Physostigma phys.

Boger's Synoptic Key — Materia Medica

C. M. Boger · Boger's Synoptic Key — Materia Medica · A Synoptic Key of the Materia Medica, 1915 — the Materia Medica half

Region

Spinal motor nerves. Eyes. Muscles. Left side.

Worse

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

Better

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

General

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.

Particulars

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

Related: Agar. Gel. Nux-v.

Keynotes and Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica

H. C. Allen · Keynotes and Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica · homeoint.org / Medi-T HTML text; edition not stated by the mirror (first edition 1898, Allen d. 1909)

Keynote

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.).

Relations

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

Homœopathic Materia Medica

William Boericke · Homœopathic Materia Medica · 9th edition

Common name

Calabar Bean

General

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.

Head

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.

Eyes

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.

Nose

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

Mouth

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

Throat

Strong heart-pulsation felt in throat.

Stomach

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

Female

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

Heart

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).

Extremities

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.

Relationship

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.

Dose

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.

A Dictionary of Practical Materia Medica

John Henry Clarke · A Dictionary of Practical Materia Medica · 1st edition (1900-02, three volumes); homeoint.org / Médi-T HTML digitization

General

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

Clinical

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.

Characteristics

"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.

Relations

Antidoted by: Coffee; Sinapisms; Arn.; (emetics are of the first importance. Injection of Atropine antagonises its effects). Lil. t. cured astigmatism of Physo. Compare: Eserin. In paralyses, Lathyr., Oxyt., Strych., Ciner., Con., Gels. Heart, Phaseol., Phos. Eyes, Onos., Lil. t., Rut., jabor., Bell. Headache with drowsiness, Brucea, Gins., Herac. Spinal irritation, hungry sensation, numbness, muscles of back rigid, wavering in brain, Act. r. Headache < by music, Phos., Phos. ac. (Physo. of organ.). Levitation, Phos., Phos. ac. Headache with inability to stop thinking (Phos. with increased mental power), Globus, Ign., Asaf. < Descending stairs, Borax. Increased irritability, tetanic spasms, cramp, tenesmus recti, stiff spine and legs, Strych. and Nux (Physo. has diminished reflexes, spinal paralysis; unsteady gait with eyes closed; death by paralysis, Strych. has death from respiratory spasm dilated pupils). Tetanus, Passif. Tongue as if scalded, Sang.

Causation

Emotions. Grief. Bathing. Injuries. Blows.

Mind

Uncommon mental activity. ─ Foolish actions, said it made him crazy. ─ Exhilarated in morning, gloomy towards noon. ─ Nothing was right, too many things in room; continually counting them. ─ Irritable. ─ Nervous, cannot endure pain. ─ Exhaustion, cannot remember anything. ─ Disinclined to work. ─ Difficult thinking; cannot concentrate the mind.

Head

Vertigo: on moving, with fainting and muscæ volitantes; with nausea; in evening, if people stepped in front of tier in the doorway; at night; when reading; on getting up after dinner; when walking; on descending stairs, with dim vision and unsteady gait; wavering in brain; as if drunk; with sensation of wavering in brain. ─ Confusion and dizziness; dull, heavy, oppressive headache. ─ Intolerable pain over both eyes. ─ Head drooping listlessly. ─ Darting pain in various parts, < motion. ─ Aching in morning with epistaxis l. side. ─ Bruised pain in brain all day, < a heavy step; < l. temple, with general fatigue and sensitiveness to cold or change of temperature. ─ Pressure encircling head, with sleepiness. ─ Constriction as from a bandage or tight cap pressed down as far as temples. ─ Severe, dull, frontal headache, esp. in the morning. ─ Darting pain in forehead, < motion, and in temples. ─ Sharp pain in supra-orbital region, running off towards nose. ─ Pain: over r. eye, in morning on waking, by noon pain in whole cerebrum, fulness of blood-vessels of brain, and contracted feeling in forehead, which extended to eyelids, causing an effort to open or close them; in l. side at 10 a.m., with heat in abdomen and nausea, the pain is heavy at 11, pain over whole head from 4 till 10 p.m., with nausea and general sweat, headache next day with lame, bruised feeling in region of kidneys. ─ Pain in temples; showing from r. temple to 2nd bicuspid. ─ In evening sound of the organ caused headache, < forehead and temples. ─ One-sided headache with fear of opening eyes lest it should < the pain. ─ Inability to stop thinking with headache. ─ Sensation of rush of blood to frontal and temporal regions. ─ Sharp, shooting pains in temples. ─ Throbbing of temporal and carotid arteries; heart beats felt in head on lying down. ─ Intense, painful pressure in vertex and both temples, the pressure in vertex extending over to occiput.

