Amyl Nitrosum

, C5H11O2

Preparation for use , Dilution with alcohol.

Authorities. [ 1 , Jahresbericht d Dresden Gesellschaft, etc., 1871; 2 , "Practitioner," 9, 881; 3 , "Practitioner," 77, 213; 4 , "Practitioner," vol. 6, 12, seven experiments; 5 , Month. Hom. Rev., 1871, five experiments; 6 , Monograph, Berlin, 1874; 7 to 11 , provings in MS, made by olfaction, as were all the other experiments.] (Provings all made by olfaction.)

1 , Batteman; 2 , Madden; 3 , Jones; 4 , Goodhart; 5 , Blake; 6 , Fick; 7 , W. P. Wesselhoeft; 8 , T. F. Allen; 9 , St. Clair Smith; 10 , Hugh M. Smith; 11 , G. L. Freeman.

MIND

• Anxiety, as if something might happen; must have fresh air, 7.
• The throbbing in the head, and bursting-out feeling in the ears, and constriction of throat and heart, made me think I had too much, and from actual fright I ran to the window to breathe the fresh air, 9.
• Complete obliviousness of recent conversation (in a few minutes), 5.

HEAD

• Confusion of head, 11.
• After the throbbing and fulness of the head had passed away, it was followed by a confused, weak feeling and a weight in top of head, as though it would be crushed in, 9.
• Vertigo (rarely), 1.
• Vertigo (in three minutes), 5.
• Slight vertigo (in a few seconds), 5.
• Giddiness (now and then), 3. [10.]
• Slight dizziness in the head (in two minutes), 4.
• Head seemed to swim around (in a second or two), 5.
• Feeling of intoxication, 3.
• Girls who have inhaled it have often complained that it gave them a headache, 3.
• Heat and throbbing in head, 1.*
• Feeling of intense fulness in the head (immediately), 4.*
• Full, confused feeling in head, mostly frontal; then a beating, throbbing, and bursting sensation, 9.
• Heavy aching all through the head (in two minutes), 4.
• After all experiments, a dull aching remained in the head for more than thirty or forty minutes, 4.
• Frontal humming, 5. [20.]
• Slight perspiration over the forehead (immediately), 4.
• Perspiration broke out on forehead, 11.
• Bursting in the forehead (in three minutes), 5.
• Throbbing in temples ; visible pulsating, 10.
• Could feel the temporal arteries throb distinctly, 9.
• Sense of tension in temples, 2.
• Vertical humming (in twenty-five seconds), 5.
• Sensation of something rushing upwards and throbbing in vertex, 7.
• Constriction, as if each parietal region was pressed in, 10.
• Dull throbbing in sides and back of head, 11. [30.]
• Throbbing in the occiput, .

EYES

• Under ophthalmoscope, the arteries of the optic disk were found small, while the veins were dilated and varicose, 4.
• Under ophthalmoscope, the veins of the disk were seen to become enlarged, varicose, and tortuous ; the arteries small, but not abnormally so (from 5 minims), 4.
• Dull heaviness over eyebrows, 8.
• Conjunctivæ bloodshot (in two minutes), 4.
• Dilated pupils, 1.
• Sight very hazy (in fifty seconds), 4.
• In full doses of 8 or 10 drops, the sight becomes impaired slightly, and the outline of objects hazy and indistinct, 4.
• Primrose halo, even with the eyes closed and shaded, 5. [40.]
• Objects begin to look yellow, 5.
• Protruding, staring eyes, [°].*

EARS

• Burning of the ears, 2.
• Much throbbing in ears (in two minutes), 4.
• Ears begin to throb (in a second or two), 5.
• Beating behind ears, 5.
• Sensation of a piston working up and down in the ears (in thirty seconds), 5.
• Bursting sensation in ears, as though the membrana tympani of each ear would be forced out with each beat of the heart, 9.

NOSE

• Pressure over root of nose, 9.

