Gelsemium
By Timothy F. Allen — The Encyclopedia of Pure Materia Medica
[Not Gelseminum.]
Gelsemium sempervirens, Ait. (Gelsemium lucidem, Poir.; G. nitidum, Michx.; Bignonia sempervirens, Linn; Lisianthus sempervirens. Mill.).
Natural order , Loganiaceæ.
Common name , Yellow Jessamine.
Preparation , Tincture of the bark of the root.
Authorities.
1 , Dr. Henry took tincture, 30 drops first and third days, and then gradually increased the dose daily for one week, Inaug. Dissert., Phila. Hom. Coll., 1852; 2 , Dr. Joshua Stone took tincture, 6 drops first day, 50 drops fourth day, 50 drops eleventh day, Inaug. Dissert., Phila., ibid.; 3 , Dr. F. Bigelow took tincture, 20 drops daily for one week, Inaug. Dissert., Phila., ibid.; 4 , Dr. William E. Payne took fluid extract, 4 drops first day, 5 drops and 6 drops second day, 6 drops third day, 10 drops and 6 drops fourth day, 6 drops fifth and sixth days, 10 drops seventh and eighth days, 3 drops thirty-second day, 5 drops twice and 6 drops thirty-third day, 8 drops twice thirty-fourth day, 6 drops and 8 drops thirty-fifth day, Am. Hom. Review, 2, 80; 5 , Dr. J. S. Douglass, provings on "at least fifty people," mostly with tincture, in doses of 1 to 5 drops, a few took 3d dil., West. Journ. of Hom., 1, 1, and introductory letter in Hale's Monograph; 6 , Dr. J. C. Morgan took tincture (saturated pellets) several times, then 4 drops four times, 5 drops and 6 drops first day, 7 drops second day, 5 drops third day, 5 drops and 7 drops fourth day, 8 drops and 9 drops fifth day, 10 drops and 15 drops sixth day, 21 drops seventh day, Shipman's Am. Journ. of Mat. Med., 1861, No, 4; 7 , Dr. B. Fincke; Mrs. S. took one drop of 1m (centes.), N. A. J., 15, 413; 8 , Dr. Fincke himself tool 3/36m (centes.), ibid.; 9 , Dr. E. M. Amos's proving with 6th dil., 1 drop every two or three hours, then 2 drops per dose, Inaug. Dissert., Hom. Med. Coll. of Missouri, 1860; 10 , Dr. E. M. Hale, symptoms from various observers, Monograph on Gelsemium, 1861; 11 , Dr. F. L. Vincent's proving, Hale's Monograph; 12 , Dr. M. E. Lazarus's proving, Hale's Monograph; 13 , Dr. E. M. Hale, provings on several persons, Monograph (additional); , Zumbrock, proving with tincture, 3 drops first day, 8 drops fourth day, Brit. Journ. of Hom., 21, 419; , Dr. J. J. Douglass, symptoms obtained by repeated provings on self and seven or eight others with tincture, in doses of 1 to 5 drops (Hale's Domestic Medicine), Brit. Journ. of Hom., 21, 414; , Dr. L. A. Fallagant; a surgeon chewed the root in mistake for licorice, Hahn. Monthly, 5, 20; , Tully, effects on a girl, aged 11 years, of eating the inner bark, with the sap, from the stem, Boston Med. and Surg. Journ., 7, 122; , Dr. King; a Mississippi planter took, by mistake, an infusion of the root for bilious fever (Dispensatory) Hale's Monograph, p. 10; , Dr. Langren, a lady took tincture, 10, 11, and 12 drops in three hours, for typhoid pneumonia, Hale's Monograph, p. 11; , A steamboat waiter partook freely of a strong decoction of the root, Nashville Med. Journ., 1866, p. 225; , Dr. Pattee; a condemned prisoner attempted suicide with 1 1/2 oz. fluid extract (Tilden's Journ.), Brit. Jour. of Hom, 21, 407; , Dr. J. T. Main took, by mistake, 1 drachm fluid extract, Boston Med. and Surg. Journ., April 15th, 1869, p. 185; , Dr. R. P. Davis, effects on Mr. B. of a tablespoonful fluid extract (Med. Press and Circular), Am. Journ. of the Med. Sci., 1867, p. 271; , the same, effects on Mr. S. of a like dose, ibid.; , Dr. T. G. Wormley, effects on a healthy woman, several weeks pregnant, of 3 tablespoonfuls fluid extract, Am. Jour. Pharmacy, 1870, p. 14; , Dr. Pinkham, Mrs. F. took "probably much more than 40 drops" of fluid extract, Boston Med. and Surg. Journ., 1871, p. 89; , Dr. W. W. Clap; a man, 27 years old, reduced by remittent fever, was given 22 drops fluid extract within ten hours, Ohio Med. and Surg. Reporter, 5, 302; , Dr. J. T. Boutelle, effects on a man, aged 24 years, of 2 teaspoonfuls fluid extract, in fifteen minutes, for neuralgia, Boston Med. and Surg. Journ., 1874, p. 321; , Dr. J. A. Munk; a child, aged 2 years, tool a teaspoonful of the tincture (Am. Med. Journ.), Am. Hom. Observer, 1875, p. 12; , Dr. Hale, effects of 10 drops of tincture, every four hours, for hysterical convulsions, Brit. Journ. of Hom., 21, 414; , Dr. E. M. Hale, effects experienced by a lady, five months' pregnant, after second dose of 20 drops of 1/10th dilution, and renewed by every repetition of the same, Hahn. Monthly, 6, 125; , effects (Tilden's Journ.), Hale's Monograph; , Dr. Langren. Dr. B. took 30 drops tincture for toothache, Brit. Journ. of Hom., 21, 408; , Holden, experiment with fluid extract, 6 drops twice, then 10 drops at half hourly intervals "The Sphygmograph," p. 150.
MIND
- Emotional.
- Intoxicated feeling, with painless, but slightly diarrhœic stool, 11.
- General vivacity after rising (second morning), 6.
- In one case (it is not said at what stage), great and almost uncontrollable mirthfulness, 5.
- Depression of spirits, with dull, uncertain pains in the head, in the afternoon (fourth day), 6.
- Depression of spirits, 11.
- Melancholy, desponding mood (first day); worse (third day), 1.
- Gloomy and disinclined to exertion of any kind, 3.
- Hypochondriac mood all day, dull, stupid (fourteenth day), 2.
- Anxiety, 11. [10.]
- Irritable, impatient, 5.
- There was at first a cheerful, careless morale, afterwards depression of spirits, 12.
- Intellectual.
- She seemed to know all that was going on; described her symptoms, 19.
- Symptoms lasted several hours, but all the while I retained a clear state of mental activity, 16.
- Dulness of all the mental faculties, 5.
- For several days, rather dull and stupid, with disinclination to conversation, which was remarked by friends, who knew nothing of my taking medicine (fifth day), 2.
- Very dull and stupid, with aversion to study (fourth day), 2.
- Dulness of mind, alleviated on profuse emission of watery urine, 10.*
- Incapacity to think or fix the attention, 5.*
- Mind listless and incapable of reflection, as after ague, with a not severe, dull headache all day, and digging in the right ear all the afternoon (seventh day), 6. [20.]
- The sensorial modification consisted of a mistiness within the brain, not much affecting the lucidity of thought, but somewhat confusing the perceptions, so that I experienced some difficulty in attending to the physical details connected with my practice, 12.
