A crystallizable acid, C15H18O3 . Santoninic acid. Obtained from different species of Russian and Levantine Artemisia, especially from "Semen cinæ". See

Cina.

Preparation , Triturations.

Authorities.

1 , Knoblauch, Deutsch Klin., 1834-5, general effects; 2 , T. Spencer Wells, Lond. Med. Gaz., 1848, p. 1035, general effects; 3 , Spengler, Deutsch Klin., 1850, effects of 2 grains twice, in a boy four years old; 4 , Schmidt, Deutsch Klin., 1852, poisoning; 5 , Schmidt and Heydloff, Preuss. Ver. Zeit., 1852, poisoning; 6 , Zimmermann, Deutsch Klin., 1853, general effects; 7 , Bohler, Zeit. f. Hom., Kl., 2, 156, 1856, two children took, for worms, 15 grains morning and evening for three days; 8 , same, the father took a powder; 9 , same, effects of 5 grains to four children for six days; 10 , Mauthner, Journ. f. Kinderkr., 1854, 22, p. 1, a healthy boy with a broken bone took 4 grains; 10 a , same boy afterwards took 6 grains; 11 , Seitz, Hannov. Convers., 5, 22, 1855, effects in children; 12 , Ann. de Thérap., 1852, a child aged four took 3 grains; 13 , James Moore, Lancet, 1859, 1, 402, effects in two children when given as an anthelmintic; 14 , same, a moderate dose in a woman; 15 , same, in a little girl; 16 , same, two other cases; 17 , Phipson, Virginia Med. and Surg. Journ., 1859, p. 49 (Gaz. Hebdom), took 5 grains; 18 , omitted; 19 , Gabalda, L'Art Méd., 10, 256, a child four and a half years old took Santonin pills every day (apparently had worms); 20 , Lohrmann, Journ. de Chim. Méd. et Pharm. J., 2d ser., 4, 91, a child three years old took about a grain in five lozenges for ascarides; 21 , Guepin, Compt. Rend., 1860, p. 794, general effects; 22 , Martin, Buchner's Repert., 2, 5 (S. J., 80, 12), experiments on self, took 3 grains, once repeated; 23 , Rose, Archiv. f. Path. Anat., general effects; 24 , same, experiments on a colleague; 25 , same, effects in two women; 26 , same, general effects; 27 , Journ. de Chim. Méd., 1862, 8, 76, a child in good health took about 12 grains within half an hour; 28 , Berg. Med. Corr. Bl., 1862, Vol. 22, p. 131, a boy swallowed 3 or 4 grains; 29 , Notta, Journ. de Chim. Méd., 10, 111, general effects; 30 , Lilienthal, N. Am. J. of Hom., 1865, p. 139, fatal effects of "Van Deuzen's Worm Confections," in a girl five years old; 31 , Kraus, Diss. ueber die Wirkungen des Santoni, Tubingen, 1869, experiment on self with repeated doses of 2 to 10 grains; 32 , same, "R." took doses of 2 to 6 grains; 33 , MacDaniel, N. Orleans Journ. of Med., 22, 244, 1869, effects in children free from fever; 33 a , continued use of S.; 34 , Smith, Dubl. Quart. J. of Sc., 1870, effects of 5 grains on self; 35 , same, a boy five years old took 4 grains on two successive days; 36 , same, a series of experiments on self; 37 , Crisp., Brit. Med. Journ., 1871, 1, 273, general effects; 38 , Sieveking, Brit. Med. Journ., 1871, 1, 166, effects of two doses of 3 grains each, in a child of four years; 39 , Farquharsen, Brit. Med. J., 1871, 2, 466, 5 grains in a boy of twelve; 40 , same, experiments on self; 41 , Courrier Med., 1871, p. 328, a boy fourteen years old took 15 centigrams; 42 , Becker, Centralblatt f. Med. Wiss., 1875, a boy of two years took 0.05 gram; 43 , Binz, Lancet, 1877, 1, 853, a child aged two years took two lozenges each of .025 milligram of S.; 44 , Hubbard, U. S. Med. Invest., N. S., 7, 203, fatal effects of 6 grains, in a child of three years.

