Amylenum Nitrosum

Nitrite of Amyl. 0-^^^ E^^ 0, NO^.

Discovered by Ballard in 1844, proposed as a medicine by Guthrie in 1859, introduced into the Materia Medica of Old School in 1866. Intro- duced into our School in 1871. Proved by T. F.

Allen and published in his Encyclopedia in 1874. Again proved by the Boston School and pub- lished by C. Wesselhoft in 1876, a first-rate proving, which could not be dispensed with. There are very few cures on record, mostly palliations of incurable cases ; but it is of the utmost importance as regards euthanasia.

Before going to press we received an excellent collection, through J. H. McClelland, by S. B.

Chanter.

^ Mind. ' ' Mental confusion and a dream-like state. 6 Epilepsy, A trance-like state, everything seeming unreal to her. I Unconsciousness, with inability to swallow. ^Convulsions

of a child. I Unable to do any business; head in a constant state of dull

confusion, d After long continued convulsions. I I Increasing sense of stupefaction, with flushing of face and

scalp. Flow of ideas becomes more lively. I Frequent piercing shrieks, d Child in convulsions. ■ Melancholy.

I Melancholy without sensation of anguish. Actual fright at the throbbing of the head. I Cannot sit still for fear of something dreadful happening. Anxiety as if something might happen ; must have fresh air. I Haunted many times a day with an indescribable dread and

sensation as of an oncoming fit, although it came on only once

or twice a week. /9 Epilepsy. From the slightest emotion flushing of the face. ^ Sensorium. I Dullness in head, and peculiar confusion, d Head- ache. Confused feeling after the congestion to the head. Confusion of head with vertigo and drowsiness. I Vertigo, headache and nausea on rising. Giddy ; drunken feeling. I Dizziness.

I Heaviness of the head.

I Dizziness with slight nausea, worse when eyes are closed. Produced so much giddiness and sensation of fullness in the

head that he preferred ether, d Angina pectoris.

AMYLENUM NITROSUM. 238

I Giddiness, confusion of mind, heaviness in head, headache

and general weakness. Giddiness, mental confusion and a dream -like state. Congestive state of head. I Great rush of blood to head and face. ^ Inner Head. Dull heavy aching all through the head. I Conscious of a dull headache for about three hours. I Headache in frontal region. I Severe dull heavy pains across the forehead, without marked

external heat. I Heaviness and pressure outward in forehead and temples. I When pain in forehead was <, pain in occiput was >• I I Sense of fullness, pressure, tension and throbbing in the

temples. I Pain in r. temple. I Painful pressure outward in temples, < in left, with dull,

heavy aching pain in occipital region extending to nape of

neck, while walking. I Severe pain in temples, occiput and over eyes, with burning

in stomach. Visible pulsating in the temples. I Headache on 1. side, parietal region. iHemicrania, especially where the aifected side looks pale in

comparison with the sound one. I A dull aching in cervical region, gradually moving to sub- occipital region, during the morning. Sensatioa of something rushing upward and throbbing in the

vertex. No pain in the head is felt until some time after the attack

comes on, and it is then of a dull aching character in the

vertex, accompanied by unusual paleness of the face and

coldness of the feet and hands. I Severe occipito-frontal headache, felt most in suboccipital

region. I Pain in r. occipital region. I Dull pain in occiput.

I Pain in occiput < in heat of room and from writing. Constant occipital headache and aching across loins, << from

fatigue. Occipito-frontal headache, with aching in r. renal region. I Heat and throbbing in the head ; feeling of fullness to

bursting. I A quick, somewhat sharp throbbing in the head. Throbbing headache with flushed face and confusion of mind. Beating and throbbing in the head and ears with constriction

of the throat and heart. A sense of fullness and distension of the head amounting at

239 AMYLENUM NITROSUM.

last to severe pain, and accompanied by intense flushing of the face, starting the perspiration on head, face and neck.

I Pressure in head, forehead and temples, with moist skin.

Severe pain accompanied with sense of distension of the head.

Bursting sensation in the head and ears as if all the blood were rushing to the head.

I Pain in head, with a stupid drowsy sensation and burning in stomach and up the throat.

I Hemicrania or sick headache ; pain most violent left side.

I Sick headache. * Outer Head. I Oppression in fronto-parietal suture, extending to frontal bone.

