Atropinum Sulphuricum
By Constantine Hering — The Guiding Symptoms of our Materia Medica
Alkaloid from Atropa Belladonna. C 17 H 23 NO 3 .
Is most commonly used or abused by ophthalmologists to dilate the pupil. See Sickel, British Quarterly, 1868, vol. xxvi, p. 672, and Norton, in New York J. M., vol. i, p. 365, 1873. Hence seventy symptoms are marked '(In sick :)', such being observed on patients. A good proving by Kafka may be found in the British Quarterly, vol. xv, page 238.
MIND [1]
Unconsciousness. θ Puerperal eclampsia. θ Epilepsy.
(In sick :) Appears profoundly intoxicated.
(In sick :) Complete unconsciousness of all preceding events.
(In sick :) Mind confused, commenced a sentence and forgot what she wished to say.
(In sick :) Incoherent in observations, while thoroughly wakeful.
(In sick :) She insisted repeatedly that her blood did not circulate, and that her feet must be put into warm water or she should die.
Slight delirium ; picking and other motions of hands and fingers in air, as if they came in contact with real objects.
(In sick :) All day wakeful and partially delirious.
(In sick :) Delirium alternating with stupor.
Spectral illusions.
(In sick :) Hallucinations of hearing and vision.
(In sick :) Frenzied with excitement and frantic in her appeals.
(In sick :) Laughed in an idiotic manner.
Muttering and smiling.
Rambling speech.
Mirthful humor.
Sad and morose, prefering solitude and a dark room to society of friends. θ Epilepsy.
Great fear and anxiety. θ Diseased pancreas.
(In sick :) Began to quarrel incoherently with his supporters.
Exaltation of brain and spine, followed by prostration.
Violent stitches in base of brain, above eyes and in temples.
Languor of body and mind, rendering incapable of active bodily or mental exertion.
SENSORIUM [2]
Giddiness, heaviness and drowsiness, or actual somnolency.
(In sick :) Sense of giddiness, figures on carpet would at times appear double.
(In sick :) Head dull and confused.
INNER HEAD [3]
Aching pain in forehead for two hours.
A slight feeling of pressure under parietal bones.
Headache and great weakness. θ Diseased pancreas.
Head attacked after puerperal epilepsy.
Meningitis, cerebritis of tuberculous cases ; diseases of cerebral membranes and hydrocephalus acutus.
SIGHT AND EYES [5]
(In sick :) Everything appears large and with a red halo.
(In sick :) During evening eyes of an attending lady seemed to her very large, and she could not avoid looking at them.
Motes before eyes.
(In sick :) Through night several times a vision of great numbers of white flies on door, which was white ; she requested that they would be brushed off ; the flies were not moving and rather smaller than the common house fly ; continued on closing eyes until noon of the following day.
(In sick :) Annoyed by appearance of a large black bug, with veritable legs, a few inches below a black door-knob.
(In sick :) The next following morning, imagining she saw a worm, a "thousand-legged worm" on her carpet, she sprang out of bed, and was found trying to find it ; failing in this she would look in another place and see it again ; this illusion kept her busy before fully satisfied of the fallacy ; the color of worm was brown, same as predominant color in carpet.
(In sick :) The large figures on the carpet appeared to her constantly and successively rising up to her face.
(In sick :) Perpendicular diplopia, the apparent object below the real one.
Dimness of vision remains, unable to thread a needle or even to read.
(In sick :) Vision was much impaired.(In sick :) She could scarcely see at all with left eye, very little with the right, which was intolerant of light, and seemed to throw out streams of light.
Pupils unchanged for two weeks.
(In sick :) Right pupil contracted, left five times increased in size (after dropping it in this eye) ; only a slight trace of iris visible.
(In sick :) Pupils on side of injection greatly enlarged.
Increasing dilatation of pupils ; pupils after two hours reach the maximum of dilatation.
(In sick :) Pupils enormously dilated, irides hardly visible, very refractory when any attempt was made to examine them closely.
Dilatation of pupil from paralysis of oculomotor nerve, or from any other cause, is often aggravated by it.
Pupils not unusually dilated, but perfectly immovable.
