GELSEMIUM.
FEVER.
►
Chilliness. ► Cold on the
surface, [21]. ► Surface cold and congested, [23]. ►
*Chilliness, especially along the spine, [15]. ► Transient
chilliness (accompanying profuse urination), [10]. ► Little
chilliness, then some heat, then cold sweat, but less than before, all
without thirst, between 2 and 4 P.M. (sixth day), [7]. ► Febrile
chilliness, with cold extremities and heat of the head and face, with
headache, an early symptom in most cases, [5].
[570.] ►
Chilly sensations over the entire body, [1].
► Very chilly at 9 P.M. (sixth day), [2]. ►
Feels very chilly all day, especially in the morning (second day), [2]. ►
Chill (part of S. 490), [7]. ► Chill after breakfast (fifth day), [2]. ►
Chill, then cold sweat more than yesterday, but not as much as before,
in the afternoon, lasting till 5 P.M. (seventh day), [7]. ► Chill,
then weakness like fainting, then profuse cold sweat, after 2 P.M.
(tenth day), [7]. ► A tremor and a chill, which all of a
sudden and urgently forced out a general cold sweat, so that the drops
were seen standing on the arms quite densely (after hour hours and a
half), [7]. ►
Slight chills during the day (fourth day), [2]. ►
“Every symptom of ague; would have thought he had the ague,” [5]. [580.]
► Feels anguish, with pain in and
between the bones of the calf of the left leg; not able to go downstairs
without holding to something, [5].
► Chilliness and chills running up
the back from the loins to the nape of the neck, [11]. ► Whilst
reading exciting news, a transient chilliness on the upper half of the
body, especially in the back and nape of the neck, at 3 P.M. (fifth
day), [6]. ►
Extremities cold, [29]; (after
five hours), [25]. ► Coldness of the extremities, especially
the feet, often severe, [5]. ► Extremities rather cold (after three
hours), [28]. ► Feet and hands cold, [19]. ► Feet
feel as if in cold water; this symptom occurs at an early stage, and is
generally accompanied with heat of the head and face, and headache, [5]. ►
Heat. ► After one to
several hours chilliness subsides, general heat supervenes, mostly about
the head and face, with full pulse, from 80 to 100, [5]. ►
Directly after the chill comes a flying heat and pricking in the skin,
rapidly followed by perspiration, which at times is profuse, and lasting
even from twelve to twenty-four hours, [15].
[590.] ►
Warmth over the whole body, as if sweat would break out, then chilly
down the back, in the afternoon (fifth day), [7]. ►
Feverish, in the forenoon (eleventh day), [7].
► Some heat and dryness of the hands,
at 10 A.M. (third day), [6]. ► Hands, especially the palms, hot and dry,
in the afternoon (third day), [6].
► Feverish heat in the face (eighth
day), [4]. ►
While usually in sickness she has cold feet, they are now constantly
warm, in the afternoon (eighth day), [7].
► Sweat. ►
Skin moist (after three hours), [28].
► In most cases perspiration follows
the febrile reaction, and continues from a few minutes to several hours,
[5]. ►
Walking or other movement easily induced perspiration (first day), [6]. ►
Free perspiration over the body (part of S. 257), [25]. [600.]
► Perspiration sometimes profuse, and
continuing from a few hours to twenty-four with languor and prostration,
[5]. ►
Much sweat, with external coldness of the whole body, in the afternoon
(eighth day), [7]. ► A little cold sweat, chill, with hot
running in the legs and burning of the soles of the feet like fire,
without thirst, at 3 P.M. (fifth day), [7].
► During the stinging in the left
breast, and after the chilly tremor, a profuse cold sweat broke out,
more profuse than yesterday (second day), [7].
► A profuse cold sweat broke out
suddenly (after the pain in the forehead), so that she was wet all over,
still worse than the day before, and lasting until 6 P.M. (third day), [7]. ►
Skin dry (after five hours), [25].
► Palms dry and heated, at 11.30 P.M.
(seventh day), [6].
CONDITIONS.
