Veratrum viride

 Veratrum viride, Ait. Natural order: Liliaceae. сommon names: American white hellebore, Indian poke, etc. Preparation: Tincture of the root.

 A man, fifty years old, had compound fracture of humerus; for a week or two his arm did well, and was rapidly recovering, while his general health continued perfectly good; his doctor gave him heroic dose of Verat-v. to see what it would do for him. Soon the patient was seized with rigors, prostration, a feeling of terrible coldness, and soon mortification of the injured limb, followed by death in a few hours.
 Generalities.
 Occasionally extreme pallor, with syncope, generally brought on from rising suddenly from the recumbent position. Tremor. She went into a spasm, with violent shrieks; body bent backwards; arms rigid and thrown up over her head; face dark blue breathing suspended for several seconds; lasted about two minutes; remained easier for a few minutes, and then went into another spasm, similar to the first, 13. Inability to control the voluntary muscles. Muscular action was not constantly interrupted, this effect occurring only after considerable exercise, as walking or jumping. сlothes would not fit me, seemed as if they were scratching me somewhere and I could not relieve myself; constant twitching of different parts of body, trying to relieve the rubbing sensation (seventh day). My clothes did not fit well, they irritated wherever they touched; would keep twitching and it seemed almost impossible to keep still, especially when sitting (third day). At 7 felt weak, especially in lower extremities, with heavy dull pain in head (first day). Very weak, with trembling all over, at 1 (third day). Loss of strength (after three hours and a half); general weakness (second day). Weakness throughout the body (after four hours). сonsiderable fatigue of the muscles (first day). Lassitude (after three hours). A general feeling of languor and quietness; a sense of exertion on going upstairs (after thirty-five minutes); decided feeling of weakness (after five hours and a half); any exertion an effort (after six hours ). Indescribable feeling of lassitude and weakness in the limbs (after six hours and a half). Prostration, 4 14, etc. Great prostration (first day), 1 2, etc. Sudden prostration and vertigo. The system becomes completely relaxed. So very profound prostration was produced by it that death appeared imminent; the stimulants were poured into the patient, and on the second day he rallied. Faintness. сollapse with the vomiting (first and second days). An intelligent colored laborer, thirty years of age, contracted a cold during the month of January last, from the effects of which he suffered considerably. He told me that for several mornings preceding the accident, which I will relate, he arose with a dull headache; was feverish; his nostrils were stuffy; he suffered with pains in the muscles of the chest and back; had a very annoying cough, with expectoration of frothy and tenacious mucus, characteristic of the first stages of catarrhal inflammation. The dry cough after a few days gave place to a moist one, by which a loose secretion was readily thrown off. He took the medicine about 3 , February 5th. I was called to see him at 1 p.m following, and found him in a condition approaching collapse. He was bathed in cold perspiration, vomiting at intervals of three and five minutes; heart acting feebly, almost inaudible; pulse at the wrist making sixteen beats per minute. After I had been in the room a few minutes, he summoned sufficient energy to speak, and complained of pain over the precordia, muscular cramps of the lower extremities, and a peculiar sensation of faintness. He was so feeble that I could scarcely hear him articulate. On inquiring what he had been taking, he replied, Noting but a cough mixture. I found its composition to be as follows: Tinct. Am. hellebore, tinct. lobelia, syrup of squills, and simple syrup, two ounces of simple syrup. The directions were a teaspoonful three times daily, which would give him five drops of the tincture of Veratrum viride at each dose. He had taken it, however, in teaspoonful doses every half hour, until the contents of the vial were exhausted, which had occurred at 10 At this time he began to feel very weak and sick, as he expressed it, and went to bed and to sleep. At about 11 1/2 o’clock he was awakened by a great rush of fluids from the mouth. The vomiting was without warning or effort, and for a time was almost continuous. Feeling so strange about the head, and so faint that he thought he would die, he tried to awaken a boy, who slept in an adjoining room, by calling, but could not do so. He tried to get out of bed, but his legs failed him. After the lapse of half hour he succeeded in crawling to the boy, and making his