NAJA.
NECK AND BACK.
►
Neck. [390.] ► Tired feel in the cervical and dorsal
vertebræ, with the peculiar burning often attendant on exhaustion, all
day (first day), [1]. ► Dull aching pains in nape of neck (after
second powder, sixth day), [10]. ► Cutting pains in nape of neck (fifth
day), [2]. ► Back. ►
Rheumatism all night in bed, which has not troubled me for six weeks,
feeling in middle of back as if bruised (first night); rheumatism of
shoulders again all night (second night); rheumatism (third night), [15]. ►
Dorsal. ► Pain between the
shoulders, as if in the spine, involving afterwards the scapulæ, [17b]. ►
Pains between the shoulders in the morning on waking, and continuing all
day (third day); the pain continues to get worse; it is aggravated by
moving the arms (fourth day); till yesterday it continued; it was worse
in moving the shoulder-blades, and felt like rheumatism of the muscles
of the scapula (seventh day); in the course of the afternoon, felt a
dull pain in the region of the spine between the shoulders, much the
same in kind and degree as on the fourth day (eighth day), [17a]. ►
In the course of the day, when busily occupied, my attention was
arrested by a heavy dragging sensation in spine between the shoulders;
it lasted about half an hour, and was very uneasy (first day), [17b]. ►
Lumbar. ► Weakness of
loins (third day), [15]. ► Slight pain in loins, in the morning
(fifth day), [19]. ► Pain in right lumbar region, similar to
what I have often felt after running a distance shortly after a meal,
somewhat like that caused by pressing on the testicle, with occasional
shootings; a similar feeling spread over the whole abdomen, and to right
groin, easier by bending forward (soon after second powder, third day), [10]. [400.]
► Severe aching contractive pain in
loins and abdomen on going to bed (third night), [10]. ► Aching
in loins (seventh day), [10]. ► Aching in loins, continuous for an hour,
and going on now (four hours and a half after second powder, fourth
day), [10]. ►
Acute pain in the small of the back, lasting for two or three hours, in
the evening (first day), [19]. ► Severe gnawing pain in lower part of
back, which kept me awake for some time; worse after going to bed (third
day), [19].
EXTREMITIES IN GENERAL.
► Felt sudden prostration of strength in limbs,
for a quarter of an hour, while walking in the evening (second day), [4]. ►
Occasional rheumatic-like pains in thighs and arms, and like those
yesterday, best marked in shoulder-joints, in the afternoon (second
day), [19]. ►
Awoke with aching in all parts of limbs; two hours after rising all
pains in limbs ceased, and a warm glow all over body succeeded
(thirteenth day), [12]. ► Awoke with the bruised sensation in limbs
before felt on the thirteenth day of former proving; all passed off in
course of an hour after rising (third day), [12a]. ► Dull
aching pains in ankle-joints, lower part of thighs, wrist-joints, and
shoulder-joints (after second powder, sixth day), [10]. [410.] ► Occasional shifting rheumatic-like
(drawing-aching) pains in arms, shoulders, and legs, worst on left side,
in the course of three hours (immediately after second powder, second
day), [10a]. ►
Right side, drawing, lacerating, for a few minutes at a time, in various
parts of limbs, worse by motion, then passing off altogether (first
day), [12].
SUPERIOR EXTREMITIES.
► Hand and arm of the same side began to
swell, and were even mottled (after a few minutes), [30]. ►
Complained of great aching all up the arm to the shoulder, all day
(first day), [2]. ► He felt instantly a sharp pain in the
part bitten, which soon spread on the palm and upwards on the arm; in
less than an hour the hand and wrist-bone considerably swelled, the pain
extended nearer the shoulder; the next morning the hand and arm were
monstrously swelled, and he complained of pain in the arm; the parts
about the punctures mortified first, the gangrene then spread over the
back and palm of the hand and part of the wrist, laying the tendons
bare, and forming an ulcer of considerable extent, which, however,
healed favorably under the usual treatment; it was several months before
he recovered the use of his hand, [25].
► Violent acute pain in bitten part,
which soon extended to top of arm (immediately), [21]. ► Shoulder.
