Calabar

Physostigma vcnenosum. Leguminoscp.

Triturations of the whole bean. First mentioned by the missionaries to the western coast of Africa; in 1846 by Daniel; in 1855 investigated by Christison ; in 1862 first observations by Frazer on the contraction of the pupil (also by Workman) ; used and abused since by many. ,

^ Mind. Uncommon mental activity.

^ Sensorium. Dizziness, with faintness and muscoe volitantes on

moving, 1 p.m. ^ Inner Head. Pain in middle of forehead in one spot above eyes,

and over and in left eye a pain, with muscse volitantes.

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Pressure in temples.

Pain through temples, as from pressure of blood to head, with throbbing of arteries on side of neck.

Pain through temples and burning of eyes.

Intense painful pressure in vertex and both temples ; has to lie down.

Pressure in vertex extending over to occiput.

Numbness and peculiar sensation in top of head, especially to- wards back of head.

Five minutes after taking dose, dull pain in 1. occipital region.

A feeling of loss of power and sensation in back of head as if head would fall over forwards, and the natural supports of head would no longer hold it back.

Congestive headache all forenoon.

Rush of blood to head, with heat and burning of nose, sneezing slight. * Outer Head. Numbness of temples and crawling sensation over head.

Between 8 and 9 p.m., a creeping numbness over back of head and all down spine, especially in part between hips. " Sight and Eyes. (Eyes feel weak.

Great pressure on eyes; with muscse volitantes.

Sore pain in eyes, with flying specks.

The medicine affects the sight very much, producing these spectres constantly: flitting before the sight, long snakes or worms, both dark and light ; also waves before eyes, making objects have a tremulous motion, as if it gave same quality of involuntary motion to optic nerve that it does to motor nerves, and made the sight movable.

Objects appear larger and nearer.

Slight sensation of double sight, as if images of objects would be multiplied.

I Felt film over eyes and blur; objects mixed, followed by dull pain over and between eyes.

Dimness of distant vision is- followed shortly after by contrac- tion of pupil.

I Dimness of vision as a sequela to diphtheritis.

I The internal rectus does not do its work rightly, and the axes of eyes do not correspond; eyes feel weak; lachrymation, especially of 1. eye.

Feeling of straining in eyes shortly after effects are produced. , On attempting to look upward, not the least movement was per- ceptible, showing paralysis of superior rectus and inferior oblique muscles.

■ In looking downward, the superior oblique muscle, which is governed by the n. trochlearis, alone acted, making a slight rotation around the visual axis, rather than a downward movement.

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■ Complete paralysis of accommodation.

\ Paralj^sis of ciliary muscles after long continued debilitating disease.

I Left pupil sluggish, not much dilated; myopia, and objects seem too large, with left eye: after a blow on left eyeball.

BPupil permanently dilated, with loss of accommodation, of eight years standing, after traumatic injury to the cornea.

Pupil was dilated, cornea turned well outward, and on looking toward the r. side it could not be brought to centre of palpe- bral fissure (showing a paralysis of internal rectus muscle.)

Occasions contraction of the pupil and sympathetically dilata- tion of the pupil of the other eye.

In twenty minutes pupil contracted to size of pin's head, with a boy.

I I Shortsightedness.

I Myopia.

The effects last longer on iris than on ciliary muscles.

'• Where iris has a tendency to protrude through a corneal wound.

B Drawing-twisting sensation in eyes.

Sharp, shooting and drawing sensation in r. eye.

Eyes are sore and give pain when moved from side to side.

I Pain in eyeball.

Symptoms of eyes all morning, with much burning of balls.

Burning of eyeballs.

Burning of eyes and bloodshot appearance of them all forenoon.

■ Eyes smart; lids feel sore.

Heavy headache and pain in eyes, with much heat in head and face ; muscse volitantes both black and light.

\ Ulceration of margin of cornea, leading to perforation, or even when prolapsus of iris has just occurred.

\ In cases of retinitis, to diminish the access of light.

Beating, or throbbing and twitching between eyebrows.

Excites salivary and lachrymal secretion.

I The whole affection came on suddenly; about a month before she went to bed well, and on rising next morning found it impossible to open the eye. ^Rheumatic attack of ocular muscles.

Endeavoring to open eye, a slight upward movement of lid re- mained, caused by the musculus orbicularis palpebrarum, governed by facial nerve, relaxing itself still more.

Upper lid of 1. eye hanging down, outer caruncle lower; that of r. side, complete ptosis.

■ Considerable tenderness of skin around eye. Mattery eyes.

■ Intolerable pain over both orbits.

'' Smell and Nose, A sensation exactly as if nose was going to

99 CALA.BAR.

bleed, and the peculiar taste wliich goes with it; at 2 and

8 P.M.

Twitching in nose, and involuntary expansion of nostrils. Numbness from between eyes down through nose. Sneezing.

Burning heat in nose and sensation as if it would bleed ; quiv- ering sensation in teeth as if they were resting on a vibrat- ing board ; at 4 p.m. * Upper Face. Stupid look and a drunken gait.

