Osmium

Osmium, an element.

Osmium tetroxide (Osmic acid), OSO4.

Preparation, Dilutions, with absolutely pure water, of Osmic acid ; or triturations of the precipitated metal.

Authorities. 1, Berzelius, Poggendorf’s Annals, 1835, effects of vapor; 2, Swanberg. ibid.; 3, Claus, effects of inhaling the fumes, from Brauell, by Bojanus, Int. Horn. Presse, 5, 193; 4, effects on Hallmann, an assistant to Claus; 5, Brauell, effects of small doses on himself; 6, Bojanus (1. c.), effects of fumes of crude and of inhalation of 1st dec. dil.; 6 a, same, provings with 10-drop doses of 1st dec. dil.; 7, Stokes, Month. Horn. Rev., 3, 164, took 2 grs. of 3d trit. (first day), same twice (second and third days), once fourth and fifth day, twice seventh day, once eighth and eleventh day (took three doses of Merc. sol. and two of Bell., thirteenth day) ; 7 a, same, subsequently took 3d trit., 1 grain first, second, third, and fourth days; 7 b, same, subsequently took same dose daily, for seven days; 8, H., D. Notes, N. Y. Med. Journ., July, 1866, p. 269, a doctor, after heating a compound of Iridium and Osmium, took a piece from the crucible and held it near the left eye (a similar effect had occurred before); 9, Raymond, Progress Med., 1874, a man, after working daily with large amounts of Osmium, and exposed to its fumes, became sick, hitherto he had been perfectly well; 10, C. Hering, provings with triturations of metal, Hering’s Monograph on Osmium; 11, Neidhard, provings by olfaction, of Osmium oxide, ibid.; 12, Rane, provings by olfaction, ibid.; 13, Mrs. Paschal, provings with 6th cent, trit., ibid.; 14, Tenth, effects of inhalation of fumes, ibid.; 15, Wcehler, effects of fumes, ibid.; 16, Hardenstein, ibid.

Mind

Morose mood

Irritable, at times even angry

He gets very impatient on account of an itching, on going to bed, which prevents sleep

Misplacement of words in the same phrase (1st dec.)

Disinclination for every work,^; (after two hours) ®

Thoughts of accidents having happened to others, by a blow, a fall, or being dashed to pieces; gradually these thoughts grow upon him, as if he were to do the same injuries to others (after several weeks)

Inward weakness; thinks he will have to give up practice on account of mental weakness, in the evening, when riding out

Head

Frightful headache, depriving him of sleep

Terrible headache above and under the eyes, on one side, tearing towards the ear; worst under the eyebrows; the eye waters and is weak (a similar effect from other influences, f. i.. Oxide of cacodyl)

Dull headache, like a band round the head above the ears; after the second dose, the dull headache extends from the base of brain into the jaws (third day); at night, dull aching at base of skull and in jaws (fourth day)

Intense dulness of the head, with heat in it (soon after 1st dec.)

Dulness of the head, with pressure and heaviness, especially in the left frontal eminence.®®.

Dull head all day (second day)

Head feels dull and full (after two hours)

Heaviness of the head

Muddled head (fifth day)

Peculiar feeling in the head (soon after olfaction)

Forehead. Headache in the right upper side of the forehead, a tearing to and fro, deep in; at the same time similar pains in the bones of the limbs, deep in, in the evening (first day, 1st dec.)

Pressing headache in the localities of the organs of ideality (after olfaction)

Pressing headache in the forehead, soon followed by ulcerative pain in the left leg and gluteal muscles, at 9 p.m. (five minutes after twice repeated olfaction)

Great pain in the upper right side of forehead (soon after olfaction)

Compressive pain in the forehead and temples

Temple. Headache, principally in the temples, with pain in the larynx, and hoarseness

Severe pressing pain in the left petrous bone, upwards and backwards of the ear (after trituration)

Vertex and Tarietdl. All the afternoon had fulness and aching at the upper and back part of the head, indoors and out; worse by throwing the head back (second day)

Occipital headache continued (sixth (lay)

External Head, Falling out of hair is increased and continues (twelfth day, after 1st dec.)

