having been well in interval, resumed proving with same potency, taking 2 gr. m. and e. up till m. ofNov. 3rd. On 1st d. nothing but violent sneezing (6 times) . 30th.-At 3 p.m., eyes heavy, great drowsiness ; at 6, sore bruised feeling in l. lumbar region ; throat full of white mucus, difficult to detach, and causing suffocative feeling by its presence. 31st.-At 3 p.m., pulse 92, temp. 100°. Headache over r. eye, sharp darting pain, at times very severe, lasting 20-30 m., leaving confused feeling; worse from motion, better in open air. At 8, still headache, worse after eating ; very sensitive, least annoyance brings tears. Nov. Ist. Bowels uneasy, rumbling and loose in early m . At 1.30 p.m., headache on r. side, half dizzy feeling, face red ; tongue white ; dry, hacking cough, causing shattered sensation in brain. 2nd.-Awoke at 4 a.m. At I p.m. great drowsiness. 3rd, 2 p.m., cannot study, head feels confused, dulness of intel

lect, weak memory, thoroughly discouraged, feels cross, least thing irritates, does not wish to talk or have anyone talk to her; lungs feel as if she had taken a hard cold. 7, severe neuralgic pain in r. temple, running through head to spine ; head painful all over, feels throbbing, congested, large, strained, confused, and so heavy that she cannot hold it up; pain extends down spine, hot burning sensation between scapulæ ; deep sighing ; eyes feel hot and sore, hurt on movement, sensitive to light ; face very red, with dark circles under eyes ; darting pain through lungs ; feels weak and exhausted all over, stomach as if collapsed, limbs nerveless ; nausea and vertigo ; urine scanty, brickdust sediment. 4th.-Sleep restless and troubled ; head still feels confused and large, with darting pain through r. temple to base of brain ; eyes feel badly, with wish to keep them closed ; weak all over, and inability for mental or physical exertion; coughing affects head as before. 5th.- Dull, heavy headache, with great pressure on vertex ; eyes sensitive to light, and with difficulty kept open ; no appetite ; weak, trembling feeling all over. 6th.-All symptoms less severe to-day. c. In Dec., began proving 2x trit., taking 2 gr. twice daily from 2nd-6th inclusive. 4th.-P.m. , tired feeling all over, with heaviness of eyes. 5th.-No sleep till after midnight, and awoke before4. Head confused, great weight on vertex ; felt too tired and ill to go to college. 3 p.m., headache severe, with throbbing of vessels ; frequent, anxious desire to urinate. 7, headache harder through r. temple,and pain runs down spine ; head very heavy, and weak, tired, languid feeling all over. 6th .-4 p.m. , very low-spirited ; head so confused she cannot study, memory weak ; eyes sensitive to light ; neuralgic pain in head extending down spine; hot sensation between scapulæ ; no strength. 7th.- Same weakness, depression, inability to study. 8th.-Same ; no appetite, stomach feels empty, craving for acids. Menses again 7 d. too soon ; character, duration and concomitants as before (Aug. 18th) . d. Jan. 8th, 1884. Renewed proving of same trit., taking 2 gr. once on 11th, twice 12th-14th, 4 times daily 15th-17th inclusive. 12th.- No sleep after 4 a.m., in m. very sleepy and yawning for 1 h., with eyelids drooping. 3 p.m., dull, heavy headache, beginning over r. temple, gradually spreading over whole r. side, with feeling ofweight on vertex ; moving head hurts it, and causes shattered confused feeling ; congested feeling, as ifall blood was in head and face; at times darting pain shocking from temple to temple; lasted about 2 h. In e. for 10 m. , chills running up back, with chattering, followed by heat and congestion to head with aching, lasting 1 h. 13th.-Sneezed several times. Weight on vertex ; ptosis as before; tongue coated yellowish-white. 6 p.m., thoroughly discouraged and disheartened, sick of living, tired at everything, irritable, despondent ; changeable disposition, jesting and laughing,then shedding tears . 9.30, chest feels constricted, and throat sore, as ifshe had taken a heavy cold ; itching of skin ; restless feeling. 14th.-Same catarrhal symptoms ; eyes feel as though full of sticks ; hands and feet cold ; head large, later painful through r. temple to occiput, with heat on vertex ; dry cough, shortness of breath. 15th.-Chest as yesterday. 8 p.m., eyes weak ; tired, languid feeling ; no ability for mental work ; great weight on vertex ;

