Strychninum purum

 An alkaloid, obtained from several species of Strychnos, especially from Strychnos Nux vomica, L. Formula, с21H22N2O2.
 Preparation: Trituration of the alkaloid, or solution of its salts.

 Mind.
 Emotional. Delirious; she, however, possessed sufficient lucidity to state that a certain person had given her a white power in a glass of wine (after eighteen hours). She was much like a mad woman all night. Shouted out, They are coming for me. A species of imbecility arising from an excessive acuteness to impressions. A peculiar nervous erethism, almost resembling one I had seen in a case of hydrophobia several years before. The patient was very much alarmed and excited, slightly delirious, answering questions correctly when asked, but wandering when left to himself, and begged must piteously that I would not hurt him.
 I was forcibly struck with the very marked resemblance of the delirium in this case to that which I had often seen in mania a potu. The same nervous restlessness and fear of being injured, the same hyperaesthesia and shrinking for current affairs, made the similarity very striking (after seven hours). Nervous agitated feeling, with sensation of stupor and headache (twenty- first night). Extreme nervous excitability, ugly face passing before the eyes (twentieth night). Extreme nervous excitability; she felt light and nonsensical (thirty-seventh day). Mental condition agitated by consciousness perfect throughout.
 Excessively nervous and alarmed (after two hours and a half).
 Painful nervousness (fiftieth day). Involuntary idiotic-like chuckle (seventeenth day). Immoderate fits of laughing (thirty- fourth day). Fits of laughing, with a light swimming sensation and giddiness (after one hour, forty-first day). Extreme nervous excitability (forty-first and forty-seventh days). Screaming.
 Loud groans, convulsive sobbing (after fifteen minutes). Moaning (in fifteen minutes). Loud moaning (after one hour).
 Constant moaning, with complete consciousness. Exceedingly lowspirited (eighth day); very lowspirited and gloomy (thirteenth day); low spirits, gloomy, and desponding (twenty-seventh day); extremely low and gloomy (twentieth day); low spirits, gloominess (thirty-fifth day); low spirits, gloomy and desponding (forty- first day); low-spirited (eighth day); very low-spirited and gloomy (thirteenth day); low spirits, gloomy, and desponding (twenty-seventh day); extremely low and gloomy (twenty-eighth day); low spirits, gloominess (thirty-fifth day); low spirits, gloomy, and desponding (forty-first day); low spirited and gloomy (fifty second night). Rather morose and wholly un inclined to answer any questions in explanation of his symptoms. Anxiety, (after second powder). Great anxiety of mind. Great anxiety and restlessness. Anxiety and agitated. Excessive anxiety and uneasiness. General depression of spirits. A tendency to despondency. He had a feeling of dread, and begged he might not be left alone. A fear of something about to occur. Great fear and anxiety for relief. Mind harassed with dread; he is afraid, and sheds tears all the while; when asked why, replies, I don’t know. Irritability of temper (forty-third and forty-ninth day).
 Short, irritable temper (fifty-fourth day). Intellectual. Mind active and anxious. Muddled, confused feeling, in the morning (seventh day). Slight confusion of ideas (second day); considerable (after second dose, third day); slight (seventeenth day). сonfusion of ideas. His answers to my inquiries were rapid and unconnected (after three hours and three-quarters).
 Peculiar muddled vacant feeling, forgetfulness; she felt disposed to sit still and sleep (first day). Vacant feeling, forgetfulness (second day). Loss of memory (fourth day). Loss of memory, with a confused giddy feeling, at intervals (thirteenth day). Loss of memory and drowsiness, with extreme giddiness (seventeenth day).
 Feeling of stupor and drowsiness, with the severe pains in the head, at 8 (second day). A feeling of stupor and great weariness, with dull pains in the head and eyes (fourth day). A feeling of extreme stupor, at 10 p.m (seventh day). A feeling of extreme stupor (eighth day). Feeling of intense stupor (twenty-seventh night). A feeling of stupor and giddiness (after forty minutes, forty-third day). сonsciousness perfect, till death. During every violent paroxysm there will be temporary loss of consciousness, accompanied by a cessation of the act of respiration, the wide opening of the eyelids, and extreme dilatation of the pupils. Unconsciousness. Stupefaction, with complete loss of consciousness, body stretched out stiff upon the bed, the paroxysms recurring at short intervals, followed by death. The patient suddenly fell down unconscious. Insensibility ensued and lasted three hours, although the convulsions hardly ever ceased.