- Inability to concentrate the mind, 11.
- Found it to affect the power of concentration very materially; I could not fix my mind on the contents of a newspaper, although the matter was of an exciting character; I could not pursue one train of thought for any time, the ideas would vanish and leave a vacancy of mind which was quite annoying, .
HEAD
- Vertigo. [30.]
- Transient vertiginous sensation, after breakfast (second day), 6.
- *Dizziness of the head and blurred vision returned, and gradually increased, so that all objects appeared very indistinct , for three hours, then gradually abated (one hour after second dose, fifth day), 4.
- Sense of giddiness (one hour and twenty-five minutes after third dose), 34.
- Giddiness is pretty constant; an intoxicated feeling and tendency to stagger; often with dizziness or imperfection of vision, 5.
- Swimming sensation in the head, 32.
- My head began to have a swimming, turning sensation, as if I were going to be seasick, 16.
- Light head, 9.
- Lightheaded and dizzy, much increased by sudden movement of head and walking (one hour after first dose, third day), 4.*
- Lightheaded, and dim vision, continuing for one hour (after first dose, third day), 4.*
- Her head felt very light, 19.* [40.]
- Head felt very light, with vertigo, 32.*
- General Head.
- Head cool to the touch, in the afternoon (eighth day), 7.
- He cannot hold the head erect, 32.
- Dulness of head, at 11 A.M. (fifth day), 6.
- Dulness of the head, with stupor, dry mouth, coated tongue, bitter taste, pulse full and strong, intoxication, vertigo unto falling, 11.
- Heaviness of the head, in the afternoon (tenth day), 7.
- Heaviness of the head, with dulness of mind, 10.
- Heaviness, with sensation of fulness in the head, which increased to a severe headache, relieved on the third day of the proving by copious urination; after which a pleasant languor pervaded the system for some hours, 11.
- Great heaviness of head; sensation as if the brain was heavy, 10.
- *Heaviness of head alleviated on profuse emission of watery urine, . [50.]
EYE
- Objective.
- Dull eyes, in the forenoon (eleventh day), 7.
- Eyes transiently bloodshot (third day), 6.
- Strabismus, and constant inclination to squint (one case), 10.
- Eyes fixed, and inability to raise the eyelids (after five hours), 25.
- Eyes much inflamed and weak, with great flow of tears at intervals, 3.
- Subjective.
- Dryness of the eyes, 5.
- Heaviness of the eyes , as after night-watching, 11.*
- Pains deep in the left eye, extending from above downwards (first day); more violent (third day), 1. [110.]
- Burning of the eyes, as if they were too dry, in the forenoon (eleventh day), 7.
- Burning in the eyes, with weakness of sight and heaviness in the forehead (fifth day), 7.
- The eyes felt quite sore; it is as if some foreign body were irritating the conjunctive, in the evening (third day), 2.
- The eyes quite sore at night; not much pain, but merely soreness, with sensitiveness to light and lachrymation (third night), 2.
- Brow and Orbit.
- Drawing over the eyes (four minutes after three drops), 14.
- Drawing over the right eye (eight minutes after five drops), 17.
- Pain in the orbits, sometimes excessive, 5.
- Dull full feeling (attended with some aching) in the whole of the orbits, 1.
- Bruised pain above and back of the orbits, 5.
- Lids.
- *Drooping of the eyelids, 29. [120.]
- Eyelids partially closed and motionless, 26.*
- Eyelids half closed, with apparent inability to move them, 23.*
- Eyes close in spite of him, on looking steadily at anything, .*
EAR
- Rush of blood into the ears, 10.
- The pains which ascend from the back to the occiput often affect the ears, 10.*
- Heavy feeling in the ears (a quarter of an hour after third dose), 34.
- Digging in the right ear (part of S. 19), 6.
- Near noon, while sitting, a stitch in the external auditory meatus (eighth day), 6.
- Hearing.
- Sudden and temporary loss of hearing, 10. [170.]
- Humming in the ears (after eighteen minutes), 14.
NOSE
- Objective.
- Sneezing and dull headache, at 9.30 P.M. (sixth day), 6.
- Sneezing, followed by tingling and a sense of fulness of the nose, at 11.30 P.M. (first day), 6.
- Watery discharge from the nose (in a few cases), 5.
- Mucus accumulates in the nose and upper part of the trachea; the mucus slips into the trachea while talking, which keeps up a hacking cough, 9.
- Bloody mucus in the nose (eleventh day), 6.
- While sewing, lively action, as of a worm or a fish, in the region of the nose, at 6 P.M. (twelfth day), 7.
- Pain extending from the bridge of the nose to the eye (third day), 1.
- Tingling in the nares (eleventh day), 6.
FACE
- Objective.
- Looked strange, staggered, and feel (after half an hour), 29. [180.]
- Heavy besotted appearance of the face, 13.*
- Countenance miserable, sunk, grayish-yellow, with dull dusky eyes (second day), 7.
- Face flushed and hot to touch (after second dose, fifth day), 4.*
- Yellow color of the face, 5.
- Complexion yellow, also the eyes, 1.
- Countenance of livid paleness, 26.
- Face somewhat congested, 23.
- The muscles of the face seem to contract, especially the orbicularis oris, somewhat impeding breathing, 11.
- Subjective.
- Numbness of the face, 11.
- Cheeks.
- Whenever she was roused from her sleepiness she felt burning in the zygomatic region and eyes (afternoon), (seventh day), 7. [190.]
- Burning at the left zygoma and in both eyes, more in the left one (fifth day), with red swelling of the zygoma, a little before 2 P.M. (sixth day), 7.
- Burning in the left zygoma, with swelling; and in both eyes, more in the left; later, also in the right zygoma at 1 P.M. (seventh day), 7.
- Burning in the left zygoma, then in the right, drawing down to a gland at the anterior right side of the neck, where it swells, and pains as if an ulcer were forming, in the afternoon (eighth day), 7 . [At this very spot she had twenty-two years ago a glandular abscess, which opened internally.]
- Lips.
- Pale lips, in the forenoon (eleventh day), 7.
- Lips dry and heated, at 11.30 P.M. (seventh day), 6.
- Chin.
- Lower jaw drooping, 23 ; (after three hours), 28.
- Lower jaw drooping, leaving the mouth wide open, 26.
- His lower jaw began wagging sideways; he had no control over it, .
MOUTH
- Teeth.
- Pain in the last back tooth on the right side up towards the temple (first day), 1. [200.]
- Stinging and burning in the left lower hollow back tooth (otherwise her teeth are good, of the ivory variety) through the lower jaw, as far as the left ear and left zygoma, at 6 P.M.; relieved by Chamom. 2/30 in watery solution (twelfth day), 7.
- Tongue.
- Thickly coated tongue, 11.*
- Tongue coated yellow (first day), 1.
- Light whitish coating on the tongue (seventh day), 6.
- Yellowish white fur on tongue (third day), 2.*
- Yellowish-white coating of the tongue, with fetid breath, 11.
- Tongue red, inflamed in the middle, 30.
- *Numbness of the tongue, 11.
- I so lost the use of my tongue that I was unable to utter an intelligible expression, and my tongue felt like some foreign body clogging my mouth, 16.
- His tongue, to use his own expression, was so thick he could hardly speak, 23.* [210.]
