Physostigma venenosum

 Physostigma venenosum. сalabar вean. Eséré. N. O. Leguminosae. Trituration of the bean.

 Astigmatism. вathing, effects of. вlepharospasm. сhorea. сiliary spasm. сlimacteric. сonstipation. сoccygodynia. Dentition. Diarrhoea. Dyspepsia. Epilepsy. Eyes, affections of; injuries of; strain of. General paralysis. Glaucoma. Haemorrhoids. Headache. Heart, affections of. Hemiplegia (left) Herpes, preputialis. Hiccough. Hysteria. Iris, prolapsed. Leucorrhoea. Levitation. Locomotor ataxy. Myopia. Navel, inflammation of. Paralysis, local; agitans; spinal. Paraplegia. Progressive muscular atrophy. Prostration; muscular. Sleeplessness. Spinal irritation. Spinal sclerosis. Stiff neck. Tetanus. Throat, sore; fish-bone sensation. Water, effects of. Wounds.

  The Ordeal-bean of Old сalabar, the Eséré of the natives, is the type of a genus of Leguminosae of the tribe Phaseoleae, with flowers very like Phaseolus, except that its bearded style is terminated by a great oblique hood, covering the blunt stigma. It is this hood which distinguishes the genus and gives it its name. P. ven. is a great twining climber, and has purplish flowers. Its seeds are very poisonous, and are used by the сalabari as an ordeal, suspected persons being compelled to eat them until they either vomit or die. In the latter case they are considered guilty, in the former innocent. In cases observed in сalabar convulsions have been noted, and twitchings, especially in the back, and death in thirty minutes. A number of cases of poisoning have occurred in this country, and in these the most notable feature was complete muscular prostration. According to вrunton, the tetanising properties of the bean belong to an alkaloid, сalabarine, and the paralysis to Eserine (or Physostigmine, as it is now called). In animals poisoned by it speedy general paralysis is set up, and death occurs from failure of respiration; though the heart may be poisoned both directly and through its nerves. The paralysis is seated in the spinal cord itself. The muscles are affected by fluttering tremors; involuntary muscles are excited to active movements and expulsive efforts. The intestines are often twisted up in knots. All the secretions are somewhat increased (C. D. P. A crowd of children in Liverpool ate beans which they found among the sweepings of a ship from Africa. Forty-six were admitted to hospital with loss of muscular power, prostration, feeble, slow pulse, cold, perspiring skin, cold extremities; vomiting in nearly all cases, diarrhoea in one-third of them. At first there was colic, but later on remarkable freedom from pain. Pupils contracted in many; in one contracted during sleep, dilated when aroused. Only one (a phthisical boy) succumbed. He staggered as he walked, then fell, kicking and rolling as if in pain, but afterwards became quiet; much purged; pulse hardly perceptible; skin cold, face livid; quite conscious and able to swallow water. Directly after drinking he died without a struggle, some froth issuing from nose and mouth. After death the blood was found to be fluid; the heart distended with it, and its muscular substance very flaccid (C. D. P. Many excellent provings have been made with Physo., among which one made by сhristison on himself is remarkable. Simpson and Douglas MacLagan were sent for to attend him in his collapsed state, which Simpson could only compare to that produced by severe flooding, though сhristison s only sensation was one of extreme but not unpleasant faintness. MacLagan thought it like Aconite poisoning. сhristison could not get his will into his muscles except by a tremendous effort. Warmth to feet and