Eyes

Eyes inflamed, first r., then l.; sclerotic dry, red, and swollen; eyeballs pain and smart; lids feel sore. ─ Eyes bloodshot all the forenoon, with burning in them. ─ Pain on attempting to use binocular vision, as in reading, so that one eye must be closed, > by a weak concave glass. ─ Pressure; with muscæ volitantes, dark and light long worms or snakes, also tremulous vision. ─ Bright marks when looking at an object; dark yellowish spots covering one or two letters when reading. ─ Sharp, shooting pains, and drawing, twisting sensation in eyes. ─ Eyes sore and painful when moved from side to side. ─ Pain deep in, over top of eyeball, running up from inner canthus to r. frontal eminence, then down obliquely outward into temple. ─ Sharp stitches in r. eyeball, > by motion in open air. ─ The muscularis internus seems not to do its work rightly, and the axis of the eyes differs in each; eyes feel weak, with lachrymation. ─ Eyes convulsed. ─ Sight blurred, hazy, or misty, film over eyes; objects mixed; after which dull pain over the eyes and between the eyes. ─ Aching in posterior part of orbit, extending back into the brain; < on reading, causing nausea. ─ Lids (esp. l.) heavy; cannot bear to raise them; twitching of lids (upper, < l.). ─ Contracted sensation in lids with difficulty in opening them and lachrymation when wide open, difficulty in keeping l. eye open. ─ Lids immovable. ─ Tight feeling in ciliary region as if something were creeping about in it, with sharp pain, < reading. ─ Contraction of pupils; in morning; by small and rapid jerks, with sensitiveness to light; then mydriasis, < morning, seeming to depend on fatigue of sphincter, which was > during day by reflex stimulus of light. ─ Pupils dilated. ─ Pupils contracted when asleep, dilated when aroused. ─ Disturbed accommodation; approximation of far point (myopia) and also of near point (the accommodation recovers before the pupil). ─ Vision abnormally acute; double; dim and indistinct; blurred, hazy, misty. ─ (Lens dislocated by blow.)

Ears

Sharp, shooting pains in the ears. ─ Shooting in l. ear; in r. ─ Pain in r. ear when writing. ─ Hammering in r. in evening, with feeling in external ear as from a hot wind. ─ Painful pressure on tympani. ─ Discomfort in r., with inclination to bore in with finger; after removal of wax some pain; with eructation a sudden pain from throat along Eustachian tube to middle ear. ─ Crawling in l. ear. ─ Fulness. ─ Stopped feeling. ─ Partial deafness of r. ─ Sensitive to every sound. ─ Singing or tuning like escaping steam, at night after lying down. ─ Hissing, buzzing, ringing in the ears.

Nose

Fluent coryza, sneezing; burning, smarting, itching, and tingling of nostrils; nose stuffed and hot. ─ Twitchings in nose and involuntary expansion of nostrils. ─ Small boil inside r. nostril. ─ Epistaxis while at supper. ─ Smarting at end of nose, it feels as if burnt by hot liquid. ─ Tension in skin of nose and forehead.

Face

Face pale; flushings of the face; heat. ─ Neuralgic pain in r. side of face. ─ Sensation of cramps or spasms in face extending to neck; with numbness of l. hand. ─ Sensation of contraction of l. side of face, with numbness. ─ Severe pain in r. upper jaw like toothache (though all teeth on that side had been extracted). ─ Numbness of lips.

Teeth

Dentition: nervous children with vacillating pupils who have trouble when nursing or taking food; pain in stomach as soon as they begin, but going off if they continue to nurse.

Mouth

Tongue sore on tip and rough. ─ Smarting of end of tongue; feels as if burnt. ─ Scalding sensation l. side. ─ Tongue coated, more heavily at root. ─ Numbness and tingling of tongue and lips, with constant desire to moisten them. ─ Bad taste in mouth. ─ Profuse salivation; thick, leathery saliva. ─ Difficult speech. ─ Power of speech retained long after inability to swallow.

Throat

Sore throat, painful swallowing. ─ Tonsils and soft palate dark red. ─ Burning, scraping, raw feeling in throat. ─ Tonsils enlarged; swollen, elongated uvula. ─ Small ulcers, with yellow centres in pharynx. ─ Feeling as of a fish-bone in throat; swallowing saliva very painful. ─ Constriction of throat and dysphagia. ─ Pain extending from throat to l. ear when swallowing. ─ Feeling as if a ball were coming up in throat. ─ Submaxillary gland tender and tumefied.

Appetite

Hunger but can find nothing to satisfy it; food has a flat taste. ─ No appetite, disgust for food, tobacco, and coffee; and esp. for cold drinks.

Stomach

Tasteless eructations. ─ Burning in stomach with hot eructations. ─ Violent hiccough. ─ Nausea and vomiting. ─ In stomach: prickling, sharp pains; darting pains, with paralysed feeling of l. side; heaviness and weight, as if undigested food were lying there; hard pain; griping; emptiness and weakness; sensation of nervousness and trembling. ─ Soreness in region of stomach. ─ Sensation at epigastrium as when large pieces of food are suddenly swallowed.

Abdomen

Lancinating pains in hypochondria. ─ Hard, sore pain in splenic region; descending to groin and across hypogastrium, < by motion. ─ Soreness and pain at navel, which was found much inflamed. ─ Severe pain in umbilical region. ─ Pain and soreness in umbilical region. ─ Stitches in l. side of abdomen. ─ Much rumbling and distension in abdomen, with discharge of large quantities of flatus. ─ Dull pain in transverse and descending colon. ─ Colicky pains, with feeling as if diarrhœa would occur. ─ Shooting pains in l. iliac region and down thigh. ─ Sharp, cutting pains in lower part of abdomen. ─ Dull pain in groins.