Involuntary twitching of mouth, also of eyebrows. ■ Sensation of contraction of whole 1. side of face, with slight numbness. " Taste and Tongue. I Smarting of end of tongue.

Tongue became very sore on 1. side, quite back to root, and it was very hard to move it; felt as if it was stiff. 13 Throat. I Feeling as if a ball were rising in throat. '* Aversions. Disgust of cold drinks.

^^ Eating and Drinking. ■ After eating: relief of pain in head. ^^ Nausea and Vomiting. B Nausea and vomiting. ^^ Scrobiculum and Stomach. Trembling sensation in nerves all down through body, especially at pit of stomach, with mo- tion going up and down in nerves like waves, accompanied by slight nausea and a sensation of faintness. Nervousness at pit of stomach. Great pain and soreness in and all around pit of stomach, and

all around body in this part before and behind. Sense of emptiness and weakness at stomach,' without hunger ; 3 P.M. '^Hypochondria. Soreness around body at waist ; 6 P.M. '^ Abdomen. Sore pain in bowels, with burning, loose discharge.

Bowels spasmodically contracted. ^^ Female Sexual Organs. Pains in womb, as if menses were coming on. Leucorrhoea.

Leucorrhoea and much weakness at 4 p.m. ^® Respiration. I Yawning and sighing respiration. B Laborious breathing.

Kills by paralyzing nerves, supplying breathing muscles. ^^ Inner Chest and Lungs. Severe pain in left side and entirely

unlike any pain in lungs that he has ever had. ^® Heart, Pulse and Circulation. Power of contraction of heart is increased. Number of beats of heart sometimes increased, sometimes di- minished. Nervous symptoms, with palpitation of heart and much weak- ness at pit of stomach. Heart's action feeble and irregular.

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Violent palpitation of heart.

Death by paralysis of muscles of heart.

Blood very fluid.

Pulse frequent.

• A weak pulse is considered a contra indication ; hard and ra- pid, an indication. ^^ Neck and Back. Inclination to stretch out neck, " to run head out," from uneasy sensations in back of neck.

Pain at back of neck, with difficulty of turning head around.

In afternoon a peculiar pain across back of neck, at base of brain, as if it were cutting oif body from head ; it went right through neck, and seemed to go to back part of throat, w^ich was sore and stiff.

Pains in back between shoulders and a little lower down.

Drawing in back, as if it were too short to allow stooping with- out pain, and yet difficulty in keeping upright.

Pain all down spine and close to it, on both sides of it.

Pains all down back of neck, especially in most prominent bone there, and on each side of it ; drawing whenever the head was turned.

Pain in back on each side of spine, from between shoulder- blades to below waist ; pain which made it hard to stoop.

Pain in back, also down arms, with weakness of same; 2 p.m.

Stiffness and pain going all down spine ; with these pains in back there is an inclination to bend forwards, as if hard to sit up straight ; 1 p.m.

The nerves in back of body (the passive nerves or nerves of sen- sation) it seems to paralyze and numb ; and during this numbing process it causes a good deal of pain, very similar to a pain in a tooth, when its nerve is dying or being killed.

Pain in lower part of back and spine, between hips.

Pain in back between hips and a slight feeling of numbness in region of womb ; 6.30 p.m. ^^ Upper Limbs. Trembling of hands, could hardly sew; 10.30a.m.

Tired feeling in arms and difficulty in lifting them.

Numbness of 1. hand as if asleep.

Numbness in 1. arm and down ring finger.

Chill and slight numbness in r. arm. ^^ Lower Limbs. Pain in lower limbs.

Pain in outside of knee ; cramps in left foot in evening while in a warm bath.

Pain in left thigh and in both knees after walking only a few steps ; about noon.

A sensation as of a drawing of cords behind leg, under knee, making it hard to walk, especially up stairs.

Trembling of legs, as if one could not walk straight.

A feeling as if all power were going out of legs and they would give way ; as if the cause of the weakness came from that

101 CALABAR.

one spot in back, between hips, and took away all power be- low that spot, from limbs.

Cramp in foot. ^' Limbs in General. Pain in limbs.

"Loss of power in limbs.

On walking, feeling of unsteadiness from knees downward, so that he had to tread carefully, especially when eyes are shut ; feels as if he must look to see where he is going. ^^ Rest. Position. Motion. Constant desire to move head from side to side.

Disinclination to move.

Hinders voluntary motion as well as causes involuntary motion.

Motion: cannot move eye upward.; difficulty in moving eye downward ; soreness of eye ; tongue stiff and sore.

Walking : pain in 1. thigh and knees ; and ascending, drawing as of cords under knee ; unsteadiness from knees down.

Stretching: uneasiness in back of neck >.

Turning: pain at back of neck <.

Bending forward: stiffness and pain down spine >.

Lifting arms : tired feeling. 36 ^QYYQs, Shuddering and trembling running down through all nerves of body.