- His tongue felt very thick; he could not articulate, 27.*
- Burning upon the tongue immediately, which after a few minutes went over the whole mouth and throat, feeling hot like an oven, and thence through the œsophagus into the stomach and abdomen, when the same burning pain passed around in all the intestines; simultaneously with the descent of the burning pain into the œsophagus, burning in the chest came on, following soon by a stitch in the anterior left lower side of the chest, going through the chest into the left shoulder-blade, and accompanied by weakness and a fluttering and beating of the heart, irregular as to quantity and quality; these symptoms lasted about three hours (first day), 7.
- Peculiar sense of constriction at base of tongue (twenty minutes after third dose), 34.
- Mouth.
- Clammy, feverish feeling and taste, 5.
- Astringent sensation in the mouth, .
THROAT
- Hawking up of bloody matter, 30.
- The burning at times seemed intolerable, and swallowing was painful, 30.
- Sore feeling during deglutition, about the root of the tongue and larynx, with accumulation of mucus in the upper part of the trachea, causing frequent clearing of the throat, 9. [230.]
- Dryness and burning in the throat, 30.
- Fauces and Œsophagus.
- Painful dryness of the fauces, 11.
- While sitting at studies a rising of tasteless semi-solid matters in the œsophagus, with flatus and a sense of something lodged therein, slightly painful, at 12.30 (one hour after 9 drops, fifth night), 6.
- Violent burning in the gullet from the mouth quite down to the stomach, 30.
- Spasmodic sensations and cramplike pains in the gullet, 30.*
- Tried to swallow but could not, 27.*
- *Owing to paralysis of the muscles of the throat the patient could not swallow when the physician was called, 20.
- External Throat.
- Pains in the neck, which confine themselves to the upper part of the sterno-cleido-mastoideus directly back of the parotid glands (first day), 1.*
STOMACH
- Appetite.
- Great hunger (one case), 5.
- After a moderate meal, experienced a sudden satiety (ninth day), 6. [240.]
- Want of appetite in the afternoon (seventh day), 7.
- Alternate increase and loss of appetite, 11.
- Thirst.
- Thirst during the sweat, 5.
- Eructations and Hiccough.
- Eructations, 5.
- Eructations of wind and bland fluid, at 11.30 P.M. (first day), 6.
- Sour eructations, 11.
- Hiccough, 5.
- Heartburn.
- At noon, slight heartburn and pain at the cardia, whilst riding (first day), 6.
- Nausea and Vomiting.
- Nausea, 5.
- Nausea and vomiting, 21. [250.]
- Slight nausea, 11.
- Considerable nausea (after three-quarters of an hour), 17.
- More or less nausea, with headache, 5.
- Stomach.
- Feeling of emptiness and weakness of the stomach and bowels, 5.
- A sensation as of something wanting in the epigastric region (third day), 2.
- Rumbling and dull pains in the epigastric relieved by expulsion of flatus, 11.
- Pain in the stomach, extending from the pyloric end of it to the axilla and under the scapula, and down the right arm to the external side of the forearm, it terminates about a hand's breath from the elbow; this passed off after taking biscuit and coffee, 9.
- Pain in the stomach, nausea, and dimness of vision (after two hours); these symptoms were soon succeeded by ineffectual efforts to vomit, great restlessness, and free perspiration over the body, 25.
- Gastralgia and colic, coincident with the intoxicated feeling, in the afternoon (fourth day), 6.
- Cardialgia, when driving, at 11 A.M. (fifth day), . [260.]
ABDOMEN
- Hypochondria.
- Slight pains in the left hypochondriac region (third day), 2.
- Frequent sharp drawing pain through the left hypochondriac region, 5.
- Pulsative pains in left hypochondrium, continuing for one hour, at 3.30 P.M. (fourth day), 4.
- Umbilical.
- Rumbling in the region of the umbilicus, 5.
- Dull aching in the umbilical region, which lasted till I go up (seventh morning), 2.
- Sharp stitches around the umbilicus, 9. [270.]
- Colicky pains below the navel, extending down to the testes, caused by flatus, and relieved by its expulsion, in the evening (fourth day), 6.
- Two little painful spots on the right side of the umbilicus, extending down into the bowels; the pain is increased by pressure, 9.
- General Abdomen.
- Rumbling and rattling in the abdomen, with emission of flatus above and below (first day), 1.
- Evacuation of flatus both ways, frequently (first day), 6.
- Palpitation of the abdominal muscles about three minutes (tenth day), 2.
- Weak nauseated feeling in the bowels, 9.
- Heaviness, and feeling of weight in the bowels, 3.
- Pain in the bowels towards morning (third night), 2.
- Slight pain in the transverse colon, with yellow color of the skin of the face (one case), 5.
- Burning in the abdomen, the pain going round in the intestines, towards 12 o'clock (second day), 7. [280.]
- Slight griping pains through the abdomen, mostly in the umbilical region, after supper, 9.
- Dull pains in the abdomen, 11.
- Dull pain in the bowels, which became very severe towards morning (first night), 2.
- Sharp pains in the bowels, with stools of a light creamy color and pappy consistence, 11.
- Sleep disturbed by lancinating pain in the abdomen, relieved by copious discharge of flatus, 11.
- Colic, in the evening (ninth day), .
RECTUM AND ANUS
- The piles returned with raw, smarting pain, 9.
- Exciting news caused, apparently, urging to stool; stool papescent, of dark-yellow color (sixth day), 6.
STOOL
- Diarrhœa.
- Bowels loose, but great difficulty in discharging anything; there seems to be great strength in the sphincter muscles (first day), 1.
- After breakfast a good stool; after supper a second stool, consistent (third day), 6.
- Bilious stools (twelfth day), 6.
- At 9.30 A.M., a soft bilious stool, preceded by threatenings of diarrhœa; the latter renewed at noon by exciting news, and afterward when walking (seventh and eighth days), 6. [300.]
- Deep yellow, soft stool, after breakfast (tenth day), 6.
- A stool, at first consistent, then papescent, bilious, homogeneous, a few minutes past 10 A.M., preceded all the morning by flatulence (fourth day), 6.
- Tea-colored, semi-solid stool (eleventh day), 6.
- Stool of deep yellow color (papescent), after breakfast (fifth day), 6.
- After breakfast, a tea-colored stool, more consistent (ninth day), 6.
- Constipation.
- At 11 A.M., having put off the usual defecation, had a slow stool, leaving a sensation of more remaining to be passed, and abdominal repletion (second day), 6.
- Insufficient stool, at 10 A.M. (first day), 6.
- Attempted to pass a stool, but much wind only passed, in the evening (ninth day), 6.
- Relief of constipation (several cases), 5.
URINARY ORGANS
- Urethra.
- Painless redness about the orifice of the urethra (eighth day), 6. [310.]
- Agreeable sensation during micturition throughout the course of the urethra, 11.
- A feeling as if something remained behind when urinating; the stream stops and commences again, 9.*
- Micturition.
- Frequent micturition; wants to urinate every half hour.
- *Frequent emission of clear limpid urine, with seeming relief to the dulness and heaviness of the head, 11.
- Urine increased in quantity, clear and watery, 5.*
- Urine much increased in quantity (first night), 2.
- In nearly every instance the profuse emission of watery urine was accompanied by transient chilliness, tremulousness, and an evident alleviation of the sensations of heaviness of the head, dulness of mind, and dimness of sight (several, who made partial provings for me, noticed the same symptoms, with the alleviations), 10.