The usual very large doses are dangerous when there are any suspicions of glaucoma, such as dilated pupil, severe pain, sudden increase of presbyopia, etc.
Iritis, except with too great intensity of inflammation, after nitrate of silver or cold applied to eye ; as soon as there is any sign of exudation, or if pain becomes very severe, and has not been controlled by remedies, commence it immediately and increase dose until it dilates pupil sufficiently.
Prolapsus of iris after hurts of cornea ; if horizontal position, shutting lids and sudden opening in bright light is not sufficient.
Left to himself he did not drop into coma, as those who have taken opium, but would occasionally open his eyes with a vacant, amaurotic expression, and turn his head from side to side.
Deep ulcers in centre of cornea, which may perforate ; to prevent iris from being drawn into opening.
Evil results of conjunctivitis, keratitis, chromopsia, amaurosis.
(In sick :) Looking into a mirror she observed a strange appearance of her eyes, as though they projected from their sockets.
Rolling eyes. θ Puerperal eclampsia.
(In sick :) Eyelids felt heavy and difficult to keep open, and yet no inclination to sleep.
Pain in and over eyes. θ Before epilepsy.
Supraorbital and orbital neuralgia.
HEARING AND EARS [6]
Ringing in ears.
(In sick :) Morbidly sensitive to sounds and objects ; with symptoms akin to early stages of meningitis.
SMELL AND NOSE [7]
Occasional dryness of Schneiderean and conjunctival mucous membranes.
UPPER FACE [8]
Sensitiveness of side usually affected, with some swelling ; some stages painful two days after.
(In sick :) Face hot and very red.
Deep red distorted face. θ Puerperal eclampsia.
Suffering appearance, without great paleness. θ Diseased pancreas.
Paleness of face.
Deathly pallor. θ Gastric disturbance.
LOWER FACE [9]
Parched lips.
(In sick :) Short but intense pains in one or the other lower jaws, and return of the usual prosopalgia ; after three days.
Bloody foam at the mouth. θ Puerperal eclampsia.
TEETH AND GUMS [10]
Gnashing of teeth. θ Puerperal eclampsia.
(In sick :) Teeth ceased to ache in two hours.
TASTE, SPEECH, TONGUE [11]
(In sick :) Pappy taste.
Taste bad, without any peculiar character. θ Pancreatic disease.
(In sick :) Difficult articulation.
(In sick :) The tongue seems partially paralyzed, articulation indistinct, rapid and chattering.
Could not speak a word for dryness in mouth ; tongue nearly adherent to roof of mouth.
Complete dryness of tongue, roof of mouth and soft palate, extending more or less down pharynx and larynx.
Tongue hard, parched and cracked. θ Typhus.
Tongue becomes covered with white fur ; after two hours.
(In sick :) Furred tongue ; 3d day.
His tongue was thickly coated.
Tongue a little loaded. θ Pancreatic disease.
INNER MOUTH [12]
(In sick :) Great dryness of mouth.
Dryness of mouth after two hours suddenly gives way to a viscid, acrid secretion of a peculiar and very highly offensive odor.
Mouth becomes foul and clammy ; after two hours.
A gradually increasing feeling of dryness of mouth and throat, increasing during one hour so that he could not speak a word ; after two hours.
PALATE AND THROAT [13]
(In sick :) Feeling in mouth and throat was such she thought she "could not swallow," and when impressed with the necessity of so doing she drank with avidity the warm water offered, though at first it seemed quite difficult.
(In sick :) Refuses obstinately to swallow anything or to answer questions in any way than by a grunt.
Swallowing appeared to give pain, manifested by grimaces and increased spasms of facial muscles.
Difficulty of deglutition from dryness extending down pharynx.
(In sick :) Took fluid food well next morning.
(In sick :) Could swallow soup, but no solids ; thickened gruel would not go down.
Throat dark red. θ Epilepsy.
APPETITE, THIRST. DESIRES, AVERSIONS [14]
Appetite often considerable, sometimes absent, with vomiting of ingesta.
(In sick :) Devouring ravenously a large slice of dry bread ; at 5 A. M.
