Thyroidinum

Thyroidin. Thyroid Extract. A Sarcode. Trituration of the fresh th3Toid gland of sheep or calf. Attenuation of a liqaid extract of the gland.

Acute stupor alternating with restless melancholia; at times could not be got to speak, but would lie on floor with limbs rigid; at other times would weep and undress herself; at times dangerous and homicidal, would put her arms round the necks of other patients so tightly as almost to strangle them (in this case the insanity was primary and the myxe- dema secondary; both conditions were removed). Evinced

THYROIDIN. 495

increased vivacity by quarreling with another patient about a trifling difference of opinion.

Depression.

Fretfulness and moroseness gave way to cheerfulness and animation.

*'A11 progressed cases of myxedema show some mental aberration which tends towards dementia, usually with delu- sions, the latter taking the form of suspicion and persecution. Occasionally actual insanity is present in the form of mania and insanity."

Delirium of persecution (three cases observed, one fatal, the result of taking Thyro. in tablets to reduce obesity).

Sudden acute mania occurring in myxedema, perfectly re- stored mentally and bodily under Thyr.

Mental aberration dating three years before onset of myxe- dema, subject to attacks of great violence, with intervals of depression and moroseness.

State of idiocy; fearful nightmares.

Excited condition, lasting all the rest of the day, grunting continuously and laughing in a way that was peculiar to her- self.

Very excited; excited state followed by considerable de- pression.

For several hours in what can be only termed a hysterical condition.

Profound depression.

Irritable and ill-tempered.

Became a grumbler.

Angry.

Had frights.

Vertigo.

Feeling of lightness in the brain, scarcely amounting to gid- diness.

Much giddiness and headache for twenty-four hours.

Awoke about 4 a. m. with sharp headache and intense ach- ing in back and limbs, which continued for three days and compelled him to keep his bed.

Ever since taking the first thyroid [had had five glands altogether, at intervals] he had a strange feeling in his head, with vertigo and palpitation on stooping.

496 THYROIDIN.

Headache (with fever symptoms); disappeared on suspend- ing treatment, reappeared seven days after recommencing.

Frontal-coronal headache after taking one tabloid for four successive days.

(Constant headache, pains in occiput and vertex.)

(Headache in case of acromegaly.)

Headache and pains in abdomen.

Fresh growth of hair (many cases).

Black hairs growing among the grey.

In one case of scleroderma and in one case of myxedema the hair fell off permanently.

In a case of myxedema the patient lost all the hair of his head and face and had a thick growth over his arms and thorax; under Thyr. The hair of the head and face grew again and that of the arms and chest fell off.

(Prominence of eyeballs — exophthalmic goitre.)

Optic neuritis (in five persons, four of them women, under treatment for obesity; no other symptoms of thyroidism).

Accommodative asthenopia.

Moist patches behind ears heal up (case of psoriasis). Hyperplastic median otitis with sclerosis and loss of mobility of the ossicles (rapid amelioration — several cases).

Flushing: with nausea and lumbar pains; loss of consciousness, tonic muscular spasms; imn^ediate; with rise of temperature, and pains all over; suddenly became breathless and livid.

Faintness, with great flushing of upper part of body and pains in back.

Swelling of face and legs.

In lupus of face, tight sensation, heat, and angry redness removed.

Burning sensation of lips with free desquamation.

Tongue became thickly coated.

Feverish and thirsty.

Great thirst.

(Ulcerated patch on buccal aspect on 1. cheek near angle of mouth.)

(Full sensation.)

THYROIDIN. 497

Goitre, exophthalmic, cured.

Goitre reduced.

Loss of appetite.

Increased appetite with improved digestion.

Eructations.

Dyspeptic troubles.

Nausea, with flushing and lumbar pains.

Nausea, slight vomiting.

Slight nausea recurring on thinking of it.

Nausea soon after taking the gland.

On five occasions the patient (a woman) vomited the thyroid.

Always felt a sensation of sickness after the injections.

Sensation of faintness and nausea (after a few injections).

Feels tired and sick.

Gastro-intestinal disturbance and diarrhea.

Flatulence increased, followed later in the case by amelioration.

Headache and pain in abdomen.

Diarrhea, with gastro-intestinal disturbance.

Relief of constipation with more natural actions.

Constipation.

Increased flow of urine.

Increased urination, usually with clear, pale yellow secre- tion.

Slight trace of albumin found in urine.

Albuminuria.

Diabetes mellitus; caused and cured.

FEMALE SEXUAL ORGANS.— Increased sexual desire.

Six days after commencement of treatment menstruation, which has been absent over a year, reappeared and continued profusely (in several cases of myxedema with or without in- sanity).

Menses profuse, prolonged, more frequent; early amenor- rhea.

(Painful and irregular menstruation.)

(Constant left ovarian pain, and great tenderness).

Looks pale and feels ill.

Pain in lower part of abdomen, headache and sickness (in

498 THYROIDIN.

girl of sixteen, probably menstrual effort provoked by Thyr. ; no catamenial flow appeared).

Acts as a galactagogue when milk is deficient; when a defi- ciency is associated with a return of the menses it will sup- press the latter.

(Puerperal insanity with fever.)

(Puerperal eclampsia.)

RESPIRATORY ORGANS.— Slight attack of hemoptysis, fol- lowed by cough and signs of phthisis at apex of 1. lung.

(Voice became clear. )

Dormant phthisis; lighted up the disease in iive cases.

HEART AND PULSE.— Death, with all the symptoms of angina pectoris.

On trying to walk uphill died suddenly from cardiac failure.

While stooping to put on her shoes she ** fainted " and died in half an hour.

On one occasion, after exerting herself more than she had done for a long time previously, ** suddenly became extremely breathless and livid, and felt as if she was dying;" < by rest in recumbent position and stimulants.

Two fainting attacks.

Frequent fainting fits.

Complained occasionally of a feeling of faintness, not occur- ring particularly after the injections.

One patient showed extraordinary symptoms after the in- jection; the skin became so livid as to be almost blue-black.

Degeneration of heart muscle in animals.

A systolic cardiac murmur was less loud after the treatment than before.

Sensations of faintness and nausea.

Palpitation on stooping.

Weakness of heart's action.

Tachycardia and ready excitability of the heart persisting for several days after the feeding was stopped.

Pulse rose to 112.

Relaxation of arterioles.

(Rapid pulsation, with inability to lie down in bed.)

(Jumping sensation at heart.)

Flushing, nausea, and lumbar pains, lasting a few minutes.

THYROIDIN. 499

Stabbing pains in lumbar region.

Intense aching in back and limbs, which continued for three days.

Flushing of upper part of body and pains in back.

(Backache.)

UPPER LIMBS. — After injection, to a great extent lost the use of her hands for two days; recurred later, lasting a few hours.

Felt queer and unable to raise her arms (after injection, another case).

Arms less stiff and painful (psoriasis).

LOWER LIMBS. — Tingling sensation in legs.

Edema of legs appeared, and subsequently subsided and continued to reappear and subside for a month.

Pain in legs.

Incomplete paraplegia.

Swelling of face and legs.

Feet frequently peel in large flakes, leaving a tender sur- face.

Profuse flow of fluid from feet (in case of dropsy cured by Thyr.).

Quivering of limbs; tremors.

Intense aching in back and limbs, lasting three days.

Pains in arms and legs, with malaise.

Skin of hands and feet desquamated.

(Acromegaly, subjective symptoms.)

Malaise > by lying in bed.

Stooping = palpitation.

Rest in recumbent position > extreme breathlessness with lividity, felt as if dying.

Myxedematous patients are always chilly; the effect of the treatment is to make them less so.

Loss of consciousness and general tonic muscular spasm for a few seconds.

Fainting attacks (many cases).

Tremors, quivering of limbs, complete unconsciousness.

(Tetany.)

Epileptiform fit, after which he was unconscious for an hour; next day felt better and warmer.

Malaise so great she refused to continue the treatment.

BOO THYROIDIN.

Agitation.

Incomplete paraplegia.

Hysterical attack.

(Hystero-epilepsy with amenorrhea.)

Nervous and hysterical, had to have nurse to watch her.

Feels tired and sick.

Stabbing pains.

Aching pains (many cases).

Aching pains all over.

Diffused pains.

Aching pains in various parts of body.

Pains over whole body.

Brawny swelling at point of injection, followed by abscess of slow development.

Myxedema removed (many cases).

*'A series of abscesses resulting from the injections, but probably originating from an accidental abscess quite inde- pendent of them."

A small abscess formed.

Increased suppuration in case of lupus.

Gained a stone in weight.

Lost weight enormously (may cases of myxedema).

Rapid gain of flesh and strength.

Anemia and debility.

Infiltration rapidly absorbed (psoriasis).

Persons suffering from skin disease can bear much larger doses than those suffering from myxedema.

(Acromegaly, headache, and subjective symptoms.)

(Fractures refuse to unite.)

A peculiar cachexia more dangerous than myxedema itself.

Syphilis, secondary, tertiary.

Flushing of skin.

Skin became so livid as to be almost blue-black.

Skin has desquamated freely, but there has been no per- spiration or diuresis.

Psoriasis: eruption extended and increased.