bronchial tubes sore, as if inflamed ; r. cheek very red, 1. pale ; dark circles under eyes ; all blood seems to be in head ; hands and feet cold. 9.30, pain between scapulæ ; hot sensation in cervical region; restless, uneasy, nervous feeling ; stomach " collapsed." 10.30, hoarseness and tightness ofchest has rapidly increased ; dry, hacking cough ; lungs feel raw, smarting sensation down bronchi ; violent headache, throbbing all over, head feels enlarged. 16th,-Chest still constricted ; tight dry cough ; in e., hoarseness almost to aphonia ; eyes feel strained, head enlarged; face veryred ; itching ofskin,especially at n.,on arms smarting also. 17th.-Breath short ; a little excitement causes palpitation ; dry, hard cough, lungs feel dry and sore, darting pains through chest ; sighing ; tired feeling all over, and inability to study; " fidgets " in feet ; itching on arms ; bloating about waist, especially r. side; urine scanty and full of sediment. 18th.-General lassitude of mind and body, as before ; limbs go to sleep ; eyes feel strained ; hoarseness, short breath, sneezing. 19th.-Severe headache, pain in every part, great weight and pressure on vertex ; nausea and vertigo. 6 p.m., faintness, even to blindness, coming on suddenly, lasting but a few moments, but leaving pain and " gone " feeling in stomach. Hoarseness ; hands and feet icy cold, all blood seems in head ; very restless feeling ; itching all over ; limbs go to sleep. Next period as last. (Publ. ofMass. Hom. Med. Soc. , viii.) 2. Mrs. NUTTER, æt. 32, blonde, 2 children, in excellent health. a. Proved 3x trit., taking I gr. twice daily for 5 d., once for 2 d. more (Nov. 7th- 13th, 1883). 7th.-At 11.30 a.m. (drug having been taken at 7), dull pain along infra-orbital ridge, through temples, and about ears ; ears felt as if filled with compressed air. Sensation as if atlas and axis had been prised apart ; on rising to feet this feeling changed to sharp pain lasting but a few m. Headache all afternoon and e.; pain, at first shifting, finally fixed, in small spot in front of 1. parietal eminence, where it was continuous and quite severe. 8th.- Soon after m. dose, and again at noon, severe attack of strong palpitation on going upstairs,-second time with great dyspnea. P.m. , on walking out in open air the same ; and again, also, while ascending stairs in e., so breathless then for several m. that she could not speak. No real headache to-day but vague pain in r. temple ; while walking severe pain in l. hypochondrium, and a few fine stitches there at n. in bed. 9th.-Soon after waking, similar, stitches through middle of chest and about heart ; slight 1. headache. While walking fast pain in chest ; and after doing so pain at 7th cervical vertebra for few m . Is becoming unusually forgetful. Epidermis above ankles becoming chapped (unwonted). Ioth.-A most unbearable headache all d., beginning soon after breakfast in central and upper forehead and front of vertex, depriving her of all power of thought, aggravated by vigorous movement and by stooping. Dyspnea and pressive pain in chest on going upstairs or bending forwards. During afternoon, while sitting, very strong pulsations in back, from neck to loins, for few m. Forgetfulness still marked. 11th.-Headache continues, but not quite so severe, but with general malaise. Dyspnea on ascending increases, and a little palpitation is experienced. 12th.-Headache still, less severe ;