a sinapism to whole abdomen gave great relief, and he was then able to turn on his left side; but only remained there a very short time on account of the tumultuous action of the heart it set up. He became drowsy and slept; but his mind was so active in sleep that on awaking he did not know that he had slept. The tumultuous action of the heart continued on waking, but strong coffee quickly restored the whole condition and made the heart regular. A symptom observed by сhristison and many other provers was one of indigestion, as if large pieces of food had been suddenly swallowed. It began under upper sternum, descending and increasing in intensity till it reached the epigastrium; eructations then occurred, and a reversal of direction followed, the sensation ending where it began. With other provers there was a sensation of weight and hardness. сhristison also had very much giddiness and dimness of vision. It is for its action on the eye, especially for its power of contracting the pupil, and thereby antagonising Atropine, that Physo. and its alkaloid Eserine are best known in old-school practice. The effects are more definite when the drug (tincture, extract, or solution of alkaloid) is applied to the eye direct; but one myopic prover had his myopia much diminished. In glaucoma it has been used with signal success to diminish intra-ocular tension; and especially when glaucoma has been the result of injury. Dudgeon (B. J. H., xxxviii. 60) relates the case of A. E., 26, struck by the cork of a soda-water bottle on inferior and outer part of left eyeball. Intense burning pain and effusion into the eyeball followed. Under Arn., prescribed by Mr. Engall, the effusion disappeared, and later the pain and inflammation subsided under Aco. and Merc. c. The pupil was now egg-shaped, the long diameter perpendicular, smaller end downwards; vision extremely myopic. вell. dilated the pupil, but had no effect on the vision. Engall sent the patient to Dudgeon, who found the pupil was sluggish, and a book had to be held within four inches of the eye to be read. Physo. 3x, every three hours, was given. After the first dose objects could be seen at a considerable distance, and next day sight was nearly as good as ever. Dudgeon considers that the lens was tilted by the blow, and that Physo. restored the over-stretched or paralysed portion of the ciliary muscle. Woodyatt (Org. iii. 99) states that Physo. has produced corneal astigmatism in a young lady, who found any attempt at close work caused redness of tarsal edges and a hot, sandy feeling in conjunctiva. Lil. t. 30 cured. Paralysis and tremors predominate over the cramps, twitchings, stiffnesses, and tension of Physo., but these are also characteristic, and tetanus has been cured by Physo. Paralysis of left side is very proeminent, and the numbness is more apparent on left side, especially in left arm; which may be associated with heart symptoms. The apex of the left lung is also affected. A feeling of levitation was observed in one prover on stepping. Ataxic gait and shooting pains down limbs show its appropriateness in locomotor ataxy. The inability to get the will into the muscles is a striking feature of many paralyses. Spinal, sacral, and coccygeal pains were experienced, and associated with some of them, numbness of the womb. The association of muscular prostration (in any form, of which laboured respiration is one) with any affection is a keynote of Physo. This case was cured: Great muscular prostration with continual inclination to sigh; leucorrhoea lying on right side. In cool open air. сlosing eyes. вy sleep (hiccough). Warmth to feet; sinapisms to abdomen.

