CROTON TIGLIUM.
GENERAL SYMPTOMS.
► Objective.
► Sudden emaciation, [36].
► Trembling of whole body, [12].
► Weakness, [26], [33]. ► Great weakness, [32], [36]. ► Great weakness on rising in the morning, with trembling of
hands and feet, [11]. ►
Very great debility, [48]. ► Prostration, [13]. [680.] ► Prostration of whole
body, with frequent slight nausea, [18]. ► Stool followed by prostration, and some pain in abdomen, [13]. ► General
prostration, [36]. ►
State of collapse, [40]. ►
During vomiting, and for two hours after, constant tendency to faint, and deathly,
indescribable feeling of prostration (one case), (after eighteen hours), [55]. ► Attacks of faintness, [16]. ► Lay in a
lethargic state, sometimes drawing himself up as if in pain (after three hours), [60]. ► Very restless;
tossing convulsively about as if in pain (after one hour and three-quarters), [60]. ► Generally lying quiet on
belly, but occasionally tossing about (after two hours and three-quarters), [60]. ► Anxious oppressed tossing
about in bed, with loss of sleep, [13]. [690.] ► Uneasiness, [34]. ► Subjective.
► Disinclination for every exertion, [13]. ► Weariness, [26]. ► Weariness, with
prostration of the limbs, in the morning, on waking, [13].
► General weariness and exhaustion, with ill-humor, [13]. ► Feeling of
weakness, [32]. ►
Sensation of complete dulness of the whole body, [13].
► General sick feeling, [26],
[34]. ► General
sick feeling, worse after eating bread and butter; she was obliged to lie down, [9]. ► Discomfort after
dinner, [31]. [700.]
► Malaise, which is soon allayed; but a sort of nausea
remains a long time after (in one hour), [1]. ► Frequent stitches, with profuse sweat on the forehead, [39]. ► Tearings in left
side, extending from groin up to the right nipple, lasting several minutes, [12]. ► The pain causing nausea is
aggravated while lying, [13].
SKIN.
► Objective. ► Redness of the skin (from triturating the seeds in a mortar),
[41]. ► Slight
redness of the skin, with a sensation of coldness, at last followed by slight warmth, [18]. ► Rubescence to a
greater or less extent dependent upon the individual susceptibility; this gradually
increases until a general, though moderate, tumefaction occurs, apparently affecting parts
deeper seated than I have seen occur from the use of any other external irritant; this is
succeeded, in a period varying from six to twelve hours, by numerous vesicles, some
distinct, others confluent, differing in size and shape; at first containing merely limpid
serum, afterwards distinct and consistent pus, and terminating in slight scabs. The redness
produced is not of a vivid, but of a dull brickdust hue. These circumstances, though regular
in their course, vary in extent according to the parts upon which the oil is applied; thus,
on the abdomen, I have never been able to excite so active a rubescence as in other parts of
the body. Over the muscular region of the arms and legs the effect is not so violent as
where the bones are more superficially situated. The most powerful effects are produced upon
the face, scalp, larynx, and chest, according to the observations I have made, in the order
enumerated. When Croton oil is applied to the face and scalp it is frequently succeeded by
erysipelas, but I have never seen any destructive or suppurating process established;
whenever applied only erysipelas followed its use upon any part of the neck, abdomen, or
extremities. In general, its effects are certain when applied to any part of the body, with
the exception of over the abdominal muscles; at least I have never seen it fail of producing
the sequelæ described when applied upon any other part of the body, [38]. ► Enlargement of a cutaneous
gland in the right lower lid, half an inch from the caruncula lachrymalis; the skin is
reddish and elevated, as large as a mustard-seed; disappearing after four days, [14]. ► Eruptions, Dry.
► Eruption of red pimples as large as millet-seeds, with
corrosive itching and sore pain when touched or rubbed (from external application), [29]. ► Erythema, with
pustules (second day), forming crusts the next day, [28].