I Redness and heat of head, face and neck, with violent throb- bing in top of head and carotids.

I Intense crushing pain upon the head, which seemed to gather into a feeling of confusion, threatening for a moment to make him unconscious.

Visible pulsation on the temples.

■ Temporal artery protruding, hard, pulsating audibly.

I Sensation as though the scalp was jerked forward from occiput towards forehead, ceasing just before it reached that point, repeated several times.

Heat and perspiration of the head, face and neck, while the hands and feet are very cold, which continue so for hours.

I Head would first fall to one side then to the other. " Sight and Eyes. If the eye is fixed on a spot or a blank wall, the spot itself with the surrounding surface appears of a yellowish hue, the yellow circle being encircled by a violet blue halo, with undulating lines at the edge.

Objects appear pea-green or yellow.

I Slight blurring of letters when reading.

I Everything appears as if trembling, wavering.

I Aching pains in eyes in sunlight, with profuse running of tears, followed by sneezing.

On closing eyes: dizziness <^.

I Pain back of eyes on looking at near objects.

I Dimness of sight.

Pupils dilated.

I Dull heavy pressure over eyes, as if a heavy weight were within.

I Pain over both eyes.

■ Ciliary neuralgia; eye injected; face or cheek sufi\ised.

1 Sudden smarting of conjunctivae with injection of both eyes,

with dimness of vision, as if caused by a film. Conjunctivae smarting and bloodshot. The eye shines.

AMYLENUM NITROSUM. 240

lEyes glazed, protruding with a staring look and immovable. d Child in convulsions.

I Eyes protruded, staring.

I I Exophthalmic goitre.

I Sudden sharp pain under 1. eye.

Twitching under outer 1. canthus.

I Twitching and creeping under 1. eye, momentary.

Arteries of the optic disc small, but the veins enlarged and tortuous. ^ Hearing and Ears, Throbbing in the ears ; bursting sensa- tion as if the membrane would be forced out with each beat of the heart.

I I Burning of ears.

I Heat in 1. ear. ' Nose. I Constant desire to sneeze.

I Numb feeling of nasal bones lasting several hours.

I Slight nosebleed from the 1. side, about an hour after the in- halation, very unusual with him. ^ Face. Features show more vivacity.

■ Neuralgia of fifth pair.

I Creeping sensation in r. cheek below malar bone, which was

momentary. I Creeping in 1. cheek.

■ Intense surging of blood to the face and head, heat and red-

ness ; feels as if the blood would start through the skin, with lachrymation. 1 Face flushed scarlet and hot.

■ Face, and even the back of the hands, deeply reddened. llFace flushes at the slightest emotion. ^Climaxis. d Heart

disease, etc.

I I Intense redness of surface with great subjective feeling of heat in face and head.

iLeft side of face and 1. ear get intensely red, coming suddenly and disappearing suddenly during the intervals of the attacks of headache; most after mental symptoms.

Intense redness and heat in the face, often with a sensation of giddiness.

I Intense glowing of the face, with general sweat, most marked in palms of hands.

I I Burning sensation in face.

I Burning of r. cheek, extending up into eye and around to r. ear.

Intensely hot and red face ; on passing off the face is paler than usual.

Turned deadly pale, felt very giddy, became partially uncon- scious for ten minutes.

I Left side of face pale and haggard, d Headache.

241 AMYLENUM NITROSUM.

* Lower Part of Face. ' A smacking of the lips as if in the act of tasting. I A short munching movement of lower jaw, which was de- pressed and elevated as if in the act of chewing. ^^ Inner Mouth. Mouth dry, throat sore.

^^ Throat. I Awoke at 5 a.m. with an extremely dry, parched sensation in throat and mouth ; arose to rinse the mouth with water ; noticed a marked stiffness and dryness of lips. As if a vapor spread from the throat through her head, ren- dering her quite powerless for one or two seconds. I Sore throat. Feeling of constriction in the throat.

■ Choking feeling on either side of the trachea, along the

carotids ; feeling of constriction.

■ Inability to swallow, with unconsciousness, d Child in con-

vulsions.

I Heat in head and along oesophagus to stomach, lasting thirty minutes.

Tickling in throat.

I Left tonsil swollen and inflamed.