►
Aggravation. ► (Morning), After breakfast, vertiginous
sensation; chilliness. ► (Forenoon), Feverish. ►
(Afternoon), Heaviness of head;
chilliness; general warmth, etc. ► (Evening), Aching in head; confusion of sight;
when sitting cardialgia. ► (After midnight), All symptoms; towards
morning, pain in bowels; pains in extremities; towards morning,
restlessness; unpleasant dreams. ► (Cool air), Aching in trapezius muscle. ► (Eating),
Aching in sacro-iliac regions, etc. ►
(Eating and drinking), Especially
warm things, the suffering. ► (Lying down), Pain in left side of neck; pains
in hand, etc. ► (Movement), Especially in going upstairs,
tendency to headache; aching in occiput; pain in hip. ► (Sudden movement
of head), Lightheadedness, etc. ►
(Sitting), Sensation in forearms,
etc. ► (When
sitting down), Catch on patella. ►
(After sleep), Headache over front
and top of head. ► (Smoking), Head symptoms. ► (Stooping),
Stitches in middle of forehead; aching in occiput. ►
(Turning head), Stitches in
forehead. ► (Turning
eyes), Stitches in forehead. ►
(Walking), All symptoms;
lightheadedness, etc.; pain in thigh; pain under knee. ► (Warmth of bed),
All pains. ► (While writing), Headache on top of head, etc.
► (After
writing), While walking, pain in bend of elbow. ► Amelioration. ►
(Closing one eye), Confusion of
sight. ► (Holding
finger before nose), Confusion of sight. ► (Movement),
Pains in muscles of extremities; languor. ►
(Pressure), Sensation in sinciput. ► (Reclining head
and shoulders on high cushion while sitting), Headache. ► (Shaking head),
Aching in head. ► (Sitting), Headache; pains in limbs. ► (Profuse
urination), Dullness of mind; headache; heaviness of head;
dimness of sight.
SUPPLEMENT: GELSEMIUM.
Authorities.
35,
W. F. Hani, Chicago Med. Journ., vol. xxv, 1868, p. 760, fatal poisoning
of a child, æt. eighteen months, by an unknown quantity of the fluid
extract; 36, A. E. Hardin, Rich. and
Louis. Med. Journ., June, 1873, p. 621, Dr. J. took about a
tablespoonful of the tincture; 37,
Dr. Freeman, Lancet, 1873 (2), p. 475, a boy, æt. three years, took
about 50 minims of the tincture (1 in 5), and died; 38, same, a girl, æt. nine years, took a
dessertspoonful of the tincture, and died in two hours; 39, omitted; 40,
R. N. Taylor, M.D., Rich. and Louis. Med. Journ., 1875 (1), p. 609, a
negro, æt. nineteen years took 15 drops of fluid extract at one dose
upon an empty stomach; 41, same, the
writer took 5 drops of the fluid extract, and in two hours 10 drops
more; 41a,
second experiment; 42, same, a boy,
æt. nineteen years, took 12 drops of the fluid extract; 43, Ringer and Murrell, Lancet, 1876 (1), p.
661, and (2), p. 569, seventeen observations on six persons; 44, Geo. S. Courtright, M.D., Cincin. Lancet
and Obs., vol. xix, 1876, p. 961, Dr. Bennett, suffering from urticaria,
took by mistake 1 to 2 teaspoonfuls of the tincture, and a little
wiskey, cured by Morphia used hypodermically; 45,
Dr. Brewster, Hahn. Month., vol. xi, 1876, Mrs. V. took before breakfast
a teaspoonful of a strong decoction of the root; 46, W. Sinkler, M.D., Philad. Med. Times,
vol. viii, 1878, p. 150, Mrs. T., æt. forty-nine years, took for
neuralgia four doses of 5 drops each of the fluid extract; 47, Ringer and Murrell, Lancet, 1878 (1), p.
858, Dr. J. B. Hill relates the case of five men taking from half a pint
to a pint of the tincture each; 48,
same, ibid., p. 892, a woman, æt. from twenty-five to thirty years,
took 15 drops of the tincture; 49,
J. G. Parsons, ibid., p. 953, G. G. P. swallowed about one drachm.
MIND.
►
Intellect was not impaired at any time, but was slightly confused, [44]. ►
Aroused with difficulty, [35]. ► Loss of consciousness, [49].
HEAD.
[610.]
► Giddiness (soon), [49]. ►
Giddiness was another prominent and early symptom. Some felt it over the
whole head, but by far the larger number said it was limited to the
brows. Stranding or walking made it much worse. When well marked the
patients staggered, and were afraid even to stand, much less to walk. So
giddy was one patient that he nearly fell off the form. Some described
their heads as going round and round. They felt and seemed drunk, though
without any incoherence, still less mental excitement, [43]. ► Pain
in the head and eyes. Patients described this pain variously. It was
generally limited to the forehead, and most marked just over the eyes.