frequent but not violent palpitation while walking on level ground ; dryness ofnasal mucous membrane and of cuticle; still forgetfulness. Menses anticipated by 8 d., flow profuse. 13th. -Heart pains now slight and wandering ; pulse at 9 p.m. 55,and irregularly intermittent ; after retiring felt strange sensation at heart with feeling of faintness. 14th.-Headache all d., but not severely ; palpitation in walking also frequent but not strong ; pulse 60 and more regular. 15th.-Palpitation, breathlessness, and fine needle-like pains in chest, ofshort duration, while walking uphill ; pulse 50, irregular but not intermittent. 16th.- Same symptoms ofhead and heart, but slighter. b. On Dec. 13th-symptoms having quite subsided, save that pulse has continued48-55, and occasionally intermittent-began same dose m. and e., continuing it till m. of 20th. 14th.-Empty and faint feeling at stomach 3 h. after m. dose; wandering pains inhead during d., after meals decided headache, increased by motion. In e. (pulse 64) fine stitching pains for an h. in middle and lower sternum, thence penetrating whole lower chest. 15th.-Some palpitation and constant (temporo-frontal) headache, with nauseawhile travelling by rail. 16th. -Awoke free from headache but it set in again soon after breakfast. 17th.-Headache throughout d., worse immediately after eating, at times nausea with it. Feeling as of combined numbness and tingling, first in r. arm, then more general ; noticed occasionally before, but now quite annoying ; always accompanied by pain in basilar region. 18th. -Headache began during breakfast, from base of brain upwards, very severe, increased by mastication. Momentary attack of dyspnea and pain about heart. 19th.-Constant headache, aggravated by eating ; radiating from base to vertex and ears. 20th. Some headache after eating, in all parts of brain. Numb-tingling feeling of 17th in all parts ofbody, especially r. arm and cervical region. c. Took 2 gr. once on March 23rd and 27th, 1884, and twice on intermediate days. 23rd.-Bitterness of drug caused (now and subsequently) nausea for some little time, followed by empty faint feeling at stomach. 24th.-On wakingpain in l., afterwards whole forehead, more severe at noon; at 3, occipital pulsations, strong throbbing of carotids, and confused dazzling feeling. In e., pulse (unaffected in 2nd proving) 54 and intermittent ; slight temporo-frontal headache. Shortly after retiring, involuntary and uncontrollable rush of disconnected thoughts. 25th.-Woke at 7 a.m., with sick headache, faintness, weakness and general malaise, all so aggravated by motion that she had toget back to bed. Throbbing in head and body ; headache sharp in temporo-frontal region, dull elsewhere, but more intense inocciput, and thence extending down between shoulders. Later, managed to get up ; pulse 56, weak and lagging ; temp. 98° ; no appetite for breakfast, but after it gastric symptoms were relieved to a great extent, though not head, which was especially sore on movement ; it was easier about 10, worse at noon, and quite bad for rest ofd. After e. dose pulsations in all parts of body save feet. 26th.-Symptoms of yesterday m. repeated to-day, but less severely. First dose not taken till 2 p.m.; headache became more severe I h. later. In e. temp. 972 , pulse 60. For last 3 m. unnatural dryness ofnasal mucous membrane ; and chap

ping of ankles, as in Ist proving, has occurred. 27th.-Began d. with violent headache, situated as before, but sharp everywhere ; pressure in epigastrium, also penetrating pricks there. Pulse 54, temp. 97 °; sick and weak all d.; some palpitation . d. Since last proving entire lack of strength, wearied from least exertion. Menses occurred6d. before time. April 13th-18th took 2 gr. twice daily. 13th.-After e. dose a transient headache (l. temple) . 14th.- 1 h. after m. dose headache set in, with weakness and trembling of limbs ; at first confusion and great tension in head, then sharp pains in forehead and 1. temple, occasionally in r. temple and vertex, worse from stooping and motion ; also sensation as if ears were filled with compressed air, and dull tingling pain along malar bones to temples (this lasted till e.) . Headache reached climax at II a.m., and was worse again at 4 p.m. (with confusion of thought, weakness ofjoints, pulsation through whole body, inability to study or think, stupidityand sleepiness), and after e. dose (with weak tingling in arms). 