FACE

• Face scarlet (immediately), 4.
• Deep facial flush (in twenty-five seconds), 5. [50.]
• *Flushing of the face (in thirty to forty seconds), 3.
• Face much flushed, 4.
• A bright florid flush spread over his face (in a few seconds), 5.
• Flushing of the face, followed by turgidity to the facial veins, 5.
• The flushing of the face did not commonly appear till from fifteen to thirty seconds after the commencement of the inhalation, 4.
• Intense surging of blood to face and head, 8.*
• Face at first very red; a few minutes after, pale, 9.
• Face became intensely red and hot; this came up and subsided like a wave; on passing off, the face became paler than usual, 8.
• Heat and redness of face, 11. [60.]
• Great heat and redness of face, with sensation as though the blood would start through the skin , with lachrymation, 9.
• Warmth of face, 3.

THROAT

• Choking feeling in throat, on each side of the trachea, along the carotids; feeling of constriction, 9.*
• The collar seemed too tight, with desire to loosen it, 9.*
• Tickling in throat, 1.

STOMACH

• Nausea, 8.
• Slight nausea, 11.
• Slight uncomfortable feeling in stomach, 8.
• Constriction and pressure over præcordial region, as though he wants to rub it, 8.

RESPIRATORY APPARATUS

• The feeling of constriction in throat extended to chest, and produced dyspnœa and asthmatic feeling in larynx and trachea , with desire to eructate, 9.* [70.]
• Peculiar sensation of choking, 5.
• The respiration were not altered in frequency, but in all cases great inclination to cough was experienced, with an indescribable feeling of fulness about the chest, 4.
• Cough and bronchial irritation, 2.
• Much cough (in fifty seconds), 4.
• Involuntary coughing (in two minutes), 4.
• Breathing 24, from 20 (in two minutes), 5.
• Normal respiration, 18; after ninety seconds, 20; after one hundred and fifty seconds, 20, 5.
• Normal respiration, 16; after ninety seconds, 20; after one hundred and fifty seconds, 20, 5.
• Respiration much easier and deeper, apparently dependent on dilatation of the bronchi (inhalation of 1 drop), 6.
• Accelerated respiration, 2. [80.]
• Desire to sigh convulsively (in thirty seconds), 5.
• Slight dyspnœa, with inclination to cough (immediately), 4.
• It sometimes causes a little breathlessness and coughing, 3.

CHEST

• Vital capacity (spirometric) of the lungs not increased nor diminished (average of large number of experiments), 6.
• Sensation as if the anterior wall of the thorax were swelled out to a convex shape, and the lower end of the sternum made a deep depression, bent in towards the spine (without objective signs of contraction of diaphragm or abdominal muscles), 2.
• *Præcordial anxiety (in thirty seconds), 5.

HEART AND PULSE

• *The beating of the heart and of the carotids is, in some persons, very marked, 3.
• Accelerated heart-action (in thirty seconds), 5.
• Increased frequency of cardiac pulsation, 3.
• Cardiac oppression and tumultuous heart-action (in a few minutes), 5.* [90.]
• Tumultuous heart-action, 2.*
• Pain and constriction around heart ; an aching pain, 9.*
• The aching pain and constriction of the heart continued more or less for at least three weeks, when it was relieved after taking

Cactus grand., 9.