Some called it a dull sensation over the eyes; others a heavy pain; and
others a giddy pain; and one patient experienced pain over the occiput,
with a sensation as though the crown of the head were being lifted off
in two pieces. This headache was sometimes absent, and sometimes
followed instead of preceding the other symptoms. Dull aching pain in
the eyeballs, now and then shooting in character, occasionally worse in
one ball, sometimes followed and sometimes preceded the headache. The
headache and pain in the eyeballs, intensified on moving the eyes, were
often severe. When ptosis was well marked, the effort to open the eyes
widely caused considerable pain, and the patient seemed to get relief by
closing them, [43]. ► I found the doctor sitting on the edge of
a lounge, being held by two persons, with the head falling forward, the
chin resting on the breast; I at once had his head raised up, but it
immediately dropped forward again on letting go of it, showing that the
parts were paralyzed; at breakfast his chin had dropped down, and it was
with difficulty he could keep his head from falling on the table; could
not eat, and with difficulty, on account of his head falling forward,
walked into the next room, [44]. ► Persistent and distressing numbness in
the occipital region, which lasted for some hours after the
consciousness returned, [49].
EYE.
►
Eyes closed, [47]. ► Eyes staring, [48]. ►
Strabismus, [49]. ► Dropping of the eyelids, especially the
left, [49]. ►
Pupils large and dilated, [35]. [620.] ►
Pupils largely dilated and insensible to light; eyes had a fixed stare;
sclerotic congested; lids drooping, so that it was necessary to pull
them apart to see the eye, [44]. ► A few drops of the solution of the
alkaloid were put into one eye, and in each case the trial pupil became
widely dilated, the dilatation usually beginning in about thirty
minutes. Not only does the pupil dilate, but the muscle of accommodation
becomes paralyzed and the sight affected. In twenty-four hours vision
again becomes nearly natural, but the pupil remains dilated much longer,
sometimes, indeed, for a week, or even a fortnight, [43]. ►
Dimness of vision, [38], [40]. ►
Vision slightly indistinct, [42]. ► Some difficulty in sight before he had
walked two squares, [44]. ► In every case the sight was affected. At
first the sight without being misty, is not as clear as usual; then
slight mist comes before the eyes, one patient comparing it to “a
lot of smoke rising before his eyes,” and another to a “thick
veil.” The sight at last becomes so affected that it fails almost
completely, failing first with distant objects, then, as the sight
becomes more impaired, nearer and nearer objects become hazy, [43]. ►
Double vision, [37], [38]. ►
The drug seems to produce two kinds of diplopia, one much more
persistent than the other. As to the transient kind, we find it on many
occasions a very passing phenomenon, lasting only a few seconds, then
disappearing, then, after a few minutes, reappearing. In this form
images in the median vertical line appeared double, distant objects at
first undergoing the duplication. Sometimes the patient was conscious
that the diplopia was coming on; thus one woman said: “I know that
it is now coming on; I feel such a heavy weight under my upper
eyelid.” The double vision then came on, and, with the heaviness,
ceased in a few seconds. One image was higher than the other; in this
respect the images varied much. The following descriptive notes were
taken down rapidly from the patient, the phenomena occurring as fast as
they could be written: “One gas-jet appears about six inches above
the other, and there is six inches above the other, and there is six
inches between them horizontally; the upper one is to the left; now the
right is upper most; now the left slightly again; going over to the
right now again; exactly over one another now, and quite close together;
now again separated, left the highest; now over one another.” With
other patients the two images seemed on a level. Sometimes the drug
produces only this transient kind of diplopia; at other times both
kinds; and sometimes one kind preceded the other, the transient usually
preceding the more constant form, and continuing to recur from time,
while the constant form lasted. The phenomena of the constant form of
diplopia follow a definite order, and take place in the upper half only
the field of vision. They occurred first with objects held at the
extreme right or left of the visual field; and as the patient passed
more under the influence of the drug, then with objects held nearer and
nearer the middle line, and at last, usually for a short time only,
objects in the median vertical plane seemed double. As the effects of
the drug wore off, the double vision disappeared in the inverse order.