15th.-Slight dull headache on waking, more severe 1 h. after breakfast (m. dose taken at 7) ; varied during d. and e.,at times occipital pain would shoot down into neck ; weakness and pulsations as yesterday ; marked tenderness of feet. 16th.-Same history ; also slight palpitation while walking, and several times fluttering in chest. 17th. The same. 18th .-Did not take ist dose till headache on waking had ceased (3p.m.). After 1 h. tingling of zygomatic processes, then dull pain crept through them, then pain and pressure in temples, and finally in occiput, vertex, and upper forehead. Weakness, pulsations, &c., as before ; dryness of nasal m.m. and tenderness of feet (these every e.). 19th.-Behaved in same manner with final dose of 3 gr. In less than 1 h. steady keen pains in every bone offace, especially in zygomatic arch ; then headache as usual but more severe ; frequent quivering tremors ; at times dyspnea and præcordial distress (noticed previously also) ; at n. sharp, steady pains 2 in. to 1. of sternum, from 2nd to 5th intercostal space ; heavy, uneasy, nervous feeling in arms and weakness of wrists. Pulse and temp. were throughout somewhat below normal standard. (Ibid.) 3. Miss C. F. BROOKS, æt. 31, liable to attacks of throbbing headache, with sensitiveness to light and sound, otherwise in good health. a. Nov. 6th-12th, 1883, took 2 gr. of 3x trit. m. and e. No symptoms till 8th, when she felt very tired alld., with heavy headache, especially in forehead and eyes ; had sudden hunger a short time before meals. 9th.-Same headache (till e.),tired feeling and sudden hunger ; itching on arms and thighs m. and e. 10th.-Same symptoms, but hunger less and itching more severe ; occasional swift needle-like pains through abdomen. 11th.-Itching intense, and hunger increased almost to faintness ; menses anticipated. 12th.-Hunger same, itching less ; unusual feeling of well-being. b. Took same m. and e. Nov. 19th-27th. 19th.- In e. slight dull pains, shifting from chest toabdomen, and inlatteron changing sides in bed, keeping on opposite side from that on which she lay. 20th.- Same palpitation and pulsation ; had only to direct attention to any spot to feel latter there. 21st.-Uneasy dreams all n., woke several times, feeling as if someone were trying to arouse her ; dull headac he

in e., also fleeting pains in hypogastrium, with pressure and fulness in vagina. 22nd.-Neuralgic-like pains in temporal, cardiac, and hypogastric region at various times, with heavy pressure in vagina. 23rd.- Same, with itching on arms and thighs. 24th.-Same as yesterday ; before dinner excessive hunger. 25th.-Sharp fleeting pains through chest and abdomen ; muscles of 1. thigh sore to touch ; during e. almost constant pain in stomach and upper abdomen ; itching as before. 26th. -Nervous hurried feeling all d.; forgetfulness ; p.m., feeling as if severe headache were coming on, took long walk to prevent it, but after walking briskly for 15 m. became very dizzy when looking at near objects or at water, had to look far ahead to prevent reeling. Same sensations as before. 29th.-Same sensations. Felt excited and hurried all d.; made to laugh easily; all feelings, as of liking and disliking, intensified, so that their manifestation must be restrained. c. Jan. 2nd, 1884, began again taking drug in same way, but was obliged to discontinue it on 6th d., because of the intense itching developed. This was felt chiefly on lower extremities, but somewhat on abdomen, head, and back. No other symptoms noticed. d. Jan. 24th, itching having entirely subsided, began taking 2 gr. of 2x trit. m. and e., and continued this for 10 d. 25th.-Slight inability to fix thoughts, soon overcome by will ; great appetite ; slight itching. 26th.