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then š grain, daily. The burning sensation in the stomach became quite
The tongue showed in various places a dark-bluish color, and in the stomach there was a sensation of increased warmth and some nausea ; these symptoms disappeared after taking food. The stools and pulse were not affected. Some time after this, Schachert increased the doses to a grain, which he took an hour and a half after dinner. The burning in the throat was very severe. The tongue showed for several days a dirty-brown color. The warmth in the stomach increased to nausea and retching, without actual vomiting, and after a few hours gave place to a persistent, periodically aggravated sensation of compression in the stomach. Towards evening diarrhea set in, and continued during the next day, with relief of the pressure in the stomach. The evacuations seemed thin, but their color was normal. In addition to these sometimes there was a distressing dull headache, seated especially in the forehead, and associated with a certain prostration and restlessness. Changes in respiration, pulse, and secretion of urine were not marked. On the third day all the symptoms of the drug action had disappeared. Eight days afterwards Schachert took 11 grain in the morning fasting. He experienced nausea and efforts to vomit. He felt unwell through the day and suffered from dull headache.
Krahmer's experiments on himself, p. 119.-When I began my experiment I was quite well and strong, but afterwards was sick, and my stomach suffered for many days after I had discontinued the use of the silver; I frequently had heartburn, from which I had never before suffered, though these symptoms gradually disappeared. But in their place there soon appeared an almost uninterrupted neuralgic pain in the left infraorbital region, which for some moments became most terribly severe, and lasted with interruptious the whole following winter. At the same time the action of the heart became irregular, and the beats at times omitted, when I had a distinct disagreeable sensation in the chest. To this was added a constant sensation of faintness in the præcordial region. I found that on turning my attention to the action of the heart its irregularity became more marked, but on moving about freely the sensation at times entirely disappeared. Upon my disposition these symptoms had no effect. The paroxysms of anxiety at the heart were not associated with it. Physical movement was uninterrupted, only sudden violent muscular action, as for example, jumping or rapid running upstairs, or after emotional excitement, caused violent palpitation ; the disagreeable sensations were least marked in a horizontal position, and in the evening in bed. Sleep was rarely disturbed by palpitation. Towards the end of the winter the attacks diminished in intensity. Physical signs of anything abnormal about the heart were entirely wanting, as I was assured by an eminent medical friend. The next summer all morbid symptoms had entirely disappeared. That these changes in my condition were really the results of the silver I have no manner of doubt; there is no other explanation of them, and I make this communication in hope that my colleagues, who may have the opportunity to make similar observations, may be able to verify them.
In observing the action of silver I have endeavored as far as possible to pay attention not only to all the subjective, but also to all the objective symptoms; changes in the pulse, temperature, and character of the urine have been especially observed. Í lacked the proper apparatus to ascertain the amount of carbonic acid eliminated by respiration.
My average pulse in the morning after rising was 66; at noon, soon after returning from my visits, 72; and in the evening, ordinarly 68. A strict milk diet for more than two weeks had no effect upon the character of the pulse. My temperature is from 29.6° to 30° R. I examined the urine, keeping account of the total amount, specific gravity, amount of water, quautity of uric acid, urea, and incinerated salts.
In order to have correct data, I examined the urine from the 6th to the 19th of October. I rise at 6 A.M., breakfast on two cups of coffee, am busy reading or writing till 9, visit patients till 1, then take dinner; work till 5 in my office, make evening visits, take supper at 8, go to bed about 11. Noon and evening I usually drink a glass of beer or wine. From October 19th to November 6th, I kept a very strict regular diet ; took daily 2293.7 grams of fresh milk, and 418.5 grams of white bread.
October 26th, I took 0.1 grain crystals four times; 27th, same; 28th, 0.2 grain ; 29th, the same; 30th, 0.3 grain four times ; 31st, 0.4 grain four times; November 1st, 0.5 grain four times; 2d, 0.6 grain four times; 3d, 0.8 grain four times; 4th, 1 grain four times; 5th, 5 grain four times.
