Coca Erythroxylon Coca

{Erythrojyylon eoaa.)

[A plant used by the natives of Peru, for the purpose of etimulation, and to eoable them to p«rfomi ardnoas hibor. Tliuse Bjmptoms are eollaied mainly from Bering's patliogenesis.— Hale.]

Pharmacology.— This is a shrub growing wild, in Sontli Amrrica, and largely cultivated in Boljria, for the sake of il^ leaves, wbicli nre much

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214 oocA.

used in tliat country for chewing. The plant which is propagated from tlie seed in nurseries, begins to yield in eighteen months, and continues productive for half a century. The leaves, on being picked, are dried in tiie 3ua, and then pacltcd in bags. They are known in South America by the name of Coca. They were in general use among tiie natives of Peru, at the time of the conquest, and have continued to be much employed to the present time.

The leaves rescmblo in size and shape those of tea, being oval-oblong, pointed, two inches or more in length, hy somewhat over .an inch in their greatest breadth, and furnished -with short delicate footstalks; but they are not, like tlie tea leaves, dentate, and are distinguished from most other leaves by a. slightly cun'ed line on each side of the mid-rib, running fl'om the base to the apex. When well dried, they resemble, in odor, lea, and a peculiar taste, wJiich, in decoction, becomes bitter and astringent. It has been found so impossible to import the leaves to this country without injury to their medicinal properties, that the tincture ought to be prepared from them as soon as gathered-

OsTiciNAL PaKPABATiowe. — Tinctiwe with strong alcohol, from fre^ leaves, dilutions.

ASALOatiEB. — Coffea, Tkea, ScufeRwria, Ignatia, PauUifiia, Cann^ii indiaa, Gypripedivm, Pficspfume aeid, ete.

Mental Sphere.

* Slow ill fir.ding the words to express himself at times.

* Erain feels so muddled that he cannot read under standingly. "Mind much clearer; spirits much better.

A peculiar sensation of isolation -from the outer world.

On any one speaking to him, it seems as if the person were at a great distance.

Their excited imaginations conjure up the most wonderful visions; at one time consisting of indeBcribahly heautiful and delightful forms; at another, however, of the most horrid figures.

Inclination to work, with sleeplessness all night; disinclination.

An irresistible inclination to feats of strength.

Shy; they ilee the society of tlieir fellow-men; seek conceal- ment in gloomy woods or lonely dwellings.

Instinctive desire to make no motions at all.

'Always relieves him from unusual fatigue; producing per- fect calmness of mind and body, and is never followed by any depression,

A kind of numbness, with a feeling of secnrity, with retention of clear self- consciousness, and the. instinctive desire to

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m^e so motion, not even to move a single finger, for an

entire day. During the evening, after the first dose at six o'clock, his

hearing became painfully acute; he felt something like

expectation; brain excited; and a i-atber painful pi-essuro

on the sides of the head. " Mental depression. Great anxiety, palpitation, humming in the ears the whole

day, and sparks before the eyes. "Peevish temper; hypochondria. I^^ausea and vertiginous feeling, ineapaeiting Ibr carrying oa

literary labors. " Loss of e

Giddiness and dizziness; involuntarily stopping quickly when

walking; the head inclined forward, with giddiness and

fear of walking. Giddiness, tliotigh slight, on going out in the open air early in

the morning; objects appearing to turn before the eyes,

for an hour's time. Great dullness in the head, like the effects of a debauch. Fullness of forehead; dull feeling over the whole brow; slight

shooting pains in right temple; sensation of tension over

forehead, as if an india rubber band were stretched over it. Tiolent headache immediately over the eyes, with low ringing

in tlie ears, jDull frontal headache, which vanished with the setting of the

sun, followed by a state of mental exhilaration. A pressing headache on the right side of the occiput as well

as of the right side of the forehead, with giddiness and

chill after dinner, disappearing toward evening. Headache in the afternoon, with chilliness. !Eather violent headache, with sensation of dryness in the

"Migraine; a one-sided headache.

Great intolerance of light, with remarkable dilatation of pupils. Black spots flying lightly before the eyes several times while

reading.

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316 oooA

White spots before the eyes, so that on reading the bookeeemB moulded white. (Chloral has " everything looks white.")

Flickering before the eyes; the letters seem to run together on the paper; it seemed as if he were writing with two pens; fiery specks float before tlie eyes. A sensation comes on as if some one were knocking about the eyes, with loud ringing in the ears; two hours later he can write without double vision or swimming.

Dullness of the head, with flying of fiery points from above downwards, and swimming together of the letters.

"White spots and glittering serpentine lines before the eyes, with great uneasiness on going out after dinner, for an hour.

The eyes become very sensitive, reading cannot be endured long; some are troubled with slight headache, while others suffer from nausea and various disorders of the digestive apparatus, whicli may be compared with sea- sickness.

Disposition on the part of the upper lids to fall, without being sleepy.

After using for a number of days, on himself and others, there broke out a circumscribed erythema — on one an ex- anthema reeemiiling herpes — around the eyelids.

