Chininum Arsenicosum

Arseniate of Quinine. 2 C20 -^24 -^2^2- ^^ -^3- 4 ^2^-

Until proved by the Philadelphia Clinical Society, at the instigation of Dr. William H. Bigler, who cured with it a case of scrofulous ophthalmia, the only proving we had was the short one by Dr. Muhr, contained in Allen's Encyclo- pcedia, v. 3, here designated No. 6.

The provers of the Clinical Society are: 1. Dr. W. B.

Trites, 2d dec. trit.; 2. Mr. J. J.

Sturges, 1st dec. trit. ; 3. Mr. E. W.

Le Roy, 6th dec. trit. (both under supervision of Dr. C. Mohr) ; 4.

Dr, C. B. Knerr, 30th cent., and 6. Mr.

Walter K. Furness (under supervision of Dr. Knerr) 2d dec. trit.

Clinical Authorities Intermittent hemicrania, Altschul., Riick. Kl. Erf., V. 5, p. 82;

Headache, D. F. and J. C. Moore, N.

E. Med. Gaz., 1869, v. 4, p. 446; Occipito-cervico intercostal neuralgia, Payr, Hom.

Klink., 1869, p. 19 ; Rheumatic headache, H. G. Bojanus, Eaue's E., 1874, p. 257 ;

Scrofulous ophthalmia and kera- titis superficialis, Wm. H. Bigler (unpublished); Malignant angina in scarlatina, Kafka's Therapie, 1, p. 433: Diphtheritis, numerous cases, Findeisen, A.

H. Z., v. 87, p. 113 and 196 ; Diphtheria, A. Neuschsefer, A.

H. Z., v. 78, 1869; Intermitting diarrhoea, Kafka, Eiick. Kl.

Erf., v. 5, p. 410; Suffocative attacks in tuberculosis, Kafka, Eiick. Kl. Erf., v. 5, p. 797;

Epileptiform spasms, Payr, Hom. Klinik, 1869, p. 2 ; Interm,ittent fever, S. E.

Geiser, Cin. Med. Adv., v. 4, p. 79.

^ Mind. Depressed in spirit, with dulness of mind^.

Listless after previous fever; no desire to do anything^. Desire to sit or lie in one place and not be disturbed^. Mental dulness, with inclination to vomit^. ■Anxiety and nightly delirium. ^Diphtheria. The chilly waves are brought on by thinking of them 2.

■ Anxiety, with dyspnoea. ^Tuberculosis.

Greatest anxiety, with unquenchable thirst; must sit up bent forward, if possible at open window. ^/Tuberculosis.

■ Child sits up in bed lamenting. ^Keratitis.

I iHe believes he cannot long endure such utter prostra- tion. ^Epilepsy.

■ Irritable mood precedes the headache, which is < by

mental and bodily exercise. ^Hemicrania.

■ In consequence of fright, 1. sided hemicrania.

■ Sensorium. ■Confused feeling in head. ^Diphtheria. ^ Inner Head. ■Severe, darting, tortuous pains running up into head and preventing sleep.

■ Without previous aura he feels it rushing like lightning

through brain and down r. side of neck into arm, which is distorted and wrenched so as to crack audibly; the

57 CHININUM ARSENICOSUM.

facial muscles are convulsively drawn, sight and speech cease, consciousness ' leaves, and he falls to the ground ; the attack is followed by cold sweat, loud eructations and a feeling of utter prostration. ^Epileptiform spasms.

Confused headache i. .

Frontal and occipital headache^.

Headache affecting occipital protuberance^.

Dull headache in frontal region, not relieved by eating.^

Neuralgic pain in r. temple and above eye, lasting several days, with inclination to move the skin over the aching place with his hand^.

■ Tearing, boring pain in 1. side of head, affecting the eye, with flickering, pain and lachrymation; ringing in ears, nausea and vomiting during the attack, which regu- larly appears at midnight; is subject to furuncles and abscesses which relieve the head. ^ Outer Head. I Burning pain in 1. occipital protuberance, extending down nape of neck, along shoulder-blade and over I: half of thorax, producing orthopnoea; the attack commences with stretching and yawning and a shaking chill, generally in the morning, and lasts until after midnight.

Bruised feeling all over head after fever and sleep 2.

Neuralgic pain about head, particularly in temples ; < in 1. side; > by rubbing the aching spots*.

Slight painful pressure in forehead and temples^.