A consequence of the strict diet was that the stools, which are usually regular, were affected, so that October 21st, one was evacuated only after violent and painful effort, and on the 23d there was no voluntary stool. After several hours' effort to evacuate hard fæces, I took 1 ounce of castor oil. In the evening there was a hard painful stool, and the next morning a pasty stool. On the 25th, repeated the oil, and the night of the 25th and 26th, took in addition an extra 1 ounce of the oil. On the 28th again took oil, also on the 29th, and from the 29th to the 2d of November, I took daily a teaspoonful of castor oil, so that the stools continued without great difficulty. “After November 3d, I did not require the oil, because the large amount of silver nitrate kept the fæces soft. November 2d, my stomach began to suffer. At noon, after taking milk and bread, I experienced a pressing sensation of fulness in the epigastric region. November 3d, especially towards evening, the whole abdomen was very tense. November 4th, there was violent headache, and I could scarcely force myself to take the necessary amount of nourishment. The night was restless; I could not remain in bed after 4 o'clock. November 5th, I was still more averse to food, though the taste was natural and the tongue not coated. Through the day I had violent headache. The following night was very restless. I rose at 3 o'clock, and took nothing but a glass of milk before noon. The headache was very violent. In the afternoon, after passing the last quantity of urine for examination, I took two cups of strong black coffee, after which I felt quite relieved. Supper was relished, but the next day I could take but a very small quantity of food on account of heartburn. The action of the silver seemed to cause a sensation of satiety, and my stomach seemed to need less nourishment than in a state of health. In the morning I took : grain in a pill form with white sugar dry on the tongue. I immediately experienced a very bitter taste, followed by warmth in the tip of the tongue, then in the pharynx, after which these two symptoms seemed to alternate with each other. I drank a little distilled water, which was followed by slight eructations, and a sensation of catarrb in the fauces and larynx. At noon, before dinner, I dissolved my dose in a drachm of distilled water. I experienced a sweetish taste and feeling of warmth in the mouth. Three hours after dinner took 1 grain in distilled water. The sensations were the same as before, but perhaps more severe. The scraping sensation in the pharynx provoked hawking and coughing.
After a quarter of an hour I had a sensation of warmth between the scapulæ and sternum, which gradually became a pinching and slight pressure in the epigastric region. This was followed by tasteless eructations. The next morning I took 1 grain in water, and had only a very bitter taste. After ten minutes there was only very transient nausea.
The relation of the urea to the solid constituents in my case is somewhat less than the average given by Simon in his Handbook. I had an average of 26.3 per cent. of urea, perhaps dependent upou the peculiarity of my diet, which is generally vegetable. Under the effects of the milk diet this per cent. rose to 37.6, and the amount of uric acid became quite small, which during my ordinary diet was 0.6, but was now reduced to 0.045; the amount of solid constituents was not essentially changed by the silver, nor was the amount of urea perceptibly changed; the average was 33.5 per cent.; the whole amount daily excreted was 1.5 gram. Uric acid entirely disappeared from the urine under the influence of the silver. The amount of incinerated salts during the milk diet remained very constant. After several days' use of the silver it rose slightly. In the evening of November 6th, there was found 0.127 gram of pure silicic acid; so far as I know no analysis of urine has shown a like amount of silicic acid. No changes were noticed in the circulation or temperature. Silver was not found in the uripe.
“ARISTOLOCHIA COLOMBIANA.” So called by Higgins in his “Ophidians," is an unknown plant; it is not possible to identify it; hence the symptoms given by Dr. Higgins have no place in this work.
The same remark applies to "a proving” of Ampelopsis trifoliata, published recently in the Investigator.