MIND

Delirium, 19.
Consciousness clear when awake, but during its restless sleep light delirium showed itself (second day), 30.
Felt very much excited, and inclined to dance and laugh (soon), 14.
Hysterical laughter, 13.
Restless, irritable (first day); wanted everything; was satisfied with nothing (second day), 44.
The best marked symptom was a feeling of profound and most unusual depression, accompanied by so much irresolution and want of confidence in my own powers as to render me quite unfit for work of any kind; this invariably followed even a single 5-grain dose, and beginning with dulness and heaviness; ran on into very much that sort of melancholia which I imagine jaundice sometimes produces, 40.
Unconscious, 26.
Comatose, 19.

HEAD

Vertigo, 31. [10.]
Dizzy feelings (in nine cases), 23.
Giddiness, 13, 37.
Head turning and twisting, restless (first day), 44.
Dulness of the head, 31.
Headache, 31.
In almost all cases of cured acute choroiditis, with the exudation more or less colored, it generally caused headache, 21.
Pain in the forehead, 31 ; (after 5 grains), 40.
Fulness about the temples, 14.

EYE

Blue rings around the eyes, 3.
Eyes rolled convulsively, 27. [20.]
Distortion of the eyes, 3.
Pressure in the supraorbital region, 31.
Pressure in the eyes, 31.
Pupil.
Dilated pupils, 12.
Pupils insensible, 3.
Pupils dilated for several days, 44.
Pupils enormously dilated and insensible, 27.
Pupils enormously dilated, 20.
Vision.
Visions (in eight cases), 23.
Flickering before the eyes, 31. [30.]
Objects seemed to totter and dance, and the child seemed to see various figures, cherries, animals, etc., 9.
Photophobia and lachrymation (second day), 22.
When the narcotism seemed to have disappeared ( i. e., when he had got used to it ), he went to dine at a restaurant; the experiment was over and forgotten; during lively conversation in a friendly circle, in comes the waiter with yellow egg soup; it smelt peculiar to him , and also looked quite red ; perfectly shocked, he sent the soup back as entirely spoilt; to the amusement of his friends, he persisted obstinately in asseverations which to them were inexplicable; they came to words, and my hot-headed colleague left the "good-for-nothing eating-house" in a pet, 24.
The conversation turned casually upon a gentleman's coat, and led to a dispute; one said it was yellow, the other a fine violet color; the gentleman, whose coat was gray, and was not aware that one had made herself violet-sighted, the other violet-blind (or yellow-sighted), was astounded; they, too, in their discussion, had forgotten the cause, and could not, without the help of a third person, shake off the illusions, 25.
The blue sky in the evening twilight looked green, not so during the day, 11.
Objects seemed green as if beheld through green glass, 9.
All objects became green and wavering, 7.
Vision green, .

NOSE

Hallucinations of smell (in six cases), 23.

FACE

Convulsive movements of the muscles of the face, especially of the lips and lids, 19. [60.]
Slight twitching of facial muscles set in (second day), 30.
Face pinched; drawing in of lips over the teeth, with pinched expression of mouth and nose (next morning), 30.
Face pale, 3.
Pale around the mouth, worse in the afternoon (first day), 44.
One cheek white, the other red, resembling a hectic flush (first day); red color of one cheek for several days, 44.

MOUTH

Grating of the teeth during sleep, 19.
Teeth clenched, 27.
Tongue deep red (second day), 30.
Dryness of the tongue, 40.
Frothing from the mouth, 27. [70.]
Burning pains apparently torment her, as she forces everything in her mouth (second night), 30.
Hallucinations of taste (in five cases), 23.

THROAT

The glands of the neck, parotid, and submaxillary commenced swelling in about five days, and continued to increase until the throat was so filled as nearly to prevent swallowing, 44.

STOMACH

Deficient appetite (after 5 grains), 40.
Intense thirst, 13.
Continual thirst for ice-water, which she swallowed greedily (next morning), 30.
Frequent eructations, 28.
Eructations, 31.
Nausea, 31, 37, 40 ; (soon), 22.
Nausea and vomiting, 3 ; (fourteen cases), 23. [80.]
Vomiting, 41.
Vomiting (after first dose); violent (after second dose), 38.
Vomiting and purging, with severe abdominal pains, 12.
Vomiting of yellowish slimy mucus set in at 11 P.M. and continued till forenoon, 30.
Excessive vomiting, accompanied by severe pain in the stomach and belly (after half an hour), 13.
One night, after taking a spoonful of nourishment, he choked and threw up half a teacupful of blood and pus, and died without any struggle, 44.
Dull pain in the pit of the stomach (second day), 30.

