Lobelia Inflata

Lobelia Inflata.

Lobelia inflata. Ινδικός Καπνός. (Αγροί και άκρες δρόμων από τον Καναδά έως τις Νότιες Η.Π.Α.) N. O. Lobeliaceae. Βάμμα φρέσκου φυτού όταν ανθίζει και καρποφορεί. Τριτύραξη αποξηραμένων φύλλων. Ασκοί.

Αλκοολισμός. Αλωπεκία. Αμηνόρροια. Στηθάγχη.

Άσθμα. Καρδιαλγία. Βήχας. Κρούπ.

Κώφωση. Καχεξία. Διάρροια. Δυσμηνόρροια.

Δυσπεψία. Εμφύσημα. Λιποθυμία. Χολόλιθοι.

Γαστραλγία. Αιμορροϊδές, εκκρίσεις. Άσθμα από γύρη. Καρδιά, παθήσεις της.

Υστερία. Μηνιγγικά κεφαλαλγικά. Άσθμα Millar. Ναυτία πρωινή (μεθυσμένων· εγκυμοσύνης).

Εθισμός στη μορφίνη. Αίσθημα παλμών. Πλευρίτιδα. Ψωρίαση.

Σκληρό τράχηλο του τραχήλου της μήτρας. Σμηγματόρροια. Ώμοι, πόνος στους. Τσάι, επιδράσεις του.

Ουρήθρα, στένωση του. Κόλπος, ορώδης έκκριση από τον. Έμετος, της εγκυμοσύνης. Λιποκύστεις.

Κοκίτης.

Matthew Lobel, whose name is given to this family of plants, was a physician and botanist attached to the court of James I. There are two British species, L. Dortmanna, found in shallow lakes, and L. urens, which grows in heathy places. L. inflata, the North American variety, is the most important of all, medically.

According to Hale, this plant was used by the Indians as an emetic detergent, in the same way as Verat. alb. was used by the ancients to produce "Helleborism." But the chief modern exponent of Lobelia is Samuel Thompson, of New Hampshire, who founded the modern Botanic School. His chief remedies were, besides Lobelia, cayenne pepper and the vapour bath. There can be little doubt that he accomplished much with these, but his unbounded faith in Lobelia led, in some instances, to fatal poisoning.

Such a result is not altogether unknown in qualified practice; but as Thompson had no medical degree these cases brought him into trouble The records of them have furnished some of the symptoms of the pathogenesis. Lob. i. probably obtained the name of "Indian Tobacco" from the similarity of its action to that of Tabacum in producing intense nausea, vomiting, profound depression at the epigastrium, and collapse. It was a true instinct On the part of Teste that led him to class Lob. i. with Sul.; and though the provings and clinical experience do not fully bear out what he says about its skin action, the results of botanic practice, confirmed by Cooper, show that it has an antipsoric action, and relieves morbid states due to the suppression of discharges.

In a paper read before the Brit. Hom. Society, November 1, 1888 (M. H.

Rev., xxxii. 717) Cooper explains that he got no good out of Lob. i. until under the advice of a herbalist he used a solution of Lobelia made with common vinegar. Here is one of his cases. A young woman, 23, of consumptive family history on both sides, had, when 14 to 15 years old, severe pain in left, and sometimes right, side, and round lower abdomen, with faint feeling. This lasted till the monthly period came on regularly and then she was well till 20, when diarrhoea came on, which nothing was able to check and which kept her in bed for months at a time.

The symptoms were: Pains all round abdomen and up the back, much < after undressing, feeling of exhaustion or failing to pieces inside and out, cannot bear anything to touch her. Four or five motions daily when taking medicine; if she leaves it off continual motions all day; it literally runs from her: watery, sometimes light-coloured, sometimes dark, never bloody. Menses very irregular, sometimes five to six weeks between; all symptoms, especially diarrhoea, < then; much tenderness all over abdomen, especially in ovarian regions, legs ache fearfully, pains all over body; faints continually.