- Urine.
- Urine at times clear and limpid; at times milky and turbid, 11.
SEXUAL ORGANS
- Male.
- In connection with the general prostration, accompanied by diuresis, there was always much flaccidity, with coldness of the genital organs, 10.
- Irritation of small spots on the mucous surface of the prepuce, with surrounding congestion (third night), 6. [320.]
- In the afternoon and evening some irritability of the right testis, afterwards dragging pain in the same, extending into both groins and the hypogastrium, followed by discharge of flatus and relief of the pain (first day), 6.
- *Emission of semen without erection (twelfth night), 2.
- Female.
- Severe, sharp labor-like pains in the uterine region, extending to the back and hips (part of S. 74), 31.
- A discharge of blood per vaginam; came on about 4 P.M., after the symptoms had subsided, lasting one hour (second day); after 6 P.M. (third day), 7.
RESPIRATORY ORGANS
- Larynx and Trachea.
- Paralysis of the glottis, with difficulty of swallowing, 10.
- When eating, the food drops into the trachea, causing strangling, 9.
- Burning in the larynx and down into the chest under the sternum, 10.
- Voice.
- Voice seems weak, 5.*
- Voice thick, as if the tongue were too large, 10.
- Paroxysms of hoarseness, with dryness of the throat, 5.
- Cough and Expectoration. [330.]
- Cough from tickling, and dry roughness of the fauces, 10.
- Cough, hacking, with a feeling as if a drop of liquid had entered the windpipe, with frequent clearing of the throat, 9.
- Inability to expectorate, 27.
- Breathing slow, sighing, and at time sobbing, 29.
- Breathing slow and superficial, with now and then a deep inhalation, 9.
- Slow breathing, with rapid pulse (primary), 10.
- Breathing unnaturally slow, 10.
- Peculiar slowness of respiration, seven to the minutes (fifty-five minutes after third dose), 34.
- Respirations somewhat diminished in number; afterwards breathing spasmodic, 23.
- Respiration almost imperceptible, 10. [340.]
- Irregular breathing and slow respiration (part of S. 510), 25.
- Sighing respiration, 10.
- Respirations of a sighing, catching character, 10.
- Respiration gasping, three or four per minute (after three hours), 28.
- Breathing stertorous, and very imperfect, 26.
- Fetid breath, 11.
- Offensive breath, slow breathing, and slow pulse (primary), followed by rapid breathing and quick, weak pulse (secondary), 10.
- Heavy breathing (in the morning), (eighth day); (in the afternoon), (seventh day), 7.
CHEST
- Great weakness in the chest on speaking (second day), 8.
- Heaviness upon the chest in the afternoon (seventh day), 7.
- Burning in the chest (part of S. 211), 7.
- Burning in the chest, with fulness, sighing, and anxiousness, going into the pit of the stomach, and radiating all over the whole abdomen like a tree the stem of which is in the pit of the stomach, and the branches of which burn asunder towards the abdomen; this burning is different in kind from the one observed on the first day; it is to her feel, not in the intestines, but in the parts covering them; at 12 M. (fifth day), 7.
- Constrictive pain round the lower part of the chest, 5.
- Short paroxysmal pain in the superior part of the right lung on taking a long breath; it sticks from above downward; this pain is one of the prominent symptoms (first day), 1.
- Stitches in the chest, 5.
- A sensation of soreness in the chest when coughing, 10.
- Pain behind the fifth rib to the left of the sternum, from flatus, relieved by eructation (third night), 6. [360.]
- Burning under the lower part of the sternum, with heaviness of the chest, drawing towards the place of the stitch in the left lower anterior side of the chest, which also now is repeated, and pain like ulceration, tender to touch; as soon as the burning went over to the left side, the chest felt easier; in the afternoon (eighth day), 7.
- Burning like fire at the very spot where she lately had the stitch in the left lower anterior side of the chest, as large as a dollar, and painful to the touch, like an ulcer, and from the pressure of even a loose dress, with fulness, at 8 A.M., lasting five minutes, and repeated four times (fifth day), 7.
- Cramp in the right side of the region of the last short ribs, 9.
- A dull, full aching, extending from the ensiform cartilage along under the free ends of the right short ribs to the lumbar region, as if the liver were congested; the worst pain is about a hand's breadth from the lower end of the sternum, 9.
- At 2 P.M., when lying down, pain under the floating ribs of the left side, suddenly, as if thrust with a sharp instrument; in an instant the pain disappeared, but appeared as suddenly in the left temple, causing an involuntary contraction of the brow (fourth day), 4.
- Stitch in the anterior lower left side of the chest in the afternoon (tenth day), 7.
HEART AND PULSE
- Præcordium. [370.]
- Stitching sensation in the region of the heart, 5.
- Shocks at the heart, with heavy breathing, at 12 M. (tenth day), 7.
- At every exertion, shocks at the heart, throbbing of the pulse through the whole body, tremulousness, weakness, and sweat, in the forenoon (eleventh day), 7.
- Heart's Action.
- Irregular beating of the heart form 12 M. till 5 P.M . (eighth day), 7.*
- Beating of the heart irregular as to quantity and quality (part of S. 211, 367), 7.
- Irregular beating of the heart , less violent than before (during the shaking, trembling of the body), in the afternoon (fifth day), 7.
- Palpitation of the heart in the afternoon (eighth day), 7.*
- Pulse.
- Pulse continued accelerated (after second dose, third day), 4.
- Pulse rapid and feeble (after three hours), 28.
- Pulse very rapid, small, and weak, 29. [380.]
- All the afternoon pulse very small and quick, 5.
- Directly after the reaction has followed the chill, the pulse rises a as far above the normal state as it has been previously below it, 15.
- On the 12th of November, at 9 P.M., six drops were taken, at 9.30 six drops more, and at 10 o'clock ten drops; the results, which were as follows, more also indicated on the chart. Not being perfectly well, there existed either a recoil or dicrotic wave in the preliminary tracing, which in thirty minutes seemed rather to become more prominent, and, but for the records that follow, might be at once set down as a true dicrotous wave, as at this time there will also be seen diminution of compressibility, as shown by diminished amplitude under the same pressure; the prominence of the waves, whatever its explanation, must be ascribed to a morbid condition, viz., that produced by the influence of the poison administered; the pulse at this interval has reached a minimum as to frequency, and in ten minutes more shows slight impairment of rhythm; the new dose of ten drops exhibits its first influence in the tracings in thirty minutes, by increased arterial tension and nervous stimulation, followed however in five minutes by diminution of both, and great decrease in frequency; from this time on to the end of an hour the tension in the arterial system slowly increased, although the frequency remained nearly the same, and after one hour and a half the appearance of some obstruction, as shown in the flattening of the conjoined apices of the first and second events, was manifest, and irregularity of impulse and of rhythm exhibited the effects of the poison upon the heart. The simple deduction from this investigation, apart from what is already known of the remedy, lies in this, that while reducing the frequency of the pulse, it does so with an , and after awhile impairment of the heart's action, indicating a toxic influence upon the nervous system, .
NECK AND BACK
- Neck.
- Rheumatic pain in the left side of the neck, on lying down, soon passing off (one hour after 15 drops, sixth day), 6.