Violent tremblings all over, in the street ; felt for an instant as if he should lose consciousness, and could hardly get home ; riding in a car for twenty minutes did not relieve sensations.

Trembling.

Felt a sudden access of vigor and felt particularly strong ; all the symptoms seemed to come like a reaction.

Loss of voluntary motion without loss of consciousness.

Complete relaxation of whole body, as if every nerve were un- strung, even to the eyes, which felt as if all power to see were going out of them.

Giddmess and faintness without uneasiness.

Paralyses motor nerves, but does not impair sensibility, intelligence and muscular irritability.

Cause of death, true suffocation, never causes paralysis of heart. ^^ Sleep. Intense sleepiness.

Intensely sleepy in morning; almost impossible to tear himself up ; feels as if drugged. ^^ Time. Morning : congestive headache ; eye symptoms ; inten- sely sleepy.

Afternoon: 1 p.m., dizziness and faintness; stiffness and pain of arms ; 8 — 9 p.m., creeping numbness over back of head and down spine; 2 — 8 p.m., nose feels like bleeding; 4 p.m., quivering in teeth; leucorrhoea and weakness ; 6 p.m., sore- ness around waist; pain across back of neck ; 2 p.m., pain in back and down arms, weakness of same ; 6.30 p.m., pain between hips, numbness in womb.

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^^ Temperature and Weather. Both days he felt weakest, were particularly cool and bracing.

Felt a perfect horror of cold water. *^ Attacks, Periodicity, The symptoms subside in the same order; first derangement of accommodation, then affection of pupil.

The trembling spells come on in fits ; and at the least thing that startles. *^ Locality and Direction. Right : shooting and drawing in eye ; ptosis ; chill and numbness in arm ; pupil much di- lated ; sight of eye impaired ; pupil small.

Left : pain in eye ; dull pain in occipital region ; lachryma- tion ; pupil sluggish ; upper lid paralyzed ; contraction of face with numbness ; soreness of tongue with difficult mo- tion ; severe pain in chest ; numbness in arm and hand ; pain in thigh.

Before back : pressure in vertex to occiput. *^ Sensations. The nervous symptoms came first, being in centre of forehead, and very much at pit of stomach, and going downwards ; soreness around middle of body came next, and last of all the pains in back and spine ; these lasted the longest and seemed the most characteristic of all the symp- toms.

Nervous motions through body and arms.

A kind of pain like that caused by stooping over work for a long time, or by long pressure of back against a chair — as if the nerves were compressed.

Shooting : in r. eye.

Burning : of eyes ; of nose ; of eyeballs ; in nose ; in bowels.

Drawing : in eyes ; in back ; drawing down back of neck when turning head ; as of cords under knee.

Smarting : of eyes ; of end of tongue.

Straining : in eyes.

Twisting : in eyes.

Cramping : in 1. foot.

Pressure : in temple ; in vertex ; in vertex to occiput ; on eyes.

Soreness : in eyes ; of lids ; of 1. side of tongue ; around pit of stomach ; around waist ; in bowels ; and stiffness of throat.

Pain : above eyes ; through temples ; dull, in 1. occipital re- gion ; headache, in morning ; in eyeball ; around pit of stomach ; in womb ; in 1. chest ; at back of neck ; in back ; down spine ; down back of neck ; down arms ; between hips; in lower limbs ; in knee ; in 1. thigh and both knees.

Beating : between eyebrows.

Throbbing : on side of neck ; between eyebrows.

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Twitching : between eyebrows ; in nose ; of mouth and of

eyebrows. Quivering : in teeth. Trembling : all through body ; of legs. Discomfort : at back of neck. Heaviness : in head. Tenderness : around eye. Stiffness : of 1. side of tongue. Contraction : of 1. side of face. Tired : in arms.

Faintness : in street and while in car. Weakness : of eyes ; at pit of stomach. Powerlessness : at back of head ; of legs. Creeping : back of head and down spine. Crawling : over head. Unsteadiness : from knees down. Numbness : in top of head ; of temples ; back of head and

down spine ; between eyes down through nose ; of 1. side of

face ; region of womb ; of 1. arm and hand ; in r. arm. Shuddering: through whole body. *^ Touch. Passive Motion. Injuries. Touch : soreness

around pit of stomach; soreness around waist, 6 p.m. " Stages of Life, Constitutioa. Girl, set. 9, pupil of r. eye very

much dilated ; a small scar on outer edge of cornea. Woman, set. 24, sight of r. eye impaired, could only distinguish

light from darkness. A woman, set, 21, paralysis of oculo-motor nerve. Woman, set. 57, r. pupil only half as large. Man, set. 53, paraplegia, pupil contracts to pin's head in size. *^ Relations. Antidotes ; Atrojna and Hydrate of Chloral. Cam-

phoj' suspends the symptoms temporarily. Compatible: Amyl. nitr., Comum, Crelsem. Compare : in eye diseases, Agaricus {Amanita), Caustic,

Chamom., Conium, Curare; in tetanus, JS^ux vom.

CALADIDM. 104