Since the illness began subject to neuralgia of face, one or other side or both, extending to chest, coming and going suddenly at any time. In spite of treatment of all kinds, including that of a skilful repertorian, she grew worse. She went into a hospital, and there a small pile was removed with but temporary benefit; and after this the vagina as well as the rectum began to discharge copiously an excoriating fluid. Lob. i. ac. Ø, eight drops three times a day, was now given.

She began to improve at once, and in a few weeks was quite well. In this case the difficulty first showed itself when the menstrual era was commencing; was relieved when the flow was regularly established; reappeared simultaneously with menstrual irregularity. In the next case there was an analogous history. A lady of 52, when 37, was exposed to a severe chill which checked the catamenial flow.

After this she had threatened phthisis with bronchorrhoea, which after two years gradually went off, leaving her subject to severe constantly recurring seizures of vertigo. Nine months before coming under Dr. Cooper's care she felt as if something was forming in the utero-vaginal region, causing much bearing down. She was obliged to go to bed, and then there occurred a profuse pouring away of apparently serous fluid from utero-vaginal and vesical mucous membranes, with paroxysms of agonising, burning, and scalding, < in evening.

Vagina swollen, extremely tender, bathed in moisture; urination always very painful and followed by paroxysm of general scalding. She was unable to sit up and decubitus could only be maintained with the knees drawn up, or on the left side. At night she would be awoke by finding her back resting in a pool of water, and the sense of uterine bearing down was almost intolerable. The bowels were unaffected; urine free from all but a trace of albumen.

A hardness and dulness to percussion existed all down right side of abdomen. Lob. infl. acet. Ø, 1/3 drop every four hours. From that time the patient had not to keep her bed for a single day, and all her symptoms cleared up. The Lob. i. was in this case assisted by Nat. chlor.

(Liq. Sodae chlor. of B. P.), 1/3 drop doses occasionally, which relieved the bearing down more than anything else. All that remained of the illness was a slight weakness in lower abdomen felt every autumn.

Cooper recalls in connection with these cases a symptom recorded by Jahr: "Violent pain in the sacrum with fever supervening upon suppression of the menses during their flow." Alongside this action of Lob. i. may be placed another, also vouched for by Cooper, the power of eliminating foreign substances like that possessed by Silica. A woman got a piece of mutton-bone down her windpipe and into one of the bronchia. She was taken to the London Hospital, but the idea of operation was abandoned as hopeless and she was sent out.

Lob. i. ac. Ø was given, five drops three times a day. Soon a most violent cough was set up, in the course of which the patient coughed up a large quantity of fetid, pus and finally the bone. B the action of Lob. i. in determining to the periphery it meets a large number of conditions due to suppression, including cases of phthisis. Cooper adds the following note to the above: "The interest of knowing that Lob. i. meets very serious symptoms connected with a profuse flow of serous discharge from the utero-vaginal mucous surfaces is to some extent marred by my having employed the acetous preparation, and subsequent trials of it would certainly have been made with the fresh plant tincture had I been able to obtain the living plant.

As it is, my inferences, re the action of Lob. i., are all derived from the acetous tincture. The indications for Lob. i. are difficult to discover, being broad and general rather than precise and localised. Its power over serous discharges from mucous surfaces accounts probably for its influence on certain very obstinate forms of chronic diarrhoea, these being more serous than watery, and it is probably owing to a similar influence over sebaceous secretions that it removes in time the most obstinate wens on the scalp, causing them sometimes to gradually disappear and at others to point and discharge their contents, and that it causes the hair to grow when used locally in seborrhoea capitis.

It is particularly called for in ailments that never finish up, whether beginning from acutely inflammatory causes or not; it also fights with symptoms occasioned by mechanical irritants in a way that I have never found any remedy do, e.g., where a spicula of bone presses on the brain (compression) or where a bone is lodged in bronchus. The late Dr. Coffin (Botan. Jour., Aug., 1849, p. 271), in a boastful way, professed to cure children and adults whose lives were despaired of from poisoning by various substances by (decoctions? of) Lobelia, but whether by directly evacuant action or not it is not stated.