(Psoriasis: redness and itching reduced; eruption separating and being shed in great scales, angry, inflamed appearance completely gone. )

THYROIDIN. 501

Moist patches behind ears heal. up.

Arms less stiff and painful; swelling diminished.

Crusts separated, leaving faint red skin; eruption not nearly so painful.

(Symmetrical serpiginous eruption; dark red; edges raised and thickened. )

Lupus: tight feeling, heat, angry redness removed; suppura- tion increased.

Eczema: irritation of skin markedly allayed.

Scattered pustules of eczema mature quickly or abort.

(Teething eczema. )

(Syphilitic psoriasis.)

(Rupia.)

Scleroderma.

Peeling of skin beginning on legs and extending over whole surface; skin has since become comparatively soft and smooth.

Peeling of skin of lower limbs, with gradual clearing (eczema).

Skin of hands and feet desquamated.

Continual tendency to sleep.

Awoke about 4 A. m. with sharp headache.

Fearful nightmares disappeared.

Insomnia.

Excited condition; could not sleep.

Flushing: with nausea; with loss of consciousness.

Always felt hot, and had a sensation of sickness after the injections.

Felt better and warmer.

Flushing of upper part of body and pains in back.

Temperature never rose above '99° but she felt feverish and thirsty.

Temperature rose to 100° F., and remained there several days; pulse 112.

Rise of temperature; diaphoresis.

Profuse perspiration on least exertion.

602 TUBERCULINUM.

TUBERCULIinrM.

Anxiety, gloomy, melancholy humor.

Has lost melancholy expression she formerly had.

Is disposed to whine and complain; dejected mind, anxiety.

She is very sad.

Nervous irritation; aversion to labor.

Indifferent.

Forgetful.

Aversion to all labor, esp. mental work.

Sensibility to music.

Does not like to be disturbed by people; trembling of hands.

Felt positively ugly; personal aversions became almost a mania.

Trifles produced intense irritation and I could not shake them off.

Very irritable, want to fight; no hesitancy in throwing any- thing at any one, even without cause.

Memory weak, unable to think.

Comprehension and concentration almost impossible.

Great anxiety for future, otherwise marked indifference.

Great sleepiness and weariness; entire muscular system re- laxed; desire to lie down all the time.

Nervous; weak; irritable.

Melancholy, despondent, morose, irritable, fretful, peevish.

Dejected, taciturn, sulky; weeps, but knows not why; naturally of a sweet disposition, now on the borderland of insanity.

Fretful, snappish, morose, depressed and melancholic, even to insanity.

Ill-mannered, quarrelsome; lies in bed and complains; lach- rymose, weeps without any provocation, cannot help it.

Irritable on waking; nothing can please him; nothing satisfies.

Melancholy with marked hypochondriacal delirium.

Everything in the room seems strange, as though in a strange place.

Intense restlessness; and inward restlessness.

TUBERCULINUM. 503

II With every little ailment whines and complains; easily frightened, particularly by dogs; screams in terror when ap- proached by a dog.

Anxiety, gloomy, melancholic humor.

Very restless in the evening when aroused.

Periodical anxiety and terror.

She is very sad, dejected, and complains continually.

Nervous irritation; averse to physical or mental labor.

Indifferent; forgetful; averse to all labor, especially mental work.

Extremely sensitive to music.

Sensibilities dulled; with chill and aching in the head, back and limbs.

Somnolence; loss of vital power; great physical weakness.

Does not like to be disturbed; trembling of hands and feet.

Soporous, dazed condition; unable to find the right way; is confused; surroundings appear strange.

Memory weak or lost; unable to think or comprehend.

Comprehension difficult; must read a paragraph several times before he can understand it.

Sopor; somnolence; with dyspnea.

Coma: profound, lasting three days, with temperature 106.

Delirium and serious meningeal symptoms, following an in- jection of Tuberculinum.

Complete unconsciousness; stupor and stertorous breathing.

Insanity; acute or chronic, with a family history of tubercu- lar affections.

When the best selected remedy fails to relieve or perma- nently cure in a marked tubercular diathesis, with a tubercu- lar family history.

Despondent, discouraged, feel as if I would rather die than live.

II Although naturally of a sweet disposition, became taciturn, sulky, snappish, fretty, irritable, morose, depressed and mel- ancholic, even to insanity. — Burnett.

Vertigo, esp. in morning; heavy with obscuration of eyes; is obliged to lean on something; by bending down, esp. by rising after bending down; with palpitation; with nausea; with backache in morning; after dinner.

504 TUBERCULINUM.

Great heat in head; flushes of heat after dinner; sensation of heat in head in evening.

Headache: deep in forehead; deep in temples; on vertex, with sensation of heat; from neck to forehead; in morning, passing away in afternoon.

Sensation of heaviness on vertex.

Headache with obscuration of sight.

Headache with vertigo.

Piercing headache.

Piercing pain in forehead from 10 A. m. to 3 p. m.

Headache in evening; in afternoon.

Frontal headache in morning.

Headache with rushing in ears.

Headache in morning with bleeding of nose.

Headache from neck to forehead; burning, piercing.

Colossal hyperemia of pia mater and brain substance; ex- treme engorgement of vessels on the surface, internally dusky red; tubercles presented no retrogressive changes (arachnitis).

(Sensation as if brain were squeezed with iron band. — Bac.)

Headache < by motion.

Sick-headache commencing about 8 A. m., increasing in severity through the day; very changeable, leaning the head to one side would increase the pain on that side.

Brain seems loose and rolling around from side to side.

Darting pain in occiput, extending down the spine.

Headache in evening 8 p. m., neurotic, first in one place then in another, over one eye then the other, then the occiput and down the spine.

Headache in afternoon, worse from going up stairs, better in open air.

Severe headache and vertigo in afternoon; a dizzy, sick at stomach sensation, like sea-sickness.

Dull headache on waking.

A strange sensation in head on first lying down as if some light substance was rolling from above eyes to vertex.

Severe headache beginning upon mastoid process on left side and extending over head to opposite side.

TUBERCULINUM. 505

ft

Complete physical exhaustion without any apparent cause.

Chilly all day, although room was warm; muscles of the whole body sore to touch or pressure.

In morning so weary and muscles ache so severely it is diffi- cult to arise.

Great heaviness in head and pain in occiput and neck.

Severe headache, < on second day, lasting until the third, recurring from time to time for many weeks and compelling quiet fixedness. — Burnett,

I Headache, with frequent sharpy cutting pains passing from, above r. eye through head to back of I, ear, — Rose,

II Headache of great intensity preceded by a shuddering chill passing from brain down spine, with attack a feeling as if head above eyes were swollen; became unconscious with screaming, tearing her hair, beating her head with her fists or trying to dash it against wall or floor. — Swan.

II Headache of forty-five years' standing, pain passing from r. frontal protuberance to r, occipital region, — Swan,

II Terrible pain in head, as if he had a tight hoop of iron around it; trembling of hands; distressing sensation of damp clothes on his spine; almost absolute sleeplessness; profound adynamia; was thought by his friends to be on verge of in- sanity; most of his brothers and sisters had died of water on brain; r. lung solid, probably from healed-up cavities, as he at one time suffered from pulmonary phthisis. — Burnett,

II Sullen, taciturn, irritable, screams in his sleep, is very restless at night, constipated; sister died of tubercular menin- gitis.— Burnett,

II Fretful and ailing, whines and complains, indurated glands can be felt everywhere, child hot, drowsy, urine red and sandy, much given to be frightened, particularly by dogs; was vaccinated and had a very bad arm for four months there- after; would not smile, whimpers when spoken to, skin dingy, skull hydrocephalic. — Burnett,

II Boy, aged 20 months, ill for days with head, high fever, restlessness and constant screaming; finally no sleep for forty hours, followed by a condition of collapse; peculiar smell of body; family history of tuberculosis. — Burnett,

II Tubercular meningitis, with effusion; head gradually en-

606 TUBERCULINUM.

I Tubercular meningitis. — Sinker,

I I Acute cerebral meningitis, with intense strabismus. — Biegler.

Plica polonica: several bad cases permanently cured with Tuberculinum. — Jackson,

Swollen lids; headache with swollen lids in morning.

R. eye much swollen, conjunctiva inflamed.

Dulness and heaviness of eyes; darkness before eyes.

Obscuration of vision with vertigo.

Opens r. eye (which had been closed).

Breaking down of cicatrices of old corneal ulcers (Stoker).

Clearing of corneal opacity the result of old tuberculous corneitis (Stoker).

Tuberculosis of eyelids, small grey and yellow nodules, ex- isting in conjunctiva of outer sections of lids, increased in size, ran together, then suddenly disappeared.

Phlyctenulae appeared where none existed before (Maschke).

Conjunctivitis; herpes on lids.

Amblyopia with irregularity and complete paralysis of pupils (in an alcoholic).

Stye appeared on upper lid of r. eye. Lid swollen, in- tensely painful; four days later opened discharging green pus.

Stye on lower lid of right eye, appeared suddenly, began to swell like a bee sting. Opened within 48 hours discharging green pus.

Tinnitus.

Rushing in ears with heavy head.

Sticking pain from pharynx to ears.

Headache with rushing in ears and pressure on vertex.

Great aching in ears and teeth.

Discharge of yellowish matter from the ears.

