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UNDER INFLUENCE OF INFUSION OF FRESH ROOT PREPARED WITH TEX

PER CENT. OF ALCOHOL,

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The increase of P.,0, on the 2d is owing possibly to the eating of oatmeal on the forenoon of Sunday, also on the following morning.

Remarks concerning my first test of the 0 of the fresh roots.- Please notice that the drug was first taken on the evening of August 13th, 1877, just before retiring, and the amount of urine passed the day following (August 14th) was slightly increased over the average of the normal amount. The specific gravity less than the average, and the amount of urea increased. The second day under the influence of the drug there is increased amount of urine and a marked increase in the secretion of urea. The third day more marked increase in amount of urine passerl, and the amount of urea nearly the same as the second day. Also notice that on the morning of the third day (August 16th) I took the largest dose, and that dose was the last taken during this test. The day following August 17th), amount of urine less than during the three preceding days while taking drug; also a decrease in secretion of urea that day (August 17th). This same decrease was marked for some two days after.

Hence I conclude that during the three days while taking drug (August 14th, 15th, and 16th) the average amount of urine was increased; the specific gravity decreased, and the amount of urea also increased. And the observations during the two days following the stoppage of taking the drug show that

the amount of urine passed was decreased, the specific gravity increased, and the amount of urea decreased. The diarrhea continued through the 19th of same month, and the symptoms as depicted under stools in the proviny were very marked. When the normal stools were restored, the concomitant symptoms passed away. Since the disappearance of the diarrhea the stools are so large that they cause much pain in expulsion. They do not smell so badly as previous to taking the medicine.

Had a craving appetite; food seemed to taste very good.

For some two or three nights after taking the drug had profuse perspiration.

I also had much nausea, but not associated with much retching nor any vomiting during the whole time that I was under the influence of the drug.

Had more or less pain in the back.
Feeling of weakness in the rectum, sphincter muscles feel relaxed.

Remarks on second test with 0 of fresh roots.—Since taking this last time to date (September 28th, 1877), my bowels have moved twice almost every day. Stools normal and less fetid than before taking the drug. Have noticed considerable blood on waste paper quite a number of times. The muscles of anus feel relaxed. I have also felt bearing down in rectum as if going to have piles. Anus also feels as if open. Have also noticed more flatus than usual.

Much headache, especially in right temple, this was followed by vertigo and nausea.

Have had much pain in knee joints, and the lower extremities feel stiff.

Catching pains in heart, of a quick and sharp character. · Some palpitation.

Have lost four pounds since taking the medicine. Appetite exceedingly good and food relishes better.

I am inclined to think from the character of stools that the drug in some way influences the secretion of bile.

Remarks on the test with hot infusion of fresh roots with 10 per

cent, alcohol. - The head and heart symptoms gradually diminishing to date (October 15th, 1877), are not now perceptible. Since the primary action of the drug on the bowels has passed away, I have had three passages almost every day, something very unusual for me, as my normal condition is only one passage per day, and that in the morning. During these days of which I speak I would feel bloated in the abdomen, with slight pains as if fatus were moving in different parts of the abdomen; this would be followed immediately by an urgent desire for stool. This desire was so sudden and urgent that I would fear that an accident might befall me. I had no con: trol of sphincter ani muscle. These symptoms of stool always occurred immediately after eating. These stools were at times mushy, and at other times a little lumpy, associated with undigested food. These stools were painless, preceded by some pains of moving flatus, and followed by tenesmus and bearing down in rectum, even to protrusion. I have also noticed considerable itching in anus. After the stool a feeling of emptiness in abdomen and some protrusion ; also the characteristic pain in the right temple.

My appetite was never better than during this time.
Pain in joints, especially those of the knee, associated with sticking pains

in the inferior angle of the scapula ; the latter pains at times are dull and aching and last quite a long time.

Litile boils on face and thighs.

I will now state (January 30th, 1878) that my bowels are regular, with one passage per day. The heart symptoms have all passed away, and the pulse is regular and normal. The only sympton that seems to remain is weakness of ani muscles; they still feel relaxed.

APOMORPHINUM.

1

Authorities. 2, J. G. Blackley, M.B., Brit. Journ. of Hom., 1873, p. 497, injected 10 minims of 10 per cent. solution under the skin of the left arm; 3, same, injected to grain Hydrochlorate of apormorph., under the skin of the arm of William J., aged twenty-eight years ; 4, Dr. Jurasz, Deutsche Arch. für. Klin. Med., 1875, p. 52 ; 5, M. Chouppe, Gaz. Hubdom., Dec. 1874 (Lond. Med. Rev., vol. iii, p. 57), general effects; 6, Dr. Brochin, Gaz, des Hop., Jav. 16th (ibid., p. 58), effects of the hydrochlorate.