Eyes p. 242

Immediately struck with a sharp pain, he shut the eye and drew back. In ten minutes he came to my office. The lids were spasmodically closed, light very distressing, and pain in the globe severe. The conjunctiva and sclera were intensely injected, and lachryraation profuse. Pupil of natural size and activity. Sight dim, viz., and reads only No. 3 of Jaeger at ten inches. All objects look dim. This dimness is not the effect of lachrymation, because wiping away the tears does not better the vision. Accommodation perfect. There are no musca nor phosphates; the visual field normal. By the ophthalmoscope, both the inverted and upright image, no material change discovered. The media clear, the optic nerve pink, but not unlike the other eye. The external inflammatory syn^ptoms continued for one day, and then the eye resumed its normal condition, both in appearance and function

Extremely violent pains in the eyes

Violent pain around the left eye, as if externally on the bone (half an hour after 1st cent.)

Burning pain in the eyes, from going into an atmosphere containing vapors of Osmium

Sensation as if the axis of vision was moved back and forth a short distance, without moving the eyes; with closed eyes, in the evening (first day, 1st dec.)

Burning sensation in the eyes, with profuse lachrymation

Extremely violent burning pain in the eyes, with very copious lachrymation

Extremely small quantities of the vapor act violently on the eyes and lungs

Lid. Muscular twitchings, both felt and seen, in the levator of the right upper lid, relieved by rubbing, but always returning and lasting two hours, during the morning (second day)

Violent itching in left inner canthus; irresistible desire to rub it (second day, after 1st cent.)Lachryniatiolt. Lachrymation, aggravated by fixing the eyes upon any object

ConJniietiua and Hall. Burning sensation in the conjunctiva

Pressive pain in the eyeballs

Vision. Acuteness of vision diminished, so that large objects, somewhat distant, seem enveloped in a fog, and cannot be distinctly recognized

Dimness of vision, especially of the right eye, that cannot be removed by wiping; it seems as though a mist were before the eye, or the room wei’e full of smoke

Decrease of sight; could just tell night from day, but could not discern tbe large letters on a title-page; this remarkable affection of the sight lasted, each time, after smelling Bioxide of Osmium, for three or four days

When attempting to read, letters run together, so that he cannot distinguish them

The candlelight is surrounded by a bluish-green circle, the outer margin of which is bright red ; if the light is removed to the distance of ten or fifteen paces from the eyes the circle disappears, and the flame seems indistinct, as if enveloped by a cloud of dust or smoke

Candlelight surrounded by a bluish-green circle, bordered by an ashy-gray margin, becoming larger as the light was removed

The flame of the candle seemed surrounded by a green circle, bordered by a red margin, which was larger or smaller, according to the distance from the light

Candlelight surrounded by a yellowish circle ; at the distance of about ten feet it had a diameter of three inches

In the evening, a very large rainbow-hued ring around the flame of every candle, whenever he is exposed to an atmosphere smelling of Osmium, even slightly

The flame of the lamp, in the evening, seemed much larger and more confused than natural

Ears p. 243

Earache, first in the right, then in the left ear, in the evening (first day, 1st cent.)

Ringing in the right ear (half an hour after 1st dec.), with pain (immediately after trituration)

Nose p. 243

Coryza

Constant discharge from the nose

Constant running from the nose, with a sensation as if the nose were full

Secretion from the nose

Sneezing

Frequent sneezing, with increased secretion of mucus in the nose

Frequent ineffectual efforts to sneeze

From the posterior nares, lumps of phlegm easily loosened

Sensation of fulness in the nose, as if coryza would come on

Prickling sensation in the nose, with increased secretion of mucus

Peculiar irritation in the nose, throat, oesophagus, and trachea, as if he had been burnt with hot water

Very violent burning irritation in the nose

Sensation in the nose as though blood rushed into it from the head

Irritation in the Schneiderian membrane, like that caused by snuff®.