But in my own hands a few drops mixed in water cured a baby of severe convulsions that I afterwards found were caused by a diabolical nurse giving the little one Chlorodyne. In symptoms existing along with hereditary syphilis and in the tuberculosis of childhood it acts with full power; in tabes mesenterica, in persistent earaches and headaches due to suppressed discharges, where the lips are dry and hot and continual feverish colds are prominent, it is specific. Here it stands side by side with Ars. iod. and our foremost antipsorics.

In severe inflammatory conditions existing along with anthrax, or with malignant deposits in different regions, Lobelia in repeated as well as in single doses will often arrest urgent mischief. A few drops of Lob. i. ac. in boiling water takes away the pain and tension of inflamed piles; the patient sits on a utensil thus filled. In the broncho-pneumonia of childhood and in imperfect recoveries from chest affections, especially where tubercle threatens, Lobelia is indispensable.

Treatment with Lobelia should always be begun with a single dose, if the symptoms permit, as in some cases it produces violent depression. In veterinary practice it is said to have proved curative in the tetanus of horses; a disease it is also said to produce. It must be kept in mind when studying Lob. i. that the herbalists used it in two forms: the decoction to produce emesis, and through which they seem to have obtained its antidotal action, or by virtue of which they aborted acute gout; and the acetous tincture, which they gave in chronic diseases, and in moderate doses."—Lob. i. may cause a rash which exfoliates, and it has cured many cases of psoriasis.

It meets a condition in which the secondary digestion is at fault. The patient is thin, poor, and has no appetite. It cures the condition which favours pediculi corporis. Referring to the skin action of Lob. i., Hale quotes P.

H. Hale as saying that, with the intense nausea it causes, there is sometimes a prickling itching of the skin, and acting on this hint P. H. Hale thinks he has seen benefit from its use in suppressed urticaria, with nausea and vomiting.

The symptom Teste gives is this: "Eruption between the fingers, on the dorsa of the hands and on the forearms, consisting of small vesicles accompanied by a tingling itching, and resembling the itch pustules exactly." As with Sulph. "faintness at the stomach" is a grand characteristic which will be found in a large proportion of the cases calling for the remedy. Jeanes, who proved Lob. i., gives these as the chief symptoms: "Constant dyspnoea, < by slightest exertion and increased to an asthmatic paroxysm by even the shortest exposure to cold; sensation of weakness and pressure in the epigastrium, and rising thence to the heart with a constant heartburn; feeling as of a lump or quantity of mucus, and also a sense of pressure in larynx; pain in forehead from one temple to the other; pain in neck; in left side; high-coloured urine; weakness and oppression in epigastrium, with simultaneous oppression of the heart." I have italicised "rising thence to the heart" because I think this a particularly characteristic feature.

There is something like it in the oesophagus; a kind of globus hystericus. Hale quotes Dr. Cutler's (allopath) account of his own case. He had been asthmatic ten years, liable to very severe and prolonged attacks, and during the intervals scarcely ever passed a night without more or less of it, and as often as not was unable to lie in bed.

In the middle of an attack he had a tablespoonful of afresh plant tincture. In three or four minutes his breathing was quite free; but there was no nausea, and thinking that necessary he took another spoonful ten minutes after the first, and this occasioned sickness. Ten minutes later he took a third, and this produced a sensible effect on the stomach coats, and a very little vomiting and "a kind of prickling sensation through the Whole system even to the extremities of the fingers and toes.

The urinary passage was perceptibly affected, by producing a smarting sensation in passing urine, which was provoked by stimulus on the bladder." But all these symptoms very soon subsided, and vigour seemed to be restored to the constitution which he had not experienced for years. The necessity of taking Lobel. in doses sufficient to cause pathogenetic symptoms was insisted on by Thompson, and though it led to some disasters seems to have been the means of saving some lives. Thompson tells how as a boy he chewed this herb and so learned practically its effects.

He used to give it to other boys out of sport. One day whilst mowing he gave a sprig of it to a companion. By the time they had got six rods the man said he thought the sprig would kill him: he never felt so ill in his life before. He was in a profuse perspiration, trembled all over, and was as pallid as a corpse.