TUBERCULINUM. 507

Swelling of the glands around the ear and on the neck, worse below the ear and behind.

Slight discharge of yellowish matter from r. ear.

No pain.

Earl, aged 2 years. Light complexion.

Coryza.

Secretion of mucus from nose, viscid, yellow-green.

Increased secretion of mucus, with frontal headache.

Aching of ears and teeth with coryza in evening, with head- ache.

508 TUBERCULINUM.

Bleeding of nose.

Comedones on nose, surrounded with minute pustules.

The nose, which used to feel **hot and burning," has lost this sensation.

Profuse discharge of blood mixed with mucus from nares.

Sneezing, burning, watery coryza. Seemed to have fresh cold all the time.

Fluent coryza.

Discharge of thick tenacious, gray-colored mucus.

Awakened every morning at 5 A. M. to clear nose and throat.

Rattling of mucus in throat immediately after eating, which must be expectorated.

Soreness inside of nose, commencing as watery pimples, which, suppurating, form scabs; nose and lips somewhat swollen; itching slightly. — Rose.

Edematous, pale face.

Clonic convulsions of musculus orbicularis inferior, acute.

Convulsions in region of facial muscle, esp. buccinator.

In one case the inflammation of the lupus (on face) pre- sented unquestionable erysipelas of a rather severe type, and the patient was for some time in danger.

Flushing of cheek of same side as lung affected, during the reaction (Borgherini).

Upper lip and nose became swollen during the first two or three reactions, the lip becoming cracked on inner surface.

Herpes on lips and eyelids (Heilferich).

After the tenth injection his 1. moustache, which was kept cut to prevent scabs from gathering, ceased to grow, every hair fell out, and for a month the 1. upper lip was perfectly denuded of hair, and had all the appearance when seen under a lens of being depilated; however, the hairs began to grow well before he left the Home. (Hine).

Slight swelling and itching of lips. — Rose.

TUBERCULINUM. 509

Vague toothache.

Teeth felt loose.

" Feeling as if the teeth were all jammed together and too many for his head."

Sordes on teeth.

Inflammation of gums, scurvy-like.

Gums turgescent, felt swollen.

Tongue foul, furred.

Tongue much coated.

Coating on soft palate and tongue.

Taste: salty, purulent.

Aphthae on tongue and buccal mucosa.

Tongue dry.

Dryness of lips.

On lips black blisters.

Palate: granulations enormously swollen and vascular.

Breath oflfensive.

Spit up blood streaked mucus from mouth and throat.

A bitter, disagreeable taste; nothing tasted natural. This continued for more than a month.

Tongue coated white at back and through the center.

Scalded sensation on tongue and in mouth as though burned; tongue sore at tip.

Lips dry, chapped; entire mouth very dry, but no thirst, worse in morning on rising.

Thirst for small quantities of water.

Wakened several times in the Qight on account of dryness of mouth.

Aching in pharynx and larynx.

Scratching in pharynx.

Tickling in throat exciting cough.

Sensation of mucus in throat.

Sensation of a tumor in throat.

Dryness in throat; tonsilitis; general inflammatory condi- tion of pharyngeal mucous membrane.

Retropharyngeal abscess.

Burning pain in throat.

Sensation of constriction in throat; in larynx.

Heaviness and sensation of rattling in throat.

610 TUBERCULINUM.

Aching extending from throat to ears.

Dysphagia increased; later diminished (in laryngeal phthisis).

Intense pain in naso-pharynx on swallowing.

Sensation as if throat was swollen on the right side; expec- torating a great deal of mucus from posterior nares, worse immediately after eating.

Needle-like pains in left side of throat < by swallowing.

Pains shooting to the left ear when swallowing; unable to eat solids.

Dryness of the throat and posterior nares, with a dry, tick- ling cough at night.

Loss of appetite, esp. in morning.

Thirst: extreme, day and night; burning in morning.

Always drank coffee, but now cannot bear even the odor of it. which < the headache.

Great thirst.

Mouth, lips and tongue dry and parched.

Craving for food, for something to eat, but not relieved by eating.

Eructations and sensation of fulness over stomach.

Nausea, vomiting.

Vomited severely with > to headache.

Nausea and vomiting, nausea with efforts to vomit with colic and diarrhea.

Transitory sickness and vomiting after dinner.

Vomiting after every meal.

Nausea and sickness in morning with heaviness in stomach region.

Pressure in stomach, going to throat, as if the clothes were too tight.

Cramping pain in stomach.

Nausea with pains in umbilical region with diarrhea.

Nausea with racking and stirring in stomach and increased thirst.

TUBERCULINUM. 511

Sickness in stomach and pressing.

Nausea in morning.

Sticking pains in stomach region.

Belching of tasteless gas.

Constant nausea, but could not vomit.

Belching, with burning sensation in esophagus from stomach to mouth.

Tasteless eructations with muqh belching.

Nausea and repugnance at sight or odor of food.

Empty, twisted sensation in epigastrium, followed by an- other stool.

Much pressing, continuous pain in epigastrium. ,

Feels as if stomach was gripped by a hand.

Great thirst for hot water, which does not relieve.

Empty sensation after eating as if not satisfied.

1 1 Windy dyspepsia, with pinching and pains under ribs of r. side in mammary line. — Burnett,

Cramping pains in stomach and abdomen.

Sensation of constriction in abdomen.

Colic with diarrhea and heaviness in stomach.

Colic with great thirst.

Fatigue and sickness in region of stomach and abdomen ; sticking pains deep in spleen; severe pain in region of liver.

Aching (sticking) in region of liver, spleen, ovaries, sper- matic cord, testicles (esp. 1.), in hip-joints, in rectum.

Pains in region of appendix vermiformis.

Mass of enlarged glands, in r. iliac fossa much smaller.

Six pustules at different parts of skin of back and abdomen, and after discharging have healed.

Discrete papular rash over chest and abdomen.

Perforating ulcer in intestines.

Bloated sensation in abdomen all day.

Borborygmus, much rattling and rumbling.

Seems as though something would start in left groin and crawl upward, with persistent rumbling.

Dull pain and rumbling in abdomen, constantly changing from one side to the other.

Great exhaustion and weakness.

Sensation in abdomen as if greatly distended; clothing very

512 TUBERCULINUM.

oppressive, particularly about the waist; obliged to remove corset immediately for fear of suffocation.

Bursting sensation in abdomen.

Empty sensation in abdomen followed by burning from waist through lower extremities.

1 1 Fever, emaciation, abdominal pains and discomfort, rest- less at night, glands of both groins enlarged and indurated; cries out in sleep; strawberry tongue. — Burnett.

II Tabes mesenterica; swelling on 1. side, also on r. ; com- plains of a stitch in side after running; languid and indisposed to talk; nervous and irritable; talks in his sleep; grinds his teeth; appetite poor; hands blue; indurated and palpable glands everywhere; a drum belly; spleen region bulging out. — Burnett,

m

1 1 Inguinal glands indurated and visible; excessive sweats; chronic diarrhea.

STOOL AND ANDS.— Obstipation; stool hard, dry, with wind and colic.

Diarrhea with pinching and burning pains.

Pressure and constriction in rectum.

Pain in rectum.

Itching sensation in anus.

Constant urging to stool; often ineffectual.

Tenesmus, painful, constant; not so severe when lying down, but not > by lying.

Ineffectual urging; no reference to stool; seems to be the sphincter muscles.

Stool seems to drop for some distance above, coming chiefly in small diarrheic dribbles without pain, until sphincter is touched. Tenesmus begins as soon as feces pass over lower portion of rectum.

Tenesmus and ineffectual urging day and night; no rest; disturbed, unrefreshing sleep.

Pain dull, more or less severe; about hips, sacrum and en- tire pelvic region.

When I cough seems as if the rectum was being torn out.

Get very weary sitting, but dread to move, as motions < the tenesmus.

Early morning diarrhea: urgent, watery, dark-brown and

TUBERCULINUM. 518

offensive, passing with great force, 5 A. m. This early morn- ing stool continued for eight days, invariably from 5 to 6 a. m.

Early morning, urgent, ineffectual with tenesmus. . Early morning diarrhea; watery, painless, bright yellow, but little or no exhaustion followed.

Mrs. S , aged 27, Denver, catarrh of nose, throat and

Profuse, watery stool two or three times a day.

Constant urging for stool. Formication.

Loose stool; slight tenesmus.

Constant, ineffectual desire.

Loose, yellow colored stool, with considerable straining; three stools since 5 p. m., attended with much thirst and bor- borygmus.

Griping pain with bearing down in lower part of abdomen; some relief after stool.

Stool pale yellow color.

Sensation of drawing and constricting of sphincter.

Profuse, watery, ill-smelling, like old cheese, at 5 p. m.

Sudden diarrhea before breakfast, with nausea.

Severe hemorrhage from bowels, cough; emaciation; family history of phthisis.

514 TUBERCULINUM.

Urine intermits, stops and starts; flows slowly; must strain at stool to pass urine.

Unable to pass urine no matter how hard he strains or how full the bladder until after spasm of anus; then it flows and stops and flows again for several times.

Diminished quantity of urine.

Is obliged to urinate very often, esp. during changes of weather.

One-tenth albumin in height of reaction; disappeared afterwards.