- Aching and soreness of the muscles of the neck and shoulders continued for four days (after eight days), 4.
- Aching on the left anterior part of the trapezius muscle (in the neck), when leaving a warm room (eighth day), 6. [410.]
- Contractive sensation in the right side of the neck at 5 P.M. (seventh day), 6.
- Back.
- Feeling of weakness in the back and limbs, with sleepiness, 15.
- Pain in the back, as in the cold stage of ague (many cases), 5.
- Dorsal.
- After breakfast, sharp shooting pain from the right shoulder to the dorsal vertebræ (seventh day), 2.
- Soreness of the trapezius muscles on moving (eighth day), 4.
- Lumbar.
- Dull pain in the lower lumbar and sacral region (tenth day), 2.
- Aching in the loins (eighth day), 4.
- Sacral.
- Dull pain in the sacral and lower lumbar region (first night), 2.
- At supper-time, going into a warm room, aching in sacro-iliac and lumbar regions and lower part of left thigh, with languor and thirst, as when a fever is commencing; felt the pains more when eating (ninth day), 6.
- Dull aching pain in the sacral and lumbar regions, which came on about 3 A.M. (third day), 2.
EXTREMITIES IN GENERAL. [420.]
- Trembling in all the limbs ; in the afternoon (eighth day), 7.*
- Trembling in the limbs, with chill, at 1.30 P.M., followed by violent stinging in left mamma, from inside outwards, along the lactiferous ducts, especially in one spot, in the sternal half of the breast (second day), 7 . [When seventeen years of age she had a sore breast, with ulceration, pain on touch; this was the result of a cancerous tumor from a contusion by a cows horn, and drawn out by an application of a black paste of a veterinary surgeon, Dr. Lang; the breast got well, though it became smaller in size than the right; she afterwards nursed her six children and never had any trouble in it; yet there was not so much milk in it and the children did not like it as well as the right; twice during pregnancy she had stinging in the place mentioned, after taking cold, but without further consequence; also from homeopathic remedies she had never observed any pain there; still in feeling with the finger, she can detect a kind of cavity, which is always somewhat sensitive on pressure, probably from rough handling at the first confinement.]
- I gradually lost the control of my limbs, so that I could not direct their movements with precision, 16.
- Weakness of the limbs towards 12 o'clock (second day), 7.
- Heaviness in all her limbs (after four hours and a half), 7.
- A sensation as if a galvanic current were passing down the forearms and hands; the same also in the feet; while sitting (after one hour, fifth day), 4.
- Awakened by pains in the limbs, at 4 A.M. (seventh day), 2.
- During the night pains in the extremities, worse after midnight, abating during the day (ninth night), 2.
- During the night pains of the limbs as usual, especially forearms and calves; also in the elbow and knee-joints, all similar to the previous, only less severe (eleventh day), 2.
- Pains in left elbow, wrist, and knee, and in both ankles (after second dose, third day), 4. [430.]
- Slight pain in the muscles of the extremities (thirteenth night), 2.
- Awoke about 3 or 4 A.M., with severe pains in both the upper extremities, which seem to be seated deep in the muscles; also severe in the left arm and forearm, and in both the calves (fifth morning), 2.
- Deepseated pains in the muscles of the extremities, relieved by movement (seventh morning), 2.
- Rheumatic pains in the extremities (sixth day), .
SUPERIOR EXTREMITIES
- Arm.
- Spasmodic pains extending from the inner condyle of the right arm to axilla (third day), 1. [440.]
- Dull pains in the muscles of the right arm and shoulder, and some of the time in the left arm and lower extremities (twelfth day), 2.
- Elbow.
- After writing for a few minutes, crampy pain in the bend of the right elbow while waking (ninth day), 6.
- At 7.30 P.M., violent aching in the left elbow (thirteenth day), 2.
- At 3 P.M., in a draughty church, felt a drawing and aching about the left elbow, for a quarter of an hour (fourth day), 6.
- Sensation as if a galvanic current were passing through the forearms, at 6 P.M., continuing for half an hour (eighth day), 4.
- Pain in the flexor muscles of the right forearm (first day), 1.
- At 9 P.M., pain in the right wrist of a full kind, with great weakness of the same (fourteenth day); the pain less severe, but still it is still quite weak (fifteenth day), 2.
- At 6 P.M., sharp pain in the right wrist (thirteenth day), 2.
- The flexor muscles of the hands and arms were paralyzed, while the extensors were nearly so, 22.
- Sensation in hands and arms blunted, but not in proportion to the loss of motion, 22. [450.]
- Drawing stitches in the dorsum of the right hand, running down into the middle and ring fingers, 9.
- Pain in the little and fourth fingers (first day), 1.
- Early in the morning sharp shooting pains in the joint of the last phalanx of the right thumb (twelfth day), 2.
INFERIOR EXTREMITIES
- Objective.
- Staggering like one intoxicated, 32.
- Gait staggering and very infirm (one hour after first dose, third day), 4.
- He tried to walk, but staggered as if drunk, 29.*
- He staggered, reeling from one room to another, as in intoxication (after half an hour), 28.
- *Fatigue of the lower limbs, after slight exercise, 11.
- During and after a walk, it seems as if the limbs could not be moved another step, 3.
- Loss of voluntary motion of the lower extremities, 11.
- Subjective. [460.]
- Pain in the lower limbs (very common), 5.
- Paroxysmal pain in the left lower extremities (first day), 1.
- Dull pain in the lower extremities, 2.
- During the headache excessive drawing, contracting, and crampy pains in the lower extremities, extending from the thighs to the toes; the pains appear to proceed from the bones as well as the muscles, 3.
- Hip.
- Pain in the left hip, only in the joint; it at times extends to the outside of the thigh; it is a sharp drawing pain, much worse on movement (first day), 1.
- Thigh.
- Transient crampy pain in the inner part of the thigh when walking (sixth day), 6.
- At 7 P.M., dull pain in the left thigh and under the left scapula (thirteenth day), 2.
- Aching of the left rectus femoris muscle and drawing in the right calf, at 11.30 P.M. (first day), 6.
- Drawing pain in the lower third of the left thigh (part of S. 559), 8.
- Drawing pain in the left hamstring, extending across the joint to the origin of the gastrocnemius, 9. [470.]
- Sharp stitches of pain, as of drawing or cramping of single fasciculi of muscle, about the origin of the gluteus maximus, on the left side; the stitches run in the direction of the hip-joint, 9.
- Continual jerking from the right sartorius muscle about the middle of the thigh, .
GENERALITIES
- Objective.
- He was lying on the left side, 23.
- Tremulousness (accompanying profuse urination), 10.
- Trembling and weakness in the afternoon (seventh day), 7.* [490.]
- Trembling, with chill in the whole body, at noon (third day), 7.
- Shaking, trembling in the whole body, and whimpering (tingling) in the legs, as if asleep, in the afternoon (fifth day), 7.
- Muscles relaxed (after three hours), 28.*
- *Complets relaxation of the whole muscular system, with entire motor paralysis, 29.
- Mental and bodily inactivity during the afternoon (ninth day), 6.
- Listless and languid, 5, 29.
- At 10 A.M. I went to the Penn Hospital, where I saw a number of severe wounds; I am not usually affected much by the sight of wounds, but to-day, that or something else caused very unpleasant sensations; I became very weak, and my friend remarked that I was very pale, accompanied with nausea and trembling of the lower extremities ; these continued some ten minutes, but disappeared in the open air (sixth day), 2.