-Woke in m. unrefreshed, from laborious dreams. Some return of previous pains, fulness in vagina, and hunger. Burning spot on 1. sole when shoe was removed at n., also for a little while next m. 27th.-Some pains and itchings. 28th.-General malaise, tired and stupid feeling, wearing off towards e. Again burning spots on feet and tenderness of callosities. 29th.-Woke with dull headache, which continued all d.; irritable, stupid, forgetful, unable to comprehend; tongue yellowish at base, papillæ raised, and bright pink anteriorly, with bitter or bloody taste in mouth ; itching and hunger as before. 30th.-Woke tired, and continued so all d.; tongue same ; occasional pains ; burning spots and itchings as before. 31st.-Same in all respects ; easily moved to tears or laughter ; itching intense. Feb. 2nd.-Sharp stitches in various parts, especially 1. temple ; itching almost unendurable on thighs ; felt hurried and energetic all d. 3rd.- Same. e. March 17th, took same for 6 d. It brought back similar symptoms to those of former occasion, viz. some headache and backache ; tired feeling ; burning spots on feet and itching there and elsewhere ; sharp pains at various parts, especially temples ; pressure and fulness in vagina ; dulness ofmind ; shortness of breath on slight exertion ; intense hunger about 1 h. before meals ; uneasy unrefreshing sleep ; sore or " lame" spots in flexors of l. forearm. (Ibid.) 4. Mrs. R. A. Lawrence. a. Sept. 1st, 1884, began in e. course of 8 powders of 4x trit., one n. and m. 2nd. On rising slight stiffness ofmuscles of r. neck and shoulder, lasting till 6 p.m. 3rd.-Nausea after e. dose for 1 h. Broken sleep during n. No other symptoms. 6th.-Began this e. course of 9 powders of 3x. 7th.- Sleepless after 2 a.m. After 3 p.m. dull frontal headache with feeling as of weight over eyes. Till 6 p.m. temp. 99°, pulse 76 ; later both normal.-8th.

-After breakfast sense as if band were about head, and heavy tired feeling from hips to knees. Former better by 10, but latter remained all d. 9th.-Languor and heaviness in legs when in motion for 3 h. 10th.-Pain in r. abdomen near hip while walking ; pulse and temp. somewhat above normal height. b. 22nd. Began course of 10 powders of 3x, 2 gr. each, one n. and m. No effect save dull frontal headache and heaviness of limbs on Ist d., and occasional slight nausea on 3rd. On 30th began course of 9 powders of 2x, 3 gr. each, as before. Oct. Ist.-Slight pain in l. head, extending to forehead ; pain in stomach, quite severe for atime. 2nd. -Early in m. stiffness and drawing of muscles of r. neck ;' later, fulness and distensive pain in stomach ; occasional flushes of heat during d. 3rd. In m. darting pains in abdomen ; slight nausea. At 10 a.m. pain in 1. shoulder, running down to elbow ; heaviness of legs, r. feeling almost useless ; at n. pain in 1. head extending over both eyes, with weight at occiput ; pain in abdomen near r. hip ; could not sleep till 1.30 a.m.; following n. also very restless. Flushes increased on 4th, and lasted till 6th. 7th .-Took 7 doses of5 gr. each at 3 h. intervals. Flushes increased in frequency, and persisted up to 9th. 12th.-Took similar doses every 4 h. Drawing pains in back of head, and stiffness of muscles of back of neck came on in n.; nausea and salivation next m., head feeling large and confused, with oppressive pains on its 1. side, slight pain in l. leg, aching between shoulders up to neck. Dull pains through top of head, relieved by pressure. 19th. -Began at 7 a.m. to take 6 gr. every h. After 4 doses slight pains began in 1. head and dull pain in forehead, with nausea and increased saliva ; aching ofthighs from hips downwards ; puffiness undereyes. P.m., after an interval of 3 h. took 5 moredoses hourly. Dull heavy headache, nausea increased ; palpitation on lying down at 4; pain in both shoulder-joints ; on lying down in bed heart-beats quickened immediately ; at same time head felt full and large, and as if band were about it, with aching and pressure at vertex. On rising next m. weak heavyfeeling of limbs, relieved by exercise. Nov. 1st.