Physostigma phys.

Spinal motor nerves. Eyes. Muscles. Left side.

Change of temperature. Eyestrain. Injury. Bathing. Heat and cold. Descending. Motion.

Lying with head low (Ver-v.). Exerting the will.

Weakness; muscles won't respond or draw into knots; < cold. Weakness in lower limbs; coming from a spot between hips. Cramp in left calf at night in bed. Shuddering, < every draft. Horror of cold water. Averse to bathing.

Active mind, even during sleep. Floating sensation. Nothing seems right. Brain falls to side lain on. Pains from forehead down nose. Sensation as of a tight cap on head. Vertigo; stumbles on ascending or descending steps. Sensation as of a band about head. Twitching of eye muscles or of nose. Can't bear to raise eyelids. Accommodation affected. Seems to have swallowed a lump. Torpid bowels. Numb womb. Flushes of heat, < in palms. Sore bloated, red navel; hypogastrium, < standing. Tremor; in head, eyes, vision, nose, teeth, muscles, etc. Dartings, here and there. Tense eye-lids, can't open or close them. Blood-shot eyes. Creeping numbness from occiput down spine. Licks lips. Teeth feel rough. Tongue feels oily; scalded. Loose skin feeling in roof of mouth. Thick, leathery saliva. Hic-cough with short breath. Gripe in right hypochondrium. Groins pain alternately. Abdomen, > extending legs. Numbness at womb. Offensive odor from hands. Sweat in excitement. Heart seems to flutter in throat or over body. Sensitive spine. Jerking limbs. Shudders from every draft of air. Attacks of overpowering sleepiness, with feeling as if to lose consciousness.

Related: Agar. Gel. Nux-v.

Uncommon mental activity; cannot stop thinking. Vision dim; from blur or film; objects mixed. Pain after using eyes; floating black spots, flashes of light, twitching of lids and muscles of eyes (Agar.); mystagmus. Great prostration of muscular system; impaired locomotion (Gels.). Tremors or trembling of young persons from mental or physical disturbances. Idiopathic or traumatic tetanus; brought on or < by slightest breath of air from a person passing (Hyper., Lys., Nux, Strych.).

Compare: Bell., Con., Cur., Gels., Hyper., Strych.

Calabar Bean

This remedy and its active principle, Eserine, form a valuable addition to Materia Medica. Stimulates heart, raises blood pressure, and increases peristalsis. Causes contraction of the pupil and of the ciliary muscles. Induces a condition of short-sightedness. Spinal irritation, loss of motility, prostration, with very sensitive vertebræ Fibrillary tremors. Rigidity of muscles; paralysis. Depresses the motor and reflex activity of the cord and causes loss of sensibility to pain, muscular weakness, followed by complete paralysis, although muscular contractility is not impaired. Paralysis and tremors, chorea. Meningeal irritation, with rigidity of muscles. Tetanus and trismus. Polymyelitis anterior. Eserine is used locally to produce contraction of pupil.

Constant pain on top; vertigo, with constrictive feeling of head. Pain over orbits; cannot bear to raise eyelids. Cerebro-spinal meningitis; general tetanic rigidity. Spastic conditions of the face-muscles.

Night-blindness (Opposite: Bothrops); photophobia; contraction of pupils; twitching of ocular muscles. Lagophthalmus. Muscæ volitantes; flashes of light; partial blindness. Glaucoma; paresis of accommodation; astigmatism. Profuse lachrymation. Spasm of ciliary muscles, with irritability after using eyes. Increasing myopia. Post-diphtheritic paralysis of eye and accommodation muscles.

Fluent coryza; burning and tingling of nostrils; nose stuffed and hot. Fever-blisters around nostrils.

Tongue feels sore on tip. Feeling as if a ball came up throat.

Strong heart-pulsation felt in throat.

Great pain immediately after eating. Sensitive to pressure in epigastric region. Pain extends into chest and down arms. Gastralgia; chronic constipation.

Irregular menstruation, with palpitation. Congestion of eyes. Rigid muscles.

Feeble pulse; palpitation; spasmodic action, with feeling pulsation through the whole body. Beats of heart distinctly perceptible in chest and head. Fluttering of heart felt in throat. Fatty degeneration (Cup ac).

Pain in right popliteal space. Burning and tingling in spine. Hands and feet numb. Sudden jerking of limbs on going to sleep. Tetanic convulsions. Locomotor ataxia. Numbness in paralyzed parts, crampy pains in limbs.