Acute hearing, and excited brain.

Loud ringing and buzzing in the ears.

DiflSculty of hearing; it seems as if the sounds came from a great distance.

ITose.

Kunning of clear water from nose, and occasional sneezing,

without having properly a coryza as he usually has it.

Burning, redness of clieeks, first left then right; white spot in the centre of latter.

Small boils m the face.

Quivering, trembling lips; pale lips and gums, with green, blunt teeth.

Ugly, blackish border around the angles of the mouth.

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orwA. S17

Dq the lips a nettle rash; scabs; bleeding.

Toothache in a hollow tooth, at noon til! evening, violent.

* Prevents caries of teeth. *!No taste in the morning.

* Much fnrred tongue. Dryness of mouth on waking.

Irritability of the pharynx, so that the stomach would not

retain food. *A distinct feeling of swelling of the uvula; difficulty of

Swelling of the uvula without any particular redness, lasting from five o'clock in the afternoon and through the whole evening.

Feeling as if some mucus were at back of pharynx; not re- moved by coughing or hawking.

Early in the morning, after a very comfortable sleep, a sensa- tion of dryness in the throat, very disagreeable on swal- lowing, as if swollen.

Appetite,

Kot hungry at noon, as usual, nevertheless ate a good deal, and with appetite.

Quickly satiated, notwithstanding great hunger and good appetite at noon.

Wants food at an earlier hour in the forenoon, notwithstand- ing a distension of the abdomen, as if from overloaded stomach.

Digestion goes on with great activity.

An intense gnawing, hungry sensation at the pit of the stomach. (Abies.) ■

Morbid hunger, even to swallow animal excrements; (chronic symptom of chewere.)

Very little need of food, even with hard labor; incredible fatigues ai'e endured with unusual vigor on the most meagre diet.

A.iways felt a sense of great satiety after taking the infusion

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in the morning, and did not feel a desire for his' next mea! until after tlie time at wliieli lie usually took it.

Prevents getting hungry; feela no hunger,

Retards approach of hunger, when taken as tea.

Enables the body to feed upon itself, witliout the huuger pains and weakness usually accompanying prolonged abstinence from ordinary food.

Drinking the decoction at three or four o'clock p. m., it has in- variably and totally deprived him of all appetite for dinner, and of his rest at night; under these eircum- Btances he always passed the night in reading or writing; he feels no fatigue or hunger on the following morning.

" Want of appetite (a remedy of doubtful value). {Hale.)

At noon, a peculiar feeling of emptiness in the stomach and abdomen; when walking, a painful contractive sensation in the stomacli, and close to the latter, on tlie left side, a pain similar to the so-called stitches in the spleen.

Debility of the digestive organs; at first it seems to be slight uneasiness; soon reaches a frightfal intensity.

° Catarrh of the stomach; a cup of Ooca after dinner.

"After taking for five days twenty drops of the tincture, once or twice a day, his digestion became extraoidinarily good, and continued so.

When walking, a pain about region of cardiac end of stomach, gradually increasing; would have amounted to a cutting pain; after standing it went off", returning in a week.

" Gastralgia, similar to that caused by coffee.

^Violent belly ache, with rumbling, as if from flatulence; tympanitic distension of the abdomen, diminished by a frequent discharge of inodorous flatus.

"Spasmodic colic; given in the hospitals in Bolivia; had no effect in Valparaiso.

" Pituitoiis disease of the abdominal organs.

* Tympanitic distenston of abdomen, diminished by frequent , discharges of inodorous flatus.

° nypoehondriae pressure and tension after meals.

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OOOA. 219

The dangerous obstructioiis wliich wonld result from tLe diet of the Indians — roasted maize and roasted barley, pounded into meal, and swallowed dry without anythingT— are pre- vented by the weli-tnown purgative action of the Coea.

Stool easier than usual in the morning, and thinner; tor three minutes after a feeling of want of farther evacuation, without any; the soft stool of a normal color.

Teaspoont'nl musty diarrhtea, four stools during the early after- noon, without pain; stools different from his habitual looseness; stopped taking Coca, and had natural stools.

Ineffectual urging to stool; constipation, with abdominal dis- tension.

Urine,

° Absence of the usual incontinentia uriuES noctuma.

Eose at night to urinate, as he had to do constantly a long time ago, but not lately, and it ceased alter the proving.

Urine had an unbroken film over its surface, iridescent in cer- tain lights, with an appearance like fissures in it, mapping it out, and a flocculent, pale sediment floating at the bot- tom, seen through the tilm.

Geuerativo Organs.

Women. — Menses delayed for two days, came on about noon; got very profuse during the night, with some pain in the lower part of the abdomen; not in a steady flow as usual, but in gushes, awakening from sound sleep; after drink- ing the infusion morning and evening for a whole week.

Hoarse voice on waking at night.

Hoarseness, with tickling in the upper part of the trachea, and some cough.

"Feels mueli stronger invoice; can sing much louder and clearer.