Slight sudden throbbing of temporal arteries after 1 p.m. ^ Sight and Eyes. ■ Intense photophobia and spasms of or- bicularis muscles, gushing hot tears, large ulcers attack- ing each eye, aggravation from midnight until 3 a.m., during which time the child sat up in bed lamenting. ^Keratitis.

■ Scrofulous ophthalmia; < after 1 a.m.

■ Flickering before 1. eye, with pain and lachrymation.

6'Hemicrania. " Hearing and Ears. ■ Ringing in ears. ^Hemicrania. ^ Smell and Nose. Watery discharge from nose''^.

Constant running of profuse limpid and watery discharge^. Yellow discharge from nose^. Left nostril fills up when lying on that side 2. Nostrils stop up, particularly left, on lying down, prevent- ing breathing through nose^. Nose clearer when prover is in an erect posture and out

of doors^. Sneezing, < sore throat^. Profuse discharge from both nostrils 2.

■ Nose stopped up with purulent and bloody substance.

^Diphtheria.

CHININUM ARSENICOSUM. 58

I Corners of nose excoriated. ^Diphtheria. ^ Upper Face. iFace pale, sallow and bloated. ^Intermit- tent fever. ^ Lower Face. ■ Swelling of submaxillary and parotid glands. ^Diphtheria.

iBlueness of lips. ^Tuberculosis. " Taste and Tongue. Sweetish taste after clearing throat and coughing 2.

Yellow slimy coating on tongue, with bitter taste ^.

Soreness and redness of tip of tongue^.

Metallic bitter taste in mouth^.

I Tongue coated thick and brown. ^Diphtheria. ^^ Inner Mouth. Burning canker spot inside of 1. upper lip^.

iFoetor oris. ^Diphtheritis. ^Scarlatina. ^^ Throat. Post nasal catarrh; < on 1. side^.

■ Diphtheria, diffused blackish exudation, hoarseness, great

prostration, confusion in head, nightly delirium, diffi- cult swallowing, fetid stench from mouth, dry tongue, dry skin, pulse 130, fever assuming- a putrid type^.

Constant hacking and clearing of throat^.

Throat feels sore and inflamed, with a good deal of cough^.

Throat feels raw and sore; < by coughing and sneezing^.

■ Malignant angina during scarlatina, with paleness of

skin, quick exhaustion and rapid destruction of mucous membrane of fauces.

■ Diphtheria: foe tor oris, swelling of submaxillary glands,

frequently also of parotids, violent fever and great prostration.

■ Diphtheria: strong foetor oris; submaxillary glands swol-

len and painful ; breathing through mouth because nose is stopped up with purulent and bloody substance; corners of nose excoriated; tongue coated thick and brown, both tonsils covered with a grey exudation, on right tonsil a bloody ulcer with uneven edges which corresponded to size of a membrane just retched out; lower half of uvula gangrenous, upper half covered with exudation; posterior wall of fauces completely covered with exudation; swallowing of liquids very difficult; great weakness; sleeplessness; pulse small, very frequent.

^* Appetite, Thirst. No appetite for breakfast after fever in the night^. No thirst with the fever^.

■Thirst which cannot be appeased; during attacks of suffocation. (^Tuberculosis.

^^ Eating and Drinking. 'Eggs and fish cause painless di- arrhrjea at once. ^Rheumatic headache.

■ She does not like cold water. ^Rheumatic headache.

59 CHININUM ARSENICOSUM.

Water tastes bitter, or has a disagreeable flavor like the water found in cars^. ^^ Hiccough, Belching, Nausea and Vomiting. Inclination to vomit, with mental dulness^.

Sudden inclination to vomit at 2 p.m., lasting only a few minutes^.

Regurgitation of food*.

Eructations. ^Epilepsy.

I Nausea and vomiting, followed by sleep. ^Hemicrania. ^'^ Scrobiculum and Stomach. Sensation from stomach through entire intestinal canal as if diarrhoea would set in*.

Burning, sore feeling in stomach; < on motion, particu- larly going up stairs*.

Uncomfortable feeling in stomach is > by expanding the chest*.

Burning in stomach*. ^^ Hypochondria. ■ Left hypochondriac region enlarged. ^In- termittent fever. * ^^ Abdomen. ■ Abdomen bloated. ^Intermittent fever.

Sore pain in a small spot, which could be covered with tip of a finger below and to right of umbilicus, coming and going, but continuing all day^.