Appetite very small, although now and then hunger is felt. θ Diseased pancreas.
Thirst after vomiting.
EATING AND DRINKING [15]
Compelled to take a glass of water ; dryness and general feeling of illness left.
Appetite is good, but as soon as she has eaten, nausea supervenes, with pressure at stomach, constant retching and empty eructations, followed by an emptying of contents of stomach.
Whenever he took breakfast he was seized with vomiting in the afternoon. θ Diseased pancreas.
Immediately after eating he was usually seized with weight and pain at epigastrium, with frequent sour eructations, retching, followed soon by vomiting of ingesta, which, without admixture of blood, or any other foreign material, was so acid as to set his teeth on edge.
After each meal pressure and pinching in stomach, retching, soon followed by vomiting of food taken ; if stomach has emptied itself, mostly free from pain.
HICCOUGH, BELCHING, NAUSEA AND VOMITING [16]
Nausea and retching with uneasiness of stomach, which increased to a pressing, sticking, contractive pain and continual belching.
Throws up all she takes. θ Gastric disorder.
Vomited all he took, whether solids or fluids, sweet or salt, little or much.
The matter vomited is not acrid, but is merely the food she has just taken.
(In sick :) Relieved of her distress after vomiting, produced by copious draughts of warm water.
The vomiting was seldom attended with nausea, it came after a short exacerbation of pain quite suddenly, often extremely violent, never followed by retching ; pain lessened afterwards. θ Diseased pancreas.
Vomiting, appears sometimes in evening between 6 and 7 ; then in night between 11 and 1 o'clock ; regularly five, six hours after a full meal. θ Diseased pancreas.
Eating no dinner he remained without vomiting until evening. θ Diseased pancreas.
Vomiting consisted of a red liquid, like washings of meat, in which food appeared when a meal had been taken five hours before. θ Diseased pancreas.
Once the substance vomited was mixed with blood. θ Diseased pancreas.
SCROBICULUM AND STOMACH [17]
Fluttering sensation in cardiac region.
Uneasy sensation in stomach, with frequent empty eructations, affording no relief.
Region of stomach very sensitive to pressure ; no organic change discoverable.
In region immediately below stomach, to left, pains not so violent as unendurable, could not describe them. θ Diseased pancreas.
Deep pressure on region below stomach, to left, is very painful, but no swelling to be felt. θ Diseased pancreas.
In region of pylorus, close to umbilicus, towards right side, a tumor nearly size of a fist, yielding some resistance, very sensitive to touch, movable, easily pushed aside, and yielding a dull sound on percussion. θ Gastric disorder.
HYPOCHONDRIA [18]
(In sick :) Great distress in epigastrium, seemed indescribable.
ABDOMEN AND LOINS [19]
Abdomen swollen, tense, tympanitic, upon firm pressure signs of suffering.
Neuralgia of peritoneum, of long standing ; as an ointment.
STOOLS AND RECTUM [20]
(In sick :) Slight action of bowels next day.
(In sick :) Bowels worse on second day in evening ; stool pappy, painless, usual color.
Diarrhœa, alternating with confined bowels. θ Diseased pancreas.
Bowels relieved once in two, three days. θ Gastric disorder.
(In sick :) During stool, felt badly, weak, terribly nervous, with general sweat.
URINARY ORGANS [21]
(In sick :) Compelled to urinate every ten, fifteen minutes, without pain, at night between 10 and 1 o'clock ; quantity profuse and almost colorless.
Involuntary, but scanty discharge of urine.
Urine normal, with gastric disorder.
(In sick :) Passed very little urine, next day.
Inability to pass his water ; a day after in drops and with difficulty ; 2 weeks.
(In sick :) Partial paralysis of bladder, requiring use of catheter.
No water passed since evening preceding ; bladder not distended.
Chronic albuminuria.
FEMALE SEXUAL ORGANS [23]
Ovarian neuralgia.
Pain in ovary extort screams. θ Epilepsy.
Severe cutting or drawing pains in left ovary, screams, has to bend. θ Puerperal epilepsy.
Pain in left ovary, which was swollen and tender during menses. θ Epilepsy.
Menses light in color and scanty. θ Epilepsy.