-Took during d. 7 powders, each containing gr. To of C. Heaviness of head with sleepiness all forenoon ; p.m., sharp pains in r. hand and arm, and over r. shoulder and hip ; pain in 1. head and temple ; great increase in urine. 2nd.-Took similar powder at 6.30 a.m. During m. looseness of bowels, with slight pain at time of stool ; urine copious and urgent, bladder feeling distended. gr.- 16th. every Menses having 3 h. till appeared 2 p.m., thenon 13th, every took 10. h. till powders containing Flushes came oneach in m.; sleepiness ; pain and heaviness of legs ; pain in l. head, extending over top, with dulness and heaviness at back ; discomfort in abdomen with pain in r. side near neck ; catamenial flow scanty during d., profuse and bright at n. 17th. On rising, muscles of r. neck stiff. Menses as yesterday. Dec. 30th.-Received 10 powders (each containing gr. ) to be taken twice on Ist d., 3 times on 2nd, and so on till used up. 31st.-Pain in groin low down, with heaviness in limbs while walking. Jan. Ist.-Stiffness of r. cervical muscles all d.; frontal headache ; pain in r. iliac region as before ; nausea after retiring. 3rd.-Dull headache in forehead and eyes in m.; uneasy feeling in

bowels; at 5 p.m. nausea and headache, heaviness at occiput ; flushing 3 ine, 10th .- Took powder, gr. 1 , every 3 h. Nothing but nausea, heaviness of limbs, and slight headache as before. (Ibid.) (It is noted that this prover was less sensitive than the others,less imaginative also, ofcalm and strong mind, and sturdy physique.- EDs. ] 5. a. During Aug., 1884, I experimented with C. I commenced with the 3x trit., 2 gr. 3 times a d., continuing this for one week. The only symptom noticed was a ringing in the ears ; this occurred several times, at different hours, and was at times prolonged and metallic. The dose was increased to 5 gr. 4 times a d.; but, as no other symptoms showed themselves, after a few d. I took the 2x in same way. Once or twice again I noticed the ringing, sometimes only in one ear, and this was the only symptom produced. At the time I was extremely fatigued from long-continued overwork. b. After a season ofrest, during which myhealth greatly improved, I made fresh experiments. Feb. 5th, 1885, took 5 gr. of 3x, without effect. 12th. Three doses of 10 gr. each ; no result. 13th.- One dose of same, 3 to 10 gr. of 2x. Two h. after Ist of these ringing in r. ear. 14th. Three 10gr. doses of2x. Ringing in r. ear noticed once ; about 5 p.m. slight dyspnea (not worse for running) for 15-20 m. 15th.-Took one dose of 10 gr., and 2 of 15 gr. each without effect. 16th.-Took in one dose all he had left, about 31 gr. About an h. after sharp pain in front of1. ankle, as ifjoint had been wrenched or " turned " (which it was not). No other symptoms. (J. P. SUTHER- LAND, M.D., Ibid.) 6. At leisure hours I took C. from the 4x trit. down to gr. doses, repeating each trit. 5-7 times before proceeding to the next in strength, and always allowing an interval to elapse to make sure of the expiration of drug-effect before taking the drug again. During all these weeks of proving and watching for effects, I am quite sure that none whatever occurred except after doses off gr., after which there wastwice only a feeling of constriction of head, and of occipital pressure, lasting about 20 m. None of the functions were disturbed at other times ; in fact, I never was reminded, by any ill-feeling whatever, of having taken a medicine. (C. WESSELHOEFT, M.D. , Ibid.) II. Poisonings.-I . PREYER has observed, as effects of triturating the poison, rush of blood to head, with transient but very violent headache ; increased secretion of nasal mucus and saliva ; bitter taste ; remarkable weariness. From getting a few drops of solution into a cut on the finger, lachrymation ; constant flowing of nasal mucus ; mouth unable to hold saliva ; a very unusual secretion of urine ; the whole body covered with sweat. As effects of emanations while evaporating a solution, headache. III. Experiments on animals.-1 . a. When small quantities are injected into veins, subcutaneous tissue, or lymph- sacs, or applied to a wound, certain uniform effects are produced. The animals sink down and die without convulsions. First the head falls, and then the limbs give way. Respiration grows weaker, and soon ceases. The animal is incapable of voluntary motion, and does not react upon painful irritation. The heart coutinues to beat vigorously in frogs even for d.,