[710.] ► Eruption on
the right side of the septum of the nostrils; when washing in the morning the spot was
painful to touch, was red, of the size of a pea; on the same day it formed a small slightly
elevated crust, which desquamated on the sixth day; the epidermis continued red and tender,
and again desquamated, [14]. ►
Burning-itching eruption round about the neck; some pimples appear seated on a red base,
small, hard, and slightly elevated, lasting four or five days (after seven days), [31]. ► Papulous eruption
on the face, [14]. ►
Erythema of the face (not unusually), often symmetrical, lasting for a few days, with
distinct heat; and this when there could have been no direct application of the remedy to
the face, [56]. ►
Eruptions, Moist. ►► *Vesicular eruption on
the scrotum and penis (the patient’s hands
not having touched the parts), (from rubbing the oil upon the limbs), [49]. ► Eruption of small vesicles
on the labial commissures, right upper eyelid, and left buttock (caused by touching these
parts when the hands were covered with the ejecta), (second day), [53]. ► Erysipelas phlyctenoides
of the face, ending in desquamation in four hours (from an external application to the
neck), [43]. ►
Several itching vesicles on the chin, which coalesce and form a scurf, which becomes moist
on pressure; after about five days the crust desquamates and leaves a red spot which lasts a
long time (after four days), [32]. ► *On the left thigh opposite the scrotum, a red moist spot, exuding
an offensive moisture; it is painfully sore to touch and on walking, which also causes
troublesome biting, [30]. ► Eruptions, Pustular. ►
The eruption which is brought out by the external use may be divided into 5 stages:1. Rubefaction of the skin;
2. Formation of vesicles;
3. Conversion of the vesicles into pustules;
4. Desiccation of the pustules;
5. Desiccation and falling off of the crusts.
These different periods or stages are not uniformly to be observed; there
are most conspicuous when the friction has been made with 10 or 12 dorps of the oil on a
part of the skin where there is much subjacent cellular tissue. The patient at first
experiences a tingling warmth, which is quickly followed by a considerable redness,
extending an inch or so beyond the sphere of the rubbing. These appearances are generally
noticed within seven or eight hours, sometimes one or two, at other times not for ten or
twelve hours; the differences of time required depending, no doubt, on the delicacy of the
skin. In from fourteen to twenty-six hours myriads of small, close-set vesicles make their
appearance upon the inflamed skin; occasionally a few of the vesicles become greatly
magnified, forming true phlyctenæ, filled with a turbid lymph, which speedily changes into
a purulent matter. In twelve out of thirty-one case, reported by our author, the vesicles
passed to desquamation without undergoing the suppurative process. The usual period at which
the serum becomes puriform is from thirty-six to fifty-four hours after the application of
the oil. In one or two days subsequently the pus begins to exude, and forms grayish crusts
over the pustules, and the desquamation is generally over by the eighth or ninth day. If the
Croton oil is rubbed upon any part which has been recently vesicated the eruption is, as we
might expect, more speedy and abundant, [51]. [720.] ► A peculiar pustular
and vesicular eruption (external application), [57]. ► Papulo-pustulous eruption (second day), [50]. ► The pustules are riper;
their bases are inflamed; some are larger than others, and have already lost the
inflammatory areola, but are full and tense. There are large phlyctenæ on the scrotum, and
some pustules on the pubis; the glans penis is partly denuded of its epidermis (from the
contact of the patient’s hand covered with the oil). The urine is darker-colored; urinating
causes pain at the end of the penis, owing to the condition of the glans and prepuce (third
day), [50]. ► Not
much smarting in the eruption; there is some heat. A general redness in the affected part,
which is covered with numerous white, glossy, tense pustules, having but slight areolæ.
Those which were in the same stage of development yesterday are now desiccated. Some small
papulous vesicles have newly appeared; others, with areolæ, are just changing into true
pustules (fourth day), [50]. ►
The pustules which desiccated yesterday have left only a yellowish spot or crust, formed of
pus and dried epidermis; those which were then at their height have sunken; there are
visible very small elevations, without areolæ, remarkable for their regular shape, their
small size, and the complete absence of surrounding redness; these are pustules developed
between the laminæ and the horny layer of the epidermis (intra-epidermic
pustules), (fifth day), [50]. ► General redness diminished. The pustules are less numerous,
and among them are some which are projecting, sensitive, surrounded by areolæ, and whose
contents are of a reddish hue, owing to blood-globules mingled with the pus; these are dermic or sanguino-purulent
pustules. A pustule was noticed surmounted by another smaller one. This is the two-story pustule. There are some thick, crusts caused by the
patient’s scratching open the pustules (sixth day), [50].