Nose and larynx very sensitive to cold air

Smell. The sense of smell is diminished (second day)

Senses of smell and taste blunted

Smell similar to Chlorine

The stinging odor of the acid remained for a long time in the nose, and afterwards changed to a sensation like that after one has received a blow upon the nose (odor of blood)

Face p. 243

Dull aching in jaws and at base of brain, at night (fourth day)

Cold jerks in the left upper jaw and front teeth, after olfaction

Pain in the muscles of chewing, after eating wheat bread (from two to three hours)

Conditions p. 243

Teeth and Oanis. The teeth creak, more than usual when rubbing them with the finger (1st dec.)

The pain in the right upper tooth returned, but was di-awing, and was relieved by sucking the tooth with the tongue (third day)

Jerking pain in a right upper hollow tooth, very painful, frequently preventing speech (have had a pain in this back tooth before, but it was of a very different character)

Broad swelling above the root of an upper left incisor, with pain and numbness; suddenly, after eating pears; disappeared after silicea (fourteenth day, after 1st dec.)

TOlUflie. There was a red stripe on the middle of the tongue, that pained as if sore; the edges of the tongue were rough and covered with small pimples; the tongue was sensitive to the slightest touch, when eating and drinking

Tongue much coated ; coffee tastes badly (third day, after 1st dec.)

Gerieval JMoiith. Mouth sticky and pasty, as after a long illness (after a few hours)

Saliva. Increased secretion of saliva, with frequent need of spitting

Copious salivation, with constant expectoration of mucus, with retching, without inclination to vomit

Copious salivation

Salivation

Taste. Taste blunted

Taste of blood in the mouth

Metallic taste (after two hours)

Tobacco does not taste as usual, it causes a scraping in the throat; cigars cannot be smoked, because they provoke cough and aggravate the rawness in the larynx

Throat p. 244

Burning irritation in the pharynx

Sensation of increased warmth along the oesophagus, in the chest (immediately)

Stomach p. 244

Appetite. Loss of appetite,*; for dinner (sixth day)

Great aversion to his coffee and tobacco, even their odor was disgusting

Eructations, Incessant, extremely distressing eructations of the odor and taste of the drug, with great nausea, so that he thought he would vomit evei’y moment, which, however, he did not; this was accom])auied by much spitting of the saliva, which constantly accumulated in the mouth, and which was very watery (after twenty minutes)

Empty eructations, at first without taste, afterwards having the taste and odor of the acid, relieving the nausea (soon)

Eructations of the odor of radish (after a few hours)

Nausea and VoniithKJ. Sensation of qualmishness and discomfort, in the abdomen below the navel, with a feeling of weakness (after a few hours)

Feeling of qualmishness in the pit of the stomach, while riding, in the open air (second day)

Qualmishness and extreme discomfort, with dull pain and heaviness in the pit of the stomach, after eating;®

Nausea, without accumulation of water in the mouth, and without retching

Nausea, with accumulation of water in the mouth; obliging frequent spitting (immediately)

Frequent attacks of nausea, without any cause (after several days)

Nausea and discomfort in the pit of the stomach, in the morning (second day)

Nausea, without vomiting

Vomiting of much watery mucus, of the odor and taste of the acid, with numerous blackish-green flakes of mucus, looking like the deposit that the acid causes when brought in contact with organic substances; vomiting paroxysmal, at first of water, afterwards of yellowish and tenacious substances; after vomiting eructations of gas of the odor and taste of the acid, with continued salivation (after half an hour)

General Stomach, Distension of stomach and bowels, with difficult passage of flatus, in the evening (third day)

All the evening had distension of stomach and abdomen, although the dinner was only plain roasted mutton and potatoes (first day)

At 6 P.M., weakness of stomach, almost amounting to nausea, and aversion to cocoa, usually so well relished; this, by-they, occurred during the digestion of meat pudding, and requires a glass of brandy and water, at 10.30, to set matters right (after three hours and a half)

All day yesterday and to-day there has been uneasiness in the stomach, increasing to anxiety and contraction; worse after food, and much aggravated by stimulants (eighth day)