wishes known to go and bring the doctor. I reached him at 1 p.m and found him in the condition already described. I gave him a hypodermic injection of one-half grain of morphia, applied mustard to the epigastrium, the nucha, the spinal column, the wrists and ankles, and gave him per rectum, one ounce of whiskey with two grains of quinine. As I observed him, there would occur at intervals of four or five minutes a regurgitation of a mouthful of fluid, resembling the albumen of egg; his eyes were rolled under the orbits, so that the sclerotics only were visible; the sighing was frequent and profound; and the pulse was proportionately less than the breathing, the perversion being to the extent of twenty to thirty respiration, which were shallow. In twenty minutes time I could plainly see that the remedies which I had administered were having good effect upon him. The vomiting ceased, the skin became warmer, and the perspiration less copious; the sighing gave place to easy respiration, the heart became steady, the pulse rose gradually in frequency and volume. A feeling of repose replaced the nervous agitation which had possessed him, and prior to my leaving him the pulse respiration ratio did differ markedly from that of health. I left him at 2 1/2 p.m, ordering his attendant to inject one ounce of diluted whiskey into the bowel at the end of an end of an hour. On visiting him next morning, he complained of sight headache and nausea, with dryness of the mouth. The heart was acting with almost its accustomed force and frequency. He recovered promptly from the effects of the Veratrum viride, but his cough persisted, and he is now suffering with that bane of his race, mesenteric phthisis. Great distress (after half an hour). Severe agues. On walking in morning shuddering for some time, with pains in the joints till he fell asleep; on walking, felt the shuddering again, but did not notice any chilliness (seventh day); woke this morning with the shuddering, with a kind of throbbing aching in right knee, on which he was lying (eighth day), 31. вetween 5 and 6 , had flying aches in different parts, recurring repeatedly, in left thorax, in right shoulder over clavicle, in head of left tibia and three or four inches above the same, in tendons of right popliteal space, in outside of right arm and left ulna, right wrist, head of left radius back of first joint of left middle finger, and second phalanx of left great toe (one hour and three-quarters after second dose, twenty dose, twenty-fourth day), 31. A transient ache in second joint of right forefinger, then distinct pain in right of lower jaw, then in left heel, then in middle of left neck, then at the same time in right heel and left knee; these in the first thirty minutes after the dose (third dose, thirtieth day), 13. A cup of hot strong coffee did more good then anything else. The symptoms most frequently occur early in the morning, on waking (twenty seventh day). During afternoon and evening had the more common symptoms, especially in evening (thirty second day).

 Temporary delirium. Quarrelsome and delirious, striking and kicking with right hand and foot; at times these movements appeared to be involuntary; this mental condition changed to a happy and comical delirious state, which continued fifteen hours. Although I thought it probable I should die, I did not feel alarmed. Same depression of spirits (forth day); great depression (fifth day)). Depression and prostration. Great fear of death. Most of the time, between the vomiting spells, he was lethargic, with slow and difficult respiration. When not vomiting she lay in a stupor. Feels stupefied, with great pain and fullness in head), (first and second days). Apparently unconscious (after seven hours).

 Eyes.
 Full, pressing, heavy feeling in eyes, with slight headache (first day). Aching in left eye, while riding in omnibus (after second dose, second day). Severe shooting suddenly- stopping pain in left eye (a few minutes after second dose, fourth day). вrown and orbit. On going to bed, had a intense, painful itching in middle of left eyebrow (twenty- fourth day). A dull heavy feeling over left eye, worse when stooping, at 2 (second day). A distinct ache, directly over right eye (immediately, after first dose, fourth day). Aching in upper part of right orbit (twelfth and sixteenth nights). Slight transient pains above the right eye (after half an hour, twenty-third day). Pain in upper half of right orbit (after first dose, thirty-eighth day). Lids. Feeling of fullness about the eyelids, as if he had been crying a good deal, with increased secretion of tears (ten minutes after third dose, first day). Eyelids heavy and sleepy, with soreness (fifth day). Lachrymal Apparatus. Increased tears), (fifth day). Profuse secretion of tears at 2.