• Dull pain in heart, 8.
• (Pulse not markedly affected, 8 .)
• In all cases, the pulse was invariably the first function to show any indication of the action of the drug.
• Generally, in from three to ten seconds, the beats were much increased in frequency.
• The pulse-beats often rose from 70 to the rate of 160 per minute in a few seconds, quickly subsiding again as the drug was left off, but nearly always remaining somewhat irregular, 4.
• When sphygmographic tracings were made, it was found that in the very first stage of its action, the up stroke produced by the contracting ventricle was almost imperceptible, giving unpleasant visions of approaching syncope.
• This feature was apparently due to the excessive rapidity of the heart's action, and was succeeded, in a very few beats, by a sudden and jerking impulse, which gave no positive indication of anything more than an exaggeration of normal conditions, 4.
• The sphygmographic pulse-curve ends abruptly in a very sudden downfall, 4.
• Frequency of pulse rapidly increases (in eight to twelve seconds), 3.
• Accelerated pulse; 96 to 136; in one minute, small; in two minutes, full; three minutes, very full, 1.
• A pulse of 20, in a quarter of a minute, will often rise, in ten or fifteen seconds, to 40, 3. [100.]
• Pulse rose from 66 (normal) to 114 (inhalation of 3 drops), 6.
• Pulse rose from 72 (normal) to 128; returned, in two minutes, to normal.
• (The face became very red), 6.
• Pulse 136, regular (normal, 54), (in two minutes), 4.
• Pulse 80, very irregular (in four minutes), 4.
• Pulse 72, more regular (in seven minutes), 4.
• Pulse 80, regular (in thirty-one minutes), 4.
• Pulse 65 (in half a minute), 4.
• Pulse 72, irregular (in four minutes), 4.
• Pulse 64 (in twenty-three minutes), 4.
• Pulse decreased 64 beats (from 168 to 104), (in two minutes), 4. [110.]
• Pulse 80 (in seven minutes), 4.
• Pulse 160, from 120 (in thirty seconds), 4.
• Pulse 104, from 84 (in ten seconds), .

NECK AND BACK

• Warmth of neck, 3.

EXTREMITIES IN GENERAL

• Tired feeling of limbs, 7.*
• Muscular tremor of arms (in two minutes), 4.
• Tremulousness of hands and stiffness and slight numbness of fingers, 7.*
• While writing, hand so tired that he can hardly hold the pen, with crampy feeling in wrist and thumb, which is sometimes difficult to overcome; the thumb seems to grasp the pen so tight that it is difficult to guide it (it is now over fifteen minutes, and the effect is still very strong), 9.

GENERALITIES

• The muscles generally seemed relaxed and heavy; this caused a sensation of unsteadiness while walking (inhalation of 1 drop), 6.
• The blood-pressure is diminished, 4. [130.]
• Slight feeling of lassitude (in seven minutes), 4.
• After all experiments, a feeling of lassitude remained behind for thirty or forty minutes, 4.
• General relaxed, weak feeling over the whole body, 9.*
• Weak feeling all over the body, 10.
• Uncertain, trembling sensation over whole body, 9.

FEVER

• Warmth, often general, 3.
• Temperature 97.9°, from 97.7° (immediately), 4.
• Temperature 98.1° (in four minutes), 4.
• Perspiration, often general, 3.*

SUPPLEMENT: AMYL NITROSUM. Authorities.