Very severe colic ^.

Pressure in solar plexus, as if he had eaten tough meat or hard nuts, extending towards back where it changes to a pinching sensation, spine painfully sensitive to touch at this point ^. ^^ Stool and Rectum. Diarrhoea from malarious poisoning ; stools thin, watery, undigested, off"ensive, dark or light brown, sometimes with a meal-like sediment.

From ten to fifteen painless, watery, very off'ensive stools from 6 to 10 a.m., with burning in anus after each pas- sage; slightly emaciated, pale and weak.

I Fetid diarrhoea with pains in bowels. ^Intermittent fever. ^' Urinary Organs. ■ Spasmodic retention of urine; > by application of hot cloths to chest, which, however, is followed by syncope. ^Occipito-intercostal neuralgia. ^ Voice and Larynx. Trachea and Bronchia, i Hoarse- ness. ^Diphtheria.

Aching in bronchial region; < 1. side*.

I Seemed to prevent diphtheritic membrane from spread- ing to larynx. ^Malignant scarlatina. ^^ Respiration. Respiration very free as if the thorax were hollow^.

iBlueness of lips, hands and nails with attacks of suffoca- tion, which begin in morning and last until noon. ^Tuberculosis.

CHININUM ARSENICOSUM. 60

I Must sit bent forward and if possible at an open window

during attack of suffocation; < by any other position. ■ Dyspnoea with anxiety. ^Tuberculosis. Every forenoon at 9 o'clock attacks of suffocating spells. "^ Cough. Coughing < sore throat^.

Cough with but little expectoration^.

Slight cough at long intervals, seems to come from full

feeling in chest^. ^ Inner Chest and Lungs, i Senile subacute catarrh with

periodical fever, generally < at night. Peculiar colicky pain in lower part of 1. lung felt like a

pain from flatulence, comes and c[uickly passes away,

often repeated 1. Sharp stitch in lower part of r. chest in front; < when

inspiring, causing him to cry out^. Desire to inflate lungs to their fullest extent to relieve un- comfortable feeling in stomach while riding in the open

air on a raw cold day^. The chest feels hollow and respiration freer*. Limbs icy cold; cold clammy sweat all over; greatest

anxiety and unquenchable thirst; must sit up, bent

forward if possible, at open window. ^Tuberculosis. ^^ Heart, Pulse and Circulation, n Angina pectoris, with

dropsical symptoms, venous hypersemia and cyanosis. Trembling of heart, with rumbling noise, unable to dis- tinguish ]3ulsations, lasting one hour^. PaljDitation ; noticed on leaning against back ^. Sensation as if heart had stopped^. No perception of beating of heart^. Beat of heart and pulse irregular, numbering 200 per

minute^. Pulse cannot be felt on 1. side^. Beat of heart becomes regular towards noon^. Pulse in radial and temporal arteries 200"^. I Pulse small, very frequent. ^Diphtheria. I Pulse 130. /^Diphtheria. Pulse 98, full and strong during fever^. ^ Outer Chest, l Paralysis of respiratory muscles on 1. side.

^Intercostal neuralgia. ■ Violent neuralgic pain in 1. mammary region, as though

that part were torn with red hot tongs. ^Intercostal

neuralgia. Aching in intercostal muscles, r. side in locality of sixth

and seventh ribs on making inspiration*. ^^ Neck and Back. Back feels weak as after taking a long

journey^. Pain in muscles between 1. shoulder and neck, as if

sprained, on rising from sleep at 4 p.m.*

61 CHININUM ARSEXICOSUM.

^" Upper Limbs. Painful weariness in shoulder and elbow- joints^. Aching in biceps of 1. arm^. Acute fugitive j)ain in 1. olecranon process^. Pain in flexors of 1. forearm on radial side near elbow^. Palms of hands hot and dry^. Sore, aching fugitive pains in first phalanx of 1. thumb,

the same, but in a less degree, in right^, I Blueness of hands and nails. ^Tuberculosis. ^^ Lower Limbs. Weariness of lower extremities.

Gooseflesh on lower extremities, with chillv feelino-2. Sore, aching fugitive pain in 1. leg near knee^. Aching, sore pain in anterior lower two-thirds of 1. tibia ^. Itching on internal malleolus of r. foot at 2 a.m. ; on in- vestigation discovered eruption of bright red pimples^.