 (third day); at 1 (forth day). Pupil. Dilated pupils. Vision. Dimness of slight. Dimness of vision; green circles around the gaslight), (fifth day). сannot walk; if I attempt it, I am very faint and completely blind; obliged to keep in the horizontal position, at 2.20 ; cannot walk across the room without becoming blind, at 4 ; can walk about ten rods, when I become blind, and am compelled to sit down, at 5 (third day), 12. сan walk about four rods, I then become blind and faint, but can sit up without any trouble, at 1 (forth day). Photophobia and vertigo, relieved by closing eyes and resting head, in the morning (third day). If I assumed the erect position for even a minute, dimness of sight and partial syncope supervened, which obliged me to resume the recumbent posture (after four hours); the inability to assume the erect position continued for an hour and a half, 25. Unsteady vision (second day). сloud before the eyes, chiefly during vomiting (first day). A little dazzling of the eyes. Immense circle of green color appeared round the candle, which, as vertigo came on and I closed my eyes, turned to red.
 Ears.
 A fullness in the left ear, with a continued beating of the carotids, I could hear it beat distinctly, during the proving. Fullness and throbbing in the carotid in the left ear; this came on soon after beginning to take the drug (fourth day). Ringing in the ear; moving quickly makes me very deaf; at 2.
 (fourth day). Hears noise in ear), (fifth day). Humming in ears and sensitiveness to noise; ears feel cold with spells of deafness), (fifth day).
 Nose.
 Nose looks pinched and blue at 2 (third day). For the third time noticed nasal catarrh and sneezing, soon passing off (shortly after third dose, thirty-second day). With the vomiting, running from the nose and eyes. Profuse secretion of mucus from the nose at 2 (third day); at 1 (third day); at 1 (fourth day).
 Face.
 Features sunken. Face pale (second day). Face very pale at 2 (third day), 12; (after seven hours). Very pale, with cadaverous look (after half an hour). Face flushed), (fifth day). Face blue. вlue hippocratic face for three hours. Stinging pain in right jugum malar (forty-fourth night). Distinct pain in right angle of lower jaw (after third dose, thirtieth day). Dry lips and mucus of much thick (third day); dry mouth and lips all day (fourth day); mouth less dry (fifth day). Jaw rigid, and nothing could be put into her mouth.

 Confusion and Vertigo. сonfused sensation in head (after two hours). Vertigo. When rising from a seat, or from bed, a slight dizziness (fourth day). Vertigo with the nausea (second day). Dizziness and nausea, followed by heat of surface (forth day). Dizziness on rising, in the morning (seventh day). Vertigo and sudden prostration. Must keep his bed; vertigo and vomiting as soon as he rises), (fifth day). Vertigo and photophobia; relieved by closing eyes and resting head, in the morning (third day). Dizziness and pain in the head (after ten or fifteen minutes). General Head. Dull feeling in the head all the afternoon and evening (forth day). Heavy dull pain in head with the weakness (first day). Head felt full and heavy (second morning). Heavy dull headache, with occasional painful throbbing in the temples (after four hours). сonstant dull headache at 4 (second day). Violent headache of a central congestive character); aggravated by noise and motion (fifth day). Violent headache, with severe vomiting every fifteen or twenty minutes), (first and second days). During this proving had no headache after the first and second days). Headache, which stopped at the temples and seemed to take a diagonal course across the head (after two hours, fourth day). Slight headache, with full, pressing, heavy feeling in eyes (first day). Queer feeling about the head (after two hours, second day). Burning sensation of head, with flushed face), (fifth day). Forehead. Some heaviness about forehead (after second dose, twelfth day). сonstant, dull, frontal headache, with neuralgic pains in the right temple, close to the eye, at 10 p.m; dull pains over the eye, with quite severe drawing pains in the umbilical region, at 11 p.m; slight frontal headache, with pricking pains in the