► Shoulder painful (after one hour), [21]. ►
Rheumatism of shoulders, at night in bed, pain extending to fingers of
right hand (first night); slight rheumatism of shoulders (fourth day);
slight rheumatism, pains in bed (sixth day), [15a]. ►
Slight rheumatic pains in shoulders, for some time past (fifth night), [10]. ►
Rheumatic drawing in left shoulder, in the morning (third day), [1]. ►
Elbow. [420.] ► Severe drawing-shooting pain in left
elbow-joint, in the afternoon (second day), [10]. ► Wrist.
► Complained of burning pain in the
wrist; hung down his arm, from which a few drops of blood fell, [40]. ►
Hand. ► Hand and thumb
considerably swollen (after one hour), [21].
► Numb pain in hands, and sometimes a
feeling like as if ether had been dropped and allowed to evaporate
(after second powder, fourth day), [10].
► Crampy pains in palm of left hand
and numbness, and shifting rheumatic-like (aching pains), felt
especially in shoulder-joints; numbness in hands, as if “sleeping” (after nine hours and a half),
[10]. ►
Fingers. ► Slight aching
in fourth and little finger of right hand, followed in a quarter of an
hour by peculiar sensation as of thumbing (fouillement) in the middle of
triceps, left arm (after one hour and three-quarters), [1]. ► Most
acute pain under the nail of the left thumb; [Where the virus had
entered.] this pain also ran up the arm, [31].
INFERIOR EXTREMITIES.
► Began to stagger in walking (after twenty
minutes), [26]. ► After first dose, felt a dragging and
weariness in the limbs, while walking, with slight frontal headache,
which went off after the second dose, [6].
► Pressive and drawing sensations on
points in lower limbs and feet, several times (first day), [1]. ►
Thigh. [430.] ► Slight pain in the anterior part of right
thigh, which soon passed off (soon, first day), [17]. ► Slight
aching in the back part of thighs, in the afternoon, [1]. ► Leg.
► Slight vague pain about the muscles
of the calf of one leg (sixth day), [16].
► Painful drawing pain in lower part
of tendo Achillis, worse by motion (after half an hour), increased to a
lameness in a few hours, and passed off in evening, [12]. ► Shoots
down legs, and tingling in feet (eighth day), [4]. ► Foot.
► Chilblains have appeared on both
feet within the last three days, very painful, cannot suffer boots on;
have not had them before for three or four years (sixth day), [15].
GENERAL SYMPTOMS.
►
Objective. ► His body
became swollen, [36]. ► Slight local inflammation, [34]. ► He
appeared as if much intoxicated (after ten minutes), [28]. ►
Movements, apparently convulsive, of the mouth and of the limbs were
observed (after twenty minutes), [26].
[440.] ►
He moaned, grasped his throat with some eagerness of action, tossed his
head from side to side, and moved his arms and legs in an uneasy,
restless manner, not apparently convulsive (after thirty-five minutes), [26]. ►
Quite stiff and insensible, apparently dying, [33]. ► He
kept very quiet, staring at his drooping hand, [40]. ► He did
not get up, but remained where he had been sleeping, groaning,
complaining of slight pain in the arm bitten, but altogether unnaturally
quiet, [39]. ►
Considerable depression of mental and physical powers, anxious to do
very many things, but not inclined to move about them; feel inclined to
huddle up near the fire, and brood over one’s business (fourteenth and
fifteenth days), [12a]. ► During the whole day, depression of vital
energies to an unusual degree (first day), [17b]. ►
Languor (next morning), [25]. ► Languid and indifferent during the last
few days (ninth day); great languor (tenth and eleventh days), [9]. ►
Very languid, all morning (eight day), [13].
► He continued many days in a very
languid state, [24]. [450.] ►
Did not recover from the fatigue for some days, [23]. ► Unable
to support himself in a sitting posture (after thirty-five minutes), [26]. ►
One natural stool; he was then sufficiently conscious to attempt to it
on a pan, and he was supported by two men even during defecation, [40]. ►
She remained weakly eight or ten days, [22].
► Became weaker and weaker, and then
suddenly almost insensible; I found him perfectly insensible (second
night), [35]. ► Sudden prostration of strength, at night;
incapable of either mental or physical exertion for an hour, at 8.30
P.M., then passed off, and became as usual (second day), [12a]. ►
Rolled about as if very faint and weak, [31].
► She was suffering from a succession
of swooning fits, having already had eight (after two hours), [43]. ►
Every vital motion seemed at a stand, [23].
► Very little sign of life remained
(after a quarter of an hour), [24].