Catarrh and dysphagia (sequelae of a recent attack of diph- theria) entirely relieved during the action of the drug, but returned after its eifects had passed off.

I Collar seems too tight ; desires to loosen it. ^* Appetite. I Loss of appetite. ^^ Hiccough, Belching, Nausea and Vomiting, i Hiccough.

I Eructation.

I Nausea, with dryness in throat.

I Great nausea.

Nausea and uncomfortable feeling in stomach.

Nausea and heat in stomach, with the pains.

I Slight nausea, followed by inclination to vomit. ^"^ Stomach. I Crampy pains in epigastric region.

I Fullness and pressure in the stomach, with belching.

I Cardialgia.

I I Hot burning sensation in the stomach, with empty belching.

I Heat principally in stomach, moist skin.

Burning in the stomach and up to the throat ; nausea. *^ Hypochondria. ' Sense of oppression near the liver. ^^ Abdomen. I Crampy, colicky pains in umbilical region and abdomen, increased when lying down.

I I Rumbling in bowels.

I Slight distension of abdomen, with dull pain. ^"Rectum and Stool. I Bowels moved at 7.40 A.M. with

rumbling, followed by a feeling of emptiness. ^^ Urinary Organs. Urine, sp. grav. 1012, 1014.

I Urine clear, acid, sp. gr. 1014 ; free from albumen and phos- phates.

AMYLENUM NITROSUM. 242

I Light cloud of an oxalate and distinct traces of sugar.

Urine clear, free, acid, sp. gr. 1016, saccharine. I Urine clear, acid, sp. gr. 1020, trace of oxalate and sugar in marked quantity.

Increased flow of urine which contains an abundance of sugar. ^^ Female Sexual Organs. I Contraction of the muscles in lower part of abdomen, as though they were all being drawn together over the region of the uterus.

i Region of uterus, fallopian tubes and ovaries felt very hard on pressure.

I During catamenia most violent left-sided headache, begin- ning in the morning ; most violent at noon, lasting till evening, with frequent vomiting.

I Neuralgia during catamenia.

I Chronic blushing in climacteric years ; blushing with disease of r. heart in the male.

I Nervous dysmenorrhoea. ^* Parturition. I Convulsions occurring immediately after de- livery. ^' Larynx. I l The feeling of constriction in throat extended to chest, and produced dyspnoea and asthmatic feeling in larynx and trachea, with desire to eructate. ^® Respiration. Inhalation followed immediately by dizziness and nausea.

After inhalation : the blood is forced up to the head ; redness of face, later very pale, more than usual, d Headache.

I Pains at times accompanied by sinking respiration.

Very deep, not more frequent breathing.

I Oppressed, difficult and rapid breathing.

I I Hastens and deepens breathing.

I I Two or three full inspirations were succeeded by one of ex- treme depth, accompanied by depression of lower jaw and elevation of ribs and scapulae.

Breathing panting in the trance-like state.

Choking feeling in throat and chest.

I Increasing dyspnoea, with sneezings, nasal catarrh and sigh- ing respiration.

I Could hardly breathe for about a minute.

I Cardiac dyspnoea with extreme anasarca, due to a dilated and hypertrophied heart.

Asthma ; arrests the paroxysm, yet on cessation of eifect dysp- noea returned.

Dyspnoea, constriction of throat and heart ; driven by actual fright to the window for fresh air.

I Feeling of suffocation from palpitation of heart.

I Dyspnoea and asthmatic feeling in larynx and trachea.

■ Suffocation and cough in paroxysms of several minutes. 6 Dis- ease of heart.

243 . AMYLENUM NITROSUM.

^^ Cough. Slight breathlessness and cough.

I Sensation in throat producing a desire to cough, similar to that produced by the fumes of a burning match.

I I Some inclination to cough.

I I Bronchial irritation, cough.

I Hacking cough five minutes after inhalation, repeated forty- five minutes after.

: Wliooping-cough. ^^ Inner Chest and Lungs. ' Slight, dull, aching pain in r. chest, more severe after a while.

I 1 Commotion in chest.

I Peculiar sensation in r. lung or chest.

I Drawing pains in 1. side, between seventh and ninth ribs, short but frequent.

I Feeling as if a band were drawn tightly around chest.

I Sense of oppression in chest, worse at lower part of sternum, ■< on going down stairs.