► Diminished eruption and redness; more crusts from torn
pustules. An herpetic spot, which was situated at about the centre of the eruption, has
almost disappeared (seventh day), [50]. ► The evolution of the latter pustules seems more speedy than
on the first days, so that those which were fully matured yesterday have now hardly left a
trace; even the raised epidermis has subsisted. The two-story
pustule, already observed, is developed; the top story, formed by an
intra-epidermic pustule, has increased in size, probably from the effect of endosmosis; its
circumference is no longer even with that of the lower pustule (eighth day), [50]. ► All the pustules have
sunken; desquamation is beginning with the small pustules without areolæ (ninth day), [50]. ► Desquamation is
proceeding; the herpetic spot appears again (tenth day), [50].
[730.] ► Here and
there new pustules, glossy and tense, arrive at maturity, whilst others are desiccating; the
herpetic spot has cleared off (eleventh day), [50]. ► When the scabs fall off from the scratched pustules they are
succeeded by pits, while they leave the others still elevated, so that the hand perceives a
roughness. Long after the scabs have gone their places are marked by a brownish
discoloration, like the coppery hue of syphilides (twelfth day), [50]. ► The redness diminishes,
and the desquamation continues to extend (fourteenth day), [50].
► Formation of pustules and almost general inflammation
of the walls of the abdomen, followed after several days by desquamation, [28]. ► Pustules thickly covering
the whole scrotum and face; the pustules on the side of the scrotum were flattened and
became suppurating ulcers; in other parts the pustules dried and desquamated, [35]. ► The whole abdomen, even
where the oil had not been applied, was covered with numerous small elevated pustules,
surrounded with bright-red areola, but without itching, and with no general symptoms (after
two hours); violent itching began in the night, disturbing sleep and causing general
discomfort; on the next morning the redness was less marked, and every pustule had a tip
somewhat paler than the skin around it; pressure upon the eruption was not painful, but
somewhat sensitive; gradually the pustules became pale, and disappeared, without crusts or
desquamation; on the eighth day only a few pale-red spots remained, not larger than a grain
of corn, [17]. ►
Slight redness, soon followed by burning; on the next morning, while lying in bed on the
left side, throbbing, tension, and frequent jerking in the left upper arm, extending to the
fingers; this spasmodic jerking involuntarily contracted the fingers; they noticed a large
number of large and small, isolated, red-pointed, and roundish pustules; the itching and
burning were worse on touch or motion, especially on rubbing with the hand; the arm and
shoulder felt heavy; the whole skin was slightly red; the place felt rough and uneven; the
small pustules disappeared as whitish, shiny, small elevations; the whole skin became
whitish; the large pustules remained red even after five days, when they gradually
diminished, with only a very slight whitish desquamation, only noticed when rubbing with the
hand, when a few small scales were found upon the hairs of the arm; an itching, which
provoked scratching, remained for some two weeks, and also an alternating sensation of
heaviness and tension in the upper arm, [18]. ► On the second day there was some itching in the place where
the oil had been rubbed, but the surrounding skin, even where the oil had not touched, was
still more red; an eruption of very numerous, isolated, large and small, dark-red pustules;
movement of the arm causes some itching and burning; touch, or uncovering the part, even in
the room, increased the painful burning and itching; the whole spot was elevated, uneven,
and rough; the small pustules disappeared after a few days, leaving a slight elevation of
the skin; the large ones remained for five days isolated and red, [18]. ► Herpetic eruption on the
scrotum (from rubbing it into the abdomen), [28]. ► Subjective. ► Itching
after half an hour, followed by painful burning, [28].
[740.] ► Prickling in
the lower third of the left lower leg, [14]. ► Prickling in the first toes of the right foot, [14]. ► Crawling in the lumbar
region, as from beetles, [6]. ►
Itching of the left upper lid, [14]. ► Itching on the right lower lid, [14]. ► Itching on the scrotum, [32]. ► Itching on the
left middle finger, and on the right ring finger, [14].
► Frequent itching, or rather smarting, as from vermin,
in the pubic region, and on the glans penis (second day), [30].
► Very troublesome irritating itching on the scrotum
(second day), [29]. ►
Prickling itching and burning on the sole of the right foot, [14].
[750.] ► Corrosive
itching on the scrotum, disturbing sleep, relieved by rubbing, which, however, caused
erections (third day), [29]. ►
Corrosive itching on the scrotum, and a moist, offensive spot on the thigh; these places
afterwards become dry and desquamate, [30].