° In phthisis laryngea, when from irritability of the pharynx, the stomach would not retain food.

After a strong infusion he could, during the whole day, climb the heights, and follow the swift-footed ■irild animals,

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without experiencing any greater difficulty of breathing than in similar rapid movements on the coast.

Great ease iu ascending high mountains, and running amongst them, without any ditBculty of breatliing.

" Mitiga'ies the difficulty of breathing, hiemoptysis, and sieep- iiiesB, incident to traveling among the hills, four thousand feet above the sea level.

" A. strong tea prevents the usual breathlessnesa in climbing hills.

"Shortness of breathing, especially on making an ascent; in the forenoon, a tickling cough wonld cause a tingling.

" Expectoration of email lumps, like boiled stai-ch, which he has had for some time, immediately after rising in the morning.

" Hawking up of small transparent lumps of mucus, chiefly in the morning.

"Asthma; (a useful palliative.) {Hale.)

° Oppression of breathing during nocturnal hours.

Rather painful weight on the chest, with constant necessity to imbibe deeply, when sitting in the evening; sensation as if the lungs were too much distended; difficulty of breathing, even in bed; palpitation, with a weakness of the whole body, though not disagreeable, as if from great exertion.

" Emphysema; (a palliative, like Chloral.)

After an infusion of the leaves, pulse becomes much accele- rated, the beats of the heart being nearly quadrupled.

Great anxiety, and strong palpitation; he broke out in a copious sweat in the evening, nine o'clocl^ while in bed.

" Disease of the heart, functional, from over exertion.

■^ Inclination to sleep, but can find no rest.

' Dry, papular eruption on back of the hand, of three years' standing, not cured by Kali, ehrom., Sulph. ac, Fluor, ac,

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coccds oAon. 231

etc., soon ceased to spread, gradually got paler, and has in some spots, where it was woi

' Protection from cutaneous diseases. (?)

Numbness of hands and teet.

frequently from rheumatism, came on from the t cold; now not from the first of October till first of November, even not with very unfavorable weather.

During manual ]abor Coca has very little iniluenee.

Ease in breathing, and feeling of freshness and vigor of the whole body, with great pleasure in walking quickly and far, notwithstanding the great heat and great power of the sun, in the forenoon.

Great bodily vigor, and endurance of great fatigue, notwith- standing extremely little nourishment and no sleep,

* Can nowhere find rest; nervousness and nightly restlessness of children during dentition.

° Erethism in the sensitive sphere; " hysterical complaints.

"Debility during convalescence from typhus.

" Fainting fits from nervous weakness.

The Stramonium patient likes company, the Coca patient soli- tude; the Stramonium patient light, the Coca patient darkness.

coccus CACTI.

{Oachtrteai )

pHARMACOiflOTT.— Tliis mscct la found wild m Mexico and Central America, iohabiling different apeciea of Cactus, and allied genera of plants. It is also cultivated to some exttnt in Ttxas and New Mexico. Tlie female Inaect Is Ihe one used in commerce, and the one we use in medicine. Tliey are collecled and killed either h> immersing m boiling water or over the heat of a fire

Cochineal has a faint, heavy odor, lod a hitter, slightly acidulous taste. When powdered, it is of a purplish carmine color, tinging the saliva in- tensely red. It is composed of animal matter, and a peculiar coloring matter, or principle, called by most authorities, Cochinilin. This is ft brilliant purpllab red, very di7 powder, unalterable in dry air, soluble in water and alcohol, insoluble in ether, and is without nitrogen.

Opficittal Preparation. — Triturations of tlie ijtteel; tincture with strong alcohol.

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222 coccus CACTI.

Amaiogoes. — (I) Bromide <^ Ammonia, Itrosem, OoralUwm, Ipeeae,

Byoscyamue. (3) I have only given the symptoms relating to cougli, larynx, kidneys, and

bladder, because fhey are the most characteristic of the drug. Tlie com- plete BymtomBtology can be found in the third volume of Allen'a

Encyclopedia. It was first published in Medcaite's New Homceopathic

Provings, 1863.

Paroxysm of short congh, witli expectoration of gloLnlar mucus.

Paroxysm of cougliiog produced by a tickling in tlie larynx and throat.

Paroxysm of cough for half-an-hour, and expectoration of a great quantity of mucus.

Cough whicli wakens him at six a. m,, having remissions of a minute; it is at first clear, dry, and barking; subsequently some thick mucus is detached, and the effort of doing this causes desire to vomit, accompanied by an excoriated feeling of the throat, and a pressive headache.

The paroxysm of cough is renewed by the heat of the bed.

He can scarcely speak for coughing, in a warm room.

Tery violent cough, which, notwithstanding the expectoration of mucus, is constantly excited by a tickling in region of bifareation of the trachjea, the attacks go on increasing.

Dry cough in the morning, which lasts several minutes, and finally produces vomiting of mucus.

The cough annoys him ali day, and at three p. m., an hour after dinner, is so violent as to vomit him.

The cough is so violent as to cause vomiting, and the ex- pectoration of a great quantity of thick, viscous and albuminous mucus.