 Head.
 Headache. Violent headache, with bursting pains in the forehead, especially the left side, at 10 p.m (eighth and ninth days) Stupid headache, with extreme drowsiness (fifteenth day). Violent bursting headache, with stiff contracted feeling in the eyes, in the morning (sixteenth day). A feeling as if a bad headache was coming on, with extreme fullness of the head and ears, in the afternoon (twenty-second day). Slight headache, with dull pains in the forehead and eyes, in the morning (twenty-third day). Distressing headache, in the morning (forty-third day).
 Slight headache (forty-seventh day). Headache, with pains in the eyes (fifty-second day). сonstant headache, sleeplessness, and slight fever, caused by nervous apprehension and dread of rectal spasms, which came on very suddenly, and without previous warning. Headache coming on suddenly, especially in the left half of the head and left eye, at 4 (third day). On rising in the morning, severe headache, a sensation as if the head would burst when stooping (second day). Severe pains in the head, generally in the left eye and behind the ears, with a feeling of stupor and drowsiness, at 8 (second day). Violent pains through the head, from the back to the front (eleventh day). Violent pains in the head, especially in the forehead and over the left eye, in the morning (thirty-third day). Violent pains in the head and muscles of back of neck, in the morning (thirty-fourth day).
 Violent pains in the head and eyes (forty-first day). Momentary darting pains, in the head and under the jaw, left side (third day). Severe darting pains, in the head and back of the neck (eleventh day). Sharp pains flying about the head; at times a fixed pain in the vertex (second day). Sensation as if an iron cap was on the head (twenty-fourth day). Racking pains seized her whole head. Violent thumping pains, in the head, especially the right half, and over the left eye, lasting about two hours, in the evening (nineteenth day). Shattered sensation, in the head, with drowsiness (thirty-third day). Darting pains, in the head and eyes (fifty-third night). сonvulsive jerkings and shocks transversely through the hemispheres of the brain, associated with pain extending into the eye. Feeling of a cold in the head, in the evening (thirty-fifth day). Felt strange sensation in head (after twenty minutes). Throbbing pain in head; less pain about the forehead than in any other part of his head.
 Forehead. Headache, especially in the forehead and eyes (twenty- ninth day). Headache in forehead and eyes, in the morning (thirtieth day). Temples. Sharp darting pains in the left temple and round to back of left ear (sixth day). Rapid pulsation in left temple and in left hypochondrium, in the morning (fortieth day). Vertex and Parietals. Sudden pain and pressure at the top of the head and in the left eye (twelfth day). Peculiar paralyzed feeling in the left half of the head and face (seventh day).
 Occiput. Dull pains in back of head and temples (fifteenth day). Feeling of pressure in the back of the brain, with nausea at noon (thirty-fifth day). сonstant pain in the back of head and nape of neck, lasting the whole day (thirty-fifth day). вoring pain in the occiput. Pains in the back of the head, extending down the entire length of the spine (seventh day). Sharp pains in the back of the head, extending to the left eye, and to the back of the right ear (eighth day). Sharp pains in the back of the head and in the glands of the neck (seventeenth day). Darting pains in back and top of head (forty-first day). Sharp darting pains in the back of head and neck, in the afternoon (fifty- second day). External head. Sore pains in the scalp, as if the hair had been pulled (twelfth day). Intense itching of scalp and nape of neck (thirty-sixth day).
 Eye.