I Feeling as if a weight was on the sternum.

I Oppression of chest on walking about. ^^ Heart, Pulse and Circulation, ii Angina pectoris.

IPrgecordial anxiety.

■ Cardiac oppression and tumultuous heart action.

I I Anxious feeling in the prsecordial region with faintness and

oppression of the head. I Stitching pains in cardiac region and feeling of constriction

(no palpitation). I Aching and constricted feeling about the heart. I I Violent beating of the heart and throbbing of arteries with a

sense of constriction. The aching and constriction of the heart continued more or less

for at least three weeks, when it was relieved after taking

Qact. grand. I Depression of the heart's action.

i Sharp pain in region of heart < by belching, several days. I Pain in 1. side, in region of heart, extending around to the

I I Quicker circulation.

Rapid dilatation of arteries, with quickened but weakened cir- culation. Relaxes the whole arterial system, greatly reducing arterial

pressure. Great dilatation of the arterioles.

sometimes doubled in size.

■ Sudden beating of the carotids, which extends to the head and

AMYLENUM NITROSUM. 244

temples, accompanied with intense flushing of the face, which

precedes debilitating perspiration. I Throbbing of the heart and carotids, felt as high as the ears.

d Angina pectoris. Accelerated heart's action, with increased cardiac pulsations.

■ Fluttering at the heart on the slightest excitement. I I Violent palpitation.

■ Tumultuous action of heart, with great prgecordial anxiety

and quick respiration, d Disease of heart.

■ During the paroxysm of cough the pulsations of heart could

not be counted, neither was it possible to count the radial pulsations, d Disease of heart.

■ The irregular rumbling sound of heart could be perceived al-

most instantaneously to change into a more regular pulsation. d Disease of heart,

■ The heart gave one strong beat, and from the state of agony

the patient passed to one of perfect repose and peace, d An- gina pectoris.

■ Aortic insufiiciency with excessive hypertrophy of heart;

with severe frontal headache.

Pulse slow and very strong, then quicker and jerking, accele- rated.

I Beating of pulse distinctly felt in fingers.

I Pulse accelerated, full and hard.

■ Pulse slightly quickened. ^Angina pectoris. Quickens the pulse in a very variable degree.

I Pulse increased about twelve beats in the minute, but could not count it at once owing to the confusion of head.

I Pulse rose twenty beats, remaining a few minutes, gradually coming to normal standard.

Pulse increased in number of beats but not in force.

I Pulse not accelerated but irregular in action, almost impossible to count.

I 1 Increase of the pulse by 20 to 80 beats in a minute, during which the tension of the radial artery is much diminished.

I Pulse sitting : 78 to 84, feeble ; QQ, regular, feeble ; 68, small, feeble.

I Pulse before taking it, 83, in 25 minutes, 63, after 2 hours, 73, not returning to the usual state till two*days after.

In some pulse sank below average, in most it rose higher, be- came fast, full and hard.

The sphygmograph pulse-curve ends abruptly in a very sudden downfall.

■ As the pain in arm increases, the curve of the sphygmograph

becomes lower, both the ascent and the descent more gradual, and dichrotism disappeared, d Angina pectoris. If blood does not flow after cupping, the cuts immediately be- gin to bleed freely after inhaling it.

245 AMYLENUM NITROSUM.

^^ Back. I Twinges near dorsal vertebrae.

I Pain and weakness in lower lumbar region. ^^ Upper Limbs. I Slight discomfort in r. shoulder.

I Lameness in r. scapula.

■ Soreness in r. arm and shoulder.

I Lameness of flexor muscles of r. arm.

■ Severe prsecordial pain, extending to the right arm. ^An-

gina pectoris. iPain and stiffness in r. arm, most near wrist, < from motion ;

effort of bending arm or of writing very painful. I Drawing, tensive pains in the wrist and finger-joints of 1. hand.

■ Veins of hands dilating to double the previous size.

■ Hands trembling and grasping at imaginary objects, d Child

in convulsions.

■ Hands tremble.

■ Tremulousness of hands and stiffness and slight numbness of

■ Cold feet, sometimes cold hands.

^* Limbs in General. Pain and stiffness in upper and lower limbs.

■ Weakness in limbs.

