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vomiting (after three hours and a half). No depression, except during the act of vomiting.
Second series of observations, including 90 cases, 30 children and 60 adults.Vomiting is always the first sign of action ; this is not attended by any depression at all comparable with that caused by tartar emetic or ipecacuanha; in children, as well as in adults, the acts of vomiting varied between none in three out of the whole number and six in two out of the whole number; they were usually two or three; very often only one; the nausea continues more or less markedly until the bowels recover.
The action on the bowels is variable, from none in a few cases to nine or ten in equally few cases ; most often the range was between three and seven ; there is no griping pain ; the motions are very watery, and of such a brown color as suggests its origin with the powder taken; if the vomiting be very early, then the purgation, although marked by a fluid stool or stools, will certainly not be violent; and in some cases, in which there was no vomiting, the bowels acted very freely; it does not always happen so, however, under the same condition; and I conclude, therefore, that some persons can take a larger dose than others.
A dose of six grains produces scarcely any effect upon children of twelve, eleven, ten, or nine years; upon children of eight and six years, the effect is uncertain ; upon children of from five years down to five weeks, it is certain to operate; but the time which elapses before its action is manifested may vary between ten minutes and nine, even twelve, hours; the effect of the same quantity is not increased as the age of the child is diminished. Thus, three children of five weeks, of three years, and of six years, respectively, were affected by the six-grain dose to the same degree.) 'I am not able to say upon what this peculiarity depends, but the intervention of sleep delays the manifestation of any effect, and was the cause of delay in the two cases in which alone so long intervals as nine and twelve hours elapsed. A scruple is a moderate dose for an adult; the interval which elapses before it begins to operate may be so long as five hours; but, if the dose be well adapted to the individual, that is quite exceptional; four hours is a pretty frequent interval, but two hours or less is the most common interval; it may be so short as fifteen minutes, but is seldom shorter than thirty. I conclude that Chrysarobin is, in a dose of twenty-five grains for adults or of six or more grains for children, an emetic purge, of which the action is unattended by any inconvenient symptoms.
Observations of Chrysophanic acid upon 116 persons, of all ages, and both sexes. The action of Chrysophanic acid is similar to the action of Chrysarobin, with this difference, that while in a suitable dose each will cause vomiting and purging, if the dose be too small Chrysarobin is most likely to purge alone, while Chrysophanic acid is most likely to cause vomiting only. A larger full dose, that is to say, from fifteen to twenty grains, will always both vomit and purge the patient very freely, at the same time that it causes an inconvenient amount of either of those effects very rarely indeed. Farther, there is but little danger of inconvenience from too large a dose.
The dose of Chrysophanic acid.-In this case, as in that of Chrysa robin, I observe first of all, with a quantity which acts well upon a child of five or six years of age, no increase in effect is observed with the same dose
upon the very youngest children ; yet farther, of Chrysophanic acid I am obliged to say what does not hold good of Chrysarobin, that on children of less than four or five years its action is uncertain, in that it sometimes fails to act entirely, or acts very feebly, or most often of all causes vomiting only; it never acts upon them with unexpected violence. I have found that six grains of Chrysophanic acid is a good dose for children of ten years and under. For adults, I find the action of the acid certain in a dose of fifteen grains ; upon some adults I have found ten and even eight grains act as often as fifteen grains upon other adults apparently of similar physique; and agaiu I have found some, but very few, who demand as much as a scruple for the manifestation of a reasonably brisk action.
Of Chrysophanic acid I have observed this effect: whatever the condition of the patient, it causes the evacuation, one way or the other, of large quantities of bile.
Fourth series of observations.-I made ten observations on adults with the resin of Chrysarobin, made into pills with Tragacanth and Glycerin. One grain had no effect upon two individuals; in three cases three-grain doses caused vomiting from twice to five times, and purging from five to seven times; in one case, two grains were taken by a man, aged twenty years, instead of four as was intended ; iu six hours, the bowels began to act, and then they acted very loosely three or four times; there was po vomiting, but considerable nausea, which lasted for eighteen hours; in the remaining four cases, four grains were taken for a dose; and this in every case acted within two hours, in one within half an hour, vomiting being the first sign, and purging very quickly ensuing; in three of these cases the acts of vomiting were three to five; of purging from five to ten ; in the fourth, a stout woman, fairly strong, and the subject of habitual constipation, the vomiting and purging were continued during five or six hours, with very small intervals ; she was suffering from neuralgia, which I bad traced to the state of the bowels, and it disappeared during this violent action; the sickness, except in the last case, was not said to be attended with much depression. It will thus be seen that the resin of Chrysarobin is identical with that of the crude powder and of Chrysophanic acid, but very much more powerful.