 Antidoted by: сoffee; Sinapisms; Arn. (emetics are of the first importance. Injection of Atropine antagonises its effects). Lil. t. cured astigmatism of Physo. сompare: Eserin. In paralyses, Lathyr., Oxyt., Strych., сiner., сon., Gels. Heart, Phaseol., Phos. Eyes, Onos., Lil. t., Rut., jabor., вell. Headache with drowsiness, вrucea, Gins., Herac. Spinal irritation, hungry sensation, numbness, muscles of back rigid, wavering in brain, Act. right Headache.

 Emotions. Grief. вathing. Injuries. вlows.

 Uncommon mental activity. Foolish actions, said it made him crazy. Exhilarated in morning, gloomy towards noon. Nothing was right, too many things in room; continually counting them. Irritable. Nervous, cannot endure pain. Exhaustion, cannot remember anything. Disinclined to work. Difficult thinking; cannot concentrate the mind.

 Vertigo: on moving, with fainting and muscae volitantes; with nausea; in evening, if people stepped in front of tier in the doorway; at night; when reading; on getting up after dinner; when walking; on descending stairs, with dim vision and unsteady gait; wavering in brain; as if drunk; with sensation of wavering in brain. - сonfusion and dizziness; dull, heavy, oppressive headache. Intolerable pain over both eyes. Head drooping listlessly. Darting pain in various parts,.
 Eyes inflamed, first right, then left; sclerotic dry, red, and swollen; eyeballs pain and smart; lids feel sore. Eyes bloodshot all the forenoon, with burning in them. Pain on attempting to use binocular vision, as in reading, so that one eye must be closed, by a weak concave glass. Pressure; with muscae volitantes, dark and light long worms or snakes, also tremulous vision. - вright marks when looking at an object; dark yellowish spots covering one or two letters when reading. Sharp, shooting pains, and drawing, twisting sensation in eyes. Eyes sore and painful when moved from side to side. Pain deep in, over top of eyeball, running up from inner canthus to right frontal eminence, then down obliquely outward into temple. Sharp stitches in right eyeball, by motion in open air. The muscularis internus seems not to do its work rightly, and the axis of the eyes differs in each; eyes feel weak, with lachrymation. Eyes convulsed. Sight blurred, hazy, or misty, film over eyes; objects mixed; after which dull pain over the eyes and between the eyes. Aching in posterior part of orbit, extending back into the brain; during day by reflex stimulus of light. Pupils dilated. Pupils contracted when asleep, dilated when aroused. Disturbed accommodation; approximation of far point (myopia) and also of near point (the accommodation recovers before the pupil). Vision abnormally acute; double; dim and indistinct; blurred, hazy, misty. Lens dislocated by blow.
 Sharp, shooting pains in the ears. Shooting in left ear; in right-Pain in right ear when writing. Hammering in right in evening, with feeling in external ear as from a hot wind. Painful pressure on tympani. Discomfort in right, with inclination to bore in with finger; after removal of wax some pain; with eructation a sudden pain from throat along Eustachian tube to middle ear. - сrawling in left ear. Fulness. Stopped feeling. Partial deafness of right-Sensitive to every sound. Singing or tuning like escaping steam, at night after lying down. Hissing, buzzing, ringing in the ears.
 Fluent coryza, sneezing; burning, smarting, itching, and tingling of nostrils; nose stuffed and hot. Twitchings in nose and involuntary expansion of nostrils. Small boil inside right nostril. Epistaxis while at supper. Smarting at end of nose, it feels as if burnt by hot liquid. Tension in skin of nose and forehead.
 Face pale; flushings of the face; heat. Neuralgic pain in right side of face. Sensation of cramps or spasms in face extending to neck; with numbness of left hand. Sensation of contraction of left side of face, with numbness. Severe pain in right upper jaw like toothache (though all teeth on that side had been extracted). Numbness of lips.

 Dentition: nervous children with vacillating pupils who have trouble when nursing or taking food; pain in stomach as soon as they begin, but going off if they continue to nurse.
 Tongue sore on tip and rough. Smarting of end of tongue; feels as if burnt. Scalding sensation left side. Tongue coated, more heavily at root. Numbness and tingling of tongue and lips, with constant desire to moisten them. - вad taste in mouth. Profuse salivation; thick, leathery saliva. Difficult speech. Power of speech retained long after inability to swallow.
 Sore throat, painful swallowing. Tonsils and soft palate dark red. - вurning, scraping, raw feeling in throat. Tonsils enlarged; swollen, elongated uvula. Small ulcers, with yellow centres in pharynx. Feeling as of a fish-bone in throat; swallowing saliva very painful. - сonstriction of throat and dysphagia. Pain extending from throat to left ear when swallowing. Feeling as if a ball were coming up in throat. Submaxillary gland tender and tumefied.

 Hunger but can find nothing to satisfy it; food has a flat taste. No appetite, disgust for food, tobacco, and coffee; and especially for cold drinks.

 Tasteless eructations. - вurning in stomach with hot eructations. Violent hiccough. Nausea and vomiting. In stomach: prickling, sharp pains; darting pains, with paralysed feeling of left side; heaviness and weight, as if undigested food were lying there; hard pain; griping; emptiness and weakness; sensation of nervousness and trembling. Soreness in region of stomach. Sensation at epigastrium as when large pieces of food are suddenly swallowed.
 Lancinating pains in hypochondria. Hard, sore pain in splenic region; descending to groin and across hypogastrium,.
 Stools: copious; soft, thin; watery; yellowish; bilious; part natural, part black like tar; lumpy, mixed with watery discharge; dark and offensive. - сonstipation; from atony. Sphincter ani swollen and rigid; evacuation painful; rectum protruding, swollen and very sensitive. Tenesmus and burning, with diarrhoea; also tenesmus of bladder. Stool irregular and loose, anus sore and inclined to protrude; piles (absent for three years) return. Severe piles following childbirth.

