Atropinum Sulphuricum

Alkaloid from Atropa Belladonna. O-^rjH^^NO^,

Is most commonly used or abused by ophthalmologists to dilate the pu- pil. See Sickel, British Quarterly, 1868, Vol. XXVI, p. 672, and Norton, in New York /. J/., Vol. I, p. 365, 1873. Hence seventy symptoms are marked TT, such being observed on patients. A good proving by Kafka may be found in British Quarterly, Vol. XV, p. 238.

^ Mind. I Unconsciousness. ^ Puerperal eclampsia. ^Epilepsy. ;rAppears profoundly intoxicated. TiComplete unconsciousness of all preceding events. TrMind confused, commenced a sentence and forgot what she

wished to say. Trincoherent in observations, while thoroughly wakeful. n-She insisted repeatedly that her blood did not circulate, and that her feet must be put into warm water or she should die.

ATROPINUM SULPHURICUM. 250

Slight delirium ; picking and other motions of hands and fin- gers in the air, as if they came in contact with real objects. ;rAll day wakeful and partially delirious. ;rDelirium alternating with stupor. I Spectral illusions.

;rHallucinations of hearing and vision. TrFrenzied with excitement and frantic in her appeals. TrLaughed in an idiotic manner. Muttering and smiling.

■ Rambling speech.

■ Mirthful humor.

I Sad and morose, preferring solitude and a dark room to soci- ety of friends, d Epilepsy. ■ I Great fear and anxiety. ^ Diseased pancreas.

;rBegan to quarrel incoherently with his supporters.

Exaltation of brain and spine, followed by prostration.

Violent stitches in base of brain, above the eyes and in temples.

Languor of body and mind, rendering incapable of active bodily or mental exertion. ^ Sensorium. Giddiness, heaviness and drowsiness, or actual somnolency.

;rSense of giddiness, figures on the carpet would at times ap- pear double.

TrHead dull and confused. ^ Inner Head. Aching pain in forehead for two hours.

A slight feeling of pressure under the parietal bones.

I Headache and great weakness, d Diseased pancreas.

I Head attacked after puerperal epilepsy.

■ Meningitis, cerebri tis of tuberculous cases; diseases of cerebral

membranes and hydrocephalus acutus. ® Sight and Eyes. ;rEverything appears large and with a red halo.

;rDuring the evening the eyes of an attending lady seemed to her very large, and she could not avoid looking at them.

Motes before eyes.

;rThrough the night several times a vision of great numbers of white flies on the door, which was white ; she requested that they would be brushed ofi"; the flies were not moving and rather smaller than the common house fly ; continued on closing the eyes until noon of the following day.

;rAnnoyed by the appearance of a large black bug, with veri- table legs, a few inches below a black door knob.

;rThe next following morning, imagining she saw a worm, a "thousand- legged worm" on her carpet, she sprang out of bed, and was found trying to find it ; failing in this she would look in another place and see it again ; this illusion kept her busy before fully satisfied of the fallacy ; the color of the

251 ATROPINUM SULPHURICUM.

•worm was brown, the same as the predominant color in the carpet.

;rThe large figures on the carpet appeared to her constantly and successively rising up to her face.

;rPerpendicular diplopia, the apparent object below the real one.

Dimness of vision remains, unable to thread a needle or even to read.

;rVipion was much impaired.

TrShe could scarcely see at all with 1. eye, very little with the r., which was intolerant of light, and seemed to throw out streams of light.

Pupils unchanged for two weeks.

;z-Right pupil contracted, left five times increased in size (after dropping it in this eye) ; only a slight trace of iris visible.

TrPupils on side of injection greatly enlarged.

Increasing dilatation of pupils ; pupils after two hours reach the maximum of dilatation.

TrPupils enormously dilated, irides hardly visible, very refrac- tory when any attempt was made to examine them closely.

Dilatation of pupil from paralysis of the oculomotor nerve, or from any other cause, is often aggravated by it.

Pupils not unusually dilated, but perfectly immovable.

The usual very large doses are dangerous when there are any suspicions of glaucoma, such as dilated pupil, severe pain, sudden increase of presbyopia, etc.

