Kali iodatum

 Potassium iodide. Preparation: Triturations.

 He suffered from a painful sensation of heat in his feet; in a few days this increased, and was accompanied by a trembling of the limbs and feeling of intoxication; his movements were uncertain from a tottering of his lower extremities; there were vertigo, dulness of the eyes, feeble, and often double vision, with a sensation of turning round. All these phenomena persisted for several weeks. Shortly after, the power of moving his lips and cheeks was lost, and he was unable to masticate. He had also vague feelings in the head, back, and limbs, which he could not describe. A day or two afterwards his gait was still faltering, with vertigo and feeble vision; the countenance was that of a drunkard; speech thick and indistinct; eyes apparently protruded, and a loss of appetite. In a paper contributed to the Revue Mensuelle de Medorrhinum et de сhir., September, 1877, Prof. A. Fournier, of the St. Louis Hospital, observes that while among the numerous and various phenomena which may follow the ingestion of Iodide of potassium, there are some which are of common occurrence and well known; there are others which have either escaped attention, or have only been imperfectly described. Among these may be ranged, he believes, a cutaneous affection, consisting in the production of small miliary, non- pruriginous, sanguineous spots, proceeding after the manner of purpura, and to which he proposes to give the name of iodic purpura, or petechial iodism. That the appearance of the exanthem, and the taking of the Iodide are not a mere coincidence, he concludes from the following observations: 1. In all cases the purpura has appeared a very short time (from one to six day) after commencing the Iodide. 2. In some of the patients the same purpuric eruption has been produced several times after each new administration of the Iodide, and in three of these it occurred every time the medicine was used. Two cases are detailed in which this was the case three or four times. 3. In another case in which the purpura was produced on three successive occasions, it was found in all these that whenever the dose was notably increased, a marked aggravation or additional production of the eruption ensued. As to the characteristics of this eruption, in all the patients the well-known appearances of purpura, and the impossibility of effacing them by pressure with the finger, were distinctly present, the petechial color due to extravasation being very obvious The seat of the eruption, with one exception (when it was on the thorax, and that only), was in all the cases on the legs only, being always more confluent on their anterior than on their posterior part. It never descended to the foot, or extended beyond the knee. This purpura seems to assume an eminently discrete form, few spots being usually observed, about a hundred of these on each limb constituting the maximum of confluence, fifty or sixty, or even less, being the number usually observed. On the successive appearances the purpuric spots are even yet fewer in number. This rarity of confluence, and the especial localization of the exanthem about the anterior tibial region, impart to this variety of purpuric affection a somewhat peculiar physiognomy of its own. It is always a miliary purpura, that is, a petechial eruption of the smallest extent, resembling in size a millet- seed, the head of a pin, or at most, and that rarely, a grain of corn, or a small lentil. The spots are usually of a regular rounded form, and less often oval or irregular in form, and notched. The eruption never advances beyond this petechial and miliary condition. The spots are quite level with the skin, seemingly incorporated with the integument, the appearance of which they only modify by their bright color. Like as in purpura vulgaris, these spots give rise to neither local nor constitutional disturbance, inducing neither heat, pain nor pruritus. Thus there is a great chance of this eruption passing unperceived, and it is always by accident that the patient have observed its existence, while undressing at the bath., so that many cases have no doubt escaped the notice of patients and their attendants. The eruption comes on at an early period of the iodic treatment, and has completed its course in two or three days, at the end of which period it ceases to increase in confluence, even when the use of the medicine is continued. It remains for a certain time in the condition of purpurin petechiae, after which the spots undergo the ordinary changes of color observed in cutaneous hemorrhages, finally disappearing at the end of two or three weeks. When under the influence of a large dose of the Iodide, a new purpuric outbreak is produced; the intruding eruption is easily distinguished from that which has preceded it by the bright purpurin color of its spots, contrasting with the faded condition of the prior spots. It has a curious appearance, this intermixture in the same locality of petechiae of different ages, with difference of color corresponding to the period of their appearance. This purpura is certainly a rare accident, or rather phenomenon, for there are few remedies which are more employed than the Iodide