■ Lameness and soreness in muscles of arms and thighs.

■ Tired feeling of the limbs.

Stiffness and pain in r. side of neck and r. shoulder, extends down r. arm to wrist, neuralgic or rheumatic. ^^ Position. Motion. ■The slightest exertion brought on in- tense pain, d Angina pectoris.

I After rising, sneezing violently three times.

Sub-occipital and loin aching, •< by fatigue.

I During and after a walk of a mile (two hours after inhalation) heaviness and pressure in head and oppressed breathing re- main, passed off two hours later.

■ Least exertion or excitement may bring on the "heats." (Violent exercise during one minute produced a dull headache. I After exercise heart beats more violently.

■ Weak, emaciated, walking with tottering gait, inclining to go

to one side when walking, d After long continued convul- sions.

Cannot sit still. See 1.

On rising : vertigo, headache and nausea.

Worse from motion : pains and stiffness in right arm ; pains in dorsal surface of r. hand.

Worse from writing : pain in occiput.

AMYLENUM NITROSUM. 246

ft

■ Convulsions. ^ A child. I Eclampsia.

I Epilepsy.

I On occurrence of the aura or before the onset of the fit (inha- lation), d Epilepsy.

■ Tetanus.

■ Succession of fits, linking together by intervening unconscious-

ness, fits recurring with increasing frequency, till at last no sooner is one fit ended or before it has finished another be- gins, d Status epilepticus.

■ After an extensive burn, violent acute tetanus, beginning the

fourth day and advancing rapidly in forty hours, temperature 102, pulse 133, breathing 32 in the minute, marked opistho- tonos, trismus, horrid tetanic grin ; swallowing interfered ; five drops inhaled twice a day, in forty-six days restored, having inhaled one ounce.

I General lassitude, did not feel like doing anything.

I I Relaxed feeling in all muscles and heaviness, most when rising, with an uncertainty.

I I General weakness with a tendency to sweat easily on slight exertion.

■ Weak feeling all over.

^^ Sleep. ■Yawning, profoundly and repeatedly in coma during an unconscious state, d Status epilepticus. I I Drowsiness.

1 I Sleep restless, full of anxious dreams. Restless, awakes with pains in the temples, stomach, etc.

■ Sleep often much broken, waking with frequent starts, feels

unrefreshed in the morning, d Flushings. I Frequent waking, with severe pain in temples, stomach and

bowels. I On awaking pains returned with increased intensity, most in

spine, lungs and conjunctivae, with shifting pains caused by

movement on dorsal surface of r. hand, 1. patella, and from

1. thumb to axilla, with catarrhal symptoms and severe fronto-

orbital cephalalgia. ^^ Time. ■Hemicrania beginning in morning, most violent at noon,

dav.

247 AMYLENUM NITROSUM.

I I Most marked during the evenings. Restless in tiie night.

39 Temperature and Weather, i Warm room causes dull pain from temple to occiput, <; 1., for 2, 3 hours.

Must have fresh air. See 1, 26.

I All symptoms ^ by exercise out doors.

I I Cold water and air relieve the symptoms.

I Open their clothes or remove the greater part of bed covering and throw open the window in coldest weather.

■ Severe burning sensation over the loins followed by sweat,

burning so unendurable that she was constrained to open the

window at night even in winter, sometimes to rush out of

doors ; for 3 years several times daily. ^ Fever. ■ Frequent chilly crawlings over the whole body, face

pale all day. I Cold chills running down the back, during the sweat. 1 Slight chill crept over the back and sides after the heat and

moisture. Sometimes the warmth and sweat affect the whole surface, or

while the surface glows hands and feet may become very cold.

■ Flushings occasionally, peculiarly and abruptly limited, reach-

ing to the thighs, knees or elbows, while all the parts above it feel burning hot, the parts below feel icy cold. 0 Climaxis.

■ After the heats pass away the skin sometimes becomes cold

and clammy, and may turn very pale.

■ Dry heats.

■ Flushings or " heats," starting from various parts, as the face,

the epigastrium, etc., thence spreading over the greater part of the body.

■ Heats are followed by sweatings, often very profuse.