I Iritis, except with too great intensity of inflammation, after nitrate of silver or cold applied to the eye ; as soon as there is any sign of exudation, or if pain becomes very severe, and has not been controlled by remedies, commence it immedi- ately and increase dose until it dilates pupil sufficiently.

■ Prolapsus of iris after hurts of cornea; if horizontal position,

shutting lids and sudden opening in bright light is not suffi- cient.

Left to himself he did not drop into coma, as those who have taken opium, but would occasionally open his eyes with a vacant, amaurotic expression, and turn his head from side to side.

iDeep ulcers in centre of cornea, which may perforate; to pre- vent iris from being drawn into the opening

lEvil results of conjunctivitis, keratitis, chromopsia, amaurosis.

;rLooking into a mirror she observed a strange appearance of her eyes, as though they projected from their sockets.

■ Rolling eyes. ^Puerperal eclampsia.

TrEyelids felt heavy and difficult to keep open, and yet no in- clination to sleep.

■ Pain in and over eyes, d Before epilepsy. ■ Supraorbital and orbital neuralgia.

® Hearing and Ears. Ringing in ears.

ATROPINUM SULPHURICUM. 252

TrMorbidly sensitive to sounds and objects ; I I with symptoms akin to early stages of meningitis. ' Smell and Nose. Occasional dryness of Schneiderean and con- junctival mucous membranes. ® Face. Sensitiveness of the side usually affected, with some swell- ing ; some stages painful two days after. ;rFace hot and very red. I Deep red distorted face. ^Puerperal eclampsia.

■ Suffering appearance, without great paleness. ^Diseased

pancreas.

Paleness of face.

I Deathly pallor. ^Gastric disturbance. ® Lower Part of Face. Parched lips.

TrShort but intense pains in one or the other lower jaws, and return of the usual prosopalgia ; after three days.

1 Bloody foam at the mouth. 6 Puerperal eclampsia. '" Teeth and Gums. I Gnashing of teeth. ^ Puerperal eclampsia.

;rTeeth ceased to ache in two hours. " Taste, Speech, Tongue. ^rPappy taste.

I Taste bad, without any peculiar character, d Pancreatic dis- ease.

;rDifficult articulation.

;rThe tongue seems partially paralyzed, articulation indistinct, rapid and chattering.

Could not speak a word for dryness in mouth ; tongue nearly adherent to roof of mouth.

Complete dryness of tongue, roof of mouth and soft palate, ex- tending more or less down the pharynx and larynx.

■ Tongue hard, parched and cracked, d Typhus. Tongue becomes covered with white fur ; after two hours. TrFurred tongue ; 3d day.

■ His tongue was thickly coated.

I Tongue a little loaded. ^Pancreatic disease. ^^ Inner Mouth. TrGreat dryness of mouth.

Dryness of mouth after two hours suddenly gives way to a vis- cid, acrid secretion of a peculiar and very highly offensive odor.

Mouth becomes foul and clammy ; after two hours.

A gradually increasing feeling of dryness of mouth and throat, increasing during one hour so that he could not speak a word ; after two hours. ^' Palate and Throat. TrFeeling in mouth and throat was such she thought she "could not swallow," and when impressed with the necessity of so doing she drank with avidity the warm water offered, though at first it seemed quite difficult.

TrRefuses obstinately to swallow anything or to answer ques- tions in any way than by a grunt.

253 ATROPINUM SULPHURICUM.

Swallowing appeared to give pain, manifested by grimaces and increased spasms of facial muscles.

Difficulty of deglutition from dryness extending down the pharynx.

TrTook fluid food well next morning.

TrCould swallow soup, but no solids; thickened gruel would not go down.

I Throat dark-red. ^Epilepsy. ^* Appetite, Thirst, Desires, Aversions, i Appetite often con- siderable, sometimes absent, with vomiting of ingesta.

;rDevouring ravenously a large slice of dry bread ; at 5 A.M.

I Appetite very small, although now and then hunger is felt. d Diseased pancreas.