[HO.] Constrictive pain in the stomach, in the forenoon (seventh day)

Before dinner (which I take at 12.30), felt contractive pain and weight in epigastrium ; this is often attended by a feeling in the stomach as if I had swallowed a lot of stones from a newly laid road (sixth day)

During the proving my digestion suffered a good deal, and during about nine or ten days, I felt no attraction to the pleasures of Venus, although at all other times very easily excited thereto. My suppressed report ran thus: “Venereal appetite suppressed for eight or ten days; the conjugal act when performed was done by a sheer act of volition, and the usual thrill in ejaculation was absent (in a letter to the Editor, Ang. 3d, 1877”)

Abdomen p. 244

Rumbling and gurgling in the abdomen, as if in the intestines air were mixed with water, indeed one can feel the bubbles of air passing through the intestines, though there is no pain

Rumbling and moving about in the abdomen (after a few hours)

Slight griping in the bowels, at night (second day)

Abdomen very sensitive, and distended all the afternoon (fourth day); again troubled with distension, all the afternoon and evening (fifth day); bowels distended, in the afternoon (sixth day)

Sensation like great weakness in both groins towards the spermatic cords (soon)

Pressure on both inguinal rings (sixth day)

Jiecf uni (111(1 Stool

Urging to stool, but only passage of flatus, in the afternoon (second day after 1st dec.)

Stool very hard, then soft, preceded by violent urging, followed by frightful burning in the anus preventing sleep, with desire for stool, but only a little yellowish mucus was passed

(Diarrhoeic stool after drinking coffee), (1st cent.)

U diarrhoea-like, bloody stools, accompanied and followed by colic; he evacuated black blood, as much as two or three centimeters every time (did not suffer from hrernorrhoids)

Evacuation soft, almost pasty, though formed thin, otherwise normal, at 9 p.m., following a normal stool, at 10 A.M. (first day)

Mushy stools in the morning, afternoon, and evening (1st dec.)

In the morning, first hard, then thin soft stool, of a striking orange-yellow color (after olfaction, third day)

The bowels were not moved till 4 p.m. ; the evacuation was passed hastily, with burning at the anus; it was bilious and partly fluid (second day); no evacuation to-day, only a small lump, like a marble, passed, after trying very hard to relieve myself (fourth day) ; no evacuation to-day until 10 p.m., it was dry and full of air (sixth day); bowels relieved at 10 a.m. ; evacuation small in volume and quantity (seventh day); the bowels remain costive (eleventh day),'b

The bowels are confined, but move daily

Evacuation delayed, small and constipated (fifth day)

Urinary Organs p. 245

Urhie. Urine very albuminous

In the evening perceived the urine to be strongly scented, somewhat like violets, very highly colored, and apparently full of bile (fifth and sixth days)

Urine brown and scanty all day (second day); this morning the urine was scanty, and strongly scented, but not so dark as before (third day) ; scanty and dark-colored urine (fourth day) ; now begins to be more free and less colored (eleventh day),'b

Much bright-red sediment in the urine, in part deposited on the bottom, in part adhering to the sides of the vessel,®*. t

Sexual Organs p. 245

3Inle, Pain in the spermatic cords, especially in the left (the same which he had after phosphoric acid), (soon after triturating; the same again after 1st dec.)

Pain in the spermatic cords, extending into the testicles, with inflammatory swelling of the right inguinal glands, as large as a pigeon’s egg; this lasted ten days

Gians penis reddened, on the left side ; during coition a longer lasting emission of semen (1st dec.)

Throbbing, stinging, pricking, pinching pain on the left side of the g1ans penis (after trituration)

Violent yet undefined pain at the tip of the glans penis and in the foreskin (1st cent.)

Pains in the right testicle (immediately after olfaction)

Pain in the testicles, so that he could not sleep the whole night

Very hard erections (sixth and following days after 1st dec.)

Very hard erections; frequently soon after midnight, always on awaking in the morning, without exception, either before or with it; later, they continue longer, even after rising ; moderate sexual desire (tenth and eleventh days, after 1st dec.)