If a dose of Chrysophanic acid be taken, and immediately followed by a meal, its action will be considerably delayed; if it be taken after a meal, its action will be delayed in proportion (more or less) to the progress which has been made with digestion; if it be taken upon an empty stomach, its action is manifested quickly; there seems reason to believe that fulness of the stomach, or the consequent delay in action, determines its effects to the bowels, without in all cases obviously diminishing its emetic power; but emptiness of the stomach does determine it rather to emetic action, and does also diminish its purgative action, notwithstanding that, except in the case of babies, the latter is never entirely absent.
From these 319 cases I conclude that Chrysophanic acid is an emetic purge; its action is as certain, when given in appropriate dose, as that of any other drug which acts in either of these ways; if either kind of action should be wanting, on account of the dose having been too small, it is the purging which will fail to appear; but that is rare.
CICHORIUM. Authority. 2, J. W. Slater, Lancet, 1855 (2), p. 379, effect on a young man from roasting chicory.
Unable to read at night, not from an outward irritation, but, as he phrased it, from a feeling of “deadness" in the eyes,'.
CICUTA MACULATA, Authorities. 4, G. W. Wright, Bost. Med. Intelligencer, vol. ii, 1825, p. 171, poisoning of a youth ; 5," W.," Bost. Med. and Surg. Journ., vol. x, 1834, p. 107, a man chewed and swallowed about 15 grains of the green root; 6, Dr. John Stock bridge, New Eng. Journ. of Med. and Surg., vol. iii, p. 334, a boy, æt. fifteen years, ate about 1 drachm of the root; 7, same, a boy, æt. seven years, ate about į drachm of root; 8, a boy, æt. five years, ate about the same quantity; 9, G. W. Norman, M.D., Virginia Med. Month., fatal poisoning of a young man, æt. seventeen years, by the root.
Mind.-Delirium (after half an hour), -[30.] Entirely insensible, Head.-Began to feel queer about the head (after half an hour),".
Eye-Eyes glassy and wandering,':- Pupils dilated,"':-Pupils were greatly dilated, and did not contract when a candle was presented, 9.-Pupils dilated and inseusible,'.-Eyes too sensible to light (after half an hour),"
Face.-Countenance pale,': - Deathly paleness, resembling that of a drowned person,'.-Jaws locked,'.
Mouth.-[40.] Frothing at the mouth,'.
Throat.- Muscles of deglutition spasmodically affected, on presenting any substance to the mouth,'.
Stomach. - Nausea and vomiting,. – Vomiting, ** 8.-Sick at the stomach (after one hour),':-Vomiting several times,' - Ejections of frothy mucus, mixed with a dark flocculent sediment and blood," -Every few minutes he complained of a sensation of universal distress, with oppression of the stomach,
Stool.-Inclination to stool,
Pulse.-[50.] Pulse hardly perceptible,':-Pulse very feeble, 65,'.— Pulse 50 to the minute,':- The pulse was almost, and at times quite imperceptible,®. -Pulse before the convulsion 51, and of the ordinary strength, afterwards weak; could not be felt during the convulsion,'.
Generalities.-Frequent twitching of the muscles of the body and extremities,". - Constant jactitation,'.-Antagonizing muscles alternately convulsed, drawing the eyes and angles of the mouth right and left, in quick succession,':-Convulsions,':-Violent convulsive fits, with frothing at the mouth, which continued for about an hour and a half, when he died, [60.] Convulsion of a decidedly epileptic kind, lasting four or five minutes, marked by frothing at the mouth, distorted, livid countenance, and short spasms of all the muscles (after half an hour),'.-Several convulsions at intervals of ten or fifteen minutes,".
Sleep.--Inclination to sleep,'.-During the intervals of vomiting he lay iu a deep sleep,*.
Fever.--Whole body and extremities cold,.-Extremities cold,'.
Authority. 21, Inaug. Thesis, presented to Hom. Med. Coll. of Penna., 1853, by Franklin Bigelow.
The tincture used in the following provings was made from the dried root gathered in the spring.
First Prover.-Mr. F. B., aged twenty-five years.
At 10 A.M., next day, a dull oppressive headache came on; pain principally in the forehead, extending along over the vertex down to the occiput. In the whole forehead the pain is very severe. On walking out into the open air, pains in the muscles of the lower limbs as from great fatigue; felt more particularly in the anterior parts of the thighs. Great disposition to yawn. Inclined to drowse much. Sleep disturbed by dreams of accidents, seeing limbs broken, great suffering, etc.
On the following morning awoke at 3 o'clock, with severe cutting pains and great uneasiness in the lower part of the abdomen (hypogastric region), with urgent desire to go to stool. Stool very thin and partly undigested. Great uneasiness in the bowels all the forenoon, without much desire to go to stool, but a sensation as though I should be obliged to soon. Next morning awoke at 3 o'clock, with diarrhoea of thin undigested character. Pain low down in the bowels. Diarrhæa continued through the day; stools, once in four or five hours.