Authorities. 40, J. Epps, M.D., Lancet, 1840-1 (2), p. 365, a lady applied the tincture to corns ; 41, Dr. Morrison, Month. Hom. Rev., 1873, p. 471, Miss 0. B., suffering from toothache, rubbed in some mother tincture; 42, 43, 44, Jas. C. White, M.D., Bost. Med. and Surg. Journ., vol. xcii, 1875, p. 61, cases of poisovous action of the tincture on the skin; 45, E. W. Berridge, U. S. Med. Invest., New Ser., vol. iv, 1876, p. 573, a boy took 200th (Lehrmann); 46, same, a boy, æt. nine years, a patient, took 1000th (Jen.); 47, J. Fayrer, M.D., Practitioner, vol. xvi, 1876, p. 52, effects of application of tincture; (48 to 58, A. Inbert Gourbeyre, M.D., Memoir on Arnica, addressed to the World's Hom. Con., at Philad., 1876); 48, Madame C. took two tablespoonfuls ; 49, a man, at sixty-nine years, fell five or six meters, and felt so bruised that he took a dose of a decoction of 30 grams of Arnica flowers in two glasses of water ; 50, Ferrand, Journ. de Chim. Med., Sept., 1869, a man, æt. thirty years, swallowed 15 grams of the tincture; 51, Ferrand, Journ. de Chim. Med., Sept., 1869, a woman took two cups of an infusion prepared with a pint of the flowers; 52, Berlin, Central f. d. Med. Wissen, Nov., 1874, a workman swallowed at one draught 60 to 80 cc. of the tincture, death in thirty-eight hours; 53, Beilt, Dict. des Sci. Med., 1812, a man was gorged with
a decoction of the flowers after a fall; 54, Guillemot, Etude sur les Prop. Physiol. et Therap. d l'Arnica, a student took 18 grams of alcoholic Arnica tinct. ; 55, Attomyr, Primeiner Naturg. der Krank., Wien, 1851, a man, æt. fifty years, rubbed his wounded hand and foot with a weak tincture ; 56, Blake, Month. Hom. Rev., Sept., 1874, Mrs. W., æt. fifty years, applied to her sprained ankle a cloth saturated with the pure tinčture; 57, an officer applied a compress of pure Arnica to a hydrarthrosis of the left knee; 58, effects on a patient; 59. Chas. W. Earle, M.D., Chicago Med. Journ. and Exam., vol. xxxv, 1877, p. 267, Mr. L. applied to a slight injury of the knee the tincture, which came in contact with other parts; 60, D. Dyce Brown, M.D., Month. Hom. Rev., vol. xxii, p. 171, a lady, æt. fifty-four years, had leucorrhea and then a bloody discharge, with all the sensations which used to accompany the period, took Arnica 3d, three or four times a day, and afterwards 200th; 61, R. S. Harnden, New Remedies, 1878, p. 357, a man applied the tincture to the stump of his arm, which had been amputated.
Loss of appetite at supper, for two successive days," --Immediately after drinking it she felt a burning pain in the throat, which persisted; five minutes afterward violent pain at the pit of the stomach, lasting a quarter of an hour; at the same time warmth and sweat, which obliged her to change her chemise. There was also some nausea. At the end of half an hour a small stool, with colic. After this painful cramp of the stomach, an almost irresistible desire to sleep followed. I arrived forty minutes after the accident. I found the patient in bed, face red, pulse frequent, skin hot, panting, complaining of nothing but sleepiness, 49 - Immediately seized with à violent burning in the stomach, followed by colics,62 - Feeling as if the abdomen were all slit down ; worse on stooping, 46. — The first effect was to make the toes itch dreadfully, keeping her from sleep the greater part of the night. The second effects, those which troubled her most, and were the most painful, presented themselves in the morning; the face was swollen and painful, the pain being smarting, particularly under the eyes ; there was great heat in the face; the patient presenting, be it remarked, the three characteristics of inflammation, swelling, pain, and heat. Besides these symptoms, blotches came out on the cheeks and the forehead, which, together with the swollen condition, did not disappear for three days, then leaving the face rough,“:— Erysipelas extending orer the left cheek, from under border of the lower maxilla to scalp, with intolerable irritation, and considerable constitutional disturbance," --Thursday I took four pilules of Arnica 3d, and three the next day. Towards evening my face ached. Next morning I felt very poorly, I took one pilule early, and another about 12 m., but my face got worse, and by evening I had every appearance of erysipelas, had to go to bed, cover it with flour, and take Bell, and Aconite diligently. During this time I felt extremely ill. I remained in bed till Monday morning, by which time the swelling had down, and I gradually got better. I have had erysipelas so often that I am always nervous about it. A few days later, after two globules of the 200th in one day, and one globule the next day, was from home from 9.15 A.M. to 4 P.M., in and out of shops. About an hour after I came in my face got hot and began to swell, but slightly. However, it was stiff and uncomfortable, so I took Aconite, and though I am still redder than usual and a little stiff