Stool and Anus

Stools: copious; soft, thin; watery; yellowish; bilious; part natural, part black like tar; lumpy, mixed with watery discharge; dark and offensive. ─ Constipation; from atony. ─ Sphincter ani swollen and rigid; evacuation painful; rectum protruding, swollen and very sensitive. ─ Tenesmus and burning, with diarrhœa; also tenesmus of bladder. ─ Stool irregular and loose, anus sore and inclined to protrude; piles (absent for three years) return. ─ Severe piles following childbirth.

Urinary Organs

Bruised, sore feeling in region of kidneys. ─ Bladder feels distended. ─ Frequent desire to urinate, often ineffectual. ─ Frequent and copious urination. ─ Urine: yellow; high coloured; strong-smelling; clear; muddy; pale and copious.

Male Sexual Organs

Frequent erections with but slight desire. ─ Two emissions without dreams or excitement. ─ Strong-smelling sweat about genitals, prepuce tender and swollen, many small vesicles on glans with burning itching.

Female Sexual Organs

Leucorrhœa; < exercising during day, esp. about 4 p.m.; with inclination to sigh; sighing < when leucorrhœa is worse; dread of cold water. ─ Menses irregular. ─ Numbness of womb with pain in back. ─ Condition like that produced by flooding after delivery. ─ Metrorrhagia. ─ Pain as if menses were coming on. ─ Menstruation, with palpitation; congestion of the eyes, with tonic spasms, rigidity, sighing respiration, consciousness retained.

Respiratory Organs

Cough from tickling in throat. ─ Slight constant inclination to cough from filling lungs. ─ Laboured, sighing respiration; yawning.

Chest

Stitches in the chest. ─ Cannot fill l. lung as inspiration = dull pain at l. apex, > by pressure. ─ Stitches under inferior angles of scapulæ during expiration. ─ Heavy weight at chest. ─ Twitches across pectoral muscles. ─ Stitches in l. breast, and unable to draw long breath.

Heart and Pulse

Dull pain, uneasiness and distress about the heart. ─ Violent palpitation of the heart, with feeling of pulsation through whole body. ─ As the fresh, bracing air strikes me, a choking sensation with fluttering of heart. ─ Heart's action irregular and tumultuous, when lying on l. side, > when lying on the back. ─ Pulse: variable; accelerated; small, frequent, slow, feeble, intermittent.

Neck and Back

Inclination to stretch out the neck. ─ Pain at base of brain as if it were cutting off body from head; going through to back part of throat, which is stiff and sore. ─ Stiffness in neck. ─ On waking, pain in r. head and neck as if latter was stiff. ─ While taking morning bath suddenly stiff neck (r.). ─ Drawing on turning head. ─ Rheumatic pains in l. neck and shoulder. ─ Feeling of weakness passed down from occiput through back to lower limbs. ─ Cramp-like stitches up and down spine; stiffness of l. neck. ─ Chilly, creeping sensations up back, 7 p.m. ─ Back very weak, unable to stand erect. ─ Dull pain in back. ─ Backache (in renal region) kept him restless all night; no > in any position; passed copious colourless urine. ─ Creeping numbness from back of head down spine. ─ Cramp-like stitches up and down the spine. ─ Pain under r. shoulder-blade. ─ Dull, heavy pain in lumbar region; also over l. hip, extending to back. ─ Pain in back between hips, with numbness of womb. ─ Pain in (l.) sacral region, as if strained by lifting, < on motion. ─ Contractive pain of anterior surface of coccyx; as if dysentery coming on; (since verified).

Limbs

Limbs feel weary, as after great fatigue. ─ (Pleasant) numbness in all the limbs; and paralytic feeling. ─ Neuralgic pains in the limbs. ─ Stiffness or bruised feeling in the joints. ─ Staggering gait. ─ Cold extremities.

Upper Limbs

Wrists feel weak; dull aching pain in them. ─ Sharp, shooting pain in l. shoulder. ─ Itching of l. palm. ─ Paroxysms of burning in palms. ─ Hands feel cold, then hot and red. ─ Pain in r. deltoid > only by violent motion. ─ Numbness in l. arm. ─ Sharp pain in l., then r. arm.

Lower Limbs

Unsteadiness from knee downward when walking, esp. with eyes shut. ─ Dragging pain in l. hip towards back. ─ Thrusts with aching down l. thigh from iliac region. ─ Stiffness in hip and knee. ─ Cramp-like pain in l. (and r.) popliteal space. ─ Sensation of a drawing cord behind leg and knee, impeding walking. ─ Gnawing in l. tibia. ─ Legs feel asleep. ─ Numbness in l. foot.

Generalities

Indescribable torpidity as from opium; "this is not debility but volition is inoperative" (Christison's experiment). ─ Great sense of fatigue and weariness; weakness. ─ Convulsive twitchings. ─ Constant fibrillary twitchings of the muscles. ─ Violent trembling all over the body. ─ Great prostration of the muscular system. ─ Diminished reflex action. ─ Omits bath on account of horror for cold water. ─ Sore and stiff all over, as from a cold. ─ Severe, sharp pains in various parts of the body. ─ In nerves in front of body waves like tremblings going up and down; at back nerves paralysed and numbed with pain as when the nerve of a tooth is being killed. ─ Stiff all over as after taking cold. ─ Paralysed feeling in l. side. ─ On raising foot in walking, momentary feeling as if he were floating upwards, and on foot touching ground an unpleasant feeling making a shuddering sensation pass all over him.