12 , Dr. Kelp, Deutsche Archiv für Klin. Med., 1875, vol. xv, p. 602, effects of inhaling 5 drops on cotton, in a case of melancholia; 13 , Dr. Aug. Ladendorf, Berliner Klin. Woch., No. 43 (Lond Med. Med. Rec., vol. iii 1875, p. 18); ( 14 to 26 , C. Wesselhœft, M.D., New Eng. Med. Gaz., vol. xi, p. 388); 14 , C. E. H., M.D., proving by inhalation; 15 , Mr. L. A. P., same; 16 , Mr. W. R. B., inhaled 1st dec. dil. three times at intervals of five minutes; 17 , Miss M. M., proving by inhalation; 18 , Miss A. E. S., same; 19 , Mr. E. B. H., took internally 2d cent. dil., took 1 drop, and after thirty minutes 3 drops, after another thirty minutes 3 drops again, the next day 10 drops, after an hour 20 drops, the next morning 40 drops; 20 , Mr. H. E. R., took 2d cent. at 1.15, 3 and 3.30 P.M., 2 drops at 4 P.M., diluted medicine and took 3 drops at 4.30 P.M., 4 drops at 5 P.M.; 21 , Miss A. W. S., took 1 drop 2d cent. at 1.30 and 3 P.M., 2 drops at 5 and 9 P.M.; 21 a , same, two days later, took 5 drops at 3 and 7.45 P.M.; 21 b , same, five days later, took 10 drops; 21 c , same, effects of inhalation; 22 , Mr. L. A. P., took 3 drops of 2d cent at 7, 8 and 10 P.M. (first day), same at 9 A.M. (second day); 23 , L. G. H. R., took 2 drops of 2d cent. in a half a spoonful of water, at 1.45 P.M.; and at 3.17 P.M.; 24 , Mr. H. P. C., took 1 drop at 3.30 P.M., 3 at 5 P.M., 6 at 7.30 and 9.30 P.M. (first day), 10 at 10 A.M. (second day), 15 at 4 P.M., 20 at 4.30 P.M.; 40 at 5.15 P.M. (sixth day); 25 , Miss A. E. S., took 3 drops 2d cent. in about three tablespoonfuls of water, a spoonful at 7, 7.15 and 7.30 A.M., put 12 drops in half a glass of water, and took 2 teaspoonfuls at 2.30, 2.45 and 3 P.M.; , M. M., took 1 drop 2d cent. at 2.35 P.M.; , A.M. Cushing, New Eng. Med. Gaz., vol. xi, p. 408, inhalation of 1st dec. atten.; , Dr. Morrison. Month. Hom. Rev., 1877, p. 302, symptoms caused by evaporation from a two drachm glass-stoppered bottle, which had been shaken in the morning; , N. F. Cooke, Cincin. Med. Advance, 1878, p. 269, effects of two strong inhalations from a vial containing 4 ozs. of the crude.

HEAD

• Vertigo.
• Dizziness, 7, 10 ; (after seventeen and a half), 25. [140.]
• Vertigo on rising in the morning (second day), 22.
• Dizziness and nausea (immediately), 15.
• Decided dizziness and heaviness of the head (after thirty-five minutes), 26.
• Dizziness, with slight nausea, worse when the eyes are closed (after first dose), 22.
• General Head.
• Great rush of blood to head and face, 17.
• Head heavy (in three hours and a half), 21.
• Dulness in head (after two hours), 23.
• Violent exercise during one minute produced a dull headache (thirty-six minutes after 40 drops), later the influence of heat (closet heated by gas) caused the dull pain to extend from temple to occiput, principally ; the dull pressing feeling in occiput remained two or three hours, 19.
• Headache and nausea on rising in the morning (second day), 22.
• Pressure (very slight) in head, forehead, and temples especially (twelve minutes after 40 drops); pressure slightly increased (seven minutes later), 19. [150.]
• Feeling as though a band were drawn tightly about the head (after eight hours an a half), 25.
• Immediately an intense, crushing pain upon the head, which seemed to gather into a feeling of confusion, that for a moment threatened to make me unconscious. At that moment I became aware of a quick, somewhat sharp throbbing in the head, and an intense glowing of the face, with general perspiration, especially marked in palms of hands, where it was quite visible. There was also a sensation as though the scalp were jerked forward from the occiput towards the forehead, ceasing just before it reached that point; this was repeated a number of times. Was conscious of a dull headache for some time, perhaps three hours, 14.
• Forehead.
• Heaviness and pressure outward in forehead and temples (immediately); pain in head increased, accompanied by stupid, drowsy sensation and burning in the stomach, and up to the throat. During and after a walk of a mile, two hours after inhaling the drug, the heaviness and pressure in the head remain; entirely passed off two hours later, 15.