Erections every morning, earlier and harder

Respiratory Organs p. 245

LdtojdX, Trachea, dud Tironclii. Small lumps of phlegm easily loosened from the larynx

The mucus hangs in the larynx like a thread, irritates to hawking and cough, causing retching and almost vomiting; after sneezing it is loosened very easily (eleventh day after 1st dec.)

With a slight cough and coryza a very severe-pain in the larynx; it pains her to talk, every word she speaks hurts her

Sore pain in the larynx

Burning irritation in the larynx and trachea

Irritation in the larynx, with hacking cough,®. Tickling in the larynx and trachea

Tickling in the larynx

Scraping in the larynx, provoking cough

Slight rawness in the larynx (eleventh day); increasing until the thirteenth day, when it was a very severe laryngeal catarrh, the voice hoarse, weak, and low, and almost extinct; lay in bed all the morning, and took three doses of Merc, sol., and two of Bell., which carried off the attack, in the afternoon,hf

Scraped, raw sensation, and prickling in the larynx, not provoking cough

Scraped, raw sensation in the epiglottis

Sensation in the larynx, causing frequent hayking

Profuse secretion of mucus in the air-passages, with constant inclination to cough

Tedious secretion of phlegm from the air-passages (after inhaling vapors of Osmium),h

Very extensive bronchitis

Voice, Hoarseness, with pain in the larynx, for eight weeks; she was hoarse when talking, but particularly when singing, so much so, that she could not sing at all; the hoarseness was much worse each time after going into the open air (riding out or walking), as soon as she came home

Hoarseness

Cough and Vxpectovatlon, ^Paroxysms of convulsive coughing

Frequent cough

Cough, with sensation of constriction in the air-passages

Cough, only in the morning (after three days)

Cough, on rising; violent short bursts of cough, without expectoration (fourteenth day after 1st dec.)

Cough short, dry, accompanied and followed by pain in the larynx and trachea, extending to the middle of the sternum, as if raw and sore; very violent, as if the mucous membrane would be torn off with every paroxysm of cough

Cough dry, racking, difficult to loosen

Dry spasmodic cough

Hacking cough, relieved by deep inspiration

Constant hacking cough

Hacking cough and irritation in the larynx, aggravated by motion, in the open air

Cough, with secretion of colorless mucus (after several hours)

After a cold, while nursing a sick child, and losing sleep at night, slight cough with pain in the larynx, she had also some coryza, but continued to take Osmium 6th cent.; the tongue became very sore, the pains in the larynx very severe; she was taken with hoarseness; she was afraid she would get the croup, and took Spongia and Hepar, which relieved somewhat

After coryza, the cough returned during the day, very severe and disturbing sleep until midnight; a slight but irresistible tickling irritation in the larynx, causing short bursts of cough, increasing in violence ; after repeated sneezing something is loosened, like a little round lump, which he is compelled to swallow (fifth day)

Hawking of mucus frequently accompanied by attempts to vomit

Incessant expectoration of mucus, causing inclination to vomit

Hespivafion. Difficult respiration

Difficult respiration, which was almost asphyxia, with dry skin, and temperature of 40.6° C.,®.

Difficult whistling respiration

Difficult respiration, with dyspnoea

Chest p. 246

Moist rales in the chest and larynx on breathing

Pneumonia very peculiar and extremely obstinate; possessing a singular motility, occupying at one time a certain portion of the lung, at another time changing its place,®.]

Air, containing vapors of Osmium, affects the lungs when

-j- I !im not positive that the laryngeal affection was medicinal, but 1 am very much inclined to think it was.