of potassium; and if iodic purpura were not almost an exceptional occurrence, it must have attracted the attention of observers. Professor Fournier, who, during the few years since he first became aware of its existence, has carefully sought for it, has not met with more than some fifteen cases. All the subjects of the affection hitherto met with enjoyed either a flourishing or a medium condition of health; and although some of them seemed affected with a certain degree of lymphatism, none could be said to suffer from anemia or scrofula, and none had presented anterior hemorrhagic proclivities. Any of these who were the subjects of syphilis exhibited only benign or medium forms of this, two-thirds of the cases being exempt from any specific manifestation of this disease at the time when the Iodide, which, in fact, was administered only as a preventive, produced the purpuric eruption. Further, in a negative point of view, neither sex, age, occupation, nor external temperature seemed to have exerted any influence. Nor can the eruption be attributed to excess of dose, since most of these patients had not taken more than 15 grains of the Iodide when the eruption had manifested itself. Still, quantity is not a matter of indifference, for when a given dose has been followed by purpura, a kind of tolerance of the remedy seems to be established, and no further manifestation ensues. вut let the dose be much increased, doubled, for example, and a new outbreak of purpura may be immediately produced, for example, and a new outbreak of purpura may be immediately produced, although this is less confluent and less important than that which preceded it. вut it is probably the individual predisposition which predominates over all the etiology, for however unknown and impenetrable in their nature, the existence of idiosyncrasies in regard to the action of certain remedies and articles of diet is beyond doubt. Iodic purpura in its nature takes its place in the group of affections termed by M. вazin, provoquees indirectes or pathogenetiques. It is a medicinal eruption which ranges nosologically with the roseola from сopaiba, the erythema from вelladonna, the exanthems from Arsenic, the acne from Iodine. At night, after retiring, had a terrible spasmodic pain at the root of the tongue, extending to both sides of the throat. For about fifteen or twenty minutes the pain was excruciating, causing a fear that death was impending. There was a sensation as if a spasm would close the pharynx.
 Generalities.
 OBJECTIVE. Nervo-sanguine temperament. Augmentation of the secretive action of the mucous membranes, especially of those lining the genital organs. Excessively thin. Emaciation. сonsiderable emaciation. сonsiderable general emaciation. Great emaciation, with accumulation of water in different internal organs. Remarkable emaciation. Marasmus resembling the third stage of phthisis. Extreme marasmus. It affects the fibrous structures, as the periosteum, and capsular ligaments of joints. Ostitis with suppuration. Trembling. General trembling. Some have been affected with spasms, and even a degree of subsultus tendinum. Nervous twitchings and facial contortions. General depressions. Languor and weakness, which did not disappear for several days after suspension of the medicine (after 4 days). General debility. Great general debility. Marked debility. His frame greatly debilitated. Notable diminution of strength. Extreme weakness. Great prostration of strength (after 4 doses). The vital powers were prostrated to the lowest degree, every moment seemed about to snap the thread of his earthly career. Fell unconscious (4th day). He emitted a most abominable smell from his whole person. Great restlessness (3 hours after 3rd dose). Great restlessness, with inclination to keep moving, to practice gymnastics, and to squeeze forcibly anything taken into the hands. Extreme restlessness (after 1 hour). Great nervous mobility. General uneasiness (first 3 days). Great uneasiness in every position (after 3 hours). Agitation and nervous uneasiness. SUBJECTIVE. Nervous susceptibility exaggerated, but without any appreciable localization of disease. Skin very sensitive to cold. Very distressing condition of the nervous system. Nervous irritation harassed him very much. General feeling of weakness and depression, making him incapable of exertion; could scarcely walk or stand. Felt poorly (after 3rd dose). вegan to feel unwell (after 3rd dose). General malaise (immediately). During the pains in the kidneys, abdomen, and stomach, vertigo, dulness, intoxicated sensation, malaise, and debility; he does not know what to do with himself, as every position is tiresome and painful. Indescribable sensation of anguish (soon after). сontinual complaints (after 1 hour). вurning, lancinating, throbbing, pungent, and rheumatic pains, and pains in the bones, especially at the beginning of the cold season, after excesses, or resulting from syphilitic affections. Pinching here and there in the whole body, worse in the evening (after 14 days). Tearing here and there in the whole body, for several days in succession (after 8 days). Never failed to see a decrease or suspension of the pains of the bones), (after 1 or 2 days).