while in warm-blooded animals it ceases somewhat sooner, the mucous membranes becoming livid, and dark colour of blood indicating death by asphyxia. b. Bernard and Kolliker have explained the chief effects of C. It does not paralyse the central motor organs ; but the seat of paralysis is to be sought in the intramuscular terminations of the motor nerves. Interrupted communication between motor nerves and muscular fibre, by C. circulating in the blood, renders all voluntary or reflex motion impossible. Frogs are simply paralysed, while warm-blooded animals die of suspended respiration. As the heart does not suffer from the poison, asphyxia and death can be prevented by means of artificial respiration. c. The heart's action is increased by paralysis of the terminal fibres of the vagi, hence it cannot be arrested by irritation of these nerves. The pupil does not dilate, nor is the saliva increased. The peristaltic motion of the intestines is undisturbed, and not arrested by irritation of the splanchnic plexus. The lymph-hearts of the frog are arrested in diastole. C. has no effect on muscular fibre itself; nor does it affect organs controlled by ganglia within their parenchyma. d. Besides the motor fibres, the secretory nerve-fibres are affected, as shown by profuse lachrymation, salivation and urinary secretion in warm-blooded animals maintained alive by artificial respiration. The urine contains much sugar, which appears as well in starving animals, whose liver contains no glycogen, as in those well nourished. The temperature is not increased, but, according to some observers, considerably diminished. (HERMANN ; from Wesselhoeft, loc. cit.) 2. a. C. paralyses peripheral ends of motor nerves, even when given in very small doses. Larger doses paralyse vagus and ends of sensory nerves. As poisoning progresses, spinal cord is paralysed, and finally heart. Voluntary muscles appear to be little affected, yet their contractility is somewhat diminished, and this diminution begins even before the motor nerves themselves are paralysed. The vessels of the surface become dilated, and sometimes a peculiar erythematous rash appears on the skin in dogs. The blood pressure is little affected by small doses, but is much lowered by large ones. When injected into salivary glands it causes intense salivation, which appears to be paralytic. Large doses produce death by paralysis of muscles of respiration, but, motor nerves of extremities being paralysed, no convulsions occur. Although the motor nerves are paralysed to such an extent that they will not excite muscular contractions, even when the nerve-centres are powerfully stimulated by asphyxial blood, they still cause muscular contractions when irritated by an interrupted current in a warm-blooded animal poisoned byC. In frogs the poisoning may be so complete that no irritation of the trunk of a nerve will excite contraction in the muscles supplied by it. b. C. is rapidly eliminated by the kidneys, and if artificial respiration be kept up, complete recovery occurs. I have succeeded in restoring an animal completely by this means after it had been apparently dead for 4 h. When given internally, C. is so rapidly eliminated that it usually produces no symptoms. When given in a very large dose on

an empty stomach, symptoms of poisoning may occur. * If elimination be prevented, in excision of kidneys or ligature of renal vessels, poisoning occurs, and in this case death is usually preceded by convulsions. (BRUNTON, op. cit.)

Volume II — Appendix

Curare-P. 491 , after " II. 1, " supply "(Ibid.) "