Compare: Eserine-the alkaloid of Physostigma--(slows action of heart and increases arterial tension; in ciliary spasm and spasmodic astigmatism due to irregular action of ciliary muscles; blepharo-spasms; pupils contracted. Twitching of lids, soreness of eyeballs, blurring of vision after using eyes, pains around eyes and head). Used locally to contract the pupil. Eserine contracts the pupils dilated by Atropin, but not those dilated by Gelsemium. Internally 6x.

Eserin Salicylate (post-operative intestinal paralysis; meteorism. Hypodermically 1/60-1/40 gr).

Compare also: Muscarin; Conium; Curare; Gels; Thebainum (tetanus); Piperazinum--(Uric acid conditions. Pruritus. Gout and urinary calculi. Constant backache. Skin dry, urine scanty. Rheumatic urthritis. Give one grain daily in carbonated water. First and second decimal trituration three times a day).

Antidote: Atropia. In full medicinal doses will relieve most of the effects of physostigmine.

Third potency. The neutral sulphate of Eserine is instilled into the eye, from one-half to four grains to one ounce distilled water, to induce contraction of pupil, in mydriasis, injuries to the eye, iritis, corneal ulcers, etc.

Physostigma venenosum. Calabar Bean. Eséré. N. O. Leguminosæ. Trituration of the bean.

Astigmatism. Bathing, effects of. Blepharospasm. Chorea. Ciliary spasm. Climacteric. Constipation. Coccygodynia. Dentition. Diarrhœa. Dyspepsia. Epilepsy. Eyes, affections of ; injuries of; strain of. General paralysis. Glaucoma. Hæmorrhoids. Headache. Heart, affections of. Hemiplegia (l.) Herpes, preputialis. Hiccough. Hysteria. Iris, prolapsed. Leucorrhœa. Levitation. Locomotor ataxy. Myopia . Navel, inflammation of. Paralysis, local ; agitans; spinal. Paraplegia. Progressive muscular atrophy. Prostration; muscular. Sleeplessness. Spinal irritation. Spinal sclerosis. Stiff neck. Tetanus. Throat, sore; fish-bone sensation. Water, effects of. Wounds.