Violent cough, without expectoration, which lasts a long time in the morning.

A little greenish yellow mucus, tasting like liquorice, is de- tached by the cough.

° Cough of drunkards. ° Whooping cough. Kidneys.

Pressive pain in the renal region, extending by degrees to the bladder and its sphincter, accompanied by vesical tenes- mus and frequent emissions of deep colored urine.

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coocra CACTI. 223

Pain in tlie kidneys, with increased secretion of urine.

Lancinating and boring pain in the region of the kidneys, in the evening in bed.

Sudden, at:ute, prolonged lancinations, extending from the left j-enal region along the ureters into the bladder.

Attacks of nephritic colic, but seldom and not violent — with very copious urine, and dull pain in the urethra.

He jumps abont, bends himself, and rubs his hypogastrium in order to relieve the spasmodic ^ins in the hidneys.

ExcesBively violent pain in the renal region seizes him sud- denly -when sitting quietly in the afternoon; it radiates from the two sides of the kidneys, and differs from the pressive and drawing pain previonsly felt there, by its spasmodic character and extension, and can only be com- pared to the pain experienced in the testicles in conse- quence of a bruise.

Pressing pain through the ureters into the bladder; relieved by discharge of flatus.

At five A. M., wakened by a drawing pain in right kidney, ex- tending along the ureters inti7 the bladder, at the same time a single lancinating thrust, and continual pressure in the urethra and navicular region.

Bruised pain in the sacro-lumbar region and in groins (on ■waking.)

" Hfemorrhage from the kidneys.

Bladder.

Alternatious of cramps, coldness and heat in the bladder.

Pain in the bladder during the night, with fruitless desire to urinate.

Excoriated, sore pain in the bladder.

Sensation of fullness and tension in the bladder, without desire to nrinate.

She is obliged to urinate very often after dinner, which, to- gether with a pressure analagous to that which is ex- perienced at tlie period (of the menses), makes her think her bladder is diseased.

Peeling of fullness and pressure in the bladder extending towards the urethra, with constant desire to urinate and

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334 cocoes CAon.

frequent discliai'ge of normally colored and sliglitlj acid

Attack of pressure, tenesmus, and cutting pain in the bladder,

dnring which the face becomee red. The pressure and pain in the bladder contimle even after the

evacuation of urine. Strong tenesmus of the neck of the bladder after urination

with tension. Very violent twisting pain in the neck of the bladder, lasting

a quarter-of an-hour, and not ameliorated by the dis

charge of urine or flatus. The Bensitivenees of the epigastrium extends throughout tho

abdomen; lancinating, drawing and presBive pains espec- ially appear in the groins and vesical region, which

obliges her to keep her bed. Lancinations, as if from needles, extend froni the bladder

the discharge of clear Btraw colored urine; the sensation

returns, however, several times in the day before urinating. The burning in the urethra and swelling of the vulva continue

fifteen days. Very violent lancmating ihTa&iA in the anterior portion of the

urethra and glans, a long time after having urinated when

in bed at night; they force hira to groan and cry out, and

last a minute-and-a-half. Burning pain in urethra, with scuBation as if a little stone

were sliding along the urethra. Sensation in anterior portion of urethra before urinating, as

if pricked.with a blunted needle. Very violent lancmatiofis, along the urethra, toward the

glans, lasting several minutes, after urinating (urine

dark color.) The meatus is so contracted and constricted that the urine

flows very slowly, and as the vulva is excoriated the

burning is very violent, and lasts an hour.

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Tiolent prurUvs and itching at the orifice of the iirethra,

oi pale, wciery urine, both by day and «.-i(/:^i (primary

effect.) Frequent, scanty discharges of nrine, but it is difficult, slow- in coming, and takes place with straining and vesical

tenesmus (secondary.) TTrine first normal in color; it then becomes citron-yellow,

then brown, and finally red. The urine becomes cloudy, and finally jumentous (namely,

like that of a horse.) The odor of the nrine is sometimes alkaline, often ammoni-

acal, also cadaverous (the latter when it is dark colored

flocks and sediments, and the sediment is entangled with

much mucus. Lateritous sediment; also a reddish sediment of the color of

brick-dust, which adheres to the vessel. [Purulent or bloody nrine did not appear in the provings; but

we do not know whether any chemical or microscopic.

tests were applied.]

(See Therapeutics, Vol. II.)

CODEINE.

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226 CODEINE.

Mental Sphere. Great mental exhilaration, {p.) Depreeeion of spirits, with dull lieadaclie. {«.) InabilJtj to apply the mind.

Heat in the head. Dull lieadaclie eoon after getting up in the morning, worse on

* Morning headaches, of a dull character, coming on after

rising and lasting until noon, ° Headaches from fatigue and excessive mental excitement.

Face, Itching and heat of the face and head, extending over the whole body.

* Involuntary twitching of tlie left eyelid, sometimes relieved

by rubbing. {M<trcy.) Burning sensation in the eyes, worse in the left.