I Thirst after vomiting. ^' Eating and Drinking. Compelled to take a glass of water ; dryness and general feeling of illness left.

■ Appetite is good, but as soon as she has eaten, nausea super-

venes, with pressure at the stomach, constant retching and empty eructations, followed by an emptying of the contents of stomach.

■ Whenever he took breakfast he was seized with vomiting in

the afternoon. 6 Diseased pancreas.

■ Immediately after eating he was usually seized with weight

and pain at the epigastrium, with frequent sour eructations, retching, followed soon by vomiting of ingesta, which with- out admixture of blood, or any other foreign material, was so acid as to set his teeth on edge.

■ After each meal pressure and pinching in stomach, retching,

soon followed by vomiting of the food taken ; if the stomach has emptied itself, mostly free from pain.

^^ Hiccough, Belching, Nausea and Vomiting. Nausea and

retching with the uneasiness of stomach, which increased to a pressing, sticking, contractive pain and continual belching.

■ Throws up all she takes, d Gastric disorder.

■ Vomited all he took, whether solids or fluids, sweet or salt, lit-

tle or much.

■ The matter vomited is not acrid, but is merely the food she

has just taken. ;rRelieved of her distress after vomiting, produced by copious draughts of warm water.

■ The vomiting was seldom attended with nausea, it came after

a short exacerbation of pain quite suddenly, often extremely violent, never followed by retching ; pain lessened afterwards. d Diseased pancreas.

■ Vomiting, appears sometimes in the evening between 6 and 7 ;

then in the night between 11 and 1 o'clock ; regularly five, six hours after a full meal, d Diseased pancreas.

ATROPINUM SULPHURICUM. 254

lEating no dinner he remained without vomiting until the even- ing, d Diseased pancreas.

■ Vomiting consisted of a red liquid, like washings of meat, in

which food appeared when a meal had been taken five hours before, d Diseased pancreas. I Once the substance vomited was mixed with blood. ^Dis- eased pancreas. ^' Scrobiculum and Stomach. Fluttering sensation in cardiac region. Uneasy sensation in stomach, with frequent empty eructations, affording no relief.

■ Region of stomach is very sensitive to pressure; no organic

change discoverable.

I In region immediately below the stomach, to the left, pains were not so violent as unendurable, could not describe them. d Diseased pancreas.

I Deep pressure on region below stomach, to the left, is very painful, but no swelling to be felt, d Diseased pancreas.

I In region of pylorus, close to the umbilicus, towards the r. side, a tumor nearly the size of a fist, yielding some resist- ance, very sensitive to the touch, moveable, easily pushed aside, and yielding a dull sound on percussion, d Gastric disorder. ^^ Hypochondria. TiGreat distress in epigastrium, seemed inde- scribable. ^^ Abdomen. Abdomen swollen, tense, tympanitic, upon firm pressure signs of suffering.

I Neuralgia of peritoneum, of long standing; as an ointment. ^" Rectum and Stool. ^rSlight action of bowels, next day.

;z-Bowels worse on the second day in the evening ; stool pappy, painless, usual color.

^Diarrhoea, alternating with confined bowels. 6 Diseased pan- creas.

I Bowels relieved once in two, three days. ^Gastric disorder.

;tA firm, thick stool next night.

;rDuring stool, felt badly, weak, terribly nervous, with general sweat. ^^ Urinary Organs. TrCompelled to urinate every ten, fifteen minutes, without pain, at night between 10 and 1 o'clock ; quantity profuse and almost colorless.

Involuntary, but scanty discharge of urine.

I Urine normal, with gastric disorder.

;rPassed very little urine, next day.

Inability to pass his water; a day after in drops and with diffi- culty ; 2 weeks.

TrPartial paralysis of bladder, requiring the use of the catheter.

No water passed since evening preceding; bladder not dis- tended.

255 ATROPINUM SULPHURICUM.

llChronic albumenuria. ^^ Female Sexual Organs, i Ovarian neuralgia. I Pains in ovary extort screams. ^Epilepsy.