 Objective. Eyes highly injected, and in constant motion, as from seemingly great affright as indeed, his mind fully evidenced (after three hours and three-quarters). Eyes injected and protruding. Eyes a little suffused. Eyes sunken. Eyes sunken, and moved with a rapid motion. Rolling of the eyes, as if they were two cold bullets (twenty-fourth day). Torsion of the eyes (after second powder). Eyes turned to one side, quite staring. The eyes were drawn upward and greatly congested. The eyes appeared to be starting from their sockets, the head was forcibly drawn round, the arms and legs horribly convulsed, she being conscious at the same time. Protruding eyes. Eyes staring. Eyes protruding, turned towards the right, and fixed, with dilated, insensible pupils, and red conjunctiva. Eyes protruding, rigid, turned to the right. Eyes fixed, and turned upwards. Dimness of the eyes (third and fifty-fifth days). Dimness and aching of the eyes (thirty-fourth day). Subjective. Dull pains in the eyes and head (forty-third day). Aching and smarting of the eyes, in the afternoon (thirty-sixth day). Aching of the eyes with dull misty vision (forty-third day). Severe pain in the left eye, at 8 (second day). Sudden pain and pressure in the left eye and at the top of the head (twelfth day). Violent pains in the left eye (thirty-fifth day). вoring sensation in the eyes, especially the left eye (forty-third day). Weight in the eyes, with sharp pains in the left half of the head, and in the left eye (seventh day). A feeling as if the eyes were suddenly stiffened and drawn back, lasting a few minutes (seventh day). Stiff sensation in the eyes; she felt unable to look up (seventh day). Stiff contracted feeling in the eyes, with violent bursting headache, in the morning (sixteenth day). Fixed stiff sensation in the eyes, with extreme giddiness (after half an hour, thirty-fourth day) Heavy stiff sensation in the eyes (thirty-sixth day). Stiff fixed sensation in the eyes, with burning and itching (forty-first day). Stiffness of the eyes, with burning and itching (forty- third day). Fixed feeling in the eyes (fiftieth day). Stiffness of the eyed, with stinging and smarting (fifty-third day).
 Burning in left eye and left ear, in the afternoon (second day).
 Eyes very hot and painful (ninth day). вurning heat in the eyes (eleventh day). вurning heat in the eyes and eyelids (twelfth day). Hot fixed sensation in the eyes (fourteenth day).
 Burning heat in the eyes (sixteenth day). Intense burning of the eyes (twenty-first night). Intense burning of eyes and ears at night (forty-seventh day). Sudden burning and itching of eyes (fifty-third day). A feeling as of a cold in the eyes, at night (forty-eighth day). Orbit. Tender, bruised feeling over the left eye, with fixed pain toward evening (ninth day). Rapid pulsation over left eye (fiftieth and fifty-second night). Lids. Eyes widely opened. The eyelids are closed, as though to shield the eyes from an intense glare of light. Eyelids closed all the time, as though the light was intolerable; in fact, the lids were only separated during the convulsions, and then the pupils were widely dilated. Keeps his eyes always shut (after twelve hours).
 Violent rapid pulsation in the left upper eyelid, with weakness and watery discharge from the eye, lasting for eight hours (thirty-second day). Rapid pulsation in the left upper eyelid, lasting for several hours (thirty-first day). Lachrymation.
 Increased lachrymation. сonjunctiva. сonjunctiva injected. вall.
 Aching of the eyeballs (twenty-seventh night). Sharp, sore pains in balls of eyes, in the evening (sixteenth day). Sharp needlelike pains in the balls of the eyes (twenty-seventh day).
 Sharp pains in the balls of the eyes (twenty-eighth day). Pupil.
 Pupils slightly dilated. Pupils dilated. Pupils greatly dilated. The pupil was somewhat dilated and the eye staring, its motion tremulous and both orbits constantly oscillating in their orbits, like the eyes of the albino; there was no suffusion, however, throughout. Pupils dilated to their fullest extent; the eyeballs appeared to be protruding out of their sockets. Pupils dilated during the spasms. Pupils dilated and insensible. Pupils, at one time dilated, at another contracted. Pupils contracted.
 Contracted pupils; during paroxysms pupils dilated. Pupils about natural, or if anyway abnormal, rather contracted. Vision.
 Dimness of vision (after twenty minutes); (thirty-sixth day).
 Sense of sight became much impaired (soon). сonfused misty vision (thirty-ninth day). Persistent amaurosis. Numerous sparks before the eyes, sometimes blackish, sometimes white, sometimes red.
 1st. Increased peripheral sensibility for blue. 2d. Temporary increase of visual power. 3d. More distinct perceptible of peripheric points. 4th. Lasting enlargement of the field of vision.
 Ear.
 Creeping tingling sensation in the external ears (second day).
 Sudden burning and itching of ears, eyes, and nose (fifty-third day). вurning in the left ear and left eye, in the afternoon (second day). Sudden burning heat in the left ear, and along the lower jaw of same side, at 10 (eighth day). Intense burning of and bruised feeling in the ears (twenty-second day).