EYE

• Dull, heavy pressure over the eyes, as if a heavy weight were within (after first and fourth doses), 22.
• Dull pain over the eyes (after eight hours and a half), 25.
• Slight pain over both eyes (after ten minutes), 23.
• Aching pain in the eyes when in the sunlight, with profuse lachrymation, followed by sneezing (second day), 22.
• Pain back of eyes on looking at near objects (after three hours), 20.
• Sudden sharp pain under left eye (in five minutes), 21.
• A decided twitching under the outer canthus of left eye (after second dose), 24.
• Vision. [180.]
• Dimness of sight (sixth day), 24.
• Everything appears as if trembling, wavering (second day), 22.
• Slight blurring of letters when reading (thirteen minutes after 3 drops), 19.
• He confirms Pick's observation (also made by others) as to objects appearing yellow after inhalation, 13.

NOSE

• Constant desire to sneeze (after three hours and a half), 21.
• Catarrh and dysphagia (sequelæ of a recent attack of diphtheria) entirely relieved during the action of the drug, but returned after its effects had passed off, 22.
• Slight epistaxis from left nostril (after one hour), 14.
• Numb feeling in nasal bones, 16, 27.

FACE

• Face flushed, 7 ; (after eight days), 25.
• Face flushed and hot (in five minutes), 21. [190.]
• After a few minutes the face became very red, and the heart's action violent, the pulse rose 30 or 40 beats in a minute; this symptom disappeared in one or two minutes, 12.
• Burning sensation in face (after half an hour and two hours), 13.
• Burning of right cheek, extending up into eye, and around to right ear (after forty minutes), 26.
• Creeping in left cheek (after four hours), 24.
• In a few minutes a slight creeping sensation in right cheek, below malar bone, which was momentary; ten minutes later, twitching and creeping under left eye, also slight and momentary, 24.

THROAT

• Sensation in the throat, which produced a desire to cough, similar to that produced by the fumes of a burning match, 14.
• Awoke about 5 P.M., with an extremely dry and parched sensation in throat and mouth; arose to rinse my mouth with water, and in doing so, noticed a marked stiffness and dryness of the lips (second day), 20.
• Feeling of constriction of throat, as though it were closing up; relieved by motion, 27.
• Feeling of constriction in the throat, and sensation as if growing up, 16.
• Left tonsil considerably swollen and inflamed (after two hours), 20.

STOMACH. [200.]

• Loss of appetite (second day), 22.
• Eructations (after forty minutes), 26.
• Nausea (after seventeen hours and a half), 14.
• Slight nausea at first, and in ten minutes inclination to vomit, 16, 27.
• Fulness and pressure in stomach, with belching of gas, 15.
• Burning in stomach (after two hours), 22.
• Hot, burning sensation in stomach, with empty eructations (after first and fourth dose), 22.
• Crampy pains in epigastric region (after two hours), 22.

ABDOMEN

• Slight oppression near the liver (after second day), 24.
• Griping pain in umbilical region, 15. [210.]
• Crampy pains in umbilical region (second day), 22.
• Slight distension in the abdomen, with dull pain (after four hours), 24.
• Slight rumbling in the bowels (after fifteen minutes), 25.
• Bowels moved with a rumbling, leaving a feeling of emptiness afterward (after half an hour), 25.
• Slight griping pain in the bowels (after eight hours and a half), 25.
• Severe colicky pains in the abdomen, increased when lying down, (after first dose), 21a.
• Contraction of the muscles in the lower part of the abdomen, as though they were all being drawn together over the region of the uterus; the region of the uterus, fallopian tubes, and ovaries felt very hard on pressure (after seventeen hours and a half), 25.

RESPIRATORY ORGANS

• Hacking cough (five minutes after first inhalation, and again three-quarters of an hour after), 16, 27.
• Could hardly breathe for about a minute, 18.
• Oppressed, difficult, and rapid breathing; feeling as if a weight on the sternum, the oppressed breathing remained during and after a walk of a mile, two hours after inhaling the drug, entirely passed off two hours later, 15. [220.]
• Feeling of suffocation from palpitation of the heart, 17.