The outer lateral image was the higher, and the further the object was
carried to the right or left the greater was the horizontal and vertical
distance between the images. When a colored glass was placed before
either eye, the outer and higher image was seen by the covered eye. When
the object was carried high above the head, the two images gradually
coalesced, and the object looked very much thinner, “like a
thread.” With well-developed diplopia there is impaired movement of
the eyeball, chiefly affecting, as far as we could ascertain, the
external and internal rectus, especially the external, for the outward
and inward movement of the eyeball was less free than before the action
of the medicine. The ball appeared to be moved by greater effort, so
that when carried as far as the weakened muscles are capable, the ball
oscillates, as though the patient with great effort moved it as far as
he could, and then the tired muscles gave way a little, but being roused
to an effort they carried the eye back again; the frequent repetition of
this effort gave rise to an oscillation. The external rectus is
generally first affected, and not unfrequently one rectus sooner and in
excess of the other. Even when the diplopia is strongly marked, the loss
of power over the muscles is not very great, and there is no obvious
squinting. Then, as the patient becomes still more affected, ptosis
supervenes, and a great part of the whole of the upper half of the field
of vision is cut off. The loss of power in the eye-muscles is then more
marked, but without the occurrence of obvious squinting. At this time
the symptoms no longer follow the order previously described, but assume
various phases, often changing rapidly. Thus, whilst on one side the
outer image is the higher, if the object is carried to the other side of
the field the inner image becomes the higher; or, perhaps, for the first
few seconds the outer and then the inner is the higher, [43]. ►
Visionless (after one hour and a half), [36].
FACE.
►
Face congested, [44], [49]. [630.]
► Face and lips blue and livid, [35]. ►
Lips of a livid color, [44]. ► Jaws rigid, [48].
MOUTH.
►
The mouth was partially open, and the lower jaw hanging as an almost
useless appendage; could move the tongue slightly, but unable to
articulate distinctly, [44]. ► Paralysis of the muscles of the mouth and
throat, [49]. ► Foaming at the mouth, [48]. ►
Interior of mouth and fauces moist, [44].
► Muffled speech, [49]. ►
Speechless (after one hour and a half), [36].
THROAT.
►
Difficulty of swallowing, [44]. [640.] ►
Deglutition impossible, [49].
STOMACH.
►
Considerable nausea (in three hours), [40].
► Retching and vomiting, [35].
URINARY ORGANS.
►
Abundant flow of urine, this secretion having been scanty for a few days
(in five hours), [41].
RESPIRATORY ORGANS.
►
Expectoration of a thick yellow pus for six or seven days, [44]. ►
Respirations slow, [44]. ► Respiration 20 (before experiment); 14
(in three hours and a half); 12 (in four hours and a half), [41]. ►
Slow, catching respiration, [48]. ► Difficulty of breathing, with oppression
in the præcordial region; the difficulty of breathing rapidly
increased, consisting of a series of short and rapid inspirations,
followed by three or four prolonged gasps, [49]. ►
Struggles for breath, [46]. [650.] ►
Thought he was going to die from suffocation, until I had his head
thrown back, when he said the air rushed into his lungs and relieved him
for a time, [44]. ► Respiration scarcely perceptible, [47].
CHEST.
HEART AND PULSE.
►
Pulse 98 to 100, and very weak, [44].
► Pulse 83 (before experiment); 78
(in three hours and a half); 53, rose to 65 on walking across the room
(in four hours and a half); 53 (in five hours); 63 (in five hours and a
half), [41]. ►
Pulse 87 (before experiment); 64 (in three hours); 84 (in four hours), [40]. ►
After the lapse of one hour the pulse had fallen twenty beats per
minute, [42]. ► Pulse weak, [47]. ► Pulse
slow, [48]. ►
No pulse at the wrist or carotids, [35].
[660.] ►
Pulseless at the wrists (after one hour and a half), [36].
SUPERIOR EXTREMITIES.
► Could not pour coffee from a cup, [44]. ►
Complete insensibility to pain in both arms, [44].
INFERIOR EXTREMITIES.
► Staggering fait, [37]. ►
Weakness in knees (in four hours and a half), [41], [42].
GENERALITIES.
►
Paralysis, [47], [48]. ►
Extremities cold, the pulse small and feeble, respirations sighing and
jerking, pupils dilated, and the eyes suffused. There was paralysis of
the bladder, the urine dribbling away constantly, and although there was
general muscular enfeeblement, it was most marked on the right side, in
the arm, and leg, [45]. ► In a few minutes she said she could not
see; her head felt strangely. She took an emetic of mustard, which
caused vomiting before the writer arrived. Found the patient in the
following condition; Could not see; the blindness was complete. Neither
could she talk or swallow; the glottis was spasmodically closed. She
could moan, which she did almost continually; but the power of
articulation was gone. Great trembling, with anxiety; was afraid she was
going to die, and was very anxious to know if anything could be done.
