Mancinella

Hippomane mancinella, Linn.

Natural order, Euphorbiaceae.

Common names, Manchioneal, Manzanillo.

Preparation, Tincture of the fruit, leaves, and bark (Bute).

Authorities. 1, Bute, provings with tincture on various persons, from Hering’s compilation. All. Zeit. f. Horn., 1850, second supplement, p. 127 ; 2, Hering, poisonous effects observed by different persons, ibid.; 3, Mure, Pathogenesis Bresilienne, p. 156, two provings by E. T. Ackermann, with the tincture (of the leaves); 4, Richard-Madiana, Recherches et exp. sur les poisons d’Amerique, from Gaz. Horn, de Paris, 1850, p. 406 (see also Am. Observer, March, 1876, same authority, from paper read before Lyceum of Nat. Hist, in New York), effects of chewing the fruit; 4 a, same, effects of volatile poison while digging the roots ; 46, same, effects of chewing the root; 4 c, same, effects of vapor while preparing a decoction of leaves in water; 4c?, same, effects of taking 4 grains of the gum ; 4e, same, effects of external application of the milky juice; 4:f, same, effects of a few drops of milky juice on tongue; 5, Peyssonel, Journ. de Med., 1757 (Frank’s Mag., 1, 753), effects of eating two dozen apples; 6, Summer, effects of the tincture (from Hering); 7, Rafiuesque, general effects ( from Hering); 8, Bardill, effects of dew from the leaves dropping on to the skin (from Hering); 9, Descourtils, as last; 10, Castera, from Wibmer, effects of breaking off a small twig; 11, Efs, Gaz. Horn, de Paris, 1850, p. 400, pathogenetic effects, from Ann. d’Hyg., 32, 126 ; 12, Petroz, symptoms (undistinguished) from provings hy self and two women (dose not mentioned), Gaz. Horn, de Paris, 1850, p. 441; 13, Karsten, having passed some hours under the trees began to experience effects. Tribune Med. (Lond. Med. Rec., 1, p. 752); 14, Hamilton, ate a very small fragment of the fruit before breakfast, Pharm. Journ., 5, 408; 15, same, effects on a man of tasting the milky juice; 16, same, effects of eating the fruit; 17, same, effects in a negro from eating several of the apples; 18, same, effects in a man of getting some sap in his eye while felling a tree.

Mind p. 143

JEinotioiifil, Silent mood (second day)

Profound mental tranquillity, in the morning

Cheerfulness ; desire to sing (first day)

Disposed to take everything in good part (first day)

Feelings of tenderness and deep compassion (third day)

Sadness (second, fourth, fifth, and seventh days) ; in morning (sixth day); before menses

Anxiety caused by uneasiness in the hypochondria; worse on walking, or becoming chilled

Fearfulness

Morose mood

Indifference and dulness, in the morning

Intellectual. Meditative mood

Activity of mind, disposed to work (ninth day)

Aversion to work (fifth day)

He is boiled by everything (third day)

Wandering thoughts (second day)

Absence of thought (second day)

Great dulness, with indifferent mood

Comatose state; constant drowsiness (third day)

Head p. 143

Confusion and Vertigo, Confusion in the sinciput, lasting eight days

Confusion in the forehead

Vertigo in the morning, and again at noon

Vertigo, worse in the open air (in a boy)

Vertigo on getting out of bed

Vertigo on looking long and steadily at anything, or reading aloud

Vertigo, better in the open air (in a girl)

Vertigo, with sensation of torpor

Slight vertigo, with sleepiness

Dizziness

General Head, Empty feeling in the head

Heaviness in the head (twelfth day)

Heaviness of the head; he is compelled to lie down, and feels nauseated

Great heaviness of the head, with constant pain in it (third day)

Excessive heaviness of the head (third day)

Mounting from the stomach to the head, and turning around in it

Mounting from the stomach gradually more and more into the head ; afterwards vomiting through the nose and mouth, followed by disappearance of the headache