* Involuntary twitching of both eyelids, whenever he

attempted fo read or write (cured by the 5th.) {Maroy.) 14'ose. Entire loss of smell.

Lips dry and parched.

Tickling eensation in the throat in the afternoon and evening.

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CODEINE. 227

Painful pnlaations of the lieart on attempting to study or wrif^,

" Short and irritating congh, worse during the night,

"Troublesome cough, with copious mucus, and sometimea purulent expectoration. [Marcy.)

" Night cough of phthisical patients. {Marcy.)

Irregular action of the heart from derangement of the gan- glionic system. {Maroj/.)

Violent pulsations of the heart and carotids. Gasttie Symptoms.

* Nausea and vomiting.

*Aciite pains in the stomach, with empty eructations.

Great thirst, with a particular desire for bitter substances.

" Tenderness in the stomach, with violent pulsations of the heart and carotids.

" Gastric and abdominal neuralgia.

" Violent spasmodic pain at the pit of the stomach.

Extreme tenderness of lower part of the abdomen.

Dull pains throughout the entire abdomen.

Constipation, tenderness of the bowels, especially the trans- verse and descending colon.

Increase of urine, it being b'ghter in color.

Semi -paralysis of the bladder.

(Men.)

Sexual excitement during the night.

Lascivious thoughts, causing frequent erections day and night Back.

Sharp pains extending from the stomach and chest through to the back, between the shoulders, worse on right side.

Convulsive movements of the muscles of the back of the neck.

Acute pains in the region of the kidneys.

Convulsions in the muscles of the neck.

Neuralgic pains from the occiput to the back of the neck.

Painful pulsations in the left side of the neck.

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238 OHLOEAL HYDRATE.

few minutes. " Neuralgic pains in the tliigha and legs, and sub-acute rheu.

matic pains in the knee and ankle joints. ' Paralytic affections of lower extremities, with extreme rest-

lessneas.

CHLORAL HTDEATE.

{Hydrate of Chloral.)

Chloral Hydrate Is a volatile, ctystaline solid, of a hot, burning taste ; insoluble in coM chloroform, but very soluble in ivater, ether, and alcohol It occurs generally as transparent, colorless tablets, but sometimes acicular, or even in rhomboidal crystals. The compound of alcohol and chloral— chloral aleolwlate — which resembles closely the hydrate, can be dis- tinguished at once by its soJubilify in cold chloroform.

If an alkali be added to a solution of Cliloral Hydrate, it breaks up into foresnic acid and chloroform, which, when water has been the solvent, at once separates in the form of oily drops.

AiiAi.oGUBS.^.E(fter, Ghloroform, Bromides, Oonium, Oelseminum, etc.

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CHLOEAI, HTDEJ.TB. 229

—The following results have been gained by giving

to insane persons a daily average qnantity from twenty

to thirty grains: When patients are destructive and violent, the Chloral acts as

an excellent hypnotic by night, and soothing agent by

(as judged by the symptoms), the sooner does the system

como under Chloral action. Very easily irritated at trifles.

* Intense itching of the inner canthi and edges of lids.

* Red, injected, and blood-shot eyes.

* Puffy swelling of the lids.

* Bwrning in the eye and eyelids.

Watery eyes, especially when looking at anything Eyeballs feel too large.

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230 CHLORAL HYDEATK.

Congestion of the retina, (p.) Contraction of the vessels of the retina, (a.)

TOoraents, when they gradually fade away. If one eye only is ased until objects fade, the other eeea objects

pass before the eyes when shut, or open in the dark. All colors are unusually bright.

Vibrations apparently in the ej'es and head when lying down Great sensitiveness to Ught and noise.

Mouth and Tongue. Apparent swelling of the tongue, with sensations of stiffness,

" Keuralgia of the inferior dental branch of the fifth nerve.

{liinger.) " Neuralgia of the temporal region. (Tb.) Congested and livid face.

Teeth and Jaws. ° Neuralgia from decayed teeth, (a grain or two in the cavity

stops the pain qnickly.) {J7ale.) " Odontalgia frawmatica, from pressure of the filling; the pain

unbearable; worse when lying down. (Cured by ten grains.

See New England Medical Gasette, Maroh 1S72.) {Hale.)

Retelling, lasting an hour, during a surgical operation. Does not usually disturb the stomach.

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CHLOEAL HTDKATE.

Sudden and violent vomiting.

° Diarrl]cea,worseat night. dnringdentition; (

excitement. Does not usually caiise abdominal symptoms.

[In the very severe colic of clin<ireii, when the paia threatens to cause spasms, 3 to 5 grs. will give prompt relief. (Hale.)}

TTrine. " ^Nocturnal incontinence of urine — in children.

G-enerative Organs. {Jfale.) Loss of sexual power, with absence of desire and

erections. Impotence.

" Chordee, during gonorrhcea, very severe, (^t'&male.) "It qnickly mitigates the pain of labor, of dys- m.enoTrhcsa and uterine spasms, but should not be given when there is a tendency to hfemorrhage, as it increases that tendency, even to the production of purpura. {Hale^ Heart and Circulation, * Great dyspncea, a sense of suffocation, oppression at the base of the chest (in front), aud urgent thirst.