■ Severe cutting or drawing pains in 1. ovary, screams, has to

bend. 6 Puerperal epilepsy. ' I Pain in 1. ovary, which was swollen and tender during menses.

d Epilepsy. iMenses light in color and scanty, d Epilepsy.

■ Severe headache previous to menses, beginning in occiput,

passing over r. side of head, locating in or over the eyes, in- creases until an attack of epilepsy sets in. " Pregnancy and Parturition. ■ Mother of seven children, in each pregnancy about 3d month : severe cutting or drawing pain in 1. ovary, extorting screams, caused to bend to that side ; afterwards head attacked and epileptic convulsions fol- low ; these attacks are more frequent and severe until a day or two before labor, almost continuous. ^Epilepsy.

■ After-pains after normal birth of a primipara ; violent convul-

sions; unconsciousness; deep-red distorted face; rolling eyes; gnashing of teeth ; bloody foam before the mouth; bending in of thumbs ; throwing about the limbs ; on remis- sion stretching of body and deep sopor. "^^ Voice and Larynx. Voice husky from dryness, extending to larynx. Dryness of larynx often induces dry cough and difficult deglu- tition. ^^ Respiration.

Breathing remains tranquil. No stertorous breathing. Occasionally heaving a deep sigh. ;rSensation of choking. " Cough. ■ Cough following epilepsy, occurring at the catamenia. ^^ Heart, Pulse. ■Failure of heart's action from chloroform or other cardiac paralyzers.

A slight throbbing or heaving sensation in the carotids. Acceleration of pulse from 20 to 70, with a slight increase in its volume, and a considerable increase in force of cardiac and arterial contraction, y ■Pulse 80 to 88, with gastric disorder.

TrPulse 108 morning after second night, while perfectly rational. TrPulse very quick, but of good volume.

^rPulse accelerated to 120, with increased tone but diminished volume.

■ Pulse 60, irregular, intermittent, weak.

■ Very weak pulse.

Pulse is observed to fall before moisture returns to the mouth, resuming its ordinary rate.

■ Pulse small, constricted, 120. ^Peritonitis.

ATROPINUM SULPHURICUM. 256

^^ Neck and Back. ■ Constant burning pains in back, under the sternum, and in region of stomach, d Gastric disorder.

lA large portion of spine so sensitive that she cried out on pressure, turned pale, and was seized with nausea, belching and retching.

I Painful affections from spinal irritation. ^^ Upper Limbs. Could not hold a vessel of fluid in his hands nor carry it to his mouth ; 2 weeks after,

I Gouty aff"ection of the r. wrist, with stiffness and want of feel- ing of the fingers.

;rHands cold ; after two hours.

■ Bending in of thumbs, d Puerperal eclampsia.

^* Lower Limbs. TrContinual dragging of legs when assisted, or rather, held up, in walking. ;rSays her "limbs feel like sticks," and thought she could not use them to walk across the room to the sofa, but with aid she did so with considerable difficulty.

■ (Edema of legs. ^ Albumenuria.

^* Limbs in General. ■ Hands and feet cold and covered with cold sweat. 6 Peritonitis.

■ Upper and lower limbs always cold, d Gastric disorder. ;rNumbness and heaviness in her limbs so great that she feared

the result of going to sleep lest she should never awaken. ^' Rest. Position. Motion. Bending : pain in 1. ovary better. TrEven when supported, could not move a step, feet being too heavy, and feeling no bottom. 36 Jferyes. Trinvoluntary movements of hands towards head. TrConvulsive trembling of muscles of upper limbs.

■ Throwing about the limbs. ^Puerperal eclampsia. Different parts affected with spasms.

TrSubsultus tendinum.

Spasms increased when disturbed ; left to himself they came every two, three minutes.

■ Convulsions after meningitis spinalis cured by Bellad.', re-

maining stiff"ness of lower limbs cured by Nux vom.

■ Epilepsy from ovarian irritation.

■ Some forms ot epilepsy and chorea.

;rMalaise and staggers, lasting more than eight hours.

Staggering, or complete inability to walk.

;rGreat helplessness, amounting to partial paralysis of arms and

legs. ;rCould not rise, felt no bottom under his feet, staggered against

the mirror.