Pulse 76; temperature 98.3° (normal); feels giddy; complains of pressure at epigastrium; pulse 88, weak, but regular; pupils moderately dilated (in four minutes); began to vomit slightly (in five minutes); vomiting profusely, this continued for three minutes in six minutes); ceased vomiting; took a drink of water, which came up immediately; milk was rejected in like manner; pulse 80, weak; temperature 98.6° (in nine minutes); still feels very giddy, and looks pale; pupils dilated (in sixteen minutes ), ':--Pulse 72 ( before experiment); 80 (in five minutes); 65 (in twelve minutes); 70 (second day),'.—[10.] Temperature 98° (before experiment); 99.2° (in five minutes); 99.2 (in twelve minutes); 97.8' (second day),?--After three minutes the pulse began to rise slightly, and the respirations became slightly accelerated. At the end of four minutes I felt a sudden qualmishuess, which was almost immediately followed by nausea and profuse vomiting. This continued for several minutes, and was followed as soon as the contents of the stomach had been evacuated by severe retching. On taking a draught of water with a little brandy in it this was immediately rejected, and on drinking cold water this too returned at once. No bile, however, came up in the vomited matters. At the end of seven or eight minutes from the commencement of the experiment I began to feel very faint and was compelled to lie down, and almost on doing so fainted entirely, and remained in a state of syncope for about five minutes. On awaking from this I felt giddy and chilly, and was obliged to take a little brandy and water. This was retained, and as I begau to feel slightly drowsy, I remained lying for the space of about one hour, during which time I perspired profusely. On rising I still felt slight giddiness, but no inclination to vomit. I went to bed and slept soundly all night, awaking about 8 A.M., in my usual health, slightly pale, but very hungry,':- In two to seven minutes after the injection of a solution of í milligram under the skin the symptoms begin, usually with dulness of the head, sometimes described as a headache, sometimes as a simple heaviness or vertigo, often associated with roaring in the ears and feeling of heat. At times the patient is suddenly attacked by a feeling of anxiety in the præcordial region, or by a pressure in the chest. With the reaction there is generally an inclination to sleep, prostration, and loss of strength, and

VOL. X-21

in a few cases nausea and retching, beginning without warning. The relaxation during the prodromal state is at times very great, reminding one of collapse, frequently associated with profuse perspiration, salivation, and paleness, especially of the face. The vomiting comes on in from four to twenty-six minutes after the injection, usually in ten to fifteen minutes after a dose of 5 milligrams. Vomiting is very easy, without effort, or after the stomach has been emptied very difficult, and associated with eructations and retching. The vomiting will occur once or be repeated two to eight times, with greater or less intensity. Between the acts of vomiting the patient is usually quiet, feels very weak, yawns or perspires very freely. Sleepiness is frequently noted. The nausea continues, frequently associated with retching or eructations, and only ceases when there is no more to vomit. Between the acts of vomiting there is very great prostration and apathy. The whole stage of vomiting varies according to the frequency of the act and the length of intervals between the acts, lasting from one to fifty minutes. After the cessation of vomiting the synıptoms gradually disappear; restoration is slow, the patient feels nauseated for some time, and weak and sleepy,'.-It appears from many experiments that Apomorphia produces vomiting by what channel soever it reaches the organism, but that its effects are more prompt and more certain when it is introduced directly into the blood by intravenous or subcutaneous injection. It given by the mouth, the dose must be increased, and the effects are less certain. During the two or three minutes immediately following the injection, the patient does not feel anything. Soon a sensation of weight at the stomach, followed by a slight pain in the head, comes on. Then salivation becomes copious, the body is covered with perspiration, one or two efforts at vomiting without any result occur, and at the third, or more rarely the fourth effort, the patient vomits three or four times successfully; then comes a period of calm. The vomitings return after an interruption of five or six minutes, followed by another interval of calm, and the same scene is repeated five or six different times, to terminate definitely at the end of about half an hour, and to give place to a very quiet sleep, lasting from half an hour to an hour,'.- A woman, forty years of age, complained of gastric troubles without fever. After some days she was attacked by sore throat and complete anorexia. The tonsils were red and swollen and the tongue very much furred. A hypodermic injection of three or four milligrams of Hydrochlorate of apomorphia was administered to her in the sternal region. The pulse was full, and marked 100 beats. In four minutes the patient felt slight uneasiness and a little vertigo; she said she felt her head turning round and becoming stupid. She turned pale, became insensible, her pulse became extremely weak, intermittent, and then imperceptible; the pupils were dilated, and the respiration seemed to be entirely suspended. Slight tonic convulsions showed themselves in the left corner of the mouth and in the left cheek. The patient became inert and did not answer to the questions put to her. After spriukling with cold water, inhalations of ammonia, frictions, mustard poultices, etc., she recovered consciousness in three minutes and vomited twice, after which she again fainteil, became extremely pallid, and the pupils were alternately dilated and contracted; these symptoms were afterwards repeated,“.

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