- When reclining, some languor and drowsiness (just before a heavy shower), (third day), 6.
- Languor and drowsiness on reclining for the purpose of study; slept and hour, and when aroused felt at first unwilling to move; less languor after stirring around awhile, in the afternoon (third day), 6.
- Great lassitude, 5.* [500.]
- General fatigue (eighth day), 4.*
- Easily fatigued, especially the lower limbs, 5.*
- Became tired and greatly exhausted very easily, 3.*
- Weakness at 12.30 P.M. (fifth day), 7.
- Weakness and a fluttering (part of S. 211), 7.
SKIN
- Objective.
- Yellowness of the skin in the forenoon (eleventh day), 7.
- Pale yellow color of the face and of the whole body in the afternoon (eighth day), 7.
- Eruptions.
- Gelsemium produces a peculiar and very marked eruption in most of the provers; it appears most on the face, less frequently and less conspicuously on the back between the shoulders, etc.; it is papulous, very much the color of the eruption of measles, which it considerably resembles, but the papulæ are larger, more distant and distinct; although very conspicuous, they are attended with little or no sensation, the subject being unaware of their existence until he happens to see himself; persons have frequently been asked what was the matter, if they had the measles, etc., when they were not aware of the eruption; this generally appears on the second or third day of the proving, and would seem to be more constantly produced by the 2d or 3d dilution than by the tincture; the eruption continues one or two weeks, or longer, 5.
- Erythema of the face and neck, 13.
- Papulous eruption on the face, very nearly resembling measles, 13.
- A sore pimple on the left side of the neck at 8 A.M.; the pimple is sore, and has an areola embracing the diameter of a pea, quite red and inflamed (such an eruption not experienced at any other time), (sixth day). Two more pimples, on at the right corner of the os hyoides, the other at the left anterior temporal ridge, above the brow (eighth day). Another pimple, sore to touch, on the left side of the larynx; the first one less sore, like a small cutaneous induration; these are like minutes furunculi; thus far no suppuration (ninth day). The first pimple sorest, the other less so (tenth day), 6.
- Eruption of vesico-pustules, painless, but having no other analogy to measly, appeared on the inside of the thighs, 12.
- Subjective. [540.]
- Sudden stinging in the skin over the whole body, as if an eruption would break out, with greenish-yellow color of the skin, then burning, then itching, with profuse sweat, at 4 P.M. (eleventh day), 7 . [At fourteen years old she had a similar sensation, when she had a dangerous "Rösselausschlag," as they call it in Upper Austria, with sore throat, the body being densely covered with red granules, except the anterior part of the chest.
Rossalia squamosa?
Cf. Schmalz's Diagnost. Tabellen, 2014; or Scarlatina miliaris?]
- Itching about the elbows and forearms at 11.30 P.M. (first day), 6.
- Intense but transient itching of small points in the face and at the edge of the hair, on the forehead, right side, and elsewhere on the scalp, at 11.30 P.M. (first day), 6.
SLEEP AND DREAMS
- Sleepiness.
- Disposition to yawn; a sort of stupor; cannot keep the eyes open; is obliged to lie down and sleep, 5.
- Drowsiness in the forenoon, 9.
- Drowsiness, with dimness of vision; a kind of drunken stupor, 11.
- At first it seemed to cause drowsiness, afterwards aggravated the habitual sleeplessness, 12.
- Slightly drowsy (half an hour after first dose); increasing (forty minutes after third dose), 34.
- Sleepiness, like a lethargy, came on after 2 P.M., lasting all the afternoon and evening (seventh day), 7.
- Sleepiness and long and sound sleep are very general symptoms, 5. [550.]
- Inclined to sleep, with deep respiration and numbness of the whole body, 24.
- Early sleep after supper (seventh day), 6.
- Sound sleep until 7 A.M.; difficult, weary waking (second morning), 6.
- Sleeplessness.
- Sleeplessness the whole night (sixth night), 7.
- Wakeful till 1 in the morning, with desire to study; sound sleep the last half of the night and weary waking (third night), 6.
- Very little inclination to go to sleep, and when it does come on, he dreams much about business, etc., 3.
- Very restless night (first night), 2.*
- Very restless during the night, especially towards morning (forty-third night), 2.*
- Had a very restless night, with unpleasant dreams after midnight (first night), 2.*
- Could not get asleep for a long time; on falling asleep, a sort of nightmare awoke me again, so that no sleep came; at last it was like falling asleep, when a second time a kind of nightmare came on, never experienced before; it was as if the whole left side from the neck along the chest, trunk, and thigh, as far as the knee were a kind of soft muscle, spasmodically jerking up and down, somewhat with the elasticity of a mass of jelly; this motion extended deep into the interior of the chest, and the centre of this motion seemed to be in the region of the heart; it was, indeed, one great motion which concerned the whole left side as a mass, with the exception of the head and foot; this whole half of the body seemed to me to be going up and down, while the right side of the back, on which I lay, was quiet; I wondered in my mind at this turmoil going on in my body, but was unable to stir; when I wake up from this condition, I was well aware of what had happened, and found myself quietly lying on the same spot where I had fallen asleep, and the pulse, with everything else, was quiet; I certainly had not moved, and all, then, was my imagination; I only felt a drawing pain in te lower third of my left thigh, which was repeated the next day, .
FEVER
- Chilliness.
- Cold on the surface, 21.
- Surface cold and congested, 23.
- Chilliness, especially along the spine, 15.*
- Transient chilliness (accompanying profuse urination), 10.
- Little chilliness, then some heat, then cold sweat, but less than before, all without thirst, between 2 and 4 P.M. (sixth day), 7.
- Febrile chilliness, with cold extremities and heat of the head and face, with headache, an early symptom in most cases, 5. [570.]
- Chilly sensations over the entire body, 1.
- Very chilly at 9 P.M. (sixth day), 2.
- Feels very chilly all day, especially in the morning (second day), 2.
- Chill (part of S. 490), 7.
- Chill after breakfast (fifth day), 2.
- Chill, then cold sweat more than yesterday, but not as much as before, in the afternoon, lasting till 5 P.M. (seventh day), 7.
- Chill, then weakness like fainting, then profuse cold sweat, after 2 P.M. (tenth day), 7.
- A tremor and a chill, which all of a sudden and urgently forced out a general cold sweat, so that the drops were seen standing on the arms quite densely (after hour hours and a half), 7.
- Slight chills during the day (fourth day), 2.
- "Every symptom of ague; would have thought he had the ague," 5. [580.]
- Feels anguish, with pain in and between the bones of the calf of the left leg; not able to go downstairs without holding to something, 5.
- Chilliness and chills running up the back from the loins to the nape of the neck, 11.
- Whilst reading exciting news, a transient chilliness on the upper half of the body, especially in the back and nape of the neck, at 3 P.M. (fifth day), 6.
- Extremities cold, 29 ; (after five hours), 25.
- Coldness of the extremities, especially the feet, often severe, 5.
- Extremities rather cold (after three hours), 28.
CONDITIONS
- Aggravation.
- ( Morning ), After breakfast, vertiginous sensation; chilliness.
- ( Forenoon ), Feverish.
- ( Afternoon ), Heaviness of head; chilliness; general warmth, etc.
- ( Evening ), Aching in head; confusion of sight; when sitting cardialgia.