[The following case of poisoning from fifty grains illustrates Its action on the circulatory system; Gold extremities, an exceseinely rapid, weak, irregular and intei-mittent puUe; jactitation of the limbs; an intolerable ntnee <f linking and oppresHon at the pit of the Btomach; gating breathing, aud eonfusioa of thought. I observed at this time and for three-quarters of an hour subsequently that the radial, temporal, and tibial pulses were all of the character I now describe— /regwsnt, leeak, irregular in, both force aTid rffthsn, ond frequently inter^Uent, but that the Jieart was acting regvlarly, althougii with increased frequency and diminished force.

Stimulants, with white of egg were administered freely, warmth was applied to the extreini- tiea, sinapisms placed on the cardiac region, fresh air was introduced plentifully Into the room, and at the end of an hour fl'om my first seeing the patient, the pulse had become much steadier, though still very frequent and very weak. The syncopal feeling had diminished; the feet were warm, and there was a tendency to sleep. This state of comparative free, dom from urgently dangerous symptoms lasted for longer than an hour, when, williout any apparent cause, they returned with increased severity.

The patient now seemed in the greatest danger. T/ie guprnjicial pulses were almost impereeptiUe, and when they could be detected, presented tiie char- acter I have described. Still the heart was regular in its beat, although feeble, and intensely rapid in its pulsations. The mind wandered ntatK,

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3SZ CHLORAL HTDEATE.

Skin, Purpura hwmorrhagiea, as the following cases eliow:

[M. A., female, aged 69, who had been an inmate of this asylum* for many years, and who was subject to periodical attacks of mania, occurring every six months, and ushered in by convulsions and coma, entered upon one of her wonted paroxysms on the 1st of March, 1870, and was ordered twenty grains of Chloral Hydrate three times a day. This produced sleep and cutaneous ansesthesia, and on the 4th of March, a very unexpected result in the form of a bright red blush, erythematous in aspect but perma. nent under pressure, over the chest and shoulders.

This blush on March 6tli had pervaded the whole trunk and limbs, and had become mottled with livid patches and deep red spots. The lips and buccal mucous mem- brane bad contemporaneously become red and raw-looking, the guma spongy, and the tongue blistered and ulcerated in aeverat parts. The breatli was I'cetid, the pulse 120, feeble and compressible, and the general condition that of great debility, with delirious excitement. On March 9lh no material change had taken place, except Uiat the ulcerations in the mouth had become more extensive and distressing; but on the 11th the petechial eruption showed signs of vanishing over the thorax and abdo- men, where it had never been so severe as on Ihe arms and legs, and where intervals of yellowish and white skin were now visible.

The arms were of a red color, speckled with shreds of white, dead epidermis partially sepa- rated from the adjacent cutis, and the lips were, covered with sordes and dried blood. On March 15th a sort of general desquamation had set in, the cutis being raised in thick round patches, like blisters from which the serum Lad been absorbed, Ihe skin beneath being of a dull purple color and in some places yellow. After this a large bed-sore formed over tlie sactum, and some superficial cracks and fissures presented themselves in. the neighborhood of the joints.

Convalescence was, however, steadily maintained, and the patient was soon restored to her usual iiealth.]

fL. T., female, aged 46, laboring under heart disease, left hemiplegia,

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HYDRATE. 233

and dementia, with excitement, who was ordered, as a calmative, on Feb- ruary 34tli, 1870, fifteen grains of OKloral thrice daily, and who seemed to derive beneiJt from tlie prescription, until March 15th, when numerous reddish purple blotches were ohaerved around the left elbow, which, on tlie following day, had enlarged and united with others of a similar kind wliieh had come out on the shouldei's aud forearm. On March 17th several livid marks had broken out on the face, while the left arm. had become swollen and indurated, and sliowed upon its red siu-face a mass of minute paints or Btigraata of a much deeper red and not disappearii g under pressure On the next day dull purple sp ts anl discolorations — some small round and circumscribed, otlieis large and regulir m sha] e— were seen on the legs abdomen and back being restiicted in the latter situatna to a band two inches in breadth along each side of the vertebral column Along with these petechia theie was gient piostrat on of s rength a tendcnc\ to som nolence weakness and irritability of the pulse a raw slate of the lips which wcie ent lely denuded of epitheln m and a Assured and thickly coated tongue On the 19th )f Mirch the spots and discolorations had spiead in every direction and had lost their vividness of hue having assumed a deej purple tinge Symptoms of pulraonarj congestion also appeared Slrengtli graduilly ebbed and iltei severjl slight attacks of Byncope death took place on the 33d of Mirch At the autopsy thirty one hoiirsafterdeath,thebody was found coverui with livid vibices and ecchy. moses of various shapes and sizes, largest upon the limbs, smallest upon the abdomen.

