Tensive, drawing sensation along course of nervus trigeminus, which at first is shooting, wandering, very often intermittent; becomes a continuous pain, 1.
EYES
Pupil dilated, with dim vision; cannot look at bright objects without blinking; both near and far objects are confused, 1.
Peculiar crawling sensation on tongue, as from peppermint; extends to lips and back part of palate, spreads to the tips of fingers and toes; is in the face and over the whole body, 1.
Sleepless at night, till near 4 A.M., when he slept two hours, 1.
Nights so restless, that he wanders about the room as if crazy, 1.
SUPPLEMENT: ACONITUM CAMMARUM. Authority.
Prof. C. D. Schroff, Einiges über Aconitum in Pharmakognostischer, Toxikologischer und Pharmakologischer Hinsicht, Geschrieben in december, 1853. (Having obtained the original work, we deem it of sufficient interest to give these experiment anew and in detail, which will be more satisfactory and complete than the meagre statement taken at second hand found in vol. i.) Proving of the alcoholic extract of the root; effects of 0.1 gram.
The first symptom is rumbling in the abdomen with eructations, after which the head becomes dull, there appears a tense drawing sensation along the course of the trigeminus, which then gives place to a shooting, wandering, very frequently interrupted, and finally constant pain. The pulse begins to fall, to become irregular, small, and weak, the dulness of the head increases, associated with weakness, prostration, and sleepiness, and a dull pain within the skull. The pupils are at first unusually mobile, varying in size, but afterwards become permanently dilated, associated with dim vision, so that she is unable to look at a strongly illuminated body without blinking, and both near and distant objects become confused.
About forty minutes after the dose, there appeared a peculiar prickling sensation on the tongue, which was at first quite similar to the effects of peppermint; it spread over the lips and posterior portion of the mouth and fauces, then extended to the tips of the fingers and toes, and over the face, and finally over the whole body. At the same time there was increased secretion of saliva, the skin became cold, dry, and rustling. The crawling continued to increase, and caused a most wonderful subjective sensation of distortion of the face and the extremities, and constriction of the body. This was associated with uneasiness; there seemed to be a tickling which compelled constant motion. In an even temperature it diminished, but increased on changing from a cold to a warm atmosphere, or the reverse. The headache and dulness of the head gradually diminished after two hours. The prover experienced most unusual weakness, weariness, oppression, and anxiety, was frequently obliged to yawn. Respiration constantly became more difficult and slower. This was associated with a sensation as if the neck and chest were constricted. The pulse constantly became more and more irregular, and fell below one-half of the normal, frequently intermittent, and at last assumed a dicrotic type. The weakness reached such a degree that the prover could not stand up, but was obliged to keep a horizontal position. The anxiety increased, was associated with apathy, indifference to the whole world. The beat of the pulse and heart at times omitted for several-seconds; respiration became more a catching for breath. Skin constantly dry and icy cold. Taste and sensation diminished. On the places where the crawling had ceased there set in a sensation of fuzziness, as in a finger which has been tightly laced by a string; subsultus tendinum; involuntary stretching of the limbs. Constant nausea and efforts to vomit, and at last, after five hours, repeated vomiting; after this the whole condition essentially improved. Pulse and respiration became more rapid, regular, the anxiety and depression decreased, and the whole body became warmer, and the crawling ceased entirely, but instead of it there remained a certain insensibility of the skin, a kind of fuzziness. The head was no longer painful and dull, but rather empty and confused, as if intoxicated by sleep; the weakness remained, so that on attempting to rise the prover became hot and dizzy, and there were flickering before the eyes, roaring in the ears, pain in the head and face, nausea, and such weakness that he was obliged to lie down again to avoid falling. The whole night was passed in this condition without sleep, only about 4 A.M. he fell into a slumber lasting two hours. The whole next day the prover went about as if half asleep; his memory and power of attention completely disordered, pupils dilated, pulse at one time rapid, at another slow. After every mental or physical effort there appeared dulness of the head and face. The tongue in the morning was coated, the taste pasty, the whole skin cold and dry, diuresis very much increased. (The symptoms given here appeared with the greatest constancy in three proving of the root, both old and young, before and after flowering, in doses up to 0.1 gram, and caused in the prover such distressing symptoms that he did not dare to ).
increase the dose
Heinrich's proving of the same dose showed so many peculiarities that I give it by itself. -Schroff.