ABDOMEN

Abdomen somewhat tumid, but soft (second day), 30.
Abdomen hot, full, 28.
Rumbling in the abdomen, 31. [90.]
Abdomen very sensitive (second day), 30.
Severe abdominal pains, with vomiting and purging, 12.
Severe pain in the belly and stomach, with the excessive vomiting (after half an hour); it was not till the second day that the bowels and stomach seemed free from irritation, 13.
Every night, before the child had a movement from the bowels, he gave manifest evidence of pain in the bowels, 44.
Pain in the abdomen, 3.

RECTUM AND ANUS

Well-marked tenesmus was experienced both by myself and by a friend who shared the experiment (after 10 grains), 40.

STOOL

Purging of watery, flaky, foul-smelling stools followed the vomiting in a few hours; passages came every ten to fifteen minutes; at 10 A.M. the stools diminished; she had only three till afternoon, but they were copious, grayish, with smell like putrefaction taking place, 30.
Purging, with vomiting, and severe abdominal pains, 12.
Profuse diarrhœa, with the vomiting (in one case), 13.
Had a movement every night while the child lived, 44.

URINARY ORGANS. [100.]

Frequent efforts to urinate, ability to pass only a few drops each time, 19.
Micturition painful on account of burning in the urethra, with constant desire to urinate, evacuation of only a few drops, that color the linen intensely yellow (after 10 grains), 31.
Five grains were taken at bedtime, and next morning an irresistible and almost uncontrollable desire to micturate was felt, the act being attended with some irritation and smarting; the urine was of a deep saffron-yellow, staining the pot and linen precisely as bile; it was of specific gravity 1028; the quantity was decidedly increased, and the urea was somewhat in excess; the diuretic action continued during the day, and it was not until 8 P.M. that the secretion was quite free from foreign pigment, 40.
Urine thick, sulphur-yellow; after standing an hour it deposited a sulphur-yellow sediment, the urine above which was slightly greenish, 28.
Urine increased in quantity, of the color of saturated saffron-water, continuing three days (after one hour), 10.
Urine increased threefold. After four days the color disappeared from the urine. Urine pale yellow, alkaline; in other respects the child was well, 10a.
Very copious and involuntary discharge of urine towards early morning, 39.
As a general rule the urine becomes colored; in some it continued colored even after the derangement of vision had passed away, 21.
The urine became light-green, and stained the linen so deeply that it could not be washed out, 7.
Urine of the peculiar greenish color which has been noticed after the exhibition of this drug, 43. [110.]
Urine greenish, 42.
In two persons, the urine was very much colored for a few hours, 2.
Urine yellowish-green, 9.
Intensely yellow color of the urine, 6.
Urine orange-colored (second day), 30.
Urine scanty, dark lemon-yellow, acid, depositing dark-yellow crystals of uric acid; nitric acid caused a transient brownish-red color; alkalies caused an amaranth-red color, 22.
Next morning the urine, which had been kept in a tall glass vessel, was of a bright pinkish-red (second day). The urine passed soon after the second dose was of a greenish-yellow color; a few drops of liq. ammonia immediately produced a clear red tint, 35.

RESPIRATORY ORGANS

Coughed incessantly the whole night from a tickling in the larynx and windpipe (first night), 30.
Respiration rapid, sighing, 3.
Breathing quick and catching (second day), 30.
Rattling respiration, 27.

CHEST

Symptoms of paralysis of the lungs, so that artificial respiration had to be resorted to in order to save the life of the patient, 42.

PULSE

Pulse quick and feeble (first day); rapid (second day), 44.
Lowering of the pulse (in two cases), 23.
At 9 P.M., the pulse on the left side was gone, thready and soft in right radial artery (second day), 30.

EXTREMITIES. [130.]

Spasms of the extremities, 12.
Twitching of the hands and feet, 3.

SUPERIOR EXTREMITIES

Convulsive jerking of the upper extremities, 27.

INFERIOR EXTREMITIES

Gait unsteady and tottering, 8.
Staggered, when walking, 28.

