Physostigma Venenosum

Calabar Bean ; Eserine. Leguminosse.

A climbing plant, native to Africa.

The alcoholic tincture is prepared from the finely pulverized bean. Toxicological reports, experiments and provings are numerous. See Allen's Encyclopedia, vol. 7, p. 466.

"Clinical Authorities Mental disorder, Kenyon, Raue's Eec, 1875, p. 32, from Trans. N. Y.

S., 1873-4, p. 293; Nervous exdfability, Nash, Times Ret , 1875, p. 37, from Trans. N. Y.

S., 1875, p. 176 ; Cerebrospinal meningitis, Hale, A. H. O., vol. 10, p. 134;

Wells, A. H. O., vol. 10, p. 476; 3Ii/opia (3 cases), Woodyatt Times, Ret., 1877, p. 64; III effects of bloiv upon eye, Dudgeon, Org., vol. 3, p. 267, from B.

J. H., Jan., 1880; Eserine in c/laucoma, Cant, Smith, Buzzard, Fitzgerald, Brailey, Snell, T.A.J. H., 1886, p. 423;

Nervous disorders durinc/dentition,'Pen^e\d, T. A. J. H., 1884, p. 256;

Files, Swan, Hah. Mo., vol. 9, p. 267; Sighing during menses, Fiske, Raue's Rec, 1875, p. 176; Neuralgic pains in limbs, Kenyon, Raue's Rec, 1875, p. 246, from Trans.

N, Y. S., 1873-4, p. 293; Tetanus, Helmuth, Raue's Rec, 1875, p. 250, from Trans. N.

Y. S., 1873-4, p. 295.

^ Mind. I 'Uncommon mental activity.

I I During climacteric change, after severe mental suffer- ing (lost three children), palpitation of heart; beats irregular; some three months ago, at time for return of menstruation, was suddenly taken with a feeling of par- tial faintness, loss of memory, face very red, eyes con- gested, violent pain all over and through head, constant disposition to talk, which made her cough, feeling as if stomach were full, even up to pit of throat, belch- ing of wind ; sensation of heart beating hard and fu- riously, yet its motion could hardly be discovered, and in a few moments a violent tonic spasm, lasting nearly an hour; every muscle in body rigid, no loss of con- sciousness; when passing off roaring in ears, great dysp- noea and excessive soreness of muscles of whole body!

I I Constant pain and distress on top of head; feels as if she must lose her mind and become insane or de- spondent ; constant moaning; thinks she is a castawa}^ ;

, insomnia with desire to sleep ; terrible tlioughls on awaking ; fears she is crazy or will certainly lose her mind ; weak feeling at stomach ; sighing respiration ; constipation ; stools light-cblored ; map-tongue. ^Nerv- ous excitability.

I I Inability to stop thinking with headache.

405 PHYSOSTIGMA.

* Sensorium. ll Vertigo: staggers like a drunken man, with constrictive feeling of head, with torpor of body and fear of getting crazy ; with sensation of wavering in brain while walking ; < when walking, reading and going down-stairs ; dimness of sight ; with faintness. ' Inner Head- l ' Intolerable pain over both orbits.

I I Dull pressing headache for nearly six months ; compar- atively free from it in morning, on rising, but < from least mental exertion, until at night after retiring it is almost unbearable; with the pain, sleeplessness and ina- bility to stop thinking; in course of an hour or two passes off suddenly, with a sharp, radiating flash of pain, sometimes starting from occiput and passing for- ward, at other times from before backward.

I I Intense painful pressure in vertex and temples; pressure in vertex extending over to occiput; pain so severe must lie down.

I I Heavy headache.

1 I Congestion of brain, with epileptiform attacks.

iCerebro-spinal meningitis; stage of general tetanic rigidity; retraction of head; severe headache, with great heat in head, flushed face; vomiting when raised up; respiration hurried and irregular; pulse 100; urine scanty.

iCerebro-spinal meningitis; primary contraction of pu- pils, secondary dilatation ; heart's action tumultuous, feeble and irregular. ^ Sight and Eyes. l Felt film over eyes and blur; objects mixed; after which dull pain over and between eyes.

I Eyes feel weak.

■ Dimness of vision.

llPain after using eyes, muscte volitantes, flashes of light, twitching of lids and around eyes; myopia.

■ Acquired myopia, resulting from ciliary spasm.