Unable to walk, he lay down and vomited "two quarts." He was helped to his house; ate a good dinner, and returned to work in the afternoon. After this he "felt better than he had for a long time." This gave Thompson his first notion of the medicinal virtues of Lobel. In Walter Besant's Life of Edward Henry Palmer, the great Orientalist, Palmer's own account of his cure by Lobel. is given. In 1859 he was seized with pulmonary disease, which rapidly increased until he was told he had probably only a few months to live.

On the advice of a herbalist named Sherringham he took a single large dose of Lobel. i., and this is what he experienced: (1) Violent attack of vomiting; (2) cold chill mounting up from feet to hands, which he could no longer move; to heart, which ceased to beat; to throat, which ceased to breathe. A doctor was sent for. "I felt myself dying," he said afterwards, describing the experience I was being killed by this dreadful cold spreading all over me.

I was quite certain that my last moments had come. By the bedside stood my aunt, poor soul, crying. I saw the doctor feeling my pulseless wrist, watch in hand; the cold dews of death were on my forehead; the cold hand of death was on my limbs. Up to my lips, but no higher, I thought I was actually dead.

I could see and hear but not speak, not even when the doctor let my hand fall on the pillow and said solemnly, "He is gone!" There was no pain, he said, and he was in no concern except about a book he wanted to finish. He recovered suddenly. New strength came to him. The consumption was arrested and was no more trouble to him for the rest of his life (H.

W., xviii. 405) The prickling sensation experienced by Cutler is characteristic, as also is tenderness of the sacrum. Carleton Smith (H. P., viii. 272) thus describes these: Extreme tenderness over sacrum; cannot bear even pressure of soft pillow; cries out if any attempt is made to touch the part; she sits up in bed, leaning forward to avoid contact.

After each vomiting spell breaks out all over with sweat, followed by sensation as if thousands of needles were piercing her skin from within out. Lob. i. is indicated in whooping-cough with dyspnoea threatening suffocation. Must keep mouth open to breathe. The headaches of Lob. i. are remarkable.

Teste describes them as follows: Pressive headache, at occiput, less frequently at the forehead, sometimes one-sided (left), < by motion; in evening and especially at night. Continual periodic headache, in afternoon and increasing till midnight, every third attack being alternately more or less violent. The brain is racked by the cough, which causes an intolerable pain. Heat and sweat about head and face, Cooper has recorded this case (M.

H. R., xxxiv. 289): Girl, aet. 9, seized with very bad headache affecting whole head and continuing night and day for two days, Merc. and Verat. v. being given in vain, Lob. i. acet. Ø, two or three drops in a little water given in the morning after a bad night, gave immediate relief and restored the appetite. Cooper considered it a meningitic headache, and he finds Lob. i. ac. and Kali iod. 30 especially useful in these (excessive sensitiveness being a leading indication for the latter).

A headache that has been frequently verified is: "Dull, heavy pain passing round the forehead from one temple to the other, immediately above eyebrows." Headache following intoxication; < afternoon till midnight; < from tobacco. A peculiar symptom of Lob. i. is semilateral coating of tongue

Sudden pallor with profuse sweat. Gastric derangements, extreme nausea and vomiting. The nausea of Lob. i. is continuous and accompanied by constant flow of saliva. This is the indication for it in morning sickness and in effects of suppressed or missed menstrual period.

Vomiting; face bathed in cold sweat. The nausea of Lobel. has been used in the same way as that of Tabac. and other emetics to produce relaxation of muscles, as, for example, rigid os. Sometimes this is effected by direct physiological action, but it may be homoeopathic as in this cured case: "With every uterine contraction violent dyspnoea, which seems to neutralise labour pains; rigid os, and perineum." But it is also of service locally, as in an enema; also in cases of difficult catheterism.

G. W. Boskowitz (H. R., xv. 357) relates the case of a man, 40, who had twice had gonorrhoea, the second attack, three years before, having left him with a gleety discharge.

For a year the stream had been diminishing until at last it took him half an hour to empty the bladder. Many surgeons had tried to pass an instrument and had failed. Boskowitz also failed several times, until one day he dropped fifteen drops of Lob. i. Ø into the urethra and held the meatus, to retain it, for five minutes. It produced a smarting which soon passed away; and then No. 10 sound passed with ease.