- ( After midnight ), All symptoms; towards morning, pain in bowels; pains in extremities; towards morning, restlessness; unpleasant dreams.
- ( Cool air ), Aching in trapezius muscle.
- ( Eating ), Aching in sacro-iliac regions, etc.
- ( Eating and drinking ), Especially warm things, the suffering.
- ( Lying down ), Pain in left side of neck; pains in hand, etc.
- ( Movement ), Especially in going upstairs, tendency to headache; aching in occiput; pain in hip.
- ( Sudden movement of head ), Lightheadedness, etc.
- ( Sitting ), Sensation in forearms, etc.
- ( When sitting down ), Catch on patella.
- ( After sleep ), Headache over front and top of head.
- ( Smoking ), Head symptoms.
- ( Stooping ), Stitches in middle of forehead; aching in occiput.
- ( Turning head ), Stitches in forehead.
- ( Turning eyes ), Stitches in forehead.
- ( Walking ), All symptoms; lightheadedness, etc.; pain in thigh; pain under knee.
- ( Warmth of bed ), All pains.
- ( While writing ), Headache on top of head, etc.
- ( After writing ), While walking, pain in bend of elbow.
- Amelioration.
- ( Closing one eye ), Confusion of sight.
SUPPLEMENT: GELSEMIUM. Authorities.
35 , W. F. Hani, Chicago Med. Journ., vol. xxv, 1868, p. 760, fatal poisoning of a child, æt. eighteen months, by an unknown quantity of the fluid extract; 36 , A. E. Hardin, Rich. and Louis. Med. Journ., June, 1873, p. 621, Dr. J. took about a tablespoonful of the tincture; 37 , Dr. Freeman, Lancet, 1873 (2), p. 475, a boy, æt. three years, took about 50 minims of the tincture (1 in 5), and died; 38 , same, a girl, æt. nine years, took a dessertspoonful of the tincture, and died in two hours; 39 , omitted; 40 , R. N. Taylor, M.D., Rich. and Louis. Med. Journ., 1875 (1), p. 609, a negro, æt. nineteen years took 15 drops of fluid extract at one dose upon an empty stomach; 41 , same, the writer took 5 drops of the fluid extract, and in two hours 10 drops more; 41 a , second experiment; 42 , same, a boy, æt. nineteen years, took 12 drops of the fluid extract; 43 , Ringer and Murrell, Lancet, 1876 (1), p. 661, and (2), p. 569, seventeen observations on six persons; 44 , Geo. S. Courtright, M.D., Cincin. Lancet and Obs., vol. xix, 1876, p. 961, Dr. Bennett, suffering from urticaria, took by mistake 1 to 2 teaspoonfuls of the tincture, and a little wiskey, cured by Morphia used hypodermically; 45 , Dr. Brewster, Hahn. Month., vol. xi, 1876, Mrs. V. took before breakfast a teaspoonful of a strong decoction of the root; 46 , W. Sinkler, M.D., Philad. Med. Times, vol. viii, 1878, p. 150, Mrs. T., æt. forty-nine years, took for neuralgia four doses of 5 drops each of the fluid extract; 47 , Ringer and Murrell, Lancet, 1878 (1), p. 858, Dr. J. B. Hill relates the case of five men taking from half a pint to a pint of the tincture each; 48 , same, ibid., p. 892, a woman, æt. from twenty-five to thirty years, took 15 drops of the tincture; 49 , J. G. Parsons, ibid., p. 953, G. G. P. swallowed about one drachm.
MIND
- Intellect was not impaired at any time, but was slightly confused, 44.
- Aroused with difficulty, 35.
- Loss of consciousness, 49.
HEAD. [610.]
- Giddiness (soon), 49.
- Giddiness was another prominent and early symptom. Some felt it over the whole head, but by far the larger number said it was limited to the brows. Stranding or walking made it much worse. When well marked the patients staggered, and were afraid even to stand, much less to walk. So giddy was one patient that he nearly fell off the form. Some described their heads as going round and round. They felt and seemed drunk, though without any incoherence, still less mental excitement, 43.
- Pain in the head and eyes. Patients described this pain variously. It was generally limited to the forehead, and most marked just over the eyes. Some called it a dull sensation over the eyes; others a heavy pain; and others a giddy pain; and one patient experienced pain over the occiput, with a sensation as though the crown of the head were being lifted off in two pieces. This headache was sometimes absent, and sometimes followed instead of preceding the other symptoms. Dull aching pain in the eyeballs, now and then shooting in character, occasionally worse in one ball, sometimes followed and sometimes preceded the headache. The headache and pain in the eyeballs, intensified on moving the eyes, were often severe. When ptosis was well marked, the effort to open the eyes widely caused considerable pain, and the patient seemed to get relief by closing them, 43.
- I found the doctor sitting on the edge of a lounge, being held by two persons, with the head falling forward, the chin resting on the breast; I at once had his head raised up, but it immediately dropped forward again on letting go of it, showing that the parts were paralyzed; at breakfast his chin had dropped down, and it was with difficulty he could keep his head from falling on the table; could not eat, and with difficulty, on account of his head falling forward, walked into the next room, 44.
- Persistent and distressing numbness in the occipital region, which lasted for some hours after the consciousness returned, 49.
EYE
- Eyes closed, 47.
- Eyes staring, 48.
- Strabismus, 49.
- Dropping of the eyelids, especially the left, 49.
- Pupils large and dilated, 35. [620.]
- Pupils largely dilated and insensible to light; eyes had a fixed stare; sclerotic congested; lids drooping, so that it was necessary to pull them apart to see the eye, 44.
- A few drops of the solution of the alkaloid were put into one eye, and in each case the trial pupil became widely dilated, the dilatation usually beginning in about thirty minutes. Not only does the pupil dilate, but the muscle of accommodation becomes paralyzed and the sight affected. In twenty-four hours vision again becomes nearly natural, but the pupil remains dilated much longer, sometimes, indeed, for a week, or even a fortnight, 43.
- Dimness of vision, 38, 40.
- Vision slightly indistinct, 42.
- Some difficulty in sight before he had walked two squares, 44.
- In every case the sight was affected. At first the sight without being misty, is not as clear as usual; then slight mist comes before the eyes, one patient comparing it to "a lot of smoke rising before his eyes," and another to a "thick veil." The sight at last becomes so affected that it fails almost completely, failing first with distant objects, then, as the sight becomes more impaired, nearer and nearer objects become hazy, 43.
- Double vision, 37, 38.