"The Ordeal-bean" of Old Calabar, the Eséré of the natives, is the type of a genus of Leguminosæ of the tribe Phaseoleæ , with flowers very like Phaseolus , except that its bearded style is terminated by a great oblique hood, covering the blunt stigma." It is this hood which distinguishes the genus and gives it its name. P. ven . is a great twining climber, and has purplish flowers. Its seeds are very poisonous, and are used by the Calabari as an ordeal, suspected persons being compelled to eat them until they either vomit or die. In the latter case they are considered guilty, in the former innocent. In cases observed in Calabar convulsions have been noted, and twitchings, especially in the back, and death in thirty minutes. A number of cases of poisoning have occurred in this country, and in these the most notable feature was complete muscular prostration. According to Brunton, the tetanising properties of the bean belong to an alkaloid, Calabarine , and the paralysis to Eserine (or Physostigmine , as it is now called). In animals poisoned by it speedy general paralysis is set up, and death occurs from failure of respiration; though the heart may be poisoned both directly and through its nerves. The paralysis is seated in the spinal cord itself. The muscles are affected by fluttering tremors; involuntary muscles are excited to active movements and expulsive efforts. The intestines are often twisted up in knots. All the secretions are somewhat increased ( C. D. P .). A crowd of children in Liverpool ate beans which they found among the sweepings of a ship from Africa. Forty-six were admitted to hospital with loss of muscular power, prostration, feeble, slow pulse, cold, perspiring skin, cold extremities; vomiting in nearly all cases, diarrhœa in one-third of them. At first there was colic, but later on remarkable freedom from pain. Pupils contracted in many; in one contracted during sleep, dilated when aroused. Only one (a phthisical boy) succumbed. He staggered as he walked, then fell, kicking and rolling as if in pain, but afterwards became quiet; much purged; pulse hardly perceptible; skin cold, face livid; quite conscious and able to swallow water. Directly after drinking he died without a struggle, some froth issuing from nose and mouth. After death the blood was found to be fluid; the heart distended with it, and its muscular substance very flaccid ( C. D. P .). Many excellent provings have been made with Physo ., among which one made by Christison on himself is remarkable. Simpson and Douglas MacLagan were sent for to attend him in his collapsed state, which Simpson could only compare to that produced by severe flooding, though Christison's only sensation was one of "extreme but not unpleasant faintness." MacLagan thought it like Aconite poisoning. Christison could not get his will into his muscles except by a tremendous effort. Warmth to feet and a sinapism to whole abdomen gave great relief, and he was then able to turn on his left side; but only remained there a very short time on account of the tumultuous action of the heart it set up. He became drowsy and slept; but his mind was so active in sleep that on awaking he did not know that he had slept. The tumultuous action of the heart continued on waking, but strong coffee quickly restored the whole condition and made the heart regular. A symptom observed by Christison and many other provers was one of indigestion, "as if large pieces of food had been suddenly swallowed." It began under upper sternum, descending and increasing in intensity till it reached the epigastrium; eructations then occurred, and a reversal of direction followed, the sensation ending where it began. With other provers there was a sensation of weight and hardness. Christison also had very much giddiness and dimness of vision. It is for its action on the eye, especially for its power of contracting the pupil, and thereby antagonising Atropine , that Physo . and its alkaloid Eserine are best known in old-school practice. The effects are more definite when the drug (tincture, extract, or solution of alkaloid) is applied to the eye direct; but one myopic prover had his myopia much diminished. In glaucoma it has been used with signal success to diminish intra-ocular tension; and especially when glaucoma has been the result of injury. Dudgeon ( B. J. H ., xxxviii. 60) relates the case of A. E., 26, struck by the cork of a soda-water bottle on inferior and outer part of left eyeball. Intense burning pain and effusion into the eyeball followed. Under Arn ., prescribed by Mr. Engall, the effusion disappeared, and later the pain and inflammation subsided under Aco . and Merc. c . The pupil was now egg-shaped, the long diameter perpendicular, smaller end downwards; vision extremely myopic. Bell . dilated the pupil, but had no effect on the vision. Engall sent the patient to Dudgeon, who found the pupil was sluggish, and a book had to be held within four inches of the eye to be read. Physo . 3x, every three hours, was given. After the first dose objects could be seen at a considerable distance, and next day sight was nearly as good as ever. Dudgeon considers that the lens was tilted by the blow, and that Physo . restored the over-stretched or paralysed portion of the ciliary muscle. Woodyatt ( Org . iii. 99) states that Physo . has produced corneal astigmatism in a young lady, who found any attempt at close work caused redness of tarsal edges and a hot, sandy feeling in conjunctiva. Lil. t . 30 cured. Paralysis and tremors predominate over the cramps, twitchings, stiffnesses, and tension of Physo ., but these are also characteristic, and tetanus has been cured by Physo . Paralysis of left side is very proeminent, and the numbness is more apparent on left side, especially in left arm; which may be associated with heart symptoms. The apex of the left lung is also affected. A feeling of levitation was observed in one prover on stepping. Ataxic gait and shooting pains down limbs show its appropriateness in locomotor ataxy. The inability to get the will into the muscles is a striking feature of many paralyses. Spinal, sacral, and coccygeal pains were experienced, and associated with some of them, numbness of the womb. The association of muscular prostration (in any form, of which laboured respiration is one) with any affection is a keynote of Physo . This case was cured: Great muscular prostration with continual inclination to sigh; leucorrhœa < by exercising during the day, especially 4 p.m.; sighing < when leucorrhœa is < ; dread of cold water. This dread of cold water is a grand keynote of Physo . One of the provers (a water drinker) developed a perfect disgust for cold water and cold drinks; and though used to a cold morning plunge, was obliged to omit it on account of his horror. Other provers felt uncomfortable after bathing, and had great reluctance to their bath. Weakness was felt on change of weather, and on cold, bracing days. A paralytic state of mind and body from grief has been cured with Physo . Sleeplessness of a peculiar kind occurs in Physo . Nash ( Med. Adv ., xx. 258) cured with Physo . 12 and 30 persistent sleeplessness in a patient who had been in an insane asylum, and feared she would have to go again. Her symptom was: "If she chanced to get a nap she awoke suddenly as if in a fright, and felt no > from what she had slept." Peculiar sensations are: As if stomach were full. As if she must lose her mind. As if a ball were coming up throat. Lower limbs as if asleep. Back as if paralysed. Tongue as if burnt (left margin); as if swollen and paralysed. Sensations of contraction and tension. Wavering in brain. Weak feeling in stomach. H. L. Chase, one of the provers, had a "very severe pain in the right popliteal space," and he afterwards cured a patient who came to him with pain in the same region two years later ( H. R ., xiii. 117). (Allen gives the symptom as in the left popliteal space.) The symptoms are < by pressure (of finger between vertebræ causing wincing); by falls and blows. < Motion; descending stairs (wavering in brain). < Walking; stepping; jar of misstep. > Lying supine. < Lying l. side; > lying on r. side. < 4 p.m. < Night (headache unbearable). If pain began at any hour it always continued till 12 o'clock following, either noon or midnight. < Cold water; perfect horror of cold drink; cold bath. < From bathing; from change in weather; on bracing days. < In church. > In cool open air. < On waking. > Closing eyes. > By sleep (hiccough). > Warmth to feet; sinapisms to abdomen.