Sleep

Irresistible desire to sleep; soporific sleep. ─ Restless sleep with dreams. ─ During sleep mind so active was unaware he had been asleep. ─ Falls asleep frequently, but awakes suddenly without relief; following night scarcely closed eyes in sleep; thoughts very active; an idea once started kept on with unusual persistence.

Fever

Creeping, chilly sensation in back; yawning; every movement and draught = shuddering. ─ Hands and feet cold. ─ Cold, clammy skin. ─ Heat in head and face; flushed and hot. ─ Heat in face and down back with chilliness of legs. ─ Dry burning in hands. ─ Perspires very easily. ─ Cold sweat in drops over whole body. ─ Strong-smelling sweat around genitals. ─ Copious sweat all over body.

The Guiding Symptoms of Our Materia Medica

Constantine Hering · The Guiding Symptoms of Our Materia Medica · 1879–91

General

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.

Calabar Bean ; Eserine. Leguminosæ.
A climbing plant, native to Africa.
The alcoholic tincture is prepared from the finely pulverized bean.
Toxicological reports, experiments and provings are numerous. See Allen's Encyclopædia, vol. 7, p. 466 .
CLINICAL AUTHORITIES.
- Mental disorder , Kenyon, Raue's Rec., 1875, p. 32, from Trans. N. Y. S., 1873-4, p. 293 ; Nervous excitability , Nash, Times Ret, 1875, p. 37, from Trans. N. Y. S., 1875, p. 176 ; Cerebro-spinal meningitis , Hale, A. H. O., vol. 10, p. 134 ; Wells, A. H. O., vol. 10, p. 476 ; Myopia (3 cases), Woodyatt Times, Ret., 1877, p. 64 ; Ill effects of blow upon eye , Dudgeon, Org., vol. 3, p. 267, from B. J. H., Jan., 1880 ; Eserine in glaucoma , Cant, Smith, Buzzard, Fitzgerald, Brailey, Snell, T. A. J. H., 1886, p. 423 ; Nervous disorders during dentition , Penfield, T. A. J. H., 1884, p. 256 ; Piles , Swan, Hah. Mo., vol. 9, p. 267 ; Sighing during menses , Fiske, Raue's Rec., 1875, p. 176 ; Neuralgic pains in limbs , Kenyon, Raue's Rec., 1875, p. 246, from Trans. N. Y. S., 1873-4, p. 293 ; Tetanus , Helmuth, Raue's Rec., 1875, p. 250, from Trans. N. Y. S., 1873-4, p. 295.

Mind

Uncommon mental activity.

Uncommon mental activity.During climacteric change, after severe mental suffering (lost three children), palpitation of heart ; beats irregular ; some three months ago, at time for return of menstruation, was suddenly taken with a feeling of partial faintness, loss of memory, face very red, eyes congested, violent pain all over and through head, constant disposition to talk, which made her cough, feeling as if stomach were full, even up to pit of throat, belching of wind ; sensation of heart beating hard and furiously, yet its motion could hardly be discovered, and in a few moments a violent tonic spasm, lasting nearly an hour ; every muscle in body rigid, no loss of consciousness ; when passing off roaring in ears, great dyspnœa and excessive soreness of muscles of whole body.
Constant pain and distress on top of head ; feels as if she must lose her mind and become insane or despondent ; constant moaning ; thinks she is a castaway ; insomnia with desire to sleep ; terrible thoughts on awaking ; fears she is crazy or will certainly lose her mind ; weak feeling at stomach ; sighing respiration ; constipation ; stools light-colored ; map-tongue. θ Nervous excitability.
Inability to stop thinking with headache.

Sensorium

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

Vertigo : staggers like a drunken man, with constrictive feeling of head, with torpor of body and fear of getting crazy ; with sensation of wavering in brain while walking ; < when walking, reading and going down-stairs ; dimness of sight ; with faintness.

Inner head

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.

Intolerable pain over both orbits.
Dull pressing headache for nearly six months ; comparatively free from it in morning, on rising, but < from least mental exertion, until at night after retiring it is almost unbearable ; with the pain, sleeplessness and inability to stop thinking ; in course of an hour or two passes off suddenly, with a sharp, radiating flash of pain, sometimes starting from occiput and passing forward, at other times from before backward.
Intense painful pressure in vertex and temples ; pressure in vertex extending over to occiput ; pain so severe must lie down.
Heavy headache.
Congestion of brain, with epileptiform attacks.
Cerebro-spinal meningitis ; stage of general tetanic rigidity ; retraction of head ; severe headache, with great heat in head, flushed face ; vomiting when raised up ; respiration hurried and irregular ; pulse 100 ; urine scanty.
Cerebro-spinal meningitis ; primary contraction of pupils, secondary dilatation ; heart's action tumultuous, feeble and irregular.