Heinrich's pulse was at first a little rapid; after twenty minutes there appeared eructations, scraping in the throat, dulness of the head, dilatation of the pupils with dimness of vision, head heavy and confused. After forty minutes the crawling began, first upon the tongue and lips, then over the face, whence it spread over the body. Together with the crawling there was observed an itching in the skin, and a drawing up of the face; the skin was dry. After an hour the headache and faceache began; the headache was aggravated by bending the body forward; it afterwards became associated with ringing in the ears and vertigo. The pulse became slow, fell from 62 to 51 within two hours, and was so small, weak, and intermittent, that is was very difficult to count. Respiration was difficult, associated with a sensation as if the chest was constricted. Secretion of saliva increased. On going home there appeared very great weakness, and after walking about pain in the joints of the elbows, knees, and hips; this pain was relieved, but not entirely removed by pressure. After about four hours the pains in the head and face became very violent and spread over the rest of the body. The followed a stool. The crawling increased and caused an inexplicable uneasiness, so that he walked almost the whole night up and down the room, as if crazy. The skin was dry and cold, respiration difficult, rapid, the pulse very slow (40). Violent eructations, effort to vomit. Spasmodic constriction of the stomach and contraction of the abdominal muscles. On walking about he had vertigo, roaring in the ears, and great sensitiveness to light. After the crawling had ceased the epidermis of the face began to desquamate. Towards morning he lay down on account of great weakness, soon fell asleep, and awoke warm and in perspiration. At this time he had erections and emissions, but without voluptuous dreams. The morning after the proving he seemed quite well, but at the college, where he was obliged to stand, he became very weak, and the pains in the joints returned.
In one proving, from the old root, some blisters developed on the skin of the lower extremities, filled with serous fluid, and were very painful. The memory was very weak. Appetite diminished, voice hoarse and rough. Power of touch diminished, so that he could not distinguish small objects by the feeling. This action is also different from that observed by Dworzak, as it was less intense but there was more variety. The rumbling in the abdomen was much less, but the itching of the skin, desquamation of the epidermis, pains in the joints, perspiration, emissions, eruption of vesicles, extension of the pain in the face over the rest body, were peculiar; on the contrary he had no vomiting, no retardation of respiration no gasping for air, no constriction of the throat, no subjective symptoms of the skin and extremities.
A closer analysis of the symptoms follows: The rumbling in the abdomen and the eructations which appeared in most of the provers, usually at once after the dose, were constant symptoms. Another constant symptom was the pain in the head and face. The headache seemed to be difficult to distinguish, especially as it seemed associated with pain in the face and in character identical with it, having its seat in the scalp, and involving the distribution of the temporal, frontal, and supraorbital divisions of the trigeminus. The faceache was always a drawing tense sensation, at times also a feeling of pressure; the upper jaw seemed leaden and heavy; followed by single shooting-jerking pains along the course of the isolated nerves; the pain changing about, till at last it became fixed. The second kind of headache came one later, after the dulness of the head had passed off and the pulse had decidedly fallen. This headache was associated with ringing in the ears, vertigo, etc.; and was seated within the skull, and from smaller doses was only a dull pressing sensation within the head; it was especially produced and aggravated by mental effort.