■ Partial blindness, on attempting to write was unable to

see a line ; dimness of vision ; nystagmus.

I I Glaucoma; may relieve intraocular tension tempo- rarily, if not permanently, by acting upon muscular tissues of vessels; it causes a contraction in their calibre, or, as is more probable, by drawing iris from angle of anterior chamber the filtration passages are opened and excretion thus accelerated ; should not be substituted for iridectomy, however; useful when operation must be postponed for some reason, or when tension in- creases after iridectomy, or in some cases of secondary glaucoma.

I I Woman, set. 65, lost r. eye by glaucoma; 1. lens be- came cataractous, and preliminary iridectom}'- was

PHYSOSTIGMA. 406

made; eleven daj^s after patient instilled some Atrop. and brought on an acute attack of glaucoma, which was overcome by use of Eserine.

I iMan, set. 29, received a blow of cane on r. e3'e; glau- coma followed ; Eserine was instilled ; recovery com- plete and permanent.

I I Lady, set. 70 ; on fifth day after a fall became glaucoma- tous (Eserine).

I I Lady, set. 64, suffering from severe neuralgia of supra- orbital nerves, had been treated by Gels., typical symptoms of acute glaucoma were found; Eserine disks caused immediate improvement and in six weeks com- plete and permanent recovery.

I I Acute glaucoma in a woman set. 35, caused by frequent instillation of strong solution of Atroj:). for the testing of refraction.

Causes slight twitching of lids, soon followed by contrac- tion of pupils and spasm of ciliary muscle from its action as an irritant to the oculo-motor nerve (antago- nistic to Atrop., which causes dilatation of pupil and pa- ralysis of ciliary muscle by paralyzing filaments of third pair).

I I After a blow upon inferior and outer part of 1. eyeball; pupil sluggish, not much dilated; could not see objects clearly beyond a distance of four inches from 1. eye and then they seemed too large.

I I A woman had a cataractous lens dislocated into anterior chamber by a blow on temple two days previously ; there were conjunctival irritation, much photophobia and lachrymation, with severe throbbing pain in eye and r. side of head ; tension of eyeball increased ; lens after some difficulty was removed ; during next twenty- four hours tension remained normal and wound tended to heal kindly ; on second morning following removal of lens complained greatly of pain, which had kept her awake during night and still continued; upper lid was swollen and oedematous ; borders of cut for a space of two or three lines were hazy and infiltrated , a slight stringy and mucous discharge had occurred and tension of eye- ball had again increased; a solution of Eserine ^^O) one drop every two hours, was instilled into eye, and Eserine^ every two hours prescribed ; in the course of twenty-four hours the tendency to sloughing had ceased, and a rapid recovery followed.

■ Prolapsus of iris: from injuries even when whole globe is vascular and irritated and sight impaired; from sloughing of cornea.

I I Paresis of accommodation after diphtheria, and in mus- cular asthenopia.

407 PHYSOSTIGMA.

I Astigmatism.

I I Continued drawing, twisting sensation in eyes. I I Sharp shooting and drawing sensation in r. eye. I I Drawing, twisting sensation in eyes at 3 p.m. I I Pain in eyeballs.

I I Eyes sore and give pain when moved from side to side. I I Eyes smart; lids feel sore.

I I Internal muscle does not seem to do its work rightly and axis of eyes differs in each ; eyes felt weak, with lachrymation, especially of 1., from which he suffered when having usual headaches. I I Twitching of lid, combined with spasm of ciliary mus- cle ; twitching around eyes, patient cannot read without much pain, frontal headache, < from light. I I Cannot bear to raise lids. I I Profuse lachrymation. ^ Upper Face, l Sensation of contraction of whole 1. side of

drinks. ^^ Scrobiculum and Stomach, i i Dyspepsia with great pain

bronchial catarrh, < by talking. ^^ Respiration. ■ Respiration : labored ; yawning and sighing. ^' Cough. I I Cough with inability to raise mucus. ^^ Heart, Pulse and Circulation, i Tremor of heart due to

emotional disturbance; violent palpitation. ^' Neck and Back, l Spinal irritation; every nerve of spinal origin is irritated under this drug; pressure of finger

PHYSOSTIGMA. 408

between vertebree causes patient to wince; rigidity of muscles from meningeal irritation ; trismus ; tetanus ; burning and twinging sensations, referable to spinal column, with numbness of feet and hands and other parts of body ; crampy pains in hands ; sudden jerking of limbs on dropping off to sleep ; muscles of back rigid, even a tetanic condition may ensue.