J Autopsy showed the whole left lung in the third stage of gray hepatization ; in the other lung, red hepatization; there were also found indications of approaching inhaled,Oppression of the chest

Oppression of the chest, with difficult respiration, as if the lungs were collapsed and they could not get air enough, relieved by deep inspiration

Tightness of the chest; dread of breathing; one can feel the air entering the bronchial tubes by the sore pain it causes

Pain near the left lower rib, about a quarter of a circle towards the front; a dull stitch (immediately after olfaction)

Rawness in the chest provokes hawking and hacking cough

Sensation of dryness in the chest

Pain beneath the sternum on coughing, extending to both sides of the chest, with a burning soreness, as if everything were raw: after coughing a long time some lumps of yellow tenacious mucus were loosened

Heart and Pulse p. 247

Pulse 90, when I am well it is 72 (sixth day); 80 (seventh day)

Pulse 80 before taking the powder (second day) ; 78 (third day) ; 84 at 11 a.m. (fourth day)

Neck and Back p. 247

Pains in the back

A peculiar pressing pain in the back, extending from the scapula to the sacral region, aggravated by motion and by cough

Pain in the lumbar region

Pressure in both loins, that on coughing extends into the testicles

Pressive pain in the sacral region

Generalities p. 247

The limbs feel as heavy as lead, with weariness and heaviness in them, especially in the knees, was unable to stand long (after two hours)

Superior Extremities p. 247

Shoulder and Arm. Pulsating, dull stinging on the inner side of right shoulder-joint (after olfaction)

Severe pinching pain in the left upper arm, a handbreadth above the elbow, inwardly and on the inner posterior side; often repeated and very severe, for fifteen minutes (soon)

Sensitive pain in the middle of the left humerus; soon after in the fingers of the left hand (two hours after olfaction)

Elhow. Violent bone-pain in the left elbow (immediately after olfaction)

Forearm. Violent pinching in the bones of the right forearm (after 1st cent.)

Drawing on the inside of the right forearm (after olfaction)

Dull weary pain deeply seated in the left radius, aggravated by lifting anything or by allowing the hand to hang down, lasting three days, gradually disappearing; on the third day, the pain extended to the same place in the right forearm but was much less severe

Burning pressure on the outer side of the right forearm (after olfaction)

Wrist. Pain in the left wrist-bones, in the morning after stool (second day after 1st cent.)

Fitlffer. Severe pains in the right forefinger, especially in the phalanx, stinging and twitching towards the point, in the forenoon (after a week)

Burning pains in the left ring finger (sixth day after 1st dec.)

Aching pain in the metacarpo-phalangeal joint of left thumb (fifteenth day)

Irregular attacks of stabbing in the tips of the fingers, particularly those of the left hand (fourth day)

Several times I havefelt the stabbing pains in the tips of the thumb and fingers of the left hand

Inferior Extremities p. 247

Fulness and restlessness in the legs which becomes quite unbearable, he does not know what to do with them, and finally he has to lie down, at 9 p.m. (fifth day after 1st dec.)

The legs and feet feel as if too full (1st cent.)

Yesterday and to-day felt a drawgiingrenous dissolution ; the bronchial glands enlarged, red and soft; the kidney3'3 showed the second stage of Bright’s disease; in the stomach were large ecchymosed spots. ing aching in the left quadriceps tendon, each side of top of patella, varied by occasional shoots below the external malleolus, and on the instep of left foot (fourteenth day) ; aching of left knee is less severe, and ceases at night (fifteenth day)

Sudden pain in the hip-joint as if it would be dislocated, preventing walking, but lasting only a few minutes

Severe pains in the right ankle, which do not prevent walking (first hour)

Pinching pain in ankles (first cent.)

Flying, cutting pains in the bones and joints of the right foot (first hour, after olfaction)

Pinching, pressing pain in the heel, as if in the bone, first left, then right (second day, after 1st cent.)

Generalities p. 248

Was obliged to keep his bed ten days on account of weakness, from which he was not free until the third week,k

Indolence

Weakness

Great weakness of the whole body, so that he was frequently obliged to sit down

Weary, as after a very long walk (after two hours)

Felt very weak and easily tired (thirteenth day)

General sick feeling (after a few hours)

Feeling so poorly, I took no more medicine (ninth and tenth days)

I rise jaded

Feel restless and fidgety (eighth day)

Arose feeling jaded, after a restless tossing night (second morning)

Arose very tired, with muddled head and aching limbs and body, and was thus all day (fifth day)

Skin p. 248

Red spots on the dorsum of the hand

The fold of the skin remains attached to the growing nail; more on the right side, and mostly on the middle finger (fourteen days after 1st dec.)