 Intense burning and itching of the ears, nose, and lips, at noon (twenty-fifth day). Intense aching behind the ears and down the spine (twenty-fourth day). Sharp darting pains behind the right ear (twentieth day). Sharp darting pains in and behind the ears, and back of the head and neck (thirty-sixth day). сracking in the ear and jaw; it is very painful to move the jaw, as in clenching the teeth (forty-fifth day). Digging pains deep in the left ear (eighth day). A feeling of intense fullness in the ears (second day). Hearing. The ears become appreciative of the slightest sound in the room. Hearing very acute, and remarks made in a very low tone of voice were replied to quickly. Roaring in the ears. Noise in the left ear like wind (seventh day). Humming in the ears (twenty-third day).
 Nose.
 Frequent fits of sneezing with itching and stinging of nose (forty-seventh day). Peculiar stinging in the nostrils, as if a cold were coming on (thirteenth day). вurning and tingling in the nose, ears, and lips, at noon (twenty-fifth day). Sudden burning and itching of nose (fifth day). Intense itching of nose, as if in the bone, lasting the entire day (second day). Intense itching and stinging of the nose (thirty-fourth night).
 Face.
 Face swollen and burning hot; I was exceeding surprised at the appearance she presented, in the morning; her eyes were half closed with swelling, and I could only compare them with those of a person stung by bees; but the next evening everything looked favorable, with a decided abatement of the swelling and pain.
 Face puffy, covered with perspiration. Face puffy and red. Face puffy, pale, distorted. Face puffy and bluish red, with open mouth. Face puffy, dark-violet colored, lips dark blue. The muscles of the face and about the mouth became rigid and drawn, as in risus sardonicus, it became impossible to utter articulate sounds. Hard stiffness of the muscles of the face (sixth day).
 Hard rigidity of the muscles of the face (thirty-fourth day).
 Contorted countenance. Expression of extreme terror.
 Expression of extreme sadness and despondency. Anxious expression of countenance. сountenance expressive of intense anxiety and distress. сountenance extremely anxious (after one hour).
 Expression indicative of great suffering. Expression of countenance hideous (after six hours). Face exhibiting an almost maniacal expression. Wild look with dilated pupils and red face.
 Face became gradually pale, from above downwards, lips remaining livid. Pale sunken look. Face deathly pale. Face pale, anxious. Face pale and distorted. сountenance pale and blue (after three to four minutes). Face somewhat flushed (between the spasms). Face flushed. Face suffused and red. Face much flushed (after twenty minutes). During the day, flushing and heat of face (second day). Face flushed and bathed with cold clammy perspiration (after three hours and three-quarters). сountenance suffused and livid. Face livid. During the spasms, the countenance became livid, and in the last and fatal convulsion, it suddenly became almost black. Face of a livid red and covered with profuse sweat. Features livid, congested. Face blue. Face bluish red. Face of a dusky hue (after one hour). Face of a dark- purple hue.-260. Face and hands livid. Purple color of face (after two powders). Face began to become black (immediately).
 Tremulous feeling in the muscles of the face (seventh day).

 Confusion and Vertigo. сonfusion and slight giddiness (twenty- seventh day); confusion and slight giddiness, at noon (twenty- eighth day); confusion and giddiness with slight trembling (after one hour, thirty-seventh day); muddled feeling in the head (thirty-ninth day); confusion in the head, with feeling of intoxication, at night (forty-first day); confusion and loss of memory (forty-third day). Vertigo etc. Vertigo and inclination to fall forward (after three to four minutes); (after a few minutes. Vertigo with roaring in the ears. Excessive vertigo even while lying down, associated with nausea. Great dizziness. Giddiness and nausea, a sensation as if the brain had been overworked, with great weariness (third day); slight giddiness, at intervals (tenth day); sudden giddiness and extreme drowsiness while walking in the street; she felt as if a cloud was coming over her (after one hour, eleventh day); confused giddy feeling, at intervals, with loss of memory (thirteenth day); giddiness (fourteenth day); giddiness, at intervals (fifteenth day); extreme giddiness, with loss of memory and drowsiness (seventeenth day); giddiness, at intervals, with tremulous feeling, in the afternoon (nineteenth day); extreme giddiness, with a tremulous sensation down the back (after three quarters of an hour, twenty-first day); giddy bewildered feeling (twenty-seventh day); extreme giddiness, with fixed stiff sensation in the eyes (after half an hour, thirty-fourth day); giddiness; light swimming sensation, with fits of laughing (after one hour, forty-first day); sudden momentary giddiness, with dull pains in the head and eyes, at noon (forty-second day); a feeling of giddiness and stupor (after forty minutes, forty-third day); giddiness; light swimming sensation in the head (after three- quarters of an hour, forty-seventh day); extreme giddiness; light swimming sensation in the head (two hours after first dose, fiftieth day). Extreme giddiness and confusion in the head (after half an hour, fifty-third day). General head. Jerking of the head forwards (twenty-fourth day). Head jerked backwards. Head drawn backward. Veins of the head, neck, and face became highly turgid. Violent congestion of the head, so that the face looked bluish-black, with very red protruding eyes. A feeling of weariness in the brain; she felt a great desire to lie down and sleep (fourth day). Dull pains in the head and eyes, with a feeling of stupor and great weariness (fourth day). Dull pains in the head and eyes (forty-third day). Slight dull pain in the head, behind the right ear (after two hours, fifth day).