The ankles and feet were of a difiuaed purple color, and tliere was much sugillation of dependent parts. Eigor mortis was present. The outer layer of pericardium was adherent to the heart, which weiglied seven- teen ounces, had thin walls, dilated cavities filled with discolorized ciota, ftnd valves incompetent and enormously thickened and puckered. Tiiere was a sort of cartilaginous deposit on the outside of the right auricle.

The right lung was congested andtedematous; the liver was fatty; the capsules of the kidney were tliickened and adherent, with wasting of the cortical substance. In the head a large arachnoid cyst was found coexistent with the right hemisphere, which was flattened beneath it. It.presented a red- dish-green appearance, and contained several ounces of a biiio-sanguineoua looking fluid. The whole brain weighed forty ounces; the right half weighed eighteen ounces, the lei't half twenty-one and one-half ounces.

There were the rusty-brown traces of an old clot in the right corpus striatum .]

In several cases, and even several times in the same person, Chloral caused all the eruption and eymptoma of an attadi of scarlatina. {British Journal of Homceofathy, April, 1873.)

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OHLOKAI, HTDKATK.

Quiet sleep, apparently natural.

Comatose condition lasting for days, ending in fatal cerebral

Eestless; screaming, noisy in sleep.

* Night terrors, especially in teething children.

Somnolence, during which he is conseions of all his actions, such as coughing, spitting, etc. [30 grs. usually causes quiet sleep for six hours, 40 gra. for 13 liours.] Wervous System.

" Trominatio tetarvus (many cases),

° Chorea (many severe cases).

" Infwntile tetari/us; (two grs. at time of each spasm).

° Tetanus, from various causes, and trismus.

" Neur^gic and rheumatic pains.

Pathological Effects.

Ocular and palpebral mucous membrane is injected.

Vascularity of tlie ears without increase of heat.

Pulseless, with contracted pupils; temperature 91-2.

Experiments on rabbits, they exhale the odor of Chloral through their nostrils, a fact which would lead one to think that it was not decomposed in the blood.

Congestion of the abdominal viscera; mesenteric vessels are turgid, all the mucous membranes are injected, particu- larly that of the trachea, if examined during the experi- mentation.

The brain, cerebellum, and their membranes show an intense vascularity.

The duration of its action is in proportion with the feebleness of the patient.

In two cases of delirium tremens, quiet sleep was induced.

In a patient suffering from bronchitis with asthma, the Chloral gave reliei".

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CEOTON-CHLOEAI.. 236

Deep and prolonged narcotism can be produced by the Chloral. '

During a portion of the period of narcotism there may be complete ansesthesia, with absence of reflex action; a condition, in short, in which every kind of operation fails to esjl forth consciousness.

In fatal cases the functions are destroyed in the following order: a, the cerebral; 5, the voluntary muscles; e, the respiratory; d, the heart.

Hydrate of Chloral should be taken, to secure safe and satis- factory effects, on a neutral condition of the stomach.

If the stomach be acid, the Chloral is not taken into the cir- culation, and acts imperfectly.

If the stomach be alkaline, the Chloral is absorbed too rapidly.

An acid stomach should be neutralized before the Chloral is given.

CEOTON-OHLOEAL.

{Oroton-cMoral Mydrate.)

OFFICINAL Prepabations.— Solutiou ; i to 3 is; dilutions.

It destroys the sensibility of the cranial nerves, affecting only the brain and nerves of the head; while chloral hydrate affects the ■whole nervoua Bj'stem.

(See Therapeutics, Vol. II.)

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286 CLEMATIS VIEGIMI4NA.

CLEMATIS VIKGINIANA.

It is a perennial, climbing plant, with a stem from eight to fifteen feet or more in length, supporting itself on shrubs lences and biush-work, by means of its long footstalks. The kaies are deep tureen, three fold; leaflets, egg shaped or heart shaped, sharp pointed, in lobea, dentated edges, and from two to three inclies in length, by one to two in breadth ; flowers in cluslera, irregularly branched, often having the stamens on one plant, and the pistils on another; the clusters, In the junction of the leaf, foot- stalk and stem ; sepitls four, white, spreading oblong and obtuse ; stamens from twenty-eight to thirty-six; fruit furnished with long plume-like tails, appearing in large downy-like tufts; seeds compressed.

Officinal Preparations. — Tincture of fresh leaves, bark, and flowers, with strong alcohol; dilutions. *

Analogubs. — PuUaUllamg.am.d Nutt, Beuidlaria, Eanunealus, Skm, Aconite, Liliwm tig., Ooffea, Ctmicifuga, BrcmiiUs, OUmatis ereeta. {See Therapeutics, Vol II.)

COLIilNSONIA CANADENSIS.