region of the heart, at 12 M.; drawing pains in forehead at 2 ; dull, frontal headache, with pricking pains in the precordial region, at 3 ; slight, frontal headache at 5 , slight, dull frontal headache at 7 (first day). Slight, dull frontal headache, with a contractive feeling of the skin of the forehead, at 9.30 p.m; dull frontal headache, with neuralgic pains in the temples, at 11 p.m; every severe frontal headache, with dull aching pains in the umbilical region, at 2 ; сonstant, dull headache at 4 ; dull frontal headache, with neuralgic pains in the right temple, at 9 (second day). Dull frontal headache at 2 ; severe frontal headache, with violent vomiting and hiccough.20 (third day). Dull frontal headache at 12 M.; every severe frontal headache at 1 ; dull frontal headache at 2 (fourth day). Steady, dull pain over right eye, gradually extending to forehead (after second dose, twenty-fourth day). Some frontal headache, with nausea; head feels full and congested), (fifth day). Awoke in the morning with frontal headache, which seemed relieved after a stool (second day). After 1 noticed a frontal headache, which extended back on left side of head to occiput; continued all day, more when lying down, especially when lying on occiput (first and second days). Frontal headache, with cold feet and hands (second day). Slight aching over right eye, also in right temple and right malar bone, just under the eye (twenty minutes, after third dose, first day). Numb constricted pain in forehead, pressing back to the ears, sensation as if membrana tympani would break (second day). Sharp drawing pain over the left eye, with a contracted feeling in the skin of the forehead (after ten minutes). On waking, after a short sleep, felt an indescribable sensation rising from forehead towards crown, and grasping, as it were, the vertex and occiput (first night). Temples. A sensation of stiffness in the voluntary muscles, particularly the temporal and extensors of the head. Pain in left side of head at junction of parietal and temporal bones, in the forenoon (thirty- first day). Pain in right mastoid process (half an hour, after fourth dose, thirty-eight day). The old pains began to fly about in temple and left trochanter major (after second dose, forty-sixth day). Headache on left side back to temple (first day); on left side, from before backwards (second day). Headache on left side to temple at 9 p.m; stopped in the afternoon (third day). Occiput. Dull headache in occipital region (third day); all day (fourth and fifth days); slight occipital headache (sixth day).

 Teeth. Toothache cured). Tongue. Tongue white, not coated; looked as if bleached (second day). Tongue white in the center, with re edges and white tip; it dose not look like a coated tongue, but as if the blood were pressed out, in the morning (third day); edges red, tip white, and center almost a pure white (fourth day). Tongue coated yellow, especially along the base and center), (fifth day). Tongue coated yellow along the center, in the morning (third and fourth days). Tongue bright red at tip and edges, and white in center (second day). Tongue red on the edges, grayish from the tip half way back; the back part gray, with red spots of the size of a pin’s head. Strawberry tongue (fourth day). Tongue feels as if he had been drinking hot tea; scalded, coated yellow at base and edges; somewhat red in center), (fifth day). Tongue feels as if it had been scalded, coated yellow, with red streak in center), (first and second days). Tongue feeling as if it had been scalded, at 9 (second day); at 8 p.m (fourth day). Acrid, burning sensation in the mouth. Saliva. Great increase of secretion of saliva (first day). With the hiccough there was copious secretion of saliva and discharge of mucus from the stomach and nose. Profuse secretion of saliva at 2 (third day); at 1.
 (fourth day). Taste. Flat taste in the mouth, in the morning (third day). Flat, bitter taste in the mouth, in the morning (fourth day). Taste bitterish, disagreeable, peculiar, reminding one of the odor of spermatic fluid. Food tastes bitter), (fifth day). Water tastes like lime- water (third day). Speech. Almost speechless. Total loss of speech for some time.