GENERALITIES

Most violent convulsions, with loss of consciousness; head hot, face flushed, purplish, 27.
Violent convulsions (after a quarter of an hour), 20.
Violent spasm, beginning in the face and extending to the extremities, affecting respiration; apparently the third to the seventh nerves were the seat of the irritation; pupils dilated, 42.
Convulsions (after eight hours), 44.
General convulsions, with loss of consciousness, with staring eyes, with red, hot face, dilated pupils (the right more dilated than the left), insensible to light; pulse rapid, weak, and irregular; extremities in constant convulsive movement, so also the muscles of the face, 28. [140.]
After midnight severe convulsions set in, more like tetanus, throwing the head back, eyes rolling about, countenance distorted, body sometimes nearly curved, with legs turned back; in the interval grasping at everything, gnawing of fingers; she thus had four convulsive attacks, and died about 2 A.M. (second night), 30.
Without any previous warning sudden clonic convulsive spasms set in, commencing at the left angle of the mouth, and thence spreading over the left side of the face; these were succeeded by similar spasms in the right arm, beginning in the fingers (after ten hours); a quarter of an hour after, a tonic spasm invaded the left side of the face and left arm, then rapidly disappeared, leaving a fibrillary twitching of the muscles of the left angle of the mouth and left eyelid, which soon afterwards ceased quite suddenly; two more convulsive attacks occurred on the same evening, and in one the respiratory movements threatened to come to a standstill, although the heart was beating quite strongly, and the pulse was normal. Two or three similar fits occurred daily at intervals for the next four or five days, after which the child was as well as before, 43.
Convulsive movements of the limbs and of the muscles of the face, 19.
In about five days the child was partially paralyzed on one side, the hand assuming the appearance of induration of the cellular tissue of the hand of an infant; the whole side presenting a blue appearance, which increased till death closed the scene, 44.
Collapsed state (next morning), 30.
As soon as she lay down, the child got restless (first night); threw herself about with her whole body from one side to the other (second day), 30.
Great restlessness, 19.
Great prostration, 12.
Lassitude, prostration (in nine cases), .

SKIN

Skin blue, 44.
Urticaria (like that produced by Bals, copaiva) with œdema of the skin of the nose, lips, and eyelids, 41.
Severe rash, described as urticaria, covering the greater part of the body, accompanied the vomiting (after one dose); almost directly after the second dose, a white wheal appeared on the nose, surrounded by a red erythematous blush, and a similar eruption rapidly covered the body, the swelling attained such a height that within a quarter of an hour the child's face was disfigured to such an extent as to make her almost unrecognizable; the lips, from which some viscid saliva was still issuing, were swollen to an enormous size, glistening from the œdematous distension; the nose, at other times a delicate feature in a sweat little face, was a negro's; and the eyes were almost closed by the same condition of the lids. I at once placed the child in a warm bath, which soothed her; and within an hour the œdema and rash had for the most part disappeared, 38.

SLEEP

Sleepy, tired, 3.
Sleep restless, 3.
Sleep was generally disturbed, and I usually woke unrefreshed, with sickness, frontal headache, and deficient appetite (after 5 grains), 40.

FEVER

Chilliness.
Whole body icy cold, 3. [160.]
The whole body became cold, the lips and ears blue, the face as white as snow, 3.
Extremities rather cold (next morning); in spite of assiduous hot applications the icy-clammy coldness crept steadily upwards (second day), 30.
Cold feet, 3.
Heat.
Violent fever, with very rapid pulse, burning heat of the skin, face puffy, eyes red, brilliant, fixed, 19.
Fever, all the afternoon (first day), 44.
Hot head, 20.
Heat about the head, increased every afternoon and evening, 44.
Sweat.
Cold sweats, 12.
Hot perspiration on the occiput, more clammy in front (second day), 30.

SUPPLEMENT: SANTONINUM.

Addition by Berridge, in a letter to the editor.

"In your Encyclopedia you quote Hubbard's recent case of poisoning by

Santonin . As the side was not specified, I send the following from Hubbard."

"It was the left side that was affected, and the left cheek that was red, and was equally red all the time. The swelling commenced nearly under the centre of the chin, spreading each way, but more particularly towards the left parotid gland." (See 44, in Vol. VIII.)