{8tone Boot)

Botanical DEScitiPTiON The stem is simple, smooth, round, straight, from one to three feet higli Leaves with broadly toothed edges, pointed, having long footstalks, and only two or three pairs, heart shaped at base, broadly egg shaped, sharp pointed, a smooth surface, and small veins. Flowers opposite, on long footstalks, witli short, oval shaped floral leaves, forming terminal, leafless, irregulirly blanched clnstei-s. Corolla two- tliirds of an incli long, yellow (eshaliag an odor like lemon), tube-shaped at base, spreading above in two lips, the upperlip being very short and notched, the lower lobed on the sides, and fringed around- Stamens, two, long and protruding; antber oval, style protruding; seeds ollen aborting, only one ripening; root, perennial, knotty, depressed, very hard, with many slender fibres.

It is called Ox-balm, Knot-root, etc.

Officinal Prbpakatioks.— Tincture with sfrong alcohol, from the whole plant, or fresh root; dilutions.

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C0LLIN80NIA CAHADENSIS. 237

Ajsaloouks. — ^JCufMS, Arnica, Aloes, Dioscorm, BigiMlii, Ramamdii, Tgnafia, Lycopodium, Lycopue, Nvx vomica, PoCojihyUvm, SuVpkur, Ban- guinaira.

Dull frontal beadache_ with laasitnde and desire to sleep,

* Headache from suppressed hemorrhoids. Slight fullness in the head; throbbing in the head.

ToTigue coated yellow along the centre or base, with Mtter taste in the mouth.

Stoma oh. Vomiting, with pain and lieat in the stomach.

* Cramp-like pains in the stomach, with nausea.

° Indigestion associated with constipation and hemorrhoids.

" Flatulence and spasms of the stomach.

° Congestion of the pelvic viscera.

" Severe colicky pains in the hypogastrinm.

Constant sensation of heaviness in stomach.

Sick feeling at the pit of the stomacli.

Sharp, cutting pains in hypogastric region. Severe colicky pain in the hypogastrinm,, with desire for stool; nausea and faintness.

* Very severe pain in the hypogastrinm every few minutes,

* Constipation, chronic, with much flatulence, and with

* Diarrhoea, mucoua discharges, or watery, with cramp-like or

diarrhoea. Stools preceded and followed by severe pains in the hypo

gastric region.

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338 COLLTNeONIA CANADENSIS.

Copious stools of yellow, bilions matter, miiciis, bile, blood, and with tenesmus.

* Light- colored, lumpy stool, with distress in the anus.

" Chronic diarrhcea after conftnement; stools of mneus and black ftecal matter, with colic and tenesmus. {£wrt.)

" Htmnorrhoids, obstinate and chronic, always attended by constipation ; bleeding or not. {Dra. JP'owl&r, Solcomhe, Bournes, J^^rrnikUn, a/nd mwny oth&rs.)

" Chronic diseases of the rectum.

° Congestions of the pelvic viscera, with piles.

" Diseases of the reetnm, associated with disease of the uterns.

Urine increased in quantity.

° Chronic cystitis and nephritis.

° Catarrh of the bladder, especially with piles.

° Dropsy from cardiac irritability.

Generative Orsana.

Amenorrhcea,from congestion of the uterus and pelvic viscera.

° Dysmenorrhcea complicated with piles and constipation.

"Prolapsus, witli pruritus, dysmenorrhcea, and most obstinate constipation.

" Uterine diseases dependent upon diseases of rectum and bowels.

Jffl^s.— Gleet (?)

° Varicocele, with extreme constipation. {Fowler?)

° Spermatorrhcea kept np by piles and constipation. (Hale.) Respiratory Organs.

"Pulmonary hffimorrhage, with a short, hacking cough; he spat very tough, and dark coagnl a, enveloped in viscid mucus; with uneasiness in the chest, but no pain,butwith bleeding from the rectum the first day. {Dr. Liebold^

" Hard, shaking cough, with bloody expectoration.

"Coiigh and dyspnoea, in connection with cardiac difficulties.

" Chest jiains, alternating with hfemorrhoids.

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OOMOCLADIA DENTATA. 239

■ Irritation of the cardiac nerves/ cardixzo hyper msthesia.

Afunctional disorder of the heart, with rapid, regular or ir- regular beating of the heart; pnlse 130 to 140 per minute; tlie slightest motion or excitement aggravates the symptoms; periodical spells of faintness and oppres- sion; attaets of syncope, with fullness of the chest and difficult breathing; and attacks of dyspnoea, with great weakness. {Dr. Fewner.') (If these symptoms occur in persons sulyect to hsmorrhoids, oi after

suppressed lisemorrboidal flux, the Collinsonla would he specially indi- cated.— Hale!\

" In cardiac disorders it seems to act by increasing the heart's tonicity; or after the heart is relieved, old haamorrhoid^ appear, or suppressed menses return. {Sale.)

° Valvular diseases after rheumatic endocarditis. {Paine?)

° Palpitation of the heart in patients subject to hsemorrhoids, dyspepsia and flatulence. {Male.)

° Disease of the mitral valve, the murmur diminished, and the patient greatly improved under its use. {Dr. Shepherd.)

° Used by the country people as a vulnerary, much as the Ger- mans use Arnica, for bruises, wounds, sprains, etc

"Dropsy, probably from heart disease, or feebleness of the circulation.