This sound was passed twice a week until No. 24 entered easily, and after this there was no further trouble. Boskowitz has used Lob. i. in many similar cases with like success. Guernsey gives this as a leading indication when found prominent: "Urine has a deep red colour and deposits a copious red sediment." Dyspnoea (as well as nausea) occurring in connection with imperfect menstrual evolution may indicate Lobel. H.

M. Broderick (Med. Adv., xviii. 568) has recorded this case: Young lady, 18, ill two years under allopathic treatment. Symptoms: Laboured breathing, sense of tightness across chest compelling her to take deep inspirations, which caused pain in heart region.

Pulse full, very rapid; cough after each deep breath. Unable to lie down from oppression and pain. Twitching of muscles of face. Menses never regularly established; would go several weeks over time and then would last only a day.

Lob. i. 3x was given in water. After the second dose she went to bed and slept. The remedy was repeated just before next menstrual period. She had no more attacks and menstruation became normal.

Among the peculiar sensations of Lobel. i. are: As of lump in pit of throat. As of foreign body in throat. As if oesophagus contracted from below upward. As of a lump or heavy load in stomach.

As if a lump rose up to meet food and obstruct. its descent. Fulness in trachea as if from chest. As of a lump in larynx. As if the heart would stand still.

As of a band about chest. As if blood stagnated in chest (> moving about). As if thousands of needles were pricking her skin from within outward. Lobel. i. is suited to persons with light hair, blue eyes, and fair complexion; inclined to be fleshy.

Symptoms are < by touch (right deltoid sore. Sits up in bed, leaning forward to avoid contact with bedclothes on sacrum. Cannot bear even a soft pillow over sacrum. Pressure at epigastrium = oppression).

Motion; slightest exertion <. Bending forward < pain under right shoulder-blade. Effort to move = fainting. Every rapid movement = dyspnoea and suffocation.

Going up or down stairs < dyspnoea. Symptoms generally > afternoon, < evening and night. Rapid walking > sensation of congestion, weight or pressure in chest as if blood from extremities was filling it. Sickness (of pregnancy) < morning.

Coldness > by warmth. Cold < dyspnoea; < from current of air. Warm food = vomiting.

Headache is < by tobacco or tobacco smoke.

Αντιδοτώνεται από: Ipec. Σύγκριση: Τα υπόλοιπα Lobelia· Digit. και Tabac. (καρδιακές παθήσεις· έμετος· < από την κίνηση, αιφνίδια ωχρότητα με άφθονη εφίδρωση)· Ars. (συμπτωματική αλλεργική ρινίτιδα· γαστρικές διαταραχές) Verat. alb.

(γαστρικές διαταραχές)· Ipec. (άσθμα—αλλά το Lob. i. έχει, μαζί με το άσθμα, αίσθημα αδυναμίας στο επιγάστριο που απλώνεται προς τα πάνω στον θώρακα, ναυτία, σιαλορροία, αίσθημα σβώλου στο στομάχι)· Ipec. και Ant. t. (πρωινές αισθήσεις ναυτίας της εγκυμοσύνης). Nux (πρωινή ναυτία των μεθυσμένων· Lob. σε ξανθούς ανθρώπους, Nux σε μελαψινούς)· Bry.

(< από την κίνηση· ο βήχας = κεφαλαλγία)· Asaf. (αντίστροφη περισταλτική κίνηση)· Sul. (ινιαία κεφαλαλγία· ο βήχας = κεφαλαλγία)· Ab. n. και Thuj. (επίδραση του τσαγιού)· Lact. ac.

(έμετος με άφθονη σιαλορροία—Merc. τη νύχτα)· Lil. t. (πόνος στην καρδιά—Lob. i. στη βάση, Lil. t., στην κορυφή)· Daph. i. και Rhus (μονομερής επικάλυψη στη γλώσσα· με το Rhus η επικάλυψη είναι λευκή)· Kali i. (μηνιγγιτικές κεφαλαλγίες).

Αλκοόλ. Τσάι. Καπνός. Βρέξιμο των ποδιών. Καταστολές εκκρίσεων. Ξένα σώματα.