- The drug seems to produce two kinds of diplopia, one much more persistent than the other. As to the transient kind, we find it on many occasions a very passing phenomenon, lasting only a few seconds, then disappearing, then, after a few minutes, reappearing. In this form images in the median vertical line appeared double, distant objects at first undergoing the duplication. Sometimes the patient was conscious that the diplopia was coming on; thus one woman said: "I know that it is now coming on; I feel such a heavy weight under my upper eyelid." The double vision then came on, and, with the heaviness, ceased in a few seconds. One image was higher than the other; in this respect the images varied much. The following descriptive notes were taken down rapidly from the patient, the phenomena occurring as fast as they could be written: "One gas-jet appears about six inches above the other, and there is six inches above the other, and there is six inches between them horizontally; the upper one is to the left; now the right is upper most; now the left slightly again; going over to the right now again; exactly over one another now, and quite close together; now again separated, left the highest; now over one another." With other patients the two images seemed on a level. Sometimes the drug produces only this transient kind of diplopia; at other times both kinds; and sometimes one kind preceded the other, the transient usually preceding the more constant form, and continuing to recur from time, while the constant form lasted. The phenomena of the constant form of diplopia follow a definite order, and take place in the upper half only the field of vision. They occurred first with objects held at the extreme right or left of the visual field; and as the patient passed more under the influence of the drug, then with objects held nearer and nearer the middle line, and at last, usually for a short time only, objects in the median vertical plane seemed double. As the effects of the drug wore off, the double vision disappeared in the inverse order. The outer lateral image was the higher, and the further the object was carried to the right or left the greater was the horizontal and vertical distance between the images. When a colored glass was placed before either eye, the outer and higher image was seen by the covered eye. When the object was carried high above the head, the two images gradually coalesced, and the object looked very much thinner, "like a thread." With well-developed diplopia there is impaired movement of the eyeball, chiefly affecting, as far as we could ascertain, the external and internal rectus, especially the external, for the outward and inward movement of the eyeball was less free than before the action of the medicine. The ball appeared to be moved by greater effort, so that when carried as far as the weakened muscles are capable, the ball oscillates, as though the patient with great effort moved it as far as he could, and then the tired muscles gave way a little, but being roused to an effort they carried the eye back again; the frequent repetition of this effort gave rise to an oscillation. The external rectus is generally first affected, and not unfrequently one rectus sooner and in excess of the other. Even when the diplopia is strongly marked, the loss of power over the muscles is not very great, and there is no obvious squinting. Then, as the patient becomes still more affected, ptosis supervenes, and a great part of the whole of the upper half of the field of vision is cut off. The loss of power in the eye-muscles is then more marked, but without the occurrence of obvious squinting. At this time the symptoms no longer follow the order previously described, but assume various phases, often changing rapidly. Thus, whilst on one side the outer image is the higher, if the object is carried to the other side of the field the inner image becomes the higher; or, perhaps, for the first few seconds the outer and then the inner is the higher, .
FACE
- Face congested, 44, 49. [630.]
- Face and lips blue and livid, 35.
- Lips of a livid color, 44.
- Jaws rigid, 48.
MOUTH
- The mouth was partially open, and the lower jaw hanging as an almost useless appendage; could move the tongue slightly, but unable to articulate distinctly, 44.
- Paralysis of the muscles of the mouth and throat, 49.
- Foaming at the mouth, 48.
- Interior of mouth and fauces moist, 44.
- Muffled speech, 49.
- Speechless (after one hour and a half), 36.
THROAT
STOMACH
URINARY ORGANS
- Abundant flow of urine, this secretion having been scanty for a few days (in five hours), 41.
RESPIRATORY ORGANS
- Expectoration of a thick yellow pus for six or seven days, 44.
- Respirations slow, 44.
- Respiration 20 (before experiment); 14 (in three hours and a half); 12 (in four hours and a half), 41.
- Slow, catching respiration, 48.
- Difficulty of breathing, with oppression in the præcordial region; the difficulty of breathing rapidly increased, consisting of a series of short and rapid inspirations, followed by three or four prolonged gasps, 49.
- Struggles for breath, 46. [650.]
- Thought he was going to die from suffocation, until I had his head thrown back, when he said the air rushed into his lungs and relieved him for a time, 44.
- Respiration scarcely perceptible, 47.
CHEST
- Pain in chest, 48.
HEART AND PULSE
- Pulse 98 to 100, and very weak, 44.
- Pulse 83 (before experiment); 78 (in three hours and a half); 53, rose to 65 on walking across the room (in four hours and a half); 53 (in five hours); 63 (in five hours and a half), 41.
- Pulse 87 (before experiment); 64 (in three hours); 84 (in four hours), 40.
- After the lapse of one hour the pulse had fallen twenty beats per minute, 42.
- Pulse weak, 47.
- Pulse slow, 48.
- No pulse at the wrist or carotids, 35. [660.]
- Pulseless at the wrists (after one hour and a half), 36.
SUPERIOR EXTREMITIES
INFERIOR EXTREMITIES
GENERALITIES
- Paralysis, 47, 48.
- Extremities cold, the pulse small and feeble, respirations sighing and jerking, pupils dilated, and the eyes suffused. There was paralysis of the bladder, the urine dribbling away constantly, and although there was general muscular enfeeblement, it was most marked on the right side, in the arm, and leg, 45.
- In a few minutes she said she could not see; her head felt strangely. She took an emetic of mustard, which caused vomiting before the writer arrived. Found the patient in the following condition; Could not see; the blindness was complete. Neither could she talk or swallow; the glottis was spasmodically closed. She could moan, which she did almost continually; but the power of articulation was gone. Great trembling, with anxiety; was afraid she was going to die, and was very anxious to know if anything could be done. Face swollen and of dark color; eyes distended; pupils dilated; great prostration; pulse small and rapid; tongue and throat very dry, 43.
- At 4.30 P.M., having swallowed two ounces of whiskey, with a view to its stimulating action upon my pulse, and having walked rapidly some distance, I had a full, strong pulse of 100 per minute, my normal pulse being 85 per minute. I injected under the skin of my left arm five minims fluid extract. I examined my pulse at 5 o'clock, and it had fallen to 84; vision a little indistinct; at 5.30 pulse was down to 80 beats per minute; vision more disturbed. At 6 o'clock pulse 76, and temperature 98 1/5°; disturbance of vision very great. It seemed almost impossible for me to fix my gaze upon any object, and when I succeeded in doing so, the object, whatever it happened to be, would fade away at first, and then reappear again. There was a sensation of fulness in my head, and a feeling of great weight and heaviness about the eyelids. When I opened my eyes to their fullest capacity, it seemed as through they were but half open. At 6.15 pulse was 72, no change in the other symptoms. At 6.30 pulse stood 69. At 7 o'clock I partook of a light supper. At 7.45 pulse was 60, and respiration 15; no change in temperature. The disturbance of vision completely passed off at 8 P.M., after which time no uncomfortable symptoms were experienced. At 8.15 pulse 60, respiration 15, and temperature 97 2/5°. At 8.45 pulse 59, and temperature 97 2/3°. At 9.15 pulse 60. At 9.45 pulse 60, and temperature 97 2/5°. I then arose from the half reclining position which I had occupied during the experiment, and walked across the room rapidly for five minutes. On resuming my former position, my pulse during the first minute indicated 67, but in ten minutes it had fallen again to the old rate of 60 per minute. The temperature was not at all affected by the exercise the thermometer recording 97 2/5° as before. At 10.30 pulse 58, and temperature 97 1/5°; at this time I passed eight ounces of rather high-colored urine. I now ascended two flights of stairs and returned, but there was no increase in the pulse or temperature produced by the exercise. At 11 P.M., pulse 63, and temperature 97 1/5°; the former very soft and compressible. At 11.30, pulse 60, and of the same character; temperature 96 3/5°. Retired at 12.30, and slept soundly for five hours. Awaking at 7.30 A.M., I about several times, after which my pulse was 61, irregular and compressible; temperature 97.4°. During the forenoon I passed an unusually large quantity of urine, and my pulse did not regain its normal force and frequency until 10 o'clock in the morning, .
SLEEP
- Drowsiness (soon), 49.