Specific gravity of urine increases from 1016 to 1023, with an excess of urates and ropy mucus.

Peptonuria in man, 33 (Maregliano).

Hematuria with renal pain.

Excess of urates.

Abundant viscid mucous discharge.

Urine frequent, copious; deposits yellow, reddish cloud on standing, loaded with urates.

Urine: odor of boiling beans.

MALE SEXUAL ORGANS.— Pains in testicles, and cord of 1. side.

FEMALE SEXUAL ORGANS.— Severe pains in breast in even- ing at beginning of menstruation.

Menstruation with pains in lumbo-sacral and ovarian region.

Sticking pain in lower abdomen; pains in lumbo-sacral region < when walking.

Weakness in genital region; painful menstruation.

TUBERCULINUM. 515

Blood lumpy, menstruation lasting more days than usual; menstruation antepones eight days.

Burning pains in external genitals; sharp leucorrhea; pains in sacral and ovarian region to hip- joints.

Sensation of heat in genitalia externa, with increased leu- corrhea.

Cramps in uterine region with pains in sacral and ovarian region.

Burning pain in ovarian region.

Menstruation returns fourteen days after parturition.

Menses five days early, offensive, scanty, dark flow only two days; ceased one day, returned on the fourth. The func- tion was wholly unnatural in appearance.

Menses usually one or two days late and four days in dura- tion.

516 TUBERCULINUM.

RESPIRATORY ORGANS.— Decided effect in laryngeal cases, mostly beneficial.

After ten injections, larynx markedly affected, inflammatory swelling and ulceration.

Central infiltration of mucous membrane of larynx, high red color, brighter than normal.

Enormous swelling of arytenoids appeared.

Tuberculous outgrowth.

Exfoliation at r. vocal cord, appearance extravasated below its posterior part.

Hyperemia of cords intensified and covered with minute ulcerating points.

Cough and expectoration lasting four months, from a wet- ting (removed, no bacilli found).

Sensation of pressure on chest.

Cough and sputa.

Irritating cough, < in night.

Little cough in night with aching in side and blood-tinged sputa.

Severe cough in evening with pains below mamma on r. side.

Inclination to cough.

Severe cough with muco-purulent secretion in morning.

Cough prevents him sleeping in evening.

Cough, secretion of phlegm, esp. by walking, with sticking pains in lungs and palpitation.

A sort of whooping-cough.

Dry cough; in night.

Cough with viscid mucus.

After much cough sensation of mucus in pharynx, mucous secretion being easily ejected.

Expectoration diminished. — Heron,

Palpitation and pains in back with cough.

Crackling rales at r. shoulder, behind.

TUBERCULINUM. 517

Cqpious watery expectoration usually seen during the re- action.— Wilson.

With every increase of dose he suffered with asthmatic fits, lasting from three to seven hours.

Extreme rapidity of respirations^ without dyspnea, 60 to 90 in the minute; if the patient is spoken to, the rapid breathing ceases at once (as with a dog panting in the sun). — Heron,

Is obliged to take deep inspirations; dyspnea.

Difficulty in breathing speedily increased.

Marked feeling of suffocation.

II Slight tedious hacking cough, which had lasted for months in a girl of a distinctly phthisic habit. — Burnett,

II Hard, dry cough, sometimes slight, but generally no ex- pectoration, slightly feverish. — Boardman,

II Hard, dry cough, shaking patient, more during sleep, but did not waken him. — Boardtnan.

1 1 Expectoration of non-viscid, very easily detached, thick phlegm from air passages, followed after a day or two by a very clear ring of voice. — Burnett,

Sensation of pressure in chest.

Heat in chest.

Sticking pain in chest, especially at the apex of 1. lung.

Sensation of constriction in the precordial region.

Pains in both sides of chest going to back.

Pains in 1. side.

Sticking in side.

Nightly pains on chest.

Sticking pains: in lungs; in 1. side, pains between scapulae.

Aching in side in night.

Sticking pain in chest on r. and L side.

Sticking pain in 1. side in morning and afternoon.

Sticking pain in lungs when laughing.

Pain in axilla, esp. when elevating arm.

Sticking pain: in lungs with cough and palpitation.

Pressure in chest, sticking pain on both sides of chest, in back.

Palpitation caused by deep inspirations, aching in back with pains under ribs.

Pains in subclavicular region with cough.

518 TUBERCULINUM.

Sticking pain in 1. lung.

Pain from clavicles to throat.

Pain in apex pulmonis radiating to axilla and arm.

Sticking pain in chest and in back < from every movement.

Pain in 1. lung to axilla.

Pain on 1. side going back.

Pain in 1. apex and in region of spleen.

Severe pain in back, in axilla and arms.

Pains in 1. side, must take deep inspiration.

Bronchitic sounds in both lungs.

Dulness r. apex.

Sudden, profuse hemoptysis, ends fatally.

Developed a cavity on side opposite to that first affected.

New deposits of tubercles on pleura.

Surface of old pulmonary cavities showed unusually intense redness of granulation layers.

Hemorrhagic infiltration of walls.

Recent hemorrhage observed in the cavities.

In fatal cases of ulcerative phthisis the lungs esp., and also the pleura, showed extensive and severe recent changes — pleurisy, for the most part very severe, simple and tubercu- lous, frequently hemorrhagic, and not infrequently bilateral.

Catarrhal pneumonia was found, but it differed from ordi- nary catarrhal pneumonia (in which the alveoli when squeezed out have a gelatinous appearance) in that the contents of the alveoli were very watery and turbid — a turbid infiltration; it resembles a phlegmonous condition.

Soft hepatizatiqn, which differs from ordinary catarrhal hepatization, in that in the midst of the patches foci of soft- ening become developed, leading to rapid breaking down and excavation.

Development of fresh tubercles; small tubercles giving rise to new ulcers have suddenly appeared, esp. in pleura, peri- cardium, and peritoneum.

TUBERCULINUM. 519

Metastasis bacilli mobilized.

Abscesses in the lungs.

Perforating abscesses in respiratory organs.

Burning sensation in both lungs, better in the open air.

Severe burning sensation in apex of right lung, uncler sec- ond rib.

Dry, hacking cough and expectoration of yellow, bloody, streaked mucus.

Chest sore, first in one place then in another.

Early morning cough, sputa streaked with blood.

Hard, dry cough for several days, resulting in the expector- ation of yellow mucus mixed with white lumps or a quantity of white, stringy substance looking like thick milk, with sore- ness of one or both lungs when coughing or taking a deep in- spiration.

Sensation of intense anxiety in the region of the heart, especially worse on waking.

Pulsation synchronous with the heart-beat felt in all parts of the body.

1 1 Slight hacking cough, continuing all day, < at bedtime and on rising; emaciation; dulness on percussion at apex of r. lung. — Burnett,

II Girl, aged 15, tall for her age; tonsils enlarged; chronic discharge from nose, < early morning on rising; speech thick; thorax of pigeon-breast type; perspires much across nose; very bad perspiration of chest, armpits, palms, nose, and feet; feels very chilly; spleen swollen; distinct dulness on percussion at apex of r. lung; suffered badly from vaccination; gets chilblains. — Burnett.

II Hectic flush of cheeks; shortness of breath; slight hack- ing cough; several strumous scars on neck; dusky skin; large, moist rales in both lungs; increased vocal resonance of r. lung; amphoric sounds in r. lung; large, soft-feeling gland in 1. side of neck; very pronounced endocardial bruit, best heard at apex beat. lodoformum 3x in four grain doses for two months, with improvement, followed by Tuberculinum c. in very infrequent doses. — Burnett,

II Incipient phthisis in a boy aged 7; loss of flesh; great prostration; morbid timidity; glands of groins and on both

520 TUBERCULINUM.

sides of neck very much enlarged and indurated, particularly glands over apex of r. lung; as he had suffered much from vaccination, Thuja 80 and Sabina 30 were first given, then Tuberculinum. — Burnett.

II Nocturnal perspirations; notched incisors; indurated glands everywhere, very large and numerous; drumbellied; grinding of teeth at night; great susceptibility to taking cold; perspiration < at back of lungs and on head; big head, with bulging forehead; subject to attacks of fever and diarrhea. — Burnett,

II Incipient tubercular disease; restless at nights; sleepless; grinds teeth; tendency to diarrhea; want of appetite; foul breath; notched teeth; pain after food; vomiting of food; in- durated glands; strawberry tongue; naughty; very irritable temper; puny growth; very thin; girl, aged 6. — Burnett,

II A nasty little cough, for seven weeks; much expectora- tion; pains in r. lung; evening fever; liver and spleen en- larged; cough morning after breakfast; neck slightly goitrous; eats hardly any breakfast. — Burnett,

1 1 No respiratory sounds at top of r. lung, and vocal reso- nance slightly increased; pain in 1. side; profuse perspiration; girl, aged 18. — Burnett,

II Much fever, < evenings; restless and terribly irritable; much depressed and in almost constant agitation; tongue very red; chronic diarrhea; has lost fourteen pounds during last six weeks; has no appetite; evacuations discharged from bow- els as from a pop-gun. — Burnett,

II Bad cough of about twelve months* duration; expectora- tion of blood; one of apices was audibly diseased; has had pneumonia; chest flat; respiration accelerated; tanned un- duly in sun. — Burnett,

II Anemic, sickly, pale; profound debility; dyspnea, cannot mount or hurry; menses irregular. — Burnett,

II Lady, aged 26, in first stage of consumption; dyspnea and rapid breathing; loss of flesh; greasy, dingy skin. — Burnett,

II Stout man, bright, florid complexion, mother died of

TUBERCULINUM. 521

phthisis, with which disease her sister is suffering; gets pneu- monia very often in cold weather; hence travels from place to place to avoid colds; coughs much, brings up much phlegm; perspired profusely and draUk great quantities of fluids; wretched sleepless nights, with almost constant fever; glands of neck much enlarged. — Burnett.