[460.] ►
Life to all appearance extinct, [27].
► Senselessness (after a few
minutes), [29]. ► Insensible (after ten minutes), [38]. ►
Insensible almost immediately, and never recovered, [42]. ►
Subjective. ► Began to
feel restless and fidgety, though I could assign no reason for it (had
entirely forgotten having taken the powder); felt as though there was a
necessity for my remaining at home, but could not comply with it; felt
extremely restless, in the afternoon (third day), [14b]. ►
Excessive sensitiveness to draught of air about head and face
(nineteenth day), [12]. ► Loss of the sense of feeling (after ten
hours), [27]. ► Torpor (after a few minutes), [29]. ►
Torpor and listlessness pervaded the whole system, and from the moment
of the bite had gradually increased (after ten hours), [22]. ►
Torpid, senseless state (after ten minutes), [28]. [470.] ► Four large punctures were visible on the
ankle, to which eau de luce being
applied, the man gave marks of sensibility by drawing up his leg (after
a quarter of an hour); totally without any sense of feeling whatever,
had it not been for a gentle heave of the breast every two or three
minutes I should have thought him dead (after three hours and a
quarter); he remained in this torpid state forty hours, and then began
to show signs of returning life, [24].
► Great desire for and power of
walking (tenth day); reaction (eleventh day), [4]. ►
Complains of a sensation of wasting away (fourth day), [18]. ►
Inclination to lie in the bed, in the morning, [7]. ► Feeling
of weariness (sixth day), [15];
(seventeenth day), [15b]; with
dull frontal headache (fourth day), [15].
► Feeling of prostration (twelfth,
fifteenth, and sixteenth days), [15a].
► Feeling of prostration and
restlessness (third day), [15b]. ► Felt peculiarly prostrate and miserable
in body and mind (sixth day), [13].
► Indefinable sensation of
alloverishness (sorte d’envahissement), with a lightness in the head
(entreprise générale), slight, lasting perhaps half an hour (first
day); the same alloverishness, lasting half an hour (immediately),
(third day), [1]. ► Felt “out of sorts,” without
any special complaint (after eleven days), [9]. [480.] ► General malaise (fifteenth day), [12]. ►
General feeling of being unwell, at 8 P.M. (sixth day), [11]. ►
Towards evening, complains of feeling generally very unwell, as though
about to have a fever (third day), [18].
► Felt the pain descend from the body
down the leg, till it ceased exactly at the spot where he was bitten, [33]. ►
He was sensible instantly of pain; pain had advanced from the toe as
high as the joint of the knee (after half an hour); it had got to the
top of his thigh and became much more severe (after forty minutes); soon
complained of severe pains in his belly, which, upon examination,
appeared tense and much swelled; after he had recovered a little, he
told me “he felt the pain descending retrograde in the same track
in which it had risen,” [23].
► He suffered intensely, and his life
was despaired of, [36]. ► Occasional crampy pains in the thighs and
shoulders and nape of neck (after second powder, fourth day), [10]. ►
Occasional dull shooting (stounding,
Scottice) in upper part of chest, in ankle-joints, and lower third of
thighs, not in the knee-joint (after second powder, third day), [10]. ►
Frequent cutting pains, shifting about, not lasting long anywhere
(fourth and fifth days), [18]. ► I had not walked a hundred yards before
all of sudden felt I felt just as if somebody had come behind me and
struck me a severe blow on the head and neck, and at the same time I
experienced a most acute pain and sense of oppression at the chest, as
though a hot iron had been run in and a hundred weight put on top of it;
soon I forgot everything for several minutes, and rolled about as if
very faint and weak; my face was of a greenish-yellow color; after
walking, or rather staggering, along for some minutes, I gradually
recovered my senses; I poured a large quantity of hartshorn into a
little water and drank it, instantly I felt relief from the pain at the
chest and head; after a second draught at the hartshorn bottle, I
proceeded on my way feeling very stupid and confused, afterwards I drank
four large wineglasses of brandy, but did not feel the least tipsy after
the operation; feeling nearly well I started on my way home, and then,
for the first time, I experienced a most acute pain under the nail of
the left thumb; this pain also ran up the arm, [31].
SKIN.