Outer head

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.

Sight and eyes

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.

Felt film over eyes and blur ; objects mixed ; after which dull pain over and between eyes.Eyes feel weak.
Dimness of vision.
Pain after using eyes, muscæ volitantes, flashes of light, twitching of lids and around eyes ; myopia.
Acquired myopia, resulting from ciliary spasm.
Partial blindness, on attempting to write was unable to see a line ; dimness of vision ; nystagmus.
Glaucoma ; may relieve intraocular tension temporarily, if not permanently, by acting upon muscular tissues of vessels ; it causes a contraction in their calibre, or, as is more probable, by drawing iris from angle of anterior chamber the filtration passages are opened and excretion thus accelerated ; should not be substituted for iridectomy, however ; useful when operation must be postponed for some reason, or when tension increases after iridectomy, or in some cases of secondary glaucoma.
Woman, æt. 65, lost right eye by glaucoma ; left lens became cataractous, and preliminary iridectomy was made ; eleven days after patient instilled some Atrop. and brought on an acute attack of glaucoma, which was overcome by use of Eserine.
Man, æt. 29, received a blow of cane on right eye ; glaucoma followed ; Eserine was instilled ; recovery complete and permanent.
Lady, æt. 70 ; on fifth day after a fall became glaucomatous (Eserine).
Lady, æt. 64, suffering from severe neuralgia of supra-orbital nerves, had been treated by Gels., typical symptoms of acute glaucoma were found ; Eserine disks caused immediate improvement and in six weeks complete and permanent recovery.
Acute glaucoma in a woman æt. 35, caused by frequent instillation of strong solution of Atrop. for the testing of refraction.
Causes slight twitching of lids, soon followed by contraction of pupils and spasm of ciliary muscle from its action as an irritant to the oculo-motor nerve (antagonistic to Atrop., which causes dilatation of pupil and paralysis of ciliary muscle by paralyzing filaments of third pair).
After a blow upon inferior and outer part of left eyeball ; pupil sluggish, not much dilated ; could not see objects clearly beyond a distance of four inches from left eye and then they seemed too large.
A woman had a cataractous lens dislocated into anterior chamber by a blow on temple two days previously ; there were conjunctival irritation, much photophobia and lachrymation, with severe throbbing pain in eye and right side of head ; tension of eyeball increased ; lens after some difficulty was removed ; during next twenty-four hours tension remained normal and wound tended to heal kindly ; on second morning following removal of lens complained greatly of pain, which had kept her awake during night and still continued ; upper lid was swollen and œdematous ; borders of cut for a space of two or three lines were hazy and infiltrated, a slight stringy and mucous discharge had occurred and tension of eyeball had again increased ; a solution of Eserine 1/200, one drop every two hours, was instilled into eye, and Eserine[3] every two hours prescribed ; in the course of twenty-four hours the tendency to sloughing had ceased, and a rapid recovery followed.
Prolapsus of iris : from injuries even when whole globe is vascular and irritated and sight impaired ; from sloughing of cornea.
Paresis of accommodation after diphtheria, and in muscular asthenopia.
Astigmatism.
Continued drawing, twisting sensation in eyes.
Sharp shooting and drawing sensation in right eye.
Drawing, twisting sensation in eyes at 3 P.M.
Pain in eyeballs.
Eyes sore and give pain when moved from side to side.
Eyes smart ; lids feel sore.
Internal muscle does not seem to do its work rightly and axis of eyes differs in each ; eyes felt weak, with lachrymation, especially of left, from which be suffered when having usual headaches.
Twitching of lid, combined with spasm of ciliary muscle ; twitching around eyes, patient cannot read without much pain, frontal headache, < from light.
Cannot bear to raise lids.
Profuse lachrymation.

Smell and nose

A sensation exactly as if nose was going to bleed, and the peculiar taste which goes with it ; at 2 and 8 P. M.
Twitching in nose, and involuntary expansion of nostrils.
Numbness from between eyes down through nose.
Sneezing.
Burning heat in nose and sensation as if it would bleed ; quivering sensation in teeth as if they were resting on a vibrating board ; at 4 P. M.

Upper face

Stupid look and a drunken gait.
Involuntary twitching of mouth, also of eyebrows.
Sensation of contraction of whole left side of face, with slight numbness.

Sensation of contraction of whole left side of face.

Taste, speech, tongue

Smarting of end of tongue.
Tongue became very sore on left side, quite back to root, and it was very hard to move it ; felt as if it was stiff.

Tongue feels sore on tip.
Smarting of end of tongue.

Palate and throat

Feeling as if a ball was rising in throat.

Feeling as if a ball were coming up to throat.

Appetite, thirst. desires, aversions

Disgust of cold drinks.

Desires, Aversions. Disgust for cold drinks.

Eating and drinking

After eating : relief of pain in head.

Hiccough, belching, nausea and vomiting

Nausea and vomiting.

Scrobiculum and stomach

Trembling sensation in nerves all down through body, especially at pit of stomach, with motion going up and down in nerves like waves, accompanied by slight nausea and a sensation of faintness.
Nervousness at pit of stomach.
Great pain and soreness in and all around pit of stomach, and all around body in this part before and behind.
Sense of emptiness and weakness at stomach, without hunger ; 3 P. M.