■ Heats with great throbbing throughout the whole body, and

followed by much prostration, seeming scarcely able to rouse

herself. I Hands moist, head and body warm, especially abdomen, later

AMYLENUM NITROSUM. 248

region ; creeping sensation in cheek ; burning of cheek ex- tending into eye and ear ; heart affected, see 23 ; pain in chest ; peculiar sensation in lung ; lameness in scapula ; soreness in and around shoulder ; pain and stiffness in arm ; precordial pain extending to arm ; stiffness and pain inside of neck and in shoulder extending to arm ; pains in dorsal surface of hand.

Left : headache : outward pressure in temple ; sharp pain un- der eye; twitching pain under outer canthus and creeping under eye ; heat in ear ; nosebleed ; creeping in cheek ; flushing of face and ear ; face pale and haggard ; tonsil swollen and inflamed ; headache during catamenia ; drawing pains in chest ; contraction of heart ; pains in cardiac re- gion ; drawing tensive pain in wrist and finger-joints ; rheu- matic pain in knee ; sharp pain in calf. *^ Sensations. Confused feeling in head, as if the scalp were jerked forward.

Stupid drowsy sensation.

Sudden sharp pain under 1. eye ; sharp pain in 1. calf.

Stitches : in cardiac region.

Twinges : near dorsal vertebrae.

Rheumatic pains : in 1. knee.

Burning : of ears ; in face ; in stomach and up the throat.

Smarting: of conjunctivae.

Soreness : in r. arm and shoulder ; in muscles of arms and thighs.

Aching: all through head; in eyes; across loins; in r. renal region ; in r. chest.

Drawing : and tension in 1. wrist and finger-joints.

Pressure : in head ; over eyes ; in stomach ; on sternum.

Crushing pain : upon the head.

Tension : in temples.

Constriction : of throat and heart ; of abdominal muscles, over uterus.

Crampy pains : in epigastric region.

Twitching : under outer canthus ; — and creeping under 1. eye.

Bursting sensation : in head ; in ears.

Throbbing : in head ; in ears ; in carotids ; of heart.

Fullness : in head ; in stomach.

Heaviness : of head ; — and pressure outward in forehead and temples.

Lameness : in r. scapula ; in flexor muscles of r. arm ; in mus- cles of arms and thighs.

Tired feeling : of limbs.

Creeping: under 1. eye; in cheeks.

Numbness : of nasal bones.

Heat : of head, face and neck ; in 1. ear ; in stomach.

Parched sensation : in throat and mouth.

249 AMYLENUM NITROSUM.

Cold hands and feet.

I Tingling sensation in different parts of body.

I Subacute smartings in prsecordial region, then in renal region, then in r. axilla, then of midsternum, then in lum- bar region, then in lower lobe of r. lung, at apex of heart and in lower lobe of r. lung, with tenderness on pressure.

I The smartings changed position rapidly, being most persistent in eyes, basis of lungs and spine.

I Soreness of extensor muscles.

** Tissues. Intense surging of blood to face and head ; later veins turgid.

II Rapidly dilates the arteries and quickens but weakens the circulation. See 29.

Venous and arterial blood are of the same hue.

■ Rigidity of muscles of limbs, d Child in convulsions.

1 1 Sea sickness. *^ Stages of Life, Constitution. Nervous, sensitive women are far more powerfully affected by it than men.

I A man, set. 60, with enlargement and softening of heart caused by years of suppression, care and anxiety ; relieved only, but wonderfully. *^ Relationship. Ringer compares it with Gfhnoine, with re- spect to the varying effect of even small doses on different persons, but the greatest similarity is the first accelerated and afterwards retarded pulse.

There is a remarkable correspondence between this remedy and the Glonoine, the first characterizing the Old School, the second ours.

In some cases more useful than 20, 30 gr. bromide of potas- sium taken daily. Old School.

Sometimes the pain returns as soon as the effect of the drug passes away, d Angina pectoris.

In some cases it loses its effects and must be taken in in- creased quantities and at shorter intervals, even to an ounce a week. 6 Angina pectoris.

Two drachms a fortnight for a year still unfailing relief, d An- gina pectoris.

As the sick grow accustomed to the remedy the dose must be increased. Old School.

Patients become habituated to it ; after a while it must be in- haled several times before it affords relief. Old School.

Antidote in failure of respiration by chloroform ; and to con- vulsions of strychnine.

Antidoted by : Cactus (cardiac constriction).