 Throat.
 Dryness of throat for one hour, causing short dry cough (one hour and a half after first dose, second day). In the throat and fauces a sense of dryness and heat, which finally reached the stomach; in the course of an hour this dryness and burning sensation in the throat and stomach became intense, and a disposition to hiccough was excited, which commenced, gradually increasing in frequency until it reached fifteen or twenty times in the minute; this was attended with some sickness and retching until vomiting took place; this was violent, and seemed to come on about every ten or fifteen minutes for the space of an hour, 15. вurning in the throat. вurning sensation in throat, oesophagus, and stomach (after ten or fifteen minutes). Ever since swallowing the dose there has been a persistent, peculiar numbness in the fauces (after twenty minutes); after second dose the numbness of fauces was for a while very marked; not so much so now (after thirty-five minutes); numbness still persistent (after one hour and a third); numbness of throat not noticeable (after three hours), 30. With the hiccough, violent and constant spasms of the upper part of the oesophagus; cannot swallow, at 2 (third day); at 1 , lasting two hours (fourth day). Sensation of something like a ball rising in the oesophagus, which seemed to extend up as far as the top of the sternum, as if propelled by a gradual tonic contraction of the stomach (after one hour). Inclination to swallow, with burning pain along the oesophagus), (first and second days). Submaxillary glands swollen, sore to touch (fourth day).

 Appetite and Thirst. Ravenous appetite on waking, in the morning (second day); at noon (fourth day). Very thirsty, drinks little, which relieves for a short time (third day). Thirst, with slight nausea, an hour after rising, in the morning (third day). Eructations. Frequent eructations of wind. For several days the patient was troubled with an acrid, sour rising from the stomach. Hiccough. с Almost constant hiccough. If causes excessive and painful singultus. Hiccough, with the frontal headache, at 2.20 (third day). сonstant hiccough, with violent and constant spasms of the upper part of the oesophagus, at 2.
 (third day); at 1 (fourth day). Hiccough, with constant and severe spasms of the upper part of the oesophagus, at 1 (fourth day). Nausea and Vomiting. Nausea. Some nausea (after four hours); considerable nausea (after six hours and a half). Nausea, which passed off on eating (after fifty-five minutes). Great nausea and vomiting, with cold sweat), (fifth day). Nausea with the frontal headache), (fifth day). Nausea and dizziness, followed by heat of surface (fourth day). Nausea, with desire for stool (first day). Nausea and vertigo, with pain in bowels; had these symptoms four times in succession, about fifteen or twenty minutes apart, and each lasted three to five minutes (second day). Stomach feels mawkish and slightly nauseated (after twenty-five minutes); slightly nauseated (after one, and hour and a half); nausea marked, relieved by eructations of wind (after two hours and a half). вegan to feel nauseated, and should have vomited had I not made an effort to restrain myself (after four hours); vomiting, with great pain, which continued for about half an hour, requiring all my strength to support myself (after four hours and a half), 17. Uneasiness at the stomach. Slight uneasiness at the stomach (in ten or fifteen minutes), 3; (after four hours). After one hour a slight sense of uneasiness at the stomach, but not amounting to nausea; this continued with very little inconvenience for half an hour, when vomiting commenced. The contents of the stomach were thrown off without nausea, but with a sense of rising in the oesophagus, which perhaps might be compared to the rumination of animals. Judging from my sensations at the time, should suppose the muscular fibres of the stomach contracted gradually and steadily upon its contents until they were expelled, the diaphragm and abdominal muscles remaining entirely inactive. Nausea and severe vomiting on rising in the morning (seventh day). Extreme sickness and distress at the epigastrium (after thirty or forty minutes). Nausea and vomiting. Frequent efforts to vomit (after half an hour). Several ineffectual attempts to vomit (after thirty or forty minutes). Severe itching (after ten or fifteen minutes). Retching and vomiting