Dyspepsia with great pain immediately after eating.

Hypochondria

Soreness around body at waist ; 6 P. M.

Abdomen and loins

Sore pain in bowels, with burning, loose discharge.
Bowels spasmodically contracted.

Female sexual organs

Pains in womb, as if menses were coming on.
Leucorrhœa.
Leucorrhœa and much weakness at 4 P. M.

With disordered menstruation.
Great muscular prostration, with continual inclination to sigh ; leucorrhœa < by exercising during day, especially about 4 P.M. ; sighing < when leucorrhœa is < ; dread of cold water.
Leucorrhœa profuse, with great weakness ; milk-white, bloody, scanty, stringy.

Respiration

Yawning and sighing respiration.
Laborious breathing.
Kills by paralyzing nerves, supplying breathing muscles.

Respiration : labored ; yawning and sighing.

Inner chest and lungs

Severe pain in left side and entirely unlike any pain in lungs that has ever had.

Heart, pulse and circulation

Power of contraction of heart is increased.
Number of beats of heart sometimes increased, sometimes diminished.
Nervous symptoms, with palpitation of heart and much weakness at pit of stomach.
Heart's action feeble and irregular.
Violent palpitation of heart.
Death by paralysis of muscles of heart.
Blood very fluid.
Pulse frequent.
(OBS :) A weak pulse is considered a contraindication ; hard and rapid, an indication.

Tremor of heart due to emotional disturbance ; violent palpitation.

Neck and back

Inclination to stretch out neck, "to run heat out", from uneasy sensations in back of neck.
Pain at back of neck, with difficulty of turning head around.
In afternoon a peculiar pain across back of neck, at base of brain, as if it was cutting off body from head ; it went right through neck, and seemed to go to back part of throat, which was sore and stiff.
Pains in back between shoulders and a little lower down.
Drawing in back, as if it was too short to allow stooping without pain, and yet difficulty in keeping upright.
Pain all down spine and close to it, on both sides of it.
Pains all down back of neck, especially in most prominent bone there, and on each side of it ; drawing whenever head was turned.
Pain in back on each side of spine, from between shoulder blades to below waist ; pain which made it hard to stoop.
Pain in back, also down arms, with weakness of same ; 2 P. M.
Stiffness and pain going all down spine ; with these pains in back there is an inclination to bend forward, as if hard to sit up straight ; 1 P. M.
The nerves in back of body (the passive nerves or nerves of sensation) it seems to paralyze and numb ; and during this numbing process it causes a good deal of pain, very similar to a pain in a tooth, when its nerve is dying or being killed.
Pain in lower part of back and spine, between hips.
Pain in back between hips and a slight feeling of numbness in region of womb ; 6.30 P. M.

Spinal irritation ; every nerve of spinal origin is irritated under this drug ; pressure of finger between vertebræ causes patient to wince ; rigidity of muscles from meningeal irritation ; trismus ; tetanus ; burning and twinging sensations, referable to spinal column, with numbness of feet and hands and other parts of body ; crampy pains in hands ; sudden jerking of limbs on dropping off to sleep ; muscles of back rigid, even a tetanic condition may ensue.
Congestive state of paralysis of spinal cord, with tetanic spasms ; stiffness of neck, with a feeling of drawing and tension ; back very weak, unable to stand erect ; stiffness and pain down spine, with inclination to bend forward, as if hard to sit up straight ; limbs weary as after great fatigue. θ Myelitis acuta.
On walking feeling of unsteadiness from knees downward so that he must tread carefully, especially when eyes are closed ; must look to see where he is going ; wants a cane to support himself ; stiffness in recti femoris ; languor, flatulence. θ Tabes dorsalis.
The will is strong, but a difficulty lies in the way of carrying out its purpose ; the palsy is commonly preceded by twitching or trembling of muscles ; attacks of partial blindness ; nystagmus ; trembling all over. θ Multiple sclerosis.

Upper limbs

Trembling of hands, could hardly sew ; 10.30 A. M.
Tired feeling in arms and difficulty in lifting them.
Numbness of left hand as if asleep.
Numbness in left arm and down ring finger.
Chill and slight numbness in right arm.

Lower limbs

Pain in lower limbs.
Pain in outside of knee ; cramps in left foot in evening while in a warm bath.
Pain in left thigh and in both knees after walking only a few steps ; about noon.
A sensation as of a drawing of cords behind leg, under knee, making it hard to walk, especially up-stairs.
Trembling of legs, as if one could not walk straight.
A feeling as if all power was going out of legs and they would give may ; as if the cause of the weakness came from that one spot in back, between hips, and took away all power below that spot, from limbs.

Limbs in general

Pain in limbs.
(In sick :) Loss of power in limbs.
On walking, feeling of unsteadiness from knees downward, so that he had to tread carefully, especially when eyes are shut ; feels as if he must look to see where he is going.

Neuralgic pains sometimes in upper arms, again in lower limbs whole length, but more severe from hip to knee, more frequently on right side ; pain dull, grinding, crushing, increasing until it became intolerable ; gradual loss of motion of limbs ; long standing, obstinate constipation ; if pain began at any hour, it always continued until 12 o'clock following, either noon or midnight, and then frequently would entirely cease within ten minutes.