The crawling was characteristic of the extract; except in those cases when the extract came in contact with the tongue, it appeared for the first time when the pulse had fallen one-quarter of the normal, and was associated with dulness of the head, pains in the head and face. Its first indication was a peculiar biting and cooling sensation on the tongue, always associated with increased secretion of saliva, after which there came on the crawling. The symptom always observed a definite order; it always appeared first on the tip of the tongue, then over the upper surface of the tongue and on the lips, extending to the posterior portion of the mouth, then began in the tips of the fingers, then in the face, and above all in the suprahyoid region and on the chin, then in the cheeks and tips of the toes, on the perinæum, chest, abdomen, and lastly, on the back. It was most violent in the forehead, least violent in the latter regions. On observing attentively the order in which this symptom appears it will be seen that it affects the different parts of the body in the same order in which Weber's measure of touch determines the sensitiveness. The crawling cannot be described; it seems like the result of pressure on the sciatic nerve, yet it is peculiar; it is not like formication, prickling, nor tickling, but rather a mixture of all these. As already stated, it is aggravated by change of temperature. I have not usually observed it on the throat. Only while eating it seems to accompany the morsel through the œsophagus to the stomach; therewith the taste is diminished.
As regards the pulse, we found that in some provers it was first increased in frequency, but after twenty minutes it sank below the normal, became small, weak, intermittent, and on retardation, as in one case from 80 to 50, it became dicrotic. This dicrotic pulse, however, was only noticed in the large arteries, mostly in the carotids, since in the radial arteries the pulse, when slow, was so small, weak, and irregular, that it could scarcely be counted. When the flat hand was placed upon the præcordial region it could be distinctly felt that the heart did not contract at once. The pulse and beat of the heart, from large doses, very frequently omitted entirely for a few seconds. In one case, from the extract of young roots, in order to feel the beat of the heart more distinctly I lay upon the abdomen, and felt plainly for some time a very violent irregular beating, which became weaker and weaker, then at last it ceased entirely for some seconds, after which it became stronger, and so on. Soon after vomiting the beat of the heart and the pulse became regular.
As regards the disturbance of respiration, we find that in the beginning there was frequent yawning, afterwards oppression, anxiety, gasping for air, with a feeling as if the chest and throat would be constricted. At this time there were a very disagreeable feeling in the throat, and nausea, so that the prover very frequently and involuntarily put is hand to the throat, where the hindrance to the breathing seemed to be. Pereira mentions this motion without being able to assign a cause for it. Previous to vomiting the respiratory movements were the most difficult and the slowest, and the anxiety of breathing the greatest (associated with the greatest retardation of the pulse); in one case the respirations fell to 8 in a minute; after vomiting the respirations became more frequent, more rapid than normal. The respiratory movements were very short, weak, and in shocks.
The temperature of the skin during the first half hour after the dose was elevated; especially the head and face were very warm, and in some cases I observed warmth in the epigastric region; after this the skin always became cool and always remained so for six or eight hours, even though well covered and heated. This coolness was not only subjective, but was very perceptible to my colleagues. The skin was pale, the features distorted, the sensibility diminished (I was able to pinch myself quite violently without experiencing pain).
As regards the subjective symptoms in the skin, they occurred at the same time as the crawling, and have been noticed as a distortion of the face, etc.; they were most marked and the most remarkable at first. They never entirely disappeared, and were always aggravated by change of temperature.
Muscular weakness made its appearance as a laxity of the joints. The movements of the extremities seemed like those of a pendulum, with no action of the muscles, or better to describe it, as if the muscular sense failed entirely. About two hours after the dose there came on a peculiar weakness, so that after a dose of 0.1 gram of the old root, when in order to relieve the increasing need of respiration, the room seeming too tight, and associated with a sense of not enough air in it, I attempted to take a walk, I was obliged to be supported by a colleague in order to avoid falling. About six hours after the dose the weakness was so great that I was obliged to keep a horizontal position.
The sleep was always disturbed, and after the larger doses the whole night was sleepless; from small doses the sleep was frequently interrupted and very restless.
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