, I have had no other ill effect,®": -A gentleman, sixty-five years of age, slipped and scraped the lower part of his back, to which the tincture of Arnica was applied. In a short time a good deal of itching was felt in the back, which caused the parts to be rubbed vigorously. On examination the skin was found to be already greatly congested, and the
gone irritation of the parts increased during the day and night. On the next day the skin of the back, nearly to the shoulders, was in a state of active hyperæmia, and already covered with innumerable papules. The inflanmatory process spread rapidly downward nearly to the knees, and forwards upon the abdomen and genitals. In a few days these parts presented all the characteristic appearances of acute eczema in its various stages of progression ; general hyperæmia, papules, vesicles, excoriating and exuding surfaces, and crusts. The subjective symptoms were intense itching, stinging, and burning in these parts. Scarcely any clothing could be borne in contact with the skin by day, and sleep for a few nights was almost impossible, but the system generally was only slightly disturbed,“:—[920.] In the morning every part of the integument which had been touched with the Arnica was slightly red and swollen, erythematous (second day); swelling and redness increased, some fever (third day); vesicles between fingers and upon the left koee (fourth day); vesicles upon portions of all the integuments (except eyelids) with which the Arnica had come in contact, eczema (fifth day); eye nearly well ; integuments less swollen ; considerable itching and burning; pustules around the margins of the affected parts (sixth day); intense itching and burning, and itching of the thorax and abdomen. An examination showed a profuse redness or vascular congestion of the entire surface, and the presence of what Wilson would probably call eczema erythematosum (seventh day); eruption on body disappearing; crusts forming on legs; fingers nearly well (eighth to twelfth day); crusts clearing; pruritus disappearing; new skin looking healthy (thirteenth to fifteenth day),59-A gentleman, sixty years old, applied to his right arm above the elbow a fomentation of tincture of Arvica on two successive days. The part became generally reddened and swollen in a few days, and the day after the applications were made he consulted me. The arm from the elbow to the shoulder was considerably swollen, of a vivid redness, and covered over the lower half of this district with a very thick eruption of papules, many of which were already partially converted into pimples. Great itching and burning was felt in the part, which gradually ceased as the inflammation subsided. The efflorescence under treatment did not progress to the vesicular stage, and the skin returned to its normal state in ten or fourteen days subsequently,“ — Arm began to swell and break out with little papules, then with vesicles, and finally to become excoriated. The whole arm became intensely red; the swelling, itching, and burning, accompanied with pain, being very great, and the discharge of serum constant from the excoriated surface, 61. —Swelling followed a strained wrist, to which was applied Arnica; a vesicular erysipelas of the whole arm followed, lasting three weeks. A year after he had erysipelas of the leg, after applying Arnica to an excoriation. He used a gargle of 15 or 20 drops of the tincture to a glass of water for toothache; the mouth and lips became inflamed; a severe erysipelas of the face followed, which lasted ten days, ---To a sprained wrist I applied a weak solution of tincture of Arpica. In a few days a few small papules appeared on the skin, but they quickly disappeared, and the surface seemed sound. About six days later I came in contact with a nettle, which stung the wrist very slightly. On the same evening violent irritation of the part set in, and the skin of the wrist and forearm, exactly corresponding to the early application of the tincture, became hot, painful, and affected with an intolerable itching and burning sensation. The following day it was much worse. The skin was much inflamed, and the pain extended up the arm