CHEST

• Oppression of chest on walking about (after four hours), 24.
• Sense of oppression in the chest, especially at the lower part of the sternum (second day), 22.
• Oppression at the end of the sternum on going downstairs (after two hours and a quarter), 24.
• A peculiar sensation in right lung or chest, not exactly a pain, however (soon), 20.
• Drawing pain in left side between the seventh and ninth ribs, but frequent (second day), 22.
• Slight, dull, aching pain in right chest (after one hour and a quarter); pain more severe (after two hours), 20.
• Sharp pain in region of heart, relieved by eructations, which continued several days, 16, 27.
• Pain in the left side in region of heart, extending around to the back (after two hours), 23.
• A short contraction at the left of the heart, ill-defined (after second dose), 24.

HEART AND PULSE. [230.]

• Stitching pain in the cardiac region and feeling of constriction, 15.
• Very violent palpitation, 21c.
• After exercise, palpitation of heart more violent than usual after same amount of exercise, 19.
• Beating of pulse distinctly felt in fingers (after one hour and a half), 23.
• Pulse accelerated (sixth day), 24.
• Pulse accelerated, full and hard (second day), 22.
• Pulse increased about twelve beats in the minute, but I was unable to count it at once, owing to the confusion of the head, 14.
• Pulse accelerated by 10 or 12 beats (fifteen minutes after first dose); rose 20 beats, remained so a few minutes, and then gradually fell to normal standard (twelve minutes after 40 drops), 19.
• Pulse 60 (after three hours), 20. [240.]
• Pulse accelerated from 60 to 72, hard and full, 15.
• Pulse 64, normally 70 (after second dose), 24.
• Pulse 83 (before taking medicine); 63 (in twenty-five minutes); 73 (after two hours); did not return to usual state for two days, 21b.
• Puls 63 (before medicine); 68 (after ten minutes); 65, not regular (after twenty minutes), 68 (after thirty minutes); 63 (after one hour and a half); 70 and irregular (after one hour and three-quarters); 65 (after two hours); 63 and quite full (after two hours and three-quarters), 23.
• Pulse not accelerated but irregular in action, almost impossible to count, 16, 27.

NECK AND BACK

• Stiffness and pain in right side of neck and right shoulder, extends down right arm to wrist, neuralgic or rheumatic in character (in five minutes); pains return (after three hours and a half), 21.
• Twinges near the dorsal vertebræ (after two hours), 24.
• Pain and weakness in lower lumbar region, in the morning (second day), 21a.

EXTREMITIES

• Trembling of the limbs, with feeling of weakness, 17.
• Weakness in the limbs, 21c. [250.]
• Lameness and soreness of muscles of arms and thighs entirely cured, perhaps by time, 22.
• Soreness of extensor muscles (after four hours), 24.
• Uneasy feeling in extremities (after half an hour), 23.

SUPERIOR EXTREMITIES

• Slight discomfort in right shoulder (after twenty-seven minutes), 26.
• Lameness of flexor muscles or right arm (after forty-five minutes), 26.
• Pain and stiffness in right arm, particularly near wrist, much increased by motion; effort of bending the arm or of writing very painful (after one hour and a half), 21.
• Drawing, tensive pains in the wrist and finger joints of left hand, 15.
• Pulsations distinctly felt in the tips of the fingers, 15.

INFERIOR EXTREMITIES

• Stiffness in lower limbs (in three hours and a half), 21.
• Rheumatic pains in left leg and knee, followed by soreness in right arm and shoulder; then lameness in right scapula (after four hours), 24. [260.]
• Sharp pain in the calf of the left (after eight hours and a half), 25.