1 1 Complains that she has been in consumption for many years; is very thin and consumed with fever; lungs very flat; respiration almost imperceptible; fever; poor appetite; lan- guid. — Burnett.

II Ringworm on scalp; lymphatic glands everywhere pal- pable; ribs very flat; strawberry tongue, bad cough, < at night; although 11 years old she had practically no teeth, they were rudimentary, and not above level of gums. — Bur^ nett.

II Pronounced phthisical habit; severe piles; constipation; brown cutaneous affection on abdomen. — Burnett.

I had thought of sending her to the hospital as she had the poorest of care at home; but the doctor said it was of no use,

522 TUBERCULINUM.

The child had previously had what I thought at the time were tubercular abscesses, from enlarged cervical glands at the base of the neck.

I always hesitate to use the remedy first hand, but have a number of times used it after other remedies failed, and with success, especially where there was a tubercular tendency. — Scholes,

Palpitation early in morning.

Sensation of heaviness and pressure over heart.

Palpitation with cough and sticking pain in lungs.

By deep inspirations severe palpitation.

Aching in heart.

Palpitation in night < when raising himself up.

Palpitation with pain in the back.

Death from paralysis of heart. — Libherts,

NECK AND BACK. — Glands in neck and scars swollen and very tender, various lupus points about them showing yellow fluid under epidermis.

Scars in neck softer and flatter; no lupus nodules now per- ceptible.

Glands cannot now be felt, except the largest, which is now reduced to size of a pea.

Cervical glands much smaller.

Aching like needle-pricks in the back.

Prickly feeling in skin of back.

TUBERCULINUM. 523

Weakness in lumbo-sacral region.

Sticking pain over both scapulae; pain in region of spleen; vague pains in back and on chest, with sensation of pressure.

Sticking in back.

Pain in back with palpitation.

(Sensation on his back as if the clothing were moist. — Bac.)

Three red patches on 1. side of back became much deeper.

Tuberculosis of sacrum greatly improved. — Kurz.

^arge boil on back of neck, intensely painful, discharge of green pus and did not heal for two months.

Beating, throbbing pain under inferior angle of right scapula.

Severe pain in left trapezius muscle, from nape of neck to occiput.

When waking after first sleep at 8 A. m. neck and back stiff and painful) wears of! during the day.

Unable to turn the head to the left, and when turning to the right, the left side is painful.

Wakened at midnight with twitching at angle of left scap- ula; passed to right scapula and down the right arm like a convulsive tremor shaking the arm.

II Indurated cervical glands.

Lump, size of a walnut on cord of neck, is movable and occasionally itches. — Rose,

UPPER LIMBS. — Aching in forearms; vague, stitching pain.

Diminution of inflammation above elbow-joint; disappear- ance of abscess over olecranon; sinus connected with radius discharging freely a thick yellow pus.

Sensation of luxation with severe pains in r. carpal joint; < . by effort to move it; ceasing by rest.

Trembling of hands.

Hands and arms so weak am unable to write; must support right wrist with left hand in raising a cup or glass to my mouth; and passing dishes at table.

Unable to dress myself from weakness of the arms.

LOWER LIMBS. — During night pain referred to r. knee; r. leg rotated in and flexed slighted at hip and knee; movement

624 TUBERCULINUM.

of r. hip-joint free; 1 p. m., 1. hip much more painful and tender, more flexed, abducted and rotated out (disease of 1. hip in girl of five).

Aching in the hip-joints.

Pain r. knee without swelling (Heron, a non-tubercular case).

The knee became easily movable and could be bent to a right angle (tuberculous affection of r. knee).

Swelling and tenderness of both knee-joints. — Heron.

Sensation of formication in arms and legs.

Great weakness in limbs after dinner.

Sensation of fatigue and faintness in all limbs.

Pains in limbs, fatigue (3 to 4 h. after injection).

Pains in limbs (2nd d.).

Pains in ulnar nerve and calves of legs and knees, 1. great toe much affected, and became very red and turgid.

Trembling of limbs (in an alcoholic).

Twitching in the limbs.

Dull pain in bones, aggravated from walking and much worse every afternoon and evening.

Left leg painful on walking, must keep weight off it as much as possible; worse sitting than when walking, but pain always worse after exercise.

Severe pain across sacrum, as if parts were massaged with a fist.

Lame feet for three weeks, would walk or stand on sides of feet to rest thi^m.

Cramps in calves.

II Tubercular swelling of knee; intermittent attacks of pain in it; has expectorated clots of blood and suffered from ex- hausting sweats; family history of phthisis. — Burnett.

1 1 Tuberculous disease of 1. knee; for eleven months had been limping; knee much enlarged and very tender; teeth dirty and carious; strawberry tongue. — Burnett,

Erythematous eruption like measles or scarlatina.

Erythema with subcutaneous indurated nodules.

Great bronze patches on the forehead and temples.

Bronze finger-points.

Finger-points as if touched by Argentum nitrtcum.

TUBERCULINUM. 525

Itching all over the body in the evening in bed; changing place after rubbing.

''Rash on chest and abdomen similar, patient says, to what came out when disease first appeared."

Rash on abdomen and back, commencing very red; speedily becoming brownish^ resembling ordinary skin eruption of secondary syphilis.

Edematous condition of upper lip.

Edematous condition of eyelids.

Nose swollen, tense, erysipelatous-looking epidermis in lupus patch raised by yellow fluid.

In two cases, at least during the febrile action, old chil- blains became again inflamed.

Slight attack of jaundice (several cases).

Site of injection slightly painful and red (2nd d.).

Erythematous blush confined to lupus parts, which were the seat of throbbing pain.

It has repeatedly caused general erythematous eruptions on the skin, and in some, nodular effusions into the cellular tissue.

Boil on right hand near base of little finger; whole hand in- tensely swollen. Boil opened in about a week, discharging large quantities of green pus.

Eruption eczematous; itching radiating from patch to patch; burning, stinging, creeping; red, hot, swollen, with nerve shocks all over body; severe stinging sensation over whole body where there is no irritation; > by cold bath or ice bags.

The itching irritation runs over the limbs and through the body, terminating in involuntary shudders that creep over the body continuously ; at times limbs burn and throb; there are intervals of a few hours, sometimes a day or two, when hos- tilities cease only to be renewed with increased vigor without intervals.

526 TUBERCULINUM.

At night about 10 o'clock or later, after drinking cold water, there is an acid sensation in stomach like heartburn; limbs are swollen from knees down; look as if the skin had dried; severe reflex irritation oyer whole body; cannot bear the least heat, this sensitiveness to heat seems to be increasing. Since the skin symptoms became so intensely irritating the normal secretions of the vagina have been greatly lessened.

A fine, red, scaly eruption in patches about an inch in diameter over the entire body, itching intensely when skin was exposed to the air. Rubbing or stratching gave relief, but was followed by soreness.

A rash-like eruption on neck, both sides, for several days.

A fine, red eruption on right wrist extending up the arm in spots, with great itching.

II Very bad tempered; very much pigmented where sun's rays impinged upon him; teeth dirty, greenish. — Burnett.

Eruption of itching blotches all over body, with exception of face and hands.

I Ringworm.

Great desire for sleep; drowsiness during day; after dinner.

Inclination to sleep in mornings.

Shivering when beginning to sleep.

Cold feet in bed.

Troubled sleep; sleeplessness.

Sleep disturbed from 3 a. m.

Sleeplessness on account of constant coughing.

Many dreams: disturbed sleep, interrupted by fearful dreams; gloomy dreams; dreams of shame; cries out in dreams.

Intense restlessness, worse from 3 a, m. until morning.

Great restlessness every night, with distressing frightful dreams, worse towards morning.

Sleepy in the day-time; can sleep all day, but it is unre- freshing.

Waken from 3 to 4 A. M. with terrible dreams; of snakes crawling upon my sister from the back; of dark-green snakes three and four feet long, two inches in circumference, they seem like the snakes in my own country, Colombia.

TUBERCULINUM. 527

Awake weeping with fear.

Restless and wakeful after 3 a. m.

Awake with sensation of fear that some evil is impending to my family.

Disturbed distressful sleep. — Burnett.

Shivering, when beginning to sleep; cold feet in bed.

Freezing and heat alternately; cold and heat for months.

II Fever.

Violent attack of ague, lasting almost an hour.

Freezing on the back in evening.

Freezing during whole day.

Sensation of heat in evening in bed.

Flush of heat from back to head.

Feverish, nausea, thirsty, with headache, no vomiting (Heron).

Flushes of heat after eating.

High temperature, abating in twelve hours.