I I Congestive state of paralysis of spinal cord, with tetanic spasms ; stiffness of neck, with a feeling of drawing and tension; back very weak, unable to stand erect; stiff- ness and pain down spine, with inclination to bend for- ward, as if hard to sit up straight; limbs weary as after great fatigue. ^Myelitis acuta.

I I On walking feeling of unsteadiness from knees down- ward so that he must tread carefully, especially when eyes are closed; must look to see where he is going; wants a cane to support himself ; stiffness in recti femo- ris; languor, flatulence. ^Tabes dorsalis.

I I The will is strong, but a difficulty lies in the way of car- rying out its purpose ; the palsy is commonly preceded by twitching or trembling of muscles ; attacks of partial blindness; nystagmus; trembling all over. ^Multiple sclerosis. ^* Limbs in General, i Neuralgic pains sometimes in upper arms, again in lower limbs whole length, but more se- vere from hip to knee, more frequently on r. side; pain dull, grinding, crushing, increasing until it became in- tolerable; gradual loss of motion of limbs; long standing, obstinate constipation ; if pain began at any hour, it always continued until 12 o'clock following, either noon or midnight, and then frequently would entirely cease within ten minutes. ^^ Rest. Position. Motion. Must lie down : pressure in head.

Unable to stand erect : from weakness in back.

Inclination to bend forward, as if hard to sit up straight : myelitis.

When raised : vomiting.

Motion : of eyes from side to side causes pain.

Going down stairs : feeling of wavering in brain.

Walking : feeling of wavering in brain ; feeling of unsteadiness from knees downward. ^*' Nerves. ' l Great prostration of muscular system; progres- sion difficult.

I I Trembling, dizziness and loss of power in limbs.

iTremors of young persons from emotional or physical disturbances; staggering gait as if drunk; feeling of constriction around head and waist ; feeling of weakness

409 PHYSOSTIGMA.

as if paralyzed; passes down from occiput through back to lower extremities, which feel as if asleep ; slight exertion causes great weakness. ^Myelitis.

I I Paralysis agitans as long as structural lesion has taken place.

I Progressive muscular atrophy.

I Muscular paralysis.

I I General paralysis of the insane.

I Chorea: of r. side, tongue feels as if swollen and paralyzed.

I I Tetanus in consequence of a slight hurt of palm of hand by a small fragment of glass ; no sleep ; spasms of mus- cles of jaws so violent that a breath of air caused by a person passing w^ould induce them.

■ Idiopathic or traumatic tetanus.

■ Epileptiform convulsions.

■ Cerebro-spinal meningitis, in the tetanic stage.

3 P.M. : drawing twisting sensation in eyes.

4 P.M. : leucorrhoea <. Night: headache unbearable.

If pain began at any hour it always continued until 12 o'clock following either noon or midnight. ^^ Temperature and Weather, i i Perfect horror of cold

water; disgust for cold drinks. ■" Attacks, Periodicity. Alternate: dilatation and contraction of pupils.

Six months: dull pressing headache.

Years' duration : constipation. *^ Locality and Direction. ■ Right : glaucoma following blow upon eye ; throbbing pain in side of head ; shooting and drawing sensation in eye; neuralgic pains in limbs < ; chorea.

Left : eye, lens became cataractous ; could not see objects clearly beyond a distance of four inches from eye ; lach- rymation < ; contraction of whole side of face.

From before backward : flash of pain in head. *^ Sensations. As if stomach were full ; as if she must lose her mind; as if a ball were coming up throat; lower extremities as if asleep ; back as if paralyzed ; tongue as if swollen and paralyzed.

Pain: in top of head; in eyeballs; in stomach; down spine.

Intolerable p)ain : over both orbits.

Violent pain : all over.

Sharp, radiating flash of pain: through head.

Sharp shooting: in r. eye.

Throbbing pain: in eye and r. side of head.

PHYSOSTIGMA. 410

Intense, painful pressure: in vertex and temples. Neuralgic pains : sometimes in upper arras, again in lower

Smarting: of eyes; of end of tongue. Soreness : of muscles of whole body ; of eyes ; of lids ; of

severe mental suffering, having lost three children in

Gelsem., Passi flora, Solanum.

411 PHYTOLACCA.