Pain in head, extending to eyes

Pain in the lower part of the head, with heaviness as if it was bruised (second day); the pains in the head continue, and make him impatient (third day)

Confused pain in the head when writing (twelfth day)

• Headache (fifth and sixth days); all day; (second day)

The headache becomes intolerable (fourth day)

Headache with vertigo, especially in the morning, after eating a piece of bread (seventh day)

Headache, with nausea and soreness beneath the right short ribs; worse while walking, and lasting several hours

Headache, disappearing after vomiting

Incessant headache (third day)

Very violent headache, with very painful lancinations, it continued all night, with sleeplessness (after one hour); continued headache, especially in the temples and above the eyes (second day)

Burning in the head

Congestion to the head, before the menses

Feeling of constriction in the forehead and occiput

Pressure on the brain

Sticking pressure from the vertex through the brain, at noon

Lancinating pain in the head, as soon as he sits down to eat (twelfth day)

Painful lancinations in the head, temples, and above the eyes (third day)

Short stitches in several parts of the head and in the bones of the face/.

Tearing pain in head/

Pain as from a blow, all around the head; after long exposure to the sun (second day),I

Throbbing in the head,’I

Throbbing in the upper part of the head,h

Hammering pain in the head and nape of the neck, with inability to bend the head down when writing (fourth day)

Forehead, Pressure in the forehead

Temples. Pain in the left temple,h

Lancinating pain in the left temple (fourth day)

Sudden sticking in the right temple and above the eye

Vertex. Pain as from a nail driven into the vertex

Pain in the right side of the head, while listening to strokes on an anvil; he felt as if receiving them himself (second day)

Farietals. Sudden headache in the left side, especially in the temple

External Head. Pain in the head, as if the skin of a bladder was applied from temple to temple (twelfth day)

Contraction of the scalp at the vertex

Itching on the scalp

Itching on the vertex, at short intervals

Eyes p. 144

Ohjective. Blue rings around the eyes

Eyes red and staring

Injection of the vessels of the eyes

The inflammation of the eye ran very high, but was easily subdued; he recovered in three days

Excessively painful inflammation in the eyes, with photophobia

Very violent, painful inflammation in the eyes, so that he feared he would lose his vision; from touching the eye after handling a twig of the plant,®.t

Subjective. Burning in the eyes on closing them (at first)

Burning in the eyes, which compels him to close them (later)

Pressure in the eyes

Sense of weight over the eyes (second day)

Sticking-itching in the right inner canthus, with fluent coryza from the right nostril

The eye symptoms usually alternate with the diminution of hearing

Idl'OW. Sticking above the left eye

Lids. After some time, the eyelids were swollen to such an extent that they could hardly be opened, and the increased sensitiveness of the eyes was such that he was obliged to shut himself for some days in an absolutely dark room, and even then he still suffered much; the swelling diminished in three days, and the cuticle began to peel off

Feeling of dryness in the lids

Sticking in the middle of the margin of the right lower lid

Fall. Cutting pain in the middle of the right eyeball only when he refrains from winking

Dull stitches deep posteriorly in the left eyeball

Vision. Objects waver before the eyes

Ears p. 144

External. Redness and heat of the ears (second day)

Pressure behind the ears

Hiddle. Sensation of numbness in the ears

Twitching in the ears

Itching in the right meatus auditory

Heariny. Roaring in the ears

Ringing in the ears, and whistling as of the wind, when walking (first day)

Ringing in the ears, with a drumming sensation, when walking in the wind (fourth day)

Noise in the ears, like voices

Nose p. 144

He blows his nose more easily than usual (second day)

Sensation of dryness in the nose

Pressure at the root of the nose

Annoying smells before the nose, like burnt horn, gunpowder, dung, etc.,'®.