►
Objective. [490.] ► The bitten part on the left ankle bled
slightly, the part became dark, and the discoloration spread up the
limb, [37]. ►
The mark of the principal puncture on left upper arm remains livid yet,
and looks as if it would long do so (after nine months), [1]. ► Hand,
arm, and breast of the same side were much swelled, mottled, and of a
dark purple, and livid color (after ten minutes), [28]. ► On the
back of right hand were discovered two punctures, as if made by a
needle, about an inch and a half apart, marking the entrance of the
fangs; upon each puncture there was a drop of nearly colorless fluid,
without any hæmorrhage, tumefaction, or ecchymosis; the wound healed
kindly by granulation, [27]. ► A pimple on upper lip (second day);
pimple on left ala nasi (fifth day), [5].
► Appeared at breakfast with the
point of the nose decorated with small papules on a slightly inflamed
base; nose sore in consequence (second day); pimples going away from
nose (sixth day), [2]. ► A large painful pimple on the brow, [17b]. ►
Neck and body broke out in small white blisters, on an inflamed base;
very itchy, passing off in an hour, in the afternoon (fourth day), [6]. ►
A small boil-like swelling on back of middle phalanx of right hand
little finger (tenth day); fades in three days, [4]. ►
Gangrene of the back and palm of the hand, as well as of the thumb; the
tendons were laid bare, and a large ulcer formed, [21]. ►
Subjective. [500.] ► I think I have felt an itching on various
parts of the trunk, after going to bed, these two or three nights;
perhaps that may be owing to the Naja (sixth day), [16]. ►
Creeping itching in various parts of the body, from time to time,
requiring them to be scratched (four hours and a half after second
powder, fourth day), [10]. ► Slight pricking in the wound, [35]. ►
Fine tingling in legs and feet, while standing (soon), [1]. ► For
several days, itching and irritation in the cicatrix of an old ulcer up
to this day, when it ceases (eighth day), [4].
SLEEP AND DREAMS.
►
Sleepiness. ► Yawning and
lassitude with the headache (sixth day), [15].
► Frequent yawning (fourth day), [19]; (fourth and sixth day), [15]. ►
Frequent yawning (after two hours); occasional yawning still, very
unusual with me (after four hours), [10].
► Very drowsy, unusually so after
tea, slept for an hour; did not make any difference to my night’s rest
(second day), [14]. ► Strong disposition to doze (in less than
hour); from this time he himself was for several hours ignorant of what
had passed, but from the reports of those about him, he at times showed
much inquietude, without making any specific complaint; at other times
he lay moaning and dozing; in the morning he had perfectly recovered his
senses, [23]. [510.] ►
In the evening felt very tired and sleepy, and had to retire at 9
o’clock; slept directly after going to bed (first night), [20]. ► Strong
desire to sleep, and slept for a quarter of an hour, [23]. ► Almost
invincible desire to sleep, which after three hours’ hard walking,
accompanied by profuse perspiration, gradually wore off, [34]. ►
Sleeplessness. ► Little
inclination for sleep; the brain appeared irritable (tenth night), [4]. ►
Have not slept well during the night (fifth night), [15]. ► Slept
ill in the first part of the night, and had a pretty severe headache
(fourteenth night), [19a]. ► Sleep broken and disturbed, during the
week (after three days), [1]. ► Restless night (sixth night), [13]. ►
Passed a wakeful night, very uncommon with me, and know no reason for
it; dreams vivid, waking up very frequently, with very dry mouth; did not feel ill, but the mind
would work constantly and actively; the body not restless (first night);
did not feel fatigued as after an ordinary bad night (second day), [13]. ►
Dreams. ► Dreams during
night (sixteenth day), [15a]. [520.] ►
Many dreams, not disagreeable (sixth night), [19a]. ► Long
and vivid dreaming at night, little recollection of subjects (sixteenth
day), [12]. ►
A vivid dreamy night; subject, affairs of the day vividly recalled, with
additions, and new plans for the morrow (third night), [12a]. ►
Dreams of murders, suicides, fires, etc. (twelfth day), [15a].
FEVER.
►
Chilliness. ► Her body was
cold and collapsed, [27]. ► Very chilly, from 6 to 8 P.M., could not
stay away from the fire, felt better after that (sixth day), [3]. ►
Chills and partial heats, at 8 P.M.; considerable fever with partial
chills, at 11 P.M. (sixth day), [11].