Severe headache previous to menses, beginning in occiput, passing over right side of head, locating in or over eyes, increases until an attack of epilepsy sets in.
PREGNANCY. PARTURITION. LACTATION [24]
Mother of seven children, in each pregnancy about 3d month : severe cutting or drawing pain in left ovary, extorting screams, caused to bend to that side ; afterwards head attacked and epileptic convulsions follow ; these attacks are more frequent and severe until a day or two before labor, Almost continuous. θ Epilepsy.
After-pains after normal birth of a primipara ; violent convulsions ; unconsciousness ; deep red distorted face ; rolling eyes ; gnashing of teeth ; bloody foam before mouth ; bending in of thumbs ; throwing about limbs ; on remission stretching of body and deep sopor.
VOICE AND LARYNX. TRACHEA AND BRONCHIA [25]
Voice husky from dryness, extending to larynx.
Dryness of larynx often induces dry cough and difficult deglutition.
RESPIRATION [26]
Breathing remains tranquil.
No stertorous breathing.
Occasionally heaving a deep sigh.
(In sick :) Sensation of choking.
COUGH [27]
Cough following epilepsy, occurring at catamenia.
HEART, PULSE AND CIRCULATION [29]
Failure of heart's action from chloroform or other cardiac paralyzers.
A slight throbbing or heaving sensation in carotids.
Acceleration of pulse from 20 to 70, with a slight increase in its volume, and a considerable increase in force of cardiac and arterial contraction.
Pulse 80 to 88, with gastric disorder.
(In sick :) Pulse 108 morning after second night, while perfectly rational.
(In sick :) Pulse very quick, but of good volume.
(In sick :) Pulse accelerated to 120, with increased tone but diminished volume.
Pulse 60, irregular, intermittent, weak.
Very weak pulse.
Pulse is observed to fall before moisture returns to mouth, resuming its ordinary rate.
Pulse small, constricted, 120. θ Peritonitis.
NECK AND BACK [31]
Constant burning pains in back, under sternum and in region of stomach. θ Gastric disorder.
A large portion of spine so sensitive that she cried out on pressure, turned pale, and was seized with nausea, belching and retching.
Painful affections from spinal irritation.
UPPER LIMBS [32]
Could not hold a vessel of fluid in his hands nor carry it to his mouth ; two weeks after.
Gouty affection of right wrist, with stiffness and want of feeling of fingers.
(In sick :) Hands cold ; after two hours.
Bending in of thumbs. θ Puerperal eclampsia.
LOWER LIMBS [33]
(In sick :) Continual dragging of legs when assisted, or rather held up, in walking.
(In sick :) Says her "limbs feel like sticks," and thought she could not use them to walk across room to sofa, but with aid she did so with considerable difficulty.
Œdema of legs. θ Albuminuria.
LIMBS IN GENERAL [34]
Hands and feet cold and covered with cold sweat. θ Peritonitis.
Upper and lower limbs always cold. θ Gastric disorder.
(In sick :) Numbness and heaviness in her limbs so great that she feared the results of going to sleep lest she should never awaken.
REST. POSITION. MOTION [35]
Bending : pain in left ovary better.
(In sick :) Even when supported, could not move a step, feet being too heavy, and feeling no bottom.
NERVES [36]
(In sick :) Involuntary movements of hands towards head.
(In sick :) Convulsive trembling of muscles of upper limbs.
Throwing about limbs. θ Puerperal eclampsia.
Different parts affected with spasms.
(In sick :) Subsultus tendinum.
Spasms increased when disturbed ; left to himself they came every two, three minutes.
Convulsions after meningitis spinalis cured by Bellad. ; remaining stiffness of lower limbs cured by Nux vom.
Epilepsy from ovarian irritation.
Some forms of epilepsy and chorea.
(In sick :) Malaise and staggers, lasting more than eight hours.
Staggering, or complete inability to walk.
(In sick :) Great helplessness, amounting to partial paralysis of arms and legs.
(In sick :) Could not rise, felt no bottom under his feet, staggered against the mirror.
Syncope from asthma or shock.