Face. Red face before a stool

Yellow complexion, with redness of the whole body (second day)

Pale face

Pale lips

Drooping of the lower lip

Lancinating pain in the lips

Mouth p. 145

Teeth. Sensitiveness of the upper teeth

Tongue, Tongue swollen

Tongue and inside of mouth covered with small pimples,h

Dry tongue

Burning of the tongue

Very slight prickling on the tongue,*h

It tingled his tongue gently

General Mouth. A blister as large as a hazelnut in the centre of the palate

Blood in the raouth,*l

The palate is excoriated

Inflammation of the mouth

Mucous membrane of mouth filled with small pimples

Inside of lips and end of tongue covered with small pimples

Dry mouth (fifth day),l

Dryness of the mouth, with tenacious mucus, in the morning; offensive odor from the mouth, with coated tongue and thirst (third day)

Almost intolerable heat and pricking in the mouth; the burning sensation is not allayed by cold water

Sensation of burning heat in mouth; the smarting was so extreme that I was obliged to hold cold water in my mouth, and renew it frequently (immediately)

Smarting heat on tongue, mouth, and throat (after half an hour).

Smarting and burning very severe ; was obliged to keep cold water in the mouth, the pain becoming insupportable (after two hours)

Mouth feels as if full of pepper

Burning, as from pepper, in the mouth and fauces

Pricking in the mouth while eating bread (eleventh day)

On account of the state of the mouth and tongue, only liquids can betaken

Saliva. Salivation

Considerable salivation (after two hours)

Copious salivation (after some minutes)

Saliva thin and fluid

Burning-hot saliva,*l

Offensive saliva,*l

Mouth filled with water (after a few minutes)

Accumulation of sour water in the mouth,*l

Taste. The juice at first tastes flat, then acrid, and causes a burning astringency posteriorly in the fauces (Hering)f.

Metallic taste in the mouth (second day)

Taste of blood in mouth all day (second day),®».

Taste of blood in the mouth, as if from a clot of blood which had risen into the throat (third and fourth days)

Throat p. 145

Great and constant dryness of the throat (second day)

Heat in the throat, along the oesophagus, without thirst

Burning, with raw pain, in the throat, the pain gradually extending forward from the arch of the palate, and lasting five hours

The throat feels contracted

Lancination in the throat

(A kind of malignant sore throat)

Scraping in the throat, in the region of the larynx, especially sensitive on smoking

Ulcerative pain in throat

Prickling extended to the throat (after adding 3 drops),*k

Throat symptoms better when yawning,*®..

Fauces Fharynoc, and Q^sophagus. Burning in the fauces and root of the tongue, with accumulation of water in the mouth

Burning in the fauces and upper part of the pharynx

Burning in the oesophagus

A burning sensation in the fauces, oesophagus, and stomach for some hours

Stomach p. 145

Appetite. Increased appetite

Great appetite (ninth day)

Desire for tobacco

Great desire to smoke (fifth day)

Loss of appetite

Alternate hunger and want of appetite (second day),®

Almost complete loss of appetite (third clay)

Complete loss of appetite (fourth day)

Aversion to everything (sixth day)

Loathing (second day)

Aversion to bread

Thirst. Thirst every hour all day; desire for water, with aversion to wine and all other liquors (fourth day)

Constant thirst all day (filth and seventh days)

Increasing thirst until evening (sixth day)

Thirst intense

Eructation, Incomplete eructations

Constant eructations of air (first day)

Noisy eructations, a kind of sobbing, when food is at all difficult of digestion; it occurs when swallowing, at night, even in sleep, and after drinking beer; also caused by stooping

Hot eructations during expiration, with an oppressed feeling (second day),l

and Vomiting/f. Nausea and pain in back during stool

Qualmishness

Vomiting

Forcible vomiting

Watery vomiting (first day)

Vomiting of ingesta, followed by violent griping and copious stools,b

Green vomiting

Black vomiting

Bitter vomiting,'.-Weak stomach (second day),l

Torpid feeling in the stomach,'l

Severe pain, with weight in the pit of the stomach, for a minute (second day)