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Physostigma venenosum. Leguminosæ.
Triturations of the whole bean.
First mentioned by the missionaries to the western coast of Africa ; in 1846 by Daniel ; in 1855 investigated by Christison ; in 1862 first observations by Frazer on the contraction of the pupil (also by Workman) ; used and abused since by many.

Uncommon mental activity.

Dizziness, with faintness and muscæ volitantes on moving, 1 P. M.

Pain in middle of forehead in one spot above eyes, and over and in left eye a pain, with muscæ volitantes.
Pressure in temples.
Pain through temples, as from pressure of blood to head, with throbbing of arteries on side of neck.
Pain through temples and burning of eyes.
Intense painful pressure in vertex and both temples ; has to lie down.
Pressure in vertex extending over to occiput.
Numbness and peculiar sensation in top of head, especially towards back of head.
Five minutes after taking dose, dull pain in left occipital region.
A feeling of loss of power and sensation in back of head as if head would fall over forward, and the natural supports of head would no longer hold it back.
Congestive headache all forenoon.
Rush of blood to head, with heat and burning of nose, sneezing slight.

Numbness of temples and crawling sensation over head.
Between 8 and 9 P. M., a creeping numbness over back of head and all down spine, especially in part between hips.

Eyes feel weak.
Great pressure on eyes ; with muscæ volitantes.
Sore pain in eyes, with flying specks.
The medicine affects the sight very much, producing these spectres constantly : flitting before sight, long snakes or worms, both dark and light ; also waves before eyes, making objects have a tremulous motion, as if it gave same quality of involuntary motion to optic nerve that it does to motor nerves, and made the sight movable.
Objects appear larger and nearer.
Slight sensation of double sight, as if images of objects would be multiplied.
Felt film over eyes and blur ; objects mixed, followed by dull pain over and between eyes.
Dimness of distant vision is followed shortly after by contraction of pupil.
(OBS :) Dimness of vision as a sequela to diphtheritis.
The internal rectus does not do its work rightly, and the axes of eyes do not correspond ; eyes feel weak ; lachrymation, especially of left eye.
Feeling of straining in eyes shortly after effects are produced.
On attempting to look upward, not the least movement was perceptible, showing paralysis of superior rectus and inferior oblique muscles.
In looking downward, the superior oblique muscle, which is governed by the n. trochlearis, alone acted, making a slight rotation around the visual axis, rather than a downward movement.
Complete paralysis of accommodation.
(OBS :) Paralysis of ciliary muscles after long-continued debilitating disease.
Let pupil sluggish, not much dilated ; myopia, and objects seem too large, with left eye ; after a blow on left eyeball.
Pupil permanently dilated, with loss of accommodation, of eight years' standing, after traumatic injury to the cornea.
Pupil was dilated, cornea turned well outward, and on looking towards the right side it could not be brought to centre of palpebral fissure (showing a paralysis of internal rectus muscle).
Occasions contraction of pupil and sympathetically dilatation of pupil of other eye.
In twenty minutes pupil contracted to size of pin's head, with a boy.
Shortsightedness.
Myopia.
The effects last longer on iris than on ciliary muscles.
(OBS :) Where iris has a tendency to protrude through a corneal wound.
Drawing-twisting sensation in eyes.
Sharp, shooting and drawing sensation in right eye.
Eyes are sore and give pain when moved from side to side.
Pain in eyeball.
Symptoms of eyes all morning, with much burning of balls.
Burning of eyeballs.
Burning of eyes and bloodshot appearance of them all forenoon.
Eyes smart ; lids feel sore.
Heavy headache and pain in eyes, with much heat in head and face ; muscæ volitantes both black and light.
(OBS :) Ulceration of margin of cornea, leading to perforation, or even when prolapsus of iris has just occurred.
(OBS :) In cases of retinitis, to diminish the access of light.
Beating, or throbbing and twitching between eyebrows.
Excites salivary and lachrymal secretion.
The whole affection came on suddenly ; about a month before she went to bed well, and on rising next morning found it impossible to open eye. θ Rheumatic attack of ocular muscles.
Endeavoring to open eye, a slight upward movement of lid remained, caused by the musculus orbicularis palpebrarum, governed by facial nerve, relaxing itself still more.
Upper lid of left eye hanging down, outer caruncle lower ; that of right side, complete ptosis.
Considerable tenderness of skin around eye.
Mattery eyes.
Intolerable pain over both orbits.