SLEEP [37]
Frequently a prolonged yawn when sitting still in a dull apathetic, or drowsy condition.
(In sick :) Restless night, with little sleep.
(In sick :) Broken sleep.
Nights restless, only sleep towards morning. θ Diseased pancreas.
Sleep was much disturbed on account of frequent gastric pains, which often occurred with great violence each night, especially when turning in bed.
(In sick :) At times during night, when nearly lost in sleep, she would suddenly start as if frightened.
Slept pretty well.
Could not be aroused at 6 A. M.
Drowsiness, or somnolency, with tendency to quiet dreams and delirium.
(In sick :) Somnolency with nervous startings.
Comatose, with clonic spasms of biceps flexor cubiti, and muscles of jaw ; limbs cold.
Deep sopor after puerperal eclampsia.
After vigorous efforts to arouse him, signs of consciousness.
TIME [38]
Towards morning : sleep.
6 A. M. : could not be aroused.
Morning : illusion of thousand-legged worm on her carpet ; pulse 108.
During day : slight action of bowels.
All day : wakeful and delirious ; passed but little urine.
Between 6 and 7 P. M. : vomiting.
Evening : the eyes of another lady seem to her very large, and she could not avoid looking at them ; diarrhœic stool.
Night : saw numberless white flies on a white door ; thick stool ; restlessness ; gastric pains ; sudden starting when falling asleep.
Between 10 P. M. and 1 A. M. : profuse, frequent urination.
Between 11 P. M. and 1 A. M. : vomiting.
TEMPERATURE AND WEATHER [39]
(In sick :) Feels faint and greatly in need of fresh air.
FEVER [40]
Slight elevation of temperature of surface, rarely exceeding one degree, still slighter of internal body.
A general diffusion of warmth throughout cutaneous surface.
(In sick :) Dry, hot skin ; 3d day.
Slight sweat.
Typhoid and septic fevers.
LOCALITY AND DIRECTION [42]
Right : eye intolerant of light ; pupil contracted ; tumor in side pyloric region ; ache side of head ; gouty affection of wrist.
Left : impaired vision of eye ; pupil increased five times in size : unendurable pains in region below stomach to side ; pain in ovary.
SENSATIONS [43]
Violent stitches in base of brain, above eyes and in temples.
Pinching : in stomach.
Burning : in back ; under sternum ; in region of stomach.
Aching : in forehead.
Neuralgia : in ovary.
Sticking, contractive pain : in stomach.
Pressure : under parietal bones ; at stomach.
Fluttering : in cardiac region.
Numbness : in limbs.
Dryness : of mouth ; of tongue ; into pharynx.
Uneasiness : in stomach.
Undefined pain : in and over eyes ; in jaws ; at epigastrium ; in ovary.
TISSUES [44]
Hyperæsthesia of some nervous branch of ophthalmic, auditory, olfactory, vagus and plexus solaris, of uterus and sphincter of bladder.
Rheumatic fever.
During last weeks, remarkable wasting. θ Diseased pancreas.
Much emaciated, from a gastric disorder.
Collapse of cholera.
TOUCH. PASSIVE MOTION. INJURIES [45]
Deep pressure : pain below stomach < ; abdomen worse.
Touch : tumor in pyloric region sensitive.
STAGE OF LIFE, CONSTITUTION [47]
Miss, æt. 24, since 5 years, headache before menses ending with epilepsy.
Blonde, slightly built woman, æt., 25, had three children ; since 5 years ; gastric disorder.
Unmarried woman, æt. 30.
(In sick :) Intelligent married woman, æt. 40, medium size, nervo-sanguine temperament, good health ; poisoned from using locally for toothache.
Unmarried woman, æt. 40, for six years vomiting after eating.
RELATIONS [48]
Antidote to Muscarine, or poisoning by mushrooms, especially dyspnœa.
Antidote to meconate of morphia, or any other salt of opium, especially where the heart's action is greatly diminished.
Atrop. sulph . is to be preferred in cases in which Bellad . does not act effectually and permanently.
(In sick :) For hours he was kept constantly on the move, and strong galvanic currents passed along nape of neck every fifteen minutes, irritating him in a great degree.