Sensation of heat in the epigastrium

Burning in the stomach,'*’. Burning in the stomach and throat, with nausea

Burning sensation in the stomach, without vomiting

Its reception in the stomach was attended with a burning sensation

Paroxysmal sticking in the stomach, with diarrhoea, . Epigastric region very sensitive to touch

Abdomen p. 146

Hypochondria. Pain in the hypochondria (fourth (Jay),'A

Pain in the right hypochondriura, worse when walking

Sudden sticking in the left hypochondrium

Lancinations in the hypochondria and scapulae (third General Abdomen. Distension of the ahdonien

After an hour, the abdomen became greatly swollen, while a burning fire raged in his bowels, with trembling of the whole body, cold sweat, weakness, and constant faintness

Increased emission of flatus and empty eructations

Copious emission of flatus (second day),^. Pains in the abdomen

Tension of the abdomen

Griping in the bowels (before the menses),'l

Griping at the appearance of the menses,'I

Dull pain in right flank, lasting all day

Transient boring pain in the abdomen on respiration

Twitching pain in the bowels (fourth day)

Cutting in the abdomen, followed by diarrhoea

Lancinating pain in the bowels (fourth day)

Frequent violent lancinations in the abdomen and bowels (third day)

Repeatedviolent lancinations in the right side of the abdomen (second day)

Great pain in the abdomen, as if it had been struck with a pointed stick (first day)

Colic and diarrhoea (fourth day),l

Colic, and four stools, one of them bloody

Hammering pain in the abdomen after breakfast (second day)

Bruised pain in the abdominal walls

Sensation as from a blow in the abdomen, followed by an evacuation (seventh day)

Ilypogastvium and lilac Regions. Pain in the lower portion of the abdomen, followed by a stool

Cramps in the hypogastrium during menstruation

Griping pain in the right side of the lower abdomen, immediately followed by emission of flatus

• Dull pain in the left groin

Lancinations in the groins (fifth day)

Rectum and Anus p. 146

Swelling of the hremorrhoids, which become blue

Dark blood from the luemorrhoids, which coagulates at once, and is offensive

Inertia of the sphincter ani, as if paralyzed

Pain in the anus after stool,'I

A pressive pain in the anus during and immediately following a stool

Pulsation in the anus after stool

Feeling of fulness in the rectum, with a sensation of emptiness in the stomach

Dragging in the rectum

Urging to stool

Stool p. 146

Diarrhoea. Frequent diarrhoea, with much emission of flatus; after the diarrhoea ceased, he was attacked with pains in the legs, from the hips to the ankles, feeling as if the flesh were beaten

Two attacks of diarrhoea and colic, with twitching pain in the bowels, at midnight (second day)

Diarrhoeic attack, with pain and tenesmus. It began with a natural stool, followed by frequent painful evacuations, at first black and offensive, then watery. Lasted more than two hours (fourth day)

Copious stools, with colic and dizziness

Frequent stools (eleventh day)

A great many stools, with discharge of blood, colic, drowsiness, and dizziness

More than twenty stools, from 2 to 8 p.m., with pain and burning heat in the bowels

Thirteen stools

Nine green stools, without blood

Two stools

Easy stools (second day)

Sudden desire for stool ill the morning, and entire inability to retain it, followed by tenesmus

Constipation, Constipation

Constipation for eight days following the diarrhoea

Urinary Organs p. 147

J^Jadder, Considerable excitement in the bladder

Lancinations in the bladder when beginning to urinate; he feels better while finishing (fourth day)

Utethva. Burning in the urethra

3Micturition, Copious micturition

Diminished micturition (fourth to sixth day)

Infrequent micturition

Urine. Urine scanty, whitish (first day); copious, but always whitish (second and third days); clear, copious, and whitish (fourth day); clear and profuse (fifth, sixth, and seventh days)