Lowering of temperature after each injection (Heron).

Lowering of temperature after a rise (Heron).

Temperature seven hours after injection, 103.8° accompan- ied by thirst, rigor, increased cough, headache, and pains in joints (Heron).

Sweat in the night.

Much sweat, esp. on head in night.

Profuse sweat after light exertion.

A little walk and slight efforts produce sweats.

Short sweats in morning, while walking.

Profuse sweats during slight exertion.

Chilly all day, most severe up and down the spine, followed in afternoon and evening by fever; pulse 104, temperature 102, with thirst and intense restlessness.

Great coldness of hands and feet with general chilliness; compelled to retire in haste.

Wanted much covering with hot applications to feet; hands are cold to waist, as if plunged into ice water; cold sweat on palms of hands.

Fever all afternoon and evening; temperature, 99 4-10; pulse, 86.

528 • TUBERCULINUM.

Suddenly became unconscious while sewing or talking, began screaming, tearing her hair, beating her head with her fists, or trying to dash it against the wall or floor; attacks daily for a month, then spasms set in, with rolling of head from side to side and moaning; continuing five weeks, followed by a recurrence of fainting fits, at least twice a week; a few hours before an attack of fainting, a shuddering like a chill seemed to go from brain down spine; when questioned about an attack, she said head would suddenly seem to swell over eyes and pain became ** horrid" and she knew no more; between attacks she was free from all complaints except fa- tigue and an ever-present frontal headache. — Swan.

Feeling of fatigue.

Malaise, depression, headache, somnolence, oppression of breathing, tightness of chest, nausea.

General fatigue in morning; sensation of faintness; great weakness in lower extremities, esp. from knees down to feet.

Terribly tired, so that she can scarcely walk.

General excessive fatigue after a short walk, so that he must lean on his companion.

Emaciation (lost six pounds in fourteen days, twenty pounds in five weeks).

In parts affected thi"obbing pain.

Leucocytosis; diminution of oxyhemoglobin.

Oxyhemoglobin first diminished then increased (Henoque).

Feeling well, but decidedly losing flesh.

Acts principally by very acute irritation of internal organs affected (in the same way as in external organs), causing in- tense redness and great swelling.

Actual inflammatory processes (not mere hyperemias), and esp. active proliferations, occur to an intense degree, in (1) edges of existing ulcers; in (2) neighboring lymphatic glands, esp. bronchial and mesenteric.

Lymphatic glands present a quite unusual degree of en- largement, and notably that form of medullary swelling, char- acteristic of acute irritations, which is caused by rapid pro- • liferation of the cells in the interior of the glands.

Leucocytosis: various infiltrations of white blood corpuscles over affected parts, esp. around the tubercles themselves.

I ,(

TUBERCULINUM. 529

Enormous dangerous swellings in parts near ulcers (even where the surface of the ulcer becomes clean), causing dan-^ gerous constriction.

Phlegmonous swelling resembling erysipelatous edema of glottis and retropharyngeal abscess.

Where tubercle is associated with any other specific disease, reaction is so slight as to be scarcely discernible (Heron).

Syphilitic cases are refractory to reaction (Heron).

Children bear the treatment well (Wendt).

Tuberculinum, a typical case: Howard L., 28 years of age, a resident of Attleboro, Mass., was indisposed in the fall of 1898, troubled with hoarseness and gastric ailments. A neigh- boring physician was called who had attended the young man's family for many years. This physician commenced in September, 1898, to inject Tuberculin (Koch's), and up to December had injected his toxin twice a week for several weeks, and then once in two weeks the remainder of the time.

The result.^ At the time of the commencement of this treatment Mr. L. could work and eat comfortably; soon his stomach rebelled against food and the bowels became consti- pated, his hoarseness increased and distressing, suffocative spells set in every forenoon, lasting an hour or so; he would then be able to breathe well the rest of the day.

In January, 1899, I was summoned hastily in the night and found him laboring for breath, the noise of his breathing audible from the street. His first words were: **MyGod, help me; relieve me, Doctor, or I shall die." Expectoration was scanty, dark green, lumpy, tubercular matter. Examina- tion of the throat revealed a larynx full of tubercular nodes. I saw that his end was near, and told his parents with whom he lived I would rather they would call their family physician.

But as they insisted on my keeping the case, I prepared some medicine which relieved him, but the next morning he was again worse, and from that time on was in agony from efforts to get breath. To relieve him intubation (through the mouth) was resorted to, but he could not keep the tube in. He died that afternoon, his great agony being > only by re- sort to chloroform applied locally. This man had been wild in his youth, had had gonorrhea several times, and of diathe-

680 USTILAGO.

sis tubercular. I asked him if he had told his former physi- cian these things and he said he had. This case is typical as far as the use of Tuberculin by injection is concerned, of a score I could mention who have died under the hypodermic use of Tuberculin in this vicinity the past two years.

USTILAGO.

Depression of spirits in afternoon.

II Very sad, cries frequently; exceedingly prostrated from sexual abuse and loss of semen; sleep restless.

Could not bear to see or talk to any one.

Irritability, being asked a question or to repeat anything.

The day seemed like a dream.

Melancholia; depression of spirits; oppression and faintness in a warm room. An aversion to or < from warmth in gen- eral.

Partial or complete loss of control over the functions of vision and deglutition.

Great irritability, mental weakness and depression.

Vertigo in attacks, sometimes with double vision, sometimes white specks blot out everything else, later attacks of vertigo with internal heat.

I Vertigo at climaxis with too frequent and profuse menstru- ation.

Headache: all the morning; at 7 A. m. ; in evening, < fore- head; < walking.

I Nervous headache from menstrual irregularities in nervous women.

Frontal pain: in morning; in forenoon, with smarting in eyes; all day, with aching distress in eyeballs and with fulness of head in morning; with distress in epigastrium.

Scalp dry, head congested, with loss of hair.

Scale-head, watery serum, oozing from scalp.

Prickling in 1. temple.

Loss of hair.

Bursting congestive sensation to the head; and various parts of the body.

USTILAGO. 581

Upward surging of blood with bursting in the head.

Vertigo from such causes, especially at climacteric.

Feeling of fulness with dull pressive headache < by walk- ing.

The headache and vertigo appear to be reflex from ovarian or uterine condition.

Frontal headache, < by walking.

Violent frontal headache as if forehead would burst open.

Sharp flying pains in forehead, congestion of the brain.

Pain on top and side of head; climaxis.

Falling of the hair and nails; complete alopecia, not a hair on the head.

Headache in temples.

ETES. — Attacks of twitching in eyes, they appear to look (revolve) in circles and dart from one object to another.

Continual watery flow from eyes and nose with occasional chills.

Spasms, with vanishing of vision and head seems to whirl.

Aching in eyes and lachrymation.

Aching and smarting in eyeballs, with profuse secretion of tears.

Hot feeling on closing lids.

Weakness of eyes.

Lachrymation in open air.

Lids agglutinated in morning.

Vision of spots dancing to and fro.

Things whirl before the eyes, appear double; white specks come into view and blot all else.

Dull aching pain in r. eyeball.

EARS AND HEARING. — Constant dull pain in 1. ear, caused by extension from inflamed tonsil.

Boil in r. nostril.

Dryness of nostrils in forenoon, with dry feeling in skin.

Bright epistaxis, > pressure.

Rhinitis, bitter taste, ofiensive odor noticeable to patient himself.

Dryness of nostrils as if he had taken cold.

Pains at root of nose, extending in toward canthi, and up and out at each eyebrow.

532 USTILAGO.

Sudden pallor in face when sitting, and in evening.

Burning of face and scalp from congestion.

Flushes of heat; the face becomes red and hot.

Sometimes looseness of teeth.

Aching all day in decayed upper first and second molars, which have ached before.

Shedding of teeth (in animals).

^Tongue coated in morning.

Prickling in tongue, with feeling as if something were press- ing the roots upward, with dryness of nostrils.

Salivation: thin, bitter; profuse.

Taste: coppery; in morning; slimy coppery.

Slimy: slimy, with burning distress in stomach.

Tonsils congested, inflamed.

L. tonsil enlarged, congested, dark reddish, r. painful on swallowing at 2 P. M. ; 1. painful at 9 p. m. ; next morning con- gestion of 1. extending along Eustachian tube and causing pain in ear.

Lancinations in r. tonsil (fauces were somewhat inflamed when the medicine was taken), next day fauces more hot and sensitive to motion.

Roughness of fauces.

Dryness of fauces, with burning dryness in stomach; diffi- cult deglutition.

Dryness of fauces with difficulty in swallowing, feeling of a lump behind larynx, later frequent efforts to swallow, with feeling as if something had lodged in fauces, afterwards irrita- tion of fauces, and on swallowing feeling of a lump in larynx.

Burning in esophagus at cardiac orifice.

Appetite: craving; poor.

Thirst at night.

Loss of appetite followed by canine hunger.

Eructations: of sour fluid; of sour food.

Cutting in stomach.

Pain in stomach; frequently in afternoon; on full inspiration.

Pain in epigastrium with drawing pain in joints of fingers.

Burning in sternum and cardia.

Distress in stomach in forenoon; in afternoon, < by supper.

Hematemesis: passive, venous, accompanied by nausea, which is > by vomiting.