■ Syncope from asthma or shock.

^^ Sleep. Frequently a prolonged yawn when sitting still in a dull apathetic, or drowsy condition. ;rRestless night, with little sleep. TrBroken sleep.

257 ATROPINUM SULPHURICUM.

■Nights restless, only sleep towards morning. ^Diseased pancreas.

■ Sleep was much disturbed on account of frequent gastric pains,

which often occurred 'Avith great violence each night, especi- ally when turning in bed.

TrAt times during the night, when nearly lost in sleep, she would suddenly start as if frightened.

Slept pretty well.

Could not be aroused at 6 a.m.

Drowsiness, or somnolency, with a tendency to quiet dreams and delirium.

jrSomnolency, with nervous startings.

Comatose, with clonic spasms of biceps flexor cubiti, and mus- cles of jaw; limbs cold.

■ Deep sopor after, d Puerperal eclampsia.

After vigorous efforts to arouse him, signs of consciousness. ^^ Time. Toward morning : sleep.

6 A.M.: could not be aroused.

Morning : illusion of thousand-legged worm on her carpet ; pulse 108.

During day : slight action of bowels.

All day : wakeful and delirious ; passed but little urine.

Between 6 and 7 p.m.: vomiting.

Evening: the eyes of another lady seems to her very large, and she could not avoid looking at them ; diarrhoeic stool.

Night : saw numberless white flies on a white floor ; thick stool ; restlessness ; gastric pains ; suddeij starting when fall- ing asleep.

Between 10 p.m. and 1 a.m.: profuse, frequent urination.

Between 11 p.m. and 1 a.m.: vomiting. ^' Temperature and Weather. TrFeels faint and greatly in need

of fresh air. ***■ Chill. Fever. Sweat. Slight elevation of temperature of the surface, rarely exceeding one degree, still slighter of in- ternal body.

A general diffusion of warmth throughout the cutaneous surface.

TrDry, hot skin ; 3d day.

Slight sweat.

1 Typhoid and septic fevers. *^ Locality and Direction. Right : eye intolerent of light ; pu- pil contracted ; tumor in side near pyloric region ; ache side of head ; gouty affection of wrist.

Left : impaired vision of eye ; pupil five times increased in . size ; unendurable pains in region below stomach to side ; . pain in ovary. " Sensations. Pinching : in stomach.

Burning : in back ; under sternum ; in region of stomach.

Aching : in forehead.

VOL. II, — 17.

ATROPINUM SULPHURICUM. 258

Pressure : under parietal bones ; at stomach.

Fluttering : in cardiac region.

Numbness : in limbs.

Undefined pain : in and over eyes.' " Tissues. iHypersesthesia of some nervous branch of ophthal- mic, auditory, olfactory, vagus and plexus Solaris, of the uterus and sphincter of bladder.

■ Rheumatic fever.

I During the last weeks, remarkable wasting, d Diseased pan- creas.

■ Much emaciated, from a gastric disorder. I Collapse of cholera.

*^ Touch. Passive Motion. Injuries. Deep pressure : pain

below stomach < ; abdomen worse. Touch : tumor in pyloric region sensitive. *'' Stages of Life, Constitution. Miss, set. 24, since 5 years,

headache before menses ; ending with epilepsy. I Blonde, slightly built woman, set. 25, had three children; since

5 years. 6 Gastric disorder. Unmarried woman, set. 30. Intelligent married woman, set. 40, medium size, nervo-sanguine

temperament, good health ; poisoned from using for toothache ;

marked tz. Unmarried woman, set. 40, for six years vomiting after eating. ^^ Relationship. Antidote to Muscarine, or poisoning by mush- rooms, especially dyspnoea. Antidote to mpconate of morphia, or any other salt of opium,

especially where the heart's action is greatly diminished. Atrop. sulph. is to be preferred in cases in which Bellad.

does not act effectually and permanently. ;rFor hours he was kept constantly on the move, and strong

galvanic currents passed along the nape of neck every fifteen

minutes, irritating him in a great degree.

259 AURANTIUM.