Πνευματική ανησυχία· μεγάλη κατάθλιψη και εξάντληση· προαίσθηση θανάτου και δύσπνοια.—Κλαυθμηρισμός σαν παιδιού.—Βίαιη παραλήρηση με έξαψη του προσώπου και αίσθημα παλμών, κάθε βράδυ, μετά από έναν ώρας ύπνο.—Έχασε τη λογική του και περιήλθε σε σπασμούς· χρειάστηκαν αρκετοί άνδρες για να τον συγκρατήσουν· αυτό συνεχίστηκε μέχρι τον θάνατο.—Ένιωθε ότι πέθαινε, με στενοχώρια στον θώρακα.—Ένιωθε ότι πέθαινε, αλλά ήταν αδιάφορος.

Θερμότητα του προσώπου· ιδρώτας στο πρόσωπο, με ναυτία.—Αίσθημα ρίγους στο αριστερό μάγουλο που εκτείνεται στο αυτί.

Ξύσιμο στον λαιμό· που μετατρέπεται σε πόνο και ναυτία, η οποία με τη σειρά της διαδέχεται από πόνους εμετού, με σφίξιμο και σπασμωδικές αναβαθμίσεις στον λάρυγγα· με αναφόραια και κάψιμο, που ανέρχονται από το στομάχι· με αίσθηση τραχύτητας στον λαιμό και στένωσης στον οισοφάγο· με μεγάλη ξηρότητα, η οποία δεν απομακρύνεται με το πόσιμο, μετά το γεύμα Κάψιμο στον λαιμό, το οποίο γίνεται αίσθημα ξυσίματος· αυξημένη έκκριση ιξώδους σάλιου, με ξύσιμο, ναυτία και αναφόραια· καύσος ξύσιμο από το ουρανίσκο έως τον λάρυγγα· < κατά την κατάποση, και με συχνό καθάρισμα του λαιμού, λόγω αυξημένης έκκρισης βλέννας στον λαιμό, κάψιμο που ακολουθείται από ξηρότητα, κατά τη διάρκεια του πρωιού

Ιξώδης βλέννα στον λαιμό Σκληρή βλέννα στον φάρυγγα, που προκαλεί συχνό καθάρισμα του λαιμού Πόνος στον οισοφάγο: με ναυτία, σφιξίματα στην κοιλιά και έκκριση δυσώδους αερίου· κατά μήκος του οισοφάγου, έως το στομάχι, επιδ. σε ορισμένα σημεία, και ειδ. κάτω από τον λάρυγγα Αίσθηση στον οισοφάγο σαν να συστέλλεται από κάτω προς τα πάνω

Η κατάποση εμποδίζεται σαν από ξένο σώμα· κατά την κατάποση, αίσθηση σαν κάτι να ανέβαινε στον λάρυγγα και να εμπόδιζε την τροφή να κατέβει.

Πόνος στο στομάχι: μερικές φορές μετά το φαγητό, αλλά ελάχιστο· μετά το γεύμα, με πληρότητα και γουργούρισμα στην κοιλιά· που ανέρχεται προς τον θώρακα, ο οποίος πιέζεται· με ναυτία· συγκέντρωση νερού στο στόμα και πόνους εμετού Πίεση στο βάθος του στομαχιού· διαμέσου του σώματος προς τον νωτιαίο μυελό, σαν από πείρο, με διακεκομμένη δράση, που γίνεται κάθε φορά πιο ισχυρή· σαν από βάρος, κατά τη νηστεία και μετά το γεύμα, < κυρίως το βράδυ, επίσης με έμετο χολής, και πίεση και αγωνία στον θώρακα, και πόνοι στη μέση

Βίαιη και επώδυνη στένωση στο επιγάστριο Σπασμοί στο στομάχι διαφόρων ειδών Πόνοι στην κοιλιά· < μετά το φαγητό, με κεφαλαλγία, κατά την επιστροφή από περίπατο, μετά το γεύμα· κοπές και πόνοι έλξης στην κοιλιά· σφιξίματα και στρέψεις, με ναυτία, βίαια αναφόραια και έκκριση δυσώδους αερίου Φούσκωμα της κοιλιάς, με δύσπνοια· φlatulency και άφθονη έκκριση αερίου, με βορβορυγμούς στην κοιλιά, οι οποίοι μερικές φορές είναι επώδυνοι.