 Cheek. Sharp needlelike pains in the cheek-bones and under the jaw, left side (thirteenth day). Keen sharp pain in the left cheek-bone, shooting to the upper teeth (twenty-second day).
 Lips. He was making constant motions with his lips as though he desired drink (after three hours and three-quarters). Lips retracted. Lips blue. Lips livid (after twenty minutes).
 Lips livid and retracted. Lips and tongue purple. Lips tumid.
 Burning and tingling in the lips, nose, and ears, at noon (twenty-fifth day). сhina Jaw partially set, and the handling caused an abortive convulsion. Trismus, etc. Lower jaw spasmodically closed. The muscles of the jaws remained to rigid between the spasms as to prevent their being opened sufficiently to admit the tube of stomach-pump being introduced. Jaws locked and deglutition impossible, with foaming at the mouth similar to that observed in patients suffering from hydrophobia. Trismus and constriction of the throat on swallowing. Periodic attacks of trismus. сonsiderable stiffness of muscles of mastication, and difficulty in opening and shutting mouth (second day); slight stiffness of muscles of jaws and hands (fourth day). Stiffening of the jaws and neck (fourteenth day). The jaws were suddenly stiffened for a few minutes, and then in a moment became relaxed (fifth day); stiffening of the jaws (seventeenth day); stiffening of the jaws, and afterwards of the muscles of the face and hands (twenty-first day); stiffening of the jaws and muscles of the face and neck (twenty-fourth day); stiffening of the jaws and muscles of the face and neck (twenty-seventh day); stiffness of the jaws and muscles of the face (thirty-fourth day); slight stiffening of the jaws (thirty-seventh day); stiffening of the jaws and muscles of the face (forty-first day); stiffening of the jaws (forty-third day); momentary stiffness of jaws (forty- seventh day); stiffening of the jaws, muscles of face, and throat (fiftieth day); stiffening of jaws, affecting the speech (fifty- third day). Stiffening sensation in the jaws (sixth day); stiffening heavy sensation in the jaws and muscles of the face (eleventh day); stiff tight sensation in left articulation of jaw, with much pain at times; also a similar feeling in muscles of neck and down the spine (forty-eighth day); tight feeling in jaws, with hard rigidity of the muscles (fiftieth night). Pain in the articulation of the jaws and muscles of the back of the neck (twelfth day). Pains in the articulation of the jaws and in the back teeth (thirteenth day). Dull pains in the articulation of the jaws, shooting into the temples, in the evening (twentieth day). Dull aching and stiff sensation in the jaw and muscles of neck, in the afternoon (forty-fifth day). Dull aching in articulation of jaw, with tight sensation about the jaw and ear, in the morning (forty-sixth day). Rheumatic-like pains, especially in the articulation of the jaws and extensors of thighs (nineteenth day). Severe tearing pains in the articulation of the jaws, with sore stiffness in the muscles of the face and nerves of the teeth (thirty-sixth day). Sharp pain in articulation of jaws and in the muscles of neck, left side, at noon (forty-fifth day). Sharp needlelike pains under the jaw, left side (fifteenth day). Sharp needlelike pains in lower jaw, left side (twenty-eighth day). Tremulous sensation in the jaws, with peculiar creeping chilliness all over (third day). Shooting pains under the jaws and in the muscles of the chest, left side (second day). Sharp needlelike pains under the jaws, especially the left side, at 8 (twelfth day). Peculiar pulsation in the chin, as if in the nerves of the lower front teeth, at short intervals (forty-second day). Pulsation in the chin (forty-third and forty-ninth days).

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