SLEEP AND DREAMS.
► Sleepiness.
► Yawning, nearly the whole forenoon, [14]. ► Frequent yawning, [14]. ► Sleepiness, [13]. ► Sleepiness and
prostration, [18]. ►
Sleepiness towards noon, so that he wished to lie down; after lying down after dinner
inability to sleep, with some palpitation of the heart, [14].
► Great somnolence and weakness (from the effluvia), [49]. ► Almost
irresistible desire to sleep, [26]. ► Easy falling asleep, followed by chill, especially across the
back, [18]. [760.]
► Falling asleep from weariness, with numerous anxious
dreams, [13]. ►
After the vomiting, fell into a deep sleep which lasted four hours, [53]. ► Sleeplessness. ► Sleep uneasy, [12]. ► Sleep uneasy, with many dreams, [11]. ► Sleep very uneasy and full
of dreams, [18]. ►
Sleep light, disturbed by many dreams, [11]. ► Sleep, with sudden waking, although he was unable to remember
having a dream, [13]. ►
Night restless; full of dreams, [13]. ► Sleeps lying on the back, and sudden awaking after an
emission, [13]. ►
Dreams. ► Sleep very dreamy, [13]. [770.] ► Sleep disturbed by many dreams, [10]. ► Sleep, with heavy dreams,
till 1 o’clock at night, when she was suddenly awakened by violent headache, [13]. ► Night full of interrupted
dreams; he could not remember ever having passed such an anxious night before, [14]. ► Dreams about the
occurrences of the day, during the afternoon nap, [14].
FEVER.
► Chilliness.
► Surface cold, [40].
► Surface of the body cool, [33]. ► Skin cool, clammy, [39]. ► Chilliness and
shivering, [14]. ►
Chilliness, especially in the abdomen, [8]. ► In the afternoon chilliness obliged him to seek his bed,
where he did not get warm for a long time, [8]. [780.] ► Very transient
attacks of chilliness extending especially over the whole of the back, [13]. ► Easily chilled, [19]. ► Coldness,
especially of the lower extremities, so that she seemed covered with gooseflesh; she was
obliged to lie in bed in order to keep warm, [2]. ► Sensation of coldness, weakness, and prostration, [22]. ► Shivering all
over (in three hours and a half), [1]. ► Extremities cool, [22].
► Extremities cold, [63].
► *Coldness of the feet, extending as far up as the calves,
[14]. ► Feeling of
coldness in the abdomen, [14]. ►
Sudden coldness and paleness of the hands, with fingers very much shrivelled, [13]. [790.] ► Feet cold (after one hour and three-quarters), [60]. ► *Feet and legs cold
(after two hours and three-quarters), [60]. ► Extremities rather cold (after three-quarters of an hour), [60]. ► Heat. ► Increased temperature of the whole body, followed by
prickling-burning warm sensation, [14]. ► Warmth of body, especially of the face, [26]. ► Warmth over the whole
body, followed by feeling of coldness in the region of the abdominal vertebræ, [14]. ► Warmth of the
surface of the body, especially of the hands, which are usually cold, with remarkably
swollen and prominent veins, [13]. ► Generally increased warmth of the whole body, with slight
sweat, [13]. ►
Skin, at first cool, becomes warm, and afterwards always profuse transpiration, [33]. ► Increased
sensation of warmth through the whole body, [13]. [800.] ► Heat of the body, [12]. ► Heat and
sensation of anxiety, so that she sought for a chair, [6].
► Feeling of heat, with increased salivation, [46]. ► Flushes of heat, [12]. ► Hot and
perspiring, with pulse as high as 190 (after five hours and a half), [60]. ► Febrile symptoms, [36]. ► Feverish
condition (with the eruption of pustules), [28]. ► Creeping warmth in the parietes of the abdomen, [14]. ► Itching warmth in
the upper third of the right tibia, [14]. ► Heat of the face, [13].
[810.] ► Slight
febrile excitement across the whole upper abdomen, [13].
► Burning in the cheeks, [14].
► Sweat. ►
Sweat, [15]. ► Skin
moist (one case), (after eighteen hours), [55]. ► Sweat on the forehead, [24].
► Sweat stood in drops on the forehead, and she thought
she was unable to go to the house on account of the nausea, [2].
CONDITIONS.
► Aggravation.