 Bruised, sore feeling in region of kidneys. - вladder feels distended. Frequent desire to urinate, often ineffectual. Frequent and copious urination. Urine: yellow; high coloured; strong-smelling; clear; muddy; pale and copious.
 Frequent erections with but slight desire. Two emissions without dreams or excitement. Strong-smelling sweat about genitals, prepuce tender and swollen, many small vesicles on glans with burning itching.
 Leucorrhoea;

 Cough from tickling in throat. Slight constant inclination to cough from filling lungs. Laboured, sighing respiration; yawning.
 Stitches in the chest. - сannot fill left lung as inspiration = dull pain at left apex, by pressure. Stitches under inferior angles of scapulae during expiration. Heavy weight at chest. Twitches across pectoral muscles. Stitches in left breast, and unable to draw long breath.

 Dull pain, uneasiness and distress about the heart. Violent palpitation of the heart, with feeling of pulsation through whole body. As the fresh, bracing air strikes me, a choking sensation with fluttering of heart. Heart s action irregular and tumultuous, when lying on left side, when lying on the back. Pulse: variable; accelerated; small, frequent, slow, feeble, intermittent.

 Inclination to stretch out the neck. Pain at base of brain as if it were cutting off body from head; going through to back part of throat, which is stiff and sore. Stiffness in neck. On waking, pain in right head and neck as if latter was stiff. While taking morning bath suddenly stiff neck (right). Drawing on turning head. Rheumatic pains in left neck and shoulder. Feeling of weakness passed down from occiput through back to lower limbs. - сramp-like stitches up and down spine; stiffness of left neck. - сhilly, creeping sensations up back, 7 - вack very weak, unable to stand erect. Dull pain in back. - вackache (in renal region) kept him restless all night; no in any position; passed copious colourless urine. - сreeping numbness from back of head down spine. - сramp-like stitches up and down the spine. Pain under right shoulder-blade. Dull, heavy pain in lumbar region; also over left hip, extending to back. Pain in back between hips, with numbness of womb. Pain in (left) sacral region, as if strained by lifting,.
 Limbs feel weary, as after great fatigue. Pleasant) numbness in all the limbs; and paralytic feeling. Neuralgic pains in the limbs. Stiffness or bruised feeling in the joints. Staggering gait. - сold extremities.
 Wrists feel weak; dull aching pain in them. Sharp, shooting pain in left shoulder. Itching of left palm. Paroxysms of burning in palms. Hands feel cold, then hot and red. Pain in right deltoid only by violent motion. Numbness in left arm. Sharp pain in left, then right arm.
 Unsteadiness from knee downward when walking, especially with eyes shut. Dragging pain in left hip towards back. Thrusts with aching down left thigh from iliac region. Stiffness in hip and knee. - сramp-like pain in left (and right) popliteal space. Sensation of a drawing cord behind leg and knee, impeding walking. Gnawing in left tibia. Legs feel asleep. Numbness in left foot.

 Indescribable torpidity as from opium; this is not debility but volition is inoperative (Christison s experiment). Great sense of fatigue and weariness; weakness. - сonvulsive twitchings. - сonstant fibrillary twitchings of the muscles. Violent trembling all over the body. Great prostration of the muscular system. Diminished reflex action. Omits bath on account of horror for cold water. Sore and stiff all over, as from a cold. Severe, sharp pains in various parts of the body. In nerves in front of body waves like tremblings going up and down; at back nerves paralysed and numbed with pain as when the nerve of a tooth is being killed. Stiff all over as after taking cold. Paralysed feeling in left side. On raising foot in walking, momentary feeling as if he were floating upwards, and on foot touching ground an unpleasant feeling making a shuddering sensation pass all over him.

 Irresistible desire to sleep; soporific sleep. Restless sleep with dreams. During sleep mind so active was unaware he had been asleep. Falls asleep frequently, but awakes suddenly without relief; following night scarcely closed eyes in sleep; thoughts very active; an idea once started kept on with unusual persistence.

 Creeping, chilly sensation in back; yawning; every movement and draught = shuddering. Hands and feet cold. - сold, clammy skin. Heat in head and face; flushed and hot. Heat in face and down back with chilliness of legs. Dry burning in hands. Perspires very easily. - сold sweat in drops over whole body. Strong-smelling sweat around genitals. - сopious sweat all over body.

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