Face swollen and of dark color; eyes distended; pupils dilated; great
prostration; pulse small and rapid; tongue and throat very dry, [43]. ►
At 4.30 P.M., having swallowed two ounces of whiskey, with a view to its
stimulating action upon my pulse, and having walked rapidly some
distance, I had a full, strong pulse of 100 per minute, my normal pulse
being 85 per minute. I injected under the skin of my left arm five
minims fluid extract. I examined my pulse at 5 o’clock, and it had
fallen to 84; vision a little indistinct; at 5.30 pulse was down to 80
beats per minute; vision more disturbed. At 6 o’clock pulse 76, and
temperature 98 1/5°; disturbance of vision very great. It seemed almost
impossible for me to fix my gaze upon any object, and when I succeeded
in doing so, the object, whatever it happened to be, would fade away at
first, and then reappear again. There was a sensation of fulness in my
head, and a feeling of great weight and heaviness about the eyelids.
When I opened my eyes to their fullest capacity, it seemed as through
they were but half open. At 6.15 pulse was 72, no change in the other
symptoms. At 6.30 pulse stood 69. At 7 o’clock I partook of a light
supper. At 7.45 pulse was 60, and respiration 15; no change in
temperature. The disturbance of vision completely passed off at 8 P.M.,
after which time no uncomfortable symptoms were experienced. At 8.15
pulse 60, respiration 15, and temperature 97 2/5°. At 8.45 pulse 59,
and temperature 97 2/3°. At 9.15 pulse 60. At 9.45 pulse 60, and
temperature 97 2/5°. I then arose from the half reclining position
which I had occupied during the experiment, and walked across the room
rapidly for five minutes. On resuming my former position, my pulse
during the first minute indicated 67, but in ten minutes it had fallen
again to the old rate of 60 per minute. The temperature was not at all
affected by the exercise the thermometer recording 97 2/5° as before.
At 10.30 pulse 58, and temperature 97 1/5°; at this time I passed eight
ounces of rather high-colored urine. I now ascended two flights of
stairs and returned, but there was no increase in the pulse or
temperature produced by the exercise. At 11 P.M., pulse 63, and
temperature 97 1/5°; the former very soft and compressible. At 11.30,
pulse 60, and of the same character; temperature 96 3/5°. Retired at
12.30, and slept soundly for five hours. Awaking at 7.30 A.M., I about
several times, after which my pulse was 61, irregular and compressible;
temperature 97.4°. During the forenoon I passed an unusually large
quantity of urine, and my pulse did not regain its normal force and
frequency until 10 o’clock in the morning, [41a]. ► Vital
capacity, average, 185 (before experiment); 217 (after first dose); 230
(after second dose); 237 (after third dose); 236 (after fourth dose);
230 (after fifth dose), [43]. [670.] ►
Vital capacity, average, 175 (before experiment); 175 (after first
dose); 190 (after second dose); 185 (after third dose), [43]. ► Vital
capacity, average, 193 (before drug); 209 (after first dose); 207 (after
second dose); 205 (after third dose), [43].
► Muscular strength, average, 75
(before experiment); 76 (after first dose); 67 (after second and third
doses); 68 (after fourth dose); 64 (after fifth dose), [43]. ►
Muscular strength, average, 87 (before experiment); 65 (after first
dose); 75 (after second and third doses), [43].
► Average muscular strength, 89
(before experiment); 87 (after first dose); 79 (after second dose); 80
(after third dose), [43]. ► A sensation of general weakness and
relaxation pervaded the entire system. Upon attempting to walk, the gait
was at first slightly staggering, resembling that of intoxication (in
three hours), [40]. ► Loss of muscular power, [38]. ►
Complete muscular relaxation, [37].
► Any movement or touch of the head
(which seemed greatly enlarged) most intensely aggravated all the
distressing symptoms, as also did the application of any fluid to the
lips, the dread of which was nearly equal to that evinced in
hydrophobia, [49].
SLEEP.
FEVER.
[680.]
► Temperature 98 1/2° (before
experiment); 95 2/5° (in three hours), [40].
► Extremities cold, [48]. ►
Profuse perspiration, [49].® 2000
Article