GENERALITIES

• Ladendorf and Dr. O. J. B. Wolff investigated the action of Nitrite of amyl on blood by microscopic examination. A drop of freshly drawn blood was placed on a slide under the objective, and a little spill of wood moistened with Amyl nitrite approximated. When the spill was 1.5 to 2 millimeters (1/16th to 1/13th inch nearly) distant from the blood-drop, there immediately occurred, independently of the movements of the blood-fluid, a violent agitation of the blood-corpuscles in the neighborhood of the spill; moving rapidly away from it, and returning, rather less quickly, to their old place, in a curved line, and then madly hastening (sic) to begin the same game again. Simultaneous experiments with indifferent bodies gave only the ordinary physical movements. The direct contact of the Amyl nitrite is said to have produced solution of corpuscles, with formation of lakelike pigment (color of winter cherry). The vapor first made the corpuscles pale, then dissolved them. Ladendorf did not employ a moist chamber; but he ascribes the whole of the effects of Amyl nitrite to this action on the blood-corpuscles, causing a backward pressure on the pulmonary arterial system first, and then on the systemic, finally inducing venous congestion as a natural consequence, 13.
• Immediately felt a sense of fulness of head and flushing of face, which increased during one minute to positive agony, without pain; a violent palpitation of the heart now began, which shook the whole body; consciousness was still perfect, and there was no feeling of alarm. I now felt myself sinking to the floor, which seemed a voluntary act, for I eased my descent by means of two tables between which I was standing, lowering myself gently until stretched at full length; my last conscious act was the endeavor to hold the head erect lest the surcharged cerebral vessels should become yet fuller. My first act of returning consciousness was to recognize my attendant, who was giving me Chloroform. Not five minutes elapsed between the first inhalation of the nitrite and complete restoration, complete save for anæsthesia at the second phalanges of the middle and ring fingers of the left hand. This symptom continued about one hour. I was informed that my "face and eyes were a deep, livid red color" and that I "looked horribly," 29.
• Entering the room at 10.25 P.M. I noticed the pungent odor of the nitrite . The effects were: An increasing sense of stupefaction, with flushing of the face and scalp. A sudden smarting of the conjunctivæ with injection of the ocular conjunctivæ, and dimness of vision as if caused by a film. Subacute smartings in præcordial region; then in right renal region; then in right axilla: then at mid-sternum; then in lumbar region; then in lower lobe of right lung, at apex of the heart, and in lower lobe of left lung, with tenderness on pressure. Increasing dyspnœa, with sneezings, nasal catarrh, and sighing respiration. Pulse (sitting) 68, small, feeble. The smartings changed position rapidly, being most persistent in the eyes, bases of the lungs, and spine. After enduring the increasing discomforts for some twenty minutes, respiration became a series of gaspings, whereupon I beat a retreat (first day). On awaking the pains returned with increased intensity, especially in spine, lungs, and conjunctivæ; with shifting pains, caused by movement, on dorsal surface of right hand, on left patella, and from left thumb to axilla; with catarrhal symptoms, and severe fronto-orbital cephalalgia. Many of these symptoms returned, with varying intensities during the day; at times accompanied by sighing respiration. They were intensified by the odor of being again inhaled. Urine clear, acid; sp. gr. 1014; free from albumen and phosphates; light cloud of an oxalate (probably lime), and distinct traces of sugar. Pulse (sitting) 78 to 84, feeble (second day). During morning a dull aching in cervical region, which gradually moved to suboccipital region, and then passed away. During the evening, smartings in the eyeballs, with injection of the conjunctivæ. Urine clear, acid; sp. gr. 1020; traces of oxalates and sugar in marked quantity (third day). After rising, sneezed violently three times; severe occipito-frontal headache, felt mostly in suboccipital region; smarting of the conjunctivæ and weakness of vision. Urine clear, free, acid.; sp. gr. 1016; saccharine. Pulse (sitting) 80; general lassitude (fourth day). Occipito-frontal headache, with achings in right renal region: smartings of conjunctivæ. Urine clear, free, acid.; sp. gr. 1020; saccharine (fifth day). Severe occipito-cervical achings, with increased frequency of the renal achings; smartings of conjunctivæ. Urine clear, free, acid.; sp. gr. 1020; abundance of sugar. Pulse (sitting) 70, regular (sixth day). Constant occipital headache, and achings across loins. Urine clear, acid.; sp. gr. 1018; less sugar (seventh day). Achings remain, with weakness of eyes, and smartings of conjunctivæ. Urine clear, acid.; sp; gr. 1016; traces of sugar (ninth day). Slight occipital headache, and smartings of conjunctivæ; returns of loin achings on waking, and on lying down at night. Urine clear, acid.; sp. gr. 1018; traces of sugar (twelfth day). Remains of suboccipital and loin achings, increased by fatigue. Urine clear, acid.; sp. gr. 1012; mere trace of sugar. Pulse (sitting) 66, regular, feeble (nineteenth day). Weakness of vision persists. Urine clear, acid.; sp. gr. 1014; traces of sugar. Pulse (sitting) 68, regular (fortieth day). The achings mentioned were increased by fatigue, and were most marked during the evenings, .