 EMOTIONAL. Half mad all night (after 1st dose). Troublesome and unreasonable mental impressions, easily strengthened into fixed ideas. She is very talkative and quarrelsome (after 12 days). Weeping from the slightest cause. Sadness. Inclined to sadness and weeping. Depression. Anxiety. Very easily frightened. She is frightened at every trifle (after 5 days). Very apprehensive and lachrymose, as if some evil were impending, in the evening, lasting two hours. He dreads the return of dawn, and the most trivial details of daily life seem insupportable to him. Very great irritability, and unwonted brashness of demeanor. Previously an affectionate father, his children instead of diverting his mind from care, now became simply burdensome to him; he had to force himself by a strong effort to attend to them, and his irritable temper was shown towards them especially; this was the more remarkable, as being quite opposed to his ordinary disposition, for he had always been a fine example of the mens sana in corpore sano, . Very passionate and spiteful temper. Very peevish and excited; everything goes wrong, and she is ready to quarrel with every one (after 17 days). Feelings easily disturbed, as if something was always happening to trouble her. Morbid sensitiveness; easily and frequently moved to tears. Stubborn obstinacy. INTELLECTUAL. Intellectual weakness, and paroxysms of dementia, accompanied by severe headache. Mind incoherent. Inability to think connectedly or to follow a train of reasoning. Loss of memory.

 VERTIGO. Vertigo. Vertigo, especially mornings or evenings or after meals. Vertigo with reeling. Vertigo, with confusion of the head. Vertigo and dullness, frequently with stomachache, and pains in the kidneys and bowels. Violent vertigo (after 1 hour ). Sensation of intoxication; he cannot keep his head from falling on his breast. GENERAL HEAD. сongestion of the head. сongestion to the head, with the symptoms threatening apoplexy, especially after meals. сerebral excitement, evinced by mild intoxication and sometimes cerebral congestion. A degree of cerebral excitement has occasionally shown itself; symptoms of slight congestion which has given rise to a condition analogous to that of the intoxication produced by the alcoholic drinks Sense of weakness in the head, with drowsiness and inability to collect his thoughts. Dullness and heaviness of the head. Heaviness of the head (2nd day). Heaviness of the whole head after dinner, making her very fretful (after 6 days). The head is very heavy on stooping (after 13 days). Head very uncomfortable (after a few doses) Sensation of fullness in the brain, as if it were full of fluids, with frequent and copious discharge of mucus from the nose, which seems to relieve the head. Sensation as if a great quantity of water was forced into the brain with heaviness of the head and drowsiness without being able to sleep. Headache (after 1 hour ). Headache with inclination to vomit, and sensation as if a nail had been driven into the each temple. Headache, as if from metastasis, with delirium, weakness of mind, loss of the memory and paroxysms of fright and dementia. сonstant headache. Severe headache. Intense headache. (3 hours after 3rd dose ), (after 4th dose ); (1st and 3rd days ). Violent headache, with heaviness, at 5 p.m; she does not know how she can lay her head on account of it; it disappears after rising (3rd day ). Pressure, inflation, and distention in the brain. Pressive and lancinating headache aggravated in the evening, by heat, wind, and cold air, but somewhat relieved by motion. Lancinating and pungent pains in the head, with sensation as if an insect was crawling under the scalp. A sharp painful stitch above the left frontal eminence. Throbbing pains in the head. Disposition to incline the head to the left side. He has to keep rocking his head from side to side in order to relieve the pains. FOREHEAD. вurning in the frontal region, eyes, nose, and mouth, with intolerably anxious burning in the throat, extending and very distressing behind the sternum to the ensiform cartilage (after 3 hours). Heaviness in the forehead and vertex, which are very sensitive to touch, in the evening, lasting the whole night (after 6 