► (Morning),
Immediately on rising, confusion of the head; on waking, head heavy, etc.; after rising,
pain in abdomen, etc.; in bed, urging to stool; cough; on rising, weakness, etc.; on waking,
weariness, etc. ► (Forenoon),
Pressure in stomach. ► (Noon),
Pains in head; pain in elbow; while sleeping, twitching of legs. ►
(Afternoon), Eructations; stitches through left chest;
palpitation of heart; sticking in kidney region; chilliness. ►
(Evening), Lips dry, etc.; bilious eructations; sticking
in spleen, colic below navel; passage of flatus; colic; mucus in larynx; cough, etc.; oppression of chest; drawing above wrist; heaviness, etc. ► (Midnight), Fulness,
etc.; at stomach. ► (After
midnight), On waking, heaviness in thighs. ► (Open air), Confusion of head; vertigo,
etc.; nausea, etc. ► (Ascending
stairs), Dyspnœa. ► (Beer
with bread), Pains in forehead, etc. ► (Bending body), Pain within anus. ►
(After bread and butter), Sick feeling. ► (On coughing), Soreness
in abdomen. ► (After dinner),
Pains in head; heartburn, etc.; griping; especially when lying down, palpitation;
discomfort. ► (While eating),
Tearing in abdomen. ► (After
eating), Symptoms always aggravated; colic. ► (During expiration),
Scraping in throat; burning in fauces. ► (Walking), Sticking in forehead; pains in abdomen, etc.; colic;
stitches in anus; pains in great toe. ► (During inspiration), Sticking in chest. ►
(Deep inspiration), Pains in walls of abdomen. ► (Looking up), Vertigo. ► (Lying), Pain causing
nausea. ► (After milk),
Nausea, etc. ► (After moving
about), Pain in anus. ► (On going out), Twinging, etc., in umbilicus. ► (Pressure), Pains in
walls of abdomen. ► (On rising
and while rising), Rumbling in intestines, etc. ►
(In room), Vision vanishes, etc. ►
(While sitting), Desire to pass flatus; tension, etc.,
pains in upper abdomen; sticking on margin of foot; jerking in foot. ►
(Sitting with abdomen bent over), Pain in umbilical
region. ► (Before every stool),
Griping in colon. ► (After stool),
Scraping in anus. ► (Touch),
Griping in intestines. ► Amelioration. ► (Eating gruel), Pains in
abdomen. ► (Inspiration),
Burning in fauces. ► (Rest),
Pain in forehead; pain within anus.
SUPPLEMENT: CROTON TIGLIUM.
Authorities.
64, M.
Andral, Gaz. Med. (Bost. Med. and Surg. Journ., vol. vi, 1832, p. 194), effect of
application to the skin of from 4 to 20 drops in more than thirty cases; 65, Dr. Maudezin, Gaz. des Hôp., 1869, p. 290, a child, æt. six
years, took all at once 3 grams of Croton oil in a cup of coffee; 66,
G. H. Snead, M.D., Rich. and Louis. Med. Journ., 1872, p. 651, Mrs. S. took two teaspoonfuls
of Croton oil mixed with two parts of sweet oil.►
The child was taken with the most acute pain in the
epigastric region, followed by violent, extremely profuse vomiting for three-quarters of an
hour. After this she fell into a profound sleep for a quarter of an hour, when she called
for food. She had no more pain in the epigastrium or abdomen, and had only two profuse
stools. Afterwards there was a fine vesicular eruption on the lips caused by contact of the
oil; in other respects the child seemed well, [65]. ► Burning sensation in stomach and bowels; rapid and drastic
purging (soon); pulse 150 and scarcely perceptible; entire surface bathed in cold, clammy
sweat; countenance sunken; copious watery choleraic dejections every few minutes (after two
hours), [66]. ► A
few hours after the friction (supposing this to have been employed for some minutes) the
patients experienced a smart tingling in the part. In some this sensation was transient; in
others prolonged, but never to such and extent as to produce troublesome nervous
disturbance; at the same time there appeared a great number of little red points, at the
apices of which there were soon perceptible little pustules which, within from thirty to
fifty hours, had become fully developed. Many of these became united, and there formed large
patches filled with white opaque fluid. The eruption increased for three or four days, after
which it remained stationary, and subsequently died away like small-pox. In some cases where
the oil was applied to the face the eruption was more copious and intense than else where. [64].® 2000
Article