Sexual Organs p. 147

Itching on the scrotum

Sexual desire (fifth day)

Menstrual blood pale

Respiratory Organs p. 147

Larynx, Tension of the larynx

Cutting in the larynx

Cough and Expectoration. Coughed a little during the day

Cough caused by irritation of the larynx

Cough after drinking

Cough, with sw^eet taste in the throat

Violent cough, with painful pricking in the throat, on the least exertion (fourth day)

Cough, with bloody mucous expectoration

The cough is more frequent at midnight

White expectoration (second day)

Respiration, Slight rattling noise in chest during respiration

Deep and frequent inspirations (fourth day)

Difficult breathing when falling asleep again (second day)

Suffocation and throbbing in the chest when about to laugh (fourth day)

Sudden suffocation, and violent throbbing in the chest, just as he begins to speak (fourth day)

Chest p. 147

Objective. The chest is much dilated wdien drawing breath, even with the mouth closed (third day)

Spasmodic contraction of the thoracic walls

Weakness of the chest (fourth day)

Subjective. Pain in the chest on the least movement (fifth day)

Sensation of heat and trembling in the chest (first day)

Burning in the chest

Constriction of the chest

Constant dull pain in the left chest

Oppression of chest

Lancinating pain in the chest (fourth day)

Bruised pain in the chest, with difficult breathing (third day)

Bruised pain in the clavicles, on turning the head to either side (twelfth day)

Lancination in the sternum

Intense lancinating pains in the left side (third day)

Heart and Pulse p. 147

Rraicordlum, Pain in the precordial region, after eating

Cramps in the heart

Pricking through the heart (fourth day)

Heart’s Action. Palpitation in the evening

Palpitation after eating

Raise. Pulse 80

Neck and Back p. 147

Neck. Pain in the nape of the neck and in the forehead, when stooping; it is so confused that he cannot describe it (second day)

Hammering pain all around the neck (second day)

Hammering pain on the left side of the neck (second day)

Hammering pain in the neck, relieved for a few moments by holding the head backwards (eleventh day)

Rack. Crawling as from worms on the right side of the back, close to the middle of the spine

Dorsal. Weakness in the dorsal muscles

Rheumatic pain in the shoulder-blade (second day)

Tearing in right shoulder-blade

Lainbav. Pain in the region of the kidneys/.

Raw pain in the lumbar region/

Sacral. Boring in the sacral region/

Pain in the coccyx/

Extremities in General p. 148

Lassitude in all the limbs, with indescribable malaise/.

Feeling of tension in the joints generally

Bruised feeling of the lind)s

Superior Extremities p. 148

Trembling of the arms

Stiffness of the arms

The arm feels swollen

Pressure in the arms

Lancination in the arms/

Three slight beats on the arm, like finger-taps (second day)

A sudden electric-like shock through the left arm and shoulder, when writing in the evening

Shoulder. Lancinating pain in the left shoulder (fourth day)

Arm. Intense lancinating and constrictive pain in the muscles of the upper part of the right arm, for more than an hour (third day)/

Elbow. Continued pain in the elbow-joint (third day)

Heat in the elbow

Tension in elbow-joint

Very sharp pain in the elbow-joints (second day)/

Wrist. Pain from morning to night in the wrist and metacarpus, as if strings were tied tight around them (second day); the constrictive pain in the wrist shifts to the middle of the left arm for nearly an hour, after which it returns to the former place (third day)

Hand. Redness of the hands during the day (second day)

Swelling of the veins of the hands (second day)/.

Twitching in the hands

Awkwardness of the hands

Lancination in the hands/

A dull stitch along the metacarpal bone of the left index finger

Fhlfjers. Blue finger-nails

A dull stitch in the ball of the left thumb

Tearing pains in the fingers like gout

Inferior Extremities p. 148

Objective. Trembling of the lower limbs

Twitching and jerking in both lower extremities

Paralysis, first of the thighs, then of the legs/.