Κουραστική βαρύτητα στα γεννητικά όργανα.—Καύσος στην πόσθη.

Κατά την έμμηνο ρύση βίαιος πόνος στο ιερό οστό.—Βίαιος πόνος στο ιερό οστό, με πυρετό κ.λπ., που επέρχεται μετά από καταστολή της εμμήνου ρύσης κατά τη διάρκεια της ροής της.

Γαργάλησμα στον λάρυγγα, με συχνές κρίσεις βραχέος βήχα· ξηρότητα στον λαιμό, με αίσθηση σαν στερεό σώμα να εμποδίζει εκεί τόσο την αναπνοή όσο και την κατάποση.—Ερεθισμός που προκαλεί βήχα και απόχρεμψη.

Στα πόδια, καταβολή· οξύς διάσπαρτος πόνος στο κνημίδιο, που εκτείνεται μέχρι την άρθρωση του γόνατος· σπασμοί στο μυ του γαστροκνημίας το πρωί, κατά την αφύπνιση από ταραγμένο ύπνο.—Φλεγμονώδης ρευματισμός στο δεξί γόνατο· με διάσπαρτους πόνους στο περόνιο.

Σουβλεροί πόνοι σε όλο το σώμα, που εκτείνονται μέχρι τα άκρα των δακτύλων των χεριών και των ποδιών· τρόμος των άκρων, όπως επίσης και ολόκληρου του σώματος· αίσθημα καταθλίψης· ασυνήθιστη καταβολή· παρατεταμένη αδυναμία· εξάντληση· κατάσταση ηλιθιότητας· σπασμοί, μερικές φορές τέτοιοι ώστε να απαιτούνται δύο άνδρες για να συγκρατήσουν τον ασθενή, ακολουθούμενοι από θάνατο· βίαιες σπασμωδικές ανατινάξεις, ακολουθούμενες από θάνατο.—Άλλα συμπτώματα που εμφανίζονται όταν διακόπτεται μια έκκριση.

Σφυγμός: επιταχυνόμενος· συχνός και πιο μαλακός από το συνηθισμένο· αργός, το βράδυ (μετά από ισχυρότερη δόση) Ε间歇ικός πυρετός: αρχίζει το μεσημέρι, με μεγάλη ωχρότητα και ανορεξία· ημερήσιος, μερικές φορές κάθε πρωί στις δέκα η ώρα· αρχικά βίαιο ρίγος, εναλλασσόμενος με μέτρια ζέστη μέχρι το μεσημέρι, κατόπιν επικράτηση της ζέστης, με ελαφρύ φρικίασμα, μέχρι το βράδυ· επίσης, άφθονη νυχτερινή εφίδρωση, μεγάλη δίψα με προσβολές (ειδ. κατά το ρίγος), αναπνοή βραχεία, αγχώδης, παρεμποδισμένη και λιποθυμική, με αίσθημα σφιξίματος στο θώρακα, αίσθηση αδυναμίας και επιβάρυνσης στο επιγάστριο και γενικά στο θώρακα· γαργαλισμός στον λάρυγγα, με συχνές προσβολές βραχέος βήχα· βίαιη μετωπική κεφαλαλγία· ανορεξία κατά τη διάρκεια και μετά την προσβολή, λευκή γλώσσα, καλυμμένη με παχιά επιδερμίδα στη δεξιά πλευρά, και μεγάλη αδυναμία

Ψύχος ολόκληρου του σώματος· ζέστη, με τάση για εφίδρωση, ειδ. στο πρόσωπο· τάση για υπερβολική εφίδρωση Δίψα πριν από το ρίγος και σε όλη τη διάρκεια του πυρετού· συχνά μόνο πριν από το ρίγος, όχι κατά τη διάρκειά του, αλλά πάλι κατά τη ζέστη Η πόση < τη βιαιότητα του τρεμουλιαστού ρίγους και του ψύχους Στο τέλος της ζέστης, εφίδρωση με ζέστη.