Copious exanthema on the forearm and on the dorsal and palmar surface of the hands and on the cheeks

Red-brown papules on the skin of the forearm, and hand, with desquamation of the epidermis

Small pointed vesicles, surrounded by red areola, with intolerable itching, on the back of the left hand, between the thumb and index finger (in a spot where, six years before, scabies had broken out) ; some vesicles appear on the ulnar margin of the same hand, extending from the metacarpal joint to the phalanges of the little finger, on the outer surface of the wrist; also on the right hand violent itching, but no vesicles; these vesicles disappear after twenty-four hours (third day)

Burning stitches in the skin on many places, particularly in the right upper lid ; worse at the inner border of the nail of the fourth finger of the left hand, where it burns like fire (soon after 1st dec.)

Prickly heat disappears on the upper half of the body and increases on the lower, first on the thigh, then on the leg, then on the ankles (after several days)

Itching, as from crawling insects, on the shoulders and back, in the evening, when going to bed ; it scarcely permits sleep, and makes him very impatient (nine days after 1st dec.)

Violent itching on a place an inch wide and a hand long above the crest of the left ilium, towards the abdomen ; the place is red, with many small pointed spots, as if tetter would appear (seventh and following days after 1st dec.)

The itching on small spots near the left hip returns, wh^n the erections return, at 3 to 4 A.M. (thirteen days after 1st dec.)

Violent itching on the legs and ankles (first day, 1st dec.)

Sleep p. 248

Overpowering sleepiness (after two hours)

Sleepiness

Night sleepless

Restless tossing night (first night) ; slept badly ; tossed about as before (third night)

Sleep restless every night, with dreams of painful events (seventh day); sleep is haunted by dreams of activity and of events of a serious and important character, but they are not remembered on waking (eleventh day)

Restless night (first day)

Nightmare during sleep

Confused, but not frightful, dreams of fire, at night

Fever p. 249

Shivering, especially in the back

Fever, with difficult respiration

Sweat in axilla, smelling of garlic (eighth day), especially in the evening and at night, lasted for a week

Aggravation p. 249

(4/or?imy), Twitching in the levator of right upper lid; nausea; on awaking, erections; cough; on rising, cough ; after stool, pain in left wrist.

[Forenoon), Pain in stomach ; pain in right forefinger.

(Afternoon), Bowels distended ; urging to stool.

(Evening), Headache; 9 p.m., headache in forehead ; ring around flame of candle ; flame of candle seemed larger ; earache ; 6 p.m., weakness in stomach ; distension of stomach and bowels; fulness and restlessness in legs; urine strongly scented; when riding out, inward weakness; on going to bed, itching; sweat in axilla.

(Night), Aching at base of skull; aching in jaws and base of brain ; sleeplessness; sweat in axilla.

(Open air). Hoarseness.

(Breathing), Moist rales in chest and larynx.

(Coughing), Pain beneath sternum ; pain in back.

(After drinking coffee), Diarrhoeic stool.

(While eating and drinking). Tongue sensitive.

(After eating). Wheat bread, pain in muscles of chewing; pears, pain and numbness in teeth; qualmishness.

(Fixing eyes upon any object), Lachrymation.

(Hanging hand down or lifting). Pain in radius.

(Motion), In open air, hacking cough ; pain in back.

(Riding in open air). Qualmishness.

(Smoking cigars), Rawness in larynx.

(Stimulants),J]neasnessin stomach.

(Talking), Pain in larynx.

(Tobacco), Scraping in throat.

(Throwing head back). Headache in upper part and back of head.

Amelioration p. 249

(Deep inspiration). Hacking cough; oppression of chest.

Twitching in levator of right upper lid.

(Sucking tooth with tongue). Pain in upper tooth.