Sabjeetive. Pain up and down the legs, after the diarrhoea; at last the pain in the left lower extremity disappears and becomes seated on the lower posterior portion of the right thigh, just above the bend of the knee, with a feeling as if a boil would develop, very much impeding walking (repeated after a second dose)

Constriction of the thigh and legs, as if a string were tied around them (fifth day)

Cramps of the legsand feet

Sudden needle-Uke stitches in both lower extremities

A bruised sensation in the lower extremities

Thi(/h. Needle-like stitches posteriorly on the thigh, near the hip-joint/.

Twitching and jerking posteriorly in the middle of the thigh

Knee. Lancination in the right knee-joint (third day)

A sharp stitch as with a needle, in the left patella, somewhat relieved by rubbing, but immediately returning

Pricking for two hours in the left knee-joint (eleventh day)

Bruised pain in the bends of the knees (fifth day)

Le(f. The right lower leg falls asleep in the evening/.

Violent pain like a cramp in the right calf, extending upward to the lower portion of the back, and transversely across the small of the back, with so great weakness that she could scarcely walk

A sore pain on the tibia, in the evening in bed; on

the hand the pain became a violent burning; next morning there was found a small inflamed spot covered with a crust

Ankle. Swelling of the left malleolus (eleventh day)

Foot. Painful heaviness in the feet, when walking (fifth day)

Burning pain on the top of the right foot, as from a glowing coal

Dull pain in the bones of the foot, extending from the heel to the toes/.

Toes. Repeated dull stitches on the inner side of the left great toe

Generalities p. 148

Objective. Hands and face swollen and inflamed/

Very active when at work/

Convulsions

It causes sleep, trembling, convulsions, etc., like narcotic poisons

General debility all day (second, fourth, and fifth days)

Prostration (fifth day)

Obliged to lie down on account of the fever (which is slight), and quite a bad headache

She is obliged to lie down ; with irregular pulse, cold extremities, and the greatest anxiety

He lies down, and gets up alternately (second day®.

Sffbjectire. Inclination to lie down (sixth day)

Inclination to remain lying (eleventh day)

General heaviness (sixth day)

A nervous sensation of lightness, as if he could soar into the air,h

Very disagreeable sensation on hearing the noise of a saw (second day)

While listening to hammer-strokes, he feels their repercussion all through him (second day)

Paralytic sensation immediately after rising in the morning; his hand trembles very much ; he cannot open his room-door (second day)

Malaise after drinking

Excessive malaise

Lancinations at irregular intervals in the left shoulder-blade, and in the muscles of the left side of the chest (second day)

Lancination in the muscles of the right knee, also in the ribs and right side (fourth day)

Sticking in the back and on the crest of the ilium

Sudden needlelike stitches here and there

Throbbing in the whole body

Burning in the stomach ; swelling of the legs up to the knees, pitting on pressure; red swollen spots as large as the hand here and there on the abdomen and chest; extremely irritable and peevish ; began to be better in cool weather; after several weeks there was an eruption of blisters half an inch in diameter, especially on the soles of the feet, when he felt better internally; the swelling remained longest on the ankles (poisoning)

Pricking in the skin, together with feverish horripilation ; succeeded by heat, with desire to be uncovered ; then loss of consciousness ; great debility; painful difficulty in swallowing; restlessness; copious urination

Emotional disturbances are accompanied by indescribable uneasiness, hammering pain in the chest, and loss of speech (fourth day)

Skin p. 149

Redness of the skin (second day)

Red spots on the nose

Yellow spots on the chest

JEittjff ioiiSf Ui’i/, Small pimples (second day)

Eruption of small pimples about the mouth and chin

Many small pimples on the chin ; they go off by desquamation, on the third day,k

Felt a great itching in the part, and perceived a few small red pimples, which occasioned an extreme itching and prickling ; they di.«appear after a few days, without suppuration (second day)