Inci'eased tenderness of corn on 1. little toe; had to remove shoe to ease pain"*. ^^ Limbs in General, i Limbs icy cold. ^Tuberculosis. ^ Rest. Position. Motion. Desire to sit or lie in one place.

Desire to move skin over aching place in temple with his

hand. Lying : on 1. side, nostril fills up. Sitting : bent forward > anxiety and suffocation. Leaning against back : palpitation noticeable. Erect posture : nose clearer.

Expanding chest : > uncomfortable feeling in stomach. Motion: and going up stairs < burning soreness in

stomach; < intercostal neuralgia. Bodily exercise : < headache.

Riding in open air : desire to expand lungs to relieve un- comfortable feeling in stomach. Sneezing: < sore throat; and coughing < rawness in throat. ^"Nerves, l Great j^rost ration. ^Diphtheria. Lassitude and fatigue*.

Feels as when suftering from partially developed malaria^. Felt sore and ached all over^. Felt like one having taken a long journey 2.

■ Great prostration, followed by a deep sleep after an attack

of dyspnoea. ^Tuberculosis. • I I Epilepsy ; after attack cold persj^iration, eructations, and a feeling of such utter prostration that patient be- lieves he cannot endure it long. ^' Sleep. Goes to sleep after tea and sleeps heavily all night*.

■ Deep sleep after suffocative attacks. ^Tuberculosis.

I Awakes from sleep exhausted and bathed in sweat after an attack of dyspnoea. ^Tuberculosis.

Restless until 3 a.m., constantly changing position, par- ticularly as soon as pillow becomes warm^.

CHININUM ARSENICOSUM. 62

Sleep frequently interrupted^.

iSleejDlessness. ^Diphtheria. ^ Time. Nightly : delirium in diphtheria.

At night: senile subacute catarrh <; sleeps heavily; is more feverish.

From midnight until 3 a.m. : ophthalmia <.

From morning until after midnight: burning pain in head with chills.

At 2 A.M. : itching eruption on internal malleolus of r. foot.

Until 3 A.M. : restless.

At 4 A.M. : sprained feeling in muscles of back.

From morning to noon : suffocation with blueness of lips, hands and nails.

In morning: broken-up feeling after fever, no appetite for breakfast.

6 to 10 A.M. : diarrhoea.

At 9 A.M. : suffocating spells.

Toward noon : beat of heart becomes regular.

Forenoon : chill at irregular hours.

Towards midnight : fever following chilliness, pulse 90.

After 1 P.M.: throbbing of temporal arteries.

At 2 P.M.: sudden inclination to vomit.

After 8.30 p.m.: chilliness with gooseflesh. ^^ Temperature and Weather. Hot cloths to chest > reten- tion of urine but cause syncope.

Warmth of pillow < restlessness.

Open window : sits there to > anxiety and suffocation.

On a raw, cold day, while riding, desire to expand lungs to relieve uncomfortable feeling in stomach.

Damp weather : is sensitive to it, and feels chilly. ^Rheu- matic headache.

Cool part of bed < chilliness.

Inclination to throw off covers and open windows, with fever towards midnight. *" Fever. Chilly feeling like cold waves after 8|- p.m. in bed, with gooseflesh all over body, but particularly on legs^.

Chilliness coming in waves, with restlessness; < by mov- ing hands and feet to a cool part of bed, also by think- ing of it^.

I Chill always in forenoon, not at a regular hour, however; sometimes once every day, again every other clay ; some- times paroxysms would close with perspiration, some- times without; before the attack, headache, yawning and stretching. ^Intermittent fever.

After chilliness, feverish towards midnight, pulse 98, full and strong, with inclination to throw off covers and open windows, no sweat^.

Feverish all the time, but more so at night^.

63 CHININUM ARSENICOSUM.

No sweat after fever, but weak, broken-up feeling in the morning and no appetite for breakfast^.

iViolentfever with great prostration. ^Diphtheria. ^Ma- lignant scarlatina. ^^ Attacks, Periodicity. Periodically : furuncles and ab- scesses. ^Hemicrania.

Like cold waves : chilliness in evening.

At long intervals : slight cough from full feeling in chest.

Coming and going quickly : peculiar colicky pain in lower part of 1. lung, often repeated.

Coming and going, all day : sore pain in spot below and to r. of umbilicus.

Lasting a few minutes : inclination to vomit.

Lasting one hour : tremor of heart.

Every day or every other day : chill.