Next day no perceptible symptoms remained except a feeling of weakness and languor.
Second Proving.–October 7th, 11 A.m. Took 100 drops of the 1st atten. (5 to 95). Great nausea and disposition to vomit for two hours after taking it. Very sleepy during the forepart of the evening. Slept well till 3 o'clock in the morning; very restless the remainder of the night.
October 8th. At 6 A.M., dull oppressive headache came on, extending from the forehead over the vertex to the occiput; violent pain in the whole forehead; pain dull, with a sense of heaviness. Great dizziness. Constant disposition to yawn. Occasional shooting pains about the sides of the bead, in the region of ideality and sublimity. Pulse rather accelerated. Feeling of great prostration of whole system. Appetite poor. Limbs feel excessively fatigued. Forehead dry and hot. Pains in head partially relieved by throwing head backward. At times very chilly over the entire body. Continually stretching and yawning. Great uneasiness and oppression in the epigastrium. Stomach feels greatly oppressed. On attempting to read immediately go to sleep. Disposed to get angry easily. Rather melancholy. Symptoms nearly all subsided by 2 P.M. In the evening great pain in lower part of bowels, with great fulness of the abdomen. Sensation as though diarrhoea would come on. Very bitter and disagreeable taste in mouth. Very drowsy and sleepy. Slept well till 3 A.M., after that time very restless. This symptom appeared regularly every morning for two weeks.
Second, third, and fourth days after 3 A.M., each day, pain in lower part of bowels, with diarrhæa of a thin, undigested character, lightish-colored. Pains in the head grew less and less severe for three or four days, and gradually subsided by the fifth. Upper lip very much swollen and inflamed for eight days. Skin cracked and came off. A small ulcer on each cheek, near the centre; very much inflamed for several days, bleeding almost constantly. Eruption, on the hands and wrists principally, resembling mosquito bites.
Second Prover.-Mr. E. H. B., aged twenty-four years.
September 29th, 1852. Took 20 drops of the tincture at 9 A.M.. One hour after, fluent coryza with violent tickling in the nares, which excited sneezing, going off in about half an hour. Great drowsiness after dinner. Weakness of the knee-joints, preceded by unnatural warmth in the feet. Weakness in the lower limbs. When walking, have to proceed with great cautiousness for fear of falling. General feeling of intoxication. Dull, heavy rheumatic pains in the upper posterior region of the neck. Tearing in the centre of the vertex, in a spot about the size of a silver dollar. Jerking in the muscles of the left thigh, more particularly in the region of the inferior third. Cold feeling of the left thigh and knee, as though a cold breeze were blowing on them. Stitching pain as of fine needles in the region of the heart, accompanied with slight twitching or pulsation in the external muscles of that region. Slight palpitation of the heart. Sleep imperfect; waking at midnight. General burning and itching of the skin after rising in the morning, continuing half an hour.
Third Prover.—Mr. E. P. G., aged eighteen years. September 29th. Took 20 drops of the tincture at 10 A.M. Soon after taking it, burning in the stomach and excessively bitter taste in the mouth. Half an hour after, felt a sensation of rawness in the throat, as from excoriation. One hour after, dull pain in the forehead and ears.
Third day, early in the morning, pain in the bowels, with thin, lightbrown diarrhea, which came on in like manner for three or four days. Eruption on the skin like mosquito-bites, a.
CINA. Authorities. 14, Mauthner, Journ. Kinderkrankheiten, 22, 1854, p. 1, a boy, aged six years, took 1) drachms; 15, M. Caravasse, Bost. Med. and Surg. Journ., vol. lxv, 1862, p. 126 (London Lancet), a nervous woman, believing that she suffered from worms, took a drachm of wormseed, semen contra ; 16, Drs. Burdick and Lilienthal, N. A. J. of Hom., 14, 139 (Hom. World, vol. xii, 1877, 441), fatal case of poisoning with Santonin lozenges, in a girl, aged five years; she took about 6 grains in divided doses.
Mind.-Consciousness clear when awake, but during her restless sleep delirious, 6.
Eye.-Chancing to look in the glass, she distinctly saw herself peagreen,'*. --Complains of seeing things yellow,'6.
Mouth.-Tongue deep red, without coating,'6.
Stomach. - Continual thirst for ice-water, which she swallowed greedily,'. - Vomiting of yellowish slimy mucus set in at 11 P.m., and continued till forenoon; purging of watery, flaky, foul-smelling stools every ten to fifteen minutes. Abdomen very sensitive, the child complaining of a dull pain in the pit of the stomach. In the evening we found ihe abdomen somewbat tumid, but soft,
Urinary Organs. – Urine saffron-yellow, containing flakes of mucus, -[330.] Urine orange-colored,"