Fine red itching rash on the inner side of the wrist, extending up to the bend of the elbow

Miliary eruption on the face; afterwards the skin is wrinkled

Miliary eruption on the abdomen

1^1‘njifioiiSf 3Moist, Dew falling from the leaves upon the skin causes blisters

It is dangerous to sleep under the tree ; the drops of water filling from the leaves cause blisters on the skin

The milky juice burns, draws blisters, inflames, and destroys the hair

Heat rises to the face ; soon followed by smarting, pricking, and burning, which last all day (first day); face swollen, iu morning; about noon vesicles appear of the size of a pin’s head, and full of yellow serum (second day); the vesicles are absorbed, and de.«quotation takes place (fourth <lay)

Herpetic eruption, an inch in diameter, on the right arm ; it disappears next day (eleventh day)

Ei'UptiOiiSf Elisfiifar. When rubbed into the skin it causes a pustular eruption

Siifijective. Burning in the thighs, and especially in the ankle-joint

A burning sensation over the whole surface of his body ; this was presently concentrated on particular points, especially on the face and around the eyes

Raw pain in the skin of the abdomen

Pricking in the feet when sitting (fifth day)

Formication in the forehead

Formication in the right hip, with lancinations when Walking (seventh day)

Continuous formication in both feet at once, especially the left (third day)

Tickling in the left tibia, of short duration

Itching on the left eyebrow

Itching of the left lower lid, disappearing when touched

Itching in the right wing of the nose, disappearing on rubbing with the hand, but soon returning

Itching on the chest

Itching just below the condyle of the right elbow, now and then returning

Itching on the right wrist

Itching on the middle joint of the right index finger

Tickling itching in the ball of the left thumb, repeated several times

His lips were completely ulcerated and itched intolerably

Sleep and Dreams p. 150

Sleepiness. Drowsiness after breakfast (second day)

Constant drowsiness (third day)

Deep sleep in daytime (fifth day)

Heavy sleep, and late waking (second day)

Sleeplessness. Sleep restless, tossing about the bed, with frightful dreams (fourth to sixth days)

Frequent waking at night in an indifferent, almost unconscious condition, but suddenly falling asleep again

No sleep at night (fourth day)

Dreams. Dreams first sad, then cheerful (third day)

Dreams about ghosts and apparitions (sixth day)

Fever p. 150

Chilliness. Rigor

Coldness of the hands and feet,'; (fifth day)

Shuddering in the abdomen, coming on at long intervals

Heat. Some fever at night (first day)

Heat in face, and afterwards a burning like that occasioned by the scorching of the fire

Great heat in the forehead and eyes

Great heat in the back of the head

Sueaf. Night-sweat

Sweat in the palms of the hands, while the rest of the body is perfectly diy (second day)

Conditions p. 150

Aggravation.

(Morning), On getting out of bed, vertigo ; after eating a ieee of bread, vertigo.

(Avenm^'), Palpitation ; in bed, pain in tibia.

(Night), The symptoms; eructations; sweat.

(Midnight), Cough.

(Open air). Vertigo.

(Anger), Some symptoms

(Beer), Eructations.

(Becoming chilled). Anxiety.

(Drinking), Cough; malaise.

(After eating). Most symptoms; pain in precordial region; palj)itation.

(Exertion), Cough.

(Looking long and steadily). Vertigo.

(Reading aloud). Vertigo.

(Stooping), Eructations.

( Walking), Anxiety; headache, etc.; pain in hypochondrium.

Amelioration p. 150

(Open air). Vertigo.

(Cool weather). Burning in stomach, etc.

(Lying down). The symptoms

( Warmth), Most symptoms

(Yawning), Throat symptoms.

Footnotes p. 144

† Relieved by the juice of Bignonia pentaphylla (the Indians use B. leucoxylon).