► Feels very cold and uncomfortable
(second day), [18]. ► Feel starved, cold, and miserable; glad
to huddle into bed; offended with the least draft of air (sixteenth
day), [12a]. ►
Extremities cold and corpselike up to upper part of his thighs and
arm-pits (second night), [35]. [530.] ►
Chilly creeping over left foot and leg (after second powder, fourth
day), [10]. ►
Feet and legs cold, hands hot (ninth day), [12a]. ► Great
coldness of the extremities, particularly the hands (seventh day), [11b]. ►
Feet very cold all day, unusually so (fourteenth and fifteenth days), [12a]. ►
Feet very cold and easily chilled, usually very warm; frequent
inclination to move the legs, stamp, etc., to keep up circulation
(seventh day); feet very cold (eighth day), [12a]. ► Very
cold feet on going to bed, though I had been sitting in a warm room
(second day); cold feet (after one hour and a half, third morning), [13]. ►
Extreme coldness of the feet (sixth day); coldness of the feet, with
aching at the vertex (eighth day), [11b].
► Icy coldness of the left arm and
back of hand, cannot keep it warm (eighth day): the coldness affects all
the left side, despite all the care to keep it protected; it is rather
peculiar, for though the skin feels icy cold to the touch, there is no
numbness or stiffness in the joints affected (ninth day); towards night
the coldness shifted to the right side, retained the same character, was
so bad at night as to hinder sleep for some time (tenth day); symptom
mitigated (eleventh day); this peculiar coldness is seldom felt now
(twenty-ninth day), [12b]. ► Heat. ►
Hot skin and pain in a small encysted tumor over the upper part of left
acromion process, like the pain in a finger which has been suppurating
and is healing (first day), [19]. ► He said he felt heated, but refused water
before he became insensible, [38].
► Feels uncomfortable and feverish;
lips dry, mouth tender and hot (sixth day), [18]. ► Very
feverish and prostrate; appears to frequently lose all power of using
the limbs; unable often to make the least effort some minutes form sheer
sense of exhaustion (seventh and eighth days), [18]. ► Heat
in head (third day), [18]. ► Head hot, and full of blood (seventh and
eighth days), [18]. ► Hands hot, and much perspiration in the
palms (seventeenth day), [12]. ► Great heat of palm of hands, and body
generally warm (fourteenth day), [12].
► Burning heat in the face at
different times during the day, without any apparent cause (unusual),
with flushing (second day), [19]. ► Burning heat in the face, especially on
the left side with slight flushing (after second powder, fourth day), [19]. ►
Sweat. [540.] ► Free perspiration over the surface
generally (after thirty-five minutes), [26].
CONDITIONS.
►
Aggravation. ► (Morning), On waking, headache; eyelids puffy;
on waking, noise in ears; dryness of mouth; cough, etc. ► (Afternoon),
About 3 o’clock, headache. ► (Evening), Aching about chest. ► (Night),
Towards midnight, the symptoms, [21],
coryza; pain in face; hoarseness, etc.; after going to bed, itching. ► (After going to
bed), Pain in lower back. ►
(After dinner), Rumbling, etc., in bowels; griping in
abdomen. ► (After
eating), Pressure in stomach. ►
(Exertion), Aching across forehead. ► (Motion),
Aching across forehead; temporal headache; lacerating in limbs; drawing
in tendo Achillis. ► (Stimulants), The symptoms, [4]. ►
Amelioration. ► (Evening), Mental depression. ► (Open air),
Pains from temple to temple; temporal headache; nausea, etc. ► (Walking in open
air), All symptoms, [12];
aching across forehead. ► (Alcoholic liquors), Temporal headache. ► (Spirits of
ammonia), Pain, etc., at chest. ►
(Acid fruit), Nausea, etc. ► (Smoking),
Temporal headache.
SUPPLEMENT: NAJA.
Authorities.
46,
Fr. Seevwright, Lond. and Edinb. M. and S. J., March, 1842, p. 257, a
child, æt. four years, was bitten on the foot by a cobra manille; 47, Lancet, 1859 (2), p. 13, woman was bitten
on the arm by a cobra.►
Pulse imperceptible at the wrist,
ptosis and paralysis of the iris, with profuse diarrhœa; purple sordes
on the lips, gums, and tongue, [47].
► Breathing stertorous and difficult;
pupils slightly dilated; skin clammy and disagreeable cold; languid,
thready, and rapid pulse, [46].® 2000
Article