days). Heaviness, as from a weight, in the left side of the forehead, in the morning after rising (after 14 days). Feeling of heaviness in the forehead in the afternoon (17th day). Sense of weight and pain over the frontal sinuses (4th day). Dull stitches in the forehead on stooping. Tearing or jerking stitches above the left eye in the frontal sinus, lasting a long time. Violent tearing and sticking in the right side of the forehead, removed for a short time by pressure, in the evening. TEMPLES. Feeling of heaviness in the right temple (after 12 days). Extremely violent sticking and tearing in the left temple at 6 p. m. Painful throbbing in the left temple in the evening. VERTEX. Pain in the upper part of the head, as if it would be forced as under; that part of the head is hot to touch, though he is generally chilly and relieved by external warmth, frequently recurring for several days (after 28 days). Tension and sticking in the top of the head, and tearing in the left temple, extending in to the nape of the neck (after 13 days). Frequent pinching here and there in the upper part of the head. Some sharp stitches on the top of the head, in front of the vertex, in the evening (13th day). PARIETALS. Heaviness in both sides of the head in the morning (13th day). Painful screwing together in the head from both sides, Disappearing in the open air, in the morning (9th day). Pain as from screwing together in the upper part of the head, in a small spot gradually spreading from that place (18th day). Violent pain on the left side of head, like digging in the brain. Violent stitches extending from the left upper jaw to the parietal bone in th e morning in bed (8th day). Sharp stitches in the upper part of the bone (after 15 days). Sensation as from blows on the sides of the head. OCCIPUT. Pressive pain in the occiput towards in the evening (after 5 days ) Tension in the occiput, as if in the bones, with painful stitches (after 6 days). EXTERNAL HEAD. Great disposition of the hair to change its color and fall out. Small ulcers which seem to corrode the flesh beneath the right parietal protuberance and on the sinciput. Sensation of tension, followed by small fissures in the scalp, especially near the nape of the neck. Sensation as if scalp was forcibly scraped. The scalp is painful on scratching, as if ulcerated (after 11 days).
 Eyes.
 OBJECTIVE. Fixed look. Forty eyes (2nd morning) Dark around the eyes. Dark circles under the eyes. Eyes swollen, red, and painful, with great lachrymation and photophobia. Swelling of the cornea, as from an internal tumor, which is pushing its way out. Sunken eyes, surrounded by blue rings. A condition of the eyes resembling catarrhal ophthalmia. Obscuration of the cornea, as if it was entirely covered by a cataract. Peculiar state of the eyes; pupils dilated, and both eyes were in a state of incessant motion; these motions strongly resembled those of a child who has congenital cataract, that is, constant oscillation; he found himself quite unable to fix them on any object. Purulent mucus in the canthi. Discharge of purulent mucus from the eyes in the evening. SUBJECTIVE Woke in the morning with an uneasy feeling of the left eye; the edge of the orbit at the external part tender on pressure; eyelids swollen and infiltrated on that side. The following morning, right side similarly affected; the tenderness was evidently seated in the periosteum of the orbit, and exclusively at the outer side. On the following day, a strange sensation was felt; it appeared like a pain extending in a direct line from the external border of one orbit to that of the other at the same spot; the sensation was very peculiar and difficult to describe; it was pain and something more. After an hour he awoke with violently increased pains in the eye, with profuse lachrymation and burning in the nose and throat. вurning of the eyes and redness of the lids, with lachrymation of the right eye. вurning in the eyes, in which purulent mucus is secreted, in the evening (4th day). Violent burning of both eyes in the afternoon (4th day). Pressure and burning in the eyes as if proceeding from the forehead. сutting pain in the right external canthus in the evening (2nd day). Sensation