USTILAGO. 688

Weak, empty, all-gone sensation in the stomach.

Burning in esophagus and stomach; extends to ovaries, heart, face and scalp.

Faint feeling in epigastrium, with pain in region of liver and bowels.

Repeated fine sharp cutting pains in epigastrium.

Constant distress in region of stomach.

Burning distress in sternum and stomach, accompanied by fine neuralgic pains in same region, lasting about three min- utes at a time; come on every ten or fifteen minutes for several hours; sharp cutting pain in stomach.

Periodical cutting in umbilical and hypogastric regions at 6 p. m. , < at 8 p. m. by a constipated stool, after- wards grumbling pain in whole abdomen.

(Pain as if intestines were tied in knots.)

Pain: in r. lobe of liver; in umbilicus; in umbilicus before natural stool; in 1. groin when walking.

Drawing pain in r. hypochondrium all day.

Distress in umbilicus and r. hypochondrium.

Grumbling pains in abdomen all afternoon, followed by dry, hard stool, fine cutting colicky pains every few minutes all day, > by hard constipated stool, followed by dull distress in bowels.

Natural stool at 4 a. m.

Loose stool at 4 a. m., with pain and rumbling in abdomen.

Light-colored diarrhea.

Soft stool, next day dry, lumpy, two days later black, dry, lumpy.

Constipated: black, dry, lumpy stools.

Tenesmus of bladder and incontinence of urine.

Urging, urine light-colored, increased.

No desire, but uneasiness.

Urine: increased; scanty, red; acid, high-colored; scanty and dark.

Frequent urination, with pain at meatus as the last drops were passing.

MALE SEXUAL ORGANS.— 1 1 Spermatorrhea after onanism ; emissions every night, talking about women causes an emis-

684 USTILAGO.

sion; very sad; cries frequently; says he cannot break off habit, has no control of himself when passion is aroused; knows it is fast killing him; cannot work, is so prostrated.

Genitals relaxed.

Erections: when reading at 4 o'clock; frequently during day and night. ' Scrotum relaxed and cold sweat on it.

Pain in testes, < r.

Pain in testes, sometimes neuralgic; in paroxysms, some- times causing faintish feeling.

Desire depressed.

Chronic orchitis, irritable testicle. Erotic fancies.

Seminal emissions and irresistible tendency to masturba- tion.

Irresistible tendency to onanism; frequent emissions; is prostrated, dull, with lumbar backache. Despondent; irritable.

Irritable weakness and relaxation of the male sexual organs, with erotic fancies and seminal emissions.

FEMALE SEXUAL ORGANS.— Yellow and offensive leucorrhea.

Tenderness of 1. ovary, with pain and swelling.

Burning distress in ovaries.

II Intermittent neuralgia of 1. ovary; enlarged, very tender to touch.

I Uterus: hypertrophied; prolapsed; cervix sensitive, spongy.

I Menses: too scanty with ovarian irritation; too profuse and too early; blood clotted; as if everything would come through.

Between periods constant suffering under 1. breast at mar- gin of ribs.

Vascular system of ovaries is most powerfully affected, pro- ducing congestion, enlargement, and great irritatiqp, with ovaralgia, dysmenorrhea and especially menorrhagia.

II Oozing of dark blood, highly coagulated, forming occa- sionally long, black, stringy clots.

II Extreme pain during period; flow very profuse and did not cease entirely until next period; most of time confined to bed.

Suppression of menses.

USTILAGO. 585

Vicarious menstruation from lungs and bowels. Constant aching distress at mouth of womb.

Menses that had just ceased returned, bright colored, sore- ness and bearing down in 1. side preceding the flow and partially ceasing with it.

Menses copious, bright red, not coagulating easily (in a woman who thought she had passed the climacteric, as there had been no discharge for over a year), it stopped as suddenly as it began, no pain, only faintness and confused feeling in head.

I Menorrhagia at climaxis; active and constant flowing with frequent clots.

Bland leucorrhea.

Abortion.

I Deficient labor pains; os soft, pliable, dilatable. Constant flooding.

Puerperal peritonitis.

II Lochia too profuse, partly fluid, partly clotted; prolonged bearing-down pains; uterus feels drawn into a knot.

I Hypertrophy and subinvolution of uterus with great atony*

Metrorrhagia, with vertigo during climacteric.

I Menorrhagia, with displaced uterus.

The ligaments of the uterus are relaxed; prolapsus, with bearing down sensation, as if all the pelvic organs would be expelled.

Flabby, relaxed condition of pelvic organs, a tonic condi- tion of uterus; a state of weakness, relaxation and atony.

Flushes of heat, and disturbances of circulation similar to those ocQuring at the climaxis, or from premature suppression of the menses; ovaries inflamed, irritable, sensitive, and swollen; burning distress in both ovaries.

Sharp pains commence in ovaries and run down the legs.

Aching distress referred to the uterus.

I Metrorrhagia after miscarriage, confinement or at the climaxis.

Discharge of blood on the slightest provocation; after

586 USTILAGO.

digital or mechanical examination; cervix swollen, bleeding easily when touched.

Uterus remains large after miscarriage or confinement; sub- involution delayed.

Hemorrhage bright red, but more frequently dark, clotted and stringy; post-partum oozing from flabby atonic uterus.

Uterus hypertrophied, heavy, feels soft, spongy or boggy.

Complaints of the lying-in woman; profuse debilitating lochia.

Milk deficient or superabundant; nursing increases the lochial discharge.

Acute pain < in 1. ovary, with swelling; pains intermittent; shoot rapidly down legs.

Ovaritis, constant pains in ovary, sharp pains passing down legs rapidly; ovary much swollen and tender, with scanty menstruation.

II Ovaritis; took cold after menstruation; constant dull pain in r. groin and back, three or four times an hour; sharp neu- ralgic pains in ovary; walking painful; bowels torpid, very languid.

II Ovarian irritation, constant pain in 1. ovary passing down hip, has to limp when walking; pains sharp and at times pass down leg with great rapidity; every few days has quite a swelling in 1. groin; cannot bear pressure over ovary.

II Every day from 12 m. to about 4 p. M., constant pain from 1. ovary to uterus; every few minutes, pain in ovary is in- tensely severe, cutting like a knife; pain in r. ovary and hypo- gastric region, but all starting from 1. ovary; ovary can be distinctly felt in groin about as large as a hen's egg and very hard; when pressed upon gives intense pain; every day thinks she has fever with paroxysm of pain, but no chill; slight leu- corrhea; loss of appetite; constipated.

Displaced uterus with menorrhagia; cervix tumefied; bleeds when touched.

II Uterus hypertrophied, sensitive, blood bright, fresh, with- out coagula.

II Subserous or interstitial fibroid of uterus (two cases), fibroid much diminished.

I Cervix tumefied, bleeds when touched.

USTILAGO. 587

For days oozing of dark blood with small coiaigula; uterus enlarged, cervix tumefied or dilated.

II Menses every three weeks, with dark coagulum; profuse, with gushes of bright-red blood when rising from a seat, or after having been startled or frightened; two days before menses, a heavy backache with sharp pain across abdomen from hip to hip, followed by expulsive pains; pains diminish after flow commences and stop with it; between menstrual periods heavy dragging backache on exertion; pain shooting up back from hips to shoulder; abdomen tender to touch; ex- cessive bearing down; pressure in head; sensation of contrac- tion in vertex, and feeling as if head were lifting off; vertigo; excoriating, albuminous leucorrhea, < before menses; raven- ous appetite; excessive tired feeling; pulse 80 and weak; mental depression.

II Subject to profuse menstruation; childless; large, fleshy, flabby, bloated-looking, with a very sallow complexion, in- clined to be (and formerly had been) dropsical from excessive loss of blood; profuse menstruation, which seems to her to be principally water and clots; says there is no outward flow when she lies still, but clots and water pass out of uterus when she gets up; feels so full in uterus that she must rise to get rid of clots; flowed fearfully during night; very low, scarcely able to speak aloud.

1 1 Severe menorrhagia for past twelve years at every men- strual period, lasting a week or ten days, sometimes longer; pale, thin, weak, very nervous.

1 1 Profuse discharge of dark, clotted blood of fetid odor, with pain and tenderness in one or both ovaries.

I Dysmenorrhea of a congestive character, with much ova- rian irritation; severe pain in ovaries; uterus and back every few minutes; scanty, pale flow accompanied by false mem- branes; poor appetite, thickly-coated tongue.

Subject to headaches ever since menstruation appeared at

588 USTILAGO.

age of fifteen; headache mostly on top of head; appetite poor; pain in 1. chest with some cough; total suppression of menses for last eight months; severe pain in back, is unable to ride in carriage; pain in uterine region, especially over ovarian region, < 1. side; vomiting of mucus and blood daily; no sleep; some leucorrhea; hysterical; no uterine displacement, but great congestion in pelvic region.

I Suppression of menses without apparent cause; trouble- some cough; considerable expectoration; sometimes also dry cough; stitching pains in chest, especially 1. side; night sweats; loss of appetite; pain in ovaries, especially 1; general debility, headache; leucorrhea; chlorotic; anemic, as if in first stage of consumption.