incessantly. An effort to vomit after the second dose, but without ejecting anything from the stomach; efforts to vomit were made every few minutes, but without success, except once, when a small quantity passed from the mouth. Retching attended with intense pain, at times almost amounting to agony (after four hours and a half). Painful retching. Ineffectual retching with the vomiting. сonstant and ineffectual retchings. Retching for three-quarters of an hour, vomiting food, mucus, etc., not getting any relief until I threw off same bitter stuff, with the characteristic taste of Veratrum (after four hours and a quarters). Vomiting. Vomiting without effort or nausea (after three-quarters of an hour). Vomiting very freely. сommenced vomiting (after a few minutes); vomiting kept up, with severe retching, every few minutes, when it gradually subsided; the matter vomited was a white, ropy mucus; the interval between vomiting, for three hours, was not any time longer than five minutes, and most of the time did not exceed one minute, 13. Repeated vomiting, with some hiccough; considerable bile thrown up (first day). Profuse vomiting of thick, glairy mucus and water, at 2 ; violent vomiting, with the frontal headache, at 2.20 (third day); violent vomiting of dinner, and then of a thick, glairy mucus, at 1 (fourth day). Severe vomiting with the violent headache, 11 p.m; continued violent, with collapse and cold sweat, at 4 ), (first and second days). Vomits food, if ever so little is taken), (first and second days). Vomiting of bile, and then of mucus and dark-colored blood; then severe retching and moaning, with great fear of death; this stage continued about an hour, when I gave a dose of Arts. 3; soon afterwards the retching and vomiting ceased. Vomiting; the vomited matter appeared to consist at first of the food and contents of the stomach, afterwards of a glairy mucus. Free vomiting, accompanied with an increased flow of saliva and general perspiration; the vomiting continued at intervals for upwards of an hour, and until considerable bile and had been thrown up (after three-quarters of an hours). Vomiting, attended with very little inconvenience, at first, but after continuing for a short time, became more severe, the ejections consisting principally of bile (after one hour and a quarter). Stomach. Great prostration of digestive functions, subjecting the experimenter to a temporary but severe attack of dyspepsia. At 6.1/2 I took supper, although food was repugnant to me, and I ate but little. All through the evening I suffered from decided dyspepsia, partially relieved by a glass of whiskey. A feeling of tightness, stomach wretchedness. Distress at the stomach. The symptoms of globus hystericus are sometimes present, but very rarely, in nervous females. Dull aching pains in the epigastrium, at 9 (second day). Dull pain in epigastrium. Spasms of the stomach and respiratory organs frequent and severe (in three persons), (after three hours). Excruciating pain in the lower part of the stomach, the pain extending to about the size of my hand; the feeling of the seat of the pain was, that all the warm tea, water, etc., that I took to provoke the vomiting, went under the stomach, as if the muscles were contracting, relieved by bending forward, for ten minutes; almost directly afterwards pain in abdomen, as if drawn in, for half a minutes (five hours after second dose, second day), 33. с (Twisting-tearing pain in stomach, aggravated by least motion), (first and second days). Feeling as if the stomach were slowly contracting on its contents, and forcing them into the oesophagus, producing a sensation as of a ball rising up to the top of the sternum (first day). Sensation in the epigastric region, as though a full dose of calomel were operating (first day). Sharp flying pains in the epigastric and umbilical regions, in the evening (first day). Sharp pains in the epigastric and umbilical regions, and passing down to the pubes, at 11 p.m (second day). Very frequent neuralgic pains in the cardiac portion of the stomach, at 7 (first day). Such great irritability of the stomach that it seemed for a while that he must die, from the impossibility of retaining the necessary stimulus. On waking a second time, felt as if waves were rising from the stomach into the chest (first night). Slight glow in the stomach (after two grains).

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