Lasting several days : neuralgia in head. ^ Locality and Direction. Left : hemicrania ; boring in side of head, affecting eye ; burning in occipital protu- berance, down nape of neck, along shoulder-blade and over half of thorax ; neuralgia about head ; flickering before eye ; nostril fills up when lying on side ; canker spot inside upper lip ; post nasal catarrh < ; hypochon- driac region enlarged ; aching in bronchial region ; pe- culiar colicky pain in lower part of lung ; pulse cannot be felt ; paralysis of resj)iratory muscles ; neuralgia in mammary region ; pain as if sprained between shoulder and neck; aching in biceps; acute pain in olecranon process ; pain in flexors of forearm ; pains in thumb ; pain in leg near knee ; pain in anterior lower two-thirds of tibia ; tender corn on little toe.

Right: rushing like lightning through brain and down side of neck into arm ; neuralgia in temple and above eye ; diphtheritic ulcer on tonsil ; sore pain in small spot to r. of umbilicus; sharp stitch in lower part of chest, in front ; aching in intercostal muscles, locality of sixth and seventh ribs; pains in thumb; itching eruption on internal malleolus of foot. *^ Sensations. As if diarrhoea would set in ; as if heart had stopped ; as if torn with red hot tongs in 1. mammary region ; as after a long journey, weakness in back ; as if he had eaten tough meat or hard nuts, in solar plexus ; as when suffering from partially developed malaria.

Pains : in flexors of 1. forearm. Acute pain : in 1. olecranon process. Neuralgic pain : in r. temple and above eyes ; about head,

particularly in temples ; in 1. mammary region. Stitch : in lower r. chest. Darting : running up into head.

CHININUM ARSENICOSUM. 64

Tearing : in 1. side of head and eye.

Boring : in 1. side of head and eye.

Burning: in 1. occipital protuberance to nape of neck, along shoulder-blade and over 1. half of thorax; canker spot in upper lip ; in stomach ; in anus.

Colicky pain : in abdomen ; in lower part of 1. lung.

Raw feeling : in throat.

Sore pain : in a small spot below and to r. of umbilicus.

Sprained pain : in muscles of back between shoulder and neck.

Pinching : back, in region of solar plexus.

Pressure : in forehead and temples ; in solar plexus.

Tenderness: of corn on 1. little toe.

Aching : in bronchial region ; iii intercostal muscles r. side ; in biceps ; in phalanges of thumbs ; in 1. leg near knee ; in anterior lower 1. tibia ; all over.

Dull pain : in frontal region.

Bruised feeling : all over head.

Sore feeling : in throat ; in stomach ; all over.

Broken-up feeling : in morning after fever.

Lightning-like sensation runs through brain and down r. side of neck into arm.

Tortuous pains : run up into head.

Hollow feeling : in chest.

Uncomfortable feeling : in stomach.

Weariness, painful : in shoulder and elbow-joints.

Throbbing : of temporal arteries.

Chilly feeling: with gooseflesh all over body.

Itching : on internal r. malleolus. *^ Tissues. Dropsical symptoms, venous hypersemia and cy- anosis. ^■' Touch. Passive Motion. Touch : spine sensitive to.

Rubbing : > aching spots in head.

Pressure of shoe : < aching of corn. *^ Skin. Recommended in plague by Lorbacher.

I Dry skin. ^Diphtheria.

Gooseflesh over the whole body, particularly lower ex- tremities 2.

■ Pallor of skin, with rapid exhaustion. /^Scarlatina. I Cold, clammy sweat all over. ^Tuberculosis. Cold perspiration after attacks. 6'Epilepsy.

■ Periodical furuncles and abscesses, which relieve the

^Hemicrania. *^ Stages of Life, Constitution. ■ Lady, set. 58, hydrogenoid

constitution; rheumatic headache. A man; epileptiform spasms of nine years standing, caused

by masturbation and use of spirituous drinks. A young lady of slender build, set. 20 ; diphtheria.

65 CHININUM ARS.— CHININUM MUR.

A stout girl, £et. 10 ; diphtheria.

Strong man of sanguine temperament; intermittent hemi-

crania of three years standing. Woman, set. 50 ; diarrhoea.

A tuberculous woman, set. 30 ; suffocative attacks. Albert S., set. 4; had chills for two weeks; intermittent

diarrhoea, tuberculosis), Cinchon. (diarrhoea, suffocative

attacks in tuberculosis).