II Menses suppressed for last fourteen months; very irri- table and depressed; uneasiness in region of stomach; pain in ovarian region, especially 1. ; skin hot and dry; constipation, stools dry and hard; no appetite; stitching pains in chest, < worse in 1. side; constant hacking cough; considerable expec- toration; night sweats; general prostration; great uneasiness in lower extremities.

1 1 Mild leucorrhea.

I Climaxis: vertigo; frequent flushing; metrorrhagia.

II Has aborted a number of times at third month; is now about three months pregnant; for last ten days has had more or less hemorrhage every day, some days quite bad; not so much at night ; blood passes a number of times through day, in dark-colored clots.

I Post-partum hemorrhages from a flabby, atonic condition of uterus.

I Constant flooding; every few minutes, expulsion of a large clot of bright red blood, with bearing-down pains.

I Persistent hemorrhage of brownish blood, with want of uterine contraction.

II One and a half hours after delivery commenced to flow violently.

USTILAGO. 589

Passive hemorrhage after miscarriage, blood in lumps, flooding for days and weeks.

II Severe flooding two weeks after labor; large bright-red clots; no pain; very weak.

Very profuse lochial discharge, very dark in color, almost black.

II Agalactia; chronic inflammation, and induration of mam- ma.

II Puerperal peritonitis; aborted about two days since, at about three months: constant fever; pulse 120; cannot bear least pressure on any portion of bowels; about six times to- day has had sharp, cutting pains in 1. ovary; has flowed con- stantly for two days; blood dark, not copious, nor attended with bearing-down pains; cannot move in bed; is compelled to lie upon her back; constant, dull, frontal headache; loss of appetite, tongue furred.

II For last year vertigo every day, some days so bad she has to go to bed; menses every three weeks for last year; last about ten days and profuse; flows as much again as she did when in health; constant aching distress under 1. mamma; rheumatic pains in shoulders and back; very weak, not able to work.

Fibroids and induration of os.

Discharge of blood from uterus, bright-red, partly fluid, partly clotted; passive congestion of uterus, so that there is a slight oozing of blood after each examination; tissues of uterus feel soft and spongy; os patulous.

Gave Mrs. Ustilago Im., four doses, for aching distress

540 USTILAGO,

Spasmodic tearing at top of 1. side and passing to sixth or seventh rib, at 3 p. m. when standing or reading, < breathing.

Pain in 1. infraclavicular region in morning.

Drawing pain in 1. inframammary region, waking me at 8 A. M., > turning on back from r. side.

Aching, burning distress in sternum and under it in stom- ach, with neuralgic pains.

Oppression along median line.

Constriction with pain.

Heat and pressure.

Sudden flying pain from heart to stomach, arrest- ing breathing.

Burning pain in cardiac region.

RESPKATORT ORGANS.— Feeling as if there were a lump be- hind larynx, which produces constant inclination to swallow.

Pain in back extending to extreme end of spine.

Severe rheumatic pain in lumbar region, < by walking; aching distress in small of back.

Pain in back of neck.

Pain in region of r. kidney, < sitting still; next day in re- gion of 1. kidney, > moving about, with heat, fulness, sore- ness on deep pressure (but it relieved the pain), with uneasi- ness in 1. thigh, frequent desire to urinate, stream very small, the following day it requires considerable effort of will to empty the bladder, which is done slowly, pain and soreness in 1. loin continue; heavy in lumbar region, in bed with uneasi- ness about bladder (had had no desire to urinate on going to bed), woke early in morning with distended feeling in blad- der, micturition slow and difficult, urine scarcely colored, pain in back < next night, < lying on face, > lying on r. side.

Bearing down in sacral region as in dysmenorrhea, chang- ing to 1. ovarian region and gradually extending through hip.

UPPER LIMBS. — Pain in both shoulders, especially in raising arms.

USTILAGO. 541

Pain in shoulder joints; rheumatic, in muscles of r. shoul- der, all night.

Intermittent, numb tingling sensation in r. arm and hand every day.

Stiffness in shoulder-joints on bringing down the arms on waking — arms extended over head when sleeping.

Pain in r. elbow, < by motion.

Stitching along metacarpal bone of r. index.

Rheumatic drawing pain in finger-joints, < second joint of r. index, all afternoon.

I Hypertrophy or loss of nails.

Rheumatic pains in arms, hands and fingers.

Dull rheumatic pains in r. elbow joint on motion.

Severe drawing pains in joints of all fingers.

Fine, sticking pains along metacarpal bone of r. forefinger, every few seconds.

Sharp, cutting pains along metacarpal bones of r. hand.

LOWER LIMBS. — Pain in 1. knee when walking, increasing to cramp, obliging me to lean upon the arm of a friend; the pain, with occasional cramps, lasted all the evening, < raising foot so as to press upon toes.

Cramp-like stiffness in 1. leg, < raising foot so as to press upon toes.

Feet swollen in morning.

Cutting in bones of r. hand and foot.

Frequent rheumatic symptoms in arms, fingers and legs.

Rheumatic pains in legs.

Flying rheumatic pains in metatarsal bones of r. foot.

Great pains in bones all over body, and especially in calves which are somewhat cramped.

The scalp became one filthy mass of inflammation, two-thirds of the hair came out, the rest matted together, with oozing of watery semen from scalp, eruption like rubeola on neck and chest, gradually extending to feet, thickest on chest and joints, itching < night, rubbing any part brought out the eruption, on face and neck it was in patches like ring- worm, but not vesicular.

Tendency to small boils.

Boils on nape.

542 USTILAGO.

Congested feeling in skin.

Skin dry and hot; congested.

Painful, destructive disease of nails.

Paresthesia of the skin; pricking, burning, itching, a marked erythema of the skin of the uncovered parts of the body, fol- lowed by a parchment-like, dark brown skin with rhagades < by warmth.

Roullin observed loss of hair and sometimes the teeth oc- curred both in animals and men; that mules fed on it often cast their hoofs, and that fowls laid eggs without shells; it has caused loss of hair on animals, and cured complete alopecia.

Pustular ulceration of the skin, scald-head and various forms of eczema.

Copper-colored spots on skin; secondary syphilis; macula.

Negro, urticaria of six years' standing, troubled more or less all the time; every night itching, scratching parts produces large pale welts on body, arms and legs.

Difficult falling asleep and then unpleasant dreams.

Restless night; with fever; with troubled dreams.

Sexual dreams; without emission; and disgusting, waking him, arose and urinated with difficulty and tenesmus.

Chills running up and down back.

Heat at night, during sleep.

Internal heat; with vertigo; < eyes, which are inflamed and sensitive to light, eyeball sore to touch; intermittent; pulse normal.

Burning in face and scalp.

Skin dry; at night; and hot.

Relapsing agues; very profuse sweat; slight nausea; op- pression of chest; cerebral disturbance, and great irritability.

Thirst for cold drinks.

Chilly externally, but not internally.

Neuralgic pains in forehead, hands and feet.

Rheumatic pains all up and down 1. side, with cutting in 1. knee and calf if I pressed any weight upon toes or flexed knee with any weight upon it.

Rheumatic pains in muscles of arms, hands, fingers, and small of back, those in back < walking.

USTILAGO.

Symptoms of a cold.

Malaise as if I had taken cold; felt sick with a cold, con- tinual watery flow from nose and eyes, with occasional chills.

Languor: during the day, with headache, < noon, and with burning frontal headache at 9 p. m. ; in morning on ris- ing; at 2 p. M.

Faint feeling at 11 A. m. in a warm lecture-room.

Faint spells beginning in epigastrium, with small pains in hypochondrium and bowels.

USTII^AGO.

Bnming; in aU parts of the body, as if sparks of fire were falling on patient.

< warmth, covering affected parts; < from heat, all diseases.

Adapted to thin, scrawny, feeble, cachectic women; irritable, nervoas, pale, snnken countenance.

Hemorrhage; copious, thin, black, watery, decomposed, bloody; hem- orrhagic diathesis; the slightest wound may bleed for weeks; defi- brinated.

Burning; in esophagus, stomach, ovaries, heart, face, scalp; less on the skin.

Paintnessand oppression in a warm room; < from warmth less marked.

Adapted to weak, relaxed, atonic patients; irritable, despondent, weak mentally.

Hemorrhage; passive, oozing, dark, clotted, bloody, forming long, black, string clots; partly dark, partly clotted and stringy, or thin and watery.

Compare: Mel., Med., Mez., Psor., Vine, m., in crusta lactea and other scalp affections of childhood; Bry., Ham., Mill., Phos., in vicarious menstruation; Agar., Mur., Sep., in bearing down and uterine collapse; Helon., Lys., Natr. h..

Sec, delayed subinvolution; Malan., Sec, affections of the hair and nails; Act., Caul., Thuj., Sul., Vib. o., in 1. ovarian pain; Bo v., Elaps, Graph., Ham., in intermittent flow;

Sang., Urt. ur., pain and rheumatic affections of r. shoul- der; Sang., 1. inframammary pain extending to scapula; Lac c, Kali bi.. Puis., erratic rheumatic pains;

Sul., faint all-gone sensation at 11 a. m. ; Cob., backache and seminal emissions; Bov., flow midway between the periods; Canth., Pyr., Sec, in expelling foreign bodies from the uterus.

544 VARIOLINUM.