SKIN

• He advises the lips, nostrils, etc., to be guarded from direct contact, as vesication is apt to arise if they are not so protected, 13.

SLEEP

• Drowsiness (second day), 22.
• Very drowsy (after forty minutes), 26.
• Confused and drowsy (sixth day), 24.
• Overpowering drowsiness, lasting more than an hour (after first dose), 21a.
• Sleep restless, full of anxious dreams; frequent waking, with severe pain in temples and in the stomach and bowels (first night), 22.

FEVER

• Slight chill crept over the back and sides (sixteen minutes after 20 drops), 19.
• His observations embracing more than forty cases, were made partly upon same persons, and partly on those recovering from different psychoses. The time selected was generally from 3 to 5 P.M. or after 8 P.M. The thermometer was placed in the mouth, between the cheek and the superior maxilla. The general result is, that the temperature always rises after the inhalation. Many circumstances affect the amount of this rise, such as the quantity of vapor inhaled, the surrounding atmosphere, the contraction of bloodvessels, individual peculiarities, etc.; so that two persons with the same initial temperature may show differences of 0.53°. Cent. It is interesting that this rise can generally be demonstrated for from one to two hours. A table of thirty-six cases is given; the smallest maximal elevation was 0.1 eventually (in three cases) cases); the highest maximal rise was 1.88°. Cent (one case); the mean rise was 0.39°. Cent (thirty-six cases). This elevation is very evident in the course of the second minute of inhalation. The purer the preparations inhaled, the more evident the effect. The effect on his pupils was not very uniform. In all cases when simultaneous observations were made, the axillary temperature rose correspondingly, 13. [280.]
• Hands moist, head and body felt warm, especially the abdomen (thirteen minutes after second dose); greater warmth especially in the chest (thirty minutes after second dose); heat was felt in head and along œsophagus to stomach; heat remained over half an hour (five minutes after 10 drops); heat was experienced principally in stomach; skin moist (ten minutes after 20 drops), 19.
• Redness and heat of head, face, and neck, with violent throbbing in top of head and carotids, 16.
• Heat in face, 21c.
• Slight heat in face (after twenty minutes), 23.
• Heat and redness of face (immediately), 15.
• Marked feeling of heat in face, with flushed face (after three-quarters of an hour), 23.
• Heat in left ear (after forty-five minutes), 26.
• Profuse perspiration on hands, 21c.
• Skin moist, free perspiration during moderate exercise (second day), 22.
• Though not warm perspiration started freely, cold chills at the same running down my back, 15.

CONDITIONS

• Aggravation.
• ( Morning ), On rising, vertigo; headache; nausea.
• ( Heat of room ), Pain in occiput.
• ( Lying down ), Griping in abdomen.
• ( Motion ), Pain and stiffness in arm.
• ( Writing ), Pain in occiput.
• Amelioration.
• ( Eructations ), Pain in region of heart.
• ( Motion ), Constriction of throat.