Rest. position. motion

Constant desire to move head from side to side.
Disinclination to move.
Hinders voluntary motion as well as causes involuntary motion.
Motion : cannot move eye upward ; difficulty in moving eye downward ; soreness of eye ; tongue stiff and sore.
Walking : pain in left thigh and knees ; and ascending, drawing as of cords under knee ; unsteadiness from knees down.
Stretching : uneasiness in back of neck >.
Turning : pain at back of neck <.
Bending forward : stiffness and pain down spine >.
Lifting arms : tired feeling.

Position. Motion. Must lie down : pressure in head.
Unable to stand erect : from weakness in back.
Inclination to bend forward, as if hard to sit up straight : myelitis.
When raised : vomiting.
Motion : of eyes from side to side causes pain.
Going down stairs : feeling of wavering in brain.
Walking : feeling of wavering in brain ; feeling of unsteadiness from knees downward.

Nerves

Shuddering and trembling running down through all nerves of body.
Violent tremblings all over, in the street ; felt for an instant as if he should lose consciousness, and could hardly get home ; riding in a car for twenty minutes did not relieve sensations.
Trembling.
Felt a sudden access of vigor and felt particularly strong ; all the symptoms seemed to come like a reaction.
Loss of voluntary motion without loss of consciousness.
Complete relaxation of whole body, as if every nerve was unstrung, even to the eyes, which felt as if all power to see was going out of them.
Giddiness and faintness without uneasiness.
Paralyses motor nerves, but does not impair sensibility, intelligence and muscular irritability.
Cause of death, true suffocation, never causes paralysis of heart.

Great prostration of muscular system ; progression difficult.
Trembling, dizziness and loss of power in limbs.
Tremors of young persons from emotional or physical disturbances ; staggering gait as if drunk ; feeling of constriction around head and waist ; feeling of weakness as if paralyzed ; passes down from occiput through back to lower extremities, which feel as if asleep ; slight exertion causes great weakness. θ Myelitis.
Paralysis agitans as long as structural lesion has taken place.
Progressive muscular atrophy.
Muscular paralysis.
General paralysis of the insane.
Chorea : of right side, tongue feels as if swollen and paralyzed.
Tetanus in consequence of a slight hurt of palm of hand by a small fragment of glass ; no sleep ; spasms of muscles of jaws so violent that a breath of air caused by a person passing would induce them.
Idiopathic or traumatic tetanus.
Epileptiform convulsions.
Cerebro-spinal meningitis, in the tetanic stage.

Sleep

Intense sleepiness.
Intensely sleepy in morning ; almost impossible to wake himself up ; feels as if drugged.

Irresistible desire to sleep ; soporific sleep.

Time

Morning ; congestive headache ; eye symptoms ; intensely sleepy.
Afternoon : 1 P. M., dizziness and faintness ; stiffness and pain in arms ; 8-9 P. M., creeping numbness over back of head and down spine ; 2-8 P. M., nose feels like bleeding ; 4 P. M., quivering in teeth ; leucorrhœa and weakness ; 6 P. M., soreness around waist ; pain across back of neck ; 2 P. M., pain in back and down arms, weakness of same ; 6.30 P. M., pain between hips, numbness in womb.
Both days he felt weakest, were particularly cool and bracing.
Felt a perfect horror of cold water.

Morning : headache >.
3 P.M. : drawing twisting sensation in eyes.
4 P.M. : leucorrhœa <.
Night : headache unbearable.
If pain began at any hour it always continued until 12 o'clock following either noon or midnight.

Attacks, periodicity

The symptoms subside in the same order ; first derangement of accommodation, then affection of pupil.
The trembling spells come on in fits, and at the least thing that startles.

Alternate : dilatation and contraction of pupils.
Six months : dull pressing headache.
Year's duration : constipation.

Locality and direction

Right : shooting and drawing in eye ; ptosis ; chill and numbness in arm ; pupil much dilated ; sight of eye impaired ; pupil small.
Left : pain in eye ; dull pain in occipital region ; lachrymation ; pupil sluggish ; upper lid paralyzed ; contraction of face with numbness ; soreness of tongue with difficult motion ; severe pain in chest ; numbness in arm and hand ; pain in thigh.
Before back : pressure in vertex to occiput.

Right : glaucoma following blow upon eye ; throbbing pain in side of head ; shooting and drawing sensation in eye ; neuralgic pains in limbs < ; chorea.
Left : eye, lens became cataractous ; could not see objects clearly beyond a distance of four inches from eye ; lachrymation < ; contraction of whole side of face.
From before backward : flash of pain in head.