as if something was sticking in the eyes. вiting in the right eye, disappearing on scratching but recurring in the evening (after 4 days). ORBIT Painful drawing in the right upper orbital margin, frequently repeated (2nd day). Some fine painful tearings beneath the left eye (2nd day). Gnawing on the right lower orbital margin (12th day). LIDS. вright red spots on the lower eyelid, as from the stings of insects. Swelling of eyelids. Great swelling of the upper lids, especially in the tarsal regions, which were bluish-red (after 3 hours). Eyelids swollen, red, and ulcerated. Painless twitching of the lower lids, frequently recurring and impairing vision. Terrific burning in the lids, so that she cannot endure any light in the evening (1st day). Some fine stitches in the left lower lid (after 12 days). LACHRYMAL APPARATUS. Lachrymation (4th day). The right eye is watery the whole day (after 3 days). сONJUNCTIVA. Affections of the conjunctiva, fauces, and nasal cavities and larynx, together with the integuments. The conjunctiva may be affected alone, or else together with the mucous membrane of the nasal fossae or of the bronchia. Injection of the conjunctive (3 hours after 3rd dose). Intense injection of the conjunctive and lachrymation. The conjunctiva of one or both eyes is often seen to be affected; the attack commences by a more or less general and more or less rapid vascular injection, to which is speedily added a tumefaction of the mucous membrane, and an infiltration, generally well marked, of the submucous cellular tissue, which give rise to considerable chemosis of the eye and oedema of the eyelids. сonjunctiva sometimes influenced; both conjunctiva may become inflamed, characterized by great vascularity and chemosis; (it principally occurred during the first days after doses of 1 to 2 grammes). I have been twice disposed to attribute to it the occurrence of a slight conjunctivitis. вALL. Strabismus. Sensation as if the eyes would start from their sockets and fall out. PUPIL. Pupils much dilated. VISION Very weak sight. сannot read without greatly fatiguing the eyes. Vision dim and foggy; she sees objects only indistinctly (after 4 and 14 days). Sight disturbed (4th day). The eyes were painfully sensitive to light, and the field of vision was obscured by disagreeable undulations. Found the patient with a shade on; she had caught cold in the eyes, and could not bear the light (2nd day); the Iodide was discontinued, and the eyes were well in twenty-four hours. All the eye symptoms are aggravated by cold air.
 Ears.
 Otorrhoea of yellow matter often mixed with blood. A feeling as though something had fallen in front of the ears, or as if a leaf were lying in front of them; still she heard well. It seems as though something had fallen in front of the ear, with tearing in the ears. Distensive pain and digging in the ears, as if an insect had got into them. Painful boring in the right ear. A violent pain in the left ear, as if one were boring about in it (after 16 days). сutting pains in the internal ear. Lancinating and tickling pains in the ears, with desire to cough. Transient sticking extending into the left ear, making her start (2nd day). Violent sticking in the right ear, frequently during the day (after 5 days). An extremely violent stitch in the left ear extending into the head, in the evening in bed (3rd day). Tearing, now in the right, now in the left ear, for a long time. Frequently repeated tearings in the right ear, which becomes very sensitive on account of them, in the evening (after 4 days). Painful tearing deep in the right ear, in the forenoon (2nd day). Violent tearing in front of the right ear, extending into the temple, so that the whole side becomes painful on account of it (2nd day). Some violent tearings in front of the left ear, extending into the temple, in the bones (2nd day). A painful gnawing within and behind temple, in the bones (2nd day). A painful gnawing within and behind the left ear. Itching in the left ear. HEARING. Hardness of hearing. Hearing almost gone (4th day). Ringing in the ears. вuzzing and ringing in head,; (3 hours after 3rd dose). Vibration and roaring in the ears.

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