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A tincture is made of the "Calabar bean," Physostigma venenosum, Balfour.

This ordeal poison produces muscular tremors and tetaniform spasms of voluntary and involuntary muscles, as well as vasomotor spasms, followed by diminished reflex and paralysis. ▶ It also produces violent vomiting and purging. ▶ Death occurs usually from failure of the respiration. ▶ One of its most marked effects is the contraction of the pupil, which is supposed to be due to a paralysis of the sympathetic fibres. ▶ Its most marked ally is Muscarine.

Agaricus mus., (Opium), Nux vom., Tabac.

Tremblings in front of body, with wavelike motions up and down in it, but in back of body paralysis, numbness and pain as when the nerve of a tooth is being killed; T. in paroxysms, first in legs, sometimes general, at the least thing that startles, once in hands, then soreness in pit of stomach; T. and shuddering, beginning in head, running down through pit of stomach, womb and whole body, the chief sensation in the head was the one in the middle of forehead, and in left eye a pain with muscæ volitantes. ▶ Nervous motions down through body and through arms at 3 P.M., with palpitation, next day with weakness at pit of stomach. ▶ Convulsions and twitchings (agg. back). ▶ Twitching of mouth, eyebrows and between brows at 8 P.M., with throbbing between brows and numbness from between eyes down through nose. ▶ Hinders voluntary motions as well as causes involuntary motions.

Lancinations in left hypochondrium, left thigh, left index, at 9.50 A.M., then sharp pain in region of liver, passing towards sternum. ▶ Darting pains wandering from one place to another. ▶ Occasional sharp pains in different parts. ▶ Twinging pain in various parts. ▶ Strange indescribable sensation through system. ▶ Feeling as if he had taken cold; and soreness and stiffness, all over body. ▶ Discomfort in morning. ▶ Floating sensation on raising my foot when walking, and when the foot touched the ground an unpleasant sensation that caused shuddering. ▶ Pulsation through whole body when sitting still, agg. chest, each beat of heart was distinctly perceptible in chest and temples. ▶ Soreness around waist at 6 P.M. sudden access of vigor at 6.30 P.M., and the symptoms that followed came like a reaction. ▶ Restless; at 10 P.M., in bed. ▶ Constant desire to change from side to side. ▶ Disinclination to move. ▶ Aversion to the usual cold bath; to the usual bath, and discomfort after bathing.

Weakness; of right side; in forepart of day (which was sultry), with uncommon mental activity; in forenoon; at 8 A.M.; 9 A.M.; at 9 A.M., agg. groins; at noon, amel. 10 P.M., with headache; at 1 P.M.; in afternoon, with fulness on forehead and tendency to ache, agg. right side; at 4 P.M., with leucorrhœa; at 8 P.M.; 9 P.M.; 10 P.M.; after stool; on ascending stairs; on walking; when walking in the street, with stupidity and vertigo; and whole frame seemed loosened; with stupidity and feeling as after carousing; with torpor; with necessity to lie down and desire to have the doors shut; at 6.30 P.M., as if every nerve were unstrung, even to eyes, which felt as if all power to see were going from them; extending from head through back and legs, with thrilling in legs, slight exertion caused lameness and weakness in small of back; muscular, with fibrillar twitchings; nervous, tremulous, at 7 P.M., agg. left arm.

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