Sensations

The nervous symptoms came first, being in centre of forehead, and very much at pit of stomach, and going downward ; soreness around middle of body came next, and last of all the pains in back and spine ; these lasted the longest and seemed the most characteristic of all the symptoms ; as if pain was cutting head from body.
Nervous motions through body and arms.
A kind of pain like that caused by stooping over work for a long time, or by long pressure of back against a chair ; as if the nerves were compressed ; as if head would fall forward ; as if nose was going to bleed ; as if a ball would rise in throat.
Shooting : in right eye.
Burning : of eyes ; of nose ; of eyeballs ; in nose ; in bowels.
Drawing : in eyes ; in back ; drawing down back of neck when turning head ; as of cords under knee.
Smarting : of eyes ; of end of tongue.
Straining : in eyes.
Twisting : in eyes.
Cramping : in left foot.
Pressure : in temple ; in vertex ; in vertex to occiput ; on eyes.
Soreness : in eyes ; of lids ; of left side of tongue ; around pit of stomach ; around waist ; in bowels ; and stiffness of throat.
Pain : in middle of forehead ; above eyes ; through temples ; dull, in left occipital region ; headache, in morning ; in eyeball ; around pit of stomach ; in womb ; in left chest ; at back of neck ; in back ; down spine ; down back of neck ; down arms ; between hips ; in lower limbs ; in knee ; in left thigh and both knees.
Beating : between eyebrows.
Throbbing : on side of neck ; between eyebrows.
Twitching : between eyebrows ; in nose ; of mouth and of eyebrows.
Quivering : in teeth.
Trembling : all through body ; of legs.
Discomfort : at back of neck.
Heaviness : in head.
Tenderness : around eye.
Stiffness : of left side of tongue.
Contraction : of left side of face.
Tired : in arms.
Faintness : in street and while in car.
Weakness : of eyes ; at pit of stomach.
Powerlessness : at back of head ; of legs.
Creeping : back of head and down spine.
Crawling : over head.
Unsteadiness : from knees down.
Numbness : in top of head ; of temples ; back of head and down spine ; between eyes down through nose ; of left side of face ; region of womb ; of left arm and hand ; in right arm.
Shuddering : through whole body.

As if stomach were full ; as if she must lose her mind ; as if a ball were coming up throat ; lower extremities as if asleep ; back as if paralyzed ; tongue as if swollen and paralyzed.
Pain : in top of head ; in eyeballs ; in stomach ; down spine.
Intolerable pain : over both orbits.
Violent pain : all over.
Sharp, radiating flash of pain : through head.
Sharp shooting : in right eye.
Throbbing pain : in eye and right side of head.
Intense, painful pressure : in vertex and temples.
Neuralgic pains : sometimes in upper arms, again in lower limbs.
Crampy pains : in hands.
Heavy pain : in head.
Drawing : in right eye ; in neck.
Drawing, twisting : in eyes.
Dull pressing headache.
Dull pain : over and between eyes.
Pressure : in vertex.
Constrictive feeling : of head ; of waist.
Contraction : of whole left side of face.
Tension : in neck.
Smarting : of eyes ; of end of tongue.
Soreness : of muscles of whole body ; of eyes ; of lids ; of tip of tongue.
Heat : in head.
Wavering : in brain.
Distress : on top of head.
Stiffness : of neck ; of spine ; in recti femoris.
Weak feeling : at stomach ; in eyes.
Numbness : of hands and feet and other parts of body.

Touch. passive motion. injuries

Touch : soreness around pit of stomach ; soreness around waist, 6 P. M.

Pressure : of finger between vertebræ causes wincing.
Hurt in hand from small piece of glass causes tetanus.
Fall caused glaucoma.
Blow upon eye caused glaucoma.

Stage of life, constitution

Girl, æt. 9, pupil of right eye very much dilated ; a small scar on outer edge of cornea.
Woman, æt. 24, sight of right eye impaired, could only distinguish light from darkness.
A woman, æt. 21, paralysis of oculo-motor nerve.
Woman, æt. 57, right pupil only half as large.
Man, æt. 53, paraplegia, pupil contracts to pin's head in size.

Miss K., æt. 17 ; myopia.
Miss M., æt. 22 ; myopia.
Man, æt. 30, student ; myopia.
Lady, æt. 49, passing through climacteric change, after severe mental suffering, having lost three children in last eight years ; mental disturbance.
Mrs. C., æt. 65, medium size, dark complexion, lost two daughters six years ago ; nervous excitability.
Mrs. P., æt. 69 ; neuralgic pains in limbs.
Young lady, after injury to hand by piece of glass ; tetanus.

Relations

Antidotes : Atropia and Hydrate of Chloral .
Camphor suspends the symptoms temporarily.
Compatible : Amyl nitr., Conium, Gelsem .
Compare : in eye diseases : Agaricus (Amanita), Caustic., Chamom., Conium, Curare ; in tetanus, Nux vom .

Compare : Agaric . in irritable weakness of accommodative apparatus of eye ; Bellad., Conium, Curare, Gelsem., Passiflora, Solanum .

Teeth and gums

Nervous children whose pupils alternately dilate and contract and who have much trouble when nursing or taking food, pain coming in stomach as soon as they begin to nurse, but passing off if they continue to nurse. θ Dentition.

Stools and rectum

Constipation of years duration, from atony of bowels.
Severe piles following childbirth.

Voice and larynx. trachea and bronchia

Chronic bronchial catarrh, < by talking.

Cough

Cough with inability to raise mucus.

Temperature and weather

Perfect horror of cold water ; disgust for cold drinks.